HomeMy WebLinkAboutContracts & Agreements_109-2020 NPS 2.2(4/23/20)
AGREEMENT TO PERFORM NON-PROFESSIONAL SERVICES
FOR IMPROVEMENT TO PUBLIC BUILDINGS AND GROUNDS
This agreement for the provision of sewer line roach control ("Agreement") is made and
entered in this 1st day of July, 2020 ("Effective Date"), by and between the City of Redlands, a
municipal corporation ("City") and Golden Bell Products, Inc ("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
ARTICLE 1 —ENGAGEMENT OF CONTRACTOR
1 1 City hereby engages Contractor to perform sewer line roach control services for City(the
"Services")
1 2 The Services shall be performed by Contractor in a professional manner, and Contractor
represents that it has the skill and the professional expertise necessary to provide the
Services to City at a level of competency presently maintained by other practicing
professional Contractors in the industry providing like and similar types of Services
ARTICLE 2—RESPONSIBILITIES OF CONTRACTOR
2 1 The Services that Contractor shall perform are more particularly described in Exhibit
"A," titled "Scope of Services," which is attached hereto and incorporated herein by
reference
2 2 Contractor shall comply with all applicable federal, state and local laws and regulations
in the performance of the Services including, but not limited, to all applicable Labor
Code and prevailing wage laws and non-discrimination laws, including the Americans
with Disabilities Act Pursuant to Labor Code section 1773.2, copies of the prevailing
rates of per diem wages as determined by the Director of the California Department of
Industrial Relations for each craft, classification or type of worker needed to undertake
the Services are on file at City's Municipal Utilities and Engineering Department, located
at the Civic Center, 35 Cajon Street, Suite 15A (Mailing P 0 Box 3005), Redlands,
California 92373
2 3 Contractor acknowledges that if it violates the Labor Code provisions relating to
prevailing wages that City may enforce such provisions by withholding payments to
Contractor or its subcontractors pursuant to Labor Code section 1771 6
2 4 If Contractor executes an agreement with a subcontractor to perform any portion of the
Services, Contractor shall comply with Labor Code sections 1775 and 1777 7, and shall
provide the subcontractor with copies of the provisions of Labor Code sections 1771,
1775, 1776, 1777 5, 1813 and 1815 Contractor acknowledges that the statutory
provisions establishing penalties for failure to comply with state wage and hour laws and
to pay prevailing wages may be enforced by City pursuant to Labor Code sections 1775
and 1813
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2 5 Contractor and its subcontractors shall comply with the provisions of Labor Code section
1776 regarding payroll records maintenance, certifications, retention and inspection
2 6 Contractor acknowledges that eight (8) hours constitutes a legal day's work pursuant to
Labor Code section 1810
2 7 Contractor shall comply with the provisions of Labor Code section 1777 5 as to
apprenticeships, and Labor Code sections 1771, 1775, 1776, 1777 5, 1813 and 1815
2.8 Pursuant to Public Contract Code section 7103 5(b), Contractor offers and agrees to
assign to City all rights, title and interest in and to all causes of action it may have under
section 4 of the Clayton Act (15 U S C section 15) or under the Cartwright Act (Chapter
2 (commencing with section 16700) of Part 2 of Division 7 of the Business and
Professions Code), arising from purchases of goods, goods or materials pursuant to this
Agreement
ARTICLE 3—RESPONSIBILITIES OF CITY
3 1 City shall make available to Contractor information in its possession that may assist
Contractor in performing the Services
3 2 City designates Rudolph S Chow, P E , Municipal Utilities and Engineering Director, as
City's representative with respect to performance of the Services, and such person shall
have the authority to transmit instructions, receive information, interpret and define
City's policies and decisions with respect to performance of the Services
ARTICLE 4—PERFORMANCE OF SERVICES
4 1 Contractor shall perform and complete the Services in a prompt and diligent manner
The Services shall commence as of the Effective Date of this Agreement
The term of this Agreement shall be for a period of one (1) year from the Effective Date
of this Agreement (the"Initial Term") The City shall have the option to extend the Initial
Term of this Agreement by one (1) additional one-year term (an "Extended Term"), on
the same terms and conditions, by providing written notice to Contractor at least thirty
(30) days prior to the expiration of the Initial Term or any Extended Term The Initial
Term and the Extended Terms are collectively referred to herein as the "Term" of this
Agreement
4 2 Contractor shall furnish a labor and material bond in the form attached hereto as Exhibit
"B," which is attached hereto and incorporated herein by reference, in an amount equal to
one hundred percent (100%) of the total compensation to be paid to Contractor pursuant to
this Agreement
ARTICLE 5 —PAYMENTS TO CONTRACTOR
5 1 Total compensation for Contractor's performance of the Services shall not exceed the
