HomeMy WebLinkAboutAgr 2006-11-16 (Community Playgrounds)
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NOV 0 9 2006
TOWN OF TIBURON
TIBURON, CALIFORNIA
DIRECTOR OF PUBLIC WORKS
TOWN OF TIBURON
OWNER-CONTRACTOR AGREEMENT
CYPRESS HOLLOW PARK PLAY AREA RESURFACING AND APPURTENANT
WORK
.
11t: THIS OWNER-CONTRACTOR AGREEMENT ("Agreement") is made and entered into this
~ day of ~~~~ , 2006, by and between the TOWN OF TffiURON, a municipal
corporation, 1505 Tiburon Boulevard, Tiburon, CA 94920, ("Owner"), and COMMUNITY
PLAYGROUNDS, INC., 1620 Grant Avenue, Suite 5, Novato, CA 94945 ("Contractor").
In consideration of the mutual covenants and agreements set forth herein, Contractor and
Owner hereby agree as follows:
ARTICLE 1
WORK DESCRIPTION
The Contractor shall do all the work and furnish all the labor, services and materials necessary to
complete the work described in the Contractor's Bid Proposal attached as Exhibit A ("Work"). The
Contractor shall complete the Work in a good, workmanlike and substantial manner, to the satisfaction
of Owner and in accordance with the terms of this Agreement and the Town's encroachment permit.
ARTICLE II
CONTRACT SUM
Contractor's compensation under this Agreement shall be known as the Contract Sum. The Contract
Sum shall be a not-to-exceed amount of$21.873.00 (twenty one thousand eight hundred seventy three
dollars) as full compensation for the Work. All payments shall be subject to the General Conditions,
set forth in Exhibit B.
ARTICLE III
TIME FOR PERFORMANCE
Contractor shall commence performance of the Work on a date to be specified by Owner to Contractor
to proceed ("Notice to Proceed"). Contractor shall diligently proceed with performance of the Work
and agrees to achieve Completion of the entire Work within 20 calendar days after receiving the
Notice to Proceed ("Scheduled Completion Date").
ARTICLE IV
EXHIBITS
This Contract includes the following Exhibits, which are attached hereto and incorporated herein
by reference:
Exhibit A
Exhibit B
The Work (Contractor's Proposal)
General Conditions
Communitv Plavqround... - Cvnress Hollow Park
IN WITNESS WHEREOF, the parties to these presents have hereunto set their hands the
day and year first herein above written.
TOWN OF TIBURON
APPROVED AS TO FORM:
.
By lfl.,~~~~ -
Margaret A. Can,'" l rr Town Manager
BY/~/~
Ann R. Danforth, Town Attorney
CONT~nity Playgrounds, Inc.
By- ~---
Its ~0P~ r lJei:4,2. I q~r;:,
,
'L /. (J. .........,
Contractor's License No. :J<..,). 7 ~ 0
I
Expiration Date: ~e 8
Community Playgrounds - Cypress Hollow Park 2
EXHIBIT A
CONTRACTOR'S PROPOSAL
Community Playgrounds - Cypress Hollow Park 3
10/18/2006 15:16
14158923132
COMMUNITY PLAYGROUND
PAGE 01
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Revised Proposal
Job Number: 60114
Project: Cypress Park
Tiburon CA
Contact: Dave Davenport
phone: 415.559.8369
Fax: 415.789.9256
Oat.: 10-18-2006
Item
Description
Amount
· 1 Lower Playground
1 RemovelOispose Exisitng Rubber Tiles -520SF
2 Fumish/lnstall 520SF of 2.5" Poured In Place
3 Replace Swing & Chains w/NewTotSeats & VinylChains
1.196.00
6,514.00
412.00
Phase Tot.,:
8,122.00
2 Upper Playground
4 RemovelOispose Exisltng Rubber Tiles -7BOSF
5 Fumishflnstall 780SF of 2.5" Poured In Place
6 New 9" Curb & Expansion of Use Zone
1,423.00
9.984.00
2,344.00
Phase Total:
13,751.00
21,873.00
Grand Total:
Notes:
Signature:
Date:
EXHIBIT B
GENERAL CONDITIONS
ARTICLE 1
IN GENERAL
1.1 DEFINITIONS
.
1.1.1 "Director" shall mean the Owner's Director of Public Works or his designee.
1.1.2 "Owner" shall mean the Town of Tiburon, and its officials, agents and employees.
1.1.3 "Contractor" shall mean Community Playgrounds, Inc. and its officials, agents, and
employees.
1.1.4 "Day" shall mean calendar day unless specifica:lly designated otherwise.
1.1.5 "Excusable Delay" shall mean an actual delay in the performance of the Work by Contractor
caused by events to the extent that such events are not reasonable foreseeable and are beyond the
reasonable control of Contractor, such as fire, flood, earthquake or unusually and unforeseeably severe
and abnormal weather conditions, war, embargo, or sabotage.
1.2 CONTRACT CONDITIONS
The Contractor shall carefully study this Contract and shall at once report in writing to the Owner any
error, inconsistency, omission or lack of coordination that may be discovered. Any discrepancies
between this Contract and conditions of the Site, or in the layout given by stakes, points or
instructions, discovered by the Contractor shall be promptly brought to the attention of the Owner.
1.3 PERFORMANCE OF THE WORK
1.3 .1 The Owner shall at all times have access to the Work.
1.3.2 At the time the contract is awarded, all contractors and subcontractors shall be
properly licensed in accordance with the provisions of Chapter 9 of Division 3 of the Business and
Professions Code. At the commencement of work, all contractors and subcontractors shall have
obtained business licenses from the Town of Tiburon.
1.3.3 Unless otherwise provided in this Contract, the Contractor shall provide, pay for and
be responsible for all labor and materials necessary for the proper execution of the Work. The
Contractor shall supervise and direct the Work, using the best skill and attention necessary for a
contractor experienced and expert in this type of construction. The Contractor shall employ only
persons skilled in the task assigned to them and only machinery and equipment of suitable capacity to
the task, and operated by an experienced operator. The Contractor shall be responsible to the Owner
for the acts and omissions of the Contractor's employees, subcontractors and their agents and
employees. NotwithstaneJing the forgoing, nothing in this Contract shall be interpreted to make the
Contractor an agent of the Owner.
1.3.4 The Contractor shall promptly correct all Work rejected by the Owner as defective or
as failing to conform to this Contract. The Contractor shall bear all costs of correcting such Work. If
the Contractor does not, within seven (7) days after receipt of written notice from the Owner,
commence and diligently complete correction of any deficient or nonconforming Work, the Owner
Community Playgrounds - Cypress Hollow Park 4
may, without prejudice to any other remedy the Owner may have, correct such deficiencies. The
Owner shall be entitled to a credit for the cost of such correction against the Contract Sum.
1.3.5 The Owner reserves the right to perform work related to the Work with the Owner's
own forces, and to award separate contracts in connection with other portions of the Work or other
work on the Site. The Owner and the Contractor shall provide for the coordination of the work. The
Contractor shall afford the Owner and separate contractor's reasonable opportunity for the
introduction and storage of their materials and equipment and the execution of their work, and shall
connect and coordinate the Work with theirs as required by this Contract.
.
