HomeMy WebLinkAboutContracts & Agreements_214-2013_CCv0001.pdf PUBLIC WORKS CONSTRUCTION CONTRACT
This Public Works Construction contract ("Contract") made and entered into this ZO day of
2013, by and between the City of Redlands, a municipal corporation organized
and existing under the laws of the State of California, (hereinafter "City"), and Pacific Titan Inc.
(hereinafter "Contractor"). City and Contractor are sometimes individually referred to herein as a
"Party" and, together, as the "Parties."L,
In consideration of the mutual promises contained herein, City and Contractor agree as follows:
I. SCOPE OF WORK: Contractor shall furnish all materials and perform all of the work
for the following: Reservoir Recoating and Improvements Project Arroyo Reservoir,
complete all items as required by the Contract Documents (as herein defined)and
Specifications for City's RESERVOIR RECOATING AND IMPROVEMENTS
PROJECT ARROYO RESERVOIR, PROJECT NO. 71245.
2. THE CONTRACT SUM: City shall pay Contractor the sum of$403,015.00 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.
3. TIME FOR COMPLETION: The Work shall be completed within Ninety (90)
calendar days from and after the date of the delivery to Contractor of a written Notice to
Proceed by City.
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
One Thousand Dollars (SIOOO) for each consecutive calendar day in excess of the
specified time for completion of Work.
Execution of the Contract shall constitute agreement
reement by City and Contractor that One
Thousand Dollars ($1000) 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 maN be deducted from
payments due Contractor if such delay occurs.
5. 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, Special Conditions, Special Provisions and Specifications, and any addenda
thereto.
CD 1
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 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. 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.
8. 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.
9. 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.
10. 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.
11. 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 shall continue to be valid and binding upon City and Contractor.
CD2
IN WITNESS WHEREOF,the parties hereto have executed this Agreement the day and year first
written above.
Citv of Redlands
(SEAL) (towner)
f P 8
By:
Mayor, City of dlands,County of
San Bernardino, California
ATTEST
Cit}' lerk, o edlands
County of San Bernardino, California (SEAL)
C i i .. 111
Name ofrContractor '
By: f
�ature of Authorize gent
Title
Sig ure ut prized Agent(if necessary)
Title
Contractor's License No.
CD 3
WORKER'S COMPENSATION INSURANCE CERTIFICATION
Description of Contract: City of Redlands
Municipal Utilities&Engineering Department
RESERVOIR RECOATING AND IMPROVEMENTS
PROJECT ARROYO RESERVOIR, PROJECT
NO. 71245
Labor Code Section 3700,provides, in part that:
"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 in one or more insurer
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.
I am 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 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 of this contract. (Labor Code section 186 1)
Dated this-2- day of Q(,1dbf/',200.
(Contractor)
Z (Signatui�
r-e g i
(Official Title)
(SEAL)
(Labor Code Section 1861 provides that the above certificate must be signed and filed by the Contractor with
the Owner prior to performing the work of the contract.)
CD 4
Bond No. 1972447
Premium $ 4,936.
FAMIFUL PERFORMANCE BOND
Whereas, the City of Redlands ("City"), State of California, and Pacific Titan tnc.
(hereinafter designated as "Principal") have entered into an agreement dated
October 28, > 2013 ("Agreement") whereby Principal agrees to install and complete
certain public improvements (the "Work"), which said Agueement is identified as
RESERVOIR RECOATING AND IMPROVEMENTS PROJECT ARROyo
RESERVOIR,PROJECT NO.71245 and is hereby referred to and made a part hereof.and
Whereas, said Principal is required under the terms of the Agreement to furnish a bond
for the faithful performance of the Agreement, now, therefore, we, the Principal
and The Hanover Insurance Company ,as Surety,are held and firmly bound unto the City
in the penal sum of four hundred three, thousand fifteen dollars and no cents ($403,015.00)
lawful money of the United States, for the payment of which sum we bind ourselves, and our
heirs, successors,executors and administrators,jointly and severally,firmly by these presents.
