HomeMy WebLinkAboutMTW Builders Inc.TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
CONTRACT
Improvements to Snack Shack Building at Purissima Park
THIS AGREEMENT, made, executed, and entered into this -�� day of 2022,
by and between the Town of Los Altos Hills a General Law City, hereinafter referred to"A the Town, and
MTW Builders Inc. hereinafter referred to as the Contractor.
WITNESSETH
ARTICLE 1. That for and in consideration of the payments and agreements hereinafter mentioned
to be made and performed by the Town, the Contractor agrees at its own cost and expense to do all the
work and furnish all materials necessary to complete in a good workmanlike and substantial manner all that
certain work involved and concerned with the Improvements to Snack Shack Building at Purissima
Park project. Said work shall be done in manner and according to the terms of the Contract as the same is
defined in Article 4 herein.
ARTICLE 2. Said Contractor agrees to receive and accept the following prices as full compensation
for furnishing all materials and doing all the work contemplated and embraced in this agreement; also for
all loss or damage arising out of the nature of the work aforesaid, or from the acts of the elements, or from
any unforeseen difficulties or obstructions which may arise or be encountered in the prosecution of the work
until its acceptance by the Town and for all risks of every description connected with the work; also for all
expenses incurred by or in consequence of the suspension or discontinuance of the work and for well and
faithfully completing the work and the whole thereof, in the manner and according to the plans and
specifications, to wit, according to Contractor's proposal to the City Council, entitled 'EXH I BIT "A," Proposal
to the City Council' and attached hereto.
ARTICLE 3. The Town hereby promises and agrees with the Contractor, to employ, and does
employ, hereby, said Contractor to provide the materials and to do the work according to the terms and
conditions herein contained and referred to, for the prices aforesaid, and hereby contracts to pay the same
at the time, in the manner and upon the conditions above set forth; and the said parties for themselves,
their heirs, executors, administrators, successors, and assigns, do hereby agree to the full performance of
the covenants herein contained.
ARTICLE 4. The complete Contract consists of the following documents: Notice to Bidders,
Proposal, Contract, Specifications and the Plans and/or Drawings. The rights and obligations of the parties
herein are governed by all of said documents, which are to be construed as a single Contract. The decision
of the Public Works Director of the Town of Los Altos Hills as to the interpretation of said Contract shall be
final and binding on the parties hereto.
ARTICLE 5. It is further expressly agreed by and between the parties hereto that the work shall be
completed within NINETY (90) working days from and after the commencement of said work.
ARTICLE 6. It is expressly stipulated and agreed that all legal and statutory requirements relating
to the execution of this Contract and the notice inviting bids have been met. Any alleged defect or omission
in the proceedings preceding the execution of this Contract is hereby waived by the Contractor.
IN WITNESS WHEREOF, the parties have executed this instrument the year and date first above
written.
CONTRACT
TOWN OF LOS ALTOS HILLS
A General Law City
City Manager
ATTEST:
a Z��4- � �e; L �
City Clerk, Town of Las Altos Hills
CONTRACTOR
By
Se
Ackni
CONTRACT
NOTARIAL ACKNOWLEDGMENT OF PRINCIPAL
STATE OF CALIFORNIA )
) ss.
COUNTY OFA MA -14-0 )
On
personally known to me (or oved to me on
name(s) is/are subscriped to the within inst ant and ack
same in his/her/t r authorized capa (ies), and that by
person(s), orjWe entity upon behal f which the person(s) a
_/, before me, a Nota ublic, personally appeared,
of satisfactory ev' nce) to be the person(s) whose
dg to me that he/she/they executed the
rftheir signature(s) on the instrument the
executed the instrument.
I cert¢y'under PENALTY V PERJURY under the
is Vuue and correcL
WITNESS my hand and official seal.
(Seal)
3
CONTRACT
of the State of California that the foregoing paragraph
See Attached
Acknowledgement - 05h2t74 22 Nif
Notary Public
ADDENDUM NO. 01
EXHIBIT "A"
PROPOSAL TO THE CITY COUNCIL
TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
FOR
IMPROVEMENTS TO SNACK SHACK BUILDING AT PURISSIMA PARK
NAME OF BIDDER: MTW DVwllbm , C. -
BUSINESS ADDRESS: QO S 1r kV -X 1 121.
