HomeMy WebLinkAboutChrisp Company (8)AGREEMENTm
THIS AGREEMENT is made and entered into on the 10b(day of M a_� 2012 by
and between the TOWN OF LOS ALTOS HILLS (hereinafter referred to as "TOWN")
-and Chrisp Company (hereinafter referred to as "CONTRACTOR"), In consideration of
their mutual covenants,.the parties, hereto agree as follows:
1. CONTRACTOR. Shall provide or furnish the following specified services and/or
materials:
Install Detail 23 centerline pavement markers on West
Loyola Drive between Eloise Circle and Eastbrook Avenue
2. EXHIBITS. The following attached exhibits are hereby incorporated. into and made
a part of this Agreement:
Proposal from CONTRACTOR dated April 27, 2012
3. TERMS. The services and/or materials furnished under this Agreement shall
commence 5/14/2012 and shall be completed by 5/18/2012, unless terminated
pursuant to Section 5(f).
4. COMPENSATION. For the full performance of this Agreement:
a. TOWN shall pay CONTRACTOR an amount not to exceed Three thousand
seven hundred fifty dollars and zero cents ($3,750.00) within thirty (30) days
following receipt of invoice and completion/delivery of services/goods as detailed
in Sections 1, 2, and 3 of this Agreement and only upon satisfactory
delivery/completion of goods/services in a manner consistent with
professional/industry standards for the area in which CONTRACTOR operates.
TOWN is not responsible for paying for any work done by CONTRACTOR or any
subcontractor above and beyond the not to exceed amount.
b. Town shall not reimburse for any of CONTRACTOR's costs or expenses to
deliver any services/goods. Town shall not be responsible for any interest or late
charges on any payments from Town to CONTRACTOR.
c. CONTRACTOR is responsible for monitoring its own forces/employees/agents/
subcontractors to ensure delivery of goods/services within the terms of this
Agreement. TOWN will not accept or compensate CONTRACTOR for
incomplete goods/services.
Town of Los Altos Hills Page 1 of 4
Short form
Updalod 4123110
5: GENERAL TERMS AND CONDITIONS.
a. HOLD HARMLESS. CONTRACTOR agrees to indemnify, defend and hold
harmless the TOWN, its officers, agents and employees from any and all
demands, claims or liability of personal injury (including death) and property
damage of. any nature, caused.. by.:or arising out of the performance of
CONTRACTOR under this Agreement. With regard to CONTRACTOR'S work
product, CONTRACTOR agrees to indemnify, defend and hold harmless the
TOWN, its officers, agents and employees from any and all demands, claims or
liability of any nature to the extent caused by the negligent performance of
CONTRACTOR under this Agreement.
b. INSURANCE. CONTRACTOR shall file with the TOWN a certificate of
insurance before commencing any services under this Agreement as follows:
i, WORKERS COMPENSATION INSURANCE: Minimum statutory
limits.
COMMERCIAL GENERAL LIABILITY AND PROPERTY DAMAGE
INSURANCE: General Liability and Property Damage Combined.
$1,000,000.00 per occurrence including comprehensive form,
personal injury, broad form personal damage, contractual and
premises/operation, all on an occurrence basis. If an aggregate limit
exists, it shall apply separately or be no less than two (2) times the
occurrence limit.
iii. AUTOMOBILE INSURANCE: $1,000,000.00 per occurrence.
iv. ERRORS AND OMISSIONS INSURANCE: $1,000,000.00 aggregate.
v. NOTICE OF CANCELLATION: The City requires 30 days written
notice of cancellation. Additionally, the notice statement on the
certificate should not include the wording "endeavor to" or "but failure
to mail such notice shall impose no obligation or liability of any kind
upon the company, its agents or representatives."
vi. CERTIFICATE OF INSURANCE: Prior to commencement of services,
evidence of insurance coverage must be shown by a properly
executed certificate of insurance and it shall name "The Town of'Los
Altos Hills, its elective and appointed officers, employees, .and
volunteers" as additional insureds.
vii. To prevent delay and ensure compliance with this Agreement, the
insurance certificates and endorsements must be submitted to:
Town of Los Altos Hills
26379 Fremont Road
Los Altos Hills, CA 94022
Town of Los Altos Hills Page 2 of 4
Short form
Updated 4123/10
NON-DISCRIMINATION. No discrimination shall be made in the employment of
persons under this Agreement because of the race, color, national origin, age,
ancestry, religion or sex of such person.
d. INTEREST OF CONTRACTOR. It is understood and agreed that this
Agreement is nota contract of employment and does not create, an ernplcyer-
employee relationship between the TOWN and CONTRACTOR- At all'.times
CONTRACTOR shall be an independent contractor and CONTRACTOR is not
authorized to bind the TOWN to any contracts or other obligations without the
express written consent of the TOWN. In executing this Agreement,
CONTRACTOR certifies that no one who has or will have any financial interest
under this Agreement is an officer or employee of TOWN.
e. CHANGES. This Agreement shall not be assigned or transferred without
advance written consent of the TOWN. No changes or variations of any kind are
authorized without the written consent of the City Manager. This Agreement may
only be amended by a written instrument signed by both parties.
