HomeMy WebLinkAboutCC 4 SIDEWALK REPAIR 07-05-83DATE: JUNE 24, 1983 i
e
TO: WILLIAM HUSTON, CITY MANAGER
FROM: DALE WICK, ASSISTANT CITY ENGINEER
SUBJECT: FINAL ACCEPTANCE OF PUBLIC IMPROVEMENTS
F.Y. '82-'83 SIDEWALK & CURB REPAIR PROGRAM
CONSENT CALENDAR
No. 4
7-5-83 (no meeting)
7-18-83
Inter -Coag
RECOMMENDATION:
It is recommended that the Tustin City Council, at their meeting of July 5, 1983,
adopt the attached resolution accepting subject project 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 $4,981.77. This
amount together with previous payments of $44,835.88 represents 100% of the final
contract amount. .
BACKGROUND:
iTF s project encompassed repair of sidewalks., driveway aprons and curbs at a total
of 140 locations throughout the city.
The work has been completed to the satisfaction of the Engineering Division.
The original contract amount for this project was $38,474.20. At the time of
award, the City Council authorized staff to add additional work to the contract to
utilize all of the $48,900.00 which was remaining in the budget for this work.
Staff added an additional 19 repair locations. Due to some minor problems which
developed, there was an overrun on the contract of $917.65 for a final contract
amount of $49,817.65.
A(16, 2-2.4
DALE A. WICK
ASSISTANT CITY ENGINEER
W
Attachment
cc: City Clerk
Finance Director
Street Maintenance Superintendent
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RESOLUTION NO. 83-46
A RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF TUSTIN ACCEPTING WORKS OF IMPROVEMENT AND
AUTHORIZING RECORDATION OF NOTICE OF
COMPLETION (FY 82-83 Sidewalk & Curb Repair)
WHEREAS, Gabi Construction Company, Inc., 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
hereinafter 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 pubic work and improvement be, and the
same is hereby accepted. Said public work and improvement is
more particularly described as follows:
FISCAL YEAR 1982-1983
SIDEWALK AND CURB REPAIR PROGRAM
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 1983.
ATTEST:
0
G tTy C LWCW- ('-Ot7y
CITY OF TUSTIN
ORANGE COUNTY, CALIFORNIA
CONTRACT
FOR THE CONSTRUCTION OF
F.Y. '82-'83 SIDEWALK AND CURB REPAIR PROGRAM
This Mreement, made and concluded, in triplicate, this %r-44�' day of
, one thousand nine hundred and eighty-three between the City of
ustin, Ca i ornia, party of the first part, and Gabi Construction Co., Inc., a
c�orpporation organized and existing under and by virtue of the laws of the State of-
-California and authorized to do business in the State of California,
Contractor, party of the second part.
ARTICLE I. Witnesseth, that for and in consideration of the payments and
agreements hereinafter mentioned, to be made and performed by the said party of the
first part, and under the conditions expressed in the two bonds, bearing date with
these presents, and hereunto annexed the said party of the second part agrees with
said party of the first part, at his own proper cost and expense, to do all the work
and furnish all the materials, except such as are mentioned in the Specifications to
be furnished by said party of the first part, necessary to construct and complete in
good workmanlike and substantial manner and to the satisfaction of the said party of
the first part, in accordance with the plans and specifications entitled, F.Y. '82-'83
Sidewalk and Curb Re air Program and in accordance with the "Standard SpecTf-icatlo-nsrr-
dated January 1981 ot the State of California, Business and Transportation Agency,
Department of Transportation, which said plans and specifications and standard
specifications are hereby specifically referred to and by such references made a part
hereof. Said plans and specifications are on file in the office of the City Engineer
of the City of Tustin, California.