CITY, STATE, ZIP: MIL.L$ON& I CA Tkol0
LICENSE NO.: -(7553ZCLASS: .C'tO,C-�b C31 EXP. DATE: t315112022—
TAX ID NO.: 45-41bt ZZZ
TELEPHONE NO: (b5o 27,�'D'S FAX NO: (bSo) 2:3W -366f)
The work for which this proposal is submitted is for construction according to the Contract Documents,
including the Special Provisions, the Agreement, the project plans described below, and California Building
Codes, 2019. The Contract Book shall be used in conjunction with the above documents, and the State of
California Department of Transportation Labor Surcharge and Equipment Rental Rates, and the State
Department of Industrial Relations General Prevailing Wage Rates current at the bid opening date.
The project plans for the work to be done are titled "Improvements to Snack Shack Building at
Purissima Park". The work consists, in general, of all work required for the improvements of the existing
snack shack building at the Purissima Park to a new multipurpose room as shown on plans and described
in the specifications. The work shall include providing all labor, tools, equipment, materials, transportation
and services, and performing all operations necessary for and properly incidental to the construction and
completion of the work as indicated on the contract documents.
A bidder's bond, in an amount and of a form described under Paragraph 1 of the Proposal Requirements
Section of these Provisions shall accompany this proposal. The project shall be awarded to the lowest
responsible bidder who meets all the Proposal Requirements, and the requirements of the Contract
Documents.
The bidder shall set forth for each item of work a unit price and a total for the item, and for each lump sum
item a total for the item, all in clearly legible figures in the respective spaces provided for this purpose. In the
case of unit basis items, the amount set forth under the "Total" column shall be the extension of the item price
bid on the basis of the estimated quantity for the item.
In case of conflict between an item price in words and the price in figures, the price in words shall prevail. In
case of discrepancy between an item price and the total set forth for a unit basis item, the item price shall
Proposal to The City Council
Improvements to Snack Shack Building at Purissima Park
11
ADDENDUM NO. 01
prevail. However, if the amount set forth as an item price is ambiguous, illegible or uncertain for any cause,
or is omitted, or is the same amount as the entry in the "Total" column, then the amount set forth in the "Total"
column for the item shall prevail and shall be divided by the estimated quantity for the item and the price thus
obtained shall be the item price.
Failure to provide the required information, or if information provided is subsequently proved false, the
proposal shall be considered as non-responsive and shall be grounds for rejection of the bid.
If this proposal shall be accepted and the undersigned shall fail to enter into the Contract and furnish the two
bonds in the sums required by Section 3-1.05 of the Special Provisions, with surety satisfactory to the Town
of Los Altos Hills within 12 days, not including Sundays and legal holidays, after the bidder has received notice
from the Town that the Contract has been awarded, the Town may, at its option, determine that the bidder
has abandoned the Contract, and thereupon this proposal and the acceptance thereof shall be invalid. If the
Town declares the proposal as invalid, the forfeiture of such security accompanying this proposal shall operate
and the same shall be the property of the Town.
The undersigned, as bidder, declares that the only persons or parties interested in this proposal as principals
are those named herein; that this proposal is made without collusion with any other person, firm or corporation;
that he/she has carefully examined the location of the proposed work, the annexed proposed form of Contract,
and the plans therein referred to; and he/she proposes and agrees, if this Proposal is accepted, that he/she
will Contract with the Town of Los Altos Hills in the form of the copy of the Contract annexed hereto, to provide
all necessary machinery, tools, apparatus and other means of construction, and to do all the work and furnish
all the materials specified in the Contract, in the manner and time therein prescribed, and according to the
requirements of the Engineer as therein set forth, and that he/she will take in full payment therefore in the
amounts shown on the following Item Price Schedule, to wit:
Proposal to The City Council
Improvements to Snack Shack Building at Purisalma Park
9
ITEM
ITEM PRICE SCHEDULE
BASE BID
�pDEOuO N0. 2 -
Item
Description
Estimated
Item Price
Item Price
Total
No.