1.4 INDEMNIFICATION
Contractor shall defend, indemnify and hold harmless Owner from any claims or damages, including
attorney's fees, arising from Contractor's performance of this Agreement, with the exception ofthose
claims or damages arising from the active negligence of Owner. In the event that the Owner's active
negligence accounts for only a percentage of the liability ,involve, the obligation of Contractor will be
for that portion or percentage of liability not attributable to the active negligence of Owner.
1.5 USE OF SUBCONTRACTS AND OTHER CONTRACTS FOR THE WORK
Contractor shall comply with the California Subletting and Subcontracting Fair Practices Act, Cal.
Pub. Contr. Code 33 4104 - 4114.1 in the use and substitution of subcontractors.
1.6 CHANGE ORDERS
1.6.1 A Change Order is a written order to the Contractor signed by the Owner and
authorizing a change in the Work and/or an adjustment in the Contract Sum and/or the Contract Time.
The Contract Sum and the Scheduled Completion Date may be changed only by specific. Change
Order. Adjustments of Contract Time, Work or Sum may be issued without notice to Sureties, and
absence of such notice shall not relieve the Sureties of any responsibilities.
1.6.2 The Owner, without invalidating the Contract, may order changes in the Work within
the general scope of the Contract Change Order. The cost or credit to the Owner resulting from a
change in the work shall be determined, at the Owner's option, by mutual agreement between the
Owner and Contractor, or on the basis of time and material actually and properly incurred, plus a
twenty percentage fee for profit and overhead.
1. 7 TERMINATION OF THE CONTRACT
1.7.1 If the Contractor becomes bankrupt or insolvent or is guilty of a substantial violation
of a provision of this Contract, and fails within seven (7) days after receipt of notice to commence and
continue correction of such default with diligence and promptness, the Owner may, without prejudice
to any other remedy the Owner may have, terminate the employment of the Contractor and take
possession of the Site and of all materials and equipment thereon owned by the Contractor as
necessary to complete the Work.
1.7.2 The Owner may terminate the performance of the Work in whole or in part, whenever
the Owner determines that such termination is in the best interests of the Owner. Any such
termination shall be effected by delivery to the Contractor of a notice of termination specifying the
extent to which the performance of the Work is terminated, and the date upon which termination
becomes effective. Upon such termination for convenience, Contractor shall stop all Work and be
entitled to reasonable compensation for Work performed and accepted under this Contract.
Community Playgrounds - Cypress Hollow Park 5
ARTICLE 2
PAYMENTS AND COMPLETION
2.1 PAYMENTS
2.1.1 The Contract Sum is stated in the Agreement and, including authorized adjustments
thereto, is the total amount payable by the Owner to the Contractor for the performance of the Work
under this Contract.
2.1.2 The Contractor shall submit monthly invoices for Work completed, for the review and
approval of the Director or his representative. Within 30 days of receipt of each invoice, the Owner
shall either approve the Work covered by the invoice or advise Contractor of the specific deficiencies
that must be corrected prior to approval. Upon approval of the Work covered by the invoice, Owner
pay shall ninety percent (90%) of the amount due. Retained percentages are for the sole protection
and benefit of the Owner and no other person, firm or cOqJoration shall be entitled to receive any part
thereof. Contractor shall have the option of substituting acceptable securities for the ten percent (1 0%)
retention, as provided by Public Contract Code 3 22300. Alternatively, Contractor may submit a lump
sum invoice for the total work cost upon final completion.
2.1.3 No payment shall constitute an acceptance of any Work not in accordance with this
Contract. The Contractor warrants that title to all components of the Work will pass to the Owner
either by incorporation in the construction or upon receipt of payment by the Contractor, whichever
occurs first, free and clear of all liens, claims, security interests or encumbrances of any kind.
2.1.4 The Owner may withhold payment in whole or in part if the Contractor fails to
perform its contractual obligations to the extent necessary to protect the Owner from damage, injury or
loss. Without limiting the foregoing, Owner may without payment as necessary to correct defective
Work not remedied; defend from existing or likely third-party claims, remedy the failure or likely
failure of payments to subcontractors, or for labor, materials or equipment; or damage to the Owner or
another contractor.
2.1.5 The Contractor following receipt of payment by the Owner shall promptly pay each
subcontractor, out of the amount paid to the Contractor on account of such subcontractor's Work, the
amount to which said subcontractor is entitled. The COIitractor shall, by an appropriate agreement
with each subcontractor, require each subcontractor to make payments to their sub-subcontractors in
similar manner. The Owner shall have no obligation to payor to see to the payment of any monies to
any subcontractor or sub-subcontractor.
2.2 FINAL PAYMENT
2.2.1 Upon Final Completion of the Work, Owner shall pay Contractor the final payment
and any remaining retainage. Notwithstanding the foregoing, in the event of a dispute between
Contractor and the Owner, the Owner may withhold from the final payment an amount not to exceed
1500/0 of the disputed amount. No payment shall be construed to be an approval or acceptance of any
defect in Work or improper materials.
2.2.2 Prior to final payment, if requested by Owner, Contractor shall submit a written
certification that all payrolls, bills for materials and equipment, and other indebtedness connected with
the Work for which the Owner or the Owner's property might in any way be responsible, have been
paid or otherwise satisfied, and if required by the Owner, other data establishing payment or
satisfaction of all such obligations to Owner's satisfaction.
Community Playgrounds - Cypress Hollow Park 6
2.2.3 Acceptance by the Contractor of final payment shall be and shall operate as a release
to Owner of and from any and all other claims, causes of action, damages or liabilities, whether or not
known or suspected, which Contractor ever had or claims to have had relating to this Contract or the
performance of the Work. No payment, however, final or otherwise, shall operate to release the
Contractor or his sureties from any obligations under this contract for the Contractor's bond for faithful
performance and Contractor's payment bond.
2.3 DELAYS AND EXTENSIONS
.
2.3.1 The Scheduled Completion Date shall not be extended except to the extent that the
Contractor is actually prevented from completing the Work before the Scheduled Completion Date
because of an Excusable Delay.
2.3.2 In the event that Contractor is actually delayed on the performance of the Work by
any Excusable Delay and because of said Delay is un~ble to complete the work by the Scheduled
Completion Date, Contractor's sole remedy shall be an extension of time for a period equal to the
length of such Excusable Delay. In no event shall it be entitled to a monetary payment over and
beyond the Contract Sum. Actual delays in activities that do not prevent the Contractor from
completing the work by the Scheduled Completion Date will not constitute an "Excusable Delay" nor
be a basis for changing the Scheduled Completion Date.
2.4 GUARANTEE
Independent of applicable manufacturers' warranties of materials used, for a period of one year
after acceptance by the Owner, the Contractor shall guarantee all work performed under this
contract. Any failure caused by defective materials or workmanship shall be promptly repaired or
replaced at the Contractor's expense. Failure of the Contractor to make such corrections will cause
the Town to make or have made any necessary repairs at the Contractor's expense. The warranty
period starts when a notice of completion is filed with the County or when final payment is made if
a notice is not filed.
