HomeMy WebLinkAbout2007-027
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RESOLUTION NO. 2007-27
RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO AUTHORIZING THE EXECUTION OF AN AGREEMENT AND
PURCHASE ORDER TO RUBBERIZED CRACKFILLER SEALANT, INC. FOR
CRACK-SEALING THROUGHOUT THE CITY OF SAN BERNARDINO.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. That Rubberized Crackfiller Sealant, Inc. submitted the lowest bid
for the negotiated purchase for crack-sealing services in the total amount of
$69,400.00.
Pursuant to this determination the Purchasing Manager is hereby
authorized to issue a purchase order to Rubberized Crackfiller Sealant, Inc. in the
amount of $69,400.00.
SECTION 2. That Rubberized Crackfiller Sealant, Inc. shall enter into a
Vendors Service Agreement in the form attached hereto in the total amount of
$69,400.00 and the Purchasing Manager may issue a purchase order for said amount.
SECTION 3. The Purchase Order shall reference this Resolution NO.2007 - 27
and shall read, "Rubberized Crackfiller Sealant, Inc. for crack-sealing services at
various locations throughout the City of San Bernardino." P.O. No.
, not to
exceed $69,400.00 and shall incorporate the terms and conditions of the purchase
order.
SECTION 4. The authorization to execute the above referenced Agreement
and Purchase Order is rescinded if not issued within sixty (60) days of the passage of
this resolution.
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January 18. 2007
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RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO AUTHORIZING THE EXECUTION OF AN AGREEMENT AND
PURCHASE ORDER TO RUBBERIZED CRACKFILLER SEALANT, INC. FOR
CRACK-SEALING THROUGHOUT THE CITY OF SAN BERNARDINO.
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the
Mayor and Common Council of the City of San Bernardino at a joint regular
22nd
January
, 2007, by the
day of
meeting thereof, held on the
following vote, to wit:
Council Members: AYES NAYS ABSTAIN ABSENT
ESTRADA x
BAXTER x
BRINKER x
DERRY x
KELLEY x
JOHNSON x
MCCAMMACK x
~h.~
Rachel G. Clark, City Clerk
l~
~ ~ 14.-:::--
day of
The foregoing resolution
January , 2007.
is hereby approved this
Tobin Brinker, Mayor Pro Tern
City of San Bernardino
Approved as to Form:
January 18, 2007
.
2007-27
VENDOR SERVICE AGREEMENT
This Vendor Service Agreement is entered into this 22nd day of January
2007, by and between Rubberized Crackfiller Sealant, Inc. ("VENDOR") and the City of San
Bernardino ("CITY" or "San Bernardino").
WITNESSETH:
WHEREAS, the Mayor and Common Council has determined that it is advantageous
and in the best interest of the CITY to acquire crack filling services; and
WHEREAS, the City of San Bernardino did solicit and accept bids from a number of
vendors who can provide the necessary crack filling services.
NOW, THEREFORE, the parties hereto agree as follows;
1. SCOPE OF SERVICES.
For the remuneration stipulated, San Bernardino hereby engages the services of
VENDOR to provide the services as set forth in Exhibit "A", Bid Specification No. F-07-21,
attached hereto and incorporated herein by this reference.
2. COMPENSATION AND EXPENSES.
a. For the services delineated above, the CITY, upon presentation of an invoice, shall
pay the VENDOR the amount of $69,400 for crack filling 200,000 lineal feet of
City streets.
b. No other expenditures made by VENDOR shall be reimbursed by CITY,
3. TERM; SEVERABILITY.
The term of this Agreement shall be for a period of one year.
This Agreement may be terminated at any time by thirty (30) days written notice by
either party. The terms of this Agreement shall remain in force unless mutually amended. The
duration of this Agreement may be extended with the written consent of both parties.
2007-27
4. INDEMNITY.
CITY agrees to indemnify and hold harmless VENDOR, its officers, agents and
volunteers from any and all claims, actions, or losses, damages andlor liability resulting from
CITY's negligent acts or omissions arising from the CITY's performance of its obligations
under the Agreement.
VENDOR agrees to indemnify and hold harmless the CITY, its officers, agents, and
volunteers from any and all claim, actions, or losses, damages andlor liability resulting from
VENDOR's negligent acts or omissions arising from the VENDOR's performance of its
obligations under the Agreement.
In the event the CITY andlor the VENDOR is found to be comparatively at fault for any
claim, action, loss, or damage which results from their respective obligations under the
Agreement, the CITY andlor VENDOR shall indemnify the other to the extent of this
comparative fault.
5. INSURANCE.
While not restricting or limiting the forgoing, during the term of this Agreement,
VENDOR shall maintain in effect policies of comprehensive public, general and automobile
liability insurance, in the amount of $1,000,000.00 combined single limit, and statutory
worker's compensation coverage, and shall file copies of said policies with the CITY's Risk
Manager prior to undertaking any work under this Agreement. CITY shall be set forth as an
additional named insured in each policy of insurance provided hereunder. The Certificate of
Insurance furnished to the CITY shall require the insurer to notify CITY of any change or
termination in the policy.
III
2007-27
6. NON-DISCRIMINATION.
In the performance of this Agreement and in the hiring and recruitment of employees,
VENDOR shall not discriminate on the basis of race, creed, color, religion, sex, physical
handicap, ethnic background or country of origin.
7. INDEPENDENT CONTRACTOR.
VENDOR shall perform work tasks provided by this Agreement, but for all intents and
purposes VENDOR shall be an independent contractor and not an agent or employee of the
CITY. VENDOR shall secure, at its expense, and be responsible for any and all payment of
Income Tax, Social Security, State Disability Insurance Compensation, Unemployment
Compensation, and other payroll deductions for VENDOR and its officers, agents, and
employees, and all business license, if any are required, in connection with the services to be
performed hereunder.
8. BUSINESS REGISTRATION CERTIFICATE AND OTHER REQUIREMENTS.
VENDOR warrants that it possesses or shall obtain, and maintain a business registration
certificate pursuant to Chapter 5 of the Municipal Code, and any other license, permits,
qualifications, insurance and approval of whatever nature that are legally required of VENDOR
to practice its business or profession.
9. NOTICES.
Any notices to be given pursuant to this Agreement shall be deposited with the United
States Postal Service, postage prepaid and addressed as follows:
TO THE CITY:
Public Services Director
300 North "D" Street
San Bernardino, CA 92418
Telephone: (909) 384-5140
III
2007-27
13. GOVERNING LAW.
This Agreement shall be governed by the laws of the State of California.
14. SUCCESSORS AND ASSIGNS.
This Agreement shall be binding on and mure to the benefit of the parties to this
Agreement and their respective heirs, representatives, successors, and assigns.
