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HomeMy WebLinkAboutAgr 2012-10-03 (Synergy Project Management)TOWN OF TIBURON TIBURON, CALIFORNIA OWNER-CONTRACTOR AGREEMENT FOR THE 2012 Del Mar Neighborhood Street Improvement Project THIS OWNER-CONTRACTOR AGREEMENT ("AGREEMENT") is made and entered into this 3rd day of October, 2012, by and between the TOWN OF TIBURON, municipal corporation, 1505 Tiburon Boulevard, Tiburon, CA 94920, ("Owner") and Synergy Project Management ("Contractor"), whose principal place of business is 30 Grant Avenue, Suite 300 San Francisco, CA 94108. 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 2012 Del Mar Neighborhood Street Improvement Project ("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 H PAYMENT See Section 5-1.7 of the Special Provisions of Contract Documents. Total compensation for the Work shall not exceed $964,879.88 without prior written authorization from the Owner, and will consist of the Base Bid plus (NA). A-1 ARTICLE III TIME FOR PERFORMANCE Section 3.1 Time of Completion: See Section 8-1.06 of the Standard Specifications and Section 4 of the Special Provisions. Section 3.2 Liquidated Damages: Contractor will pay liquated damages as set forth Section 8-1.07 of the Standard Specifications and Section 4 of the Special Provisions. The Parties acknowledge that time is of the essence in this Agreement and wish to avoid the cost, difficulty and delay of proving the damages caused by delay. Accordingly, the Parties agree that the Contractor shall pay to the Town the sum of $1000 per day, for each and every calendar day's delay in finishing the work in excess of the number of working days prescribed in Section 3.1 hereof. 8L-A- J_ OWNER C NTRACTOR 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 A-2 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 The Site Exhibit B The Contract Documents Exhibit C Bid Proposal (Pages Pl-~2<frl`a IN WITNESS WHEREOF, the parties to these presents have hereunto set their hands the day and year first hereinabove written. APPROVED AS TO FORM: By Town Attorney TOWN OF TIBURON By Town M ) ger CONTRACTOR: B Its ~/1 S / Q 45-/4j 7 Contractor's License No. Expiration Date: 4"" -210 '161 A-3 EXHIBIT A The Site The public rights-of-way located in the Town of Tiburon, California and known as: 1. Avenida Miraflores 2. Felipa Court 3. Geldert Drive 4. Hilary Drive 5. Howard Drive 6. Ham Court 7. Malvino Court 8. Mark Terrace 9. Porto Marina Drive 10. Rowley Circle 11. Wilkens Court A-4 EXHIBIT B The Contract Documents • Project Plans • Standard Specifications • Standard Plans • Special Provisions • Proposal and Contract • Contract bonds(Payment Bond and Performance Bond) • Any supplemental agreement amending or extending the work • Any working drawings, sketches, or instruction clarifying or enlarging upon the work specified • Pertinent portions of any other documents included by reference in the specifications, Standard Specifications, or Plans A-5 TOWN OF TIBURON SAMPLE PAYMENT BOND (Section 3247, Civil Code) WHEREAS, The Town of Tiburon, acting by and through the Public Works Department, hereafter referred to as "Obligee", has awarded to Contractor , hereafter designated as the "Principal", a contract for the work described as follows: AND WHEREAS, said Principal is required to furnish a bond in connection with said contract, to secure the payment of claims of laborers, mechanics, material, men and other persons as provided by law. NOW, THEREFORE, we the undersigned Principal and Surety are bound unto the Obligee in the sum of for which payment, we bind ourselves, jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH, dollars That if said Principal or its subcontractors shall fail to pay any of the persons named in Civil Code Section 3181, or amounts due under the Unemployment Insurance Code with respect to work or labor performed by such claimant, or any amounts required to be deducted, withheld, and paid over to the Franchise Tax Board for the wages of employees of the Principal and his subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work and labor, that the surety herein will pay for the same in an amount not exceeding the sum specified in this bond, otherwise the above obligation shall be void. In case suit is brought upon this bond, the surety will pay a reasonable attorney's fee to fixed by the court. This bond shall inure to the benefit of any of the persons named in Civil Code Section 3181 as to give a right of action to such persons or their assigns in any suit brought upon this bond. Dated: 920 Correspondence or claims relating to this bond should be sent to the surety at the following address: Principal Surety (SEAL) By : Attomey-in-Fact NOTE: Signatures of those executing for the surety must be properly acknowledged. A-6 State of California Town / County of. On this day of personally appeared CERTIFICATE OF ACKNOWLEDGEMENT SS in the year 20 before me , , personally known to Attorney-in-fact me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument as the attorney-in-fact of and acknowledged to me that he/she subscribed the name of the said company thereto as surety, and his/her own name as attorney-in-fact. (SEAL) Notary Public A-7 TOWN OF TIBURON SAMPLE PERFORMANCE BOND (To Accompany Contract) Bond No. WHEREAS, the Town of Tiburon, acting by and through the Department of Public Works, has awarded to Contractor , hereafter designated as the "Contractor", a contract for the work described as follows: AND WHEREAS, the Contractor is required to furnish a bond in connection with said contract, guaranteeing the faithful performance thereof: NOW, THEREFORE, we the undersigned Contractor and Surety are held firmly bound to the Town of Tiburon in the sum of $ dollars to be paid to said Town or its certain attorney, its successors and assigns: for which payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, That if the above bound Contractor, its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the foregoing contract and any alteration thereof made as therein provided, on his or their part to be kept and performed at the time and in the manner therein specified, and in all respects according to their intent and meaning, and shall indemnify and save harmless the Town of Tiburon, its officers and agents, as therein stipulated, then this obligation shall become and be null and void; otherwise it shall be and remain in full force and virtue. IN WITNESS WHEREOF, We have hereunto set our hands and seals on this day of 20 Correspondence or claims relating to this bond should be sent to the surety at the following address: Contractor Name of Surety (SEAL) By : Attorney-in-Fact NOTE: Signatures of those executing for the surety must be properly acknowledged. A-8 CERTIFICATE OF ACKNOWLEDGEMENT State of California, Town of Tiburon On this day of appeared in the year 20 before me a notary public in and for the Town of Tiburon, personally , known to me to be the person whose Attorney-in-fact name is subscribed to this instrument and known to me to be the attorney-in-fact of and acknowledged to me that he/she subscribed the name of the said company thereto as surety, and his/her own name as attorney-in-fact. (SEAL) Notary Public A-9 Bond Executed in Triplicate TONVN OF TIBURON PERFORMANCE BOND (To Accompany Contract) Bond No. 07S201605 Premium: $ 11,244.00 WHEREAS, the Town of Tiburon, acting by and through the Department of'Public Works, has awarded to Contractor Synergy Project Management, Inc. hereafter designated as the "Contractor", a contract for the work described as follows: 2012 Del Mar Neighborhood Street Improvement Project AND WHEREAS, the Contractor is required to furnish a bond in connection with said contract, guaranteeing the faithful performance thereof- NOW, THEREFORE, we the undersigned Contractor and Surety are held firmly bound to the Town of Tiburon in the sum of ,Nine hundred sixty-four thousand eight hundred seventy-nine & 88/100thsdollars (S 964,879.88 to be paid to said Town or its certain attorney, its successors and assigns: for which payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, That if the above bound Contractor, its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the foregoing contract and any alteration thereof made as therein provided, on his or their part to be kept and performed at the time and in the manner therein specified, and in all respects according to their intent and meaning, and shall indenulify and save harmless the Town of Tiburon, its officers and agents, as therein stipLtlated, then this obligation shall become and be null and void; otherwise it shall be and remain in full force and virtue. IN WITNESS WHEREOF, We have hereunto set our h~uids and seals on this September '2012. Correspondence or claims relating to this bond should be sent to the surety at the following address: 1340 Treat Blvd., Suite 550 Walnut Creek, CA 94597 25th day of Syner Project gemertt, Inc. _ By: k-ej_ Q Contractor Liberty Mutual I urance Company Name o ",Suret (SEAL) r By: Attorney-in-Fact Joan DeLuca NOTE: Signatures of those executing, for the surety must: be properly acknowledged. A-8 CERTIFICATE of ACKNOWLEDGEMENT State of California, Town of Tiburon On this day of in the year 20 before me a notary public in and for the Town of Tiburon, personally appeared , "own to me to be the person whose Attorney-in fcrcl name is