ARTICLE 3
WORK MANAGEMENT RESPONSIBILITIES
3.1 SAFETY PRECAUTIONS AND PUBLIC CONVENIENCE
3.1.1 The Contractor shall be responsible for initiating, ma~ntaining and supervising all
safety precautions and programs in connection with the Work. This duty shall extend, without
limitation, to the safety of all employees on the Work and all other persons who may be affected
thereby; all the Work and all materials and equipment to be incorporated therein; other property at the
Site or adjacent thereto, and the work of the Owner or other separate contractors. Without limiting the
foregoing, Contractor, not Owner, shall remain fully responsible for the disposition and the exposure
to persons of materials, whether or not hazardous. Contractor remains fully responsible for the
handling of and the removal of products and systems and shall take necessary measures to protect
employees, subcontractors, general public, design consultants and others.
3.1.2 The Contractor shall so conduct his operations as to offer the least possible
obstruction and inconvenience to the public. The Contractor shall provide for the convenience of
abutting owners along the right-of-way as far as practicable. No material or equipment shall be stored
where it will interfere with the free, safe, and convenient passage of public traffic.
Community Playgrounds - Cypress Hollow Park 7
3.2 SITE MANAGEMENT AND CLEAN UP
The Contractor shall confine operations at the Site to areas permitted by law, ordinances, permits and
this Contract, and shall not unreasonably encumber the Site with any materials or equipment. The
Contractor shall keep the Site free from accumulation of waste material or rubbish caused by his
operations under the Contract. At completion of the daily work, the Contractor shall remove from and
about the Work such waste and rubbish, and the Contractor's tools, construction machinery,
equipment, surplus materials and other property. Good and reasonable house-keeping practices shall
be applied at the end of each working day, as approved by the Owner.
.
ARTICLE 4
INSURANCE
4.1 CONTRACTOR'S LIABILITY INSURANCE
Contractor shall provide and maintain insurance as set forth in this Article on behalf of the Owner.
4.1.1 Commercial General Liability Insurance (primary) shall be provided on ISO-CGL
form No. CG 00 01 11 85 or 88 or equivalent. Policy limits shall be no less than one million dollars
per occurrence for all coverages and two million dollars general aggregate. Owner and its employees
and agents shall be added as additional insured using ISO form CG 70 57 (03-96) or equivalent.
Coverage shall apply on a primary, non-contributing basis in relation to any other insurance or self-
insurance, primary or excess, available to Owner or any employee or agent of Owner. Coverage shall
not be limited to the vicarious liability or supervisory role of any additional insured. Coverage shall
contain no contractors' limitation endorsement. There shall be no endorsement or modification
limiting the scope of coverage for liability arising from pollution, explosion, collapse, underground
property damage or employment-related practices.
4.1.2 Business Auto Coverage shall be written on ISO Business Auto Coverage from CA
00 01 06 92 including symbol 1 (Any Auto). Limits shall be no less than one million dollars per
accident. This policy shall be scheduled as underlying insurance to any umbrella policy required
above for a total limit of no less than five million dollars each accident.
4.1.3 Workers Compensation/Employer's'Liability shall provide workers compensation
statutory benefits as required by law. Employer's liability limits shall be no less than one million
dollars per accident or disease. Employer's liability coverage shall be scheduled under any umbrella
policy described above. Unless otherwise agreed, this policy shall be eGdorsed to waive any right of
subrogation as respects the Owner.
4.1.4
Contractor and Owner further agree as follows:
4.1.4.1 All insurance coverage and limits provided pursuant to this Contract shall apply to the full
extent of the policies involved, available or applicable. Requirements of specific coverage features or
limits contained in this Section are not intended as a limitation on coverage, limits or other
requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a
given coverage feature is for purposes of clarification only and is not intended by any party to be all
inclusive, or to the exclusion of other coverage, or a waiver of any type.
4.1.4.2 Unless otherwise approved by Owner, Contractor's insurance shall be written by insurers
authorized to do business in the State of California and with a minimum ABest's Insurance Guide
rating of AA:VII. Self-insurance will not be considered to comply with these insurance specifications.
Community Playgrounds - Cypress Hollow Park 8
4.1.4.3 Contractor shall provide evidence of the insurance required herein, satisfactory to Owner,
consisting of certificate(s) of insurance evidencing all of the coverages required and an additional
insured endorsement to Contractor's general liability and umbrella liability policies using ISO form
CG 70 57 (03-96) prior to commencing work under this Contract. Certificate(s) are to reflect that the
insurer will provide 30 days notice of any cancellation of coverage. Contractor agrees to require its
insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer
to mail written notice of cancellation imposes no obligation, and to delete the word Aendeavor= with
regard to any notice provisions.
4.1.4.4 Contractor shall require all subcontractors or other parties hired for this Work to purchase and
maintain insurance of the type specified above naming as additional insureds all parties to this
Contract. Contractor shall make reasonable efforts to ensure that such coverage is provided as
required here.
4.1.4.5 Contractor shall provide immediate notice to O~ner of any claim or loss against Contractor
that includes Owner as a defendant. . Owner assumes no obligation or liability by such notice, but has
the right (but not the duty) to monitor the handling or any such claim or claims if they are likely to
involve Owner.
4.1.4.6 In the event of any loss that is not insured due to the failure of Contractor to comply with these
requirements, Contractor shall be personally responsible for any an all losses, claims, suits, damages,
defense obligations and liability of any kind attributed to Owner as a result of such failure.
4.1.4.7 Contractor shall not attempt to avoid its defense and indemnity obligations to Owner by using
as a defense Contractor's statutory immunity under workers compensation and similar statutes.
4.1.4.8 Contractor shall ensure that coverage provided to meet these requirements is applicable
separately to each insured and that there will be no cross liability exclusions that preclude coverage for
suits between Contractor and Owner or between Owner and any other insured or Named Insured under
the policy, or between Owner and any party associated with Owner.
4.2 OTHER INSURANCE PROVISIONS
The policies are to contain, or be endorsed to contain, the following provisions:
4.2.1
General Liability and Automobile Liability Coverages
4.2.1.1 The Owner is to be covered as insureds as respects: liability arising out of activities
performed by or on behalf of the Contractor; products and completed operations of the Contractor;
premises owned, leased or used by the Contractor; or automobiles owned, leased, hired or borrowed by
the Contractor. The coverage shall contain no special limitations on the scope of protection afforded
to the Owner.
4).1.2 The Contractor's insurance coverage shall be primary insurance as respects the Owner. Any
insurance or self-insurance maintained by the Owner shall be excess of the Contractor's insurance and
shall not contribute with it.
4.2.1.3 Any failure to comply with reporting provisions of the policies shall not affect coverage
provided to the Owner.
Community Playgrounds - Cypress Hollow Park 9
4.2.1.4 Coverage shall state that the Contractor's insurance shall apply separately to each insured
against whom claim is made or suit is brought, except with respect to the limits of the insurer's
liability.
4.2.2 Each insurance policy required by this clause shall be endorsed to state that coverage
shall not be suspended, voided, canceled, reduced in coverage or in limits except after thirty (30) days'
prior written notice by has been given to the Owner.
4.3 SUBCONTRACTORS
.
Contractor shall include all subcontractors as insureds under its policies or shall obtain separate
certificates and endorsements for each subcontractor.
