HomeMy Public PortalAboutAMERICAN ASPHALT SOUTH, INC.dp
CITY OF CARSON
LOS ANGELES COUNTY, CALIFORNIA
CONTRACT AGREEMENT
101-1111
CITY OF CARSON
PROJECT NO. 1301
ANNUAL SLURRY SEAL PROGRAM9 CITYWIDE
With
American Asphalt South, Inc.
- I -
CONTRACT DOCUMENTS
PROJECT NO. 1301
ANNUAL SLURRY SEAL PROGRAM.,CITYWIDE
To be Submitted
AFTER
Award of Contract
PROPOSAL
PROJECT NO. 1301
BIDDING SCHEDULE
HONORABLE MAYOR
MEMBERS OF THE CITY COUNCIL
CITY OF CARSON
701 EAST CARSON STREET
CARSON, CALIFORNIA 90745
Mayor & Councilmembers:
The undersigned declares that he has carefully examined the location of the proposed work and
that he has examined the Plans and Specifications, has read the Contract Documents, and hereby
agrees to furnish all labor, materials, equipment, tools, transportation, and services to do all work
required for:
OWNER'S PROJECTS NO.: 1301
TITLE: ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
In accordance with the Plans and Specifications prepared by the Engineer, in accordance with the
Special Provisions and Technical Provisions, the Contract Documents, and in accordance with
the Standard Specifications for Public Works Construction (current edition), and the
requirements of the Engineer under said documents, for the prices shown herein. All work shall
be completed within 30 working days from the date the notice to proceed is issued by the
Engineer.
-3-
BID SCHEDULE
PROJECT NO. 1301
ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
Item
No.
Description
Quantity
Unit
Unit Price
Total Price
I
RUBBERIZED EMULSION
AGGREGATE SLURRY SEAL (REAS)
TYPE I[
1,452,493
S.F.
$0.182
$264,353.72
2
CRAACK SEALING
LS
$25,481
$25,481.00
3
TRAFFIC STRIPS AND PAVEMENT
MARKINGS
LS
$10,560
$10,560.00
$300,394.72
TOTAL CONTRACT
BID AMOUNT
(F'gures)
$300,394.72
(Words)
Three Hundred Thousand, Three Hundred Ninty Four Dollars and
Seventy Two Cents
In case of any discrepancy between the unit price and the extended total, the unit shall prevail.
-4-
CONTRACT
PROJECT NO. 1301
AGREEMENT
THIS AGREEMENT is made and entered into by and between Owner, consisting of one or both
of the following described public entities:
Ix 1 0 The City of Carson, California
[ 1 0 The Carson Redevelopment Agency
and American Asphalt South, Inc, hereinafter called Contractor.
The Owner and the Contractor mutually agree as follows:
ARTICLE 1.
THE PROJECT
For and in consideration of the mutual promises set forth herein, Contractor agrees with Owner
to perform and complete in good and workmanlike manner all work required by the Contract
Documents for Owner's Project No. 1301 , which is described as follows:
Title: ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
Said work shall be performed in accordance with the Plans, Specifications and other Contract
Documents, all of which are referenced in Article III hereof and incorporated herein as though
fully set forth. Contractor shall furnish at its own expense all labor, materials, equipment and
services necessary therefor, except such labor, materials, equipment and services as are provided
in the Contract Documents to be furnished by Owner.
ARTICLE 11.
CONTRACT SUM AND PAYMENT
For performing and completing the work in accordance with the Contract Documents, Owner
shall pay Contractor, in full compensation therefor, the contract sum set forth in the Bidding
Schedule. Said sum shall constitute payment in full for all work performed hereunder, including,
without limitation, all labor, materials, equipment, tools and services used or incorporated in the
work, supervision, administration, overhead, expenses and any and all other things required,
furnished or incurred for completion of the work as specified in the Contract Documents. Owner
shall make payments to Contractor on account of the contract sum at the time, in the manner, and
upon the conditions specified in the Contract Documents.
ARTICLE III.