ARTICLE II. And said Contractor agrees to
prices as full compensation for furnishing all
contemplated and embraced in the Agreement; and
out of the nature of the work aforesaid, or fro
any unforseen difficulties or obstructions whic
prosecution of the work until its acceptance by
of every description connected with the work; a
consequence of the suspension or discontinuance
completing the work, and the whole thereof, in
and specifications, and the requirements of the
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receive and accept the following
materials and for doing all the work
also for all loss or damage arising
m the action of the elements, or from
h may arise or be encountered in the
the City of Tustin, and for all risks
]so for all expenses incurred by or in
of work and for well and faithfully
the manner and according to the plans
Engineer under them, to wit:
SCHEDULE OF WORK ITEMS AND CONTRACT PRICES
FISCAL YEAR 1982-83
SIDEWALK AND CURB REPAIR PROGRAM
Item
No.
Item With Unit Price
Written In Words
Approximate
Quantity
Unit Price
In Figures
Total In
In Figures
1.
Sawcut Asphalt Concrete Pavement
or Portland Cement Concrete at
Fifty Cents
1,509.9 L.F.
$0.50
$754.95
Per Lin. Ft.
2.
Remove and Replace PCC Driveway
Apron at Two Dollars and Fifty
Cents
2,037.1 Sq. Ft.
2.50
5,092.75
Per Sq. Ft.
3.
Remove and Replace PCC Sidewalk at
Two Dollars
8,640.9 Sq. Ft.
2.00
17,281.80
Per Sq. Ft.
4.
Remove and Replace Type A-2
Concrete Curb and Gutter at
Twelve Dollars
300.2 L.F.
12.00
3,602.40
Per Lin. Ft.
5.
Remove and Replace Type "D"
Concrete Curb & Gutter at Eleven
Dollars
719.3 L.F.
11.00
7,912.30
Per. Lin. Ft.
6.
Furnish and Construct Aggregate
Base under Curb and Pavement at
Twenty Dollars
79.9 Tons
20.00
1,598.00
Per Ton
7.
Furnish and Construct Asphalt
Concrete Pavement and Variable
Thickness Asphalt Concrete
Feathering at Sixty Dollars
37.2 Tons
60.00
2,232.00
Per Ton
TOTAL CONTRACT $38,474.20
Total or gross sum written in words Thirty-eight Thousand Four Hundred and Seventy -Four
llars and Twenty Cents.
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ARTICLE III. The said party of the first part hereby promises and agrees with
the said Contractor to employ, and does hereby employ, the 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 IV. It is further expressly 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 said 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 TUSTIN 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 Clerk. 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 ($25.00) for each calendar day or portion thereof for each worker
paid (either by Contractor or any subcontractor under Contractor) less than the
prevailing rate set forth herein on the work provided for in this contract, all in
(1 accordance with Sections 1774 and 1775 of the Labor Code of the State of California.
3. Section 1773.8 of the Labor Code of the State of California, regarding the
payment of travel and subsistence payments, is applicable to this contract.
4. Section 1777.5 of the Labor Code of the State of California, regarding the
employment of apprentices, is applicable to this contract if the prime contract
involves Thirty Thousand Dollars ($ 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 calandar
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 calandar week by each worker employed by
Contractor in connection with the public work.
6. Contractor agrees to keep accurate payroll records showing the name, address,
social security number, work classification, straight time and overtime hours worked
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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 his 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 Divison
of Apprenticeship Standards, and shall comply with all of the provisions of Labor
Code Section 1776, et seq., 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, use of improper materials or equipment in construction of 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 wilfull 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 employess, 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 claim 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 damages as aforesaid.
ARTICLE VII. The Contractor shall take out, maintain and pay all premiums 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 with the City of Tustin and its officers, employees and agents as named
additional insureds. The Contractor shall require any subcontractor to provide him
with evidence of the same liability insurance coverages. The failure of the
with evidence of the same liability insurance coverages. The failure of the
Contractor to require any subcontractor to provide him with such evidence of the same
liability insurance coverages shall constitute a material breach of this contract.
The amount of insurance shall not be less than single limit coverage applying to
bodily and personal injury liability and property damage in the amount of $1,000,000.
The following endorsements must be indicated on all certificates of insurance:
(1) The City of Tustin, its officers, employees and agents are named as additional
insureds in the policy as to the work being performed under the contract;
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r�.