15. HEADINGS.
The subject headings of the sections of this Agreement are included for the purposes of
convenience only and shall not affect the construction or the interpretation of any of its
proviSIOns.
16. ENTIRE AGREEMENT; MODIFICATION.
This Agreement constitutes the entire agreement and the understanding between the
parties, and supercedes any prior agreements and understandings relating to the subject manner
of this Agreement. This Agreement may be modified or amended only by a written instrument
executed by all parties to this Agreement.
III
III
III
III
III
III
III
2007-27
IN WITNESS THEREOF, the parties hereto have executed this Agreement on the day
and date set forth below.
Dated: z;jt ,200Z
VENDOR.
By: fj1~A
Its: c;;e (J {/'laM ft-
.
Dated
/ -,:lj/ , 200..7
CITY OF SAN BERNARDINO
By: C}6-lA.~
Tobin Brinker, Mayor Pro Tern
City of San Bernardino
Approved as to Form:
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TECHNICAL SPECIFICATIONS
BID SPECIFICATION NO. F-07-21
Crack Sealing
NOTICE:
"SPECIAL INSTRUCTIONS TO THE BIDDER"
Requirements: Bidder shall state brief reasoning lor exceptions to requirements when not
acceptable or state "Acceptable" ifrequirements are agreeable. Failure to
complete right hand column will invalidate bid.
Pricing:
Bidder shall complete pricing along with all requested information as listed.
Pricing and inf,)rtnation not listed will be considered not available from vendor.
Failure to complete all pricing and information as rcquested may be cause for
rejection.
A. Traffic Control
The Contractor shall be responsible lor providing traffic control and posting of"No Parking"
signs for all projects assigned. Signs shall be postcd at I 50-foot intervals a minimum of forty-
eight (48) hours prior to beginning work. Undcr no circumstances shall signs be attached to trees,
shrubs. or any other vegetation. Alltraftic contmlmeasures sholl be subject to approval by the
City. representativ~.
Accepwble As Specilied
n. Work Site Schedule
Work sites shall be located throughout thc entire City. Contract Administrator will provide to the
Contractor a list of selected work sites. Work shall commence within ten (10) colendar days of
list being provide.d. The list provided will include:
Street Names (starting and ending point)
Square footage of Street Segment
Acceptable As Specitied ~ (,
C. Work Standards
Contractor shall adhere to all applicablc requirements including but not limited to:
7
.
.
.
~OOO Edition of the Standard Specifications for Public Works Construction, commonly referred to
as [he "Cireenbook".
Latest Edition o[the CaliflJrnia [Jepartment o[Transportation. Manual of Traffic Controls for
Construction anu MaintellLlnct.' \Vork LOlles.
Acceptable As Specified ')-',)
D. Crllck Sell ling Requirements
Cracks to be scaled shall be JlX inch ,lI' larger. COlHractor shall seal only transverse. longitudinal.
block. or rdkctive cracks. Contractor shall not seal alligator cracked areas.
Acceptable As Specified (I \)
;\ II cracks to be scaled shall be completely clean. dry, and free of all loose material. vegetation.
311U any other foreign substancc. which may cause the sealant not to a~here to the crack wall.
SPECIFICA nONS
Cracks shall be cleaned using a hot ClJmpressed air lance (HCL) apparatus. The Contractor shall
clean and dry all cracks \\ith the IICI. immcdiately before scaling. Air exiting the lance shall be
heated to a temperature surticient enough to remove the oxidized sur.tace from the crack walls.
The HCL shall meet the fl)llo\\ing specitications:
a. Compressed air capacity: 40 to 100 CFM. 75 to 150 PSI
b. Heated air temperature: 600 to ~.OOO Fahrenheit
Crack sealant mawrial used shall be Road Works 306. or CRAFCO Polytlex Type 3, or an
approved equal. Sealant shall be prepared and applied to the pavement cracks in conformance
\\ith alll11anutacturers' instructions except \\here noted otherwise in this document.
Sealant shall be applied ti'olllthe bottom of the crack up to the surface in a manner. which does
not result in sealant bridging or entrapping air pockets. The sealant shall be applied to a slightly
overfilled condition and then leveled with a squeegee. The overband shall not exceed I y, inches
on either siJ~ of the crack.
Acceptable As Specilied f'1'l
E. Insurance ,11111 License
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Contractor must have insurance coverage from an insurance carrier licensed in the State of
Calitl'fnia anu rated "A" or bener by tbe A.tvl. 8est Key Rating Guide, Coverage shall include:
Commereial General Liability Itlr a minimum of one million dollars each occurrence ($1,000,000
EO), The City of San Bernardino must be named as an additional insured on the certilicate,
Automobile Liability It1l' a millimum of one million dollars combincd single limit ($ 1.000,000
CSL), The City ot'San8ernardino must be named as an additional insured on the certilicate,
Workers' Compensation wverage shall bc in accordance with the laws of the State of California,
Contractor must hold a C-32 Stdte Contractor's License, Please provide License Class and
Number.
Contractor l11ust have a Cit: is;:;..ucd business license.
Acceptable As Specified f b
F. Scope of Work
Contract shall bid completion of200.000 lineal feet of crack sealing work on a per lineal foot
basis, All costs associated with this work shall be included in the cost per lineal foot. These costs
may include. but arc not limited to insurance, traffic control. mobilization, overhead, equipment
rates, labor and material.
Contractor shall indicate in their response if their price can be used to award a second year of
simildr work with at least 200,000 lineal feel.
Aceeptable As Spec i tied ;.. \)
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PRICE FORM
REQUEST FOR QUOTES:
RFQ 1'-07-21
DESCRIPTION OF RFQ:
Crack Sealing
BIDDER'S NAME/ADDRESS
BOND BLACKTOP, INC.
P.O. Box 616
Union City CA 94587
NAME/TELEPHONE NO. OF
AUTHORIZED REPRESENTATIVE Edward Dillon (510) 441-9981. ext. 110
or Eduardo Aguerro (916) 772-9342 (estimator)
FAX NO.
(510) 441-9982
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I. Crac~ Scaling - 201l.000 Lincal Fcet
PRICE FORM
UII;I Coxl per Lineal Feet $ 0.39
Price may be used to award a second year of similar work with at least 200,000 lineal feet.
,/
Yes 0io ~
,
Or
Percentage increase of
AUTHORIZED SIGNATURE:
PRINT SIGNER"S NAME AND TITLE:
DA TE SIGNED:
TELEPHONE:
CO:V1PANY NAME & ADDRESS:
PHONE: (510) 441-9981
% for the second year.
PrI"nvn ft'r,._
Edward Dillon, President
11/20/06
(510) 441-9981
Bond Blacktop, Inc.
