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Home My WebLink AboutAgr 2004-09-30 (Maggiora & Ghilotti) RECEIVED SEP 20 2004 TOWN OF TffiURON TffiURON, CALIFORNIA MGS""O~,ll &. GHILOTTf, INC. OWNER-CONTRACTOR AGREEMENT FOR THE 2004 CAPITAL IMPROVEMENTS PROJECT - DRAINAGE & SIDEWALK REPAIRS THIS OWNER-CONTRACTOR AGREEMENT ("AGREEMENT") is made and entered into this 3o~ day of September, 2004, by and between the TOWN OF TIBURON, municipal corporation, 1505 Tiburon Boulevard, Tiburon, CA 94920, ("Owner") and MAGGIORA & GHILOTTI, INC. ("Contractor"), whose principal place of business is 555 DuBois Street, San Rafael, CA 94901. In consideration of the mutual covenants and agreements set forth herein, Contractor and Owner hereby agree as follows: ARTICLE I CONSTRUCTION Subject to and in accordance with the terms of this Agreement, the Contractor shall do all the work and furnish all the labor, services, materials and equipment necessary to construct and complete, in accordance with the Contract Documents (as hereinafter defined) in a good, workmanlike and substantial manner and to the satisfaction of the Owner, the 2004 Capital Improvements Project - Drainage & Sidewalk Repairs ("Project") located in Tiburon, California more particularly depicted on Exhibit A ("the Site"). The Project is that described and reasonably inferable from the drawings and specifications and documents enumerated in Exhibit B, such construction and furnishing of labor, services, materials and equipment and the performance of Contractor's other services and obligations required by the Contract Documents are hereinafter referred to as the "Work." The term "Contract Documents" shall mean this Agreement, and all of the items enumerated in Exhibit B. ARTICLE IT PAYMENT Attention is directed to Section 5-1.8 of the Contract Documents. 4fT/ipf. ARTICLE III TIME FOR PERFORMANCE Section 3.1 Time of Completion: Attention is directed to Section 8-1.06 of the Standard Specifications and Section 4 of the Contract Documents Section 3.2 Liquidated Damages: Attention is directed to Section 8-1.07 of the Standard Specifications and Section 4 of the Contract Documents. ARTICLE IV PREVAILING WAGES The general prevailing rate of per diem wages and the general prevailing rate for holiday and overtime work in this locality for each craft, classification, or type of workman needed to execute this Agreement is that ascertained by the Director of the Department of Industrial Relations of the State of California, copies of which ("Prevailing Rate Schedules") are on file in the Owner's principal office. The Prevailing Rate Schedules shall be made available to any interested party upon request. The holidays upon which rates shall be paid shall be all holidays recognized in the collective bargaining agreement applicable to the particular craft, classification or type of workman employed on the Project. Attention is directed to Section 7-1.01A(2) of the Standard Specifications. Contract shall forfeit, as a penalty as set forth in California Labor Code ~ 1775, twenty-five dollars ($25.00) for each calendar day or portion thereof, for each workman paid less than the prevailing rates set forth in the Prevailing Rates Schedules for any work done by any subcontractor under Contractor. ARTICLE V NON-DISCRIMINATION The Contractor hereby agrees to comply with the provisions contained in Section 5-1.1 of the Contract Documents. ARTICLE VI WORKER'S COMPENSATION INSURANCE By my signature hereunder, as Contractor, I certify that I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the Work of this Agreement. ARTICLE VII CONFLICT In the event of conflict between the terms of this Agreement and the bid or proposal of said Contractor, then, this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the proposal conflicting herewith. ARTICLE VIII EXHIBITS This Agreement includes the following Exhibits, which are attached hereto and incorporated herein by reference: Exhibit A Exhibit B Exhibit C The Site Contract Documents Contract Prices IN WITNESS WHEREOF, the parties to these presents have hereunto set their hands the day and year fIrst hereinabove written. APPROVED AS TO FORM: TOWN OF TIBURON BY~~?~. Town Attorney By ::~~ Its --?~"b.o~ Contractor's License No. 22<p } l.o 7 Expiration Date: n 's ' ~ I ~ OS'- CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~~~~~~~-C<"~~~~~~.c<'.e<'~.e<'~,e<'~~~~:ff~~.c<'.c<'.c<'..e<'~~~~~~1 ~ ~ ~ State of califOrnia} ~ ~1 ss. ~ I County of '1\'\ ~~ ~ I ~ On 01- 2. 2 - 01.{ before me, h1A~..J?1i" ~ ,v"'~i<.::t If' ~""I " , ~.. ~i Date Name and Title of Officer (e.g., "Jane Doe, Notary Pu lie") I ~....jl personally appeared b""'-'t ~~'\ ...: ~j Name(s) of Signer(s) ~~rsonaIlY known to me ..' I i to be the person(s) whose name(s) is/are ~ fO"4. COMM. #1425111 e subscribed to the within instrument and ~ ~ ~ . NOT ARyMPAURBINLlCCO-UCNATL~FORNIA...... acknowledged to me that he/she/they executed ~ 1(:Si ..