HomeMy WebLinkAboutContracts & Agreements_82-2009_CCv0001.pdf rN
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CITY OF
w
REDLANDS
municipal utilities
and
engineering
department MEMO
To: Lorrie Poyzer, City Clerk
From: Tim Wilson, Associate Engine
Subject: Centrifuge Project at the Water Reclamation Facility
Date: June 22, 2009
This memo is to request the Mayor's signature on the agreement for the installation of a Centrifuge at
the Water Reclamation Facility. The lowest responsible qualified bidder for Schedule"A"as a result
of the formal bid process was Spiess Contractors, Inc.
The form of the agreement document was reviewed by the City Attorney and is deemed acceptable.
The agreement was prepared and reviewed by the MUED engineering staff and is also deemed
acceptable. The Insurance certificates were reviewed by Kim Braun of HR and is also deemed
acceptable.
Please return the signed agreements and we will return one original copy to Spiess Contractors,Inc,
with a notice to proceed.
xc: File
Attachments: 2 COPIES of Agreement Dated June 10, 2009, Attachment A and.B
AGREEMENT
THIS AGREEMENT, made and entered into this 10thday of June 2009, by and between
the City of Redlands, a Municipal Corporation, organized and existing s—tinounderthe laws
of tile State of
California, hereinafter referred to as the ""City", and -Spiess construction Co. , Inc. of
the City of Santa Maria COUr1tV Of Santa Barbara State of Cal—ifo-n-i-ia, hereinafter referred
to as the"Contractor".
WITNESSETIJ: That the City and the Contractor, for the consideration hereinafter named, agree
as follows:
L SCOPE OF WORK: The Contractor will furnish all materials and will perform all of tile work
for the following:
Construction ofthe Centrifuge project, complete, as required by the Contract Documents and
Specifications for: CENTRIFL'1GF PROJECT AT WATER RECLAMATION
FACILITY, Project No. 2-0903.
THE CONTRACTsum: S 724 , 820 . 00 in accordance with the terms and
conditions set forth in the Contract Documents.
APursuant I() Secl,(jii 0,the California Public Cuntract Cod,�,, Contf-atAtoi� %as
the option to deposit securities with in Escrow Agent as a substitute f*k)r retention of,
earnings requirement tel he withheld by City pursuant to an Escrow Agreement as set
forth in the Public Contract Code Section 22"300,
3, TIME FOR COMPLETION: The lkork- under this Contract is to be collipleted within two
hundred twenty(2220)calendar days from and after the date of the Notice to Proceed.
4, LIQUIDATED DAMAGES: Failure Of the Contractor to complete the work within the little
allowed will result in damages being sustained by the City. Such damages are, and will
continue to be, impracticable and extremely difficult to determine, The Contractor shall pay to
the City, or have withheld from monies due it, the sum of$500 for each consecutive calendar
davn
I excess oftile: specified time for completion ofthe work. EXMItioll cif the Contract shall
constitUte agreement by the Ci ;
I itv and Contractor that $500 per cim I is the 1111ninitim all(l actual
darnaae caused by the fallurc of the Contractor to complete the «v`ork within tile alloy' cd tilde.
Such SUM is liquidate(] damages arid shall not be construed as -I pcnalty,., In(] may be deducted
from pavirients due the Contractor if such delay occurs,
5. CONTRACT DOCUMENTS: The complete contract documents, under the Agreement,
include all of tile, documents set fbi-th herein, to wit-, Notice Inviting Bids, Instructions lolls to
Bidders, Proposal, Bid Bond, Agreement, Perforniance Bond, Labor and Material Bond, Plans,
General Conditions, Special Conditions, Special Provisions and Specifications and anv
addenda thereto.
6. ATTORNEYS' FEES: In the event any legal action is corlinienced tel enforce or interpi—t the
te-1115 or Conditions of the Contract dOCUments, the prevailing party in sucli action, In addition lo
any costs and other relief, shall lie entitled to rtcover its reasonable attovnev,
�sfees,
CD--1
7. RESOLUTION OF CONSTRUCTION CLAIMS: Claims by the Contractor in the amount
of S375,000 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 Contracts' 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 Contracts Code Scction 20104,211
shall extend the time limit or supersede the notice requirements provided in this case from
filing claims by Contractor.
h. ELIGIBILITY OF CON'I'PACTOR/St.JB('ONI'RAc,rOR: Contractor and ally
Subcontractors agree to 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 hereto of any rights or
I -
interests under this agreement will 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, its partners,
successors, assigns, and legal representatives in respect to all covenants, agreements, and
obligations contained in the Contract Documents.
1 1. SEVERABILITY.- Any provision or pirt, of the contr,
let docurnent,c hold to h(Y vol(i t-)r
unenforceable under any law or regulation shall be deemed stricken, and all remaining
provisions shall continue to be valid and binding Up011 City and Contractor.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first
written above.
City of Redland
(SEAL) Oviler)
Bv:
%ilayor..,6ty ot'Redlands, CoUntV of L/
ATTI�'S f Sail Keernardino. California
C1tvClerJ�, Citvk4
/' of MIA—
I IBernI J
COUnty6fSan aet!4 , California
(SEAL)
Spiess Construction
Name of Contractgr
Signature of Authorized Agent
Scott A. Coleman, President
Title
...............
Signature of Authorized Agent (if necessary)
..........
Title
333989
Contractor's License No,
CD-2
06/05/2008 09:39 FAX 805 934 4432 SPIESS CONST. Willis 007/008
BOND #105194128
Premium: $6, 375 . 00
PERFORMANCE BOND
Whereas,the City Council of the City of Redlands, State of Call fornia,:and
Spiess Construction Co. , inc.
desip
,nated as, "Pi-Inc I pal") have entered into
an agreement whereby Principal agrees to install and completc certain designated public improvements,
which Said agrcerneni,dated -- I D J LA >J k -1 2009, and identified as CENTRIFUGF
PROJECT AT WATER ll' FCLAMATION FACILITY, Project No. 2-0903 is hereby referred
to and mode part.hercof, ,und
Whereas, said Principal is required under the (erms of said apreernent to furnish a bond fi)r the
perl4matice of said project.
Travelers Casualty and Surety
Now, therefore.said Principal and CoIgDany. of._America as sus-0tV are held
firmly bound unto the City of Redlands(hereinafter call"City"), in the penal surn of Seven Hundred Twenty
Four Thousand Eight Hundred Twenty--Dollars 724,82 0.00
luwf'lll nlolicy (11, tile
United States, tor the payinen I of WlIrCil -surn W ell and truly to lie made, we bind oursclvt�s. our heirs,
I
successors.executors and saclrrairtistratcars,.tcairatly andseverally. firmly by these presents.