CONTRACT DOCUMENTS
The Contract Documents, which constitute the entire agreement between the Owner and the
Contractor, are enumerated as follows: Proposal Documents, including the Notice Inviting Bids,
Instructions to Bidders, Bidding Schedule, Bidder's Declaration, Designation of Subcontractors,
Bidder's Assurance, Project Labor Agreement and Fair Employment Practices documents; this
Agreement; Standard Specifications; Special Provisions; Technical Provisions; Drawings; Plans;
and all addenda issued prior to and all modifications issued after the execution of this
Agreement. These form the Contract, and all are as fully a part of the Contract as if attached to
this Agreement or repeated herein.
ARTICLE IV.
EFFECTIVE DATE
This Agreement shall become effective and commence as of the date set forth below on which
the last of the parties, whether Owner or Contractor, executes said Agreement.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed and
attested by their proper officers thereunto duly authorized.
Attest: OWNER
A By:
By:
HEL S. KAWAGOE, ��MC/ C MAYOR JIM DEAR
CITY CLERK T
Dated:
APPROVED AS TO FORM:
By: W. vlek—�
City AtOiey
Attest:
By: Je- ;�' A 4
Print Name J
Vi(a Pref /We vi
Title
By: 4Q12
Print34ame
Secrc'A!!�
Title J
SEAL
CONTRACTOR
-C;44� --
Signt(wre ?--
Date
S
,jifrature
Date
CONTRACT
PROJECT NO. 1301
FAITHFUL PERFORMANCE BOND
WHEREAS, the Owner, consisting of one or both of the following described public entities:
IX 1 0 The City of Carson, California
0 The Carson Redevelopment Agency
has awarded to American Asphalt South, Inc., hereinafter designated as the "Principal", a
Contract for:
PROJECT NO.: 1301
TITLE: ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
WHEREAS, said Principal is required under the terms of said Contract to furnish a bond for the
faithful performance of said Contract;
NOW, THEREFORE, we,
as Principal, and
as Surety, are held and firmly bound unto the Owner in the sum of Three Hundrd Thousand,
Three hundred Ninly F2ur Dollars and Sevgpty Two Cents ($300,394.72), this amount being not
administrators, and successors, jointly and severally, firmly by these presents. In case suit is
brought upon this bond, the Surety will pay a reasonable attorney's fee to the "Owner" in an
amount to be fixed by the court.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the hereby bounded Principal,
his or its heirs, executors, administrators, successors, or assigns, shall in all things stand to and
abide by, well and truly keep and perform all the undertakings, terms, covenants, conditions and
agreements in the said Contract and any alteration thereof, made as therein provided, all within
the time and in the manner therein designated and in all respects according to their true intent and
meaning, then this obligation shall become null and void; otherwise, it shall be and remain in full
force and effect.
FURTHER, the said Surety, for value received, hereby stipulates and agrees that no change,
extension of time, alteration or modification of the Contract Documents, or of the work to be
performed thereunder, shall in any way affect the obligations of this bond, and it does hereby
waive notice of any such change, extension of time, alteration or modification of the Contract
Documents or of the work to be performed thereunder.
IN WITNESS WHEREOF, three (3) identical counterparts of this instrument, each of which shall
for all purposes be deemed an original thereof, have been duly executed by the Principal and
Surety named herein, on the day of , 20_, the name and
corporate seal of each corporate party being hereto affixed and these presents duly signed by its
undersigned representative pursuant to authority of its governing body.
Principal
LIM
Surety
m
-8-
CONTRACT
PROJECT NO. 1301
PAYMENTBOND
WHEREAS, the Owner, consisting of one or both of the following described public entities:
IX I M The City of Carson, California
[ I M The Carson Redevelopment Agency
has awarded toAmerican Asphalt South, Inc., as Contractor, a contract for the work described as
follows:
PROJECT NO.: 1301
TITLE: ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
AND WHEREAS, said Contractor is required to furnish a bond in connection with said contract,
to secure the payment of claims of laborers, mechanics, materialmen and other persons, as
provided by law;
NOW, THEREFORE, we, the undersigned Contractor and Surety, are held firmly bound unto the
Owner in the sum of Three Hundrd Thousand, Three hundred Nipty Four Dollars and Seven
Two Cents ($300,394.72) for which payment well and truly to be made we bind ourselves, our
heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these
presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if said Contractor, its heirs,
executors, administrators, successors, assigns, or 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 under the contract, or any amounts required to be
deducted, withheld, and paid over to the Employment Development Department from the wages
of employees of the Contractor and its subcontractors pursuant to Section 13020 of the
Unemployment Insurance Code, with respect to such work and labor, then the Surety or Sureties
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 said
Surety will pay a reasonable attorney's fee to the plaintiff(s) and Owner in an amount to be 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.