subscribed to this instrument and known to me to be the attorney-in-feet of and acknowledged to me that he/she subscribed the name of the said company thereto as surety, and his/her own nanye as attomey-in-fa t. (SEAL) See Attached Notary Public A-9 ACKNOWLEDGMENT State of California County of _Marin___ ) On September 25, 2012 before me, K. Holt emann Notar Public (insert name and title of the officer) personally appeared Joan DeLuca _ who proved to me on the basis of satisfactory evidence to be the person(G) whose name( is46- subscribed to the within instrument and acknowledged to me that -hqe she/executed the same in -4jfWherA44s4 authorized capacity(4ee), and that by 1;+s/her4ha4 signature(&) on the instrument the person(-€4, or the entity upon behalf of which the person* acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. r < K. HOLT y _ COMl41.#19058-45 NOTARY PUBLIC-CALIFORNIA Q MARIN COUNTY G~ ~i YL-- My Com Expires Oc lobar 37, 2014 Signature -_-_4-_ r (Seal) Bond Executed in Triplicate TOWN OF TIBURON PAYMENT BOND Bond No. 07S201605 (Section 3247, Civil Code) Premium: (Included) WHEREAS, "1`he Town. of Tiburon, acting by and through the Public Works Department, hereafter referred to as "Obligee", has awarded to Contractor Synergy Project Management, Inc. , hereafter designated as the "Principal", a contract for the work described as follows: 2012 Del Mar Neighborhood Street Improvement Project AND WHEREAS, said Principal is required to furnish a band in connection with said contract, to secure the payment of claims of laborers, mechanics, material, men and other persons as provided by law. NOW, THEREFORE, we the undersigned Principal and Surety are bound unto the Obligee ,n the silill of Nine hundred sixty-four thousand eight hundred seventy-nine & 88/100ths dollars 964,879.88 for which payment, we bind ourselves, jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH, That if said Principal or its subcontractors shall fail to pay any of the persons named in Civil Code Section 3181, or amounts due urider the Unemployrllent Insurance Code with respect to work or labor performed by such claimant, or any amounts required to be deducted, withheld, and paid over to the Franchise Tax Board for the wages of employees of the Principal and his subcontractors pursuant to Section 18806 of the Revenue and 'T'axation Code, with respect to such work and labor, that the surety herein will pay for the same in an amount not exceeding the sunl specified in this bond, otherwise the above obligation shall be void. In case suit is brought upon t11is bond, the surety Nvill pay a reasonable attorney's f'ec to fixed by the court. This bond shall inure to the benefit of any of the persons narned in Civil Code Section 3181 as to give a right of action to such persons or their assigns ill any suit brought upon this bond. Dated: September 25 20 12 Correspondence or claims relating to this bond should be sent to the surety at the following address: 1340 Treat Blvd., Suite 550 Walnut Creek, CA 94597 SyneraJ Project Magr rent, Inc. B Principal Liberty Mu ual Ins nce Company Surety l (SEAL) By : Attorney-in-fact Joan DeLuca NOTE: Signatures of those executing for the surety must be properly acknowledged. A-6 State of California Town / County of. On this day of personally appeared in the year 20 before me personally known to .4tt«rne~y-in fuct me (or proved to me on the basis of satisfactory evidence) to be the person whose narne is subscribed to this instrument as the attorney-in-fact of and acknowledged to me that. he/she subscribed the name of the said company thereto as surety, and his/her own name as attorney-in-fact. See Attached (SEAL) CER'T'IFICATE OF ACKNOWLEDGEMENT SS Notary Public A-7 ACKNOWLEDGMENT State of California County of _Marin_ ) On September 25, 2012_____! before K. Holtemann _EQtjLjy Public (insert name and title of the officer) personally appeared _ _Joan DeLuca _ who proved to me on the basis of satisfactory evidence to be the person(-s) whose name(-&) 1s4.rG- subscribed to the within instrument and acknowledged to me that he/she/executed the same in 4Wher/444 authorized capacity(4es), and that by 14&/her4h4@-!; signature() on the instrument the person(-s-}, or the entity upon behalf of which the person) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature ° ~ K. HOLTEMANN ~ COMM. #1905845 ~ NC i ARY PUBLIC-CALIFORNIA rnaRIN COUNTY 0 My Comm. Expires October 31, 2014 (Seal) 4549661 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. LIBERTY MUTUAL INSURANCE COMPANY BOSTON, MASSACHUSETTS POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: That Liberty Mutual Insurance Company (the "Company"), a Massachusetts stock