The condition of this obligation is such that if the above bounded Principal, his or its
heirs-, executors, administrators-, successors or assigns, shall in, all things stand to and abide by,
and well and truly keep and perform the covenants, conditions and provisions in the Agreement
and any afteration thereof made as therein provided, on his or its part, to he kept and performed
at the time and in the manner therein specified, and in all respects according to their true intent
and meanin&and shall faithfully fulfill the one-year guarantee of all materials and workmanship,
and shall defend, indemnify and save harmless the City and its elected officials.officers,agents
and employees,as therein stipulated, then this obligation shall become null and void;otherwise it
shall be and remain in full force and effect.
As a part of the obligation secured hereby and in addition to the face amount specified
therefor, there shall be included costs and reasonable expenses and fees, including reasonable
attorneys' fees, incurred by the City in successfully enforcing such obligations,all to be taxed as,
costs-and included in the judgment rendered.
As a condition precedent to the satisfactory completion of the Agreentcnt,the above
obligation shall hold good for a period of one(1)year or longer if required by the Agreement
after the acceptance of the work by the City,during which time if the Principal shall fail to make
full, complete,and satisfactory repair and replacements and totally protect the City from loss or
damage made evident during this period from the date of completion of the Work,and resulting
from or caused by defective materials or faulty workmanship,the above obligation in penal sum
thereof shall remain in full farce and effect. The obligations of Surety here under shall continue
so long as any obligation of the Principal remains.
Whenever the Principal shall be,and is declared by the City to be, in default under the
Agreement.the City having performed the City obligations thereunder,the Surety shall promptly
remedy the default, at die.City's option-,
I. Caniplete the Agreement in accordance with its ternis and conditions; or
2. Obtain a bid or bids for completing the Agreement in accordance with its to and
conditions,and upon determination by Surety of the lowest responsive and responsible
CD
5
bidder.arran
ge for a contract between such biddera n
d the City=and make available as
work progresses sufficient funds to pay the cost of completion of the Work less the
balance of the Agreement price, but not exceeding, including other costs and damages for
,ivhich Surety may be liable hereunder.the amount set forth'above. The term,-balance of
the Agreement price,"as used in this paragraph, shall mean the total amount payable to
the Principal by the City under the Agreement and any modifications thereto, 'less the
amount previously properly paid by the City,to the Principal.
Surety expressly agrees that the City may reject any contractor or subcontractor which
may be proposed by Surety in fulfillment of its obligations in the event of default by the
Principal.
Surety shall not utilize the Principal in completing the Agreement nor shall Surety accept
a bid from the Principal for completion of the Work if the City, when declaring the Principal in
default, notifies Surety of the City's objection to the Principal's further participation in the
completion of the Work.
No right of action shall accrue on the bond to or for the use of any person or corporation
other than the City named herein or the Successors or assigns of the City. Any suit under this
bond intist be instituted within the applicable statute of limitations period,
The said Surety, for value received, hereby stipulates and agrees that no change,
extension of time, alteration or addition to the terms of the agreement or to the work to be
performed thereunder or the Specifications accompanying the same shall in any way affect its
obligations on this bond, and it does hereby wraive notice of any such change,extension of time,
alteration or addition to the terms of the agreement or to the work or to the specifications.
No final settlement bet-ween the City and the Principal shall abridge the right of any
beneficiary hereunder whose claim may be unsatisfied.
The Principal and Surety agree that if the City is required to engage the services of any
attorney in
connection with the enforcement of this bond, each shall pay the City's reasonable
attorneys fees incurred, with or without suit, in addition to the above sum,
The Surety hereby stipulates and agrees that no change., extension of time alteration or
addition to the terms of the Agreement or to the Work to be performed thereunder or the
specifications accompanying the same shall in any vkffay affect its obligations on this bond,and it
does hereby waive notice of any such change, extension of time, alteration or addition to the
terms of the agreement or to the work or to the specifications.