quantity
(in words)
(in figures)
(in figures)
1
Demolition per Drawing C-101
LS
H
Oo
$ ?�e000
2
Improvements per Drawing C-102
LS
NoiRt Trio
Kajfta D
$12,000
$ dz
3
Roof replacement and skylight
LS
w1w,"Ipi
$ I t 000
I 5,00o
installation scope per Drawing C-103
4
Electrical System per Drawings E-101,
LS
Tart W -T
$ 5t 0oo
$-913,poo
E-102, and E-103
p
5
Mobilization
LS
Te'' T"°``l
$1QF—
$ l Oi Ogg
6
Allowance for unforeseen site
Allowance
Ptm T '
$50,000
$ 50, 000
conditions
TOTAL OF BASE BID PRICE: I t, Z 6 b, 0 00
TOTAL BASE BID AMOUNT IN WORDS
Two N.uAstimb SocSAX TH0%xSh%--o
Proposal To The City Council
tmprovemenu to Snack Shack Building at Purissima Park
10
LIST OF SUBCONTRACTORS
The Bidder shall list the name, address and telephone number of each subcontractor, required to be listed by
the provisions in Section 2-1.10, "Subcontractor List" of the Special Provisions and the Standard
Specifications, to whom the Bidder proposes to subcontract portions of the work.
SUBCONTRACTOR'S NAME
PLACE OF BUSINESS
DESCRIPTION OF PORTION
& LICENSE NO.
(ADDRESS & PHONE)
OF WORK SUBCONTRACTED
NI
N
WIN
List of Subcontractors
Improvements to Snack Shack Building at Purissima Park
11
ADDENDA ACKNOWLEDGMENT AND INFORMATION
The undersigned acknowledges receipt of Addendum No. --�- through -1 inclusively.
PRINCIPAL PERSONS WITH INTEREST IN PROPOSAL
The names of all persons interested in the foregoing proposal as principals are as follows:
IMPORTANT NOTICE. If bidder or other interested person is a corporation, state legal name of
corporation, also names of the president, secretary, treasurer, and manager thereof; if a co-
partnership, state true name of firm, also names of all individual copartners composing firm; if bidder
or other interested person is an individual, state first and last names in full.
V MY
110 a J f
EXPERIENCE AND FINANCIAL QUALIFICATIONS
The bidder has been engaged in the contracting business under State License No. _ 115,53Zfor a period of
years.
The bidder's three most recently completed Contracts are: 110--'01,912 1. Title of Project: l 10_-'01Q9_gQ� r1.�C� ST.oO�Q.rhita"h�l
Owner: %';"� OF uou,4%rl VI1F1\4
Address: Soo GOgTMo a ou,aThk1 U16y CA
Telephone No.: (G 60) 2.00 Ajgq
Engineer in Charge: boll- kaau .0
Date Accepted:
2. Title of Project: C.I Y UM-\Ithtt Lohb% ! lo"Av, &Odg--►
Owner: CAW— OE Flo UAIN N M IEW
Address: &oo CxTeA S1, may-A k" Vl VV�
&
Telephone No.: 5— :16-6516
Engineer in Charge: a4V4A �7LwAA 116
Date Accepted: ML—
Addenda Acknowledginm and WV—allon
linpmventmL8 to Snack Shack Building al Puriesima Pak
12
3. Title of Proiect: �,.o�.G &OLF "O(L 1 UtMOM 4*,OJA
Owner: Cly 0 ADU&Mt4 VtL-w
Address: ST, 4A%,t ft n6 V ttvJ ON
Telephone No.: r bi 50"� 2$0
Enaineer in Charae: —bkT-,- AbAuc
Date Accepted:
Reference is hereby made to the following bank or banks as to the financial responsibility of the bidder:
Name of Bank
Address
555 bO*x>WA ,I MIL e—
Reference is hereby made to the following surety companies as to the financial responsibility and general
reliability of the bidder: //►►.. ,�
Company: �2�c�EC�s CMM st-tMW I✓0 WhE!q 0I: kmr-- {'iC.at
Address: I Oell Wkt'T, ?4cA,- Ra , & tklop SmxirkO CO OV R M ?s.00
Company:
Address:
Addenda Acknowledgment and Intmmation
Improvements In Snack Shack Building at Purissima Park
13
PUBLIC CONTRACT CODE
Public Contract Code Section 10285.1 Statement
In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby
declares
under penalty of perjury under the laws of the State of California that the bidder has _ , has not X
been convicted
within the preceding three years of any offenses referred to in that section, including any charge of fraud,
bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in
connection with the bidding upon, award of, or performance of, any public works contract, as defined in
Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section
1100, including the Regents of the University of California or the Trustees of the California State
University. The term "bidder" is understood to include any partner, member, officer, director, responsible
managing officer, or responsible managing employee thereof, as referred to in Section 10285.1.