- the same in his/her/their authorized ~I ~ My Comm. Expires July 15, 2007 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 ~ ~ pm:nd a:d on se~. ~ @ . Signature of Notary Public ~ ~ ~ ~ ~ I:.:,.... OPTIONAL ~..:,..III . 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: I ~ Document Date: Number of Pages: i ~ Signer(s) Other Than Named Above: ~ I Capacity(ies) Claimed by Signer I ~ ~ ~ Signer's Name: ~ ~i '. 0 Individual Top of thumb here ~ I 0 Corporate Officer - Title(s): ~ !I n Partner - U Limited n General ~ I ~ ~~;~~~i~-:::~seNator I ~ Signer Is Representing: I ~'<X.~~~~~~~'<%~z;'Cz.~'<X.'<X.'G:.'G:.~~'Q(,~~~~~~~~~~~~~'<X.'<~<>Q<,'~'<;<;;<x~,<~:<~y~ @ 1999 National Notary Association. 9350 De Soto Ave., P.O. Box 2402. Chatsworth, CA 91313-2402. www.nationalnotary.org Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 EXHmIT A THE SITE The public rights-of-way located in the Town of Tiburon, California and known as: Spanish Trail near Vistazo East Taylor Road near Barner Lane Greenwood Court Tiburon Boulevard at Cove Road ~ ~ 1:;; "'. E,)(~{8l\ C - Cb~TMc-T 'PR-tC-ES 2004 CAPITAL IMPROVEMENTS PROJECT BID PROPOSAL The contractor agrees to accept payment, in full therefore, at the following prices to wit: Bid Schedule A ITEM EST. QTY UNIT PRICE I TOTAL PRICE DESCRIPTION UNIT ,<;=i_~ ~ ~ ~~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -j- - - - - - - - - - - - - - - - - - - -j- - - - - - - - - - - - - - - - - - - - - I 1 ;~~~c Control and Construction Area 1 LS I I . QS II 000 ,-.. - -..... - - - - - - - - - - - - - - -. - - --... -. -. - -.. - -- - - ..-. --. - --. -. - -- _m_ - - - -- - - - -..... - - - -l- - - j CXf:) -. -. T -. J. - - - -.. -- -. - - - -- l-- _ _ ~.. __ _ ~~~~I~~~_t~~n__(~o~ _t~ _~~~_~~_~ _5~! __ _ _ _ _ _ ___ __ _ __ _ _ __1__ __ _ __ _ __ __ L_S _ _ _ _ JI,c2:b.~ J _ . 4::20Q _._ i I i l__ _ __~ _ __ _ _ ~~~~_~~_~~~_r~~_~_~_ ~~~~~i~~_ __ _ _ _ __ _ _ _ _ ___ _ ____ ____~ _ ___ _ _ _ _ _ _ _~_~ _ _ _ _ J _ _ _'- OO_~__ _ _1_ -1 C(1_ _ _ _ _ _ _ _ __ SITE - TAYLOR BOULEVARD _________________________________,_____________________ r------------------------------------------------------------------------- ! j I 4 Remove and Replace AC Swale 45 LF I 70.& i,3 I 5 0 ~--------------------------------------------------------------------------------------~------------------1----- --------------- i 5 Install 6" AC Dike 231 LF I J 5 s.:Q I .3 4 b5" ~--------------------------------------------------------------------------------------r-------------------r-----~-------------- ~. _. . _~. _. . _ln~t~"_~~O~~. ~~~~_ ~~.~ _._~~ _ ~a~~~_ _~~_~i~ _ _ _. _ _ _ ~ _ _ _ _ _ _ _. . . . ~_ _ _ _ .1. _4--CXJo .~_I_ 8,LXX) _ i I I I 7 Install Storm Drain Type "A" Manhole 1 __ __ ___~~_____L~J---4-oJ::)-O- f-------------------------------------------------------------------- -- - i i ~ i 8 Install 15" RCP Pipe 90 LF I Sub-Total Bid Price for the above Site: L Cj 4/ S SITE - GREENWOOD COURT ~~!_~ }_~ _~_~~_I!~_ R!9_~~:<?f~yy_C!y_ J~~~ _~<?~~ ~!l_ ~~!~~t_~ _'='!~P_~~yL~~f~!J5>_ ~~~!!!~~J~!~_ !~~!!'_~,} _ _ __ __ _ _ __ _ _ _ _ _ _ _ _ __ ! I ! i 9 Remove and Replace PCC Walkway 30 SF I 1 0 d2 ! I ) 0 b ~--------------------------------------------------------------------------------------~-------------------~---~------------- j I I I 10 Install Storm Drain Type "A" Manhole 1 EA 1C;;~..Bj ~ dDc) r--------------------------------------.-----------------------------------------------r-------------------!-----1--------------- I 11 Install Shallow Manhole 1 EA i c LYY:J I 5oC) Q ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -1- - -~~- - - - - - - - - - - - -( - - - - - /" - - - - - - - - - - - - I 12 Install 12" HDPE Pipe 142 LF I / / 0 ~ I Sub-Total Bid Price for the above Site: _~!r~ _: _~.9~~ _~_9~~ _ _ __ _ _ _ _ _ _ _ _ _ _ _ - - - - - - -- - - - - - - - - -- - - - - - - - - - - - - - - -- - - - - - - - - - -- - - -,-- - - - - - - - - - - - - - - - - - -,- - - - - - - - - -- - - - - - - - - -- j i i , , I I 13 Construct pce Sidewalk 119 SF I .30 _~~_--'___3_~__10____ r--------------------------------------------------------------------------------------r----------- ! I : 14 Adjust Storm Drain Manhole to grade 1 EA! 400 g__J____1_QO_____ ~______________________________________________________________________________________1_________________ P-3 { 1 1 1 ~ r, I 1 15 Reconstruct Drainage Inlet cover LS Sub-Total Bid Price for the above Site: 5. Cj 1 0 SITE - SPANISH TRAIL ~--------------------------------------------------------------------------------------.