P.O. Box 616
Union City CA 94587
FAX: (510) 441-99B2
. Are there any other additional or incidental costs required by your firm? Yes Ie)
(circle one). If)ou answcred "Yes". please provide detail of said additional costs:
Have you included in your bid ':." informational items and forms as reqUestedG) I
(cIrcle one). It you answered "No . please cxplaln:
No
This offer shall remain tirm for 90 days from RFQ close date. Terms and conditions as set forth
in this RFQ apply to this bid. Cash discount allowable % days; unless otherwise
stated. paymcnt terms arc: Net thirty (30) days. In signing this bid. Bi9der warrants that all
certilicalions and documents requested herein are attached and properly completed and signed.
From time 10 time. the City may issuc one or more addenda to this RFQ. Below. please indicate
all Addenda to this RFQ received by your firm. and the date said Addenda was/were received.
.
Verilication of Addenda Received r;r-'r,' r,; '.' :~. t
Addcnda No:
Addenda No:
Addenda No:
Received on:
Received on:
Received on:
AUTHORIZED SIGNATURE:
~AJ'Y-\,~ (Ct,~
PRINT SIGNER'S NAME AND TITLE:
Edward Dillon, President
DATE SIGNED:
J 1/20/06
COMPANY NAME & ADDRESS:
Bond Blacktop, Inc.
P.O. Box 616
Union City CA 94587
PHONE: (510) 441-9981
FAX: (510) 441-9982
.
.
.
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IF SUBMITTING A "NO BID", PLEASE STATE REASON(S) BELOW;
NON - COLLUSION AFFIDAVIT
TO: THE COMMON COUNCIL. CITY OF SAN BERNARDINO
In accordancc with Title 23. I ;nitcd States Code. Section 112. the undersigned hereby states,
under penalty of perjury:
That he/she has not. either directly or indirectly. entered into any agreement. participated in any
collusion. or otherwise taKen action in restraint of free competitive bidding in connection with
RFQ 1'-07-21.
Business Name Bond Blacktop, Inc.
Busincss Addrcss P.O. Box 616, Union City CA 94587
Signature of bidder X FC\Il7i"t1 !.1c...
Union City , CA
Place of Residence
SEE ATTACHED NOTARY ACKNOWLEDGMENT
Subscrihed and sworn befrm.: me this
day of
,20_
Notary Public in and for the County of
. State of California,
My commission expires__
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CALIFORNIA ALL.PURPOSE ACKNOWLEDGMENT
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TECHNICAL SPECIFICATIONS
BID SPECIFICATION NO. F-07-21
NOTICE:
Crack Sealing
"SPECIAL INSTRUCTIONS TO THE BIDDER"
Requirements: Bidder shall state brief reasoning for exceptions to requirements when not
acceptable or state "Acceptable" if requirements are agreeable. Failure to
complete right hand column will invalidate bid.
Pricing:
Bidder shall complete pricing along with all requested information as listed.
Pricing and information not listed will be considered not available from vendor.
Failure to complete all pricing and information as requested may be cause for
rejection.
A. Traffic Control
e
The Contractor shall be responsible for providing traffic control and posting of "No Parking"
signs for all projects assigned. Signs shall be posted at ISO-foot intervals a minimum of forty-
eight (48) hours prior to beginning work. Under no circumstances shall signs be attached to trees,
shrubs, or any other vegetation. All traffic control measures shall be subject to approval by the
City representative.
\.
'.
A,(:Cr7/'IAf:.f..~
Acceptable As Specified
B. Work Site Scbedule
Work sites shall be located throughout the entire City. Contract Administrator will provide to the
Contractor a list of selected work sites. Work shall commence within ten (10) calendar days of
list being provided. The list provided will include:
Street Names (starting and ending point)
Square footage of Street Segment
Acceptable As Specified //Cr:~f'74"'''-E
C. Work Standards
e Contractor shall adhere to all applicable requirements including but not limited to:
7
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2000 Edition of the Standard Specifications for Public Works Construction, commonly referred to
as the "Greenbook".
Latest Edition of the California Department of Transportation. Manual of Traffic Controls for
Construction and Maintenance Work Zones.
Acceptable As Specified
A((:C;~T4JI.'~
D. Crack Sealing Requirements
Cracks to be sealed shall be 1/8 inch or larger. Contractor shall seal only transverse. longitudinal,
block. or reflective cracks. Contractor shall not seal alligator cracked areas.
Acceptable As Specified ,4('('c;:"T/18J,,/2
A II cracks to be sealed shall be completely clean, dry. and free of all loose material. vegetation,
and any other foreign substance. which may cause the sealant not to adhere to the crack wall.
SPECIFICA nONS
Cracks shall be cleaned using a hot compressed air lance (HCL) apparatus. The Contractor shall
clean and dry all cracks with the HCL immediately before sealing. Air exiting the lance shall be
heated to a temperature sufficient enough to remove the oxidized surface from the crack walls.
The HCL shall meet the following specifications:
a. Compressed air capacity: 40 to 100 CFM, 75 to 150 PSI
b. Heated air temperature: 600 to 2,000 Fahrenheit
Crack sealant material used shall be Road Works 306. or CRAFCO Polyflex Type 3, or an
approved equal. Sealant shall be prepared and applied to the pavement cracks in conformance
with all manufacturers' instructions except where noted otherwise in this document.
Sealant shall be applied from the bottom of the crack up to the surface in a manner, which does
not result in sealant bridging or entrapping air pockets. The sealant shall be applied to a slightly
overfilled condition and then leveled with a squeegee. The overband shall not exceed I Y, inches
on either side of the crack.
Acceptable As Specified .'.:r . Jr: '::{<.'J~'" :':
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Insurance and License
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Contractor must have insurance coverage from an insurance carrier licensed in the State of
California and rated "AU or better by the A.M. Best Key Rating Guide. Coverage shall include:
Commercial General Liability for a minimum of one million dollars each occurrence ($1,000,000
EO). The City of San Bernardino must be named as an additional insured on the certificate.
Automobile Liability for a minimum of one million dollars combined single limit ($1,000,000
CSL). The City of San Bernardino must be named as an additional insured on the certificate.
Workers' Compensation coverage shall be in accordance with the laws of the State of California.
Contractor must hold a C-32 State Contractor's License. Please provide License Class and
Number.
Contractor must have a City issued business license.
Acceptable As Specified
/1(' (t.'I-'T/i,i:t.,:
F. Scope of Work
Contract shall bid completion of 200,000 lineal feet of crack sealing work on a per lineal foot
basis. All costs associated with this work shall be included in the cost per lineal foot. These costs
may include, but are not limited to insurance, traffic control, mobilization, overhead, equipment
rates. labor and material.
Contractor shall indicate in their response if their price can be used to award a second year of
similar work with at least 200.000 lineal feet.