CD 6
In witness whereof, this instrument has been duly executed by the Principal and Surety
above named,on October 253 `011
Pacific Titan, Inc. (SAI J The Yanover Insurance Company ( IvAI,
(Contractor) v
13y:
(Signature) (Signature) V
Drew Ebright A_ttornev in Fact
Address-1411 N1- Batavia # 201
(Sea] and Notarial Acknowledgment of Telephone(714 ) 516 1232
Surety)
D
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWERS OF ATTORNEY
CERTIFIED COPY
KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being
corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation
organized and existing under the laws of the State of Michigan,do hereby constitute and appoint
Daniel Huckabay,Arturo Ayala,Dwight Reilly,Allison Rift and/or Drew Eb►ight
of Orange,CA and each is a true and lawful Attomey(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and
deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,
undertakings,contracts of indemnity or other writings obligatory in the nature thereof,as follows:
Arty such obligations in the United States,not to exceed Ten Million and No/100($10,000,000)in any single instance
and said c ornpanies hereby ratify and confirm all and whatsoever said Attorney(s)4n-fact may lawfully do in the premises by virtue of these presents.
These appointments are made under and by authority of the foliowing Resolution passed by the Board of Directors of said Companies which resolutions
are still in effect:
'RESOLVED,That ltie President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered loappoint
Attorneys4n-fact of the Company,in its name and as its acts,to exeafbe and acknowledge for and on its behalf as Surety any and all bonds,recognizances,
contracts of indemnity,waivers of citation and all other writifgs obligatory in the nature thereof,with power to attach thereto the seat of the company,Any such
writings so executed by such Attcxneys-ln-fa:t shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly
elected officers of the Company in their own proper persons.'(Adopted October 7.1981 -The Hanover Insurance Company,Adopted April 14,1982-
Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE
COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents,
this 18th day of June 2013.
THE HANOVER INSURANCE COMMPANY
1MASSACHUSEM SAY INSURANCE comPANY
AOM%kCITIZENS ANY OF AARERICA
3M
I!Slqu
Robert'Phomas,Vice President
THE COMMONWEALTH OF MASSACHUSETTS
COUNTY OF WORCESTER )ss. Joe.8renscrom,Vii President
On this 18th day of June 2013 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance
Company and Citizens Insurance Company of America,to me personalty known to be the individuals and officers described herein,and acknowledged that the
seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens
Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said
instrurnent by the authority and direction of said Corporations.
BAFSMA A.GAN"
ui c>esesnn�sw t•.�
Barbara A.Garlick,Notary Public
My Commission Expires September 21,2018
1,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,
hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further
certify that the said Powers of Attorney are stili in force and effect.
This Certificate may be signed by facsrm4e under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company,
Massachusetts Bay Insurance Company and Citizens Insurance Company of America.
'RESOLVED,That any and all Powers of Attorney and Certirred Copies of such Powers of Atkxney and certification in respect thereto,granted and executed
by the President or any Vice President in conjunction with any Vice President of the Company,shaft be binding on the Company to the same extent as if an
signatures therein were n-4y affixed,even though one or more of any such signalizes thereon may be facsimile.' (Adopted October 7,1981 -The
Hanover ftUran0e Company Adopted April 14,1982-Maw3c�Bay Insurance Corrgany,Adopted September 7,2001-Citizens irm rance Company of
GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this �gd- _�2
THE RA 40VER 04St1lMKVE COMPANY
BAY COW%XY
OF AAR"CA
J- ,Vflce t
CALIFORNIA ALLACKNOWLEDGMENT
STATE OF CALIFORNIA
County of Orange
On _ .,- before me, Andrew Waterbury, Notary Public
Date Here Inset Name and Ti?!e of the C7fficer
personally appeared Drew Ebright._ _
Namers}of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(x) whose name(yj isles subscribed to the
within instrument and acknowledged to me that he&hodhRy
executed the same in hi sir authorized capacity(' ),
and that by his/ba0twic signature(g)on the instrument the
person(&), or the entity upon behalf of which the person(g)
( N PIW b ?c€f acted, executed the instrument.
