HomeMy WebLinkAboutContracts & Agreements_33-1996_CCv0001.pdf AGREEMENT
THIS AGREEMENT, made and entered into this second day of April, 1996, by and between the City
of Redlands, a Municipal Corporation, organized and existing under the laws of the State of California,
hereinafter referred to as the "City", and
S J BURKHARDT , INC A California Corporation
a partnership consisting of
or an individual trading as
of the City of Mira Loma County of Riverside
State of California, hereinafter referred to as the "Contractor".
WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, agree as follows:
I SCOPE OF WORK: The Contractor will furnish all materials and will perform all of the work for the
following:
To perform construction of the Colton Avenue Storm Drain and University Street Realignment
project, complete, all as shown, specified, and made a part of Contract No. 29-6213-4230.
2. THE CONTRACT SUM OF: $1 , 6 7 9 , 2 4 3 . 0 0, which includes Additive Bid Item C.
3. TIME FOR COMPLETION: The work shall be completed within one hundred and twenty(120)work
days from and after the date of the Notice to Proceed.
4. CONTRACT DOCUMENTS: The complete Contract includes all of the contract documents set forth
herein, to wit; Notice Inviting Bids, Instructions to Bidders, Proposal and Bid Forms, Bid Bond,
Agreement, Faithful Performance Bond, Labor and Material Bond, Plans and Specifications,all referenced
specifications,and any Addenda thereto.
5. ATTORNEY FEES: In the event any legal action is commenced to enforce or interpret the terms or
conditions of this Contract the prevailing party shall, in addition to any costs and other relief, be entitled
to recovery of its reasonable attorney's fees.
6. DEFENSE OBLIGATION: The Contractor shall defend the City,its elected officials,officers,agents,
and employees from and against any and all claims, losses,damages, and causes of action,including death,
brought by any person or persons for or on account of any wrongful or negligent act or ommission of the
Contractor,its employees or agents in connection with the performance of the Contractor's obligation under
this Contract.
7. INSURANCE: All policies of insurance required by this Contract shall name the City, its elected
officials, employees, and agents as additional insureds, and such insurance shall be primary with respect
to such additional insureds and non-contributing to any insurance or self-insurance maintained by the
additional insureds.
CD-20
IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate on the day
and year first written above.
CITY'S SEAL
Mayor, City of Redlands
County of San Bernardino, California
ATIT ST:
N
Ct y^ler , City of
Cour f San Be c,, ;'gifornia
S J BURF:HARDT , INC
Na—me of Contractor
CON'TRACTOR'S SEAL By:
rgna of Authorize Agent
Stev J. Schmi
Secretary/Treasurer
Signatory's Title
Signature of Authorized Agent (if necessary)
Signatory's Title gnecessary)
510982 "A"
Contractor's License No.
CD-21
WORKERS' COMPENSATION INSURANCE STATEMENT
1, the undersigned and authorized agent for the Contractor, 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 under the City's Contract
No. 29-6213-4230.
—S J BURKHARDT , INC.
Name of Contractor
Al"'WzZ
BY:
Signatur)If Au&rizedent
Steven J. Schmitt
�T
Secretary/Treasurer
Signatory's Title
510982 "A"
Contractor's License No.
CD-22
BOND # S-500 1145
PREMIUM: $17,024.00
EXECUTED IN DUPLICATE
PERFORMANCE BOND
KNOW ALL PERSONS BY TBESE PRESENTS
That S J BURKHARDT , INC . as Contractor,
and WASHINGTON INTERNATIONAL INSURANCE COMPANY as Surety,
are held and firmly bound unto the City of Redlands, hereinafter called City, in the sum of ($1,679,243.00)---
ONE MILLION SIX HUNDRED SEVENTY NINE THOUSAND 1740 HUNDRED FORTY THREE-- dollars,
for the payment of which sum well and truly be made, we bind ourselves, our heirs, executors, administrators,
successors, and assigns,jointly and severally, firmly by these presents.
WHEREAS, said Contractor has been awarded and is about to enter into the annexed contract with said City to
perform all work required under the City's Contract No. 29-6213-4230.
NOW, THEREFORE, if said Contractor shall perform all of the requirements of said contract required to be
performed on their part, at the times and in the manner specified therein, then this obligation shall be null and void,
otherwise it shall remain in full force and in effect until 90 days after completion.