insurance company, pursuant to and by authority of the By-law and Authorization hereinafter set forth, does hereby name, constitute and appoint CHARLES R. SHOEMAKER, ROGER C. DICKINSON, NANCY L. HAMILTON, STANLEY D. LOAR, ROSEMARIE GUANILL, MARK M. MUNEKAWA, NERISSA S. BARTOLOME, YVONNE RONCAGLIOLO, LAWRENCE J. COYNE, KELLY HOLTEMANN, THOMAS E. HUGHES, BRUCE G. OKREPKIE, JOAN DELUCA, ALL OF THE CITY OF SAN FRANCISCO, STATE OF CALIFORNIA , each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any 'and all undertakings, bonds, reco nizances and other surety obligations in the penal sum not exceeding TWO HUNDRED MILLION AND 00/100 DOLLARS 200,000,000.00********************* ) each, and the execution of such undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents, shall be as binding upon the Company as if they had been duly signed by the president and attested by the secretary of the Company in their own proper persons. That this power is made and executed pursuant to and by authority of the following By-law and Authorization: ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such N attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their Q signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be O as binding as if signed by the president and attested by the secretary. By the following instrument the chairman or the president has authorized the officer or other official named therein to appoint attorneys-in-fact: .ie d C Pursuant to Article XIII, Section 5 of the By-Laws, Garnet W. Elliott, Assistant Secretary of Liberty Mutual Insurance Company, is hereby authorized to appoint such attorneys-in-fact as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. L w That the By-law and the Authorization set forth above are true copies thereof and are now in full force and effect. > IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of Liberty Mutual Insurance Company has been affixed thereto in Plymouth Meeting, Pennsylvania this 27th day of April , 2011 04) LIBERTY MUTUAL INSURANCE COMPANY 60 1.I_ o..i. By6a,.a:= It- C L r Garnet W. Elliott, Assistant Secretary COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF MONTGOMERY r On this 27th day of April , 2011 , before me, a Notary Public, personally came Garnet W. Elliott, to me known, and acknowledged 0-5 that he is an Assistant Secretary of Liberty Mutual Insurance Company; that he knows the seal of said corporation; and that he executed the above ar Power of Attorney and affixed the corporate seal of Liberty Mutual Insurance Company thereto with the authority and at the direction of said corporation. 0 W .a IN TESTIMONY WH unto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year 0 first above written. > CON1NtUiVVdEAL7HF PENNSYLVANIA C13 C Notarial Seal 4.0 O i. Teresa Pas;elia, Notary Pubft 3 Plymouth Twp, Montpornery county By Z~,~ lut& Z V X My Comm;ssion Expires March 28:2013 Ter sa Pastella, Notary Public VA A umber, Penn?3y€u iv:a Association or Notwirs CERTIFICATE I, the undersigned, Assistan ecretary of Liberty Mutual Insurance Company, do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate; and I do further certify that the officer or official who executed the said power of attorney is an Assistant Secretary specially authorized by the chairman or the president to appoint attorneys-in-fact as provided in Article XIII, Section 5 of the By-laws of Liberty Mutual Insurance Company. This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the following vote of the board of directors of Liberty Mutual Insurance Company at a meeting duly called and held on the 12th day of March, 1980. VOTED that the facsimile or mechanically reproduced signature of any assistant secretary of the company, wherever appearing upon a certified copy of any power of attorney issued by the company in connection with surety bonds, shall be valid and binding upon the company with the same force and effect as though manually affixed. <Ifl " ESTIMON WHEREOF I have hereunto subscribed my name and affixed the corporate seal of the said company, this day of ~t i I I a f By r Davi M. Carey, Ass' fit Secretary N N C U) 3 .a C c~ C O vH yW L 0a ° M O~ OE n M yO O C ~ O O O co L Oa 0 r - CO I PROPOSAL TO THE TOWN OF TIBURON PUBLIC WORKS DEPARTMENT NAME OF BIDDER LJ~I n1 BUSINESS P.O. BOX TOWN, STATE, ZIP BUSINESS STREET ADDRESS ~D 1 c ~y tT~ 21 D~ (Please include even if p.0. Boa- used TOWN, STATE, ZIP ( y TELEPHONE NO: AREA CODE FAX NO: . AREA CODE 4t~,T CONTRACTOR LICENSE NO. <v 4ti~ v2 The work for which this proposal is submitted is for construction in conformance with the special provisions (including the payment of not less than the State general prevailing wage rates or Federal