Acceptable As Specified rJ("'r ".;7I c' (c
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PRICE FORM
REQUEST FOR QUOTES:
RFQ F-07-21
DESCRIPTION OF RFQ:
Crack Sealing
BIDDER'S NAME/ADDRESS:
r~d.'{Ef~/<',:e.! ,/'>:'elr.,~r:i/e.: ;::",;/n/cT 1.<-.
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NAME/TELEPHONE NO, OF
AUTHORIZED REPRESENT A TlVE
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FAX NO.
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1. Crack Sealing - 200,000 Lineal Feet
PRICE FORM
Unit Cost per Lineal Feet $
3~/7
,
2. Price may be used to award a second year of similar work with at least 200,000 lineal feet.
Yes
,/
No
Or
Percentage increase of
~
~-
AUTHORIZED SIGNATURE:
PRINT SIGNER'S NAME AND TITLE:
DATE SIGNED:
TELEPHONE:
COMPANY NAME & ADDRESS:
% for the second year.
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FAX: .7/y~.u/5.Z-/~7;
PHONE: ,,;'/ 'J' Vt.fJ .~/'-:.;..-
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Are there any other additional or incidental costs required by your firm? Yes I
(circle one). If you answered "Yes", please provide detail of said additional costs:
,)
.---'
Have you included in your bid all informational items and forms as requested{ Yes) I No
(circle one). If you answered "No", please explain: -.~
This offer shall remain firm for 90 days from RFQ close gate. Terms and conditions as set forth
in this RFQ apply to this bid. Cash discount allowabl~ % NI'1 days; unless otherwise
stated, payment terms are: Net thirty (30) days. In signing this bid, Bidder warrants that all
certifications and documents requested herein are attached and properly completed and signed.
From time to time, the City may issue one or more addenda to this RFQ. Below, please indicate
all Addenda to this RFQ received by your firm, and the date said Addenda was/were received.
Verification of Addenda Received
Addenda No:
Addenda No:
Addenda No:
Received on:
Received on:
Received on:
AUTHORIZED SIGNATURE:
"
.' ~iI~!.<t'7'
C/?EC (-'/'^H( rl/<!JN,"",,"
PRINT SIGNER'S NAME AND TITLE:
DA TE SIGNED:
/- IF If' :
COMPANY NAME & ADDRESS:
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PHONE: '.', 'f ~'":,,s'. ~"',
FAX: '71'1 Eo''!':: ,S-I ': 'f
[f SUIBMnnNG A "NO Bm", PLEASE STATE REASON(S) BELOW:
e NON - COLLUSION AFFIDAVIT
TO: THE COMMON COUNCIL, CITY OF SAN BERNARDINO
In accordance with Title 23, United States Code, Section 112, the undersigned hereby states,
under penalty of perjury:
That he/she has not, either directly or indirectly, entered into any agreement, participated in any
collusion, or otherwise taken action in restraint of free competitive bidding in connection with
RFQ F-07-21.
Business Name ftjb~I(../-z..~eI CIL/9t!l/';IJ,.. .r"AIA..t j",.,
Business Address foo C W"q/ /l/ut 4V<.. ~/),wf~ C4 9l-FliJ
Signature of bidder ~~~ Aq
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//u~hn..';'" &"",l
Place 0 esidence
c..
Subscribed and sworn before me this
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,20_,
.~//
Notary Public in and for the County of /
/
/
My commission expires //
/
/
,
, State of California.
,20_,
SEE A~~~EO CERTIFICATE 1IR
DATE~&oTARY INITIAl~
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.
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CALIFORNIA .JURAT WITH AffiANT STATEMENT
~~~=^'~~~~~~~ -
State of California
} ss
County of
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Xl See Attached Document (Notary to cross out lines 1-6 below)
o See Statement Below (Lines 1-5 to be completed only by document slgner[s). not Notary)
',--
---
Signature 01 Document Signer No 1
IQnature.
umenl rgnerNo.2(1 any)
).- - - - :~ ~~:2e~4 - J
~ -". Notcry Public . Co'lIOInia ~
. Orange County -
My Carrm, expires Mar 22. 2009
tA)cU, by
Year
(1)
~r.;vIIQlly """-'nrl 18 me
roved to me on the basis of satisfactory evidence
to be the person who appeared before me (,) (.)
(and
(2)
'--
Name of Signer
~
o Persona~wn to me
o Proved to me ~ basis of satisfactory evidence
to be the erson who' ared before me.)
Place Notary Seal Abo...e
OPTIONAL
Though the information below is not required by law, it may prove
valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document
.
Top of thumb here
Top of thumb here
Further Description 01 Any Attached Document , ,
""eo,T,pe 01 Document I'kN - [til~/ hU~i ~1,lt-Wi r
. f'. '
ill i 7/ {LXV Numbe,ol Pages L
Document Date'
Signer(sl Other Than Named Above
~~~~~~~>:!:~_~ _~:...:C~~~~:...:~~"""'_~,.:;: -~
Cl2004 National Notary Assoc,ahono 9J50 De SolO Ave PO 60. 2.t02 'Chalsworttl. CA 91313.2.t02' wwwNat,onalNotal')'Ofg Item '5910 Reorder-Call Toll-Free l-BOQ-876-6827
TECHNICAL SPECIFICATIONS
.
BID SPECIFICATION NO. F-07-21
NOTICE:
Crack Sealing
"SPECIAL INSTRUCTIONS TO THE BIDDER"
Requirements: Bidder shall state brief reasoning for exceptions to requirements when not
acceptable or state "Acceptable" if requirements are agreeable. Failure to
complete right hand column will invalidate bid.
Pricing:
Bidder shall complete pricing along with all requested information as listed.
Pricing and information not listed will be considered not available from vendor.
Failure to complete all pricing and information as requested may be cause for
rejection.
A. Traffic Control
Thc Con:ra~..or shall be responsible for providing traffic control and posting of "No Parking"
signs for "II projects assigned. Signs shall be posted at ISO-foot intervals a minimum of forty-
eight (4S) heurs prior to beginning work. Under no circumstances shall signs be attached to trees;
':lcubs. or any other vegetation. All traffic control measures shall be subject to approval by the
e Cit)' representative. /?h-' - :/-{
Acceptable As Specified (7:~>>
B. Work Site SChett;{-
Work sites shall be located throughout the entire City. Contract Administrator will provide to the
Contractor a list of selected work sites. Work shall commence within ten (10) calendar days of
list being provided. The list provided will include:
Street Names (st(lrting ande:tding oint)
Square footage of Street Segmen
." -~
/ \~
Acceptable As Specified( -" ~-----z.....
/
/
C. Work Standards
Contractor shall adhere to all applicable requirements including but not limited to:
.
7
.
.
.
2000 Edition of the Standard Specifications for Public Works Construction, commonly referred to
as the "Greenbook".
