HomeMy WebLinkAboutContracts & Agreements_207-2016®RYGINAL
PUBLIC WORKS CONSTRUCTION CONTRACT
This Public Works Construction contract ("Contract") made and entered into this 5TH day of
J7tOWJ ?017 , by and between the City of Redlands, a municipal corporation organized
and existing under the laws of the State of California, (hereinafter "City"), and R B Development
(hereinafter "Contractor"). City and Contractor are sometimes individually
referred to herein as a "Party" and, together, as the "Parties."
In consideration of the mutual promises contained herein, City and Contractor agree as follows:
1. SCOPE OF WORK: Contractor shall furnish all materials and perform all of the work for the
following: RUNWAY 8-26 LIGHTING AND SIGNAGE IMPROVEMENTS PROJECT,
complete all items as required by the Contract Documents (as herein defined) and Specifications
for City's RUNWAY 8-26 LIGHTING AND SIGNAGE IMPROVEMENTS PROJECT, AIP
No. 3-06-0195-014-2016.
2. THE CONTRACT SUM: City shall pay Contractor the sum of $ 820,870.00 (1) as
consideration for its performance of the Work in accordance with the terms and conditions set
forth in the Contract Documents. Pursuant to Public Contract Code Section 22300, Contractor has
the option to deposit securities with an escrow agent as a substitute for retention of earnings
requirement to be withheld by City pursuant to an escrow agreement as set forth in the Public
Contract Code Section 22300. (1) Eight Hundred Twenty Thousand Eight Hundred Seventy and 001100`s DOLLARS
3. TIME FOR COMPLETION: The Work under Base Bid shall be completed within 61 calendar
days from and after the date of the delivery to Contractor of a written Notice to Proceed by City.
Work under Bid Alternate No. 1 shall be completed within 28 calendar days from completion of
Base Bid. Work under Bid Alternate No. 2 shall be completed within 14 calendar days from
completion of Bid Alternate No. 1. Work under Bid AIternate No. 3 shall be completed within 7
calendar days from completion of Bid Alternate No. 2.
4. LIQUIDATED DAMAGES: Contractor's failure to complete the work within the time allowed
will result in damages being sustained by City. Such damages are, and will continue to be,
impracticable and extremely difficult to determine. Accordingly, Contractor shall pay to City, or
have withheld from monies due to Contractor, the sum of $1.000 for each consecutive calendar
day in excess of the specified time for completion of Work.
Execution of the Contract shall constitute agreement by City and Contractor that $1,000 per day is
the estimated damage to City caused by the failure of the Contractor to complete the Work within
the allowed time. Such sum is for liquidated damages and shall not be construed as a penalty, and
may be deducted from payments due Contractor if such delay occurs.
S. CONTRACT DOCUMENTS: This Contract includes all of the Contract documents set forth
herein, to wit; Notice Inviting Bids, Instructions to Bidders, Contractor's Proposal, Bid Bond,
Agreement, Performance Bond, Labor and Material Bond, Plans, General Conditions, General
Requirements, Technical Specifications, and any addenda thereto.
6. ATTORNEYS' FEES: In the event any legal action is commenced to enforce or interpret the
terms or conditions of the Contract documents, the prevailing Party in such action, in addition to
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any costs and other relief, shall be entitled to recover its reasonable attorneys' fees, including fees
for use of in-house counsel by a Party.
7. COMPLIANCE WITH REGULATIONS: The contractor (hereinafter includes consultants)
will comply with the Title VI List of Pertinent Nondiscrimination Acts And Authorities, as they
may be amended from time to time, which are herein incorporated by reference and made a part
of this contract.
8. NON-DISCRIMINATION: The contractor will not discriminate against any employee or
applicant for employment because of race, color, religion, sex, or national origin. The contractor
will take affirmative action to ensure that applicants are employed, and that employees are treated
during employment without regard to their race, color, religion, sex, sexual orientation, gender
identify or national origin. Such action shall include, but not be limited to the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or
termination; rates of pay or other forms of compensation; and selection for training, including
apprenticeship. The contractor agrees to post in conspicuous places, available to employees and
applicants for employment, notices to be provided setting forth the provisions of this
nondiscrimination clause.
9. SOLICITATIONS FOR SUBCONTRACTS, INCLUDING PROCUREMENTS OF
MATERIALS AND EQUIPMENT: The contractor will, in all solicitations or advertisements
for employees placed by or on behalf of the contractor, state that all qualified applicants will
receive considerations for employment without regard to race, color, religion, sex, or national
origin.