The condition of this obligation is such that if the abovc boundcd Principal, his or hers heirs, executors,
administrator, successors or assigns, shall in all things stand to and abide by,and well and truly keep and
perforril the eoNenants,conditions and provisions in the said agreement and anyalteration thereofiliade as
therein provided, or his of, their part, to he kept and performed at the time and in the manner therein
specihcd, and mall respects according to their true intent and meaning,, and shall defend, indemnify III(]
savc hjrmlcs,, (tic City, Its elected officials,officers, a"ents and employees. as therein stipulated,then
obligation shall hccofne null and vole}; otherwise it shall be and remain in full force and effect.
As as part ofthe obligation secured hereby sand in addition the face•arnount specified therefore, them shall
be included costs and reasonable expenses and fees, including reasonabic, altorne,y's t'ecs� incurred by tile
City In sucQcssfully ent'Orcing such obligation, all to be taxed as costs and included In any judgillent
rendered,
1110 Surety hereby StIPUh1tCS and agrees thio no chingw, extension of How, ilteration or addition to the
terins of Inc agreenicnt or to the work to be performed thereunder or the specificatiotiF accompanying,the
saille shall in anywisc afft-vt its obligations on iflUs brand, srrad It does herelivwaive ll(')ticC
I Of afly Such
chaiigc, extension of time, alteration or addition to tile teens ofthe agreement or to the work of, to the
specificatiofls.
In witncNs whcrcol', this instrument has been duly executed by the Principal and Surety above narneJ, oil
June 5 2009,
,A (SEAL) (SEAL)
Spiess anstrtictionA Inc. Travelers Casualty and Surety Company of America
(Sure
By:
BY:
Erin ttorney�-in- act
(Is,I gin—atur-e-)- -Or"" 99ut (Zgnature
'V�-r A. CoLC-NAN, Pwc-N—r Address, 100 California Street, Suite 3.90
San Francisco, CA 94111
(Scal and Notarial Acknowledi
gment of' 'I'Clepholle( 415 }732 1452
.............------......
Surety)
CD-4
06/05/2008 09:40 FAX 805 934 4432 SPIESS CONST. Willis 008/008
BOND #105194128
LABOR AND MATERIAL BOND
Whereas,the City of the City of Redlands, State of California, and
Spiess Construction Co. , !no. dcsigrialed a.q Principal".) have
title , into an agreement whereby Prilicipal agrees to install and complete certain de.,zignated pub!Ie
improvements,which said agreement..datedNl2t 09. and identified 3s
CENTRIFUGE PROJECTAT WATER RECLAMATION FACILITY, Project No. 2-0903
is hereby referred to and made a part hereol',and
Wheresi, under the terms of said agreement, Principal is required before entering upon lite performance;
tai'the work, to file a good and sufficient payment bond with the City of'Rediands to secure lite claims to
which reference is mide in Title 15 (commencing with Section 3082) of Part 4 of Division 3 of they Civil
Code ofthe Stale ofCa,11R)rnia.
Now. therefore, said Principal and the undei,signed as corporatc surety, are held firmly hound onto. the
City of Redlands and all, contractors, Subcontractors, laborens. matcrial rocit and other persons employed
in the performancv. of the aforesaid agreement and referred to in ihcafore�sald Code of Civil Procedure. in
-Seven Hundred TwentV dour
01C slant 01 I)ollars �20-00} for materials furnished or labor
thereon of any kind, or for anjQonjS due Under the Unemployment Insuraricc Aa with respect to such
work or labor, that said surety will pay ffic same inari artiount not exceeding the arnount hcj-cinabove set
l'ordi, and also in case suit is, brought upon this bond, will pay, in addition to the face. arnount, ilivreol,
costs and reasonablv, cxpvnscs and fees. including reasonable attorney's fcvs, incurred by the City of
Redlands in successfully ent'orcing, such obligation, it)be awarded and fixed by the court, and to be taxed
as costs and to tv.- included in the judgment.thercin 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 Oalrns under Title 15 (conirnencing with !,"."cetton
3082) of'Part 4 of Division 3 of the Civil Code, so as to give a right of action to them or their a-ssigns in
any suit brought upon this bond.
Should the condition of this bond be fully performed, then this obligation sh.all become 11011 and void,
otherwisc it shall be and remain in full force and effea
The suretyhereby stipulates and agrevs that no ohange, extension of tinie, alteration or iki(iihon to Lhe
Z�
terni,,', of said agreement or the specifications accompanying ihe sarne shall in any manner afl'cct its
obligations on 1111's bond, and it does hereby waive notice of any such change, extension of time,alteration
or addition.
In witness whereof, this instrument has been duly executed by the Principal and surety above named, on
June 5 2009.
Spiess Anhtrucjtion)Coinc. Travelers Casualty and Surety Company of America
are
�(Signaturc) Er4n_-1aUtistLa - (SignaturT) A torney-in-Fact
'St A. (CLEMAH, E6 1 LE-JJ7 Address; 100 California Street, Suite 300
San Francisco, CA 94111
(Scat and Notarial Acknowledginent ot'Sittety) 'tel ep'lone(4 15 }732-1482
CD-5
WORKER'S COMPENSATION INSURANCE CERTIFICATION
Description of Contract: City ot'Redlands
municipal [ftilities& Enginecrim, Department
CENTRIFUGE PROJECT AT WATER
RECLAMATION FACILITY
Project No. 2-0903
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 beinL, insured against liability tot pay compensation in one or more insurer
duly authorized to wvrite compensation insurance in this State,
(b) By securing fi-orn 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 ant aNvare 4 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 ofthis conn-act. (Labor Code section 1SC}1)
Dated this 10th day of June 2009,
Spiess Construction Co-._,_._._Inc .
