HomeMy WebLinkAboutCC 10 SIDEWALK REPAIR 07-17-89(.;UNSI-N I
NO. 10
7-17-89
DATE:
JULY 7, 1989
Inter- Corn
TO:
FROM:
SUBJECT:
WILLIAM HUSTON, CITY MANAGER
PUBLIC WORKS DEPARTMENT/ENGINEERING DIVISION
FINAL ACCEPTANCE OF PUBLIC IMPROVEMENTS
SIDEWALK AND CURB AND GUTTER REPAIR PROJECT, 1988-89 FY
RECOMMENDATION:
That the City Council at their meeting of July 17, 1989 adopt the
attached resolution accepting said work and authorizing the recordation
of the notice of completion.
Assuming no claims or stop payment notices are filed, it is further
recommended that 30 days after the date of recordation of the notice of
completion that the Council authorize payment of the final 10%
retention amount of $7,679.66. This amount, together with previous.
payments of $106,546.33, represents 100% of the final contract amount.
BACKGROUND:
This project encompasses removal and replacement of sidewalks and curb
and gutters, root pruning, and installing root barriers at various
locations throughout the City.
The work has been completed to the satisfaction of the Engineering
Division. The final contract amount is $114,225.99. This exceeds the
original contract amount of $98,194.17 by $16,031.82 which represents
the cost of new. added locations to consume the budgeted funds.
Bob Ledendecker
Director of Public Works/City Engineer
BL:WA:mv
Wisam Altowaij i
Assistant Civil Engineer
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RESOLUTION NO. 89-104
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF TUSTIN, CALIFORNIA, ACCEPTING WORKS OF
IMPROVEMENT AND AUTHORIZING RECORDATION OF
NOTICE OF COMPLETION FOR SIDEWALK AND CURB
AND GUTTER REPAIR PROJECT, 1988-89 FISCAL YEAR
WHEREAS, Raymor Electric Company, having a contract with
the City of Tustin to construct the hereinafter described public
work and improvement; and
WHEREAS, the City Engineer has duly certified to the
construction and completion of said public improvements herein-
after mentioned in a manner satisfactory to the City Council of
the City of Tustin; and
WHEREAS, the City Council finds that said contractor has
completed said public improvement hereinafter more particularly
described in accordance with the provisions of the contract
documents and the notice of completion, and acceptance of said
public work and improvement should be filed and payment of the
balance due said contract authorized in accordance with the
contract documents.
NOW THEREFORE, BE IT RESOLVED by the City Council of the
City of Tustin that said public work and improvement be, and the
same is hereby accepted. Said public work and improvement is
more particularly described as follows:
Sidewalk and Curb and Gutter Repair Project
1988-89 Fiscal Year
AND BE IT FURTHER RESOLVED that the City Engineer of the
City of Tustin be and is hereby authorized to execute and file a
notice of completion and acceptance of said public work and
improvement described herein as required by law.
PASSED AND ADOPTED at a regular meeting of the City
Council of the City of Tustin on the day of
of , 1989.
ATTEST:
Mayor
City Clerk
SECTION C
CONTRACT
SIDEWALK AND CURB AND GUTTER REPAIR PROJECT, 1988-89 FY
(PROJECT NO. 6235)
This agreement, made and concluded, in triplicate, this '3'
day of fix. -c y�r- 19S' -/F between the City of Tustin,
California, hereinafter called City, and Raymor Electric Company, enc.
hereinafter called Contractor.
ARTICLE I. Witnesseth, that for and in consideration of the
payments and agreements hereinafter mentioned, to be made and performed
by the City, and under the conditions expressed in the two bonds, bearing
date with these presents, and hereunto annexed, the Contractor agrees
with City, at his own proper cost and expense, to do all the work and
furnish all the materials necessary to construct and complete in good
workmanlike and substantial manner and to the satisfaction of the City,
in accordance with the specifications entitled: Sidewalk and Curb and
Gutter Repair Project, 1988 8-89 FY, Project No. 6235,
which said specifications are hereby specifically referred to and by such
references made a part hereof. Said specifications are on file in the
office of the City Engineer of the City of Tustin, California.
ARTICLE II. Contractor agrees to receive and accept the following
prices as full compensation for furnishing all materials and for doing
all the work contemplated and embraced in the Agreement; and also for all
loss or damage arising out of the nature of the work aforesaid, or from
the action 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 City of Tustin, and for all risks of
every description connected with the work; also for all expenses incurred
by or in consequence of the suspension or dis5ontinuance of work and for
well and faithfully completing the work, and the whole thereof, in the
manner and according to the plans and specifications, and the
requirements of the Engineer under them.