minimum wage rates), the project plans described below, including any addenda thereto, the contract annexed hereto, and also in conformance with the California Department of Transportation Standard Plans, dated 2010, Standard Specifications, dated 2010; and the Labor Surcharge and Equipment Rental Rates in effect on the date the work is accomplished. The project plans for the work to be done were approved August 23, 2012 and are entitled: TOWN OF TIBURON 2012 Del Mar Neighborhood Street Improvement Project Bids are to be submitted for the entire work. The amount of the bid for comparison purposes will be the total of all items. The bidder shall set forth for each unit basis item of work a unit price and a total for the item, and for each lump sum item a total for the item, all in clearly legible figures in the respective spaces provided for that purpose. In the case of unit basis items, the amount set forth under the "Item Total" column shall be the product of the unit price bid and the estimated quantity for the item. In case of discrepancy between the unit price and the total set forth for a unit basis item, the unit price shall prevail, except as provided in (a) or (b), as follows: (a) If the amount set forth as a unit price is unreadable or otherwise unclear, or is omitted, or is the same as the amount as the entry in the item total column, then the amount set forth in the item total column for the item shall prevail and shall be divided by the estimated quantity for the item and the price thus obtained shall be the unit price; P-1 TOWN OF TIBURON 2012 Del Mar Neighborhood Street Improvement Project BID PROPOSAL The contractor agrees to accept payment, in full therefore, at the following prices: BID SCHEDULE Item Item Estimated Unit of Unit Item No. Description Quantity Measure Cost Total 1 Traffic Control I Lump Sum ►O~oAD. D uo ooo. iD& 2 Grind and Remove Asphalt 27,012 S.Y. If t9f yg3 Concrete • 3 Digout Repair 1,911 S.Y. o 4 Asphalt Concrete Surface, 4,967 Ton Ile. 00 OW- S'~+6 PV T eA 01 , 5 Pavement Reinforcing 3g 8,22 13 S.Y. V Fabric 6 Sidewalk 354 S.Y. Sn tl'g . ' 7 Curb and Gutter 2 L.F. orD 8 Detectable Warning Warning 2 Each av- O e ! it bo, Surface w 9 Traffic Signal Detector 4 Each ~'pS• d~ o, Oa Z Loos 10 Adjust Water Valve Box to 67 Each. I~ S T r Grade : 11 Adjust Sewer Cleanout Box 7 Each Lr✓ I. d v Z, ijo a . D~ to Grade 12 Adjust Manhole Frame and 58 Each 0.4 Cover to Grade 13 Adjust Monument Box to 24 Each p d I ~7 00 ~ ~Z9 Grade a , , 14 14 Thermoplastic Stripe, 4- i h Whit 919 L.F. • ~ ~v' g , nc e , i 15 Thermoplastic Stripe, 8- inch, White 98 L.F. 16 Thermoplastic Stripe, 12", 1? 19 L.F. White Thermoplastic Crosswalk 17 Markings and Words, 2,147 S.F. ~y2d © Id Yellow 18 Thermoplastic Stripe, 4- 2,152 L.F. inch. Detail 1, Yellow ✓ 19 Thermoplastic Stripe, Double 4-inch, Detail 21, 1,628 L.F. 3, re j , 6o Yellow P-3 This Page intentionally Left Blank P-5 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder f24 U&V_&y PP_t,~srC~ MPrr-r~G~-L proposed subcontractor has not , hereby certifies that he has participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of' the Office of' Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports-due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of'Labor. P-7 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealahle finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. P-9 DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of' perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil -judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. P-11 Place ol'Residence ~GtiVl wtl~~ ' P-13 ADDENDUM. NO. I to PROJECT PLANS, SPECIAL PROVISIONS AND PROPOSAL FOP, CONSTRUCTION OF 2012 DEL MA,R NEIGBBORHOOD STPLEET IWROVEMENT PROJECT IN THE TOWN OF TIB URON DATE: September 10, 2012 TO; Plan Holders SUBJECT: Changes in Special Provisions and Bid Schedule RID OPENING DATE September 13, 2012 This Addendum forms a part of the Bidding and Contract Documents and modifies the Special Pr(wisions and Bid Schedule as described below: Changes is Special Provisions and Bid Schedule: 1, Scction I0-7.01 ASPHALT CONCRETE The paragraph reading: "Asphalt concrete surface shall be compacted to a relative compaction of not less than 97%." is deleted and replaced with the following; Construction shall be in accordance with Section 39-3, "Method Construction Proccss," of tile Standard Specifications. Asphalt concrete shall be compacted to 92-971/0 of maximum thearetica.I compaction (California Test 309) as determined by California Test 375 (Nuclear Density Device may be used). Tlie Contractor shall use asphalt spreading machinery with automated controls, 2. Section 10-11.02 TRAFFIC SIGNAL DETECTOR LOOPS The Contractor is responsible Caltrans Encroachment Permit fee up to a cost of S1.000. 