(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 covers 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 and until
thirty (30) days written notice is given to the City of Tustin.
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In Witness Whereof, the parties of these presents have hereunto set their hands
and seals the year and the date first above written.
THE CITY OF TUSTIN
DATE OF EXECUTION BY CITY OF TUSTIN-�-°�• 2� 199--3
BY:
(Seal) Mayor of the City of Tu in
ATTEST: ��- " £ . 1A) -
ity Clerk ocnthe City(of Tustin
Contract and and Approved:
Date
4*i Ittorney
APPROVED AS TO CONTENT:
A24i42 J(Z� Date 34 43
,(s t'r. City Engineer GABI CONSTRUCTION CO. INC.,
A California W rDAation
(Seal) BY
STATE OF CALIFORNIA )
COUNTY OF ORANGE )
resident/Treasurer
6iiqie Poppin, a President/Secreta
On Parch 18 , 19 83 before me, the undersigned, a Nortary Public in and for the
said state personally appeared Bill Poppin Jr., known to me to be the
President/Treasurer, and Rosalie Poppin, known to me to be the Vice
President/Secretary of Gabi Construction Co. Inc., the corporation that executed the
within instrument, known to me to be the persons who executed the within instrument on
behalf of the corporation herein named, and acknowledged to me that such corporation
executed the within instrument pursuant to its bylaws or a resolution of its Board of
Directors.
C-6
Witness my
OFFICAL SEAL
official
AtAY .10 RIJSSELL
NOTARY P
NO1 CRY PUBLIC -CALIFORNIA
FRSAID
PRINCIPAL OFFICE IN
ORANGE COUNTY
i
My
Commission Exp. Uaobe; 241, 1986 ,
C-6
Witness my
hand and
official
seal:
NOTARY P
I
N AND
FRSAID
SAT E
RELIA TCE INSURANCE C, VIPANY
HEAD OFFICE, PHILADELPHIA, PENNSYLVANIA
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, That the RELIANCE INSURANCE COMPANY, a corporation duly organized under the laws of the State of
Pennsylvania, does hereby make, constitute and appoint
TODD M. ROHM of BREA, CALIFORNIA
its true and lawful Attorney -in -Fact, to make, execute, seal and deliver for and on its behalf, and as its act and deed
ANY AND ALL BONDS AND UNDERTAKINGS OF SURETYSHIP ----
and to bind the RELIANCE INSURANCE COMPANY thereby as fully and to the same extent as if such bonds and undertakings and other writings
obligatory in the nature thereof were signed by an Executive Officer of the RELIANCE INSURANCE COMPANY and sealed and attested by one other
of such officers, and hereby ratifies and confirms all that its said Attorneys) -in -Fact may do in pursuance hereof.
This Power of Attorney is granted under and by authority of Article V11 of the By -Laws of RELIANCE INSURANCE COMPANY which became
effective September 7, 1978, which provisions are now in full force and effect, reading as follows:
ARTICLE VII — EXECUTION OF BONDS AND UNDERTAKINGS
1. The Board of Directors, the President, the Chairman of the Board, any Senior Vice President, any Vice President or Assistant Vice President
or other officer designated by the Board of Directors shall have power and authority to (a) appoint Attorneys -in -Fact and to authorize them to execute
on behalf of the Company, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and (b)
to remove any such Attorney -in -Fact at any time and revoke the power and authority given to him.
2. Attorneys -in -Fact shall have power and authority, subject to the terms and limitations of the power of attorney issued to them, to execute
and deliver on behalf of the Company, bonds and undertakings, reoognizances, contracts of indemnity and other writings obligatory in the nature thereof.
The corporate seal is not necessary for the validity of any bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory
in the nature thereof.
3. Attorneys -in -Fact shall have power and authority to execute affidavits required to be attached to bonds, recognizances, contracts of indem-
nity or other conditional or obligatory undertakings and they shall also have power and authority to certify the financial statement of the Company and
to copies of the By -Laws of the Company or any article or section thereof.