Said Surety, for value received, hereby stipulates and agrees that no change, extension of time,
alteration or modification of the Contract Documents or of the work to be performed thereunder
-9-
shall in any way affect its obligations on this bond, and it does hereby waive notice of such
change, extension of time, alteration or modification of the Contract Documents or of work to be
performed thereunder.
IN WITNESS WHEREOF, we have hereunto set our hands and seals on this
20
CONTRACTOR
SURETY
day of
CONTRACT
PROJECT NO. 1301
WORKER'S COMPENSATION INSURANCE CERTIFICATE
The Contractor shall execute the following form as required by the California Labor Code,
Sections 1860 and 1861:
I am aware of the provisions of Section 3700 of the Labor Code which require
every employer to be insured against liability for workers' compensation or to
undertake self-insurance in accordance with the provisions of that Code, and I will
comply with such provisions before commencing the performance of the work of
the Contract.
DATED: 1�a�r/
, I � 1019
ATTEST:
B 6 Y—��Signature
Title/
-11-
CONTRACTOR
B
Y—*Si ature
Title
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
AND WAIVER OF SUBROGATION AND CONTRIBUTION
Contract/Agreement/License/Pertnit No. or description:
Indemnitor(s) (list all nanles):
To the fullest extent permitted by law, Inderrinitor hereby agrees, at its sole cost and expense, to defend, protect,
indemnify, and hold harmless the City of Carson and the Carson Redevelopment Agency and their respective elected
officials, officers, attorneys, agents, employees, volunteers, successors, and assigns (collectively "Indemnitees")
from and against any and all damages, costs, expenses, liabilities, claims, demands, causes of action, proceedings,
expenses, judgments, penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys,
or other professionals and all costs associated therewith (collectively "Liabilities"), arising or claimed to arise,
directly or indirectly, out of, in connection with, resulting from, or related to any act, failure to act, error, or omission
of Indemnitor or any of its officers, agents, servants, employees, subcontractors, materialmen, suppliers or their
officers, agents, servants or employees, arising or claimed to arise, directly or indirectly, out of, in connection with,
resulting fi7om, or related to the above -referenced contract, agreement, license, or pernift (the "Agreement") or the
performance or failure to perform any term, provision, covenant, or condition of the Agreement, including this
indemnity provision. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active
or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence.
This indemnity provision shall survive the termination of the Agreement and is in addition to any other rights or
remedies which Indemnitees may have under the law. Payment is not required as a condition precedent to an
Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an Inderrinitee shall
be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Indemnitor shall pay
Indemnitees for any attorneys fees and costs incurred in enforcing this indemnification provision. Notwithstanding
the foregoing, nothing in this instrument shall be construed to encompass (a) Indemnitees' sole negligence or willful
misconduct to the limited extent that the underlying Agreement is subject to Civil Code 2782(a), or (b) the
contracting public agency's active negligence to the limited extent that the underlying Agreement is subject to Civil
Code 2782(b). This indemnity is effective without reference to the existence or applicability of any insurance
coverages which may have been required under the Agreement or any additional insured endorsements which may
extend to Indemnitees.
Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation
and contribution against the Indemnitees, while acting within the scope of their duties, from all claims, losses and
liabilities arising out of or incident to activities or operations performed by or on behalf of the Indeninitor regardless
of any prior, concurrent, or subsequent active or passive negligence by the Indemnitees. Accountants, attorneys, or
other professionals employed by Indemnitor to defend Indemnitees shall be selected by or subject to the approval of
Indemnitees.
In the event there is more than one person or entity named in the Agreement as an Indemnitor, then all obligations,
liabilities, covenants and conditions under this instrument shall be joint and several.