ARTICLE 5
PREV AILING WAGE REQUIREMENTS
5.1 GENERAL REQUIREMENTS
5.1.1 The Contractor shall forfeit as penalty to the Owner $50.00 for each calendar day or
portion thereof, for each workman paid less than the stipulated prevailing rates for such work or craft
in which such workman is employed for any work done under the Contract by him or by any
subcontractor under him, in violation of the provisions of the Labor Code of the State of California,
and in particular, Section 1770 to 1780 thereof, inclusive. The general rate of prevailing wages is on
file in the Owner's offices.
5.1.2 The holidays upon which such 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 Work. The difference between such stipulated prevailing wage rates and the amount
paid to each workman for each calendar day or portion thereof for which each workman was paid less
than the stipulated prevailing wage rate shall be paid to each workman by the Contractor pursuant to
the requirements of Section 1775 of the Labor Code of the State of California.
5.1.3 The Owner will not recognize any claim for additional compensation because of the
payment by the Contractor of any wage rate in excess of the prevailing wage rate set forth in the
Contract.
5.1.4 Notwithstanding any other provision of the Contract to the contrary, the general
prevailing rate of wages in this locality for each craft, classification, or type of workman needed to
execute the Contract for the Work (which rate includes employer payments for health and welfare,
vacation, pension, travel time, and subsistence pay as provided for in Section 1773.8 of the Labor
Code of the State of California, apprenticeship or other training programs authorized by Section 3093
of the Labor Code, and similar purposes) app licab Ie to the work to be done for straight time, overtime,
Saturday, Sunday and holiday work is that ascertained by the Director of the Department of Industrial
Relations of the State of California and determined by the Town, which said rates are made a part
hereof, incorporated herein by reference as though fully set forth. The holiday wage rate listed shall
be applicable to all holidays recognized in the collective bargaining agreement of the particular craft,
classification or type of workman employed on the Work.
5.1.5 Attention is directed to the provisions of Section 1777.5 and 1777.6 of the California
Labor Code concerning the employment of apprentices by the Contractor or any subcontractor. The
Contractor and any subcontractor shall comply with the requirements of Section 1777.5 and 1777.6 in
the employment of apprentices. Information relative to apprenticeship standards, wage schedules, and
Community Playgrounds - Cypress Hollow Park 10
other requirements may be obtained from the Director of Industrial Relations, ex-officio the
Administrator of Apprenticeship Standards and its branch offices.
5.1.6 The Contractor shall make such travel and subsistence payments to each workman
needed to execute the Work as are established in the applicable collective bargaining agreements filed
in accordance with Section 1773.8 of the California Labor Code.
.
5.1.7 The Contractor and each subcontractor shall keep an accurate payroll record showing
the name, address, social security number, work classification, straight time and overtime hours
worked each day and week and the actual per diem wages paid to each journeyman, apprentice,
worker or other employee employed by the Contractor or subcontractor in connection with the Work.
The payroll records shall be kept in accordance with the provisions of Section 1776 of the California
Labor Code and Contractor and each subcontractor shall otherwise comply with all requirements of
such Section 1776.
5.2 HOURS OF LABOR
The Contractor shall forfeit to the Owner, as a penalty, the sum of Twenty-five Dollars ($25.00) for
each workman employed in the execution of the Contract for each calendar day during which such
laborer, workman or mechanic is required or permitted to labor more than eight (8) hours in violation
of the provisions of Sections 1810 to 1816, inclusive, of the Labor Code of the State of California.
ARTICLE 6
DISPUTE RESOLUTION
6.1 MEDIATION
The parties will make a good faith attempt to resolve any disputes arising from this Agreement through
mediation prior to initiating litigation. The parties shall mutually agree upon a mediator and shall
share the costs of mediation equally. If the parties are unable to agree upon a mediator, the dispute
shall be submitted to JAMSIENDISPUTE ("JAMS") or its successor in interest. JAMS shall provide
the parties with the names of five qualified mediators. Each party shall have the option to strike two of
the five mediators selected by JAMS and the mediator thereafter remaining shall hear the dispute.
6.2 ARBITRA TION
Claims not resolved by mediation shall be decided by arbitration which, unless the parties mutually
agree otherwise, shall be in accordance with the Construction Industry Arbitration Rules of the
American Arbitration Association currently in effect. A demand for arbitration shall be made within
30 days after the Claim has arisen, and in no event shall it be made after the date when institution of
legal or equitable proceedings based. on such Claim would be barred by the applicable statute of
limitations. The party filing a notice of demand for arbitration must assert in the demand all Claims
then known to that party on which arbitration any party may demand under this Agreement. The
award rendered by the arbitrator or arbitrators shall be final, and judgment may be entered upon it in
accordance with applicable law in any court having jurisdiction thereof.
ARTICLE 7
MISCELLANEOUS PROVISIONS
7.1 GOVERNING LAW
Community Playgrounds - Cypress Hollow Park 11
7.1.1 The Contract shall be governed by the law of the place where the Work is located.
The Contractor shall conform to and abide by all local, state and federal building, sanitary, health and
safety laws, rules, and regulations, including all Town ordinances and regulations.
7.1.2 All Contractors and subcontractors employed upon the Work shall and will be
required to conform to the provisions of the Labor Code of the State of California, and shall also
comply with all rules, regulations and Labor Laws of the federal government and the various acts
amendatory and supplementary thereto, and all other laws, ordinances and legal requirements.
Without limiting the foregoing, Contractor, will comply with applicable provisions of Section 3700 of
the Labor Code, which requires every employer to be insured against liability for Worker's
Compensation or to undertake self-insurance in accordance with the provisions of that Code.
.
7.2 SUCCESSORS AND ASSIGNS
The Owner and the Contractor, respectively, bind themselves, their partners, successors and assigns to
this Contract. Neither party to the Contract shall assign t.he Contract or sublet it as a whole without the
written consent of the other. '
7.3 RIGHTS AND REMEDIES
The duties and obligations imposed by this Contract and the rights and remedies available thereunder
shall be in addition to, and not a limitation of, any duties, obligations, rights and remedies otherwise
imposed or available by law. No action or failure to act by the Owner shall constitute a waiver of any
right or duty afforded any of them under the Contract, nor shall any such action or failure to act
constitute an approval of or acquiescence in any breach thereunder, except as may be specifically
agreed in writing.
7.4 PENALTY FOR COLLUSION
If, at any time, it is determined by the Town that the person, firm or corporation to whom the Contract
has been awarded has, in presenting any bid or bids, colluded with any other party or parties, then the
Contract shall be null and void, and the Contractor and his sureties shall be liable for loss or damage
which the Owner may suffer thereby, and the Owner may advertise for new bids for said work.
7.5 EQUAL OPPORTUNITY
Contractor shall comply with the provisions of Section 1735 of the Labor Code of the State of
California, which provides as follows:
"No discrimination shall be made in the employment of persons upon public works because of the
race, religious creed, color, national origin, ancestry, physical handicap, medical condition, marital
status, or sex of such persons except as provided in Section 12940 of the Government Code, and every
contractor for public works violating this section is subject to all the penalties imposed for a violation
of this chapter."
END OF GENERAL CONDITIONS
Community Playgrounds - Cypress Hollow Park 12
ENCROACHMENT PERMIT APPLICATION
Town of Tiburon · 1505 Tiburon Boulevard · Tiburon. CA 94920 · (415) 435-7354
.