This power of attorney is signed and sealed by facsimile under and by authority of the following Resolution adopted by the Board of Directors of
RELIANCE INSURANCE COMPANY at a meeting held on the 5th day of June, 1979, at which a quorum wes present, and said Resolution has not been
amended or repealed:
"Resolved, that the signatures of such directors and officers and the seal of the Company may be affixed to any such power of
attorney or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile
signatures or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by
facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached."
IN WITNESS WHERE the RELIANCE IN URANCE COMPANY has cc�sad these presents to be signed by its Vice President, and its corporate seal to
be hereto affixed, this ��h day of t9i.32,
REL►ANC INSzo"CE MPA �J,
O AAd
Vice President
STATE OF Washington
COUNTY OF King ) u'
On this 27th day of July 1982, personally appeared Charles B. Schmalz
to me known to be the Vice -President of the RELIANCE INSURANCE COMPANY, and acknowledged that he executed and attested the foregoing
instrument and affixed the seal of said corporation thereto, and that Article VII, Section 1, 2, and 3 of the By -Laws of said Company and the Resolu-
tion, set forth therein, are still in full force.
My Commission Expires:
May 1 • t 9 86•:. ��ii :�° Notary Public in and for State of W
ashington
Residing at Tacoma
I. Charles J. Falskow , Assistant Secretary of the RELIANCE INSURANCE COMPANY, do hereby certify that the above
and foregoing is a true and correct copy of a Power of Attorney executed by said RELIANCE INSURANCE COMPANY, which is still in full force and
off Oct.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company this 11 day of March 19 83
BOR -1431 Ed. 6/79\datii/ Assistant Secretary���ic�:,��r
CITY OF TUSTIN
• - CERTIFICATE OF Ur INCE AND DESIGNATION OF NAMED Al
IU: CITY OF TUSTIN
300 Centennial Way
Tustin, CA 92680
LAME AND ADDRESS OF INSURED CONTRACTOR
GABI CONSTRUCTION
311 LATCHWOOD LANE
LAME AND ADDRESS OF INSURANCE AGENCY
GENERAL INSURANCE AGENCY
P.O. BOX 6010
s
PR=CT :
CONSTRUCTION OF F. Y. '82-'83 SIDEWALK & CURB
REPAIR PROGRAM
NAME AND ADDRESS OF INSURANCE CCMPANY(IES)
MISSION INS. GROUP, INC. FAIRMONT INS. CO.
P.O. BOX 4375 P.O. BOX 7750
WOODLAND, CA. 91365 BURBANK, CA. 91510-7750
SAYRE & TOSO
2600 WILSHIRE
.nis is to certiry that the policies of insurance -11 nam -
A above, are in force at this time, that the City of Tustin is a named additional insured thereon
is respects claims arising in connection with the hereinabove named Project and that such insur`
ince shall be primary with respect to any other insurance in force Purchased by the City of Tustin
-ype of Insurance Policy Policy Limits of Liability in Thousands
Insurance Canpany Number Expiration Each
Date OCcurrPnrt- AnrTrarr;;4-a
MNERAL LIABILITY
:anprehensive form
(remises -operations
:xplosion and collapse
hazard
3nderground Hazard
'roducts/canpleted
operations hazard
ontractual insurance
3road form property
damage
=ndependent contractors
'ersonal Injury
MISSION MLA0406181
y in7 ury
9-19-83 JProperty Damage $
,UT MC BILE
�IABII,ITY
:apprehensive form
MISSION MLA0406181 9-19-83
aired
:anbined
Bodily Injury $1,000, $1,000,
& property
damage canbined
PERSONAL INJURY $ 1,000,
Bodily Inj ury
(each person)
Bodily Injury $ $
each
Occurrence
tiooi-Ly ink ury &
Property Damage
Canbined $
Bodily Injury &
U �,nbrella form
(Property Damage $ $
�Xt�X SAYRE & TOSO MN019181 9-19-83
Form Canbined $1,000, $1,000,
DRKERS'
1CMPENSATION FAIRMONT F04055 6-23-83 Statutory
and
:MPIJ'JYERS' ( each
LIABILITY $100, accident)
.t is certified that a waiver of subrogation is hereby issued to the City of Tustin as pertains to
he terns of all Workers Canpensation Insurance.