amount of fifty five thousand dollars ($55,000) for the Services provided during the
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NPS 2.2(4/23/20)
Initial Term Should this Agreement be extended, the compensation for Contractor's
performance for the Services shall not exceed the amount of fifty five thousand dollars
($55,000) for the Extended Term, bringing the total possible amount of compensation to
a not-to-exceed amount of one hundred ten thousand dollars ($110,000) For the Initial
Term and Extended Term, City shall pay Contractor on a time and materials basis up to
the not to not-to-exceed amount in accordance with the rates specified in Exhibit "B,"
titled "Price and Fee Bid Sheet," which is attached hereto and incorporated herein by
reference
5 2 Contractor shall submit monthly invoices to City describing the Services performed
during the preceding month Contractor's invoices shall include a brief description of the
Services performed, the dates the Services were performed, the number of hours spent
and by whom City shall pay Contractor no later than thirty (30) days after receipt and
approval by City of Contractor's invoice
5 3 Any notice or other communication required, or which may be given, pursuant to this
Agreement, shall be in writing Any such notice shall be deemed delivered (i) on the date
of delivery in person, (ii) five (5) days after deposit in first class registered mail, with
return receipt requested, (iii) on the actual delivery date if deposited with an overnight
courier, or (iv) on the date sent by facsimile, if confirmed with a copy sent
contemporaneously by first class, certified, registered or express mail, in each case
properly posted and fully prepaid to the appropriate address set forth below, or such other
address as a Party may provide notice in accordance with this section
City Contractor
City Clerk Michelle Webster, Program Manager
City of Redlands Golden Bell Products, Inc
35 Cajon Street P O Box 366
P O Box 3005 (mailing) Atwood, CA 92811
Redlands, CA 92373 info@goldenbellproducts coin
jdonaldson@cityofredlands org (714) 363-3985
(909) 798-7531 (714) 997-4807
ARTICLE 6—INSURANCE AND INDEMNIFICATION
6 1 The following insurance coverage required by this Agreement shall be maintained by
Contractor for the duration of its performance of the Services Contractor shall not
perform any Services unless and until the required insurance listed below is obtained by
Contractor Contractor shall provide City with certificates of insurance and endorsements
evidencing such insurance prior to commencement of the Services Insurance policies
shall include a provision prohibiting cancellation or modification of the policy except
upon thirty(30) days prior written notice to City.
A Workers' Compensation and Employer's Liability insurance in the amount that meets
statutory requirements with an insurance carrier acceptable to City, or certification to
City that Contractor is self-insured or exempt from the workers' compensation laws
of the State of California Contractor shall execute and provide City with Exhibit"D,"
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NPS 2.2(4/23/20)
titled "Workers' Compensation Insurance Certification," which is attached hereto and
incorporated herein by this reference, prior to performance of the Services
B Comprehensive General Liability insurance with carriers acceptable to City in the
minimum amount of One Million Dollars ($1,000,000) per occurrence and Two
Million Dollars ($2,000,000) aggregate, for public liability, property damage and
personal injury is required City shall be named as an additional insured and such
insurance shall be primary and non-contributing to any insurance or self-insurance
maintained by City
C. Business Auto Liability coverage, with minimum limits of One Million Dollars
($1,000,000) per occurrence, combined single limit bodily injury liability and
property damage liability This coverage shall include all Contractor owned vehicles
used in connection with Contractor's provision of the Services, hired and non-owned
vehicles, and employee non-ownership vehicles City shall be named as an additional
insured and such insurance shall be primary and non-contributing to any insurance or
self-insurance maintained by City
6.2 Contractor shall defend, indemnify and hold harmless City and its elected officials,
employees and agents from and against any and all claims, losses or liability, including
attorneys' fees, arising from injury or death to persons or damage to property occasioned
by any negligent act or omission by, or the willful misconduct of, Contractor, or its
officers, employees and agents in performing the Services
ARTICLE 7—CONFLICTS OF INTEREST
7 1 Contractor covenants and represents that it does not have any investment or interest in
any real property that may be the subject of this Agreement or any other source of
income, interest in real property or investment that would be affected in any manner or
degree by the performance of Contractor's Services Contractor further covenants and
represents that in the performance of its duties hereunder, no person having any such
interest shall perform any Services under this Agreement
7 2 Contractor agrees it is not a designated employee within the meaning of the Political