`on n-,ctor)
(Signature)
S_cqtt A. Colenan_,__President
(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-3
SPIECON-02 MALE
ACORQTM %IIDDN"
,. CERTIFICATE OF LIABILITY INSURANCE '2009
PRODUCER (805)965-0071 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown&Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.O. Box 1469 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Barbara,CA 93102-1469
INSURERS AFFORDING COVERAGE NAIL#
INSURED Spiess Construction Co.Inc. iNsuRERk.Travelers Property Casualty Co of Americ,
PO Box 2849 INSURER B:Travelers Indemnity Company of Connecti
Santa Maria,CA 93457
INSURER C:
INSURER 0:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
i ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
i i
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN-SR AD D'LPOALICYMFFECTIVE E
LTR POLICY NUMBER DTE( "Wou"E'W"MM9N LIMITS
TYPE OF INSURA;1��
GENERAL LIABILITY EACH OCCURRENCE 11000,000
_1 300,000
A X COMMERCIAL GENERAL LIABILITY DTEC07999B022TIL08 812212008 8122/2009
_EREMISFS JEq qcc�enc;el $
CLAIMS MADE L_X_J OCCUR MED EXP(Any one person) i 10,000
PERSONAL&ADV INJURY Is 1,000,005
GENERAL AGGREGATE S 2,000,000
GENL AGGREGATE LIMIT APPLIES PER, PRODUCTS-COMP/OP AGG $ 2,000,000
JECT [7
POLICY I X]IRO-
LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $ 1,000,000
B X ANY AUTO DT8107999BO22TCTOB 812212008 8/2212009 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
-5c, HIREDAUTOS BODILY INJURY
(Per accident)
X 1 NON-OWNFD AUTOS
PROP ERTY DAMAGE 1
I(Per
accide"')
GARAGE LIABILITY LAUTO ONLY-EA ACCID-EN T__
ANY AUTO011-IER THAN _EAACC_ $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,005
A XOCCUR CLAIMSMADE DTSMCUP7999BO22TIL08 8/2212008 8/22/2009 AGGREGATE s 6,000,000
DEDUCTIBLE
$
—XI RETENTION 10,0001
1117ORLII
H-
WORKERS COMPENSATION AND TY MIT ER
EMPLOYERS"LIABILITY 1 1 E.L.EACH ACCIDENT s
ANY PROPRIETOFZIPAFZTNERtF.)(r-.CLTIVC -------------
OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEEI$
11 yes,describe under
SPECIAL PROVISIONS t0ow E.L.DISEASE-POLICY LIMIT 1$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
10 Days Notice of Cancellation for Non-Payment of Premium
lability
Job#2916,Centrifuge Project at the Water Reclamation Facility.Certificate Holder is included as Additional Insured under the General
IS
ability per the attached form CGD246 08105. General Liability Insurance Is Primary&Non-Contributory per the attached form CGD246 08105.
a a
Iver of Subrogation applies to the General Liability per the attached form OGD316 07/04.
1 1
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Redlands
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
P.O. Box 3005
Redlands,CA 92373- NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO So SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
ACORD 25(2001108) 0 ACORD CORPORATION 1988
---------------------
SPIECON-02 MALE
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed,A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s),authorized representative or producer,and the certificate holder,nor does it
affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon,
ACORD 25(2001108)
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. WHO IS AN INSURED—(Section 11) is amended c) The insurance provided to the additional in-
to include any person or organization that you sured does not apply to "bodily injury" or
agree in a "written contract requiring insurance" property damage" caused by "your work"
to include as an additional insured on this Cover- and included in the "products-completed op-
age Part, but: erations hazard" unless the "written contract
a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you
"property damage"or"personal injury";and to provide such coverage for that additional
insured, and then the insurance provided to
b) If, and only to the extent that, the injury or the additional insured applies only to such
damage is caused by acts or omissions of "bodily injury" or "property damage" that oc-
you or your subcontractor in the performance curs before the end of the period of time for
of "your work" to which the "written contract which the "written contract requiring insur-
requiring insurance" applies, The person or ance" requires you to provide such coverage
organization does not qualify as an additional or the end of the policy period, whichever is
insured with respect to the independent acts earlier.
or omissions of such person or organization. 3. The insurance provided to the additional insured
2. The insurance provided to the additional insured by this endorsement is excess over any valid and
by this endorsement is limited as follows: collectible "other insurance", whether primary,
a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is
this Coverage Part shown in the Declarations available to the additional insured for a loss we
exceed the limits of liability required by the cover under this endorsement. However, if the
"written contract requiring insurance", the in- "written contract requiring insurance" specifically
surance provided to the additional insured requires that this insurance apply on a primary
shall be limited to the limits of liability re- basis or a primary and non-contributory basis,
quired by that "written contract requiring in- this insurance is primary to "other insurance"
surance". This endorsement shall not in- available to the additional insured which covers
crease the limits of insurance described in that person or organization as a named insured
Section III—Limits Of Insurance. for such loss, and we will not share with that
"other insurance". But the insurance provided to
b) The insurance provided to the additional 'in- the additional insured by this endorsement still is
sured does not apply to Obodily Injury", "prop- excess over any valid and collectible "other in-
erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or
of the rendering of, or failure to render, any on any other basis, that is available to the addi-
professional architectural, engineering or sur- tional Insured when that person or organization is
veying services, including: an additional insured under such "other insur-
1. The preparing, approving, or failing to ance".
prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the
ings, opinions, reports, surveys, field or- additional insured by this endorsement:
ders or change orders, or the preparing,
approving, or failing to prepare or ap- a) The additional insured must give us written
prove, drawings and specifications; and notice as soon as practicable of an "occur-
rence' or an offense which may result in a
ii. Supervisory, inspection, architectural or claim. To the extent possible, such notice
engineering activities. should include:
CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page I of 2
�
`
^ . �
�
COMMERCIAL GENERAL LIABILITY |
!
I. H�` w�n �� �om �� ^�cm�n�' w�pmv�r��h��u�n�'w�h�u
' �
the additional insured for a loss we
mo�n���p�e cover
covwrunder th� ondo�ement Howover, this
i1. The names and mddneaa�nofonYi'�umd condition dues � affect whether the insur-
ancei
p�rsuno�mdv�tnmsaeo�and provided to the additional insured by i
iii. The mduna and location of any injury or this endorsement is primary to "other }naur- �
damogeeriwingoutof\he~oouurrenme''or anoa" available to the additional insured
offense. which covers that person mrorganization eaa �
b) If claim is made or"suit" is brought against named insured as described In paragraph 3. `
the additional insured, the additional insured above.