,
FOR OFFICE USE ONLY
EncroachmenfPermit ~o: 0 ~ "7~
Date Received: II, /?1 /01,
Plan Attached: ,rYe: 0 No
Payment Amt:
o Check No:
o Cash
Notes:
1>
~ Inspection Required. Contact Tony Iacopi,Deputy Drreclor of Public Works, at 435-7399.
8 No Inspection Required. , ., '
CONDITIONS OF APPROVAL: S6!; ~~ ~jOL~-S .
CL\l.L- ,4'). !.vIS '~6~ ~)-k~""~ "
l~ \ .
. t/ /~l>~
Approfal Date
- \l -+-T~ \ ---' --
~pproVed by Tony Iacopi, Deputy Director of Public Works
'f\"l'~
APPLICATION INFORMATION
Basic applications (e.g., driveway resurfacing or routine utility connections) are reviewed by the Deputy Director of Public
Works and usually ganted within 5 to 7 business days. The basic Encroachment Application fee is $90. Applications for
more involved projects are reviewed by the Town Engineer. The applicant may be charged an additional fee for applications
requiring review by the Town Engineer. After the encroachment application has been reviewed and granted by either the,
Deputy Director of Public Works or the Town Engineer, the applicant will be notified to pick up a copy of the approved
application Which serves as the permit~ When the project is completed, a final inspection may be performed by the Deputy
Director of Public Works and/or Town Engineer.
;( C~:p;>u:><: \-kr,\...Lov..! ?~
Location of W~rk & Nearest Cross Street
,K ~'--'~ 00 ~u\Zo~
Name of Property Owner
K Description of Proposed Work -Attach drawings to illustrate. For qriveways, specify type of surfacing and size of culvert,
if applicable. (. _ '
\26~O-.J{5: 1 ~ ~?L~U 1?v:?->.~~ ~\,~
K.... Estimated Start Date: ! ,TJ ruz-5i7~
t- C U;~r- kk7Qr?~
Name of Applica __
~ i~ -- 8(1).,- If /00
(Area Code) Phone Numbe
~stimlltecJCompletion Date:
K. Cv 111 M (.J tV (. 6rl'z-cv.Jc~ f
Name of Contractor
K 3 t.~,)-. C1 (-0
License No. /
(Area Code) Phone Number
The undersigned hereby applies for permission to perform the above described w~rk and/or otherwise encroach on Town of
Tiburon right:of-way or property pursuant to any required building permits. Applicant agrees that all work shall be
performed in accordance with the ruJes, regulations and standards of the Town of Tiburon, in addition to the General
Provisions or Special Conditions as applicable. All wo .hall be subject to inspection and approval by the Public Works
Department. Applicant agrees to indemnify, defen d hol 'the Town of Tiburon, and its employees, agents, and officials,
harmless from any claims, losses or damages t may . e from Applicant's exercise of this encroachment permit and any
other permit granted by the Town.
Date:
II /> /c0
(. Applicant's Si2nature:
TOWN OF TIBURON
PUBLIC WORKS PERMIT CONDITIONS - Permit No. 01,.... ...,.,
Note: The following standard and checked (...J) conditions apply to this permit.
1. APPENDING LIST OF CONDITIONS: In the event that these following conditions conflict with the
conditional notes and language found in a work contract with the Town, the work contract language will
supersede and prevail.
. 2. ACCEPTANCE OF THE PROVISIONS: It is understood and agreed by the Permittee that all conditions have
been read, and understood. The Permittee agrees to comply with all conditions.
3. KEEP PERMIT ON WORK SITE: This permit, or a complete copy, shall be kept at the site of the work and
upon request must be shown to any representative of the Town or any law enforcement officer.
4. PERMITS FROM OTHER AGENCIES: Permittee must obtain all other permits required by other public or
private agencies or individuals necessary in order to perform the intended work. It shall be the responsibility of
the Permittee to notify the utility and cable TV companies prior to starting any construction that may involve
their underground or overhead utilities.
5. INSPECTION NOTIFICATION: A preconstruction meeting or discussion will occur. Permittee will provide
construction schedule, initially and periodically, and contact information.
6. CONSTRUCTION METHODS: Any work performed without inspection or contrary to discussions with the
Town's inspector, the APW A Greenbook (latest edition), Caltrans Standard Plans (latest edition), California
Uniform Building Code (latest edition), or approved plans shall be deemed non-complying and will not be
accepted by the Town. Attention is called to the following special provisions:
(a) Plating of trenches will be allowed for up to five (5) calendar days. Ramping of plates is required.
(b) Temporary repairs to existing grades, backfilling, and making the work site safe are required.
(c) Others:
7. WORK HOURS: All work shall be restricted to 8:00 am ~) to 5:00 pm (L-), Monday - Friday
(excluding holidays) or as provided by the Engineer. Work at times other than regular workdays requires
additional compensation for overtime inspection and written approval from the Town.
8. TRAFFIC CONTROL: Construction traffic control shall conform to the current edition of the "Manual of
Traffic Controls for Construction and Maintenance Work Zones", as published by the State of California,
Department of Transportation. Provisions shall be made for lighted barricades, delineators, traffic control
personnel during construction and excavation
9. PERMIT EXPIRATION: This permit is valid for a period of six (6) months or until liability insurance expires,
whichever comes first.
10. UNDERGROUND SERVICE ALERT: Permittee must notify a Dig Alert network at least 48 hours in advance
of start of work for location of underground utilities.
11. ~ GUARANTEE: For a period of one (or ) year after acceptance by the Engineering
DIvision, the Permittee shall guarantee all work performed under this permit. Any failure caused by defective
materials or workmanship shall be promptly repaired or replaced at the Permittee's expense. Failure of the
Permittee to make such corrections will cause the Town to make or have made any necessary repairs at the
Permittee's expense.
Town of Tiburon - PW Permit Conditions - Permit No. ()" -7t::f
lof4
12. X STORAGE OF MATERIAL: Excavated material, sand, gravel, or any construction materials and debris
shall not be stockpiled or stored on the Town right-of-way, except under the following conditions:
13. PUBLIC CONVENIENCE:
(a) The Permittee shall conduct his operations as to offer the least possible obstruction and inconvenience
to the public and abutting property owners, and he shall have under construction no greater amount of
work than he can prosecute properly with due regard to the rights of the public.
.
(b) Spillage resulting from hauling operations along or across any publicly traveled way shall be removed
immediately by the Permittee at his expense.
(c) As applicable, noxious fumes and smells shall be mitigated to the satisfaction of the Town, at the
Permittee's expense. Action may include using alternative material or relocation of material until
installed.
(d) Convenient access to driveways, houses, and buildil).gs along the work shall be maintained and
temporary approaches to crossings or intersecting hIghways shall be provided and kept in good
condition. When the abutting property owner's access across the right-of-way line is to be eliminated,
or to be replaced under the Permit by other access facilities, the existing access shall not be closed until
the replacement access facilities are usable.
(e) If ordered by the Inspector, water shall be supplied by the Permittee for the alleviation or prevention of
dust nuisance. The Permittee may use water from a fire hydrant for this purpose provided he first
obtains any appropriate Fire Hydrant Permit.