Reform Act because Contractor
A. Does not make a governmental decision whether to.
(i) approve a rate, rule or regulation, or adopt or enforce a City law,
(ii) issue, deny, suspend or revoke any City permit, license, application,
certification, approval, order or similar authorization or entitlement,
(iii) authorize City to enter into, modify or renew a contract,
(iv) grant City approval to a contract that requires City approval and to which
City is a party, or to the specifications for such a contract,
(v) grant City approval to a plan, design, report, study or similar item,
(vi) adopt, or grant City approval of, policies, standards or guidelines for City
or for any subdivision thereof
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NPS 2.2(4/23/20)
B Does not serve in a staff capacity with City and in that capacity, participate in
making a governmental decision or otherwise perform the same or substantially
the same duties for City that would otherwise be performed by an individual
holding a position specified in City's Conflict of Interest Code under Government
Code section 87302
7 3 In the event City determines that Contractor must disclose its financial interests,
Contractor shall complete and file a Fair Political Practices Commission Form 700,
Statement of Economic Interests, with the City Clerk's office pursuant to the written
instructions provided by the City Clerk
ARTICLE 8—GENERAL CONSIDERATIONS
8 1 In the event any action is commenced to enforce or interpret any of the terms or
conditions of this Agreement the prevailing Party shall, in addition to any costs and other
relief, be entitled to the recovery of its reasonable attorneys' fees, including fees for the
use of in-house counsel by a Party
8 2 Contractor shall not assign any of the Services, except with the prior written approval of
City and in strict compliance with the terms and conditions of this Agreement Any
assignment or attempted assignment without such prior written consent may, in the sole
discretion of City, results in City's immediate termination of this Agreement
8 3 Contractor is for all purposes under this Agreement an independent contractor and shall
perform the Services as an independent contractor Neither City nor any of its agents
shall have control over the conduct of Contractor or Contractor's employees, except as
herein set forth Contractor shall supply all necessary tools and instrumentalities required
to perform the Services Assigned personnel employed by Contractor are for its account
only, and in no event shall Contractor or personnel retained by it be deemed to have been
employed by City or engaged by City for the account of, or on behalf of City Contractor
shall have no authority, express or implied, to act on behalf of City in any capacity
whatsoever as an agent, nor shall Contractor have any authority, express or implied, to
bind City to any obligation
8 4 This Agreement may be terminated by City, in its sole discretion, by providing not less
than five (5) days prior written notice to Contractor of City's intent to terminate If this
Agreement is terminated by City, an adjustment to Contractor's compensation shall be
made, but (i) no amount shall be allowed for anticipated profit or unperformed Services,
and (ii) any payment due Contractor at the time of termination may be adjusted to the
extent of any additional costs to City occasioned by any default by Contractor Upon
receipt of a termination notice, Contractor shall immediately discontinue its provision of
the Services and, within five (5) days of the date of the termination notice, deliver or
otherwise make available to City, copies (in both hard copy and electronic form, where
applicable) of project related data, design calculations, drawings, specifications, reports,
estimates, summaries and such other information and materials as may have been
accumulated by Contractor in performing the Services Contractor shall be compensated
on a pro-rata basis for Services completed up to the date of termination
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NPS-2.2(4/23/20)
8 5 Contractor shall maintain books, ledgers, invoices, accounts and other records and
documents evidencing costs and expenses related to the Services for a period of three (3)
years, or for any longer period required by law, from the date of final payment to
Contractor pursuant to this Agreement Such books shall be available at reasonable times
for examination by City at the office of Contractor
8 6 This Agreement, including the Exhibits incorporated herein by reference, represents the
entire agreement and understanding between the Parties as to the matters contained
herein, and any prior negotiations, written proposals or verbal agreements relating to such
matters are superseded by this Agreement Except as otherwise provided for herein, any
amendment to this Agreement shall be in writing, approved by City and signed by City
and Contractor.