10. INFORMATION AND REPORTS: The contractor will send to each labor union or
representative of workers with which he has a collective bargaining agreement or other contract or
understanding, a notice to be provided advising the said labor union or workers' representatives of
the contractor's commitments under this section, and shall post copies of the notice in conspicuous
places available to employees and applicants for employment.
The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965,
and of the rules, regulations, and relevant orders of the Secretary of Labor.
The contractor will furnish all information and reports required by Executive Order 11246 of
September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant
thereto, and will permit access to his books, records, and accounts by the administering agency
and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,
regulations, and orders.
11. SANCTIONS FOR NONCOMPLIANCE: In the event of the contractor's noncompliance with
the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders,
this contract may be canceled, terminated, or suspended in whole or in part and the contractor
may be declared ineligible for further Government contracts or federally assisted construction
contracts in accordance with procedures authorized in Executive Order 11246 of September 24,
1965, and such other sanctions may be imposed and remedies invoked as provided in Executive
Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or
as otherwise provided by law.
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12. INCORPORATION OF PROVISIONS: The contractor will include the provisions of
paragraphs (8) through (11) in every subcontract or purchase order unless exempted by rules,
regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order
11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or
vendor. The contractor will take such action with respect to any subcontract or purchase order as
the administering agency may direct as a means of enforcing such provisions, including sanctions
for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is
threatened with, litigation with a subcontractor or vendor as a result of such direction by the
administering agency the contractor may request the United States to enter into such litigation to
protect the interests of the United States.
13. TITLE VI LIST OF PERTINENT NONDISCRIMINATION ACTS AND AUTHORITIES:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin);
• 49 CFR part 21 (Non-discrimination In Federally -Assisted Programs of The Department of
Transportation—Effectuation of Title VI of The Civil Rights Act of 1964);
• The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42
U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been
acquired because of Federal or Federal -aid programs and projects);
• Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended,
(prohibits discrimination on the basis of disability); and 49 CFR part 27;
• The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits
discrimination on the basis of age);
a Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as amended,
(prohibits discrimination based on race, creed, color, national origin, or sex);
• The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and
applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975
and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms
"programs or activities" to include all of the programs or activities of the Federal -aid
recipients, sub -recipients and contractors, whether such programs or activities are Federally
funded or not);
• Titles 11 and III of the Americans with Disabilities Act of 1990, which prohibit discrimination
on the basis of disability in the operation of public entities, public and private transportation
systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131 –
12189) as implemented by Department of Transportation regulations at 49 CFR parts 37 and
38;
• The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123)
(prohibits discrimination on the basis of race, color, national origin, and sex);
• Executive Order 12898, Federal Actions to Address Environmental Justice in Minority
Populations and Low -Income Populations, which ensures non-discrimination against minority
populations by discouraging programs, policies, and activities with disproportionately high
and adverse human health or environmental effects on minority and low-income populations;
• Executive Order 13166, Improving Access to Services for Persons with Limited English
Proficiency, and resulting agency guidance, national origin discrimination includes
discrimination because of limited English proficiency (LEP). To ensure compliance with
Title VI, you must take reasonable steps to ensure that LEP persons have meaningful access to
your programs (70 Fed. Reg. at 74087 to 74100);
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Title IX of the Education Amendments of 1972, as amended, which prohibits you from
discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq).
14. BREACH OF CONTRACT: Any violation or breach of terms of this contract on the part of the
Contractor or its Subcontractors may result in the suspension or termination of this contract or
such other action that may be necessary to enforce the rights of the parties of this agreement.
The City will provide Contractor written notice that describes the nature of the breach and
corrective actions the Contractor must undertake in order to avoid termination of the Contract.
The City reserves the right to withhold payments to Contractor until such time the Contractor
corrects the breach or the City elects to terminate the contract. The City's notice will identify a
specific date by which the Contractor must correct the breach. The City may proceed with
termination of the contract if the Contractor fails to correct the breach by deadline indicated in the
City's notice.
The duties and obligations imposed by the Contract Documents and the right and remedies
available thereunder are in addition to, and not a limitation of, any duties, obligations, rights and
remedies otherwise imposed or available by law.
15. TERMINATION FOR DEFAULT: The terms and conditions in paragraph 80-08 of the
General Provisions of these Contract Documents are hereby made a part of this agreement as fully
as if set out at length herein.
16. TERMINATION FOR CONVENIENCE: The City may terminate this contract in whole or in
part at any time by providing written notice to the Contractor. Such action may be without cause
and without prejudice to any other right or remedy of City. Upon receipt of a written notice of
termination, except as explicitly directed by the City, the Contractor shall immediately proceed
with the following obligations regardless of any delay in determining or adjusting amounts due
under this clause:
(1) Contractor must immediately discontinue work as specified in the written notice.