3. BID PROPOSAL, BID SCHEDULE, Page P-3 For Bid Item No. 6, Sidewalk, the Unit of Measure is changed from. "S_Y." to "S.F." The Estimated Quantity remains at 354 units. PLEASE SIGN THIS ADDENDUM IN THE SPACE PROVIDED AND INCLUDE THE SIGNED COPY OF THE ADDENDUM WITH YOUR BID DOCUMENTS. NOTE THAT 131D DOCUMENTS SUBMITTED WITHOUT A SIGNED COPY OF THIS ADDENDUM MAY BE CONSUDERED NON»RESPONSIArE AND MAY BE REJECTED. 13y; "t Septem_ba 10. 2012 Paul W. Wade, P.E. Date The undersigned has received end read this addendum. Contractor i ginature 1--t L Name (printed) Date TOWN OF TIBURON PUBLIC WORKS DEPARTMENT BIDDER'S BOND We, Synergy Project Management, Inc. as Principal, and Liberty Mutual Insurance Company as Surety are bound unto the Town/eavnty of _Tiburon-, State of California, hereafter referred to as "Obligee", in the penal sum of ten percent (10%) of the total amount of the bid of the Principal submitted to the Obligee for the work described below, for the payment of which sum we bind ourselves, jointly and severally, THE CONDITION OF T US OBLIGATION IS STLJCI1, THAT: WHEREAS, the Principal is submitted to the Obligee, for 2010 Del Mar Neighborhood Street Improvement Pr-o-J t (Copy here the exact description of work including location as it appears on the proposal) for which bids are to be opened at Tiburon, CA on September 13, 2012 (Insert place where bids will be opened) (Insert date of bid opening) NOW, THEREFORE, if the Principal is awarded the contract and, within the time and manner required under the specifications, after the prescribed forms are presented to him for signature, enters into a written contract, in the prescribed form, in conformance with the bid, and files two bonds with the Obligee, one to guarantee faithful performance of the contract and the other to guarantee payment for labor and materials as provided by law, then this obligation shall be null and void; otherwise, it shall remain in full force. In the event suit is brought upon this bond by the Obligee and judgement is recovered, the Surety shall pay all costs incurred by the Obligee in such suit, including a reasonable attorney's fee to be fixed by the court. Dated: September 13 , 20 12 . - Synera Proiec .-emen Inc/ B Principal Liberty Mtjf-ilal f1S e Comp-any-- Joan y DeLuca Attorney-ink act P-14 ACKNOWLEDGMENT State of California County of Mar in K_, Holtemann,~ Notarv_Public_______ ______September 131 2012 before rne, ----(insert name and title of the officer) Joan D_e Lu c a personally appeared - - who proved to me on the basis of satisfactory and that by evidence to be the person(s) whexecut d t he (same in subscribed to the within instrument and acknowledged to thagtn#~ re(/) on the instrument the i~l 4&/her44e4 authorized capacity( I acted, executed the instrument. person(->4, or the entity upon behalf of which the person~} i certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. r K. HOLTEMANN D f 1_: COMM. #1906845 0 J NOTARY PUBLIC-CALIFORNIA n Q MIARIN COUNTY 1 (Seal) Comm Expires Actuter31, 2014 Signature 4549550 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. LIBERTY MUTUAL INSURANCE COMPANY BOSTON, MASSACHUSETTS POWER OF ATTORNEY KV JW ALL PERSONS BY THESE PRESENTS: That Liberty Mutual Insurance Company (the "Company"), a Massachusetts stock insurance c mpany, pursuant to and by authority of the By-law and Authorization hereinafter set forth, does hereby name, constitute and appoint CHARLES R. SHOEMAKER, ROGER C. DICKINSON, NANCY L. HAMILTON, STANLEY D. LOAR, ROSEMARIE GUANILL, MARK M. MUNEKAWA, NERISSA S. BARTOLOME, YVONNE RONCAGLIOLO, LAWRENCE J. COYNE, KELLY HOLTEMANN, THOMAS E. HUGHES, BRUCE G. OKREPKIE, JOAN DELUCA, ALL OF THE CITY OF SAN FRANCISCO, STATE OF CALIFORNIA , each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations in the penal sum not exceeding TWO HUNDRED MILLION AND 00/100 DOLLARS 200,000,000.00********************* ) each, and the execution of such undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents, shall be as binding upon the Company as if they had been duly signed by the president and attested by the secretary of the Company in their own proper persons. That this power is made and executed pursuant to and by authority of the following By-law and Authorization: ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings. resident and subject to such limitations as the the chairman or the ur ose in writin b authorized for that Com an ffi r f th A p , p g y p p y ny o ce o e chairman or the president may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their Cn signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be 4) Q as binding as if signed by the president and attested by the secretary. •N .te d) By the following instrument the chairman or the president has authorized the officer or other official named therein to appoint attorneys-in-fact: Q C Pursuant to Article XIII, Section 5 of the By-Laws, Garnet W. Elliott, Assistant Secretary of Liberty Mutual Insurance Company, is hereby authorized to appoint such attorneys-in-fact as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. ° i o w That the By-law and the Authorization set forth above are true copies thereof and are now in full force and effect. V h- W 3 E o > IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of C. Liberty Mutual Insurance Company has been affixed thereto in Plymouth Meeting, Pennsylvania this 27th day of April 2011 Q 'o • c d. O LIBERTY MUTUAL INSURANCE COMPANY L r 6° 0E ° By _y l e cp « Garnet W. Elliott, Assistant Secretary H o ` COMMONWEALTH OF PENNSYLVANIA ss C d COUNTY OF MONTGOMERY p t d C On this 27th day of April , 2011 , before me, a Notary Public, personally came Garnet W. Elliott, to me known, and acknowledged ° E that he is an Assistant Secretary of Liberty Mutual Insurance Company; that he knows the seal of said corporation; and that he executed the above 3 M d Power of Attorney and affixed the corporate seal of Liberty Mutual Insurance Company thereto with the authority and at the direction of said corporation. lvania on the da and ear Penns mouth Meetin l at Pl d m n me and ffi ed l se ib t i IN TESTIMONY WHE T b ,6 e t v ~C C y g, y , y y y x e a a my no ar a a reun o su scr 0 , first above written. ~~~a. 4. `r COMMONWEALTH 01: PENNSYLVANIA aNo > L E~ N S l N i 4-f L 0 a otarial ea I Teresa Pastella, Notary PuNic i OF Pi th T ? M G C I B cr) r 00 Z y„ u vq . or. aomery cunty y hy Camrnssion Expires starch 28. 2013 E Notary Public Ter sa Pastella ° o v ~ , gS ,,,.e ~~~1£T`~ g ~<igfi 6:atr:hear.Fannr>ylvar::,As~uxiai~u•:rttv:>ta:ir•s ° r " CERTIFICATE F I-- ~ a:R w; I, the undersigned, Assistantecretary of Liberty Mutual Insurance Company, do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate; and I do further certify that the officer or official who executed the said power of attorney is an Assistant Secretary specially authorized by the chairman or the president to appoint attorneys-in-fact as provided in Article XIII, Section 5 of the By-laws of Liberty Mutual Insurance Company. This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the following vote of the board of directors of Liberty Mutual Insurance Company at a meeting duly called and held on the 12th day of March, 1980. VOTED that the facsimile or mechanically reproduced signature of any assistant secretary of the company, wherever appearing upon a certified copy of any power of attorney issued by the company in connection with surety bonds, shall be valid and binding upon the company with the same force and effect as though manually affixed. TESTIMONY W iEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said company, this <fG day of By r David M. Carey, Assi rit Secretary CERTIFICATE OF ACKNOWLEDGEMENT State of California 'I'own/County of _ On this _ before me day of in the year 20 personally appeared Attorney-in fart personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument as the attorney-in-fact of and acknowledged to me that he (she) subscribed the name of the said company thereto as surety, and his (her) own name as attorney-in-fact. (SEAL) _ See Attached Notary Pubic SS P-15 4CORD~ CERTIFICATE OF LIABILITY INSURANCE (MM DATE YYYY) (MMIDD/ o9 1 20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). RODUCER V d f-S CONTACT NAME: _ OO rut awyer & Co. PHONE FAX 8 R l d W S i 180 Arc No Ext : A/c No an ow ay, te u E-MAIL t CA 94945 ADDRESS: - J0va o, 415) 878-2460 INSURER(S) AFFORDING COVERAGE NAIC_# INSURER A : Old Republic General Insurance Corporation 24139 SURED INSURER B : National Union Fire Ins. Co. of Pittsburgh.PA 19445 Vnergy Project Management Inc. 0 Grant Avenue, Suite X00 INSURER C - - - - - - an Francisco. CA 94108 INSURER D. INSURER E INSURER F : OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IR' ADDUSUBR POLICY EFF POLICY EXP R TYPE OF INSURANCE IN 5R WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY x A I CG9972 120 I 02 2 2012 07 24 20 13 EACH OCCURRENCE S 1,000,000 X COMMER A DAMAGE TO RENTED 100 000 CI L GENERAL LIABILITY PREMISES (Ea occurrence) S , CLAIMS MADE ! XI OCCUR MED EXP (Any one person) S 5,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMPOP AGG S 2,000,000 POLICY ECT LOC S AUTOMOBILE LIABILITY I CA9972 1201 02 2-1 2012 02, 2 } 20 13 COMBINED SINGLE LIMIT (Ea accident) 1.000.000 X . ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S NON-OWNED Y X PROPERTY DAMAGE S HIRED AUTOS AUTOS _ (Per accident) UMBRELLA LIAR OCCUR X BE 145005244 02 2-1 201 02 2 1 201 EACH OCCURRENCE_ S_ - x,000.000 X EXCESS LIAR CLAIMS MADE AGGREGATE S 5.000.000 DED RETENTION S $ WORKERS COMPENSATION ` 1 I f I It ~ , 1 ,f1 it l 711 I WC STATU- OTH- \ Cq V AND EMPLOYERS' LiABILiTY Y/N I 4 7 7 I - . - ANY PROPRIETOR: PARTNERiEXECUTIVE N / A F EL EACH ACCIDENT S - - - - - 1,000,000 - OF ICERMEMBER EXCLUDED? (Mandatory in NH) - E.L. DISEASE EA EMPLOYEE S 1,000.000 If yes. describe under 1 000 000 DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT S , . SCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) aject: 2012 Del Nlar Neighborhood Street Improvements. The Town of Tiburon and its employees and agents are named additional insured per forms CG 10 07 04 and CG 20 37 07 04 attached. Coverage is Primary and Non-Contributory per form CG EN GN 002 9 09 06 attached. A Waiver of Subrogation plies per form WC 99 03 15 01 07 attached. licies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non- avment of premium. :RTIFICATE HOLDER CANCELLATION Town of Tiburon 1505 Tiburon Blvd. Tiburon, CA 94920 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE_f.XPIRATION DA TH OF, NOTICE WILL BE DELIVERED IN A OR NCE WITH T E POLICY PROVISIONS. ESENTA'NVE LOAN 'ORD 25 (2010/05) ID © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NAMED INSURED: Synerw Project NIanayement Inc. POLICY NUMBER: A1CG99721201 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization s : Location And Description Of Completed Operations Town of Tiburon Project: 2012 Del Mar Neighborhood Street lmprovements. The 1505 Tiburon l3k d. Town of Tiburon and its employees and agents are nam;:d additional Tiburon. CA 94920 insured per forms CG 20 10 07 04 and CG 20 3' 0-7 04 attached. CoveraL,e is Primarv and Non-Contributory per forn-i CG E\ G\ 0029 09 06 attached. A Waiver of Subrogation applies per form vV( 99 03 15 01 07 attached. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that ad- ditional insured and included in the "products-com- pleted operations hazard". CG 20 37 07 04 Copyright, ISO Properties, Inc., 2004 Page 1 of 1 UNIFORM OLD REPUBLIC GENERAL INSURANCE CORPORATION CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Name of Additional Insured Person(s) Location(s) of Covered Operations Or Organization(s): Town of Tiburon Project: 2012 Del %far Neighborhood Street Improvements. The 1 505 Tiburon Bled. To,,N-n of Tiburon and its employees and agents are named additional Tiburon, CA 94920 insured per forms CG 20 10 07 04 and CG 20 37 07 04 attached. Coveraae is Primary and Non-Contributory per for-i CG EN Gti As required by written contract: 0029 09 06 attached. A Waiver of SubroLyation applies per form WC 99 03 1 01 07 attached. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other insurance of a like kind available to the person or organization shown in the schedule above unless the other insurance is provided by a contractor other than the person or organization shown in the schedule above for the same operation and job location- If so, we will share with that other insurance by the method described in paragraph 4.c. of Section IV - Commercial General Liability Conditions. All other terms and conditions remain unchanged. Named Insured ~ Synergy Project tilanagement Inc. o1io D1 I Number y I A 1 CG99721'01 C.rrlrr on4 nl~ I m p „ _ Policy Period 02.24 2012 to 02,24 2013 Endorsement Effective Date. Producer's Name: , I Producer Number: AU HORIZED REPRESENTATIVE 09 23 2012 DATE CG EN GN 0029 09 06 OLD REPUBLIC GENERAL INSURANCE CORPORATION WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: We have the right to recover our payments from anyone liable for an injury covered by this policy. VJe will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ',r'VHEN REQUIRED BY WRITTEN CONTRACT. The premium charge for this endorsement is $0.00 Town of Tiburon 1 505 Tiburon Blvd. Tiburon. CA 94920 Project: 2012 Del 'tar Neighborhood Street Improvements. The Town of Tiburon and its employees and agent are named additional insured per forms CG 20 10 07 04 and CG 20 3? 0' 04 attached. Co%erage is Primary and Non-Contributor, per torm CG E\ GN 0029 09 06 attached. A Waiver of Subrogation applies per forni WC 99 03 13 0 l attached. Named Insured Svnerav Project Ntanauement Inc. Policy Number AIO`"9972)I2)0I i Endorsement No. 000 Policy Period 0? 24 2012 021. 214 2013 Endorsement Effective Date: Producer's Name: OLD REPUBLIC CONSTRUCTION INSURANCE AGENCY, INC. Produ r Yffl~_ 10000007000 I AUTHORIZED R PRESENTATI 09 25 2012 DATE WC 99 03 15 (01/07)