8 7 This Agreement shall be governed by and construed in accordance with the laws of the
State of California
8 8 If one or more of the sentences, clauses, paragraphs or sections contained in this
Agreement is declared invalid, void or unenforceable by a court of competent
jurisdiction, the same shall be deemed severable from the remainder of this Agreement
and shall not affect, impair or invalidate the remaining sentences, clauses, paragraphs or
sections contained herein, unless to do so would deprive a Party of a material benefit of
its bargain under this Agreement
IN WITNESS WHEREOF, duly authorized representatives of City and Contractor have
signed in confirmation of this Agreement
CITY OF REDLANDS GOLDEN BELL PRODUCTS, INC
B By
Paul W Foster, Mayor Michelle W ster, Program Manager
ATTEST
J e Donaldson, City Clerk
6
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NPS 2.2(4/23/20)
EXHIBIT "A"
SCOPE OF SERVICES
Provide sewer line roach control services for the City's Wastewater Division's on an as needed basis
Scope of services include but are not limited to
I Supply and apply Instecta®45600-1 insecticidal latex coating in sanitary manholes,
2 Provide project coordination, proper supervision, and appropriate traffic control at the job site
during all phases of work,
3 Work will take place in accessible alleys,yards,parking lots, and streets,
4 Prepare and apply according to manufacturer's specifications for preparation instructions treating
to depth of seven(7) feet or less, with an approximate area of 100 square feet per manhole and at
the manufacturer's recommended label rates of five (5) manholes per gallon, not to exceed three
(3)pints per manhole,
5 When applying remove existing sewer manhole covers, sweep and clean the inside of the cover
area, spray treatment, reseat the cover and mark the reinstalled cover with a painted white line
extending from the manhole cover to the adjoining pavement, indicating that the cover has been
reseated properly and firmly,
6 Mark each manhole cover with an identifying white dot after treatment,
7 Contractor to provide liability for damage caused by covers that have been reinstalled and marked
is limited to 24 hours Covers that are damaged or will not reseat properly must be immediately
reported to designate City staff,
8 Contractor to notify City of inaccessible manholes,
9 Guarantee the application for eighteen (18) months from the date of treatment If more than 50
living roaches are found in a manhole during the warranty period, the manhole must then be re-
treated by contractor at no additional charge or obligation to City Contractor will retreat any
manhole in which inspections report live roaches within fourteen (14) calendar days after
notification, providing more than 50 live roaches are found inside the manhole during two
inspections occurring two days apart,
10 Report number and location of manholes treated when submitting billing invoices Contractor
will indicate in writing on each quarter section map, the number of manholes treated and
applicator's name with the date of completion and enter relevant data into the City's GIS
mapping system This will serve as the record of application for the necessary Agencies and
warranty information (City to supply maps and access to GIS mapping system), and
11 No more than 90 calendar days will elapse between date of notice to proceed and completion of
application A reasonable delay for potentially unfavorable weather will be mutually agreed upon
by City and Contractor
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L 1ca\djm\Agreements\Golden Bell-Roach Control FY 20 21 doc.jn
THE FINAL PREMIUM IS This bond was issued in two(2)
original counterparts
PREDICATED ON THE
FINAL CONTRACT AMOUNT
NPS-2.2(4123120)
Bond No 024245262
EXHIBIT "B" Premium $1,650 00
LABOR AND MATERIAL BOND
Whereas, the City of Redlands, State of California, and Golden Bell Products, Inc.(hereinafter
designated as "Principal") have entered into an agreement (the "Agreement") whereby Principal agrees to
sewer line roach control (the"Work"),which said agreement,dated July 1, 2020, and identified as sewer line
roach control is hereby referred to and made a part hereof,and
Whereas, under the terms of the Agreement, Principal is required before commending the
performance of the Work,to file a good and sufficient Labor and Material bond with the City of Redlands to
secure the claims to which reference is made in Title 3 (commencing with Section 9550) of Part 6 of Division
4 of the Civil Code of the State of California
Now, therefore, said Principal and the undersigned as corporate surety, are held firmly bound unto
the City and all contractors, subcontractors, laborers, material men and other persons employed in the
performance of the Agreement and referred to in the aforesaid Code of Civil Procedure in the sum of one
hundred ten thousand dollars ($110,000) for materials furnished or labor thereon of any kind, or fot amounts
due under the Unemployment Insurance Act with respect to such work of labor, that said surety will pay the
same in an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this
bond, will pay, in addition to the face amount thereof, costs and reasonable expenses and fees, including
reasonable attorneys' fees, Incurred by the City in successfully enforcing such obligation, to be awarded and
fixed by the court,and to be taxed as costs and to be included in the judgment therein rendered
*The Ohio Casualty Insurance Company
It is hereby expressly stipulated and agreed that this bond shall insure to the benefit of any and all
persons, companies and corporations entitled to file claims under Title 3 (commencing with Section 9550) of
Part 6 of Division 4 of the Civil Code,so as to give a right of action to them or their assigns in any suit brought
upon this bond
Should the condition of this bond be fully performed,then this obligation shall become null and void,
otherwise it shall be and remain in full force and effect
The surety hereby stipulates and agrees that no change,extension of time,alteration or addition to the
terms of the Agreement or the specifications accompanying the same shall in any manner affect its obligations
on this bond,and it does hereby waive notice of any such change,extension of time,alteration of addition
In witness whereof,this instrument has been duly executed by the Principal and surety above named,
on May 29th ,2020
(SEAL) (S --.