(t) In order to expedite the passage of public traffic through or around the work and where ordered by the
Inspector, the Permittee shall install signs, lights, flares, barricades, and other facilities for the sole
convenience, safety and direction of public traffic.
(g) Also, where directed by the Inspector, the Permittee shall provide and station, at Permittee's expense,
competent flag-persons whose sole duties shall consist of directing the movement of public traffic
through or around the work. Flag-persons and guards, while assigned to traffic control, shall perform
their duties and shall be provided with the necessary equipment in accordance with the current
"Instructions to Flagmen" of the California Department of Transportation. The equipment shall be
furnished and kept clean and in good repair.
(h) Pedestrian access shall be maintained and provisions -for ADA accessibility shall be required.
14. EROSION AND SEDIMENT CONTROL MEASURES: The Permittee is obligated to insure compliance
with all applicable stormwater regulations at all times. The BMPs (Best Management Practices) according
to the Marin County Stormwater Protection Program (MCSTPP) shall be implemented and maintained to
effectively prevent the potentially negative impacts on this project's construction activities on stormwater
quality. The maintenance of the BMPs is the permittee's responsibility, and failure to properly install or
maintain the BMPs may result in enforcement action by the Town or others. If installed BMPs fail, they
must be repaired or replaced with an acceptable alternate within 24 hours, or as soon as safe to do so.
(a) Stockpiles of soil, material, and wastes shall be properly contained to minimize sediment transport
from the site to streets, drainage facilities or adjacent properties via runoff, vehicle tracking, or
wind.
(b) Attention is called to Stormwater Best Management Practice Handbook Construction BMP Fact
Sheets: Sweeping and Vacuuming, Storm Drain Inlet Protection, Stockpile Management, Spill
Prevention and Control, and Concrete Waste Management.
15. CLEAN UP: Upon completion of daily work the Permittee shall clean the right-of-way of all rubbish, dirt,
construction debris, trees, brush, excess materials, temporary structures and equipment.
Town of Tiburon - PW Permit Conditions - Permit No. ~..?.,
2 of4
16. SAFETY:
(a) The Permittee shall be solely and completely responsible for the conditions of the job site, including
safety of all persons and property during performance of the work. This requirement shall apply
continuously and not be limited to normal working hours. Work and Safety provisions shall conform to
all applicable Federal, State, and local laws, ordinances, and codes, and to the rules and regulations
established by the California Division of Industrial Safety, and to other rules oflaw applicable to the
work.
.
(b) The services of the Inspector in conducting construction review of the Permittee's performance is not
intended to include review of the adequacy of the Permittee's work methods, equipment, bracing or
scaffolding or safety measures, in, on, or near the construction site, and shall not be construed as
supervision of the actual construction nor make the Inspector or the Town responsible for providing a
safe place for the performance of work by the Permittee, Contractor, subcontractors, or suppliers; or
for access, visits, use work, travel or occupancy by any person.
( c) The Permittee shall carefully instruct all personnel ~orking in potentially hazardous work areas as to
potential dangers and shall provide such necessary safety equipment and instruction as is necessary to
prevent injury to personnel and damage to property.
(d) Nothing in this Permit is to be construed to permit work not conforming to governing law.
( e) Shoring and Trench Safety Plan - Attention is directed to Section 832 of the Civil Code of the State of
California, Section 6705 of the State Labor Code, and the Construction Safety Orders of the State of
California Division of Industrial Safety.
17. PROTECTION OF PERSON AND PROPERTY:
(a) The Permittee shall take whatever precautions are necessary to prevent damage to all existing
improvements, including above ground and underground utilities, trees, shrubbery that is not
specifically shown to be removed within or adjacent to the work. If such improvements or property are
injured or damaged by reason of the Permittee's operations, they shall be replaced or restored, at the
Permittee's expense, to a condition at least as good as the condition they were in prior to the start of
the Permittee's operations.
(b) The Permittee shall protect against injury any pipes, conduits or other structures crossing any trenching
or encountered in the work and shall be responsible for any injury done to such pipes or structures, or
damage to property resulting therefrom. He shall support or replace any such structures without delay.
(c) The Permittee is cautioned that he must replace all improvements in rights-of-way and within the
public streets to a condition equal to what existed prior to his entry onto the job.
18. RESPONSIBILITY FOR REPAIR OF FACILITIES: All public or private facilities, including but not limited to
structures, telephone cables, roadways, curbs, gutters, parking lots, private drives, and storm drains disturbed
during construction of the work shall be repaired and/or replaced by the Permittee to match facilities existing
prior to construction. In addition, the Permittee shall be responsible for any settlement damage to such facilities
or adjoining areas for a period mentioned in Item 11 - "Guarantee" after acceptance of such required facilities.
19. TOWN'S REPAIR: In the event the Permittee refuses or neglects to make good any loss or damage for which
he is responsible under this Permit, the Town may itself, or by the employment of others, make good any such
loss or damage, and the cost and expense of doing so, including any reasonable engineering, legal and other
consultant fees, and any costs of administrative and managerial services, shall be charged to the Permittee.
20. CONTRACTOR'S LICENSE NOTICE: Contractors are required by law to be licensed and regulated by the
Contractor's State License Board. Any questions concerning a contractor may be referred to the registrar,
Contractor's State License Board, 9821 Business Park Dr., Sacramento, California.
Town of Tiburon - PW Permit Conditions - Permit No. -C.o -?."
3 of4
21. INDEMNITY AND LITIGATION COST:
(a) The Permittee specifically obligates himself and hereby agrees to protect, hold free and harmless,
defend and indemnifY the Town, the Engineer and his consultants, and each of their officers,
employees and agents, from any and all liability, penalties, costs, losses, damages, expenses, causes of
action, claims or judgments, including attorney's fees, which arise out of or are in any way connected
with the Permittee's, his Contractor's, or his subcontractors' or suppliers' performance of work under
this Permit. To the extent legally permissible, this indemnity and hold harmless agreement by the
Permittee shall apply to any acts or omissions, whether active or passive, on the part of the Permittee
or his agents, employees, representatives, or Subcontractor's agents, employees and representatives,
resulting in liability irrespective of whether or not any acts or omissions of the parties to be
indemnified hereunder may also have been a contributing factor to the liability. Unless waived,
Permittee shall include the Town, the Engineer and his consultants, and each of their officers,
employees and agents as additional insureds on their policy and insurance documents shall be
submitted to the Town prior to work commencing.
(b) The indemnification obligation under this Section shall not be limited in any way by any limitation on
the amount or type of damages, compensation or be.nefits payable by or for the Contractor or any
Subcontractor under Worker's Compensation statutes, disability benefit statutes, or other employee
benefit statutes.
22. OTHER:
Permittee:
//[7. ..
LOMI" ';/0. ; 7 'tL,<lT ~t IN; ;;J
Prmt name
~
Signature
/I/s loc
Date / /
~
Town of Tiburon - PW Permit Conditions - Permit No. 1'"..,,.,
4 of4
11/20/2005 10:31
14158923132
COMMUNITY PLAYGROUND
PAGE 01
To~
FAX COVER SHEET
~1A#- ~'((~ From:
~"rflJ r,~
q.. ?J' ~.c.p > f
tr1S/ 7?;1)
;Date:
Rita Schoch ~~rn
. . ~JII~'
Estlmator/Asst. Project Manager - ..--....'