"Indemnitor"
Name— �2�&rz- Zell
By:_.
its x?"
Name le
By:
Its
TO BE SIGED BY THE CONTRACTOR
-12-
ACORD, CERTIFICATE OF LIABILITY INSURANCE VA
T141S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
WGUREPS AFFORDING COVERAGE NAIC
INSURED .. . ....... . ......
INSURERA:Old F 1
American Asphalt South, Inc.
INSURERB:Nati ngl C"Q P_"'
14436 Santa Ana Avenue s"
-ontana CA 92337 INSURER C:
INSURERD:
COVERAGES I-- - —
ITHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI I ICATED.
ICOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WH CH THIS
ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SH JECT TO ALL THE
LIMITS SHOWN MJC! HA' -T EFFN XE �)CFM' SY ',,-,AIT
P wqYtFrtC7tVE . . . ....
EXPtRAT)ON
. . . . .. ....... .. . ...................... . . ...... .. . ........
Q.0-
MED
City Project No. 1301; Annual Slurry Seal 7--�Wam
City of Carson, its elected officials, officers, agents and eTrTilcj,��a ar(t addf::! ar
ired by written contract including Auto Liability, per the attached Pr�triary wcrdJzi�,
ration of insured and XCU are included. Waiver of Subrogation apjf�liea ti� '70�pensatl.,)n'
City of Carson
Piqv
4
ACORD 25 (2001/08)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
W77,1, MAI' ' 30 r-)VfS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
Nw?nr "N T!�F !�,FFT,
---- ------ J,
(510)578-2000
(DACORD CORPORATION 1988
�2
PRO LOC
POLICY [X JECT_ 7
A
AUTOMOBILE
LIABILITY
AICA36070905
l/l/2009
1/l/2010
X
ANY AUTO
COMBINED SINGLE LIMIT :L'
(Ea mcddent)
000, 000
ALLOWNEDAUTOS
BODILY INJURY S
SCHEDULEDALITOS
X
HIREDAUTOS
P/A)4A)NiftJPV
NON -OWNED AUTOS
GARAGE LIABILITY
U T 0 uf�� Y EA AG CID E NIT
ANYAUTO
.. . .. ...........
EA ACC
-A,
AUTO CPA, y
EXCESSIUMBRELLA LIABILITY
.. .. ... . ...........
BE18325893
2 c -9
1/ 2, C, EAQ40CCURRENCE
n
x OCCUR E] CLAIMS MADE
AGGREGAT'f�
... .............. ___ ....... ....
'Y'
ji� DE UCTIBLE 10 0 0 0
. ...
RETENTION $
... . . ...... . .. .
A
WORKERS COMPENSATION AND
1CW360709 05
l/l/20D9
1 1 20 10 x 1 R,
EMPLOYERS'LIABILITY
. ..... .. . ... ....
.
14,
E EAU I ACCIDE 1
0 Q. I
. .......... — — -- - — -------- - -----
.......... . ....... ..... . .. ...........
City Project No. 1301; Annual Slurry Seal 7--�Wam
City of Carson, its elected officials, officers, agents and eTrTilcj,��a ar(t addf::! ar
ired by written contract including Auto Liability, per the attached Pr�triary wcrdJzi�,
ration of insured and XCU are included. Waiver of Subrogation apjf�liea ti� '70�pensatl.,)n'
City of Carson
Piqv
4
ACORD 25 (2001/08)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
W77,1, MAI' ' 30 r-)VfS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
Nw?nr "N T!�F !�,FFT,
---- ------ J,
(510)578-2000
(DACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statern ant
on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subect to the terms and conditions of the policy, certain policies �ay
require an endorsement. A statement on this certificate does not confer rights to the cerfific+te
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract betw n
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor doe it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed there�n.
ACORD25
POLICY NUMBER: COMMERCIAL GENEF�'A' LIABILITY
AlCG36070905 20100704
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Location(s) Of Covered Operations
Where requirea by written contract
Tn —fo 7rr, -., -J"I J ccirnpJefe lhis ScheduJe, if not shown above, will be shown in the Declarations.
A. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s)
designated above.