Golden Bell Products, Inc T e Ohio Casual,r, surance Com.an
'ontrac o St t
� �, . BY\
(Signature) (Signature) Daniel kabay, Attorney-in-Fact
Address
790 The City Drive South, Suite 200
Orange, CA 92868
(Seal and Notarial Acknowledgment of Telephone(714)937-1400
Surety)
8
L:\caid}mlAgreementsLGolden Bell Roach Control FY 20-2t.doc.jn
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 Orange _)
On 5/29/2020 before me, Melissa Ann Vaccaro, Notary Public
(insert name and title of the officer)
personally appeared Daniel Huckabay
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
• MELISSA ANN V A(,CARp
WITNESS my hand and official seal COMM 2241394
, Notary Public-California a
ORANGE COUNTY
x�k
My C film Expires May 12 2022
Signature -O-rO (Seal)
Melissa Ann Vaccaro
w This Power of Attorney limits the acts of those named herein and they have no authority to
pee bind the Company except in the manner and to the extent herein stated
` Bond No 024245262
1�l�
11er Liberty Mutual Insurance Company
FsMutual. The Ohio Casualty Insurance Company Certificate No 8202806-969561
West American Insurance Company
SURETY
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana(herein collectively called the Companies"),pursuant to and by authority herein set forth,does hereby name constitute and appoint
Arturo Ayala,Daniel Huckabay Frank Morones R Nappi Dwight Reilly,Shaunna Rozelle Ostrom,Ben Stang,Michael D Stone
all of the city of Orange state of CA each individually if there be more than one named its true and lawful attorney in fact to make
execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed any and all undertakings bonds recognizances and other surety obligations in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons
IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 31st day of December , 2019
— Liberty Mutual Insurance Company
P4 Ittsr. -Y INS INsu, The Ohio Casualty Insurance Company y.,
sa tpgP°Agr'c, a eeseie > y v��0R9O,4r 4.. West American Insurance Company a
3 Fo m 4 `o m 2* a` Fo rn
N rs1992 0 ° , 191J .�I 4�991 o a)
r¢�y�swcyusdD .° niuv��'dad rS 'Nauu� bb4,../742- c
°�) * r� �tid ).- ./14 * 0 By .a
asDavid M Carey,Assistant Secretary a
cis State of PENNSYLVANIA ss
II) a,County of MONTGOMERY to
c
o
z On this 31st day of December 2019 before me personally appeared David M Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
o is Company The Ohio Casualty Company and West Amencan Insurance Company and that he as such being authorized so to do execute the foregoing instrument for the purposes m
therein contained by signing on behalf of the corporations by himself as a duly authorized officer
IN WITNESS WHEREOF I have hereunto subscribed my name and affixed my notarial seal at King of Prussia Pennsylvania,an the day and year first above written C
m _, gas oM
O L l COMMONWEALTH or PENNSYLVANIA .
— syOriiVuw.