(2) Terminate all subcontracts to the extent they relate to the work terminated under the notice.
(3) Discontinue orders for materials and services except as directed by the written notice.
(4) Deliver to the City all fabricated and partially fabricated parts, completed and partially
completed work, supplies, equipment and materials acquired prior to termination of the work
and as directed in the written notice.
(5) Complete performance of the work not terminated by the notice.
(6) Take action as directed by the City to protect and preserve property and work related to this
contract that City will take possession.
City agrees to pay Contractor for:
a) completed and acceptable work executed in accordance with the contract documents prior to
the effective date of termination;
b) documented expenses sustained prior to the effective date of termination in performing work
and furnishing labor, materials, or equipment as required by the contract documents in
connection with uncompleted work;
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c) reasonable and substantiated claims, costs and damages incurred in settlement of terminated
contracts with Subcontractors and Suppliers; and
d) reasonable and substantiated expenses to the contractor directly attributable to City's
termination action
City will not pay Contractor for loss of anticipated profits or revenue or other economic loss
arising out of or resulting from the City's termination action.
The rights and remedies this clause provides are in addition to any other rights and remedies
provided by law or under this contract.
17. RESOLUTION OF CONSTRUCTION CLAIMS: Claims by Contractor in the amount of
$375,000 or less shall be made by Contractor and processed by the City pursuant to the provisions
of Part 3, Chapter 1, Article 1.5 of the Public Contract Code (commencing with Section 20104).
All claims shall be in writing and include the documents necessary to substantiate the claim.
Nothing in subdivision (a) of Public Contract Code Section 20104.2 shall extend the time limit or
supersede the notice requirements provided in this case from filing claims by Contractor.
18. ELIGIBILITY OF CONTRACTOR/SUBCONTRACTOR: Contractor and all of its
subcontractors shall abide by California Public Contract Code, Section 6109, and California
Labor Code Sections 1777.1 and/or 1777.7, and certify that they are not debarred and are eligible
to work on this project.
19. ASSIGNMENT OF AGREEMENT: No assignment by a Party of any rights or interests under
this Contract shall be binding on another Party without the written consent of the Party sought to
be bound.
20. SUCCESSORS AND ASSIGNS: City and Contractor each binds itself and their respective
successors and assigns in respect to all covenants, agreements, and obligations contained in the
Contract Documents.
21. SEVERABILITY: Any provision or part of the Contract documents held to be void or
unenforceable under any law or regulation shall be deemed stricken, and all remaining provisions
zn
shall continue to be valid and binding upon City and Contractor.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first
written above.
(SEAL)
ATTEST:
Clerk, City of Redlands
County of San Bernardino, California
City of Redlands
(Owner)
B r
Mayor, City of Redlands,
County of San Bernardino, California
(SEAL)
R B Development
Name of Contractor
B ,^ Randy Bales
Signature of Au rued Agent
Owner
Title
Signature of Authorized Agent (if necessary)
Title
449906
Contractor's License No.
f:
POLICYHOLDER COPY
P_0, BOX 8192, PLEASANTON, CA 94888
CERTIFICATE OF WORKERS` COMPENSATION INSURANCE
ISSUE DATE: 09-30-2016 GROUP:
POLICY NUMBER: 1515029-2016
CERTIFICATE ID: 87
CERTIFICATE EXPIRES: 01-01-2017
01-01-2016/01-01-2017
CITY OF REDLANDS SP JOB:RUNWAY 8-26 LIGHTING AND -SIGNAGE
IMPROVEMENTS PROJECT
PO BOX 3005 REDLANDS
REDLANDS CA 92373-1505 CA 92373
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
�.7
Authorized Representative President and CEO
UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING:
THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER;
EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING
CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS'
COMPENSATION LAW.
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-1999 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 2016--09-30 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME:
CITY OF REDLANDS
EMPLOYER
BALES, RANDALL B
531 COUNTRY CLUB DRIVE
BIG BEAR CITY CA 92314
(REV.7-20t4)
SP
[P16,SGI
PRINTED : 09-30-2016
SP
RBDEVEL-02 SEDGEI
'`ecoCERTIFICATE OF LIABILITY INSURANCE
��"
DATE(M1'YY)
9/3012016 DlY
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER License # 0757776
HUB International Insurance Services Inc.
