HomeMy WebLinkAboutContracts & Agreements_207-2002THIS AGREEMENT, made and entered into this 17"' day of December. 2002, 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 TASCO Construction, Inc., located in the City of Riverside,
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 Salvation Army Playground project, complete, all as shown, specified, and
made a part of Contract No. 243300-7150/43014.
2. THE CONTRACT SUM OF: $72,135.00
3. TIME FOR COMPLETION: The work shall be completed within forty-five (45) 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,
Performance Bond, Payment 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 attorneys 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 omission 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 insured, and such insurance shall be primary with respect to such
additional insured and non-contributing to any insurance or self-insurance maintained by the additional
insured.
The contractor is required to comply with all prevailing wage laws with regard to this HUD funded project within the
State of California. The Federal Labor Standards Provisions (HUD 4010) as contained in Part 11 of these contract
supplemental specifications are included and inserted with this Agreement and made a part of this contract.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate on the day
and year first written above.
CITE S SEAL
U-2
STTy� crk, City of }ANDS
A "
County of San Bernardi 0California
Mayor, City of REDLANDS
County of San Bernardino, California
TASCO Construction, Inc.
Name of Contractor
CONTRACTOR'S SEAL By:
(�Ignature oekniiiorized Agent
President
Signatory's Title
Signature of Authorized Agent (if necessary)
Signatory's Title q neresstay)
685331
Contractor's License No.
rill
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
Contract No. 243300-7150/43014.
TASCO Construction. Inc.
Name of Contractor
By:
gnature of Authorized 'thorized Agent
� M
Signatory's Title
685331
Contractor's License No.
A. APPLICABILITY. The Project or Program to which the construction work covered by this contract
pertains is being assisted by the United States of America, and the following Federal Labor Standards
Provisions are included in this contract pursuant to the provisions applicable to such Federal assistance.
1. Minimum Wages.
(i) All laborers and mechanics employed or working upon the site of the work (or under the
United States Housing Act of 1937 or under the Housing Act of 1949 in the construction or
development of the project), will be paid unconditionally and not less often than once a week, and
without subsequent deduction or rebate on any account (except such payroll deductions as are
permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR Part
3), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time
of payment computed at rates not less than those contained in the wage determination of the
Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual
relationship which may be alleged to exist between the contractor and such laborers and
mechanics. Contributions made or costs reasonably anticipated for bona fide fringe benefits under
Section l(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages
paid to such laborers and mechanics, subject to the provisions of 29 CFR Part 5.5(a)(1)(iv). also,
regular contributions made or costs incurred for more than a weekly period (but not less often than
quarterly) under plans, funds, or programs, which cover the particular weekly period, are deemed
to be constructively made or incurred during such weekly period. Such laborers and mechanics
shall be paid the appropriate wage rate and fringe benefits on the wage determination for the
classification of work actually performed, without regard to skill, except as provided in 29 CFR
Part 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be
compensated at the rate specified for each classification for the time actually worked therein:
Provided, that the employer's payroll records accurately set forth the time spent in each
classification in which work is performed. The wage determination (including any additional
classification) and wage rates conformed under 29 CFR Part 5.5(a)(1)(ii), and the Davis -Bacon
poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site
of the work in a prominent and accessible place where it can be easily seen by the workers.
(i) (a) Any class of laborers or mechanics which is not listed in the wage determination and which
is to be employed under the contract shall be classified in conformance with the wage
determination. HUD shall approve an additional classification and wage rate and fringe
benefits therefore only when the following criteria have been met:
I - The work to be performed by the classification requested is not performed by a
classification in the wage determination; and
2- The classification is utilized in the area by the construction industry; and
3- The proposed wage rate, including any bona fide fringe benefits, bears a reasonable
relationship to the wage rates contained in the wage determination.
(b) If the contractor and the laborers and mechanics to be employed in the classification (if
known), or their representatives, and HUD or its designee agree on the classification and wage
rate (including the amount designated for fringe benefits where appropriate), a report of the
action taken shall be sent by HUD or its designee to the Administrator of the Wage and Hour
Division, Employment Standards Administration, US Department of Labor, Washington DC,
20210. The Administrator, or an authorized representative, will approve, modify, or
disapprove every additional classification action within 30 days of receipt and so advise HUD
or its designee, or will notify HUD or its designee within the 30-day period that additional
time is necessary, (Approved by the Office of Management and Budget under OMB Control
Number 1215-0140.)
(c) In the event the contractor, the laborers or mechanics to be employed in the classification
or their representatives, and HUD or its designee do not agree on the proposed classification
and wage rate (including the amount designated for fringe benefits, where appropriate), HUD
or its designee shall refer the questions, including the views of all interested parties and the
recommendation of HUD or its designee, to the Administrator for determination. The
Administrator, or an authorized representative, will issue a determination within 30 days of
receipt and so advise HUD or its designee, or will notify HUD or its designee within the 30-
day period that additional time is necessary. (Approved by the Office of Management and
Budget under OMB Control Number 1215-0140.)
(d) The wage rate (including fringe benefits where appropriate) determined pursuant to
subparagraphs (1)(b) or (c) of this paragraph, shall be paid to all workers performing work
in the classification under this contract from the first day on which work is performed in the
classification.
(hi) Whenever the minimum wage rate prescribed in the contract for a class of laborers or
mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall
either pay the benefit as stated in the wage determination or shall pay another bona fide fringe
benefit or an hourly cash equivalent thereof.
(iv) If the contractor does not make payments to a trustee or other third person, the contractor
may consider as part of the wages of any taborer or mechanic the amount of any costs reasonably
anticipated in providing bona fide fringe benefits under a plan or program, provided that the
Secretary of Labor has found, upon the written request of the contractor, that the applicable
standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the
contractor to set -aside in a separate account assets for the meeting of obligations under the plan
or program. (Approved by the Office of Management and Budget Control Number 1215-0140.)