-------------------~---------------------- . . . i 16 Mill ExistAC-6" 417 SY i /5~ IbU~-i r - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -) - - - - - - - - - - - - - - - - - - - -: - - - - -1 - - - - - - - - - - - - - - - ! 17 Asphalt Concrete 225 TONS! CJ if I 2.0 D [) I ,--------------------------------------------------------------------------------------j-------------------~--------.-------------, i i ! : I 18 Install 3" AC Dike. 182 LF I 4 02 II 638 I r-------------------------------------------------------------------------------------1-------------------,----,-----------------: 19 Adjust Sanitary Sewer Manhole To Grade 1 EA I bOOttt62 I bDD Sub-Total Bid Price for the above Site :~ 7 ~.7 dl BASE BID. Sum of General prices and su~-total prices II q /J q4 r? for the sites shown above. See Note 1 below. .. I I _ t:L II I SITE - GREENWOOD COURT (ADDITIVE BID ITEMS - REVOCABLE IF NOT USED) A. _ W_~~~_ ~I]_ ~~~~!l_t~ _~~~p~~y_(~~f~!_ !~_~~~~_ ~!~_f~~~~!_~ _in _r:'_~~_I!~_ R~g!!~-:<:>f~W-~y) _ _ _ _ _ _ _ -,- _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ __ i i A1 Remo~e and Reconstruct Wood Fence 53 LF i. ~ I C1 Q 4- On .Private Property i J 88 ! - I I b -----------------------------------------------------------------------------------r------------------l-------1-------------- A2 Remove and Reconstruct Wood 20 LF I .J212 I 8 ZD Retaining Wall On Private Property ! f 4 I I L - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -.- - - - - - - - - - -. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -j- - - - - - - - - - - - - - - ;,,:,.- - -:- - - - - - - t2 - - - - - - - - - - -- A3 Install 12" HOPE Pipe On Private 94 LF i Z:::.O aU I z. ~) 5""0 (;) Property I ~ I ~ Sub-Total Price for the Additive Bid Items at the above site NOTES 1. THE BASE BID, CALCULATED IN ACCORDANCE WITH THE CONTRACT DOCUMENTS, WILL BE USED TO DETERMINE THE LOWEST BIDDER. ITEMS DESCRIBED AS "ADDITIVE" WILL BE ADDED TO THE PROJECT AT THE DISCRETION OF THE TOWN AND ARE REVOCABLE IF NOT USED. 2. ALL BLANKS IN THE BID SCHEDULE MUST BE APPROPRIATELY FILLED IN. Grand Total of Bid items I through 19 (written) Dollars $( numbers) By my signature hereunder, as Contractor, I certify that I am aware of the_provisions of Section 3700 of the Labor Code which requires every employer to be insured against liability for workmen's compensation or to undertake self insurance in accordance with the provisions of that code, and I will comply with such provi~ sions before commencing the performance of the work in this proposal and contract. P-4 In the case of any discrepancies between unit prices and totals, the unit price shall prevail. By my signature hereunder I understand and agree that the quantities of work under each item are approximate only, being given for a basis of comparison of proposal, and the right is reserved to the Town to increase or decrease the amount of work under any item as may be required, in accordance with the provisions s rrh in the specification of this contract. \ Name - :PR..E..~ I Df:xJ-J Signature Company NAG c;./ 0 (LA , GAIl L 0 71)/ I'JJ c. I l I [ t,'- l r H ~r I Ii; J i I l I P-5 CONTRACTOR'S BOND FOR FAITHFUL PERFORMANCE TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford, Connecticut 06183 (Bond issued in duplicate) BOND NO. 104340986 PREMIUM: $ 498.00 KNOW ALL MEN BY THESE PRESENTS: That we, MAGGIORA AND GHILOTTI, INC. as Principal, and TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, a corporation organized under the laws of the State of Connecticut and duly authorized under the laws of the State of California to become sole surety on bonds and undertakings, as Surety, are held and firmly bound unto TOWN OF TIBURON as Obligee, in the full and just sum of NINETY-FOUR THOUSAND NINE HUNDRED FORTY-EIGHT AND NO/100THS ----------- Dollars, ($ 94,948.00) lawful money of the United States of America, to be paid to the said Obligee, successors or assigns; for which payment, well and truly to be made, we bind ourselves, our heirs, executors, successors, administrators and assigns, jointly and severally, firmly by these presents. Sealed with our seals and dated this 22ND day of SEPTEMBER, 2004 THE CONDITION OF THE ABOVE OBLIGATION is such that whereas the said Principal has entered into a contract or is about to enter into a contract with the said Obligee 2004 CAPITAL IMPROVEMENTS PROJECT DRAINAGE & SIDEWALK REPAIRS as is more specifically set forth in said contract, to which contract reference is hereby made. NOW, THEREFORE, if the said Principal shall well and truly do the said work, and fulfill each and every of the covenants, conditions and requirements of the said contract in accordance with the plans and specifications, then the above obligation to be void, otherwise to remain in full force and virtue. TRAVELERS CASUAL TV AND SURETY COMPANY OF AMERICA rl ;1 / ~// By /(~/1 ~'ZJ1U.