Note: The bidder must place a check mark after "has" or "has not' in one of the blank spaces provided.
The above Statement is part of the Proposal. Signing this Proposal on the signature portion
thereof shall also constitute signature of this Statement. Bidders are cautioned that making a
false certification may Vbjegt the certifier to criminal prosecution.
Public Contract Cod.
Lnpro—enu to Snack Shack Building at Puriamma Park
14
Public Contract Code Section 10162 Questionnaire
In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the
following questionnaire:
Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder,
ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local
government project because of a violation of law or a safety regulation?
YES NO X_
If the answer is yes, explain the circumstances in the following space:
Public Contract Code 10232 Statement
In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury,
that no more than one final unappealable finding of contempt of court by a federal court has been issued against the
Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an
order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board.
Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the
signature portion thereof shall also constitute signature of this Statement and Questionnaire.
Bidders are cautioned that making a false certification may subject the certifier to criminal
prosecution.
k*w ab
Public Contract Code
lmptovementa to Snack Shack Building at Purissima Park
15
NON -COLLUSION DECLARATION
To Be Executed by Bidder and Submitted with Bid
In accordance with Title 23 United States Code Section 112 and California Public Contract Code
7106, the undersigned declares:
I am the U IUB Pie'& t of kTjA) -JuAd .C. 1.�UC „ the party making the foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership,
company, association, organization, or corporation. The bid is genuine and not collusive or
sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a
false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or
agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. The
bidder has not in any manner, directly or indirectly, sought by agreement, communication, or
conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any
overhead, profit, or cost element of the bid price, or of that of any other bidder. All statements
contained in the bid are true. The bidder has not, directly or indirectly, submitted his or her bid
price or any breakdown thereof, or the contents thereof, or divulged information or data relative
thereto, to any corporation, partnership, company, association, organization, bid depository, or to
any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not
pay, any person or entity for such purpose.
Any person executing this declaration on behalf of a bidder that is a corporation, partnership,
joint venture, limited liability company, limited liability partnership, or any other entity, hereby
represents that he or she has full power to execute, and does execute, this declaration on behalf
of the bidder.
I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct and that this declaration is executed on -a , [date], at
gk('� [city], _ A [state].
(Signature of authorized
represe ative of Bidder)
TWA �O
(Type Name)
V 'N -W,
(Title)
Public Contract Code
lmpmvements to Snack Shack Building at PuriWaaa Park
16
TOWN OF LOS ALTOS HILLS
STATE OF CALIFORNIA
IMPROVEMENTS TO SNACK SHACK BUILDING AT PURISSIMA PARK
BID BOND
KNOW ALL PERSONS BY THESE PRESENTS, that we MTW Builders, Inc. , as
Principal, and Travelers Casualty and Surety Company of America as Surety,
are held and firmly bound unto the Town of Los Altos Hills, hereinafter called "Town", in penal sum of ten
percent (10%) OF THE TOTAL AMOUNT OF THE BID OF THE PRINCIPAL submitted to the said "Town"
for the work described below for the payment of which sum in lawful money of the United States, well and
truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the
accompanying Proposal dated May 5 2022, for the Improvements to Snack
Shack Building at Purissima Park Project.
NOW, THEREFORE, if the Principal shall not withdraw said Proposal prior to the date and time for the opening
of bids, and if the Principal is awarded the Contract and shall within the period specified in the Proposal after
receiving notice that the Contract has been awarded and the prescribed forms are presented to him/her for
signature, enter in a written Contract with the Town, in accordance with the Proposal as accepted and give
insurance and bond with good and sufficient surety or sureties, as may be required, for the faithful
performance and proper fulfillment of such Contract and for the payment for labor and materials used for the
performance of the Contract, or in the event of the withdrawal of said Proposal within the period specified or
the failure to enter into such Contract and give such Town bonds, within the time specified, if the Principal
shall pay the Town the difference between the amount specified in said Proposal and the amount for which
the Town may procure the required work and/or supplies, if the latter amount be in excess of the former,
together with all costs incurred by the Town in again calling for bids, then the above obligation shall be voided
and of no effect, otherwise to remain in full force and virtue.
Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the Contract on the call for bids, or to the work to be performed there under, or the
specifications accompanying the same, shall in anywise affect its obligation under this bond, and it does
hereby waive notice of any such change, extension of time, alteration or addition to the terms of said Contract
or the call for bids, or to the work, or to the specifications.
In the event suit is brought upon this bond by the Town and judgment is recovered, the Surety shall pay all
costs incurred by the Town in such suit, including a reasonable attorney's fee to be fixed by the court.
IN WITNESS WHEREOF, the above -bounded parties have executed this instrument under their several seals
this 3rd day of May , 2022, the name and corporate seals of each corporate
party being hereto affixed and these presents duly signed by its undersigned representatives, pursuant to
authority of its governing body.
Bid Rotel
lmpmv mts to Snack Shack Building at Pwissimo Park
17
(Corporate Seat)
(Acknowledgment)
(Corporate Seal)
(Acknowledgment)
Bid Brod
lmp'uvcncnu to Snack Shwk Building at Puflnuna Park
18
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Sacramento }
On 3 2022- before me, E. Johnson , Notary Public,
D to Insert Name of Notary exactly as it appears on the official seal
personally appeared Sandra R. Black
Name(s) of Signer(s)
Place Notary Seal Above
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s)
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of
the State of California that the foregoing paragraph is true
and correct.
Witness m
Signature
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Sandra R. Black
❑ Individual
Corporate Officer—Title(s):
Partner ❑ Limited ❑ General
Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer is Representing:
Travelers Casualty and
Surety Company of America
Number of Pages:
Signer's Name:
❑ Individual
❑ Corporate Officer—Title(s): —
❑ Partner ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer is Representing:
E. JOHNSON
�lJ
COMM #2310061 E
NOTARY PUBLIC ® CALIFORNIA .n
-� SACRAMENTO
COUNTY'
Comm. Exp. OCT. 22, 2023
Place Notary Seal Above
who proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s)
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of
the State of California that the foregoing paragraph is true
and correct.
Witness m
Signature
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of the form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Sandra R. Black
❑ Individual
Corporate Officer—Title(s):
Partner ❑ Limited ❑ General
Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer is Representing:
Travelers Casualty and
Surety Company of America
Number of Pages:
Signer's Name:
❑ Individual
❑ Corporate Officer—Title(s): —
❑ Partner ❑ Limited ❑ General
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer is Representing:
Travelers Casualty and Surety Company of America
AWSK Travelers Casualty and Surety Company
TRAVELERS J St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Sandra R Black of
CONCORD , California , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
u ...�
JPItY AMO
�P Gpi
�f A a HARTFQRD, .
`\ CONN.
State of Connecticut
By:
City of Hartford ss. Robert L. Rane enior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
+' \P P NOOZ',
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NOTARY ��
My Commission expires the 30th day of June, 2026 �ro y�
FUS`. Anna P. Nowik, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this 3 day of 2 ��
2s4 PTY AN,
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KMOM
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Kevin E. Hughes, Assistant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
Please refer to the above-named Attorneys) -in -Fact and the details of the bond to which this Power of Attorney is attached.
CALIFORNIA ALL-PURPOSE ACKNOWLEDMENT CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached, and not the
truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
COUNTY OF jS an M qty o
On th , 2022, before me, U • pen 41014 -Vel , Notary Public,
personagy appeared Lh 02d L Z 0 who proved to me on
the basis of satisfactory evidence to be the so
n,W whose name is res cubed to the within
instrument and acknowle d to iexecuted
ha he e/they executed t e same i hi er/their authorized
capacity(i, and that by is rsignaturey on the instrument the person, or the entity upon
behalf of which the person ac the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature:
rsh "•rasa G. PENAL0ZA-VE
GA
a 4Comm, # 2347441 rn
N r ® "o NOTARY PUBLIC -CALIFORNIA VJ
(Seal) COUNTY OF SAN MATEO
P45,
ac�ovaC MY COMM. EXP. FEB. 17, 2025'
Bid Bond
Impto—ca [s to Snack Shack Building at Puriasima Perk
19
CALIFORNIAALL-PURPOSE ACKNOWLEDGEMTNT
IA Notary Public or other officer completing this certificate verifies only the identity of the individual who signed I
the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of San Mateo
On a6-11212627— beforeme, Monica Armon. Notar Public,
Personally appeared % jtno s 40
who proved to me on the basis of satisfactory evidence to be the person(t whose name( s�re
subscribed to the within instrument and acknowledged to me tha�she/they executed the same
irxIDYher/their authorized capacity(3eej, and that by4LOherAheir signatures on the instument
the p cis on(A), or the entity upon behalf of which the pemou(4 acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of State of California that the foregoing
paragraph is true and correct.