COMW
1 € t ,, r3 I certify under PENALTY OF PERJURY under the laws of
t ORANGE C L the State of California that the foregoing paragraph is true
+Y-Omm € .it= € a and correct.
Witness my hand and c seal.
f
Signature `
Place Notary Seat Above Signature of Notary Public Andrew Waterbury
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document-
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) {ether Than Named Above:
Capacity(ie )Claimed by Signer(s)
Signer's Name:Drew Ebright Signer's Name:
1 II Individual Q Individual
D Corporate Officer—Title(s):— _ _ El Corporate Officer—Title(s):
El Partner—u Limited El General Partner---i�''s Limited El General
Attorney in Fact Attorney in Fact
c Trustee ° 10 Trustee RIES
IL Guardian or Conservator of thumb here i ❑ Guardian or Conservator j Top of thumb
A—
Toper
I #
El Other. _1 Other:
I a
Signer Is Representing: 1 Signer Is Representing:
i
102007 National Notary Association•9350 De Soto Ave-P.O.Box 2402•Chotsworth.CA 91313.24.62•wr Ax.Nationalr1otarf.org Item-*5907 Reorder:Gall Tall-Free 1-800-876--,827
Bond No. 19724A7
Premium Inc]-uded
LABOR AND MATERIAL BOND
Whereas,the City Council of the City of Redlands, State of California,and Pacific Titan Inc.(hereinafter
designated as'iMncipar)have entered into an agreement(the"Agreement")whereby Principal agrees to
install and complete certain designated public improvernents(the"Work"),which said agreementdated_
October 28- 2013, and identified as RESERVOIR RECOATING AND
IPROVE WNTS PROJECT ARROYO RESERVOIR,PROJECT NO. 71245 is hereby referred to
and made a part herec&-and
Whereas.under the terms of the AgreementPrincipal 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"Citic 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
four hundred three thousand fifteen dollars and no cents ($403,015.00)for materials furnished or
labor thereon of afty, kind, or for amounts due under the Unemployment Insurance- Act with respect, to
such work or 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 CipNo- 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.
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 sWI 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 said Agreement or the specifications accompanying the same shall in any manner affect its
obligations on this band,and it does hereby waive notice of any such change,extension of time,alteration
or addition-
CD 8
In witness whereof this l strU ent has been,duly executed by the Principal and stirety above named, on
October 28 2011
(SEAL), (SEAL)
l
Pacific Titan, Inc. The Hanover Insurance Carinan r
(contractor) �
(Signature) e
T}rew Fbri , t Attorney in Fact
Addres l_411 _.._Batavia # 201
(Seat and Notarial Acknowledgment of Surety) `telephone(714
CD 9
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWERS OF ATTORNEY
CERTIFIED COPY
KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being
corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation
organized and existing under the laws of the State of Michigan,do hereby constitute and appoint
Daniel Huckabay,Arturo Ayala,Dwight Reilly,Allison Ritbo and/or Drew Ebright
of Orange,CA and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and
deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,reeognizances,
undertakings,contracts of indemnity or other writings obligatory in the nature thereof,as follo":
Any such obligations in the United States,not to exceed Ten Million and No/100(=10,000,000)in any single instance
and said companies hereby ratify and confirm all and whatsoever said Attomey(s)4n-fact may lawfully do in the premises by virtue of these presents.