N 0 �c, 7 Norms/Seal - � �O c
cz
pal OF 7eres.'rPassetis Notary !, � � /Lc coi�:�J 43 ,_
Upper Merlon Twp.Montgomery County By / �l
.7 My Commission Expires March 2a 2021 Ce
r xtvL1,-. Teresa Pastella Notary Public o
y' 1Aumbar PonnayivnniaASSXCraWn ofwpmnoe a-4
N N 4/i7 P' cn 4
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company Liberty Mutual.-c
0 E Insurance Company and West American Insurance Company which resolutions are now in full force and effect reading as follows a m
m ARTICLE IV-OFFICERS Section 12 Power of Attorney ,"
o m Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President and subject to such limitation as the Chairman or the"7,3 set
.9 u President may prescnbe shall appoint such attorneys-in fact as may be necessary to act in behalf of the Corporation to make execute seal acknowledge and deliver as surety >4
c any and all undertakings bonds recognizances and other surety obligations Such attorneys-in fact,subject to the limitations set forth in their respective powers of attorney shall_c
o •W have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation When so executed,such E co N
z c0i instruments shall be as binding as if signed by the President and attested to by the Secretary Any power or authority granted to any representative or attorney-in fact under the 2
provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority o 0
ii ARTICLE XIII-Execution of Contracts Section 5 Surety Bonds and Undertakings o co
Any officer of the Company authorized for that purpose in writing by the chairman or the president and subject to such limitations as the chairman or the president may prescnbe, I—
shall appoint such attorneys-in-fact as may be necessary to act in behalf of the Company to make execute seal acknowledge and deliver as surety any and all undertakings,..
bonds recognizances and other surety obligations Such attorneys-in fact subject to the limitations set forth in their respective powers of attorney shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary
Certificate of Designation—The President of the Company acting pursuant to the Bylaws of the Company authorizes David M Carey Assistant Secretary to appoint such attorneys-in
fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings bonds recognizances and other surety
obligations
Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with
the same force and effect as though manually affixed
I,Renee C Llewellyn,the undersigned Assistant Secretary The Ohio Casualty Insurance Company Liberty Mutual Insurance Company and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and
has not been revoked
IN TESTIMONY WHEREOF I have hereunto set my hand and affixed the seals of said Companies this 29th day of May , 2020
Av 1HSUR4 ,04 0,180 N 0134N. 4
s' o s� At' a o o c �o sn � dye..1912 0 1919 h 1991 ,
r���,' ue A If y°N 4410-�4.... V,p IMO` Ate By Renee C Llewellyn Assistant Secretary
LMS 12873 LMiC OCIC WAIC Multi Co 12I19
NPS 2.2(4/23/20)
EXHIBIT "C"
PRICE AND FEE BID SHEET
Sewer line roach control services,including all labor,materials,equipment and associated costs is included in the
unit price per manhole treatment Amount of services to be performed is subject to change based on City needs
VAVOR
t4.* e llescnpf.on Manhol s o Manhole TotB)
Es f
1 Sewer Manhole Roach Treatment Service 2200 $23 75 $52,250
TOTAL BID
$52,250
For any item(s)that do not have price listed above,Golden Bell has agreed to offer the City a not to-exceed mark up
of 2 5%over manufacture cost
9
L•Icaldjm\Agreements\Golden Bell Roach Control FY 20 21 docjn
TIPS 2.2(4/23/20)
EXHIBIT "D"
WORKERS' COMPENSATION INSURANCE CERTIFICATION
Every employer, except the State, shall secure the payment of compensation in one or more of
the following ways
(a) By being insured against liability to pay compensation by 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, either as an individual employer, or as one employer in a group of
employers, 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 to his or her employees
CHECK ONE
VI 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 commencing the performance of the work and activities required or permitted under this
Agreement (Labor Code §1861)
I affirm that at all times, in performing the work and activities required or permitted under
this Agreement, I shall not employ any person in any manner such that I become subject to the
workers' compensation laws of California However, at any time, if I employ any person such
that I become subject to the workers' compensation laws of California, immediately I shall
provide the City with a certificate of consent to self-insure, or a certification of workers'
compensation insurance
I certify under penalty of perjury under the laws of the State of California that the information
and representations made in this certificate are true and correct
GOLDEN BELL PRODUCTS, INC
By '0 1J64y9? Date 5/—I/g,Va
Michelle bster, Program Manager
10
L 1ca\djm\Agreements\Golden Bell-Roach Control FY 20 21 doc jn
ACKNOWLEDGMENT
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STATE OF CALIFORNIA
COUNTY OF ORANGE
On Ma -' i 2020_before me, Andrea Akazaki , Notary Public,
personally appeared M iAYr 11 (rplctriA,N &a►il S , 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
ANDREA AKAMXI
WITNESS my ha4 aroofficia seal =r' Noiary Public-California ,
orange County
r Commission#2172879
My Comm Expires Nov 20.2020
r'
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(seal)
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Title or Type of Document
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❑ Corporate Officer—Title(s) ❑ Corporate Officer—Title(s)
• Limited Partner ❑ General Partner ❑ Limited Partner ❑ General Partner
❑ Individual ❑ Attorney in Fact ❑ Individual ❑ Attorney in Fact
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