2. Withholding. HUD or its designee shall upon its own action or upon written request of an
authorized representative of the Department of Labor withhold or cause to be withheld from the
contractor under this contract or any other Federal contract with the same prime contractor, or any
other Federally -assisted contract subject to Davis -Bacon prevailing wage requirements, which is held
by the same prime contractor so much of the accrued payments or advances as may be considered
necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by
the contractor or any subcontractor the fall amount of wages required by the contract. In the event
of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or
working on the site of the work (or under the United States Housing Act of 1937 or under the Housing
Act of 1949 in the construction or development of the project), all or part of the wages required by the
contract, HUD or its designee may, after written notice to the contractor, sponsor, applicant, or
owner, take such action as may be necessary to cause the suspension of any further payment, advance,
or guarantee of funds until such violations have ceased. HUD or its designee may, after written notice
to the contractor, disburse such amounts withheld for or on account of the contractor or subcontractor
to the respective employees to whom they are due. The Comptroller General shall make all
disbursements in the case of direct Davis -Bacon Act contracts.
3. Payrolls and Basic Records.
(i) Payrolls and basic records relating thereto shall be maintained by the contractor during the
course of the work, preserved for a period of three years thereafter for all laborers and mechanics
working at the site of the work (or under the United States Housing Act of 1937, or under the
Housing Act of 1949, in the construction or development of the project). Such records shall
contain the name, address, and social security number of each such worker, his or her correct
classification, hourly rates and wages paid (including rates of contributions or costs anticipated for
bona fide fringe benefits or cash equivalents thereof of the types described in Section l(b)(2)(B)
of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual
wages paid. Whenever the Secretary of Labor has found under 29 CFR Part 5.5(a)(1)(iv) that the
wages of any laborer or mechanic include the amount of any costs reasonably anticipated in
C� I
providing benefits under a plan or program described in Section 1(b)(2)(B) of the Davis -Bacon
Act, the contractor shall maintain records which show that the commitment to provide such
benefits is enforceable, that the plan or program is financially responsible, and that the plan or
program has been communicated in writing to the laborers or mechanics affected, and records
which show the costs anticipated or the actual cost incurred in providing such benefits.
Contractors employing apprentices or trainees under approved programs shall maintain written
evidence of the registration of the apprenticeship programs and certification of trainee programs,
the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the
applicable programs. (Approved by the Office of Management and Budget under OMB Control
Numbers 1215-0140 and 1215-0017.)
(ii) (a) The contractor shall submit weekly for each week in which any contract work is performed
a copy of all payrolls to HUD or its designee if the agency is a party to the contract, but if the
agency is not such a party, the contractor will submit the payrolls to the applicant, sponsor,
or owner, as the case may be, for transmission to HUD or its designee. The payrolls
submitted shall set out accurately and completely all of the information required to be
maintained under 29 CFR Part 5.5(a)(3)(i). This information may be submitted in any form
desired. Optional Form WH-347 is available for this purpose and may be purchased from the
Superintendent of Documents (Federal Stock Number 029-005-00014-1), U S Government
Printing Office, Washington DC 20402. The prime contractor is responsible for the
submission of copies of payrolls by all subcontractors. (Approved by the Office of
Management and Budget under OMB Control Number 1215-0149.)
(b) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by
the contractor or subcontractor or his or her agent who pays or supervises the payment of the
persons employed under the contract and shall certify the following.
I - That the payroll for the payroll period contains the information required to be maintained
under 29 CFR Part 5.5(a)(3)(i) and that such information is correct and complete;
2 - That each laborer or mechanic (including each helper, apprentice, and trainee) employed
on the contract during the payroll period has been paid the full weekly wages earned, without
rebate, either directly or indirectly, and that no deductions have been made either directly or
indirectly from the full wages earned, other than permissible deductions as set forth in 29 CFR
Par 3; and
3 - That the laborer or mechanic has been paid not less than the applicable wage rates and
fringe benefits or cash equivalents for the classification of work performed, as specified in the
applicable wage determination incorporated into the contract.
(c) The weekly submission of a properly executed certification set forth on the reverse side
of optional Form WH-347 shall satisfy the requirement for submission of the "Statement of
Compliance" required by paragraph A.3.(ii)(b) of this section.
(d) The falsification of any of the above certifications may subject the contractor or
subcontractor to civil or criminal prosecution under Section 1001 of Title 18 and Section 231
of Title 31 of the United States Code.
(in) The contractor or subcontractor shall make the records required under paragraph A.3.(i) of
this section available for inspection, copying, or transcription by authorized representatives of
HUD or its designee or the Department of Labor, and shall permit such representatives to
interview employees during working hours on the Job. If the contractor or subcontractor fails to
submit the required records or to make them available, HUD or its designee may, after written
notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to
cause the suspension of any further payment, advance, or guarantee of funds. Furthermore,
failure to submit the required records upon request or to make such records available may be
grounds for debarment action pursuant to 29 CFR Part 5.12.
4. Apprentices.
(i) Apprentices will be permitted to work at less than the predetermined rate for the work they
performed when they are employed pursuant to and individually registered in a bona fide
apprenticeship program registered with the U S Department of Labor, Employment and Training
Administration, Bureau of Apprenticeship and Training, or with a State Apprenticeship Agency
recognized by the Bureau, or if a person is employed in his or her first 90 days of probationary
employment as an apprentice in such an apprenticeship program, who is not individually registered
in the program, but who has been certified by the Bureau of Apprenticeship and Training or a State
Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an
apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft
classification shall not be greater than the ratio permitted to the contractor as to the entire work
force under the registration program. Any worker listed on a payroll at an apprentice wage rate,
who is not registered or otherwise employed as stated above, shall be paid not less than the
applicable wage rate on the wage determination for the classification of work actually performed.