Latest Edition of the California Depa)lmel)t of Transportation, Manual of Traffic Controls for
Construction and Maintenance Work Zopes;'o >-
//' \ /"
Acceptable As Specified (0/ ~)~_______
(/ .
D. Crack Sealing Re~irements
;'
Cracks to be sealed shall be 1/8 inch or I~er. Contractor shall seal only transverse, longitudinal,
block, or reflective cracks. Contractor",hall not seal alligator cracked areas.
Acceptable As Specified,' .. r~~'~-~
" C
All cracks to be sealed S'II be completely clean, dry, and free of all loose material, vegetation,
and any other foreign substance, which may cause the sealant not to adhere to the crack wall.
SPECIFICA nONS
Cracks shall be cleaned using a hot compressed air lance (HCL) apparatus. The Contractor shall
clean and dry all cracks with the HCL immediately before sealing. Air exiting the lance shall be
heated to a temperature sufficient enough to remove the oxidized surface from the crack walls.
The HCL shall meet the following specifications:
a. Compressed air capacity: 40 to 100 CFM, 75 to 150 PSI
b. Heated air temperature: 600 to 2,000 Fahrenheit
Crack sealant material used shall be Road Works 306, or CRAFCO Polyflex Type 3, or an
approved equal. Sealant shall be prepared and applied to the pavemeni cracks in conformance
with all manufacturers' instructions except where noted otherwise in this document.
Sealant shall be applied from the bottom of the crack up to the surface in a manner, which does
not result in sealant bridging or entrapping air pockets. The sealant shall be applied to a slightly
overfilled condition and then leveled with a squeegee. The overband shall not exceed I y, inches
on either side of the crack. o'-/'~
Acceptable As speCified~~
/~;/
.(, ,
E. Insurance and License
8
.
.
.
Contractor must have insurance coverage from an insurance carrier licensed in the State of
California and rated "A" or better by the A.M. Best Key Rating Guide. Coverage shall include:
Commercial General Liability for a minimum of one million dollars each occurrence ($1,000,000
EO). The City of San Bernardino must be named as an additional insured on the certificate.
Automobile Liability for a minimum of one million dollars combined single limit ($1,000,000
CSL). The City of San Bernardino must be named as an additional insured on the certificate.
Workers' Compensation coverage shall be in accordance with the laws of the State of California.
Contractor must hold a C-32 State Contractor's License. Please provide License Class and
Number.
Contractor must have a City .issued b~i7~~
Acceptable As Specified / ~.::-'----
//
F, Scope ofWorly--
Contract shall bid completion of200,000 lineal feet of crack sealing work on a per lineal foot
basis. All costs associated with this work shall be included in the cost per lineal foot. These costs
may include, but are not limited to insurance, traffic control, mobilization, overhead, equipment
rates, labor and material.
Contractor shall indicate in their respons'-,iftheir price can be used to award a second ye., of
similar work with at least 2~0~:OOO.?~~ ~
Acceptable As speclfied,.~~ ~.
~" /'
/'
9
PRICE FORM
e
I. Crack Sealing - 200,000 Lineal Feet
Unit Cost per Lineal Feet $ . 4499
2. Price may be used to award a second year of similar work with at least 200,000 lineal feet.
Yes X
Or
No
Percentage increase of
% for the second
A UTHORIZED SIGNATURE:
PRINT SIGNER'S NAME AND TITLE:
(
s. Nelson * President
DA TE SIGNED:
TELEPHONE:
COMPANY NAME & ADDRESS:
November 21. 2006
951-940-0200
NPG Corporation
P 0 Hal< 151S
Perris. CA 92572
FAX: 951-940-9192
e
PHONE: 951-940-0200
e
,,.,., .,.-
---""
e
e
e
I. Crack Sealing - 200,000 Lineal Feet
PRICE FORM
Unit Cost per Lineal Feet $ .4499
2. Price may be used to award a second year of similar work with at least 200,000 lineal feet.
Yes X
Or
Percentage increase of
No
AUTHORIZED SIGNATURE:
PRINT SIGNER'S NAME AND TITLE:
DATE SIGNED:
TELEPHONE:
COMPANY NAME & ADDRESS:
PHONE: 951-940-0200
-"
% for the second.
S. Nelson * President
November 21, 2006
951-940-0200
NPG Corporation
P O. Box 1515
Perris, CA 92572
FAX: 951-940-9192
e
e
e
Are there any other additional or incidental costs required by your firm? Yes / Q
(circle one). If you answered "Yes", please provide detail of said additional costs:
Have you included in your bid all informational items and forms as reqUestedG / No
(circle one). If you answered "No", please explain:
This offer shall remain firm for 90 days from RFQ close date. Terms and conditions as set forth
in this RFQ apply to this bid. Cash discount allowable Nip., % days; unless otherwise
stated, payment terms are: Net thirty (30) days. In signing this bid, Bidder warrants that all
certifications and documents requested herein are attached and properly completed and signed.
From time to time, the City may issue one or more addenda to this RFQ. Below, please indicate
all Addenda to this RFQ received by your finn, and the date said Addenda was/were received.
Verification of Addenda Received
Addenda No: N:YE
Addenda No:
Addenda No:
Received on:
Received on:
Received on:
/
,
/'
AUTHORIZED SIGNATURE:
PRINT SIGNER'S NAME AND TITLE:
S. Nelson
President
DATE SIGNED:
November 21. 2006
COMPANY NAME & ADDRESS:
NPG Corporation
P.O. BOX 1515
Perris, CA 92572
PHONE: q~1-q4n-n?nn
FAX: q~1-g4n-g1 g2
.
.
.
IF SUBMITTING A "NO BID", PLEASE STATE REASON(S) BELOW:
NON - COLLUSION AFFIDAVIT
TO:
THE COMMON COUNCIL, CITY OF SAN BERNARDINO
In accordance with Title 23, United States Code, Section 112, the undersigned hereby states,
under penalty of perjury:
That he/she has not, either directly or indirectly, entered into any agreement, participated in any
collusion, or otherwise taken action in restraint of free competitive bidding in connection with
RFQ F-07-21.
Business Name NPG Corporation
CA 92572
Perris, California
Place of Residence
Subscribed and sworn before me this
21 st day of November
,2006
Notary Public in and for the County of
Riverside
, State of California.
My commission expires
September 2
,20Jl.L.
~o/~
~------------J
~ SHARON J. NELSON
_ Commission" 1511052
i .. Notary Public. CoNlomla i
, RlveBlde County , -
j _ _ _ ~:o~m.:..E.~re~Se!2.:.2~t
.
TECHNICAL SPECIFICATIONS
.
City of San Bernardino
.
6
.
.
.