must: 5. The following definition is added to SECTION V. |
|
L Immediately record the specifics of the —DEF|N|T|ONS: �
claim or"ouU" and the date received; and "Written contract requiring insurance" means �
U' Notify usassoon oapracticable. that part ofany written contract nragreement �
under which you are required to include a
The additional insured must see to it that we person or organization as an additional in-
receive written notice of the claim or"suit" as sun*d on this Coverage Port, provided that
soon oypracticable, the "bodily injury" and "property damage"oc-
|
o) The additional insured must 'immediately curs and the "personal injury" |scaused byan �
send us copies of all legal papers received in offense committed:
connection with the claim or^suit". cooperate m. After the signing and execution ofthe
with us in the investigation o, setUementnf contract oragreement byyou; !
the claim or defense against the ''suit", and
otherwise comply with all policy conditions. b. While that part ofthe contract or
d) The additional insured must tender the de-
agreement|sineffect; and
feneoand indemnity ofany claim or ~muit' \o c. Before the end ufthe policy period,
�
Page of 2 0 2005 The St. Paul Travelers Companies, Inc. CGD24O08 05
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS XTEND ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE—Provisions A.-H,and J.-N.of this endorsement broaden coverage,
and provision 1. of this endorsement may limit coverage. The following listing is a general coverage description
only. Limitations and exclusions may apply to these coverages. Read all the PROVISIONS of this endorsement
carefully to determine rights,duties, and what is and is not covered.
A. Broadened Named Insured H. Additional Insured—State or Political Subdivisions
B. Extension of Coverage—Damage To Premises 1. Other Insurance Condition
Rented To You J. Increased Supplementary Payments
• Perils of fire,explosion,lightning, smoke,water 0 Cost of bail bonds increased to$2,500
• Limit increased to$300,000 * Loss of earnings increased to$500 per day
C. Blanket Waiver of Subrogation K. Knowledge and Notice of Occurrence or Offense
D. Blanket Additional Insured—Managers or Lessors L. Unintentional Omission
of Premises
E. Incidental Medical Malpractice M. Personal Injury—Assumed by Contract
N. Blanket Additional Insured—Lessor of Leased
F. Extension of Coverage—Bodily Injury Equipment
G. Contractual Liability—Railroads
PROVISIONS 3. This Provision A. does not apply to any per-
son or organization for which coverage is ex-
A. BROADENED NAMED INSURED
cluded by endorsement.
1. The Named Insured in Item 1. of the Declara-
tions is as follows: B. EXTENSION OF COVERAGE — DAMAGE TO
The person or organization named in Item 1. PREMISES RENTED TO YOU
of the Declarations and any organization, 1 The last paragraph of COVERAGE A. BOD-
other than a partnership,joint venture or lim- ILY INJURY AND PROPERTY DAMAGE LI-
ited liability company, of which you maintain ABILITY (Section I — Coverages) is deleted
ownership or in which you maintain the major- and replaced by the following:
ity interest on the effective date of the policy. Exclusions c.through n.do not apply to dam-
However, coverage for any such additional age to premises while rented to you, or tem-
organization will cease as of the date, if any, porarily occupied by you with permission of
during the policy period, that you no longer the owner, caused by:
maintain ownership of, or the majority interest a. Fire;
in, such organization. b. Explosion;
2. WHO IS AN INSURED (Section 11) Item 4.a. c. Lightning;
is deleted and replaced by the following:
a. Coverage under this provision is afforded d. Smoke resulting from such fire,explosion,
only until the 180th day after you acquire or lightning;or
or form the organization or the end of the e. Water.
policy period,whichever is earlier. A separate limit of insurance applies to this
coverage as described in Section III Limits Of
insurance.
CG D3 16 07 04 Copyright,The Travelers Indemnity Company, 2004 Page I of 6
COMMERCIAL GENERAL LIABILITY
2. This insurance does not apply to damage to 5. This Provision B. does not apply if coverage
premises while rented to you, or temporarily for Damage To Premises Rented To You of
occupied by you with permission of the COVERAGE A. BODILY INJURY AND
owner, caused by: PROPERTY DAMAGE LIABILITY(Section I—
a. Rupture, bursting, or operation of pres- Coverages)is excluded by endorsement.
sure relief devices; C. BLANKET WAIVER OF SUBROGATION
b. Rupture or bursting due to expansion or We waive any right of recovery we may have
swelling of the contents of any building or against any person or organization because of
structure,caused by or resulting from wa- payments we make for injury or damage arising
ter; out of: premises owned or occupied by or rented
c. Explosion of steam boilers, steam pipes, or loaned to you; ongoing operations performed
steam engines, or steam turbines. by you or on your behalf,.done under a contract
with that person or organization; "your work"; or
3. Paragraph 6. of LIMITS OF INSURANCE "your products". We waive this right where you
(Section 111) is deleted and replaced by the have agreed to do so as part of a written contract,
following: executed by you before the "bodily injury" or
Subject to 5. above, the Damage To Prem- property damage" occurs or the "personal injury"
ises Rented To You Limit is the most we will or"advertising injury"offense is committed.
pay under COVERAGE A. for the sum of all D. BLANKET ADDITIONAL INSURED — MANAG-
damages because of "property damage" to ERS OR LESSORS OF PREMISES
any one premises while rented to you, or WHO IS AN INSURED (Section 11)is amended to
temporarily occupied by you with permission
include as an insured any person or organization
of the owner, caused by: fire: explosion; light-
ning; smoke resulting from such fire, explo- (referred to below as "additional insured") with
whom you have agreed in a written contract, exe-
sion, or lightning; or water. The Damage To cuted before the "bodily injury" or"property dam-
Premises Rented To You Limit will apply to all
"property damage"proximately caused by the age" occurs or the "personal injury" or "advertis-
same "occurrence", whether such damage ing injury" offense is committed, to name as an
results from: fire; explosion; lightning; smoke additional insured, but only with respect to liability
resulting from such fire, explosion, or light- arising out of the ownership, maintenance or use
ning; or water; or any combination of any of of that part of any premises[eased to you, subject
these causes. to the following provisions:
1. Limits of Insurance. The limits of insurance
The Damage To Premises Rented To You afforded to the additional insured shall be the
Limit will be the higher of:
limits which you agreed to provide in the writ-
a. $300,000; or ten contract, or the limits shown on the Decla-
b. The amount shown on the Declarations rations,whichever are less.