In addition, any apprentice performing work on the job site in excess of the ratio permitted under
the registered program shall be paid not less than the applicable wage rate on the wage
determination for the work actually performed. Where a contractor is performing construction on
a project in a locality other than that in which its program is registered, the ratios and wage rates
(expressed in percentages of the journeymen's hourly rate) specified in the contractor's or
subcontractor's registered program shall be observed. Every apprentice must be paid at not less
than the rate specified in the registered program for the apprentice's level of progress. expressed
as a percentage of the journeymen hourly rate specified in the applicable wage determination.
Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship
program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid
the full amount of fringe benefits listed on the wage determination for the applicable classification.
If the Administrator determines that a different practice prevails for the applicable apprentice
classification, fringes shall be paid in accordance with that determination. In the event the Bureau
of Apprenticeship and Training, or a State Apprenticeship Agency recognized by the Bureau,
withdraws approval of an apprenticeship program, the contractor will no longer be permitted to
utilize apprentices at less than the applicable predetermined rate for the work performed until an
acceptable program is approved.
(ii) Trainees. Except as provided in 29 CFR Part 5. 16, trainees will not be permitted to work
at less than the predetermined rate for the work performed unless they are employed pursuant to
and individually registered in a program which has received prior approval, evidenced by formal
certification by the US Department of Labor, Employment and Training Administration. The ratio
of trainees to journeymen on the job site shall not be greater than permitted under the plan
approved by the Employment and Training Administration. Every trainee must be paid at not less
than the rate specified in the approved program for the trainee's level of progress, expressed as
a percentage of the journeyman hourly rate specified in the applicable wage determination.
Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program.
If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of
fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour
Division determines that there is an apprenticeship program associated with the corresponding
journeyman wage rate on the wage determination which provides for less than full fringe benefits
for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and
participating in a training plan approved by the Employment and Training Administration shall be
paid not less than the applicable wage rate on the wage determination for the work actually
performed. In addition, any trainee performing work on the job site in excess of the ratio
permitted under the registered program shall be paid not less than the applicable wage rate on the
wage determination for the work actually performed. In the event the Employment and Training
Administration withdraws approval of a training program, the contractor will no longer be
permitted to utilize trainees at less than the applicable predetermined rate for the work performed
until an acceptable program is approved.
(ifi) Equal Employment Opportunity. The utilization of apprentices, trainees and journeymen
under this part shall be in conformity with the equal employment opportunity requirements of
Executive Order 11246, as amended, and 29 CFR Part 30.
5. Compliance with Copeland Act Requirements. The contractor shall comply with the
requirements of 29 CFR Part 3 which are incorporated by reference in this contract.
6. Subcontracts. The contractor or subcontractor will insert an any subcontracts the clauses
contained in 219 CFR Part 5.5(a)(1) through (10) and such other clauses as HUD or its designee may
be appropriate instructions require, and also a clause requiring the subcontractors to include these
clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance
by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR Part 5.5.
7. Contract Termination; Debarment. A breach of the contract clauses in 29 CFR Part 5.5 may
be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as
provided in 29 CFR Part 5 . 12,
8. Compliance with Davis -Bacon and Related Act Requirements. All rulings and interpretations
of the Davis -Bacon and Related Acts contained in 29 CFR Parts 1, 3, and 5 are herein incorporated
by reference in this contract.
9. Disputes Concerning Labor Standards. Disputes arising out of the labor standards provisions
of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall
be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR Parts
5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or
any of its subcontractors) and HUD or its designee, the US Department of Labor, or the employees
or their representatives.
10. Certification of Eligibility.
(i) By entering into this contract, the contractor certifies that neither it (nor he or she) nor any
person or firm who has an interest in the contractor's firm is a person or firm ineligible to be
awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR Part
5.12(a)(1) or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR
Part 24.
(ii) No part of this contract shall be subcontracted to any person or firm ineligible for award of
a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR Part 5.12(a)(1)
or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR Part 24.
(iii) The penalty for making false statements is prescribed in the US Criminal Code, 18 USC
1001. Additionally, US Criminal Code Section 1010. Title 18, USC, "Federal Housing
Administration transactions", provides in part, "Whoever, for the purpose of ... influencing in
any way the action of such Administration . . . makes, utters or publishes any statement, knowing
the same to be false shall be fined not more than $5,000 or imprisoned not more than two
years, or both."
It. Complaints, Proceedings, or Testimony by Employees. No laborer or mechanic to whom the
wage, salary, or other labor standards provisions of this contract are applicable shall be discharged or
in any other manner discriminated against by the contractor or any subcontractor because such
employee has filed any complaint or instituted or caused to he instituted any proceeding or has testified
or is about to testify in any proceeding under or relating to the labor standards applicable under this
contract to his employer.
B. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT. As used in this paragraph, the
terms "laborers" and "mechanics" include watchmen and guards.
1. Overtime Requirements. No contractor or subcontractor contracting for any part of the contract
work which may require or involve the employment of laborers or mechanics shall require or permit
any such laborer or mechanic in any work -week in which he or she is employed on such work to work
8 of eight hours in any eaiettdar day or in excess of forty hours in such workweek unless such
laborers or mechanic receives compensation at a rate not less than one and one-half times the basic rate
of pay for all hours worked iin excess of forty hours
in such workweek, whichever is greater-
2. Violation; Liability for Unpaid Wages; Liquidated Damages. In the event of any violation of
the clause set forth in subparagraph (1) of this paragraph, the contractor and any subcontractor
responsible therefor shall be liable for the unpaid wages. In addition, such contractor and
subcontractor shall be liable to the United States (in the case of work done under contract for the
District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such
liquidated damages shall be computed with respect to each individual laborer or mechanic, including
watchmen and guards, employed in violation of the clause set forth in subparagraph (1) of this
paragraph, in the sum of $ 10 for each calendar day on which such individual was required or permitted
to work in exeess of eightimurs-or in excess of the standard workweek of forty hours without payment
of the overtime wages by the clause set forth in subparagraph (1) of this paragraph.