TECHNICAL SPECifICATIONS
BID SPECIFICATION NO. F-07-2I
NOTICE:
Crack Sealing
"SPECIAL INSTKUCTIONS TO THE BIDDER"
Requirements: Bidder shall state brief reasoning for exceptions to requirements when not
acceptable or state "Acceptable" if requirements are agreeable. Failure to
complete right hand column will invalidate bid.
Pricing:
Bidder shall complete pricing along with all requested information as listed.
Pricing and information not listed will be considered not available from vendor.
Failure to completc all pricing and information as requested may be cause for
rejection.
A. Traffic Control
The Contractor shall be responsible for providing traffic control and posting of "No Parking"
signs for all projects assigned. Signs shall be posted at ISO-foot intervals a minimum of forty-
eight (48) hours prior to beginning work. Under no circumstances shall signs be attached to trees,
shrubs, or any other vegetation. All traffic control measures shall be subject to approval by the
City representative.
Acceptable As Specitied
Acceptable
B. Work Site Schedule
Work sites shall be located throughout the entire City. Contract Administrator will provide to the
Contractor a list of selected work sites. Work shall commence within ten (10) calendar days of
list being provid,d. The list provided will include:
Street Names (starting and ending point)
Square loolage of Street Segment
Acceptable As Specitied
Acceptable
C. Work Standards
Contractor shall adhere to all applicable requirements including but not limited to:
7
e
e
e
2000 Edition of the Standard Specifications for Public Works Construction, commonly referred to
as the "Greenbook".
Latest Edition of the California Department of Transportation, Manual ofTraftic Controls for
Construction and Maintenance Work Zones.
Acceptable As Specified
Acceptable
D. Crack Sealing Requirements
Cracks to be sealed shall be I/g inch or larger. Contractor shall seal only transverse, longitudinal,
block, or retlective cracks. Contractor shall not seal alligator cracked areas.
Acceptable As Specified
Acceptable
All cracks to be sealed shall be completely clean, dry, and free of all loose material, vegetation,
and any other foreign substance, which may cause the sealant not to a'dhere to the crack wall.
SPECIFICA nONS
Cracks shall be cleaned using a hot compressed air lance (HCL) apparatus. The Contractor shall
clean and dry all cracks with the HCL immediately before sealing. Air exiting the lance shall be
heated to a temperature sufficient enough to remove the oxidized surface from the crack walls.
The HeL shall meet the following specifications:
a. Compressed air capacity: 40 to 100 CFM, 75 to 150 PSI
b. Heated air temperature: 600 to 2,000 Fahrenheit
Crack sealant material used shall be Road Works 306, or CRAFCO Polytlex Type 3, or an
approved equal. ''Sealant shall be prepared and applied to the pavement cracks in conformance
with all manufacturers' instructions except wherc noted otherwise in this document.
Sealant shall be applied from the bottom of the crack up to the surface in a manner, which does
not result in sealant bridging or entrapping air pockets. The sealant shall be applied to a slightly
overtilled condition and then leveled with a squeegee. The overband shall not exceed 1 \/, inches
on either side of the crack.
Acceptable As Specilied
Acceptable
E. Insurance and License
8
e
e
e
Contractor must have insurance coverage from an insurance carrier licensed in the State of
California and rated "A" or better by the A.M. Best Key Rating Guide. Coverage shall include:
Commercial General Liability for a minimum of one million dollars each occunence ($1,000,000
EO). The City of San Bernardino must be named as an additional insured on the certificate.
Automobile Liability for a minimum of one million dollars combined single limit ($1 ,000,000
CSL). The City of San Bernardino must be named as an additional insured on the certificate.
Workers' Compensation coverage shall be in accordance with the laws of the Slate of California.
Contractor must hold a C-32 State Contractor's License. Please provide License Class and
Number.
Contractor must have a City issued business license.
Acceptable As Specified
Acceptable
F. Scope of Work
Contract shall bid completion of 200,000 lineal feet of crack sealing work on a per lineal foot
basis. All costs associated with this work shall be included in the cost per lineal foot. These costs
may include, but are not limited to insurance, traffic control, mobilization, overhead, equipment
rates, labor and material.
Contractor shall indicate in their response if their price can be used to award a second year of
similar work with at least 200,000 lineal feet.
Acceptable As Specified
Acceptable
9
.
e
.
REQUEST FOR QUOTES:
DESCRIPTION OF RFQ:
HlDDER'S NAME/ADDRESS:
PRICE FORM
RFQ F-07-2!
Crack Sealing
Road Works, Inc.
303 Short Street
Pomona, CA 91768
NAME/TELEPHONE NO. OF
AUTHORIZED REPRESENTATIVE
FAX NO.
Nathan Blocker
(909) 469 5101 / (626) 945 3509
(909) 469 5112
.
.
e
1. Crack Sealing - 200,000 Lineal Feet
PRICE FORM
VI/it Cost per Lineal Feet $
0.36
2. Price may be used to award a second year of similar work with at least 200,000 lineal feet.
Yes
No
Or
Percentage increase of CPI or 5 % for the second year.
.I
AUTHORIZED SIGNATURE:
PRINT SIGNER'S NAME AND TITLE:
DATE SIGNED:
TELEPHONE:
COMPANY NAME & ADDRESS:
PHONE: (909) 469 5101
.-J
C ",-
/~~
/
Larry Blocker, President
/J.2D~O~
.
(909) 469 5101 / (818) 612 0884
Road Works, Inc.
303 Short Street
Pomona, CA 91768
FAX: (909) 469 5112
.
.
.
Are there any other additional or incidental costs required by your firm? Yes / @
(circle one). lfyou answered "Yes", please provide detail of said additional costs:
Haw you included in your bid ~," informational items and forms as requested?@ / No
(cIrcle one). If you answered "No, please explam:
This offer shall remain firm for 90 days from RFQ close date. Terms and conditions as set forth
in this RFQ apply to this bid. Cash discount allowable - % days; unless otherwise
stated, payment terms are: Net thirty (30) days. In signing this bid, Bidder warrants that all
certifications and documents requested herein are attached and properly completed and signed.
crom time to time, the City may issue one or more addenda to this RFQ. Below, please indicate
all Addenda to this RFQ received by your firm, and the date said Addenda was/were received.
Verification of Addenda Received
Addenda No:
Addenda No:
Addenda No:
N/A
N/A
N/A
Received on:
Received on:
R""i"""~,
AUTHORIZED SIGNATURE:
6It./.
Blocker, President
PRINT SIGNER'S NAME AND TITLE:
Larry
II . 376 .-/~
DATE SIGNED:
COMPANY NAME & ADDRESS:
Road Works, Inc.
303 Short Street
Pomona, CA 91768
PHONE: (909) 469 5101
FAX: (909) 469 5112
.
.
.