for Damage To Premises Rented To You 2. The insurance afforded to the additional in-
Limit. sured does not apply to:
4. Paragraph a.of the definition of"insured con- a. Any "bodily Injury" or "property damage"
tract" (DEFINITIONS — Section V) is deleted that occurs,or"personal injury"or"adver-
and replaced by the following: tising injury" caused by an offense which
a. A contract for a lease of premises. How- is committed, after you cease to be a ten-
ever, that portion of the contract for a ant in that premises;
lease of premises that indemnifies any b. Any premises for which coverage is ex-
person or organization for damage to cluded by endorsement;or
premises while rented to you, or tempo- c. Structural alterations, new construction or
rarily occupied by you with permission of demolition operations performed by or on
the owner, caused by: fire; explosion; behalf of such additional insured.
lightning; smoke resulting from such fire,
explosion, or lightning; or water, is not an 3. The insurance afforded to the additional in-
"insured contract", sured is excess over any valid and collectible
Page 2 of 6 Copyright,The Travelers Indemnity Company,2004 CG D3 16 07 04
` \
�
|
COMMERCIAL GENERAL LIABILITY |
"other insurance" available to such additional together With all related acts momissions in |
ineured, unless you have agreed inthe writ- the furnishing of the aan/ioes described in |
ton contract that this insurance must be pri- paragraph 1' above toany one person will be �
maryhn. or non-contributory with, such "other deemed one"occurronce". �
|
insurance". 5. This Provision E. does not apply ifyou are in
E. INCIDENTAL MEDICAL MALPRACTICE the business or occupation of providing any of �
Y. The following is added to paragraph 1. |nsor- the services described inparagraph 1.above. .
ing Agreement of COVERAGE A. — BODILY 6. The Insurance provided by this Provision E. '
INJURY AND PROPERTY DAMAGE L|AB|L- shall bmexcess over any valid and collectible
|TY(Section I—Covonogas): "other insurance" available to the insured,
"Bodily injury" mhuinM out nfthe rendering of,
whether primary, exu���. contingent or on |
or tmi|un* to render, the following will be any other bayia, except for insurance that you L
bought specifically app|y |n exn�ms of the
deemed to be caused byan"occunenoe": |
Limits of Insurance shown on the Dedara- !
a. Madicm|,surgical, dental, |aboratory,x-ray tions of this Coverage Pa,t
or nursing service, advice or instruction, F EXTENSION OF COVERAGE — BODILY IN-
or the related furnishing of food urbeve� '
JURY |
ages; `
The definition of "bodily ir�u�� (DEFINITIONS /
b. The furnishing or dispensing of drugs or `
modioa|, dental, or surgical supplies or Section V) is deleted and replaced bythe follow-
appliances; Ing:
"Bodily injury" meansbodilyinjury, mentalan-
n. First aid;or
guish, mental injury, shock, fright, disability, hu-
d. "Good Somuhten services." As used in mi|ioUon, sickness or disease sustained by o per-
this Provision E, 'Good Samaritan ser- uon, including death resulting from any of these at
vices" are those medical services ren- any time. {
dmred orprovided inun emergency and
G. CONTRACTUAL LIABILITY—RAILROADS
for which no remuneration is demanded \
�
or received. 1. Paragraph u^ofthe definition o("insured uon- |
�nso� (DEF|N|T|(}NS — S��on \�) iade|eted
2. Paragraph 2.o.(1)(d) of WHO IS AN !N-
SURED (Section H) does not apply to any and replaced bythe following:
registered nurse, licensed practical nurse, o. Any easement orlicense agreement;
emergency medical technician or paramedic 2. Paragraph [(1) of the definition of "insured
employed by you, but only while performing contract" (DEFINITIONS — Section V) is de-
the services described
e'thesem|masdesuhbed in paragraph 1.above la\ed.
and vvbDe acting within the scope of their em- H. �OT|0��L |NSURED — STATE OR � L|T|'
p|oyment by you. Any 'employees" rendering CAL
CAL SUBDIVIS|0NS—PERMITS
'Good Samaritan services"will be deemed to
be acting within the scope of their employ- WHO |8ANINSURED (Section 1|)iaamended to
mentbyyou. include as on insured any state or political subdi-
3. The following exclusion|madded toparagraph vision,subject tothe following provisions:
2. Exclusions of COVERAGE A. — BODILY 1. This insurance applies only when required to
INJURY AND PROPERTY DAMAGE L|AB|L' be provided by you by an ordinance, law or
|TY(Section \—{omerages): building code and only with respect to opera-
(This insurance does not apply tn.)"Bodily In- tions performed by you or on your behalf for
�
jury" or "property damage" arising out of the which the state orpolitical subdivision has Is-
willful violation of a penal st
s-wi|Ku|v{ofatiunn[apena|stsued permit.
'
relating tothe sale of phaxnaueubmalsoom- 2. This insurance does not apply bo�
mittedbyorwith the knowledge orconsent of a. "Bodily injury," "property damage." "per-
the
ep
tbmineured. suna| injury"c«"advm�|�ng injury" arising
4. For the puq»umos of determining the opp|ios- out of operations performed for the state
b|* limits of insummnno, any act or omission or political subdivision;or
CG D3 16 07 04 Copyright,The Travelers Indemnity Company,2004 Page 3 of
�
. �
|
i
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COMMERCIALgENEFg\ LIABILITY
i
b. "Bodily injury" or "property damage" in- insured under any other policy, �
oluded |nthe ~producta-completed opera- including any umbrella or excess
tions hazard". policy, �
\. OTHER INSURANCE CONDITION When this insurance is excess, we �
will have nuduty under Coverages A �
A. COMMERCIAL GENERAL LIABILITY CON- or todefend the insured against �
D|T|QNS (Section |V), paragraph 4. (Other any "suit" ifany provider of "other in-
Insurance) Is deleted and nap|eoed bythe fol- eunanoe" has a duty to defend the in-
lowing: ounad against that "suit', If no pro'
4. Other Insurance vider of "other insurance" defends. |
wewill undertake hodoso,but wewill
|fvalid and collectible"other insurance"is be entitled to the ineuvad'oNn
available to the insured for a |ooe we against all those providers of "other
cover under Coverages A or B of this imaunannm^
Coverage Part, our obligations are limited !
When this insurance in excess over |
as follows:' "other insunanuo", we will pay only
o. Primary Insurance our share ofthe amount ofthe loss, if
This insurance is primary except any,that exceeds the sum of:
when b. below applies. If this |nour- (1) The total amount that all such
onma is phmary, our obligations are "other insurance" would pay for
not affected unless any of the ^cdh*r the kzsm in the absence of this in-
insurance" is also primary. Then, we munanoe;and
will share with all that "other insur-
ance" bythe method described in m, (2) The total of all deductible and
self-insured amounts under that
below.