3. Withholding for Unpaid Wages and Liquidated Damages. HUD or its designee shall upon its
own action or upon written request of an authorized representative of the Department of Labor
withhold or cause to be withheld, from any moneys payable on account of work performed by the
contractor or subcontractor under any such contract or any other Federal contract with the same prime
contract, or any other Federally -assisted contract subject to the Contract Work Hours and Safety
Standards Act, which is held by the same prime contractor such sums as may be determined to be
necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated
damages as provided in the clause set forth in subparagraph (2) of this paragraph.
4. Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth
in subparagraph (1) through (4) of this paragraph and also a clause requiring the subcontractors to
include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for
compliance by anv lower tier subcontractor with the clauses set forth in subparagraphs (1) through (4)
of this paragraph.
C. HEALTH AND SAFETY.
1. No laborer or mechanic shall be required to work in surroundings or under working conditions
which are unsanitary, hazardous, or dangerous to his health and safety as determined under
construction safety and health standards promulgated by the Secretary of Labor by regulation.
2. The contractor shall comply with all regulations issued by the Secretary of Labor pursuant to Title
29 Part 1926 (formerly Part 1518) and failure to comply may result in imposition of sanctions pursuant
to the Contract Work Hours and Safety Standards Act (Public Law 91-54, 83 Stat. 96).
3. The contractor shall -include the provisions of this Article in every subcontract so that such
provisions will be binding on each subcontractor. The contractor shall take such action with respect
to any subcontract as the Secretary of Housing and Urban Development or the Secretary of Labor shall
direct as a means of enforcing such provisions.
NOTE: Edited text above is in accordance with revisions provided by the US Department of Housing and
Urban Development. HUD form 4010 (2-84), (HB 1344. 1)
PAYMENT BOND
WHEREAS, the City Council of the City of Redlands, State of California (hereinafter designated as
"City"), and TASCO Construction, Inc. (hereinafter designated as "Principal") have entered into an
agreement whereby Principal agrees to install and complete certain designated public improvements, which
by said agreement dazed December 17, 2002, and identified as Contract No. 243300-7150/43014, is hereby
referred to and made a part hereof; and
WHEREAS, under the terms of said agreement, Principal is required before entering upon the
performance of the work, to furnish a good and sufficient labor and materials payn"t bond with the City
to secure the claims to which reference is made in Title 15 (cotturtencing with Section 3082) of Part 4 of
Division 3 of the Civil Code of the State of California.
NOW, THEREFORE, said Principal and the undersigned as corporate surety, are held and firmly bound
unto the City and all contractors, subcontractors, laborers, rraterialmen. and any other persons employed
in the performance of the aforesaid agreement and referred to in the aforesaid Civil Code of the State of
California in the sum of Seventy—two thousand one hundred thirty—f ive _ dollars
(S 7 2, 13 5.0 0 ) for materials furnished or labor thereon of any 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 herein above 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 attorney's fees, incurred by the City in successfully enforcing such obligation, to be
awarded and fixed by the court, and to be taxed as costs and to be included irm the judgement therein
rendered.
It is hereby expressly stipulated and agreed that this bond shall inure to the benefit of any and all persons,
companies and corporations entitled to file claims under Title 15 (cotnr=cing w7tb Section 3092) of Part
4 of Division 3 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 fuUy performed, then this obligation shall become null and void:
otherwise it shall be and retrain in full force and effect.
The surety hereby stipulates and agrees that no change, extension of time. alteration or addition to the
tetras of the agreement or to the work to be performed thereunder or the specifications accompanying the
same shall in anywise 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.
IN 'FITNESS WHEREOF, this instrument bas been duly executed by the Principal and surety
named, on
Dec. 13
200? . Bond No. BD471872
TASCO Construction, Inc. (SEAL) Nationwide Mutual Insurance Got )
Principal sumly
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By. / By:
/Sfgrn�nerc � S+g+�
Addmr 7777 Alvarado Rd. Ste 201
La Mesa CA 91941
(NcutiAl wciawwkd"na of Carxr cror and surety) Telephone:: 8( L0) 822 3666
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127938
KNOW ALL MEN BY THESE PRESENTS THAT Nationwide Mutual Insurance Company, a corporation organized
under the laws of the State of Ohio, \kith its principal office in the City of Columbus, Ohio, hereinafter called "Company"
does hereby make, constitute and appoint CHRISTOPHER MILTON HILL PHILLIP JUSTIN HILL
NANCY J. UNDERWOOD
SANTA BARBARA CA
each in their individual capacity, its true and lawful Attorney -In -Fact with full power and authority to sign, seal, and execute
in its behalf any and all bonds and undertakings and other obligatory instruments of similar nature in penalties not exceeding
the sure of TWO HUNDRED FIFTY THOUSAND AND NO/100 DOLLARS ; 250,000.00
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized
officers of the Company; and all acts of` said Attorney pursuant to the authority hereby given are hereby ratified and
confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the
Board of Directors of the Company.
"RESOLVED, that the President, or any Senior Vice President, Resident Vice President or Second Vice
President by, and the same hereby is, authorized and empowered to appoint Attorneys -In -Fact of the Company
and to authorized them to execute any and all bonds, undertakings, recognizances, contracts of indemnity,
policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature which the business of the Company may require; and to modify or revoke, with
or without cause, any such appointment or authority. The authority granted hereby shall in no way limit the
authority of other duly authorized agents to sign and countersign any of said documents on behalf of the
Company."