�M
CONTRACT
SIDEWALK AND CURB AND GUTTER REPAIR PROJECT, 1988-89 FY
(PROJECT NO. 6235)
ITEM CONTRACT ITEM
NO. DESCRIPTION
1. Sawcut asphalt or concrete
2. Remove and replace PCC sidewalk
3. Remove and replace PCC drive apron
4. Remove and replace Type A-2 C&G
5. Remove and replace Type D C&G
6. Root pruning/barrier Type A
7. Root pruning/barrier Type B
8. Asphalt concrete pavement
APPROXIMATE
QUANTITY
3,305 LF
11,903 SF
547 SF
333 LF
1,485 LF
48 LF
284 LF
77 TN
UNIT
TOTAL
PRICE
AMOUNT
0.60
1,983.00
3.31
39,398.93
5 43
1) QAA 7A
21.00
16.50
29.00
25.00
180.00
TOTAL CONTRACT PRICE $98,194.17
C-2
a 001 nn
24,502.50
1,392.00
7,100.00
13,860.00
a' ARTICLE III. City hereby promises and agrees with Contractor to
employ and does hereby employ 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 IV. It is further expresssly agreed by and between the
parties hereto that should there be any conflict between the terms of
this instrument and the bid or proposal of Contractor, then this
instrument shall control and nothing herein shall be considered as an
acceptance of the said terms of said proposal conflicting herewith.
ARTICLE V.
1. The CITY OF TU TIN has obtained from the Director of Industrial
Relations the general prevailing rate of per diem wages and the general
prevailing rate for legal holiday and overtime work in the locality in
which the work is to be performed for each craft or type of work needed
to execute this contract and maintains copies thereof in the office of
the City Engineer. The Contractor agrees that not less than said
prevailing rates shall be paid to workers employed on this public works
contract as required by Labor Code Sections 1771 and 1774 of the State of
California.
2. The Contractor, shall, as a penalty to the CITY OF TUSTIN,
forfeit twenty-five Dollars ($25.00) for each calendar day or portion
thereof for each worker paid (either by Contractor or any subcontractor
under Contractor) less than the prevailing rate set forth herein on the
work provided for in this contract, all in accordance with Sections 1774
and 1775 of the Labor Code of the State of California.
3. Section 1773.8 of the Labor Code of the State of California,
regarding the payment of travel and subsistence payments, is applicable
to this contract.
4. Section 1777.5 of the Labor Code of the State of California,
regarding the employment of apprentices, is applicable to this contract
if the prime contract involves Thirty Thousand Dollars ($30,000.00) or
more, or twenty (20) working days or more, or if contracts of
subcontractors not bidding for work through the general or prime
contractor are Two Thousand Dollars ($2,000.00) or more, or five (5)
working days or more.
5. In performance of this contract, not more than eight (8) hours
shall constitute a day's work. The Contractor shall conform to Article
3, Chapter 1, Part 7 (Sections 1810 et seq.) of the Labor Code of the
State of California, and shall forfeit to the City as a penalty, the sum
of Twenty-five Dollars ($25.00) for each worker employed in the execution
of this contract by Contractor or any.subcontractor for each calendar day
during which any worker is required or permitted to labor more than eight
(8) hours in any one calendar day and forty (40) hours in any one week in
violation of said Article. Contractor shall keep an accurate record
showing the name and actual hours worked each calendar day and each
calendar week by each worker employed by Contractor in connection with
the public work.
C-3
6. Contractor agrees to keep accurate payroll records showing the
name, address, social security number, work classification, straight time
and overtime hours worked each day and week and the actual per diem wages
paid to each journeyman, apprentice or worker employed by him in
connection with the public work,and agrees to insist that each of this
subcontractors do the same. Contractor. further agrees that his payroll
records and those of his subcontractors shall be available to the
employee or his representative, the Division of Labor Standards
Enforcement, and the Division of Apprenticeship Standards, and shall
comply with all of the provisions of Labor Code Section 1776, et seg., in
general.
7. Contractor is also aware of the provisions of Section 3700 of
the Labor Code which requires every employer to be insured against
liability for Worker's Compensation or undertake self-insurance in
accordance with the provisions of that code and will comply with such
provisions before commencing the performance of the work of this
contract.