he issuing canpany will give thirty (30) days written notice to the City of Tustin prior to
codification or cancellation. Date Issue: 3-15-83
TO MODIFICATIONS OR ADDITIONS MAY BE MADE d li�ti1AL�*i
O THIS FORM. Authorized Representative of the above-
named insurance canpany(ies)
9/25/82 (P-Jrustin )
C-11
NAME AND ADDRESS OF AGENCY
GENERAL INSURANCE AGENCY
COMPANIES AFFORDING COVERAGES
P.O. BOn 6010
MISSION VIEJO, CA. 92690-4010
COMPANY
LETTER A MISSION WOODLAND HILLS
COMPANY
LETTER
FAIRMONT' BURBANK
NAME AND ADDRESS OF INSURED
COMPANY
LETTER SAYRE S TOSO
GASI CONSTRUCTION
311 LATCHWOOD LANs=
COMPANY D
LETTER
LA HASRA, CA. 90631
COMPANY
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time.
COMPANY
POLICY
Limits of Liability in Thousands
(000)
EACH
OCCURRENCE
AGGREGATE
LETTER
TYPE OF INSURANCE
POLICY NUMBER
EXPIRATION DATE
GENERAL LIABILITY
® COMPREHENSIVE FORM
MLA0406181 *
9-19-83
BODILY INJURY
$
$
® PREMISES—OPERATIONS
PROPERTY DAMAGE
$
$
A
® EXPLOSION AND COLLAPSE
HAZARD
®
UNDERGROUND HAZARD
® PRODUCTS/COMPLETED
OPERATIONS HAZARD
® CONTRACTUAL INSURANCE
BODILY INJURY AND
PROPERTY DAMAGE
$ 1).000P
$ 1 , 000,
® BROAD FORM PROPERTY
COMBINED
DAMAGE
®
INDEPENDENT CONTRACTORS
® PERSONAL INJURY
PERSONAL INJURY
$
AUTOMOBILE LIABILITY
BODILY INJURY
$
pp�7
LTJ
(EACH PERSON)
COMPREHENSIVE FORM
KIOWNED
BODILY INJURY
(EACH ACCIDENT)
$
MLA0406181
9=19-83
AKI
HIRED
PROPERTY DAMAGE
$
KI NON -OWNED
BODILY INJURY AND
1 000
PROPERTY DAMAGE
$
.9 >
COMBINED
EXCESS LIABILITY
C
.:] UMBRELLA FORM
MN019181
9-19-83
BODILY INJURY AND
PROPERTY DAMAGE
$ 1 , 000,
$ 1 000,
❑ OTHER THAN UMBRELLA
COMBINED
,
FORM
WORKERS' COMPENSATION
STATUTORY
B
and
P04055
6-23-83
EMPLOYERS' LIABILITY
$ ,
(EACHACCIDENn
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES
* THE CITY OF TUSTIN, ITS OFFICERS AND EMPLOYEES WHILE ACTING WITHIN THE SCOPE OF THEIR DUTIES
AGAINST ALL CLAIMS ARISING OUT OF OR IN CONNECTION WITH THE WORK T BE PERFORMED
ARE NAMED AS ADDITIONAL INSURED UNDER THE
POLICY.
Cancellation: Should any of the above described policies
be cancelled before the expiration date thereof, the issuing com-
pany will}6(yM)0()ft mail _.40 days
written notice to the below named certificate holderJOAJ (WA
NAME AND ADDRESS OF CERTIFICATE HOLDER:
3-15-83
CITY OF TUSTIN
DATE ISSUED:
300 CENTENNIAL
TUSTIN, CA. 92680
AUTHORIZED REPRESENTATIVE
CORD 25 (Ed. 1 1 -77) ■