'RESOLVED FURTHER, that such attorneys -In -Fact shall have full power and authority to execute and
deliver any and all such documents and to bind the Company, subject to the terms and limitations of the power
of attorney issued to them, and to affix the seal of the Company thereto, provided, however, that said seal shall
not be necessary for the validity of any such documents."
This Power of Attorney is signed and sealed by facsimile under and by the following By -Laws duly adopted by the Board
of Directors of the Company.
ARTICLE Vlll
"Section 10. Execution of instruments . Any Vice President and any :assistant Secretary or assistant Treasurer
shall have the power and authority to sign or attest all approved documents, instruments, contracts or other
papers in connection with the operation of the business of the company in addition to the Chairman and Chief
Executive Officer, President, Treasurer and Secretary; provided. however, the signature of any of them may be
printed, engraved or stamped on any approved document, contract, instrument or other papers of the Company.
IN WITNESS WHEREOF, the said Nationwide 'Mutual Insurance Company has caused this instrument to be sealed and
duly attested by the signature of its Vice President the 28th day of April, 1999.
ACKNOWLEDGMEN`i'•QQ1���4aa j♦ T. } By:
STATE OF IOWA.:Vice President
COUNTY OF POLL SSuSIE
On this 28th day of April, 1999, before me came the above named Vice President for ';Nationwide Mutual Insurance
Company, to me personally known to be the officer described in and who executed the preceding instrument, and he
acknowledged the execution of the same, and being by me duly sworn, deposes and saes, that he is the officer of the Company
aforesaid, that the seal affixed thereto is the corporate seal of said Company, and the said corporate seal and his signature
were duly affixed and subscribed to said instrument by the authority and direction of said Company.
11AN1 r�r s tWVA = atJ OMMSKMEXPOM
Notary Public
My Commission expires March 24, 2002
CERTIFICATE
1, John F. Delaloye, assistant Secretary of Nationwide Mutual Insurance Company, do hereby certify that the
Resolution included herein is a true and correct transcript from the minutes of the meeting of the Board of Directors duly
called and held on the 6th day of September, 1967, and the same has not been revoked or amended in any manner; that said
Douglas L. Andersen was on the date of the execution of the foregoing Power of Attorney the duly elected Vice President
of Nationwide Mutual Insurance Company and the corporate seal and his signature as Vice President were duly affixed and
subscribed to the said instrument by the authority, of said Board of Directors.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate
seal of said Company this 3 day of Z) �
07077 This Power of Attorney expires .. / Assistant Secretary
6d T (04-00) 00 01/25/03 q li+lrr'�'aw
use
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
ss.
County of -
On 1.2 -/> -V .?-- before me,%_���
Date _ Name and T,Ve�o-ff ttiFer ((e-g-.'Jane Doe. 1,e .,y P�f:] ,
personally appeared
U Name(s) of S(gnifns)
1ersonally known to me
proved to me on the basis of satisfactory
evidence
GLORIA C. CLEMENTS
Gomrnissiott t 12WM
tiot«r Pt"C • CMMar.
SWft Swbom C 0"
My Car+m. Exp. NpV.11, 2004
to be the person(s) whose name(s) is/are
subscribed to the within instrument and
acknowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s)
acted, executed the instrument.
WITNESS my hand and official seal.
Cyr , (q�i?x'�_
Signature of Notary Pco[e
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:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
Individual
Corporate Officer—Title(s):
Partner — - Limited General
Attorney -in -Fact
Trustee
Guardian or Conservator
Other:
Signer Is Representing:
Y
Number of Pages:
�� 1999 Natrona( No ar,, - _,.x.= De, Soto Ave., P.O. Box 2402 - Chatsworth, CA 91313-2402 --www nauonainomrry org Pmd No 5WJ7 Pc , i s, 1-800�876-6827
r
State of
County of
On before me,
Gate Name and T4ie of OHIC'1_g. -jSne Doe, N3ia-y Public'I
personally appeared i-6o //"" ZI
p6rsonally known to me - OR - proved to me on the basis of satisfactory evidence to be the person(s)
whose narne's, ist'are subscribed to the within instrument
and acknowledged to me that he/she/they executed the
same in his/her/their authorized capacity(ies), and that by
his/her/their signature(s) on the instrument the person(s),
THA),_'TON or the entity upon behalf of which the persons) acted,
0
Commission # 1315120 Z executed the instrument.
Notary Public - California
Ventum County WIT SS my hand official sea'.
My CwynEjOrw Aag 242006
- Ul
Though the information below is not required by law, it may
fraudulent removal andreatta,,
Description of Attached Document
Title or Type of Document:
Document Date-
Signer(s) Other 1. ban Named Above:
Capacity(ies) Claimed by Signer(s)
individual,
Corporate Officer
Title(s):
Partner Limited General
Attorney -in -Fact
Trustee
Guardian or Conservator
Other:
Signer Is Representing
WAL
raluable to persons relying on Me docurpent and could prevent
of this form to another document
Individual
Corporate Officer
Title(s)
Partner — Limited :-,General
Attorney -in -Fact
Trustee
Guardian or Conservator
Other:
Signer is Representing
,C, 1995 Nat-onal 'I'dotary Associalian - 8236 RemmctAve, R0, B'nx 7184 - Canoga Park, CA 91309-7184 Prod, Nlc; 5907 Reorde. Cail To'l-Pee 1-800-876-6827
Bond # BD471872
P'E"ORMA,NCE BOND
WHMA,S, the City Council of the City of Redlands. State of California (hereinafter designated as
"City"), and TASCO CoaYsmtction, Tnc. (hereinafter designated as "principal") have entered into an
agreement whereby principal agrees to install and complete certain designated public improvements, which
by said agreement dated December 17, 2002. and identified as Contract No. 243300-7150/43014, is hereby
referred to and made a part hereof-, and
WHEREAS, under the terms of said agreement, Principal is required before entering upon the
performance of the work. to furnish a good and sufficient faithful performance bond With the City.