«� MONICA ARMON�
1' g' y coNM• # 2314616 WITNESS my hand and official seal.
N F
NOTARY
$ ^
A% MATEO
O r
MY COMM. W. MEC. 5, 2715 �/}}��
SIGNATURE 4%ye.,v al&4'L
PLACEI\TOTARYSERALABOVE
......................... ........................... ..................................... ............................... ....... _...................................................... ....... .... ..... ... ..... .............. ............................ ..................... .....................
..............,........,.....
Though the information below is notreguired by law, it may prove valuable to persons relying on the document
and could prevent fraudulentremoval and reattachment of this form to another document.
Description bf attached document
Title or type of document:. %D" J -&j alIDS
Cin--
DocumentDate: Q�IIZIZD22 Number ofPages:
Signers) Other than Named Above: _
ttached
edgement
GENERAL LIABILITY ENDORSEMENT
TOWN OF LOS ALTOS HILLS
26379 Fremont Road, Los Altos Hills, CA 94022
Public Works Director
A. POLICY INFORMATION
1.
Insurance Company:
EVANSTON INSURANCE COMPANY
Policy Number:
3457
(GLEXCESS49EZXS 3030901
2.
Policy Term: From:
08103/2021
To:
08/03/2022
Endorsement Effective Date:
08/03/2021
3.
Named Insured:
MTW BUILDERS, INC.
4.
Address of Named Insured:
905 HELEN DRIVE, MILLBRAE, CA 94030
5.
Limit of Liability ny One Occurrence/Aggregate $1,0001000$13,000,000 $4,000,000/ 5 000 000
6.
Deductible or Self -Insured Retention Nil unless otherwise s
ecified : NIL
7.
"Claims Made" coverage: Retroactive Date: NLA
Tails:
B. POLICY AMENDMENTS
This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent
statement in the policy to which this endorsement is attached or any other endorsement attached thereto it
is agreed as follows:
1. INSURED: The Town, it's elected or appointed officials, employees, and volunteers are included
as insured with regard to damages and defense of claims arising from: (a) activities performed by or on
behalf of the Named Insured, (b) products and completed operations of the Named Insured, or (c) premises
owned, leased or used by the Named Insured.
2. CONTRIBUTION NOT REQUIRED: As respects: (a) work performed by the Named Insured for
or on behalf of the Town; or (b) products sold by the Named Insured to the Town, or (c) premises leased
by the Named Insured from the Town, the insurance afforded by this policy shall be primary insurance as
respects the Town, its elected or appointed officials, employees or volunteers; or stand in an unbroken
chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event,
any other insurance maintained by the Town, its elected or appointed officials, employees or volunteers
shall be excess of this insurance and shall not contribute with it.
3. SCOPE OF COVERAGE: The policy: (1) if primary, affords coverage at least as broad as
Insurance Services Office form for Broad Form Commercial General Liability Insurance and Insurance
Services Office form for Broad Form Commercial General Liability endorsement; or (2) if excess, affords
coverage which is at least as broad as the Primary Insurance form referenced in the preceding Section (1).
4. SEVERABILITY OF INTEREST: The insurance afforded by this policy applies separately to
each insured seeking coverage or against whom a claim is made or a suit is brought, except with respect
to the Company's limit of liability.
GENERAL LIABILITY ENDORSEMENT
5. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS: Any
failure to comply with reporting provisions of the policy shall not affect coverage provided to the Town, its
elected or appointed officials, employees or volunteers.
6. CANCELLATION NOTICE: The insurance afforded by this policy shall not be suspended,
voided, canceled, reduced in coverage or in limits except after thirty (30) days prior written notice by
Certified Mail Return Receipt Requested have been given to the Town. Such notice shall be addressed as
shown in the heading of this endorsement.
C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER
1, CHRISTINA CHEUNG (print/type name), warrant that I have authority to
bind the below -listed insurance company and by my signature hereon do so bind this company.