- 1/ / LAWRENCE J. COYNE, Attorney-in-Fact /,:, !(J'?-'>" 0 ;"':" "-" ., .. .;." '"", I~ i..v ("~'!i ,'~'. .. t..." .. ... '\ ~!,...?'"\: r:" q Ii · · <1 ll. ,,=.i!ur.~ ,r...~ iI',;J flvil'UYI 4/7 ./,~//~.~ ANN DANFORTH TOWN ATTORNEY TOWN C ~:. TI '; '.... , ,:.J CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT *~~~~~~~~~~~~~~~&5?~~~tG<'"c<'~.c<'tG<'.c<'..c<'~&;&Q.<:x'~~~tG<',(X'~~~&-~ ~ ~ I State ot California } ss. I ~ County of IYI~,.J ~ ~ On <)- L 1 -.0'-1 before me, frliTrTli-€"i.<.J I/JS1\~ tv~~'1- r.Lb Il '- ~ ~ - - Dat;- - - Name ~nd Title of Olficer (e.g., "Jane Doe, +.Jot~bliC") ~ ~ personally appeared b~ 6\,,"\~~~ ~.' ~ ~~~~~ ~ ~1 ~sonally known to me ~ ~ D proved to me on the basis of satisfactory ~ ~ evidence ~ ~ to be the person(s) whose name(s) is/are I ~",...,.. '. ~;;;~E:l ~m~ i Gi :~~~~~~e~~e~Oto t~: t:;h~~/s~~~t~~;:~:c~~~ ~.'..I ~ NOTARY PU"BLlC . CALIfORNIA;: the same in his/her/their authorized ~5 ~I ',:. lA... commM.AE~~f~~~~T:5. 2007 capacity(ies), and that by his/her/their ~...'.II ~1 I~" ^t'" signature(s) on the instrument the person(s), or t5 ~ the entity upon behalf of which the person(s) ~ ~ acted, executed the instrument. g I ~ES: ha~ and official :a~ i I \ ~ Si~"",,Q" ~bl;, ~ ~ 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: ~ ~ ~ I ::::~:~~:::Than Named Above: Number of Pages: I I I Capacity(ies) Claimed by Signer ~ ~ ~ ~ D Individual Top of thumb here ~ I D Corporate Officer - Title(s): ~ I' D Partner - D Limited D General ~, II D Attorney-in-Fact ;5 I D Trustee ~ I D Guardian or Conservator ~ ~ D mher ~ ~ Signer Is Representing: ~ ~x:x.~'<R~~~~~~<<-~~~<<-~~~~~~'{X.'<X-~~-g;~~~~~~'<X>~~'<Y~ Signer's Name: @ 1999 National Notary Association. 9350 De Soto Ave., P.O. Box 2402 . Chatsworth, CA 91313-2402 . www.nationalnotary.org Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 CALIFORNiA Al.L.PURPOSE AC'KNO,Wl.5DGMENT No. 5907 State of . County of On CALIFORNIA SONOMA 9/22/04 . before. me" . K. HOLTEMANN NAME. TITLE OF OFFICER. E.G.., "JANE DOE. NQTARY PUBLIC. DATE personal'ly appeared . LAWRENCE J. COYNE, ATTORNEY- rn-FACT NAME(S) OF SIGNER(S) QQc personally known to me - OR .. 0 proved to me an the basis :of satisfactory eviden c,e to be the pers~n($) whose name(:s9 ,is~ subscribed to the within instrument and ac- knowledged to me that he~ executed tn,e same in ..hls~ authorized 1iapaclty~); and th.at by hi~/~ signature(s) on the instrument the persan~), or, the entity upon behalf of which the person(~ acted, executed the instrument. ~~~~'~~~:~:::~~ CL ;7'N:':';~ j~",,"J f)IIBi I(~ . c: 1\1 IF ;0 U ",,:, ',f':Y..ii:;',j . ...~. _"~ .n '.. I 2 ,\~'I',...r.~1 C'" ''..11 J r". ("'~CVv1^ ...... tl~":1?*~j.~~;;;;.;,;,j~~~i~ WITNESS my ~an"d and official seal. .-~L '--1: . I . ., _{I'L't" ",- SIGNATURE OF NOTARY ~ 'C f OPTIONAL Though the data below is not required by law, it may, prove valuable to persons relYIng on the document and could prevent . fraudulent reattachment of this form. :GAPACITY CLAIMED BY SiGNER '0 INDIVIDUAL o CORPORATE OFFICER DESCRIPTION OF ATIACHED DOCUMENT. PERFORMANCE BOND TITLE OR TYPE OF DOCUMENT . 'TITLE{S) o PARTNER(S) o LIMITED o GENERAL , ONE NUMBER OF PAGES [?fJ A TIORNEY -IN,;,FACT o TRUSTEE(S) o GUARDIAN/CONSERV A TOR o OTHER: SEPTEMBER 22, 2004 DATE OF DOCUMENT . SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTiTY(iES) n/a SIGNER{S) OTHER THAN NAMED ABOVE TRAVELERS. CASUALTY AND SURErY COMPANY OF AMERICA e.e.; @1993 NATIONAL NOTARY ASSOCLA,TlON. 8236 Remme( Ave., P.C' 2,0:: 7 ",P.l, ,:;"n'~:E ~'2d: CJ 9" :":Jf-:--''1 8-' PAYMENT BOND - PUBLIC WORK SECTIONS 3247 - 3252, CIVIL CODE (CALIFORNIA) TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford, Connecticut 06183 (Bond issued in duplicate) Bond No. 104340986 Premium $(included) KNOW ALL MEN BY THESE PRESENTS: THAT WHEREAS, The State of California, acting by and through the TOWN OF TIBURON has awarded to MAGGIORA AND GHILOTTI, INC. as Contractor, a contract for the work described as follows: 2004 CAPITAL IMPROVEMENTS PROJECT DRAINAGE & SIDEWALK REPAIRS AND WHEREAS, Said Contractor is required to furnish a bond in connection with said contract, to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, We the undersigned Contractor and Surety are held and firmly bound unto the State of California in the amount required by law, the sum of NINETY-FOUR THOUSAND NINE HUNDRED FORTY-EIGHT AND NO/100THS-- ($ 94,948.00 ) Dollars, for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, That if said Contractors shall fail to pay (1) Any of the persons named in