PROVIDED, that any alterations in the work to be done or the materials to be fumished, which may be made
pursuant to the terms of said contract, shall not in any way release either said Contractor or said Surety thereunder,
nor shall any extensions of time granted under the provisions of said contract release either said Contractor or said
Surety, and notice of such alterations or extensions of the contract is hereby waived by said Surety.
SIGNED AND SEALED, this 24TH day of APRIL 11996. -
WASHINGTON INTERNATIONAL
S. J. BURKHARDT, INC. (SEAL) INSURA.WEC()MPA (SEAL)
NY
Principal Surety/ ---
By:
igna
Signature MICHAEL A. QUIGLLE
Steve J.4SchmitTSec./Treas.
Address: 1930 THOREAU DRIVE, #101
SCHAUMBURG, IL 60173
Telephone: (220 ) 338-0753
(Seal and Notarial Acknowledgment of Surety)
CD-23
STATE OF CALIFORNIA
SS.
COUNTY OF ORANGE
On APRIL 24, 1996 before me, M. TREDINNICK, NOTARY PUBLIC
PERSONALLY APPEARED MICHAEL A. QUIGLEY
personally known to me (or proved to mt� on the basis of
satisfactory evidence) to be the person(s) whose names)
is/are subscribed to the within instrument and acknowl-
edged to me that he/she/they executed the sone in his/
her/their authorized capacity(ies), and that by his/her/ s _
their signature(s) on the instrument the person(s), or the FIA. TED=N
entity upon behalf of which the person(s) acted, executed COPMR.A.
the instrument.
0MAJ o
my comm EX-Pifest
WITNESS my hand and official seal. �
f
Signature This area for Official Notarial Seal
OPTIONAL
Though the data below is not required by law. it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
Ll CORPORATE OFFICER
�— TITLE OR TYPE OF DOCUMENT
mtE(s)
Q PARTNER(S) ❑ LIMITER
❑ GENERAL
D ATTORNEY-IN-FACT NUMBER OF PAGES
❑ TRUSTEE(S)
GUARDIAN/CONSERVATOR
OTHER:
_ DATE OF DOCUMENT
SIGNER IS REPRESENTING.
NAME OF PERSON{S}OR ENTITY{SES)
SIGNER(S)OTHER THAN NAMED ABOVE
"'-081 Rev o/94 ALL—PURPOSE ACKNOWLEDGEMENT
WASHINGTON /NT&HNA IIUNAL 1NSUKANC Z t Ulv1rH/v r
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS: That the Washington International Insurance Comapny, a corporation organized and existing under the
laws of the State of Arizona, and having its principal office in the Village of Schaumburg, Illinois does hereby constitute and appoint
SHAWN BLUME, JENNIFER JOHNSTON, MICHAEL A. alllGLEY AND DWIGHT REILLY
EACH IN THEIR SEPARATE CAPACITY
its true and lawful attorneys)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings,
recognizances, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required, or
permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents,
shall be as binding upon.the said Washington International insurance Company as fully and amply, to all intents and purposes, as if the
same has been duly executed and acknowledged by its President and its principal office.
This Power of Attorney shall be limited in amount to $2,000,000-00 for any single obligation.
This Power of Attorney is issued pursuant to authority granted by the resolutions of the Board of Directors adopted March 22, 1978,July
3, 1980 and October 21, 1986 which read, in part, as follows:
1. The Chairman of the Board, President, Vice President, Assistant Secretary, Treasurer and Secretary may designate Attorneys-in-
Fact, and authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds, and
undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and to appoint Special
Attorneys-in-Fact, who are hereby authorized to certify copies of any power-of-attorney issued in pursuant to this section and/or
any of the By-Laws of the Company, and to remove,at any time,any such Attorney-in-Fact or Special Attomey-in-Fact and revoke
the authority given him.
2. The signatures of the Chairman of the Board,the President,Vice President, Assistant Secretary, Treasurer and Secretary,and the
corporate seal of the Company, may be affixed to any Power of Attorney, certificate, bond or undertaking relating thereto, by
facsimile. Any such Power of Attorney,certificate bond or undertaking bearing such facsimile signature or facsimile seal affixed
in the ordinary course of business shall be valid and binding upon the Company.