ARTICLE VI. The Contractor shall indemnify and save harmless the
City of Tustin and all officers and employees thereof from all claims,
suits, or actions of every name, kind and description, brought for, or on
account of, injuries to or death of any person including but not limited
to workmen and the public, or damage to property resulting from the
construction of the work or by or in consequence of any negligence
regarding the work, neglect or refusal of Contractor to faithfully
perform the work and all of Contractor's obligations under the contract,
or by or on account of any act or omission by the Contractor or his
agents or a subcontractor or his agents or a third party during the
progress of the work or at any time before its completion and final
acceptance, or which might arise in connection with the agreed work or is
caused by or happening in connection with the progress of said work; or.
on account of any passive or active negligent act or omission by the City
of Tustin, its officers, employees and agents, save and except claims
arising through the sole and exclusive negligence or sole and exclusive
wilful misconduct of the City of Tustin. The defense in indemnification
by Contractor shall include all costs and expenditures including
attorney's fees incurred by the City of Tustin or its employees, officers
or agents with respect to such claim or suit and Contractor will, if
requested by City of Tustin, defend any litigation arising out of such
claims at the sole cost and expense of Contractor.
In addition to any remedy authorized by law, so much of the money
due the Contractor under and by virtue of the contract as shall be
considered necessary in the sole discretion of the City of Tustin may be
retained by the City until disposition has been made of such claims for
C damages as aforesaid.
ARTICLE VII. The Contractor shall take out and maintain during the
life of the contract comprehensive automobile and general liability
insurance that provides protection from claims which may arise from
operations or performance under this contract. The amount of insurance
shall not be less than the following:
\ Single limit coverage applying to bodily and personal injury liability
and property damage: $1,000,000.00.
C-4
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The following endorsements must be indicated on all certificates of
insurance:
(1) The City of Tustin, its elective and appointive boards, officers,
agents and employees are named as additional insureds in the policy
as to the work being performed under the contract;
(2) The coverage is primary and no other insurance carried by the
City of Tustin will be called upon to contribute to a loss under
this coverage;
(3) The policy cover blanket contractual liability;
(4) The policy limits of liability are provided on an occurrence basis;
(5) The policy covers broad form property damage liability;
(6) The policy covers personal injury as well as bodily injury
liability;
(7) The policy covers explosion, collapse and underground hazards;
(8) The policy covers products and completed operations;
(9) The policy covers use of non -owned automobiles;
(10) The coverage shall not be cancelled nor materially altered unless
thirty (30) days written notice is first given to the City of
Tustin.
Contractor shall furnish the City of Tustin with satisfactory proof of
insurance coverage as required.
C-5
In Witness Whereof, the parties have hereunto set their hands and
seals the year and the date first above written.
THE CITY OF TUSTIN
BY:.-
(Seal)
Y:.—(Seal) Mayor of the City of Tustin
ATTEST: 1�2 a,y F- L.
City Cl er of the ity of Tustin
t
l CONTRA OND APPROVED:
Date
City Attorney
APPROVED AS TO CONTENT:
Date:,?--f-Py
City Engineer
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
>TAT? OF CALIFORNIA )
SS.
COUNTY OF LOS ANGELES)
ONI THIS 3rd day of February , 19 89 before me, the
undersigned, a Notary Public in and for said State, personally
appeared Angus H. O'Brien and _,
personally known to me or proved to me on the basis of satisfactory
evidence) to be the persons who executed the within instrument as
V;cf. President and Secretary, respectively,
on behalf of Ra,ymor Electric Company_,_ Inc. --- Y
the corporation therein named, and acknowledged_ me that such
corporation executed the within instruent pars nt to its by -Laws
or a resolution of its board of dire ors.
-- c -FICIAL ��� WITN ha and a seal.
L ; ; L0uwT
My commission Expi e,s App 22, 19 i
(28) CORPORATION
PWE 113
Executed in Duplicate
BOND pREMIUM EASED ON
FINAL CONTRACT PRICE
CITY OF TUSTIN
PUBLIC CONTRACT
KNOW ALL MEN BY THESE PRESENTS: That
BOr,d No. 1172419
Amount $98,194.17
Premium $2,946.0
Raymor Electric Company, Inc. , as and hereinafter referred to
collectively as "Principal", and Amwest Surety Insuranc,P company
a corporation organized and existing under the
laws of the State of California , and duly authorized to
transact surety business in the State of California, as, and hereinafter
referred to as, "Surety", are held and firmly bound unto the City of
Tustin hereinafter referred to as the "City", in the sum of $ 98,194.17
for payment of which Principal and surety bind themselves, their heirs,
administrators, successors and assigns, jointly and severally as follows:
THE CONDITION OF THE ABOVE OBLIGATION IS THAT:
/C -
WHEREAS, Principal has entered into a contract dated
F
19I with City to do and perform the following,
generally described work, which is more particularly described in said
contract for the construction of: Sidewalk and Curb and Gutter Repair
Project- 1988-89 FY (Protect No. 6235); and
WHEREAS, all of such improvements are to be constructed and
installed in accordance with the plans and specifications described,
referred to and incorporated in said contract; and
WHEREAS, Principal shall commence and complete the construction and
installation of such improvements as provided in said contract; and
NOW, THEREFORE, if Principal shall faithfully perform all agreements
contained in the aforesaid contract, then this obligation shall be null
and void.