f. TERMINATION. This Agreement may be terminated by TOWN upon seven (7)
days written notice to CONTRACTOR. Monies owed for work satisfactorily
completed shall be paid to CONTRACTOR within 14 days of termination.
g. RECORDS. All reports, data, maps, models, charts, studies, surveys,
calculations, photographs, memoranda, plans, studies, specifications, records,
files, or any other documents or materials, in electronic or any other form, that
are prepared or obtained pursuant to this Agreement and that relate to the
matters covered hereunder shall be the property of the TOWN. CONTRACTOR
hereby agrees to deliver those documents to the TOWN at any time upon
demand of the TOWN. It is understood and agreed that the documents and
other materials, including but not limited to those described above, prepared
pursuant to this Agreement are prepared specifically for the TOWN and are not
necessarily suitable for any future or other use. Failure by CONTRACTOR to
deliver these documents to the TOWN within a reasonable time period or as
specified by the TOWN shall be a material breach of this Agreement. TOWN
and CONTRACTOR agree that until final approval by TOWN, all data, plans,
specifications, reports and other documents are preliminary drafts not kept by
the TOWN in the ordinary course of business and will not be disclosed to third
parties without prior written consent of both parties. All work products submitted
to the TOWN pursuant to this Agreement shall be deemed a "work for hire."
Upon submission of any work for hire pursuant to this Agreement, and
acceptance by the TOWN as complete, non-exclusive title to copyright of said
work for hire shall transfer to the TOWN. The compensation recited in Section 4
shall be deemed to be sufficient consideration for said transfer of copyright.
CONTRACTOR retains the right to use any project records, documents and
materials for marketing of their professional services.
Town of Los Altos Hills Page 3 of 4
Short form
Updated 4/23/10
h. ENTIRE AGREEMENT. This Agreement represents the entire agreement
between the Parties. Any ambiguities or disputed terms between this Agreement
and any attached Exhibits shall be interpreted according to the language in this
Agreement and not the Exhibits.
6. INVOICING. Send all invoices to the contract coordinator at the address below.
This Agreement shall become effective upon its approval and execution by TOWN. In
witness whereof, the parties have executed this Agreement the day and year first
written above.
CONTRACT COORDINATOR and
representative for TOWN: CONTRACTOR:
Richard Chiu
Public Works Director
Town of Los Altos Hills By:
26379 Fremont Road nature Dat
Los Altos Hills, CA 94022 xf
lw&-U�ALLKCAPrint name, Title —�—
TOWN OF LOS ALTOS HILLS:
By: 772
Carl Cahill, City Manager ate
Town of Los Altos Hills Page 4 of 4
Short form
Updated 4/23/10
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter. 1 94 2578099
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other U.S. person (defined below).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are Currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. See the instructions on page 4.
Sign Signature of //j
Here U.S. person E Date it• C. G /
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who is required to file an information return with the
IRS must obtain your correct taxpayer identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connected income.
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
o An individual who is a U.S. citizen or U.S. resident alien,
s A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
States,
• An estate (other than a foreign estate), or
o A domestic trust (as defined in Regulations section
301.7701-7).
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of income
from Such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United States is in the
following cases:
The U.S. owner of a disregarded entity and not the entity,
�� Cat. No. 10231X Form W-9 (Rev. 10-2007)
Request for Taxpayer
Give fora, to the
nn„
:Rev October 2007)
Identification Number and Certification
requester. Do not
I epaorncnr of rhe ireasury
send to the IRS.
Internal Revenue Service
Name (as shown on your income tax return) '
Chrisp Company
M
Business name, it different from above
Q
C
o
o. o
Check appropriate box: ❑ Individual/Sole proprietor ® Corporation ❑ Partnership
—
Exempt
i
❑ Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) > ......_
p
❑ payee
O
❑ Other (see instructions) 1►
Address (number, street, and apt. or suire no.) - -
Requester's name and address (optional)
CL 2
43650 Osgood Road -
0
City, state, and ZIP code
w
Fremont, CA 94359-5631
W
List account number(s) here (optional)
to
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter. 1 94 2578099
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other U.S. person (defined below).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are Currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. See the instructions on page 4.
Sign Signature of //j
Here U.S. person E Date it• C. G /
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who is required to file an information return with the
IRS must obtain your correct taxpayer identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connected income.
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
o An individual who is a U.S. citizen or U.S. resident alien,
s A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
States,
• An estate (other than a foreign estate), or
o A domestic trust (as defined in Regulations section
301.7701-7).
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners' share of income
from Such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United States is in the
following cases:
The U.S. owner of a disregarded entity and not the entity,
�� Cat. No. 10231X Form W-9 (Rev. 10-2007)
e&, o- P exp anY t
__Fremont Office
3650 Osgood Rd
remont CA 94539
Phone: (510) 656-2840 Fax: (510) 656-2397
A!