IN TESTIMONY WHEREO&pj46p4j6Rhin9ton international insurance Company has caused this instrument to be signed and its corporate
seal to be affixed by` 4of, this 2nd day of November, 1994.
4 a
! ,i. '' • �i ASHiNGTON INTERNATiONAL INSURANCE COMPANY
' #CORPORATE
d SEA L �-s�.c '`
*4 dam. iiliiam D. Starrett, Chairman of the Board
STATE OF ILLWOIS��
COUNTY OF COOK)
On this 2nd day of November, 1994, before me came the individual who executed the preceding instrument, to me personally know, and,
being by me duly sworn, said that he is the therein described and authorized officer of the Washington International Insurance Company;
that the seal affixed to said instrument is the Corporate Seal of said Company;
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal, the day and year first above written.
"OFFICIAL SEAL"
CHRISTINE ZARETSKY 4L
t)-tary puaCZt, state of Illinois stine Zaretsky, ota Punic
(orun'si cn Exp sea 10-7 96 My Commission E res ctober 7 896
STATE OF ILLINOIS)
COUNTY OF COOK)
1,the undersigned, Secretary of WASHINGTON INTERNATIONAL INSURANCE COMPANY,an ARIZONA Corporation, DO HEREBY CERTIFY
that the foregoing and attached POWER OF ATTORNEY remains in full force and has not been revoked, and furthermore that Article III,
Section 5 of the By-Laws of the Corporation, and the Resolution of the Board of Directors, set forth in the Power of Attorney, are now
in force.
Signed and sealed in the County of Cook. Dated he 24TH day of APRIL _' 19 96
Lewis M. Moeller, Secretary
BOND # S-500 1146
PREMIUM INCLUDED ON PERFORMANCE BOND
EXECUTED IN DUPLICATE
PAYMENT BOND
KNOW ALL PERSONS BY TBESE PRESENTS
That S J BURKHARDT , INC . as Contractor,
and WASHINGTON INTERNATIONAL INSURANCE COMPANY as Surety,
are held and firmly bound unto the City of Redlands, hereinafter called City, in the sum of ($1,679,243.00)--
ONE MILLION SIX HUNDRED SEVENTY NINE THOUSAND TWO HUNDRED FORTH THREE— dollars.
for the payment of which sum well and truly be made, we bind ourselves, our heirs, executors, administrators,
successors, and assigns,jointly and severally, firmly by these presents.
WBEREAS, said Contractor has been awarded and is about to enter into the annexed contract with said City to
perform all work required under the City's Contract No. 29-6213-4230.
NOW, THEREFORE, if said Contractor, or Subcontractor, fails to pay for any materials,equipment, or other
supplies, or for rental of same, used in connection with the performance of work contracted to be done, or for
amounts due under applicable State law for any work or labor thereon, said Surety will pay for the same in an
amount not exceeding the sum specified above, and, in the event suit is brought upon this bond, a reasonable
attorney's fee to be fixed by the court. This bond shall inure to the benefit of any persons, companies, or
corporations entitled to file claims under applicable State law and will remain in force until 90 days after
completion.
PROVIDED, that any alterations in the work to be done or the materials to be furnished, which may be made
pursuant to the terms of said contract, shall not in any way release either said Contractor or said Surety thereunder,
nor shall any extensions of time granted under the provisions of said contract release either said Contractor or said
Surety, and notice of such alterations or extensions of the contract is hereby waived by said Surety.
SIGNED AND SEALED, this 24TH day of APRIL 11996.
WASHINGSN INTERNATIONAL
S. J. BURKHARDT, INC. INSUI C ,90DIPAN
(SEAL) -,—�EAL)
Principal Surety/ I/
h/
B B
1 f 4&, AE A. )D
ure M, QUIGLEY
Igna Signature 4L Sec./Treas. A RN
Ste.ven J. sc�x Address: 1930 THOREAU DRIVE, #101
SCHAUMBURG, IL 60173
Telephone: (�00 ) 338-0753
(Seal and Notarial Acknowledgment of Surety)
29-6213 CD-24
STATE OF CALIFORNIA
SS.