B. With respect to the insurance afforded to these additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, d n
the project (other than service, maintenance or repairs) to be performed by or on behalf of tl��
additional insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or subcontractor
engaged in performing operations for a principal as a part of the same project.
CG 20 10 07 04 Fred Vjdfrey, Account Executive
ISO Properties, Inc., 2004 (510)578-2000
POLICY NUMBER:
AICG36070905
COMMERCIAL GENERAL
LI�BIILITY
CG 20 3107 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
,Or Organization(s)- I Location(s) Of Covered Operations
re q, i
, , � - �! -, red by wfitten contrari,
i. lt;t�,.aiaaza� raqda&d to compiala this SchedvW, it nol shown above, will be shown in the
Section 11 — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(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 additional
insured and included in the "products -completed
operations hazard".
CG 20 37 07 04
0 ISO Properties, Inc., 2004
Fre Godfrey, Acco
(510)578-200
Page 1 011
7E,
Executive
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)
Or Organization(s):
As required by written contract:
Location(s) of Covered Operations
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 abov.e
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 insuranc by
the method described in paragraph 4.c. of Section IV — Commercial General Liability Conditions.
All other terms and conditions remain unchanged.
Named Insured
American Asphalt South, Inc.
Policy Number
AlCG36070905
Endorsement No.
Policy Period
1/1/09-1/1/10 to
Endorsement Effective Date:
l/l/2009
Producer's Nam
CPG/Special Risk Resources Insurance Agency, In
Producer Number:
AUTHORIZED R ENTATIVE
Fred Godfrey, Account Executive
(510)578-2000
CG EN GN 0029 09 06
DATE
OLD REPUBLIC GENERAL INSURANCE CORPORATION
ADDITIONAL INSURANCE WHERE REQUIRED
UNDER CONTRACT OR AGREEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
BUSINESS AUTO COVERAGE FORM
The following is added to Section 11 — Liability Coverage, A. — Coverage, 1. Who Is An Insured:
Any person or organization to whom you become obligated to include as an additional
insured under this policy, as a result of any contract or agreement you enter into which
required you to furnish insurance to that person or organization of the type provided by
this policy, but only with respect to liability arising out of your operations or premises
owned by or rented to you. However, the insurance provided will not exceed the lessor of:
The coverage or limits of this policy, or
The coverage or limits required by said contract or agreement.
Named Insured
American Asphalt South, Inc.
Policy Number
Endorsement No.
AlCKIS07ID905
Policy Period
1/1/09-1/1/1010��
— — - -------
Endorsement Effective Date:
1/1/2009
Producer's Name:
CPG Special Risk Resource Insurance Agency, Inc.
Producer Number:
AUTHORIZED R'EPRESENTATIVE --dA—TE
Fred Godfrey, Account Executive
(510)578-2000
CA EN GN 0020 09 06
OLD REPUBLIC GENERAL INSURANCE CORPORATION
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:
WORKERS'COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE
We have the right to recover our payments from anyone liable for an injury covered by this policy. We *1 not enforce
our right against the person or organization named in the Schedule. This agreement applies only to the tent 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
WHEN REQUIRED BY WRITTEN CONTRACT.
The premium charge for this endorsement is $0.00
Named Insured
American Asphalt South, Inc
Policy Number
AlCW36070905
Endorsement No.
Policy Period
1/j/09-1/l/loto
Endorsement Effecfive Date:
1/l/2009
Producer's Name:
CPG/Special Risk Resources Insurance Agency, Inc.
Producer Number:
t
AUTHORIZED
Fred Godfrey, Account Executive
(510)578-2000
WC 99 03 15 (09/06)
DATE
EXHIBIT -F-
American Asphalt
South, Inc,
ATTACHMENT "A"
Mr. Jerry Groomes
City Manager
City of Carson
701 East Carson Street
P.O. Box 6234
Carson, CA. 90749
SUBJECT: CITY OF CARSON CONSTRUCTION,
PROJECT NO. 1301, ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
Dear Mr. Groomes:
This is to certify that the undersigned Contractor/Employer has examined a copy of the subject
Project Labor Agreement entered into by and between the City of Carson and signatory Building
and Construction Trades Councils and Unions dated June 27, 2005. The undersigned
Contractor/Employer hereby agrees to comply with all of the terms and conditions of the
aforementioned Project Labor Agreement as such labor Agreement may, from time to time, be
amended by the parties or interpreted pursuant to its terms.