P. O. Box 5345
Riverside, CA 92517
NAME;CONTACT Patricia Finnerty
NAME;
PHONE 951 779-8545 FAX
Alc No E:t : ( ) Na :(951) 231-2572
E-MAIL
E-MAILADDRESS: Cal .CPU^^Vhub international.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: Scottsdale Insurance Company 41297
INSURED
INSURER a :
INSURER C:
R.B, Development
Randall Bales
P.O. BOX 2384
INSURER D :
INSURER E:
Big Bear City, CA 92314
INSURER F:
02104I2016
COVLRAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
D
INSD
BR
WVD
POLICYNUMBER
POLICY EFF
MMIDDIYYW
POLICY EXP
MM1DD[YYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE S 1,000,000
CLAIMS MADE FRI OCCUR
X
BCS0033715
02104I2016
02I0412017
PREMISES Eaoccurrence S 100,000
MED EXP (Anyone person) 5 0
X B11PD Ded: $5,000
PERSONAL BADV INJURY 5 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000,00()
POLICY [:]PROJECT LOC
PRODUCTS -COMPIOPAGG $ 2,000,000
S
OTHER:
AUTOMOBILE LABILITY
COMBINED SINGLE LIMIT S
Ea accident
BODILY INJURY (Per person) S
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident) 5
PROPERTY DAMAGE $
Per acciden4
HIRED AUTOS NON -OWNED
AUTOS
S
UMBRELLA UAB
X
OCCUR
EACH OCCURRENCE 5 1,000,000
AGGREGATE $ 1,000,000
A
X
EXCESS LIAB
CLAIMS -MADE
XLS0098919
02/0412016
02/04/2017
DED I X I RETENTIONS 0
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE❑
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED?
N 1 A
(Mandatory in NH)
E.L. DISEASE -EA EMPLOYE $
Ifyes, descdbe under
DESCRIPTION OF OPERATIONS betow
E.4. DISEASE -POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 161, Additional Remarks Schedule, may be attached if more space is required)
City of Redlands is Additional Insured with regard to General Liability per attached endorsement form CG2010 04113. General Liability Insurance is Primary
and Non -Contributory when required by written contract per attached endorsement form CG2001 04113. Excess Liability is following form for the General
Liability Additional Insured and Primary and Non -Contributory Wording.
"Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be
afforded within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thirty (30) days of
the cancellation date, except in the event the cancellation is due to non-payment of premium, in which case Hub will provide to such certificate holder notice
of such cancellation within ten (10) days of the cancellation date."
i
C:FRTIFICATF HOI f1FR CANCELLATION
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CI of Redlands
City
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Quality of Life Department
P.O. Box 3005
AUTHORIZED REPRESENTATIVE
Redlands, CA 92373
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER! BCS0033716
COMMERCIAL GENERAL LIABILITY
CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -- OWNERS, LESSEES OR
CONTRACTORS -SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILI'T'Y COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Or anizatio s
Locations Of Covered operations
ANY PERSON OR ORGANIZATION WHEN YOU
ALL VOCATIONS
AND SUCH PERSON OR ORGANIZATION HAVE
AGREED TAT WRITING IN A CONTRACT OR
AGREEMENT, EXECi7T8D PRIOR TO THE
nOCCURREVCE" TO WEICH THIS INSURANCE
APPLIES, THAT SUCH PERSON OR
ORGANIZATION DIE ADDED AS AN ADDITIONAL
INSURED ON YOUR POLICY
Information required to complete this Schedule if not shown above, will be shown in the Declarations.
A. Section 11 — Who Is An Insured is amended to 2. If coverage provided to the additional insured is
include as an additional insured the person(s) or required by a contract or agreement, the
organization(s) shown in the Schedule, but only insurance afforded to such additional insured
with respect to liability for "bodily injury", "property will not be broader than that which you are
damage" or "personal and advertising injury" required by the contract or agreement to
caused, in whole or in part, by: provide for such additional insured.
1. Your acts or omissions: or
2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law: and
CG 20 10 0413 C Insurance Services Office, Inc., 2012 Page 1 of 2
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Lirift Of insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
t. Required by the contract or agreerncnt; or
Page 2 of 2
2. Available under the applicable Limits of
Insuranceshown in the Declarations;
whichever Is fess.
This endorsement shall not increase the
applicable umits of Insurance shown in the
Declarations.