H (17(06
Company:
Fax:
. Phone:
Pages faxed;
~
(Including this cover sheet)
P-S~L (..
RE:
~l
He-v. IJU-. /sM.. ,,^. 5~L-<-
c,V:iX;j;~s ~ ~~.
~ -GJ-.. IAh- ~ ;f tJrv--.
~ ~~.e1~1
'~. SLt--
Community Playgrounds Inc.
1620 Grant Avenue #5
Novato, CA 94945
:8
r.,y
1fT
emall: rita@eommplay.us
phone: (415) 892-8100.
fax: (415) 892-3132
11/20/2005 10:31
14158923132
COMMUNITY PLAYGROUND
PAGE 02
nom: Mi'chel Maciel At: Inl~r'vVest In;lurance Services ft~XID: In1er\N!~ IMUr:.lhCf! To Commllnl~ j:l1~ygrOLlndr.;
Date: 11/17nOOIS 04:26 PM ,,~~~::) of 7
ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP1DFI OAT!:: (IIUT/'ODNVYV)
COMM-O 11/03/06
P~DUC!!It THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO~
In~erweat Insuzanca services ONLY AND CONFI:AS NO RIGHTS UPON THE CERTIFICATI:
capitgl Division HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.o. Box 255188 ALTER THE COVERAGE AFFORCED BYTHE POLICIES BELOW
Sae~amento CA 95865-S18~
Phcne:916-489-3100 FQx:91S-488~34g2 INSU~ERS AFFORDING COVERAGE NAIC fI
INau~EO -- . .... ..... ,,- ., -"..,-
INSURER A: Asp-!'~ Sp~~~alty In~. Co
, ..
INSURER B; nal;;l.Qltwi~..,~tual ;l;U~"
Cammu~i~y Platl~ounda 11'l8URER v: Z=ni th ~~sura.n(]e C~Y..,
1620 Grant~ S e 5 INSLJ~~R. h
N'ovato~!. 490\5 ...... -,. .....-., ....... ."..----
INSl.JF.:E~ 5;
COVERAGES
THE POl.lCI~ OF INSURANCe LISTE:D BelOW HAve ae:E;N ISSIJI:C TO TMI: INSU~EO NAMEO A.I3OVE FOR Tti: POLICY PERICO INOICAT!:lO, NOTWITHSTANtllNG
ANY RECUIR!;~IF.NT, TERMOR OONDITION Of! ANY CONTRACT OR OTHER OOCUMENiWITH RE;SPF.CT TO WMIOH THle CERTIFICATI;i MAY eE' ISElUEOOR
MAY PERTAIN, THE: INSURANci: AFFORDED BY THI:: POLlCII::S OESCFlIBEO ~1:A.eIN IS SUBJECT TO ALL TI-E TERMS, ~XCLUSIONS ANO OONOltlolllS OF SUCH
POl.lCleS, AGGREGATE LIMITS SHOWN MAy I1AVE SEEN ~EOIJC=D ElY PAID CLAIMS.
-.-.. . .-....-- 1"Q~leYE1:ttc_.._}~c ~ ..... ... ,...-. .... ,..,--
LTft. INSIU TYPE CFINSURANCF. POLIO'r NUMBER OATF. iMMIOD'Y DIl. :'IMMttJtliril LIMITS
~ 13F,Nr:~A.~ 1.114611.11"1' . EACH :)CCL.lRR!;.NC~ ~LOO~t..~OO
~ETOR~jqTrn---
A X X : I;O\,:MEFlr.:IA'. G~NERAL L1ABILlN rJloOO30950.2 09/14J06 08/14/07 P~~n~~l:a IF.~ M!!1I~~1 $ SO, 000 '.'_
~D CLAIMS MAD~ ~ OCCUR : MED EXP [Any ~ne pe~} $ Excluded
,-.
PERSONAL to ADV INJURy' .$ _~-,_~OO/OOO__.
~- -------.... ... ........"
'-- ()ENERAL I\GGR~(l^T!: ~2,OOO,OOO
..../'
Qi:=N'1 !\OClRR<ATF: UMIT I\PPI.IF.~ P::R,: , PROnlJC':T!'l . COMPIO::l AGG ,,~ .2 ,000 , 000
ITx n p~o n '
X PCl.IGY ,II:<:T LOC
AUTQMOBILE WAB1LlTY I COMBINl:D ,sINGLE L1i11IT
B X ~ .'NY AUTC ACP780192B320 OB/14/06 08/14/07 ~ (Eugoidenl) $l"OOO,OOO
! ........ ,..-
ALL C\tVNCD "'UTOS ElOOfl.Y II'UURv
$
: SCI,I:DULIm AUTOS (PilI ~GIMl"I)
'-- " u__
~IAEO I\lJlDS BODILY INJURY S
'-- (I"lu .a:Ii;I",,~
NON.OWNED AUTOS
--- ... ~..,,-, .."" ".
- .. -.. PFtO!!lE~iY ~M^;]e ~
(j;Ior j\/'1lId~~~
GARAGE I.IABILITY I AUTO <:JNLV. ~/l. MelD!:'" ~
l AN'\' AUTC ..........- --." ,
FAI\CG !Ii
i on.jg( Tf./AN ......' ....-
Al,!iOONLY; AC,G $;
EXCESSAJ M8~LLA LlAllI LlTY I I GACH DCCU~~I::,~~.~ $
"""] OCCU~ !=t CL41t.IS ~~O~ ; AG~~E~ATE $
$
,"~:,'.'.'I ~:~~~~~ -_..." ...-
$
'--"',' ..I _..
S S
WO~K~S COMP!NSATIOtl AND ~ TT~1J~m I I~t -.......... '" ,--
C EMPlOYERS" UAIlIUIT 2:067729902 10/01/06 10/01/07 E L. EAml AOOJr::NT ~ 1 c9~.~J_OD~
ANY P~PRIF-m~~JI ATNP.R/~~CUTtV~
nFFlCERIMF;MI'IER EXCI,lJr;l1:1J? E,L" DISE,.SE - Ell GM:lLOYEE i ~.r...9,~O 1000
~~d:tp~~~~~~ bDlow ,.
E. L. DI6EAm:: . POLlCV LIMIT $1,000,000
OTHEIil
B Inata,llation ACP7801g28~20 09/14/06 09/14/07 timi t $100,000
Ded $1,000
D!!!3CfIIlrnON OF ClP'ERATIONS I LOCATIONS / VEHICLE:.\ I EXCLU~ION5 AQi:lED BY !!NCO~SI!MI!NT I SI'I!C:IAL P~CV\~'OI\lS
'I'own of Tib'Uron. aqents llmd. emplQyeelS are named as aaitional insured. as
re~.~t. proj.~t: J.epairs to play az:e.a.. - <:ypr.s!I; Hollow Park per attached
policy fo.r:m OG2010 1195 for Gene:ral Liabili ty . Waiver of Subz-ogatioD a.pplies
foZ' GL policy per attached pol~oy fo~ CG2404 1D93.
'1'O\fZl Of l'i.bu;r:clJ).