COUN'T'Y OF ORANGE
On — APRIL 24, 1996 before me, M. TREDINNICK, NOTARY PUBLIC
PERSONALLY APPEARED MICHAEL A. QUIGLEY
personally known to me (or proved to m:� on the basis of
satisfactory evi ence to be the person(s) whose names}
is/are subscribed to the within instrument and acknowl-
edged to me that he/she/they executed the sane in his/
her/their authorized eapacity(ies), and that by his/her/ .Xvli
their signature(s) on the instrument the person(s), or the
entity upon behalf of which the person(s) d acted, execute . lNl
the instrument.
ORANGEC
My Commm En'es Av
WITNESS my hand and official seal.
�AThis area for Official Notarial Seal
Signature `� L
OPTIONAL
Though the data below is not required by law. it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑l CORPORATE OFFICER
TITLE OR TYPE OF DOCUMENT
TME(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT NUMBER OF PAGES
C� TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
CRATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PERS ONtS)OR ENTITYPES}
SIGNER(S)OTHER THAN NAMED ABOVE
1t)-081 Rev t,/94 ALL-PURPOSE ACKNOWLEDGEMENT
WASHINGTON INI&HNAI1UNft1 '"Ounr"w" - ••-
POWER OF ATTORNEY
:NOW ALL BY THESE PRESENTS: That the Washington International Insurance Comapny, a corporation organized and existing under the
aws of the State of Arizona, and having its principal office in the Village of Schaumburg, Illinois does hereby constitute and appoint
SHAWN BLUME, JENNIFER JOHNSTON, MICHAEL A. QUIGLEY AND DWIGHT REILLY
EACH IN THEiR SEPARATE CAPACITY
-ts true and lawful attorney(si-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings,
recognizances, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required, or
permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents,
shall be as binding upon the said Washington International Insurance Company as fully and amply, to all intents and purposes, as if the
same has been duly executed and acknowledged by its President and its principal office.
This Power of Attorney shall be limited in amount to $2,000,000.00 for any single obligation.
This Power of Attorney is issued pursuant to authority granted by the resolutions of the Board of Directors adopted March 22, 1978,July
3, 1980 and October 21, 1986 which read, in part, as follows:
1, The Chairman of the Board, President, Vice President, Assistant Secretary, Treasurer and Secretary may designate Attornndes samd-
Fact, and authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, b
undertakings. recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and to appoint Special
Attorneys-in-Fact, who are hereby authorized to certify copies of any power-of-attorney issued in pursuant to this section and/or
any of the By-Laws of the Company, and to remove,at any time,any such Attorney4n-Fact or Special Attorney-in-Fact and revoke
the authority given him.
2. The signatures of the Chairman of the Board, the President,Vice President, Assistant Secretary,Treasurer and Secretary,and the
corporate seal of the Company, may be affixed to any Power of Attorney, certificate, bond or undertaking relating thereto, by
facsimile. Any such Power of Attorney, certificate bond or undertaking bearing such facsimile signature or facsimile seal affixed
in the ordinary course of business shall be valid and binding upon the Company.
IN TESTIMONY WHEREOJ Kington international Insurance Company has caused this instrument to be signed and its corporate
seat to be affixed by�►ir 6 or, this 2nd day of November, 1994.
M'� �•' '���� ASHiNGTON INTERNATIONAL INSURANCE COMPANY
z:CORPORATE
ARIZON ,'�� iNiam 0. Sterrett, Chairman of the Board
STATE OF luWOIS�� � �•��r.�
COUNTY of COOK) klk��Z0
On this 2nd day of NavOmber, 1994,before me came the individual who executed the preceding instrument, to me personally know, and,
being by me duty sworn, said that he is the therein described and authorized officer of the Washington international Insurance Company;
that the seat affixed to said instrument is the Corporate Seal of said Company;
IN TESTIMONY WHEREOF, 1 have homer-eeunto set my hand and affixed my Official Seal, the day and year first above written.
itoFFIC1AL SEAL"
CHRISTINE ZARETSKY S . Z
11-tary publit, State of IIIi";$ Stine ZaretskyAires
Public
µrr toatr+ss'on Expr� 10-7-96 My Commission Ectober 7 996
STATE OF ILLINOIS)
COUNTY OF COOK)
I,the undersigned, Secretary of WASHINGTON INTERNATIONAL INSURANCE COMPANY,an ARIZONA Corporation, DO HERESY CERTIFY
that the foregoing and attached POWER OF ATTORNEY remains in full force and has not been revoked, and furthermore that Article III,
Section 5 of the By-Laws of the Corporation, and the Resolution of the Board of Directors, set forth in the Power of Attorney, are now
in force.