CO Insurance Services Office, inc., 2012
Inwec Copy
CG 2010 0413
A� o® CERTIFICATE OF LIABILITY INSURANCE
ATE
MM/DDIYYYY
D09/29/20 6 )
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Denise K Hudson Insurance Agency, Inc
License # OB86530
StateFarm 1045 W Katella Ave Ste 240
t�s Orange, CA 92867
CONTACT LORRIE SASAN
PIAMEie FAx
A C o E t .714-633 8118 AIc Not:714 -633-3720
ADDRE SS: lorrie@denisekhudsan.cam
INSURER(S) AFFORDING COVERAGE NAIC#
INSURERA:State Farm Mutual Automobile Insurance Company 25178
INSURED
INSURER B;
INSURER C:
BALES, RANDY DBA RB DEVELOPMENT
INSURER D:
PO BOX 2384
INSURER E:
BIG BEAR CITY, CA 92314-2384
INSURER F:
$
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
MM DICY DI EFF
POLMMIDDf EXP
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE EIOCCUR
EACH OCCURRENCE $
PREMISES Ea cccu ince S
MED EXP fAny one person) s
PERSONAL R ADV INJURY S
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO ❑ LOC
JECT
ROTHER:
GENERAL AGGREGATE S
PRODUCTS - COMP/OP AGG 5
$
A
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED X SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS
Y
414 0543 -A13 -75G
2012 FORD F250
VIN 1FD7X2A6XCEC06390
0711312016
01/13/2017
W_= OtSINGLE LIMIT s
BODILY INJURY (Per person) S 1,000,000
BODILY INJURY (Per accident) S 1,000,000
PROPERTY DAMAGE 5 1,aoo,0o0
Peraccident
S
UMBREI-LA LIAB
EXCESS LIAB
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE S
AGGREGATE S
DED RETENTION S
5
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PRCPRIE roRIPARTNERIEXECUTIVE❑NIA
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $
E.L. DISEASE -EA EMPLOYE S
E.L. DISEASE -POLICY LIMIT S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Additional Insured Endorsement requested and will follow
CERTIFICATE HOLDER CANCELLATION
City of Redlands
Quality of Life Department
P.O. Box 3005
Redlands, CA 92373
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014
A� " CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDNYYY)
0912912016
THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE -A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must he endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Denise K Hudson Insurance Agency, Inc
Tense # aaa653o
SfafeFarm 1045 W Katella Ave Ste 240
�., Orange, CA 92867
CONTACT LORRIE SASAN
NAME:FAX
N E .714-633-6118 AIC No:714-633-3720
E-MAIL
ADDRESS: lorrie@denisekhudson.com
INSURERSIAFFORDING COVERAGE NA€C
INSURER A:State Farm Mutual Automobile Insurance Company 25178
INSURED
INSURER B:
BALES, RANDY DBA RB DEVELOPMENT
INSURER C:
PO BOX 2384
INSURER P:
E:
BIG BEAR CITY, CA 92314-2384INSURER
INSURER F:
S
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1NSR
LTR
TYPE OF INSURANCE
ADDL
SUBRpgLICY
POLICY NUMBER
EFF
MMIDD
POLICY EXP
MMR]D
LIMITS
COMMERCIAL GENERAL LIABILITY
LA,M.-MADE
COCCUR
EACH OCCURRENCE S
DAMAGES RENTED
PREMISES Ea Occurrence 5
MED RXP fAny one person) $
PERSONALB,ADVINJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYPRO r-1LOG
JECT
OTHER:
GENERAL AGGREGATE $
PRODUCTS -COMPIOPAGG S
S
A
AUTOMOBILE
X
IS
LIABILITY
ANY AUTO
ALLOWNED �: SCHEDULED
NON -OWNED AUTOS
HIRED AUTOS X AUTOS
y
324 2605 -E13 -75H
08 FORD F350 SD FLATBED
1 FDWF36R88EA03271
os11312p16
11113!2016
COMBINED SINGLE LIMIT S
BODILYINJURY (Per person) S 1,000,000
BODILY INJURY (Peraccident) $ 1,000,000
PROPERTY DAMAGE 1,000,000
Peraccident
Is
UMBRELLA LIABOCCUR
EXCESS LIAR
HCLAIMS-MADE
EACH OCCURRENCE S
AGGREGATE $
DEO I I RETENTION $
S
WORKERS COMPENSATION
AND EMPLOYERS` LIABILITY YIN
ANY PROPRIETORIPARTNERIEXEGUTIVE E-1
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER OTH-
STATUTE I I ER
E.L. EACH ACCIDENT S
E.L. DISEASE - EA EMPLOYEd S
E.L. DISEASE- POLICY LIMIT S
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 161, Additional Remarks Schedule, maybe attached if more space is required)
Additional Insured Endorsement requested and will follow
City of Redlands
Quality of Life Department
P.O. Box 3005
Redlands, CA 92373
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014