"other !
inaunxnoe,. |
b �zce�a |nsumanoe
' We will share the remaining loss, if
This insurance in excess over any of any,with any"other insurance"that\o
the "other insurance", whether Ph- not described in this Exo*aa |neur-
mary. excess, contingent or on any onoepn�iainn�
other basis:
|
� c. Method OfSharing |
(1) That is Fire, Extended CovensQe,
Builder's Risk, Installation Risk, if all of the "other insurance"
permits
contribution by equal shares, we will
or similar coverage for 'your follow this method a|a�. Under this
work";
|�
approach each provider mfinsurance /
(2) That is Fin* insurance for prem' contributes equal amounts until it has
isomnented to you or temporarily paid its applicable limit of insurance
occupied byyou with permission or none of the )oan oammine' which-
of the owner,
hich'mfthaowner, ever comes first.
(3) That is insurance purchased by If any of the "other insurance" does
you to cover your liability as a not pwnn|1 contribution by equal
tenant for "property damage~ to mhmrea, we will contribute by limits.
premises rented toyou urtempo- Under this method, the share ofeach
rahly occupied by you with pep provider ofinsurance Is based on the
mission nfthe owner; or ratio of its applicable limit of |nsur-
(4) If the k»ms arises out ofthe main- enoe to the total applicable limits of
tenmnoe or use of aircraft, insurance of all providers of imuup
°autos", or wabamnmft to the ex- anma.
tent not subject toExclusion g^ cf B. The following definition imadded toDEFINITIONS
Section | — Cm/anmge A— Bodik/
(Section V):
Property|,�uryAnd Pnup�, Damage U- ,
ability-,or ~Other|nsunan�e :
(5) That is available to the insured m. [Naano inaunmnoe, or the funding of |msmms,
when the insured is on additional that is provided by,through o/on behalf of:
Page 4WG Copyright,The Travelers Indemnity Company, 2OD4 CG D316 0784
COMMERCIAL GENERAL LIABILITY
(1) Another insurance company: 2. Notice of an "occurrence" or of an offense
(2) Us or any of our affiliated insurance com- which may result in a claim will be deemed to
panies, except when the Non cumulation be given as soon as practicable to us if it is
of Each Occurrence Limit section of given in good faith as soon as practicable to
Paragraph 5 of LIMITS OF INSURANCE your workers' compensation insurer. This ap-
plies only if you subsequently give notice of
(Section 111)or the Non cumulation of Per-
the "occurrence" or offense to us as soon as
sonal and Advertising Injury limit sections practicable after you, one of your "executive
of Paragraph 4 of LIMITS OF INSUR-
officers"(if you are a corporation),one of your
ANCE(Section 111)applies;
partners who Is an individual (if you are a
(3) Any risk retention group; partnership),one of your managers(if you are
(4) Any self-insurance method or program, a limited liability company), or an "employee"
other than any funded by you and over (such as an insurance, loss control or risk 7
which this Coverage Part applies;or manager or administrator) designated by you
(5) Any similar risk transfer or risk manage- to give such notice discovers that the "occur-
rence"or offense may involve this policy.
ment method. 3. This Provision K. does not apply as respects
b. Does not include umbrella insurance, or ex- the specific number of days within which you
cess insurance,that you bought specifically to are required to notify us in writing of the
apply in excess of the Limits of Insurance
shown on the Declarations of this Coverage abrupt commencement of a discharge, re-
Part. lease or escape of "pollutants" that causes
"bodily injury" or "property damage" which
J. INCREASED SUPPLEMENTARY PAYMENTS may otherwise be covered under this policy.
Paragraphs Ib. and I.d. of SUPPLEMENTARY L. UNINTENTIONAL OMISSION
PAYMENTS—COVERAGES A AND B (Section I The following is added to COMMERCIAL GEN-
-Coverages)are amended as follows: ERAL LIABILITY CONDITIONS (Section IV),
1. In paragraph I.b., the amount we will pay for paragraph 6. (Representations):
the cost of bail bonds is increased to$2500, The unintentional omission of, or unintentional
2. In paragraph 1A., the amount we will pay for error in, any information provided by you which
loss of earnings is increased to$500 a day. we relied upon in issuing this policy shall not
K. KNOWLEDGE AND NOTICE OF OCCUR- prejudice your rights under this insurance. How-
RENCE OR OFFENSE ever,this Provision L. does not affect our right to
collect additional premium or to exercise our right
1. The following is added to COMMERCIAL
of cancellation or nonrenewal in accordance with
GENERAL LIABILITY CONDITIONS (Section applicable state insurance laws, codes or regula-
IV), paragraph 2. (Duties In The Event of Oc- tons.
currence,Offense, Claim or Suit): M. PERSONAL INJURY — ASSUMED BY CON-
Notice of an "occurrence" or of an offense
TRACT
which may result in a claim must be given as
soon as practicable after knowledge of the 1. The following is added to Exclusion e. (1) of
"occurrence"or offense has been reported to Paragraph 2., Exclusions of Coverage B.
you, one of your "executive officers" (if you Personal Injury, Advertising Injury, and
are a corporation), one of your partners who Web Site Injury Liability of the Web XTEND
is an individual (if you are a partnership), one Liability endorsement:
of your managers (if you are a limited liability Solely for the purposes of liability assumed In
company), or an "employee" (such as an in- an "Insured contract", reasonable attorney
surance, loss control or risk manager or ad- fees and necessary litigation expenses in-
ministrator) designated by you to give such curred by or for a party other than an insured
notice. are deemed to be damages because of"per-
Knowledge by any other "employee' of an sonal injury"provided:
,.occurrence" or offense does not imply that (a) Liability to such party for, or for the cost
you also have such knowledge. of,that party's defense has also been as-
CG D3 16 07 04 , Copyright,The Travelers Indemnity Company, 2004 Page 5 of 6
COMMERCIAL GENERAL LIABILITY
surned in the same "insured contract"; N. BLANKET ADDITIONAL INSURED — LESSOR
and OF LEASED EQUIPMENT
(b) Such attorney fees and litigation ex- WHO IS AN INSURED (Section 11)is amended to
penses are for defense of that party include as an insured any person or organization
against a civil or alternative dispute reso- (referred to below as "additional insured") with
lution proceeding in which damages to whom you have agreed in a written contract, exe-
which this insurance applies are alleged. cuted before the "bodily injury" or"property dam-
2. Paragraph 2.d. of SUPPLEMENTARY PAY- age" occurs or the "personal injury" or "advertis-
Ing injury" offense is committed, to name as an
MENTS —COVERAGES A AND B (Section I
— Coverages) is deleted and replaced by the additional insured, but only with respect to their Ik
ability for"bodily injury", "property damage", "per-
following:
sonal injury" or "advertising injury" caused, in
d. The allegations in the "suit" and the in- whole or in part, by your acts or omissions in the
formation we know about the "occur- maintenance, operation or use of equipment
rence"or offense are such that no conflict leased to you by such additional insured, subject
appears to exist between the interests of to the following provisions:
the insured and the interests of the in- I. Limits of Insurance. The limits of insurance
demnitee; afforded to the additional insured shall be the
3. The third sentence of Paragraph 2 of SUP- limits which you agreed to provide in the writ-
PLEMENTARY PAYMENTS — COVERAGES ten contract, or the limits shown on the Decla-
A AND B (Section I — Coverages) is deleted rations,whichever are less.