It is understood that the signing of the letter of Assent shall be as binding on the undersigned
Contractor/Employer as though the Contractor/Employer' had signed the above referred
Agreement and shall require all its subcontractors, of whatever tier, to become similarly bound
for all work within the scope of this Agreement.
This Letter of Assent shall become effective and binding upon the undersigned
Contractor/Employer the �;4< _ day of 10w-,5" -, �W,9 . and shall remain in full
force and effect until the completion of the above stated project.
Sincerely,
By:
cc:
www.americanasphaltsouth.com
Lic. # 784969
MAILING ADDRESS: P.O. BOX 310036 - FONTANA, CA 92331 - PHYSICAL ADDRESS: 14436 SANTA ANA AVE. - FONTANA, CA 92337 - (909) 427-8276 - FAX (909) 427-8279
Bond No.: 12060021
CONTRACT Premium: $2,103.00
PROJECT NO. 13 01
FAIMFUL PERFORMANCE BOND
WHEREAS, the Owner, consisting of one or both of the following described public entities:
IX I E The City of Carson, California
[ J K The Carson Redevelopment Agency
bas awarded to American Anhalt South, Inc., hereinafter designated as the "Principal", a
Contract for:
PRQJECT NO.: 1301
TITLE: ANNUAL SLURRY SEAL PROGRAM,CITYWIDE
WHEREAS, said Principal is required under the terms of said Contract to f�rnish a bond for the
faithful performance of said Contract;
NOW, THEREFORE, we, American Asphalt South, Inc.
as Principal, and The Guarantee Company of North America USA
as Surety, are held and firmly bound unto the Owner in the sum. of Three Hundrd Thousand,
Three hundred.WinV Four Dollars and Sevmty..Twq- Cents (S300,394.72 , this amount being not
administrators, and successors, jointly and severally, firraly by these presents, In case suit is
brought upon this bond, the Surety Nvill pay a reasonable attorneys fee to the, "Owner" in an
amotmt to befixed by the courL
THE CONDITION OF THIS OBLIGATION IS SUC14 THAT, if the hereby bounded Principal,
his or its heirs, executors, administrators, successors, or assigns, shall in all thiligs stand to and
abide by, well and truly keep and perform all the undertakings, terms, covenants, conditions and
agreements in the said Contract and any afteration thereof, made as therein provided, all within
the time and in the manner therein designated and in all respects according to their true intent and
meaning, then this obligation shall, become null and void; otherwise, it shall be and remain in fi-Lll
force and effect.
FURMER, the said Sur&5� for value received, hereby stipulates and agrees that no change,
extension of time, alteration or modi-flcation of the Contract Documents, or of the work to be
perfomed thereunder� shall in any way affect the obligations of this bond, and it does hereby
waive notice of any such change, extensiQn of time, alteration or modification of the Contract
Documents or of the work to be performed thereunder.
IN WITNESS WHEREOF, three (3) identical counterparts of thi,4 instrmnent, each of which shall
for all purposes be deemed an original thereof, have been, duly executed by the Principal and
Surety named herein, on the 25th day of March
20 09 the name and
.7-
corporate seal of each corporate party being hereto affixed and these presents duly signed by its
undersigned representative pursuant to authority of its governing body,
American Asphalt South, Inc.
Principal
BY- k6t
e A�Irec,"11
The Guarantee Company of North America USA
Surety
B
James 13. Shea,'Attomey-in-Fa-ct
- 8 -
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
..........
State of California
County of
Santa Clara
On March 25, 2009 before me, D. G117man- Notary Public
Date Here Insert Narne anti Title of the Officer
personally appeared James B. Shea, Attorney -i n -Fact
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(o) whose name(j) istarer subscribed to the
within instrument and acknowledged to me that
- - - - - - - - - he/sftefther executed the same in his/hefA4-�uthorized
0. GIMAN capacity(ies), and that by hisl%eniheir-signature(j) on the
Comoduft 0 1762739 instrument the person(i), or the entity upon behalf of
N"y PWW - C400l which the person(i) acted, executed the instrument.