Contract rs License No. 7 00
A General Engineering
C-13 Fence, Wire, wood
C-32 Highway Improvement
Quotation Union Contractor / No minority Status
TO:
LOS ALTOS HILLS
26379 FREMONT ROAD
LOS ALTOS HILLS CA 94022
Phone: (650) 941-7222 Fax: (650) 941-3160
Current Date: 5/10/2012
BidDate: 4/27/2012
JobName: WEST LOYOLA DRIVE
Location: LOS ALTOS HILLS Bid#: 15646 0
Contract#: Job# 1A2038
Contact: JOHN CHAU Working Days:
email-..,jchau@losaltoshills.ca.gov Liquidated Damages
ITEM NO DESCRIPTION QUANTITY UNIT UNIT PRICE TOTAL
�
1 INSTALL DETAIL 23 CENTERLINE PAVEMENT 1 LS 3750.000 $3,750.00
MARKERS ON WEST LOYOLA DRIVE BETWEEN
ELOISE CIRCLE AND EASTBROOK AVENUE
Written Authorization is Required Prior to Proceeding With Work
ACCEPTED BY: P.O. Number
TITLE: Job Number
This quote includes all stipulations found on page 2
Page 1 of 2
Subtotal $3,750.00
TOTAL $3,750.00
Bond Rate 1.5 Addendums
QUOTE PREPARED BY Danny Azcueta
(650) 224-1115
CHRISP COMPANY
ehw,, P eompan#
Fremont Office
Contractors License No. 374600
650 Osgood Rd A General Engineering
remont CA 94539 C-13 Fence, Wire, wood
Phone: (510) 656-2840 Fax: (510) 656-2397 C-32 Highway Improvement
Quotation Union Contractor / No minority Status
COMMENTS, EXCLUSIONS, AND STIPULATIONS
The following stipulations are hereby incorporated into and made part of the quotation from Chrisp co. dated May 10,
2012 for the following project
WEST LOYOLA DRIVE
• NO RETENTION TO BE TAKEN
• 1 Move- In(s) included. Additional Move- Ins $1,550.00
• Chrisp Company reserves the right to withdraw proposal if written acceptance is not received within 30 days of bid
date
• EXCLUDE: Installation or removal of temporary delineation
• Clean, clear and unobstructed access required for Chrisp Co. work
• Final PAY QTYS presented by owner MUST be agreed by Chrisp Co.
• Changeable Message board if required to be provided by General Contractor for Chrisp Co. Use at no Charge to Chrisp
Co.
EXCLUDE. Traffic Control Plan
• EXCLUDE: Removal of Existing Striping & Markings
• EXCLUDE: Removal of Existing Pavement Markers
• EXCLUDE: Removal of Concrete Curing Material prior to PAINT / THERMOPLASTIC / PAVEMENT MARKER application.
• EXCLUDE: Red -Lined As -Built Drawings
• Traffic Control INCLUDED for Chrisp Company work ONLY
• After receiving contract 10 working days written notice required prior to scheduling of
work
• Chrisp Co. will remove contractors short term temporary markers (Floppys) placed for lanelines and centerlines only (no
edgelines or shoulders). No Tape removal. Short Term Temporary markers are to be placed so that striping may be placed
before removal of markers.
• This quotation excludes Primary Liability Insurance greater than $2,000,000.
• This quotation excludes all work associated with the project SWPP and WPCP.
• This quotation excludes installing permanent striping while other operations are in progress on jobsite.
• EXCLUDE: Encroachment Permit (if required to be provided at No Cost to Chrisp Company)
• EXCLUDE: ALL Safety Training, Badging and Orientation (To be paid at time and material Cal -Trans rates)
Page 2 of 2
WQ
Form NN -W
Request for Taxpayer
Give form to the
(Rev. October 2007)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
Name (as shown on your income tax return)
0
Chrisp Company -
W
Business name, if different from above
o_
c
0
a o
Check appropriate box: ❑ Individual/Sole proprietor ® Corporation ❑ Partnership
❑ Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) ` _ _ _ _ _. _
Exempt
p
❑
o
❑ Other (see instructions) 10-
payee
Lr c
Address (number, street, and apt. or suite no.)
Requester's name and address (optional)
43650 Osgood Road -
City, state, and ZIP code
U
Fremont, CA 94359-5631
Q
I-ist account number(s) here (optional)
U)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid social security number
backup withholding. For individuals, this is your social security number (SSN). However, for a resident I
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose I Employer identification number
number to enter. 94 2579099
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. 1 am a U.S. citizen or other U.S, person (defined below).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently Subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. See the instructions on page 4.
Sign Signature of
Here U.S. person ► Date ►
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
Purpose of Form
A person who is required to file an information return with the
IRS must obtain your correct taxpayer identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners' share of effectively connected income.
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester's form if it is
substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
• An individual who is a U.S. citizen or U.S. resident alien,
• A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
States,
• An estate (other than a foreign estate), or
• A domestic trust (as defined in Regulations section
301.7701-7).
Special rules for partnerships. Partnerships that conduct a
trade or business In the United States are generally required to
pay a withholding tax on any foreign partners' share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S, status and avoiding withholding
on its allocable share of net Income from the partnership
conducting a trade or business in the United States is in the
following cases:
• The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X Foran W-9 (Rev. 10-2007)