Signed and sealed in the County of Cook. Dated he 24TH day of APRIL _' 19 96
Lewis M. Moeller, Secretary
CERTIFICATE MJF INSURANCE CSR EV DATE 0422/96
/
BURKSJI 22 96
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MERIDIAN INSURANCE SERV. INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
JOHN BACCARELLA HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
4501 E. LA PALMA AVE #150 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ANAHEIM CA 9280? r COMPANIES AFFORDING COVERAGE
A —
JOHN BACCARELLA aaMPara
-- ��AIG—AMER INT`L SPEC LINES INS
Phone No. 714-693-9100 Fez No.
INSURED COMPANY
B VALLEY FORGE INS CO (CNA) **
COMPANY
S. J. BURKHARDTS INC. I C HOMESTEAD INSURANCE COMPANY
6157 Marlatt COMPANY
Mira Loma CA 91752 D CONTINENTAL CASUALTY (CNA)
COVERAGES
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.
CO POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE S 1,000,000
A X COMMERCIAL GENERAL LIABILITY 91644-CA9505293 05/31/95 05/31/96 PRODUCTS-COMP/OPRGG $ 1,000,000
CLAIMS MADE X OCCUR PERSONAL&ADV INJURY s 11000,000
X OWNER'S&CONTRACTOR'S PROT I EACH OCCURRENCE $ 1,000,000
!i XCU INCL. FIRE DAMAGE(Any one fire) $ 50,000
MED EXP(Any one Person) $ 5,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
B X ANY AUTO I Al 29079707 05/19/95 05/19/96 '
ALL OWNED AUTOS BODILY INJURY $
(Per person)
SCHEDULED AUTOS
X HIRED AUTOS BODILY INJURY $
XNON-OWNED AUTOS {Per accident/
i
B X PHYSICAL DAMAGE $1,000 DED COMP & COLL PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
� EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY I EACH OCCURRENCE s2,000,000
C X UMBRELLA FORM I UL 04461 09/19/95 05/19/96 {AGGREGATE 52,000,000
OTHER THAN UMBRELLA FORM i $
D I WORKERS COMPENSATION AND 4 X ,STATUTORY LIMITS
D
EMPLOYERS'LIABILITY i EACH ACCIDENT $ 1,000,000
THE PROPRIETORI �tINCL 1044500571 11/20/9'53 11/20/96 !DISEASE-POLICY LIMIT $ 15000,000
PARTNERS/EXECUTIVE {--
OFFICERS ARE: I 'EXCL E 1044500571 11/20/95 i 1112019.6 DISEASE-EACH EMPLOYEE 5 15 000 5 000
OTHER
i
E SCHEDULED EQUIP. IMP 8778626 05/19/951 05/19/961 TOTAL LMT $1,393,231
E ; LEASED RENTED EQUI IMP 8778626 05/19/951 05/19/961 ANY 1 ITM $ 50,000
I �
i
DESCRIPTION OF OPERATIONSILOCATIONSJVEMCLESISNECIAL ITEMS
* 10 DAY NOTICE FOR NON PAYMENT OR NON REPORTING OF PAYROLL.
**COMPANY E=AMERICAN NATIONAL FIRE INS. CO.
RE: ALL CALIFORNIA OPERATIONS
COLTON AVE. STORM DRAIN AND UNIVERSITY STREET REALIGNMENT-
CONTRACT x#29-6213-4230 >ADDITIONAL INSURED PER ATTACHED<
CERTIFICATE 14OLDER1 . CANCELLATION
CITYRED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
CITY OF REDLANDS BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
P.O. BOX 3005
REDLANDS CA 92373 OF ANY KIND UPON THE COMP ITS AGENTS PRESENTATIVES.
AUTHORIZED R€PRESENTATIV
JOHN BACCAREL
ACORD 25-$13/93) OOM4"N 1993
POLICY NUMBER: 91644-CA9505293
INSURED: S.J. BURKHARDT, INC.