NOW, THEREFORE, said prizitipal and the undersigned as corporate surety, are held end firmly bound
unto the City in the sum of Seventy—two thousand one hundred thirt —f . oilars
(S 72,135.00 ) for the payment of which sum well and truly to be made, we bind ourselves,
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 her heirs, execrators.
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 said agreement and any alteration thereof made
as therein provided. or his or her part, to be kept and performed at the time and in the mutner therein
specified, and in all respects according to their true intent and meaning, and shall defend, indemnify and
save harmless the City, its elected officials, officers, agents, and employees, as therein stipulated. then this
obligation shalt 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 the face atnount specified therefor, there shall
be included cost_-, and reasonable expenses and fees. including attorney's fees incurred by the City in
successfully enforcing such obligation, all to be taxed as costs and included in any judgement rendered.
The surety bercby 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 anywise affect its obligations on this band, 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.
IN WITNM WHEREOF, this instrument has been duty executed by the Principal and surety harried,
on Dec.13 200 2 Band No. BD 471872
TASCO Construction Inc (sFAL) Nationwide Mutual Insurance Co(SML)
Principal � Su+z'�?'
OABY: ' By:
gtwouc Sigrtwure
kdprm, 7777 Alvarado Rd. #201
La Mesa CA 91941
(NoarWYkcSrnoWkdginrMofContrw-Mrxxisurety) Tatephow;620 1 822 3666
KNOLL' ALL MEN BY THESE PRESENTS THAT Nationwide Mutual Insurance Company, a corporation organized
under the laws of the State of Ohio, with its principal office in the City of Columbus, Ohio, hereinafter called "Company',
does hereby make, constitute and appoint CHRISTOPHER MILTON HILL PHILLIP JI STIR HILL
NANCY J. UNDERWOOD
SANTA BARBARA. CA
each in their individual capacity, its true and lawful Attorney -In -Fact wr th full power and authority to sign, seal, and execute
in its behalf any and all bonds and undertakings and other obligatory instruments of similar nature in penalties not exceeding
the sum of TWO HUNDRED FIFTY THOUSAND AND NO/100 DOLLARS 250,000.00
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized
officers of the Company; and all acts of said Attorney pursuant to the authority hereby given are hereby ratified and
confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly_ adopted by the
Board of Directors of the Company.
"RESOLVED, that the President, or any Senior Vice President, Resident Vice President or Second Vice
President bv, and the same hereby is. authorized and empowered to appoint Attorneys -In -Fact of the Company
and to authorized them to execute any and all bonds, undertakings, recognizances, contracts of indemnity,
policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature which the business of the Company may require, and to modify or revoke, with
or without cause, any such appointment or authority. The authority granted hereby shall in no way limit the
authority of other duly authorized agents to sign and countersign any of said documents on behalf of the
Company."
"RESOLVED FURTHER, that such Attorneys -In -Fact shall have full power and authority to execute and
deliver any and all such documents and to bind the Company, subject to the terms and limitations of the power
of attorney issued to them, and to affix the seal of the Company thereto, provided, however, that said seal shall
not be necessary for the validity of anv such documents."
This Power of Attorney is signed and sealed by facsimile under and by the following By -Laws duly adopted by the Board
of Directors of the Company.
ARTICLE VIII
"Section 10. Execution of instruments . Any Vice President and any Assistant Secretary or Assistant Treasurer
shall have the power and authority to sign or attest all approved documents, instruments, contracts or other
papers in connection with the operation of the business of the company in addition to the Chairman and Chief
Executive Officer, President, Treasurer and Secretary; provided, however. the signature of any of them may be
printed, engraved or stamped on any approved document, contract, instrument or other papers of the Company.
IN WITNESS WHEREOF, the said Nationwide Mutual Insurance Company has caused this instrument to be sealed and
duly attested by the signature of its Vice President the 28th day of April, 1999.
ilk
ACKNOWLEDGMENT 1� �%��f By: �4 � U_L_
STATE OF IOWA'� Vice President
COUNTY OF POLK SSu use
�'�
On this 28th day of April, 1999, before me came the above named Vice President for Nationwide Mutual Insurance
Company, to me personally known to be the officer described in and who executed the preceding instrument, and he
acknowledged the execution of the same, and being by me duly sworn, deposes and says, that he is the officer of the Company
aforesaid, that the seal affixed thereto is the corporate seal of said Company, and the said corporate seal and his signature
were duly affixed and subscribed to said instrument by the authority and direction of said Company.
I MR 2k2= Notary Public
My Commission expires March 24, 2002
CERTIFICATE
1, John. F. Delaloye, Assistant Secretary of Nationwide Mutual Insurance Company, do hereby certify that the
Resolution included herein is a true and correct transcript from the minutes of the meeting of the Board of Directors duly
called and held on the 6th day of September, 19671. and the same has not been revoked or amended in any manner; that said
Douglas L..dersen was on the date of the execution of the foregoing Power of Attorney the duly elected Vice President
of Nationwide Mutual Insurance Company and the corporate seal and his signature as Vice President were duly affixed and
subscribed to the said instrument by the authority of said Board of Directors.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate
seat of said Company this/3day of j o
Y+ b
U
0 (r,7 This Power of Attorney expires Assistant Secretor
PJ 1 t04_00j 00 01/25/03 q tMtirS,
IL
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
ss.