"a CIIIIING COWNY
Mv Cow. Eoft Ag 20,2011
- - - - - - - - - - - - - - - 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 an o a seal.
Signature- ft� r"
Place Notary Seal Above &A
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signers Name:
E Individual
L1 Corporate Off icer — Title(s):
L! Partner — 0 Limited D General
Ll Attorney in Fact
F-1 Trustee
E Guardian or Conservator
E Other:
Signer Is Representing
RIGHTTHUMBPRIN
OF SIGNER
Top of thumb hore�
Signer's Name:
El Individual
L3 Corporate Officer — Title(s):
El Partner — E3 Limited 0 General
D- Attorney in Fact
Ll Trustee
Ll Guardian or Conservator
LJ Other:
Signer Is Representing:_
RIGHTTHUMBPRIN
OF SIGNER
Top of thumb here
Qaao�l
02007 National Notary Association- 9350 DO Soto Ave., PO.Box 2402 -Chatsworth, CA 91313-2402- www.NabonaINciary.org hm#5907 Reorder: Can T011 -Free, 1 8013-876-6827
THE GUARANTEE COMPANY OF NORTH AMERICA USA
I�M[11
Southfield, Michigan
15 POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the
laws of the State of Michigan, having its principal office in Southfield, Michigan, does hereby constitute and appoint
Jeffiey N. Aber, James B. Shea, Dora M. Hockett, Dianna Guzinan
Leavitt Pac�fiic Insurance Brokers, Inc.
its true and lawful aftorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of
indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract
or otherwise.
The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA
USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the
principal office.
The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws
adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31" day of December, 2003.
The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority:
1 - To appoint Aftorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds
and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, and
2. To revoke, at any time, any such Aftorney-in-fact and revoke the authority given, except as provided below
3. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the Power and authority hereby given to
the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting
duly called and held on the 31 " day of December 2003, of which the following is a true excerpt:
RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification
thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and
such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused
Tck't, this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 5th day of
January, 2009.
THE GUARANTEE COMPANY OF NORTH AMERICA USA
STATE OF MICHIGAN
County of Oakland Stephen Dullard, Vice President Randall Musselman, Secretary
On this 5 1h day of January, 2009 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly
instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directo S
sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to aid
said Company. rs of
Cynthia A. Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee
Notary Public, State of Michigan Company of North America USA offices the day and year above written.
County of Oakland
My Commission Expires February 27, 2012
4", Acdng in Oakland County AbL4_.� 9,
1, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERIC
A USA, do hereby certify that the above and foregoing is a true
and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect.
IN WIT�ESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 25th day of March, 2009.
0�
Randall Musselman, Secretary
Bond No.: 12060021
Premium: Included in Performance Bond
CONTRACT
PROJECT NO. 1301
PAYMENTBOND
WHEREAS, the Owner, consisting of one or boill of the following described public entities:
IX I M The City of Carson, California
I I M The Carson Redevelopment Agency
has awarded toAmerican AMhalt South, Inc., as Contractor, a contract for the work described as
follows:
PROJECT NO.: 1301
TITLE, ANNUAL SLURRY SEM, PROGRAMCTTYWIDE
AND WHEREAS, said Contractor is required to furnish a bond in COUT)ection with said corktract,
to secure the payment of claims of laborers, mechanics, matcrialmen and otber persons, as
provided by law;
NOW, THEREFORE, we, the undersigned Contractor and Surety, are held firmly bound unto the
Owner in the sum of Three Hundrd Tbousand, Three hundred Niaty Four Dollars and Seventv
Two Cents ($300.394.72) for which payment well and truly to be Made we bind ourselves, our
beirs, executors and administrators, successors and assigns, jointly andsevcrally, firmly by these
presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if said Contractor, its heirsi
eXccutun,, administrator$, successors, assigns, or 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 under the contract, or any amounts required to be
deducted, withheld, and, paid over to the Employment Development Department from the wages
of employees of the Contractor and its subcontractors pursuant to Section 13020 of the
Unemployment Insurance Code, with respect to such work and labor, tlien the Surety or Sureties
herein will pay for the same in an amount not exceeding the sum specified in this bond,
otherwise the above obligation sball be void. In. case suit is brought upon this bond, the said
Surety will pay a reasonable atto=3�s fee to the plaintiff(s) and Owner in an amount to be fixed,
by the court.