Signature of
(original signature on endorsement furnished to the Town)
ORGANIZATION: SIR INSURANCE SERVICES TITLE: BROKER —
ADDRESS: 1080 BROADWAY, MILLBRAE CA 94030 TELEPHONE: 650-552-0055
GENERAL LIABILITY ENDORSEMENT
AUTOMOBILE LIABILITY ENDORSEMENT
TOWN OF LOS ALTOS HILLS
26379 FREMONT ROAD, LOS ALTOS HILLS, CA 94022
Public Works Director
A. POLICY INFORMATION
1.
Insurance Company:
PROGRESSIVE EXPRESS INSURANCE CO
Policy Number:
018539254
2.
Policy Term: From:
02/25/2022
To:
08/25/2022
Endorsement Effective Date:
02/25/2022
3.
Named Insured:
MTW BUILDERS, INC.
4.
Address of Named Insured:
905 HELEN DRIVE, MILLBRAE, CA 94030
5.
Limit of Liability Any One Occurrence/A re ate $1,000,000-00
6.
Deductible or Self -Insured Retention Nil unless otherwise specified): 5 000
7.
"Claims Made" coverage: Retroactive Date: N/A
Tails:
B. POLICY AMENDMENTS
This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent
statement in the policy to which this endorsement is attached or any other endorsement attached thereto it
is agreed as follows:
1. INSURED: The Town, its elected or appointed officials, employees, and volunteers are included
as insured with regard to damages and defense of claims arising from: (a) activities performed by or on
behalf of the Named Insured, (b) products and completed operations of the Named Insured, or (c) premises
owned, leased or used by the Named Insured.
2. CONTRIBUTION NOT REQUIRED: As respects: (a) work performed by the Named Insured for
or on behalf of the Town; or (b) products sold by the Named Insured to the Town, or (c) premises leased
by the Named Insured from the Town, the insurance afforded by this policy shall be primary insurance as
respects the Town, its elected or appointed officials, employees or volunteers; or stand in an unbroken
chain of coverage excess of the Named Insured's scheduled underlying primary coverage. In either event,
any other insurance maintained by the Town, its elected or appointed officials, employees or volunteers
shall be excess of this insurance and shall not contribute with it.
3. SCOPE OF COVERAGE: This policy affords coverage to the Named Insured which is at least
as broad as Insurance Services Office form for Automobile Liability, Code 1 ("any auto").
4. SEVERABILITY OF INTEREST: The insurance afforded by this policy applies separately to
each insured seeking coverage or against whom a claim is made or a suit is brought, except with respect
to the Company's limit of liability.
5. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS: Any
failure to comply with reporting provisions of the policy shall not affect coverage provided to the Town, its
elected or appointed officials, employees or volunteers.
AUTOMOBILE LIABILITY ENDORSEMENT
6. CANCELLATION NOTICE: The insurance afforded by this policy shall not be suspended,
voided, canceled, reduced in coverage or in limits except after thirty (30) day prior written notice by Certified
Mail Return Receipt Requested has been given to the Town. Such notice shall be addressed as shown in
the heading of this endorsement.
C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER
1, CHRISTINA CHEUNG (print/type name), warrant that I have authority to
bind the below -listed insurance company and by my signature hereon do so bind this company.
Signature of
(original signature on endorsement furnished to the Town)
ORGANIZATION: SIS INSURANCE SERVICES TITLE: BROKER
ADDRESS:1080 c:•'•N MILLBRAE CA .40 • 00
a
AUTOMOBILE LIABILITY ENDORSEMENT
WORKERS COMPENSA710NIEMPLOYEES LIABILITY ENDORSEMENT
TOWN OF LOS ALTOS HILLS
26379 FREMONT ROAD, LOS ALTOS HILLS, CA 94022
Public Works Director
A. POLICY INFORMATION
1. Insurance Company:
Policy Number:
STATE COMPENSATION INSURANCE FUND
9061019 2021
2. Endorsement Effective Date:
07/17/2021
3. Named Insured:
MTW BUILDERS, INC.
4. Employers Liability Limits (coverage B) $1,000,000.00
B. POLICY AMENDMENTS:
This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent
statement in the policy to which this endorsement is attached or any other endorsement attached thereto
it is agreed as follows:
1. CANCELLATION NOTICE: The insurance afforded to this policy shall not be suspended, voided,
canceled, reduced in coverage or in limits except after thirty (30) days prior written notice by Certified Mail
Return Receipt Requested have been given to the Town. Such notice shall be addressed as shown in the
heading of this endorsement.