Civil Code Section 3181, (2) amounts due under the Unemployment Insurance Code for work or labor performed in connection with said contract by any such claimant, or (3) any amounts required to be deducted, withheld and paid over to the Employment Development Department from wages of the employees of Contractor and his sub-contractors with respect to such work and labor, pursuant to Section 13020 of the Unemployment Insurance Code, then the Surety or Sureties herein will pay for the same in an aggregate amount not exceeding the sum specified in this bond, and also in case suit is brought upon the bond, a reasonable attorney's fee, to be fixed by the court, otherwise the above obligation shall be void. This bond shall inure to the benefit of any of the persons named in Civil Code Section 3181 so as to give a right of action to such persons or their assigns in any suit brought upon this bond. This bond is executed and filed to comply with the provisions of the act of Legislature of the State of California as designated in Civil Code, Sections 3247 - 3252 inclusive, and all amendments thereto. IN WITNESS WHEREOF, We have hereunto set our hands and seals on this 22ND day of SEPTEMBER,2004 . ~ts Contractor TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA ,. ./ (1 ;; By /lalV~;j ~.~ {/ 1 AWRENCE J. COYNE, Attorney-in-Fact CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 1=::=MM.-<X'~~~)'X'-<X'<<~~~~~<w.m&<,,c('~~-<X'~~.c<'&<t~l ~ } ss. ~ ~ County of MI't12.. \.A. ~ I On q , L "l. - 0 -1 ~ ~ D,. ~ ~ personally appeared (,;& "J ~ l-h [.,...-i N=",) ,fS;g~"') ~ ~.....' ~sonally known to me ~.:: ~ ~Vi~~~~~d to me on the basis of satisfactory ~ ~!..... to be the person(s) whose name(s) is/are ~.'...I ~1 subscribed to the within instrument and ~ ~ ~ .-^.. """- --: '^- ./'- /~~T~E; ~E;R;Y /" ~ acknowledged to me that he/she/they executed ~ ~I".... _ ~"".. ". COMM. #1425111 cj the same in his/her/their authorized ~".',II ~ t3 Q;) NOTARY PUBLIC - CALIFORNIA::: capacity(ies), and that by his/her/their ~~ ~ I- # MARIN COUNTY signature(s) on the instrument the person(s), or ~ ~ My Comm. Expires July 15. 2007 the entity upon behalf of which the person(s) ~ ~ acted, executed the instrument. ~ ~ ~ ~ ~ ~ I ~ ~ ~ ~ I ( OPTIONAL ~ ~ ~ ~ ~ ~ I Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Ii Signer(s) Other Than Named Above: 'I Capacity(ies) Claimed by Signer Signer's Name: . ~ D Individual Top of thumb here ~ D Corporate Officer - Title(s): ~ ~ D Partner - D Limited D General ~ ~ D Attorney-in-Fact ~ ~ D Trustee ~ ~ D Guardian or Conservator ~ ~ D Other: ~ ~ Signer Is Representing: ~ L~~~~'<X.~-g,~-g,~~'Q(.~~~'(%-<%~~~~~~~~~,g'<>Q<,."Q<;,~~~~~~-<%~W~ I' I' I, @ 1999 National Notary Association. 9350 De Soto Ave., P.O. Box 2402. Chatsworth, CA 91313-2402. www.nationalnotary.org Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 CALIFORNIA Al.L-PURPOSE AC'KNO.WLEDGMENT tic, 5907 State of County of CALIFORNIA SONOMA On 9/22/04 before, me" . K. HOLTEMANN . I DATE NAME, TITLE OF OFFICER. E.G., "JANE DOE. NQTARY PUBLIC~ personaHyappeared LA'WR.E'.N'CE J. COYNE, AITORNEY- IN-FACT ~ 4 4 . NAME{S) OF SIGNER(S) ~ personalty known to me - OR - 0 proved to me on the basts :of satisfactory evidenc.e to be the pers.on~) whose name(:s9 .is~ subscribed to the within instrument and ac- 'knowledged to me that he~ executed th.e same in ..his~ authorized ~apaci-ty~); and th.at by hi~/~ signature(:s:) on the instrument the pe.rsQn{~), or, the entity upon behalf of wh ich the person(~ acted, executed the instrument. t~~~~~f0~~~';~."?::"~'~~~.';~::~:"':':~'~;~:~~;~-11 or;- (.~'.. ... ., ..i}..'\..\.~') f( H 0 LJErVl,t, f\! N . Z rY . .'~" .. .j. .- L._ .;.,-....,.; ...{...~f~j,<.... Pl'BI ,.,... ~.(''I. I Ie: \. ') U \ .~. ..."" ,6 .'" . ) - .. ".,. .. ,. .JJ Z. \.~,.." ...' nr: "c~'r)HI I tI~ y :~~,~:;;#;~~i~~J~~ WITNES~ my hf:'d and Offi..C.. Jal seal. "-----:.-( . {I f2~ \.._~t... .. -. -- \... / ,0 ... v., ..., ..-_. SIGNATURE OF NOTARY OPTIONAL Though the data below is not required by law, it may. prove valuable to persons relying on the document and could prevent - fraudulent reattachment of this form. :GAPACiTY CLAIMED BY SIGNER . 