This bond shall inure to the benefit of any of the pmons.n=ed 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.
Said Surety� for value received, hereby stipulates and agrees that no change, extension of time,
alteration oT modification of the Contract Documents or of the work to be performed theretmder
-9-
shall in any W-,ty affect its obligations On this bond, and it does hereby waive notice of such
change, extension of time, alteration otmodification Of the Contract Documents or of work to be
performed thereunder.
IN WITNESS WHEREOF, we have hereunto set our hands and seals on this 25th dav of
March 2009 —.1
American Asphalt South, Inc.
CON TO
0
� By:
R
-10-
The Guarantee Company of North America U A
SURETY
By:
Im,. B. SlhelaAt4t.,y�-inFd
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of
Santa Clara
On March 25, 2009 before me, D. Guzman, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared James B. Shea, Attorney -in -Fact
Narne(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(o) whose name(j) isMm subscribed to the
within instrument and acknowledged to me that
he/shefter executed the same in his/herAfteif-authorized
0 capacity0es), and that by his,4%mfteir-signature(j) on the
C"011111"10101 1762739 instrument the person(i), or the entity upon behalf of
Nowy pwk - caftwo which the person(j) acted, executed the instrument.
soft CW8 CVAIY
20. 2011 1 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 al.
Place Notary Sea[ Above Signature- tsehIL6
I OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
L. Individual
E Corporate Officer —Title (s):
L, Partner — El Limited 11 General
* Attorney in Fact
* Trustee
* Guardian or Conservator
D Other:
Signer Is Representing:
RIGHT THUMBPRINT
OF SIGNER
Top of thumb here
Number of Pages:
Signer's Name:
L1 Individual
EJ Corporate Officer — Title(s):
1-3 Partner — L1 Limited 0 General
El Attorney in Fact
D Trustee
LJ Guardian or Conservator
LJ Other:
Signer Is Representing:
RIGHTTHUMBPRINT
OF SIGNER
Top of thumb here
02007 National Notary Association - 9350 De Solo Ave., PO_ Box 2402 -Chatsworth, CA 91313-2402 - www.NationaiNotary.org JIGM#5907 Reorder: Call Toll -Free 1-BW-876�61V7
THE GUARANTEE COMPANY OF NORTH AMERICA USA
SoutlTield, MicWgan
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the
laws of the State of Michigan, having its principal office in Southfield, Michigan, does hereby constitute and appoint
Jeffrey N. Aber, Janies B. Shea, Dora M. Hockett, Dianna Guzinan
Leavitt Pacific Insurance Brokers, Inc.
its true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of
indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract
or ot he rwise.
The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA
USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the
principal office.
The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws
adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31 d day of December, 2003.
The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority:
I . To appoint Aftorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds
and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and
2. To revoke, at any time, any such Attorney-in-fact and revoke the authority given, except as provided below
3. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to
the Aftorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner —
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting
duly called and held on the 314 day of December 2003, of which the following is a true excerpt:
RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification
thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and
such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused
this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 5�h day of
TE4 January, 2009.
THE GUARANTEE COMPANY OF NORTH AMERICA USA
?"h A
STATE OF MICHIGAN Stephen Dullard, Vice President Randall Musselman, Secretary
County of Oakland
On this 5 th day of January, 2009 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly
sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said
instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of
said Company.
lmlwffffillh� Cynthia A. Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee
Notary Public, State of Michigan Company of North America USA offices the day and year above written.
County of Oakland
My Commission Expires February 27, 2012
AcUng in Oakfand County AbU4_'� 0 -
1, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true
and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect.
IN WIT�ESS WHEREOF, I nave thereunto set my hand and attached the seal of said Company this 25th day of March, 2009.
Randall Musselman, Secretary