and replaced by the following:
2. The insurance afforded to the additional in-
Notwithstanding the provisions of Paragraph sured does not apply to any "bodily injury" or
2.b.(2) of Section I—Coverage A—Bodily In-
property damage" that occurs, or "personal
jury And Property Damage Liability, or the injury"or"advertising, injury"caused by an of-
provisions of Paragraph 2.e.(1) of Section I — fe�nse which is committed,after the equipment
Coverage B—Personal Injury, Advertising In- lease expires.
jury And Web Site Injury Liability, such pay- 3. The insurance afforded to the additional in-
ments will not be deemed to be damages for sured is excess over any valid and collectible
"bodily injury" and "property damage", or �other insurance" available to such additional
damages for"personal injury", and will not re- insured, unless you have agreed in the writ-
duce the limits of insurance. ten contract that this insurance must be pri-
4. This provision M. does not apply if coverage mary to, or non-contributory with, such "other
for "personal injury" liability is excluded by insurance".
endorsement.
Page 6 of 6 Copyright,The Travelers Indemnity Company, 2004 CG D3 16 07 04
SPIECON-02 MALE PAGE I OF I
F-SCRIPTION OF OPERATIONS-
Spiess Construction Co.Inc. City of Redlands
PO Box 2849 P.O.Box 3005
Santa Marla,CA 93457 Redlands,CA 92373-
10 Days Notice of Cancellation for Non-Payment of Premium
RE:Job#2916,Centrifuge Project at the Water Reclamation Facility.Certificate Holder Is included as Additional Insured under the
General Liability per the attached form CG0246 0=6 and under the Auto Liability per the attached form CA2048 0299. General
Liability Insurance Is Primary&Non-Contributory per the attached forin CGD246 08106. Waiver of Subrogation applies to the
General UaWlft per the attached form CGO316 07104.
'this certificate revises and supersedes certificate issued on 619109.
COMMERCIAL AUTO
POLICY NUMBER: DT-81 0-799OB022-TCT-08 ISSUE DATE:08-21-08
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modl-
fied by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi-
sion of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name of Persion(s)or Organization(s)*
ANY PERSON OR ORGANIZATION WHOM YOU HAVE
AGREED IN A WRITTEN CONTRACT, EXECUTED
PRIOR TO LOSS AND IN EFFECT DURING THIS
POLICY PERIOD, TO NAME AS ADDITIONAL
INSURED.
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to the endorsement.)
Each person or organization shown in the Schedule is an 'insured"for Liability Coverage, but only to the e)dent
that person or organization qualifies as an"insured"under the Who Is An Insured Provision contained in Section
11 of the Coverage Form.
11100,
CA 20 49 02 99 Copyright, Insurance Services Office,Inc., 1998 Page I of I
1-
SPIECON-02 MALE
ACORDDATE(MWDDNYYY)
,. CERTIFICATE OF LIABILITY INSURANCE 1 6/9/2009
PRODUCER (805)965-0071 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown& Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.O.Box 1469 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Barbara,CA 93102-1469
INSURERS AFFORDING COVERAGE NAIC
INSURED Spiess Construction Co Inc INSURER k.SeaBright Insurance Company
PO Box 2849 INSURER B:
Santa Maria,CA 93457 INSURER C:
INSURER 0:
INSURER E
COVERAGES
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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE ICY EXPIRATION 1
IWff 06117 TYPE Of INSURANCE POLICY NUMBER P RAL TE IMMIDDIYY) LIMITS
LTR INSRCI DATE(MWDDIYYI
GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO-RI—NTE15—
COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) $
CLAIMS MADE OCCUR MED EXP(Any one person)
E]
PERSONAL&ADV INJURY
i GENERAL AGGREGATE $
I GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
POLICY[ JPERC'T 71 LOG
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea aca,dent)
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
$
SCI ILDULED AUTOS (Per person)
HIREDAU1QS BODILY INJURY
(Per accident) $
NON.OWNEDAUTOS
PROPERTY DAMAGE
(Per accident)
LIABILITY AUTO ONLY-EA ACCIDENT
ANY AUTO CTHLR I HAN EA ACC $
AUTO ONLY: AGG
_�XCESS[UMBRELLA LIABILITY EACH OCCURRENCE
OCCUR CLAIMS MADE AGGREGATE $
$
S
DEDUCTIBLE
RETENTION
WORKERS COMPENSATION AND
A 1 EMPLOYERS'LIABILITY
iBB1081543 10/112008 1
ANY PROPR�ETORIPARINIERIEXECt,'TIVE
I
OFF!CEPJME'MBER EXCLUDED? I
ff y s,describe under
SP'E'CLAL PROVISIONS belew
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS VEHICLES I EXCtUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
0" ,1 i
10 Days Notice of Cancellation for Non-Payment of Premium
L/
IRE:Job#2916,Centrifuge Project at the Water Reclamation Facility.Waiver of Subrogation t
attached form WC 00 0313(ed.4-84).Proof of Insurance.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE AS
City of Redlands
DATE THEREOF,THE ISSI
P.O. Box 3005 f
NOTICE TO THE CERTIFIC
Redlands,CA 92373- IMPOSE NO OBLIGATION( t
v
REPRESENTATIVES.
AUTHORIZED REPRESENTA
ACORD 25(2001108) CACORD CORPORATION 1988
SPIECON-02 MALE
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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),
DISCLAIMER
The Cetficate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it
affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon.