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`PROVIDED, HOWE if Principal shall no aithfully perform all
agreements contained in the hereinabove described contract and all
obligations, then this obligation shall remain in full force and effect.
PROVIDED FURTHER, HOWEVER, that Surety hereby stipulates and agrees
that no change, extension of time, alteration or modification of the
contract documents or of the work to be performed thereunder shall in
any way affect its obligation on this bond and it does hereby waive
notice of any such change, extension of time, alteration or modification
of the contract documents or of the work to be performed thereunder; and
PROVIDED FURTHER, that in case suit is brought upon this bond by the
City or any other person who may bring an action on this bond, a
reasonable attorney's fee, to be fixed by the Court, shall be paid by
Principal and Surety.
SURETY: Amwest Surety Insurance Company
(NAME)
NOTE: Attach proper
acknowledgements for y GSC/
both Surety & Principal BY: ce
A orney-in-Fact
Beverly M. Ward
(Seal) BY:
APPRWAttorney
RM: Address of Surety:
224 F:_ Gepp I St -0 Suite, 102
Principak'10.'BRitN-V
yn Electric Company, Inc.
APPROVED AS TO CONTENT: BY:
ANGUS
(Seal) BY:
Address of Principal:
315 S. SAN GABRIEL BLVD.
City Engineer
SAN GABRIEL, CA 91776
C-8
Executed in Duplicate bL..,d No. 1172419
Amount $98,194.17
Premium incl. on perf.bond
CITY OF TUSTIN
PUBLIC CONTRACT
LABOR AND MATERIALS PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS: That
Raymor Electric Company, Inc. as and hereinafter referred to
collectively as "Principal", and Amwest Surety Insurance Companv
a I corporation organized and existing under the
laws of the State of California , and duly authorized to
transact surety business in the State of California, as and hereinafter
referred to as, "Surety", are held and firmly bound unto the City of
Tustin hereinafter referred to as the "City", in the sum of $ 98,194.17
for payment of which Principal and surety bind themselves, their heirs,
administrators, successors and assigns, jointly and severally as follows:
�- THE CONDITION OF THE ABOVE OBLIGATION IS THAT:
WHEREAS, Principal has entered into a contract dated17
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19_a, with City to do and perform the following,
generally described work, which is more particularly described in said
t contract for the construction of: Sidewalk and Curb and Gutter Repair
Project, 1988-89 FY (Project No. 6235); and
WHEREAS, Principal shall commence and complete the construction and
installation of such improvements provided in said contract; and
NOW THEREFORE, if Principal shall pay the contractor, his
0, subcontractor, and all persons renting equipment or furnishing labor or
materials to them for such improvements, for the full cost of such
improvements then this obligation shall be null and void.
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PROVIDED, HOWEVL , if Principal shall not pay the subcontractor and
all persons renting equipment or furnishing labor or materials to them
for such improvements for the full cost of such improvements, then this
this obligation shall remain in full force and effect and such
contractor, subcontractor and persons shall have a direct right of action
against the Principal and Surety under this obligation, subject to
priority of City.
PROVIDED FURTHER, HOWEVER, that Surety stipulates and agrees
that no change, extension of time, alteration or modification of the
contract documents or of the work to be performed thereunder shall in
any way affect its obligation on this bond and it does hereby waive
notice of any such change extension of time, alteration or modification
of the contract documents or of the work to be performed thereunder; and
PROVIDED FURTHER, that in case suit is brought upon this bond by the
City or any other person who may bring an action on this bond, a
reasonable attorney's fee, to be fixed by the Court, shall be paid by
Principal and Surety.