IF SUBMITTING A "NO BID", PLEASE STATE REASON(S) BELOW:
NON - COLLUSION AFFIDAVIT
TO THE COMMON COUNCIL. CITY OF SAN BERNARDINO
In accordance with Title 23, United States Code, Section 112, the undersigned hereby states,
under penalty of perjury:
That he/she has not, either directly or indirectly. entered into any agreement, participated in any
collusIOn, l1r otherwise taken action in restraint of free competitive bidding in connection with
RH) 1-07-21.
Business Namc Road Works, Inc.
Business Address 303_ShorUtreet.
/
Pomona,
.-----, .
I~
C1L91768
Signature ofhidder X ~
c/ 0
5141 Picasso Dr., Chino Hills, CA 91709
Place of Residence
Suhscrihed and sworn before me this
1/
day of November ,2oP-6
Notary Public in and forthe County of 51n /Y"'J(JIJfr)1 nD , State of California.
My commission expires J(L f)U/.l r'i /4 .,20#.
~U'ud-'L L. 'i3lLl-t' ~IL
. -. ~---~.. " .
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Page 1/1
909 4695112 ; Nov'20-0e 11 :55;
.sen~:~ ;OF SAN BERN.ARDINO BUSINESS ~G[S) TlON CERTIFICATEAPPLlCAT N
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cITY CLER~
300 NORTH 0 STREET
S~N 0ERN~RDIN, CA 92410
TIO: 00006414116
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AmlIJ~ COOt, 020243 SEa, i02
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DAlE: 11/21196
San Bernardino 3000 / 3002
"/20/2006 10:47:55 Reg CC2CoUNTER
Account: 919000 - ROAD HORKS, ~
Starting Balance S
Validation Receipt
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CHARGES-
0010004301
545C Construction BusinesS
100.00
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561431
ROAD VVOF1KS INt:
CORP
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03/3 I i2007
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STATE
COMPENSATION
INSURANCE
. FUND
PO BOX 420807, SAN FRANCISCO,CA 94142-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 11-20-2006
GROUP, 000046
POLICY NUMBER 0014175-2005
CERTIFICA TE 10, 80
CERTIFICft.TE EXPIRES, 12-01-2006
12-01-2005/12-0'-2006
SHELIA A. FULCH
300 N D ST 4TH FL
SAN BERNARDINO CA 92418-0001
SC
ThiS IS to certify that we have issued 01 valid 'vVorkers' Compensation insurance policy in Oil form approved by the
California Insurance Commissioner to the employer named below for the policy period that will expire or did
expire as indicated above.
ThiS certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded
by the policy listed herem. Notwithstanding any requirement, term or condition of any contract or other document
With respect 10 whir.h this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by lhe policy described herein is subject to all the terms, exclUSions, and conditions, of such poliCY.
0V1
UTHORiZED REPRE~
~
.
PRESIDENT
ENDDRSEMENT #2400 THIS ENDDRSEMENT APPLIES EXCLUSIVELY TO. EMPLDYEES TEMPORARILY
WDRKING DUTSIDE DF CALIFDRNIA DN A SPECIFIC ASSIGNMENT ONLY IN THE JURISDICTIDN DF:
STATE OF ARIZDNA
DUT DF STATE BENEFITS WILL BE REIMBURSED.
------EMPLDYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER DCCURRENCE.
ENDORSEMENT #1600 - LARRY BLDCKER SECTY - EXCLUDED.
ENDDRSEMENT #1600 - NATHAN BLDCKER VICE PRESIDENT - EXCLUDED.
ENDORSEMENT #1600 - KELLY BLDCKER PRESIDENT - EXCLUDED.
------ENDDRSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-01-2003 IS
ATTACHED TO AND FDRMS'A PART DF THIS PDLICY.
EMPLOYER
.
RDAD WDRKS, INC
303 SHORT ST
PDMONA CA 91768
SC
IREV.2-0'51
PRINTED
[B14.SC]
11-20-2006
ACORD,"
CERTIFICATE OF LIABILITY INSURANCE
Cllent#: 35002
DATI {NWlDorrYYYl
11/20/2006 '
THIS CERTIFICATE IS 'SSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE PO~ICIES BELOW.
PRooucflt
Hilb, Rogal & Hobbs Insurance
ervices of CA, Inc. #0511289
5 West Katell. Suite 300
.ngo, CA 92667
INSURED
Road Works, Inc.
303 Short Str.et
Pomona, CA 91768
INSURERS AFFORDING COVERAGe
INSURER~: Peerless Insurance Company
INSUFtER B Golden Eagle Ins. Corp.
:NSUREFl. c:
INSURER 0:
INSUFlERE:
NAIC#
24198
10375
THe POLICIES OF INSURANCE L1STeO BELOW HAVE SEEN t$SUiD TO THE INSURED NAMED ABOVE FOR THE POLICY PER.lOO INDICATED. NOTVVITHSTANDING
ANY REQUIREMENT. TERM OR CONOITION of ANY CONTRACT OR. OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTifiCATE MAY BE ISSUED OR
MAY PERT"N, THE 'NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGRE.GATE LIMITS SHOWN MAY HAVE B!;E:N REDUCED BY PAID CLAIMS
''" . TYpe OF INSURANce POLICY NUMBER Pc?A~i~J::~8~~,E Pg~'iE ~X,:,~.:v8.N I.IMITS
A X ~NiRAl UABH.ITY CBP9514686 08/16/06 08/16/07 ,.eH occuAAENCE 11 oon 000
X COMMERCIAL GeNER.Al U.l.8ll1TY ~~~ T9J'ONTEO 1100000
1 CLAIMS MADE [!] OCCUR. MEO EX" {/vIy one ~'f'Ol'I\ 15000
- P'-RSONAI. & AD" INJURY 11.000.000
lL OCP aeNERAL^GGRECATE 12 000 000
~~ AGG~EnE ILlMIT A'"As :ER PRODUCTS. COMPIOP AGG 12.000 000
pOLlCY ~~Ri LOC
A ~TOM08'lE LIABILITY CBP9514686 08116/06 08/16/07 COMBINED SINGLE LIMIT
L ^NY AUTO (E3lctioc:nll 11,000,000
- ALL OWNED AUTOS eOQIL Y INJURY
,
L-- SCt-IliOUL'-O AliTOS {p~(~r&onl
L HIRED AUTOS EOOIL Y INJURY
I
!... NON,OWNiO ^UT05 (Perlt:OCl."11
- PROPERTY DAMA.GE I
(Pet'ueic!'r\l)
=rOE UAOILITV AUTO ONLY' EA ACCIQENT ,
ANY AUTO OTHE.R THAN EA Ace ,
AUTO ONl v; '00 ,
B :=J~'$IUM'.iLU UABIUTY CU9550590 08/16/06 08/16/07 EACH oCCURRENCE ,4 000 000
OCCUR 0 CLAIMS MAOt; AGGREGATE ,4 000 000
I
Fx1 OEOUCT'O" I
X RETENTION ,0 ,
WORKERS coMPENSATION AND I_We $T-'TU._ I IOJ~'
EMPLOYER$' UABILlTY
ANY PROPRleYOR/PARTNER/EXECUTIVE E.l_ EACH ACCIDENT S
OFFICERJMEMBER EXCLUDED? - EL DI.$EA:5E' Ell fMP\.OYEE S
If~t!!.Il.sctIDe under
5 ErJAl PROVISIONS 1;1. III E,L DISe....SE . POLICY LIMIT $
A OTW'IIi:R InlandMarine CBP9514686 08/16/06 08/16/07 See Schedule on File
oESCRIPTK)N OF OPE".dIO-"S I LOCATIONS I VEH,CLf.S I EXCLUSIONS A.OOED B'i' ENDORSEMENT I SPECIAL PROVIsiONS
RE: Cr.ck Sealing on various str.ets in the city.