0 JNDIVIDUAL D CORPORATE OFFICER DESCRIPTION OF ATIACHED DOCUMENT' PAYMENT BOND TITLE OR TYPE OF DOCUMENT . TrTLE(S) o PARTNER(S) o LIMITED o GENERAL ONE NUMBER OF PAGES ~ A TIORNEY -IN~rACT o TRU8TEE(S) o GUARDIAN/CONSERVATOR o OTHER: SEPTEMBER 22, 2004 DATE OF DOCUMENT ~ SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(i:S) n/a TRAVELERS . CASUALTY AND. SUREI'Y COMPANY OF AMERICA SlGNER(S) OTHER THAN NAMED ABOVE ~ eG @i993 NATIONAL NOTP-,RY p,SSOCr~,TI0N. B236 Remme~ Ave., P.c. ~.O:~ ijP.l ">m~~~ ~'2ri; Ct. 9' 2':::S::-:'H'.,' ~>>d Travelers ~ IMPORTANT DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE On November 26, 2002, President Bush signed into law the Terrorism Risk Insurance Act of 2002 (the "Act"). The Act establishes a short-term program under which the Federal Government will share in the payment of covered losses caused by certain acts of international terrorism. We are providing you with this notice to inform you of the key features of the Act, and to let you know what effect, if any, the Act will have on your premium. Under the Act, insurers are required to provide coverage for certain losses caused by international acts of terrorism as defined in the Act. The Act further provides that the Federal Government will pay a share of such losses. Specifically, the Federal Government will pay 900/0 of the amount of covered losses caused by certain acts of terrorism which is in excess of Travelers' statutorily established deductible for that year. The Act also caps the amount of terrorism- related losses for which the Federal Government or an insurer can be responsible at $100,000,000,000.00, provided that the insurer has met its deductible. Please note that passage of the Act does not result in any change in coverage under the attached policy or bond (or the policy or bond being quoted). Please also note that no separate additional premium charge has been made for the terrorism coverage required by the Act. The premium charge that is allocable to such coverage is inseparable from and imbedded in your overall premium, and is no more than one percent of your premium. ILT-I018 (2/03) IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 30th day of April, 2004. STATE OF CONNECTICUT }SS. Hartford COUNTY OF HARTFORD .. #\\-a~~I~:;#Ib.~ I~.'~~ I ~ lIiARTFOAO.\ ~.. ~~ CONN. I{lo- ~ ._.....~t '.I If. ~~~t,." TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRA VELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY /w~>~ - By George W. Thompson Senior Vice President On this 30th day of April, 2004 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. ~~ c.. My commission expires June 30, 2006 Notary Public Marie C. Tetreault CERTIFICATE I, the undersigned, Assistant Secretary of TRAVELERS CASUAL TY AND SURETY COMPANY OF AMERICA, TRA VELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority, are now in force. Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this 22ND SEPTEMBER , 20 04 day of =r;;;e- tU- r--. p7 - By .~ Kori M. Johanson Assistant Secretary, Bond ACORDTM CERTIFICATE OF LIABILITY INSURANCE OP 10 K~ DATE (MMlDDIYYYY) MAGGI-1 09/21/04 PRODUCER (W~l THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Don Ramatici Insurance, IncRECEIVE!D HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 551 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Petaluma CA 94953 Fax:707-782~J 2 2004 Phone:707-782-9200 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Insurance MAGl1l0AA & INSURER B: National Union Fire Ins. of PA Ma~giora & Ghilotti, InGtiILOTTI; 'Ne, INSURER C: At n: Matt petray 555 Dubois Street INSURER D: San Rafael CA 94901 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. IN~f( ~~~~ POLICY NUMBER PD'i~~1J~Jg~E Pgk\-CEY(~~6~J!,.~N LIMITS LTR TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE $1,000,000 f--- A X X COMMERCIAL GENERAL LIABILITY DTEC07975A495TIL04 09/01/04 09/01/05 UAIVIA~t: I v N:t:I'j I t:u $300,000 PREMISES (Ea occurence) I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,000 X PD Ded. $10,000 PERSONAL & ADV INJURY $1,000,000 f--- GENERAL AGGREGATE $2,000,000 I--- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,000,000 n [Xl PRO- nLOC Emp Ben. 1,000,000 POLICY X JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I--- $1,000,000 A X ANY AUTO DT8107975A495TIL04 09/01/04 09/01/05 (Ea accident) f--- ALL OWNED AUTOS BODILY INJURY f--- $ SCHEDULED AUTOS (Per person) I--- HIRED AUTOS BODILY INJURY f--- $ NON-OWNED AUTOS (Per accident) f--- X PD Ded. $5,000 PROPERTY DAMAGE I--- $ Each Accident (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ =1 ANY AlITO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 B :!J OCCUR D CLAIMS MADE BE2684901 09/01/04 09/01/05 AGGREGATE $ 5,000,000 $ ~ DEDUCTIBLE $ X RETENTION $25,000 $ WORKERS COMPENSATION AND IT~~/~I~:~S I IU1H- ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Operations of the Named Insured for the Certificate Holder JOB: 2004 Capital Improvements Project-Drainage & Sidewalk Repairs M&G#4107 *its officials, employees & agents 30XCGD247 CERTIFICATE HOLDER CANCELLATION TIBUR05 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL EUBEN,BR TB MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BtlT fJldLtlRE TB BB SB 811. bl Town of Tiburon 1505 Tiburon Blvd. Tiburon CA 94920 ".,rO.!.! I~O OBLlGA'fIOI~ 01\ L1ABILlT I or A14, ttlJ~D l::J" 01. "1 I!:: n."tlftf:l\, IT5 A6E:lJT3 6ft ACORD 25 (2001/08) Named Insured: Maggiora & Ghilotti, Inc. Policy No.: DTEC07975A495TIL04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY - CONTRACTORS COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): Town of Tiburon, its officials, employees & agents PROJECT/LOCATION OF COVERED OPERATIONS: 2004 Capital Improvements Project-Drainage & Sidewalk Repairs M&G#4107 1. WHO IS AN INSURED - (Section II) is amended to include the person or organization shown in the Schedule above. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The person or organization is only an additional insured with respect to liability caused by "your work" for that additional insured at the location shown in the Schedule. 2. The insurance provided to the additional insured is limited as follows: a) In the event that the limits of liability stated in the policy exceed the limits of liability required by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought, the insurance provided by this endorsement shall be limited to the limits of liability required by such contract or agreement. This endorsement shall not increase the limits stated in Section III - LIMITS OF INSURANCE. b) The insurance provided to the additional insured does not apply to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and II. Supervisory or inspection activities performed as part of any related architectural or engineering activities. CG D2 47 10 02 Copyright, The Travelers Indemnity Company, 2002 Page 1 C) This insurance does not apply to "bodily injury" or "property damage" caused by "your work" included in the "products-completed operations hazard" unless you are required to provide such coverage for the additional insured by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought and then only for the period of time required by such contract or agreement and in no event beyond the expiration date of the policy. 3. Subpart (l)(a) of the Pollution exclusion under Paragraph 2., Exclusions of Bodily Injury and Property Damage Liability Coverage (Section I - Coverages) does not apply to you if the "bodily injury" or "property damage" arises out of "your work" perfoffiled on premises which are owned or rented by the additional insured at the time "your work" is performed. 4. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought specifically requires that this insurance apply on a primary or non-contributory basis. When this insurance is primary and there is other insurance available to the additional insured from any source, we will share with that other insurance by the method described in the policy. 5. As a condition of coverage, each additional insured must: a.) Give us prompt written notice of any "occurrence" or offense which may result in a claim and prompt written notice of "suit". b.) Immediately forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with policy conditions. c.) Tender the defense and indemnity of any claim or "suit" to any other insurer which also insures against a loss we cover under this endorsement.:. This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For purposes of this requirement, the term "insures against" refers to any self-insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured with a defense and/or indemnity under that policy of insurance. d.) Agree to make available any other insurance that the additional insured has for a loss we cover under this endorsement. CG D2 47 10 02 Copyright, The Travelers Indemnity Company, 2002 Page 2 CERTHOLDER COPY STATE P.o. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FU NO CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 09-21-2004 GROUP: POLICY NUMBER: 1758056-2003 CERTIFICATE 10: 107 CERTIFICATE EXPIRES: 10-01-2004 10-01-2003/10-01-2004 TOWN OF TIBURON 1505 TIBU~ON B':LVD TIBURON CA 94920 40Q.~.g~.:!:>.;rTAL IMPROVEMENTS PROJECT DRAXNAGE& SIDEWALK M&G#4107 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period that will expire or did expire as indicated above. This certificatepf...insy.raqc~.js...pot..f\P in~..urf\nG.~..poIISX anq..does not alJlepq....~xt~n.q..or f\lt~rth~Ggverage afforded by the policy listed h~rein; ~Qt:-vith~tf\ndiqg aqy requi~~mept;\terrr or conditiQ.Qgf anx cOl')tr~cto~ oth~rqocument with respect to whiG.bt9iss~rtifiYf\te of!p.~ur~q.s~ rr~x t>~i~~y~q9r to whigbi~maxpe!aiqlth~insyrf\npe afforded by the policy described herein is subjectto all the terms, exclusions, and conditions, of such policy. ~ ,&~ C. ~ AUTHORIZED EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENn' '2q6~\~N'fI'lj~ED CERTlflq",TEHOLDERS' NO'r!IGBEFFECTIVE 10-01-2003 IS ATTACHED..