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
ADDITIONAL INSURED ENDORSEMENT
YOU ARE REQUIRED TO ADD ANOTHER PERSON OR ORGANIZATION AS AN
IF INSURED ON THIS POLICY UNDER A WRITTEN CONTRACT OR
ADDITIONAL EFFECTIVE DURING THE
AGREEMENT CURRENTLY IN EFFECT OBE
CON THAT
TERM OF THE POLICY ANDAETITE OF INSURANCE LISTING
PERSON OR ORGANIZATION AS AN ADDITIONAL INSURED TO HAS BEEN ISASSUED,
THEN WHO IS AN INSURED (SECTION ii) IS AMENDED INCLUDE AN
INSURED THAT PERSON OR ORGANIZATION (CALLED "ADDITIONAL
INSURED") .
THE INSURANCE FOR THAT ADDITIONAL INSURED IS LIMITED AS FOLLOWS:
1, THAT PERSON OR ORGANIZATION IS ONLY AN ADDITIONAL INSURED
FOR ITS LIABILITY ARISING OUT OF OUR WORK" OR ON BEHALF
OF THIS ADDITIONAL INSURED; AND
2 , THE LIMITS OF LIABILITY FOR THE ADDITIONAL INSURED ORN
ARE
OR , I
THOSE SPECIFIED IN THE RITEN CONT
EVER IRI
LESS. THESRAECT LIMITSAGREEMENTARE INCLUSIVE
THIS POLICY, WHICH
OF AND ARE NOT IN ADDITION TO THE LIMITS OF INSURANCE SHOWN
IN THE DECLARATIONS; AND
POLICY TERMS, CONDITIONS AND RESTRICTIONS ALSO
3 . ALL OTHER IMITED TO THE "OTHER INSURANCE"
APPLY INCLUDING, BUT NOT L
PROVISIONS.
THIS ENDORSEMENT AND ANY COVEAGES PROVIDED HEREINEXTENDED APPLY ONToLY ANY
TO
THE POLICY TO WHICH IT IS ATRTACHED AND IS NOT
OTHER POLICY ISSUED TO THE INSURED.
PREMIUM: INCLUDED.
ADDITIONAL INSURED(S) :
CITY OF REDLANDS
LAC-AD1992
Recorded in official Records County of
San Bernardino, Errol J Mackzum, Recorder
RECORDING REQUESTED BY No Fee
AND WHEN RECORDED MAIL TO k10 19970028399
Doc N JI -. 53am oi /28/97
CITY CLERK
CITY OF REDLANDS
35 CAJON STREET 205 3003151 1 03 t
P 0 BOX 3005 P FEE APF SIMS PH CFY CRT VY Aill)NM PfN PR PcoR
REDLANDS CA 92373
L 5
NflN ST LN SVY C-0
TRANS TAX DA CRR6 EXAM —
NOTICE OF COMPLETION an NOT REQUIUD
Notice pursuant to Civil Code Section 3093, this notice must be filed within 10 days after completion of work. ffs mummml C"
$MM6103
Notice is hereby given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereinafter described:
2. The full name of the owner is: CITY OF REDLANDS
3. The full address of the owner is: 35 CAJON STREET, P 0 BOX 3005
REDLANDS CA 92373
4. The nature of the interest or estate of the owner is; In fee.
5. The full names and full addresses of all persons,if any, who hold title with the undersigned as joint tenants or as tenants in common are:
NOT APPLICABLE
6. A work of improvement on the property hereinafter described was completed on January 17, 1997. The work done was:
Colton Avenue Storm Drain and University Street Realignment project, Contract No. 29-6213-4230.
7. The name of the contractor for such work of improvement was: S J Burklhardt Inc.
6157 Marlatt Street, Mira Loma CA 91752 April 2, 1996
(Date of Contract)
8. The property on which said work of improvement was completed is in the city of Redlands, County of San Bernardino, State of
California, and is described as follows: Colton Avenue between Church Street and Judson Street.
9. The street address of said property is: None
Dated: January 21, 1997 1 ff
A
z
Contract Administration Engineer,P c Wor Department,City of Redlands
VERIFICATION
1, the undersigned, say I am the Public Works Director of the declarant of the foregoing Notice of Completion, and have read said Notice of
Completion and know the contents thereof; the same is true of my own knowledge.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on January 21, 1997, at Redlands, California. 7
Public Works Director,Public Works Department.City of ands