County of -„n� �-
On
____ I 2 /� —6 2_
Date
personally appeared
7 7 before me, �cr,,,'c�> z: ---
. Name and Title of Officer (e.g.. 'Jane Dc>n, No!�ry p_riz
GLORIA C. CLEMENTS
Comrrtistion # 128W96
► twy vublfc - CsMlseMs
SOWA dsrbWe C«ny
► Y CorWwn. Exp. NOV. 11, NOW
ifat4te(s) pf Sqg (s)
-<personally known to me
proved to me on the basis of satisfactory
evidence
to be the person(s) whose name(s) is/are
subscribed to the within instrument and
acknowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s)
acted, executed the instrument.
WITNESS my hand and official seal.
S(gna re of etary a,-nl
OPTIONAL
Thouon the :nfotmar�on below is not required by law, it may prove valuable to persons relying on the and could prevent
V fraudulent removal and reattachment of this form to another document.
Description of Attached Document/ }
Title or Type of Document: / �� �►1 43,
Document Date: _ Number of Pages: _
Signer(s) Other Than Named Above:--
Capacity(ies) Claimed by Signer
Signer's Name: — —
a -r
Individual�[ her,,
Corporate Officer ---- Title(s): �. --
Partner — Limited General
i
%-Attorney-in-Fact
Trustee l
Guardian or Conservator
Other:
Signer Is
i 494 National P a �r ri;D 6e 5e.*to ave.. PO. Boa 2402 - Cr.ais—If, CA 913t3-2402 nauonalnofary.org Prat. No S1,437 Fy'.'oU Pr- t-BW-876-6827
WIT
State of It
County of f
n E, before me, t _ k j
Dare Name and Tito Officer -g.. "jan D ,*. Nci ary Pi
personally appeared-
arris , of Silgn r(s)
Ao
Jersonally noon to me -- proved to e on the basis of satisfactory evidence to be the person(s)
,' whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she `they executed the
sane in his/her/their authorized ca cit ies), and that by
his/her/their signature(s) on the instrument the person(s),
or the entity Capon behalf of which the persons, acted,
t EMNE execrated the instrument.
Commission 9 3315120 �
Notary r u iic - California
ntur Count �1 ray hand ofri al seal.
fig, ;. 24, `
Yh
Though the in`ermation below is not required by iavy it may grove vaJl to persons relying on the document and could prevent
fieudulent removal and reattachment of this forrn to another dicui77e'nL
• ..
l
Individual
Corporate Officer
Title(s)-
Partner — --Limited _.. General
Attorney -in -Fact
Trustee
Guardian or Conservator
Other;
Signer Is Representing:
Number of Pages;
individual
Corporate Officer
Title(s):
Partner Limited ' = General
Attorney -in -Fact
Trustee
Guardian or Conservator
Other.
Signer Is Representing
.� , ¢:. 4yafiJ;��,; harp :tt��:;at3a: •re:?efv FG. >"sup i *.i Canoga �';rk: G �i3-J-9£tru.+v.3...:?' rer. Cali T's.cr�.. 70--62 i"
Company Profile
Page 1 of 2
Company Profile
4%
Ins°te
NATIONWIDE MUTUAL INSURANCE
COMPANY
ONE NATIONWIDE PLAZA
COLUMBUS, OH 43216
800-523-7828
Agent for Service of Process
JERE KEPRIOS, C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET, 2ND
FLOOR LOS ANGELES, CA 90017
Unable to Locate the Agent for Service of Process?
Reference Information
NAIC #:
23787
NAIC Group #:
0140
California Company ID #:
1805-1
Date authorized in California:
August 03, 1965
License Status:
UNLIMITED -NORMAL
Company Type:
Property & Casualty
State of Domicile:
OHIO
Lines of Insurance Authorized to Transact
The company is authorized to transact business within these lines of insurance. For an
explanation of any of these terms, please refer to the loss y.
AIRCRAFT
AUTOMOBILE
BOILER AND MACHINERY
BURGLARY
COMMON CARRIER LIABILITY
DISABILITY
FIRE
LIABILITY
"MAWLM
http://www4.insurance.ca.gov/wu/idb—co_prof utl.get_co_prof?p_E1D=3720 1/2/03
Company Profile
Page 2 of 2
MISCELLANEOUS
PLATE GLASS
SPRINKLER
SURETY
TEAM AND VEHICLE
WORKERS' COMPENSATION
Company Complaint Information
t ,} Company Enforcement Action Documents
Comi)any Performance& Comparison_Data
Composite_Compiaint Studies
Want More?
Help Me_F nd a Com_ pany_RepresentativeinMyArea
Financial Rating Organizations
Last Revised - December 16, 2002 01:54 PM
Copyright (0 California Department of Insurance
Disclaimer
http://www4.insurance,ca.gov/wu/idb_co__prof utl.get_eo_pro0p_EID=3720 1/2/03
F I L H No. 021 12/20 '02 17:12 I D : OG I LVY-HILL INSURANCE FOX :805 966 7810 Pli' 'IE
.7
CERTIFICATE OF LIABILITY INSURANCE opr) jvT'.
T%CO-
a—A -U�A
T141S CMR�T1FIC*tE IS ISSUED h-S A MATTER Dii WFCRIi, ic
0 i
-ERS NO RIGHTS UPON THr! CEIrr,:vj,: i,7.11 111-17-Flill Insurance ONLY AND CONJ-
P- 0. Bt.-lx 929 NOLDEP- THIS CERTIFICATE _TOES NOT A11EI Irt, I- it
ALTER THE COVERAGE AFFvmED BY THE PE
SmD,t�-, Barbara CA 93102
-Plaoni�, :805-966-4101 Fax.-SOS-966-7810 �m"UE ;Ap= INSURERS AFFOR
;PXf5-5 R—k ��DING WVEItkaE
Pew!less Tritsittrance, CGS
RER 8:
TASCO Construction, Inc.�Statj!��naation 3::--!