IN WITNESS WHEREOF, Principal and Surety have caused these presents
to be duly signed and sealed this 3rd day of February . 19M
SURETY: Amwest Surety Insurance Company
(NAME)
NOTE: Attach proper
acknowledgements for J
both Surety & Principal BY: z. G </
torney-in-Fact
Beverly M. Ward
(Seal) BY:
APPROV FO Address of Surety:
1224 E. Green St., Suite 102
City Attorney
Pasadena, Ca. 91106
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APPROVED AS TO CONTENT:
City Engineer .4-p-0
(Seal)
Principal:. Ray-rtor Electric Company, Inc.
BY: _
• ANGUS ' Rftff
BY:
Address of Principal:
315 S. SAN GABRIEL BLVD.
C-11
SAN GABRIEL, CA 91776
t....WEST SURETY INSURANCE �.
P.O. Box 4500
Woodland Hills, CA 91365
(818) 704-1111
POWER OF ATTORNEY
KNOW ALL .MEN SY THESE PRESENTS. That AMWEST SURETY INSURANCE COMPANY, A CALIFORNIA CORPORATION
does hereov make, constitute and appoint
BEVERLY M. WARD OF PASADENA,CALIF'ORNIA
its true and lawiul Attorney(s)-in-Fac:, with full power and authority for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto if a seal is required, bonds, undertakings, recognizances or other written obliga-
tions in the nature thereof, as follows:
UNLIMITED
and to bind AMWEST SURETY INSURANCE COMPANY thereby, and all of the acts of said Attorneys-in-Fact, pursuant to these
J presents. are hereby ratified and confirmed. This appointment is made under and by authority of the following provisions of the By-
Laws of the company, which are now in full force and effect:
C` Article 111, Section 7 of the By-Laws of AMWEST SURETY INSURANCE COMPANY
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by
the board of directors of AMWEST SURETY INSURANCE COMPANY at a meeting duly held on December 15, 1975.
RESOLVED that the president or any vice-president. in conjunction with the secretary or anyassistant secretary.
may accoint attorneys-in-fact or agents with authority as .defined or limited in the instrument evidencing the appoint-
ment in each case, for and on behalf of the company to execute and deliver and affix the seal of the Company to bonds.
undertakings. recognizances, and suretyship obligations of all kinds: and said officers may remove any such attorney-
in-fact or agent and revoke any power of attorney previously granted to such person,
RESOLVED FURTHER that any bond undertaking, recognizance. or suretyship obligation shall be valid and
binding upon the company
(i) when signed by the president or any vice-president and attested and sealed (if a seal be required) by any
sec-retary or assistant secretary; or
(ii) when signed by the president or any vice president or secretary or assistant secretary, and countersigned'
and sealed (if a seat be reguired)by:a duly authorized attorney-imfact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and
within the limits of the authority evidenced by the power of attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seat of the company may be affixed
Dy facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, unoer-
taking, recognizance, or other suretyship obligations of the company; and such Signatureand seat when so used shall
have the Same force and effect as though manually affixed.
IN WITNESS WHEREOF. AMWEST SURETY INSURANCE COMPANY has caused these presents to be signed by its proper of-
fiver, and its corporate seal to be hereunto affixed this 24th day of October 1988
AMWEST SURETY INSURANCE COMPANY
a. c
c enna ✓�� Vice—
Kare G.Cohen Secretary
ST ATE OF CALIFORNIA, COUNTY OF LOS ANGELES — ss
Onthis_ 4t dayof October A.D..19 88 .personally came beforeme E.J.McKenna
and Karen G.Cohen to me known to be the individuals and officers of AMWEST SURETY INSURANCE COM-
PANY, CALIFORNIA who executed the above instrument. and they each acknowledged the execution of the same, and being by me
duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid, and that the seal affixed to the
above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed
and subscribed to the said instrument by the authority of the board of directors of said corporation.
OFFi0L4l SEAT. (SEAL) 7�
JENNETTE FENNELL ?^
ycS NOtarY PIANic-CalUomle t% Notary Public
Principe, Office In
LOS ANGELES COUNTY
My Comm. Exis. March 27. 1992
STATE OF CALIFORNIA, COUNTY OF LOS ANGELES — ss
CERTIFICATE
. 1, the undersigned. secretary of the AMWEST SURETY INSURANCE COMPANY, a California corporation, DO
HEREBY CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked, and further-
more, that the provisions of the By -Laws of the company and the Resolutions of the board of directors set forth in the Power of
Attorney, are now in force.