\.TO AND..EORMSA PART OF THZSl?OLllCY. ENDORSEMENT #2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 10-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: TOWN OF TIBURON EMPLOYER MAGGIORA & GHILOTTI, INC 555 DU BOrSST SAN RAFAELCA949 SCIF 10262E Accept this certificate only if you see a faint watermark that reads "OFFICIAL STATE FUND DocUMENr [S,NC] PRINTED: 09-21-2004 PAGE 1 OF 1 License Detail Page lof2 California Home License Detail Contractor License # 226767 CALIFORNIA CONTRACTORS STATE L1CEN DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the Iin button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments known to the CSLB are di . Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 09/27/2004 * * * Business Information * * * MAGGIORA AND GHILOTTIINC 555 DU BOIS STREET SAN RAFAEL, CA 94901 Business Phone Number: (415) 459-8640 Entity: Corporation Issue Date: 07/14/1964 Expire Date: 03/31/2005 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * IClassl1 Description IA IIGENERAL ENGINEERING CONTRACTOR IB IIGENERAL BUILDING CONTRACTOR Ic-s IlcONCRETE IC12 IIEARTHWORK AND PAVING IC21 IIBUILDING MOVING, DEMOLITION IC42 IlsANITATION SYSTEM . .. http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 9/27/2004 License Detail Page 2 of2 IC32 \IPARKING AND HIGHWAY IMPROVEMENTI IC34 IIPIPELINE I * * * Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 5S103174818BCn amount of $10,000 with the bonding company TRAVELERS CASUAL TY_ AND SURETY COMPANY OF AMERICA. Effective Date: 01/01/2004 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(1): The Responsible Managing Officer (RMO) G MICHAEL GH,ILOTTI certified that he/she owns 10 percent or more of the voting stocklequ corporation. A bond of qualifying individual is not required. Effective Date: 12/12/1991 * * * Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1758056 Effective Date: 10/01/2003 Expire Date: 10/01/2005 Workers Compensation History Personnel listed on this license (current or disassociated) are listed on other lice. p~rsonnel List Other Licenses License Number Req_I!~s;t ContragorNameRequest Personnel Name Request Salespe___~_IlI!E!guest Salesperson Name RE!~uest @ 2004 State of California. ConditioilS of Us;~ Erjv~PQli9' http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 9/27/2004 Company Profile Company Profile Page 1 of2 a Insurance TRAVELERS INSURANCE COMPANY (THE) ONE CITY PLACE HARTFORD, CT 06103-3415 A ff /5 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 #: NAIC Group #: California Company ID #: Date authorized in California: License Status: Company Type: State of Domicile: 87726 0041 0221-2 September 08, 1868 UNLIMITED-NORMAL LIFE/DISABILITY CONNECTICUT 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 glossary. COMMON CARRIER LIABILITY DISABILITY LIABILITY LIFE WORKERS' COMPENSATION Company Complaint Information http://cdinswww.insurance.ca.gov/pls/wu_co_lines/idb_ co -prof_ utl.get_ co j)rof?p _ EID=2... 9/27/2004 Company Profile Page 2 of2 Company Enforcement Action Documents Company Performance & Comllilrison Data Composite Con1plaint Studies Want More? HeIR Me find a Company RepreseI1tative ill My Area financial Rating Organizations Last Revised - August 17,200407:34 AM Copyright cg California Department of Insurance Disclaimer http://cdinswww.insurance.ca.gov/pls/wu_co_lines/idb_ co -prof_ utl.get_ co -prof?p _ EID=2... 9/27/2004 Company Profile Company Profile Page 1 of2 NATIONAL UNION FIRE INSURANCE A+t 16 COMPANY OF PITTSBURGH, P A ,70 PINE STREET NEW YORK, NY 10270 800-551-0824 Agent for Service of Process LORI CASTANEDA, 2730 GATEWAY OAKS DR SUITE 100 SACRAMENTO, CA 95833 Unable to Locate the Agent for Service of Process? Reference Information NAIC #: NAIC Group #: California Company ID #: Date authorized in California: License Status: Company Type: State of Domicile: 19445 0012 0131-3 November 28, 1902 UNLIMITED-NORMAL Property & Casualty PENNSYLVANIA 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 glossary. ' AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY DISABILITY FIRE LIABILITY MARINE MISCELLANEOUS http://cdinswww.insurance.ca.gov/pls/wu_co_lines/idb_ co -prof_ utl.get_ co -prof?p _ EID=2... 9/27/2004 Company Profile Page 2 of2 PLATE GLASS SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION Company Complaint Information Company Enforcelnent Action Documents Company Performance & Comparison Data Composite Complaint Studies Want More? Help Me Find a Company Representative in My Area Financial Rating Organizations Last Revised - August 17,200407:34 AM Copyright @ California Department of Insurance Disclaimer http://cdinswww.insurance.ca.gov/pls/wu_co_lines/idb_ co -prof_ utl.get_ co -prof?p _ EID=2... 9/27/2004