Frank Tomasello WSURER C.-
651 Via Alondra A-Y -I r
Castarillo CA 93012 ores
�OVEFIAGES
*MRER 0:
INSMER E,
I Wit � I I
•
49imMUR W. WIg
I GEiERALLAWL11TY
Poucy
i-X-1 COMMERCIAL GMERAL UAStLay
1 CLANS MADE rx� OCCUR
CBP9514823
07/01/02
07/01/03fd
'04OCCURRENX
ffL34SES (Ev
ffft!rC�ML & AM L 1
—�DUCTS-COW:-7,7'.:3al
GEN L AGGREGATE Lim APPLIES PER -
112
I pOL4Cy 17—(, PRO-
JECT LOC
AU" q:)MOSILE LtAEUW
X ANY AUTO
ALL OWNED AUTOS
CBP9SI4823
07/01/02
07
cc,,,�
1 ;:L
SCHEDULED AUTOS
i HIRED AUTOS
ac D1,-y Iwwry
Person)
80,114-YINJURY
NON-OWNEDAJJTOS
CAFRAGE LtAMuTy,
"PERRY '�AMACE.
;radar�z}
JkNYAUT0
------------
E7CuCS4— i
SMA#13RELLA LL40UW
CLANS vADE
IXDUCTIBLE
M186331657-01
07/01/02
107,/01/03
OT'4ER'r-M r
AUTC) CNLY:
ZI,,H OCCURREWCE
1 RETENTION $
W(N �:ERS i'�OMPE4SATION AND
EWI-,:)`ER3'UA&UTY
ANY ORIPARTNER/D(ECUMIF
OFF ExCLUDED?
S86-62-01
04/01/02
04/01/03
X R
E.,, E�X�ACCIDENT
desai3eune
AL P40VISIONS below
F-L DISEASE - EA E 1AP! C Em
OTF1 --il
Ij
E.C. DISEASE - POLJL# 'IT
i4 OF 50 E� V&1C LE-31 ikC—Ltv..t A DDED SY SgMW
roJevtr Salvation Army 3plaYgrOund,Coutract#-243300-723C)/A-41AIA
I SpW&
e14
ty of
F`Odlal�'ds, its elected offici4s,officers,agents and eMloyees are Add.-.tional
lusui-,sd as respects GIeneral
Liability per attachod Additional Xnaura,
endorvtm--zt GzC(;601(10-99)
.*16 day notice of Cancellationkb
for non _Payr,lszt
r-RTIFIC' ATE HOLDER
RRD30OS'
City of Redlands
P.O.Box 3005
Redlands CA 92373
,.- I ND1, FILE- o.021 12/20 '02 17:13 ID:OGILVY-HILL INSURANCE FAY 966 7810 -,iL
M M.19T.F.Try "IT
ADDITIONAL INSURED — CITY OF REDLANDS, POLICY,1: CBP9514:R2k!
ITS ELECTED OFFICIALS,OFFICERSAGENTS
AND EMPLOYEES
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ T CAREF-J
r, his endorsement modes 1T, - 1 1111[ j• I
COMMERCIAL GENERAL LIABILITY COVEWkG-E PAIA
Who is an insured (Section 11) Is amended to include as; an jnsur)td the pqrirrl)
organbmdon shown In' the
Of "your work" for that insured by or for you.
The coverage afforded the additional Insured does not apply tc) any project tw,
21111
which 11yourwork" was completed prior to the effactfive date of tils endcr'3(T11,rH '
SCHEDULE
'Project: Salvation ALrny d- eil"T
mmftmi,�
I-ILi- No.021 12/20 '02 17:13 ID:OGILVY-HILL INSURANCE
1
FAX:805 966 7810 wig ;fi
STATE
C0MPfff48^TJ0N
I N * U R A N C S
FUN
POLICYHOLDER COP' ,
P-0. BOX 420807, SAN FRANCISCO, CA 94142-0807
CERIVICATE OF
DEC ER 20, 2002
CITY OF REDLANDS
P.O-BOX 300S
RL'DLANDS CA 92373
GROUP:
POLICY NUMBER:
CERTIFICATE ID -
CERTIFICATE EXPIRES.
04
04-01-200210e
This
Insurance to certify that we have Jssued a valid Worker's Compensation insurance policy in 2 form approved by Vie Cafiloni,
ance Commissioner to the enVIOYet named below for the pok-yperiod indi:ated
This policy is not subject to c4veilat'On by the Fund
except upon .30 days advarl* written nOt,"ce to the
We will also give you 30 days:OdVance notice should this policy its none expiration.
be cancelled Prk)r to n i expirat n.
This certificate of insuranceiltinot an insurance policy and does root arnend� extendI grafter the coverage afforduj t)), 1-le
Policies listed herein. Notwfthstanding any requirtment. term or condition of any 6ontrs6t or cftar document wftt
respect to which this cerfificati of ineu
described herein is subject to all the rRncs may be issued Or may pertain, the insurance afforded by the policiel,,
terms, exclusions, and conditions, of such p3licies.
/refs
4.�+++.�a�r:f.�.I"\!
AUTHORLMOREP PMEWAYM
PRMOENT
EMPLOYER'S LIABILI* LIMIT INCLUDING DEFENSEI COSTS. !$1,000,000 pER OCCUp-
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS, ERS' NOTICE 2FpECTI,1g 04-01
ATTACHED To AND
FORMS A PART OF THIS POLICY.
TASco CONSTRUCTION INC TO
LIE LW, FRANK TOMS'
KEL
651 VIA ALMRA STE 715
CAMARILLO CA 93012
30F ims
fEPF4A: So