1155 '1'iburon Blvd
Tib1.1~Gn CA 94920
CANCELLATION
~Of4NO 0 2 SHOULrl AN.,. OF THE A~ DES!=:AIBErI POLI!=:1ES BE CANCELl..l;tJ BI;FtlRE THiii EiXPIR'" nON
CATE THI:R:t:CF, THE II!ISUlNa INBURERWILL ENDEAVOR TO MAIL ~ l;)ilYlI: WWITT8t
NO~E TO THECERTI~feAl'E HaLD~~ IIIAMED f01"'E:l.1:f!:'t, BI.I1'FAILuRE TO 00 SO SHALL
IMPO~ ND OFlLIO"TICN OR LlARIl.ITV DF ANY KINO IJPCr4 Tfffi It.I!lURER, ITS A<Je.lTS O~
CERTIFICATE HOLDER
ACORD 25 (2001/08)
@ACORDCORPORATION 19M
11/20/2005 10:31
14158923132
COMMUNITY PLAYGROUND
PAGE 03
From: Mi'cI"u!1 MaOlel At: II1tP.r\f\IP.~ Ir'l~ur:!lnce Si!!'rvioes F:a~rD: Intllllr\AlAl!ii Il'\sl.IrSnce To: COl"!"ll'l'lLlr'lity ~lli\'>'!.!1rouncls
[j;l!te; 11/1712005 04:2e PM P'.!:!!:lt!l: 401 i
Prima~ w~%dinq appliea per attach~d poliQ~ for.m ASPG~061 1104.
Wavie~ of Sub~oqat1on for th~ Worke~B Comp~nsation pcliay has ~~n
xequested .nd onor'GmGnt will be issued ai%Qctly ~y ~Br~~~~.
11/20/2005 10:31
14158923132
. COMMUNITY PLAYGROUND
PAGE 04
From: Ml'ehel Madel At: InterW~'!d Inr::I.lr~nOl!l S~rvl~~ Fa)(ID: InterWest In!:L1r:lln~ To: Community Playgrllund~
O<.lt",; 11/171200e 0-1.:25 PM PM/!/: 5 of7
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED ~ DESIGNATED PERSON OR ORGANIZATION
This €ndornement modifies insurance provided under the following:
BUSINESS AUTO COV~RAC3c FORM - AlIIe~ Insurance - ACP7801926320
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
W~h respect to coverage provided by this endorsement, the provisions of the Coverage Form
apply unless modified by the endorsement.
SCHEDULE
Name Of Flersor'l or Organization: Town Of Tiburon
RE: Repairs to play areas - Cypress Hollow Park,
DeSCription Of covered "Autos~: Hired, Owned, Non-Owned
{If no entry appears above, information required to complete this endorsement will be shown in
the Oeolarations as applicable to t~is endorsement.)
The WHO IS AN INSURED provision under LIABILITY COVERAGE is changed to include as an
"Insured-
1. Your operations or services performed for that person or organization at the loca1ion
shown in the Schedule; or
2. The ownership, maintenance or use of the covered "autDs" described in the Schedule.
A Person's or organizationls status as an additional insured under this endorsement ends when:
1. Your Dperatlons or services perfolTT1ed for that person or organization are completed; or
2, That person's or organization's Interest In the described ~auto'" ends.
11/20/2005 10:31
14158923132
COMMUNITY PLAYGROUND
PAGE 05
I I Vfll. I'VII "'111:111 HilClVlDI nL. .1.\.CI u'Ica\. IIj~.alfvC' .....el YIWC~ ( QA'....,. UTv-', ...~.. II '~II'1to11I''''''' ''-'I ~111I'."'1""1 ' 1'2.]'~IU'U'IU'=
L...II:L\C. I I' I "",U\.IU U....;(...., I IIojI t 15I~r::;. W"" I
POUCY NUMBER: GL003095-02
Aspen Specialty Insurance Company
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS ~ (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization:
Town Of Tlburon
RE: Repairs to play areas.. Cypress Hollow Park
Any person or organization to which you are obligated by virtue of a written contract to provide
insurance such as Is afforded by this pOliCy, but only with respect to (1) occurrences taking place
after such wMtten contract has been executed and (2) occurrences resulting from work performed
by you during the poliCy period.
<If no entry appears above, information required to complete this endorsement will be shown In
the Declarations as applicable to this endorsement.)
V\lHO IS AN INSURED (Section II) Is amended to include as an insu~d the person or
organization shown in the Schedulel but only with respect to liability arising out of your work for
that insured by or for you.
Coverage provided by this policy to the ACfClttiOnallnSured(S) snown in the Schedule shall be
primary insurance and any other insurance maintained by the Additional Insured(s) shall be
excess and non-contributory, t:iut only as respects any claim or liability determined to be the result
of the sole negligence or responsibility of the Named Insured and on Iy If req ulred of the Named
Insured by wrItten contract.
CG Z010 11 85
Copyr1ght, Instlrsl1ce Services Office, Inc" 1984
Page 1 of 1
11/20/2005 10:31
1415Sg23132
COMMUNITY PLAYGROUND
PAGE 05
From: Mi'chel Maciel At: Inter'vVe5:'lIn!:;ur.aMt!!! SeNle~~ F~xIO: Il"1terW~:;;t Ins,lrance To: Community PI~ygroLIt"ld~
D~tc: 11/171200G 04:215 ~M Flage:; off
THIS ENDORSEMENT CHANGES THE POLJCY~PLEASE READ IT CAREFULLY
PRIMARY AKD NON-CONTRfBtYrfNG INSURANCE
(THIRD-PARTY)
This cndorsctncnt modifies insurance under the foljowing~
ENTER TN COVERAGE PART
Section IV: Commerci.al General Liability Condition~, Paragmph 4, and a.ll subpm1s thcroof, as
cont.ained in the policy is deleted in its c:ntlrcl:y and rcp]actd wjt;h the f()llowtng condition as
respects the Third Party shown below:
Seet,lon lV: Commercial GeDeral LiabfUty Conditions
4. Ot.her Insurance:
(3) With rr::;.pccr 1:0 the Third Party shDwn below, the l.n~umnce provided hy this poli.cy shall
be primary and non-contributing insurance. Any ~nd all other valid and collecta.ble
insurance available to sllch Third Party in respect of work perfonned by you under
writlen conttflcnul1 agreements with Raid Third Party for loss covered by this policy, shall
in:nQ instance be con~idered as prin:131"Y. CI)-iJ1~UraTlCel or cOTltrHmting im;m:ance. Rather,
a.ny such other insurance shall be considered CXCCS8 over and above the in~ura.ncc
provided. by this poli1.;y.
The Third Party to whom this endorsement applies is:
Absence of a specifically named Third Parry above m,~ans that th~ -provisions of this endorsement
apply L<a~ required by wri,tten contractual agreement with any Third Party for whom you arc
performing work.!l
All other tcrm~ and conditlons of thi~ policy rema.in unchanged.
This endotsertlent i.s effective on the inception da.f:e of the policy llnle~8 mherwi!>e ~tated .herein.
(The information hclow is required only when. this endorsement is jSlSued subsequent to
preparation of this policy.)
Policy Nllmbtr: GL00309502
Named Insured: CommunitY-Playgrounds
Endorsement Effective Dnte: 8/14/06
ASPGJ.061l1()4