These appointments are made under and by authority of the folkyMrvg Resolution passed by the Board of Directors of said Companies which resolutions
are still in effect:
RESOLVED,That the President Or any Vice President,in oonluncbw with any Vice President,be and they ane hereby authorized and empowered loappoint
Attorneys-in-fad of the Company,in its name and as its acts,to execute and aclaxWedge for and on its behatt as Surety any and aH bonds,rec cgrimanoes,
contracts of indemnity,warvers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company.Any such
writings so executed by such Attomeys-in-fact shall be as binding upon the Company as if they had been duty executed and ad(nowliedged by the regularly
elected ofters of the Company in their own proper persons.'(Adopted October 7,1981 -The Hanover insurance Compary;Adopted April 14,1982-
Massachusetts Bay Insurance Compary;Adopted September 7,2001-Citroens Insurance Company of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE
COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents,
this 18th day of June 2013.
THE HANOVER INSURANCE COMPANY
MASSACHUSEM BAY INSURANCE COMPANY
is ANY OF AN*TdCA
r�J1�
9)cp
Robert Thorns,Vice president
THE COMMONWEALTH OF MASSACHUSETTS
COUNTY OF WORCESTER )ss. Jcerengr�ont 'tc�Presideru
On this 18th day of June 2013 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance
Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged that the
seats affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens
Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duty affixed and subscribed to said
instrument by the authority and direction of said Corporations.
a BARBARA A.t3/6Rt"
Nowy preio `
aosw.r.9641N.m6aL.//�
+rrr�.saar.zau
Barbara A.Garlick,Notary Public
My Commission Expires September 21,2018
I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,
hereby certify that the above and foregoing is a full,true and corned copy of the Original Power of Attorney issued by said Companies,and do hereby further
certify that the said Powers of Attorney are still in force and effect.
This Certificate may be signed by famm4ee under and by authority of the foNowing resolution of the Board of Directors of The Hanover insurance Company,
Massachusetts Bay Insurance Company and Citizens Insurance Company of America.
'RESOLVED,That any and an Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed
by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all
signatures therein were manually affixed,even though one or more of any such signatures thereonbe facsimile.' (Adopted October 7, 1981 -The
Hanover Insurance Company,Adopted April 14,1982-Massadwsefts Bay Insurance Corrparny,Adopted8eimptember 7,2001-Citizens lnswa,,0e Company of
GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this d4ffQ��4tj 3
THE l Ajg0VER iNNStgtANCE COMPANY
BAY COMPANY
+�AICA
� ,Vice
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
County of t3range
On before me, Andrew Waterbury. Notary Public
ate Here Insert Name arrd Tit9e of tha officer
personally appeared Drew Ebright
Name(s)of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(X) whose name( is4m subscribed to the
within instrument and acknowledged to me that herd my
executed the same in hi fir authorized capacity(' ),
and that by histb mk signature(x) on the instrument the
person(s), or the entity upon behalf of which the person{ }
(
ANDREW WAD f,URY acted, executed the instrument.
ccmw
Notary l£3)=t nfn ma I certify under PENALTY OF PERJURY under the laws of
m u
ORANGE -U�4iY
, k` the State of California that the foregoing paragraph is true
and correct.
Witness my hand ar of ial seal.
q
Signature
Place Notary Seal Above OPTIONAL Signature of Notar,Public Andrew Waterbury
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Gate: Number of Pages:
Signer(s) Other Than Named Above: _--
Capacity(ies)Claimed by Signer(s)
Signer's Name: Drew Ebright Signer's Name:
lEl Individual 11 Individual
❑ Corporate Officer---Titles):, E1 Corporate Officer--Titles):
Partner—E!Limited i—I General El Partner—El Limited O General
V Attorney in Fact El Attorney in Fact
Trustee ° ❑ Trustee
Guardian or Conservator Top of thumb here El Guardian or Conservator I Top of thumb here
Other: ; El Other-
j
Signer Is Representing: ! Signer Is Representing:
i
rC 200-1 National Notary Assoctatior.9350 De Soto Ave_RO,rox 2402 Chatsxorlh,CA 91313-2402-+rwxhtafbna?Nota .crg Item 95W7 Roo der_,-,all roll-Free 1-800-8761821