Signed and sealed at Pasadena this 3rd day of February ig ag
Secretary
i
F E e 41st.10i„tu'r; Uk' 1N5 E
AND DESTQ3AfiIOi GIC7NA. 1 PI3Si1FD
SCh' 'CITY OP T=IN
�. �: SID WALK AND CURB r
GUTTEI
360 C-ntennial Way
REPAIR PitO,TEGT,`' FY 1' $&-$9 (PROJECT N0. (
r)
Tustin C& 42680
VAE AND khaoff' INSURED CONTRAC.' o
NAIVE AND � .INSu COF ANY
Raymor Electric Cc., Inc.
S. San Gabriel Blvd,
Maryland Casualty Company
D
.315
L� V L
N
AML AND ADD 43F XSC1Tt�',NC�E AGENCY
U
U �
Bolton & Company
FES
1100 E1 CEntro Street
,youth Pasadena, Ca. 91030
'his ls'to Mrt ty that the pa ries at
T 3 p YlUis
insura,ticc listed below, have:: n issued to ins,
f `
d above, are in force at this time, that the City of Tustin �.s a';^riaca? additional insuredrec
s respects claims arising in connection
with the hereinabove `ii ed Project; and that such
sr-
nce 'shad be prirmEX with respect to any
other insurance in foie :purchaW by the Cit o,
istin
ype o ; : insurance Policy- Policy ,: ), is ,o ," L abxl.2ty in T
i
nsuranCe Company
Number Expira. ml, Foch
Date, occkir ence r"
Late
ENEIM LI}1PIILI7YBodily,'
npt*.SinslveformMaryland Casualty #EPA81329633 3/25/8
IWTU-iy $ $
:mases- operatf.Oris
qty' ` $
'cglas vn and collapse
im axd`
i��'tgrourx'� �lazazK3
;;
'oducts�!c�rnpleted
,:
c7peLrottiow bazard
Bodily, Injury $1, 000, $ 1, 000,
ntrACt�ai °it ralnce
Qat fdmi arty
Vie; < cibjned
d:nt contractors
t" .'>I►7 `u
P Yi►iRW $1,000 ,
Maryland Casualty
#EC86773553 3/25/89
1 yh'-' jury $ $
`person°)
each
tXeve form
Bodily`<j►jury $ $
O
ribne6''
p1roverty Damage
$ 1, 000,
Comb nom.
1SS LIASILl'i'Y
x y"Iix,uy &
T
Pra�rty � $ S
wells 'bzm Maryland Casualty
#UB24071383 3/25/89
<
rer than umbrella
•f $ 1, 000 $1, 000
� .. ,,
�Il�tST
Staf,tteyr
and
E�XERS'
4 (eac
Bi£,ITY
is certified that a waiver of subrogation is hereby issued tc►'thie ty'of Tustin as gertai
to
terms, of all Wbrkers Compensation insurance.
issuing CO --any will give thirty (30)
days written notice bo tae City of Tustin prior to
Lfica'tion or cancellation.
Date �;'ssue.: 2'44- 9
VMf'j, 'IONS OR ADDITIONS MAY 13E MADE
"FiIS F'l"XM.
Au 1 " pr ntative of the above.
"25/82(p�stin)
named insu7qe pmpany ( fes )
C-12
41,
V
COMPENSATION INSURAh__ CERTIFICATE
Pursuant to Section 1861 of the State Labor Code (amended by Stats. 1979,
C.373, p.343), each contractor to whom a public works contract has been
awarded shall sign the following certificate and shall submit same to the
City prior to performing any work on the contract:
I am aware of the provisions of Section 3700 of the Labor Code which
requires every employer to be insured against liability for Workers'
Compensation or to undertake self-insurance in accordance with the
provisions of that Code, and I will comply with such provisions before
commending the performance of the work of this contract.
Ra mor IHI 1 ctr'c Company, Inc.
Con
trac
By:
1 f 4�1
VICE PR SIDENT
Title
Date
Section 3700 of the State Labor Code reads as follows:
"Every employer except the State shall secure the payment compensation in
one or more of the following ways:
(a) By being insured against liability to pay compensation in one or more
insurers duly authorized to write compensation insurance in this State.
(b) By securing from the Director of Industrial Relations a certificate
of consent to self -insure, which may be given upon furnishing proof
satisfactory to the Director of Industrial Relations of ability to
self -insure and to pay any compensation that may become due of his
employee."
(Amended by Stats. 1978, c. 2379, p. 4571)
COMPENSATION INSURANCE CERTIFICATE
TO BE SUBMITTED WITH CONTRACT
C-13