AGORD 25(2001108)
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule, (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
Schedule
WHERE REQUIRED BY WRITTEN CONTRACT, PROVIDED THE
CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF
LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE
SHALL THE PROVISIONS AFFORDED BY THIS ENDORSEMENT
BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE.
THE PREMIUM CHARGE FOR THIS ENDORSEMENT SHALL BE 2%OF THE PREMIUM DEVELOPED IN CA, BUT
NOT LESS THAN$500 POLICY MINIMUM PREMIUM.
This endorsement changes the policy to which it is attached and is effective on the date iMued unless otherwise stated,
(rho information below is required only when this endorsement Is issued subsequent to preparation of the policy.)
Endorsement Effective 10/01108 Policy No. BBIOSIS43 Endorsement No.
Insured Spless Construction Co.,Inc. Policy Effective Date 10101/08
Insurance Company SeeBright Insurance Company
Ar
Countersigned By
WC 00 03 13
(Ed.4-84)
cop"ht 1983 WWORid COU0011 CM compansaftn kmuranm
MALE
DATE(MM/00"
AAQQRD,� EVIDENCE OF PROPERTY INSURANCE 619/2009
THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED,IS IN FORCE,AND CONVEYS ALL THE
RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY.
PRODUCER PH�
_�L��
8�05 COMPANY
965�-0071
i Brown&Brown Insurance Pacific Insurance Company Limited
'P.O. Box 1469
!Santa Barbara,CA 93102-1469
i
-------------
I CODE: SUIR CODE:
AGENCY RIO 9:SPIECON-02
LOAN NUMBER -POLICY NU"ili........--------
Spiess Construction Co. Inc. !RVDOD4060
PO Box 2849 EFFECTIVE DATE EXPIRATI,ON DATE I ONTINUED UNnL
Santa Maria,CA 93457-0000 8/2212008 1 8122/2009 ERMINATED IF CHECKED
EPLACES PRIOR EVIDENCE DATED'
I
PROPERTY INFORMATION
LOCATION/DESCRIPTION
SCCI Job#2916;Centrifuge Project at the Water Reclamation Facility for City of Redlands
COVERAGE INFORMATION
COVERAGFJPERILSIFORMS DEDUCTIBLE
1**All Risk$5000 Per Occurrence 724,820
**Earthquake:5%of Values at Risk Time&Place of Loss per Project subject to 25,000 minimum
—Flood;2%of Values at Risk Time&Place of Loss per Project,subject to 25,000 minimum
REMARKS(including Special Conditions)
10 Days Notice of Cancellation In the Event of Non-Payment of Premium
CANCELLATION
THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS,AND RULES IN EFFECT FOR EACH POLICY PERIOD.SHOULD THE
POLICY BE TERMINATED,THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 30 DAYS
WRITTEN NOTICE,AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT
INTEREST,,IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW,
ADDITIONAL INTEREST
NAME AND ADDRESS EE Li AODITIONAI INSURED
MORTGAG
City of Redlands
P.O.Box 3005
LOAN*
Redlands,CA 92373-
AUTHORIZED REPRESENTATFVE
ACORD 27(3193) Q ACORD CORPORATION 1993
—�09 748 6411 CofR Treasury 04-08 02 p m. 06-08-2009 1
CITY OF REDLANDS
Office of the City Treasurer P YMENT UE
35 Cajon Street,Suite I 5B-P�0.Box 3005 ��ym
Redlands,CA 92373-1505 Phone: (909)798-7557 6130/ '9
aIt
BUSINESS CERTIFICATE RENEWAL NOTICE Penalt Apply After
Now License Period is; 7 11
07/01/2009-06/30/2010 7 1120019
BUSINESS LICENSE NO. 1000441 EXPIRATION DATE 0613012007 0 Bushms Sold
Business Spiess Construction Co Inc Phone No. (805)937-5859 Ef"I Daft or swo
Nameand Job Site Fax No. (805)934-4432 0 Susirm"CW*d_
Location Entw Do%
Redlands,CA 92373 Start Date 01/25/2006 0 -cwtnictors-No worit in V*city
Rat#Typ* 2242.1 of R#dfands of this dm&
Mailing SPIESS CONSTRUCTION CO INC SIC Code 1521001
Address PO BOX 2849 NAIC Code 236115
SANTA MARIA CA 93457 Ownership Corporation
Email Address State License No. 33399
License Type A(B/C27/C33
Description of Business Gen Const Expiration Date
Federal ID No, 95-3119974 State ID No. Resale No.
Ownws,ParbwM Or C*rP*r*t*Officem-Plee"make any necessary correctlions.
Name Scott A.Coleman Title Pres Date of Birth
Address 612 Hillside Ct Phone#1 (805)331-7230 Driver's Lic It
Arroyo Grande,CA 93420 Phone#2 SSIN#
Name Barry L.Matched Title Vp Date of Birth
Address 1144 Shady Glen Phone#1 (805)331-7236 Driver's Lic#
Santa Maria,CA 93455 Phone#2 SSN#
Emergency Contact-Polig-9&Fim use this COD Ct for Ofter h0mrs emompinclos,(not spolicarWo for"omo Occupations)
Name Title Phone No.
Address
Alarm COMPanY-Piss"make any necessary corrections.
Name Lic.No.
Address
Phone No.
Payment is now due for your 2009 City of Redlands Business Tax, PLEASE COMPLETE THE FOLLOWING:
in the amount of$100.00,plus the renewal processing fee of$20,00,
The Total Amount Due is$120.00. Actual Gross Receipts $ N/A
Previous Balance
If you have any changes to the information above,please make them on this (includes Penalty) $0.00
form and return the form to the office. Business Fee (00
if you are no longer doing business In this City,please note that fact In the DRIBA N/A
box at the top right of this form and return this notice or contact our office
immediately, L.A.Fee
If you have any questions,please call(909)798-7557 Other
Penalty
Rene"'(Fee
....................
TOTAL AMOUNT DUE
Z)Cash L)Check* ...... y�Order
tvcI declare, under penalty that the information pro "cled he I t e d correct.
Signature of Owner or Representative T-Itie T
RETURN COMPLETED RENEWAL NOTICE A89OVE ADDRESS WITH A CHECK PAYABLE TO CITY OF REDLANDS.
Printed 6/8/2009:5:00 pm
06/08/2009 MON 17!og rTX/RX Nn Q1nA1 a oni