City of San Bernardnio is named additional insured with respects to
general liability per attached endorsement. . 10 day notice of cancellation
for non paymen of premium.
COVERAGES
CANCELLATION
ACORD 25 (2001106) 1 of 2
#SS0443S/M236818
SHOULD ANY OF THE ABovE OESeFUQ'ED pouC.IES BE CANCELLED BEFORl THE eXPlRAllON
OAn THEREOl', THe ISSUING INSUReR WILL ENDEAVOR 10 WI!.. ~ DAY$WIil:ITTEN
NOTICE TO THE Cfj;RTIFICA1E HOl.OER NAMED TO THE I.EH, BUT FAILURE TO DO so SHAl.1.
IMPO$l! NO OSllCATlON OR UA.B'UTY OF ANY KINO UPON THli INSURER,ITS AGIHllTS OR
REPRESENTATlVea,
O\UTHORllEO REPRESENTATIVE
~ tvl.d~~ ~
2JMEN
" ACORD CORPORA liON 1988
CERTIFICATE HOLDER
City of San Benardino
Attn: Sheila Futch
300 Nor1h "0" Street, 4th Floor
San Bernardino. CA 92418
IMPORTANT
If the cert'lficate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on thIS certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the termS and conditions of the policy, certain policies may
require an endorsement. A statement on this cartificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend. Qxtend or alter the coverage afforded by the pOlicies listed thereon
e
ACORD 25-S (2001108)
2 of 2
#S504435/M23681 B
NUV <"_'0 C-t:.Jt:.JU
.
.
.
CBP9514686
NAMED INSURED:
ROAD WORKS INC.
24. "Product recall notification expenses" means the reasonable additional expenses (including. but not
Iim~ed to, cost ot correspondence, ne'M;paper and magazine advertising, radio or television announcements
and transportation c~st), necessarily incurred in arranging for the return of products, but excluding costs of'
the replacement products and the cash value of the dam.ged products.
The following PrOVisions are .150 added to this Coverage Parl:
A. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT
1. Paragraph 2. under SECTION II _ WHO IS AN INSURED is amended to include as an insured any person
or organization when you and such person or organization have agreed in writing in a contra"t, agreement
or permit that such person or organization be added as an additional insured on your policy to provide
insurance such as is afforded under this Coverage Part. Such person or organization is not entitled to any
notices that we are required to send to the Named Insured and Is an additional insured only with respect to
liability arising out of:
a. your ongoing operations performed for that person or organization; or
b.'f1remises or facilities owned or used by you.
With respect to provision 1.a. above, a person's or organization's status as an insured under this
endorsement ends when your operations for that person or organization are completed.
With respect to provision 1.b. above, a person's or organization's status as an insured under this
endorsement ends when their contract or agreement with you for such premises or facilities ends.
2. This endorsement provision A. does not apply:
a. Unless the written contract or agreement has been executed, or permit has been issued, prior to the
"bodily injury', 'property damage' or 'personal and advertising injury":
b. To 'bodily injury" or 'property damage' occurring afler:
(1) All work, including materials, parts or equipment furnished In connection with such work, in the
project (other than service, maintenance or repairs) to be performed by or on behalf of the
additional insured(s) at the site of the covered operations has tieen 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;
c. To the r~dering of or failure to render any professional services including, but not limited to, any
professional architectural, engineering or surveying services such as:
(1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders or drawings and specifications; and
(2) supervisory, inspection, architectural or engineering "ctivities;
d. To 'bodily injury', 'property damage' or 'personal and advertising injury" arising out of any act, error or
omission that resulls from the additional insured'S sole ne~ligence or wrongdoing;
e. To any person or organizaUon included as an insured under provision B. of this endorsement;
f. To any person or organization included as an insured by a separate "dditional insured endorsement
issued by us and made a part of this policy.
GoCO 602 (0710J)
Includes copyrigntcd En,lenal of lnSl,lfWlQC Scl'\'ic:cs OffiCClIlni;, ""i\h iu pmnisiion
Paac6or7
.
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B. ADIJIlIUI'<I"'1.. 1I'l1........~--
Paragraph 2, under SECTION II _ WHO IS AN INSURED is amended to include as an insured any person or
organization (referred to below as 'vendo") with Whom yoU agreed, in a written contract or agreement to
provide insurance such as is afforded under this policy, but only with respect to 'bodily injury' or . property
damage' arising out of 'your products' which are distributed or sold in the regular course of the vendor'S
business, subject to the following additional exclusions:
1. The insurance afforded the vendor does not apply to:
a. 'Bodily injury' or 'property damage' for Which the vendor is obligated to pay damages by
reason of the assumption of liability in a contract or agreement. Tnis exclusion does not apply
to liability for damages that the vendor would have in the absence of the contracl or
agreement;
b. MY express warranty unauthorized by you;
c. MY physical or chemical change in the prodUct made Intentionally by the vendor.
d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or
substitution of parts under instruclions from the manufacturer, and then repackaged in the
origindll container;
e. MY failure to make such inspections, adjustments, tests or servicing as the vendor has agreed
to make or normally undertakes to make in the course of business, in connection with the
distribution or sale of lhe prodUcts;
f. Demonstration, installation, servicing or repair operations, except such operations pertormed
at the vendor's premises in conneclion with the sale of the product:
g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or subStance by or for the vendor: or
h. To 'bodily injury- or 'property damage' arising out of any acl, error or omission that results from the
additional insured's sole negligence or wrongdoing,
2. This insurance does not apply to any insured person or organization, from whom you have acquired such
products, or any ingredient, part or container, entering into, accompanying or containing such products.
OECG!Ol (07'0l)
lneludcl copyngh1ed mlteri.l or It\iunncc Scrvil:lCl Otri~GI we. with i13 pennissi06
Pas. 7 .17
- - -- _.