2. WAIVER OF SUBROGATION: The Company agrees to waive all rights of subrogation against
the Town, its elected or appointed officials, agents and employees for losses paid under the terms of this
policy which arise from work performed by the Named Insured for the Town.
C. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER
I, CHRISTINA CHEUNG (print/type name), warrant that I have authority to
bind the below -listed insurance company and by my signature hereon do so bind this company.
Signature of
(original signature on endorsement furnished to the Town)
ORGANIZATION: SIS INSURANCE SERVICES _ TITLE:
BROKER
ADDRESS: 1080 BROADWAY MILLBRAE CA 94030 TELEPHONE: 650-552-0055
WORKERS COMPENSATION/EMPLOYEES LIABILITY ENDORSEMENT
Town of Los Altos Hills
Town Hall
Los Altos Hills, CA 94022
Attention: Public Works Director/City Engineer.
Public Works Director
LOS ALTOS HILLS ("the Town")
A General Law City
CERTIFICATE OF INSURANCE
This certifies that the following described policies have been issued to the insured named below and are
in force at this time.
Insured MTW BUILDERS, INC.
Address 905 HELEN DRIVE, MILLBRAE, CA 94030
Description of operations/locations/products insured (show Contract name and/or number if any).
POLICIES AND INSURERS
LIMITS
EXPIRATION
Bodily Injury Property Damage
DATE
Policy Number
Worker's Compensation
Employer's Liability $ 1,000,000
07/17/2022
STATE COMPENSATION INSURANCE FUND
9061019-2021
Insurer
Commercial General Liability
Each Occurrence$1,000,000
Each Occurrence
08/03/2022
EVANTON INSURANCE CO.
Aggregate $2,000,000
Aggregate
3AA493457
Insurer
Combined Single Limit
Business Auto Policy Liability
Each Person
Each Accident
08/25/2022
Coverage Symbol SCHEDULED
Each Accident
Combined Single Limit
01853925-4
Insurer PROGRESSIV
- EXPRESS INS. CO.
$1,000,000 CSL
---
Umbrella Liability
Occurrence/Aggregate $ 3,000,000/$3,000,000
08/03/2022
EVANTON INSURANCE CO.
Self -Retention $ 5,000
EZXS 3056222
Insurer
The following covera es or conditions are in effect:
Yes 64
No ❑
The Town, its officials, and employees are named on all liability policies
described above as insured as respects: (a) activities performed for the
Town or on behalf of the named insured, (b) products and completed
operations of the named insured and (c) premises owned, leased or
used by the named insured
Products and com leted o orations:
Yes 14
No ❑
The undersigned will mail to the Town 30 days written notice of
cancellation or reduction of coverage or limits, cross liability clause (or
equivalent wording).
Yes ❑
No ®
Personal Injury, erils A, B, and C.
Yes ❑
No 0
Broad form property damage.
Yes ❑
No M
X, C, U hazards included.
Yas ❑
No 04
Contractual liability coverage applying to this Contract.
Yes ❑
No W
Liquor liability.
Yes 14
No ❑
Coverage afforded the Town, its officials, employees and volunteers as
an insured applies as primary and not excess or contributing to any
insurance issued in the name of the City.
Yes NNo
❑
Waiver of subro ation from worke s com ensation insurer.
CERTIFICATE OF INSURANCE
This certificate is issued as a matter of information. This certificate is not an insurance policy and does not
amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any
requirement, term or condition of any contract or other document with respect to which this certificate or
insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject
to all the terms, exclusions and conditions of such policies.
SIS INSURANCE SERVICES
Agency or Brokerage Insurance Company
1080 BROADWAY, MILLBRAE, CA 94030
Address
CHRISTINA CHEUNG
Name of Person to be Contacted
650-552-0055
Telephone
Home Office
L166-
�f''f"iX1 /6- 2
Au Mfi-ied Srg ure
05/11/2022
Date
NOTE: Authorized signature may be the agent's, if agent has placed insurance through an agency
agreement with the insurer. If insurance is brokered, authorized signature must be that of official
ofinsurer
CERTIFICATE OF INSURANCE