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Item No. 02 Ext of Agreemnt DM Contracting, Inc.
Text File City of Lake Elsinore 130 South Main Street Lake Elsinore, CA 92530 www.lake-elsinore.org File Number: ID# 17-218 Agenda Date: 6/13/2017 Status: Consent AgendaVersion: 1 File Type: ReportIn Control: City Council Agenda Number: 4) Page 1 City of Lake Elsinore Printed on 6/8/2017 REPORT TO CITY COUNCIL To:Honorable Mayor and Members of the City Council From:Grant Yates, City Manager Approved by: Jason Simpson, Assistant City Manager Prepared by: Catherine Eakins – Administrative Assistant Date:June 13, 2017 Subject:Amendment No. 2 Extension of Agreement for Contract Services (On- Call) for DM Contracting, Inc. Recommendation Approve and authorize the City Manager to execute Amendment No. 2 On-Call Contract Services Agreement with DM Contracting Inc., to allow for a one (1) year renewal term and in an amount not to exceed amount of $55,000, in such final form as approved by the City Attorney. Background On August 25, 2015 , City Council approved the award to DM Contracting Inc., for On-Call Contract Services for the Annual Curb, Gutter, and Sidewalk (CGS) Repair Program, with an option to extend the contract two addition twelve month renewal terms. Amendment No. 1 dated July 1, 2016 extended the contract for a further 12-month term. Discussion The Public Works Department periodically performs miscellaneous inspections and repairs on displaced, deteriorated, or damaged curbs, gutters, and sidewalks within the City Right-of-Way. Throughout the year, an inventory of locations requiring repairs is compiled based upon public input and City staff site investigations. Occasionally, the repair work requires the use of an on- call Contractor for larger and more complicated repairs that requires specialized expertise, labor, and equipment. Fiscal Impact Funds in the amount of $55,000 have been allocated for the Annual Curb, Gutter, and Sidewalk Repair Program for FY17/18 Project No.Z10001. Exhibits: DM Contracting, Inc. – Exhibit A Amendment No. 2 DM Contracting, Inc. – Exhibit B Amendment No.1 DM Contracting, Inc. – Exhibit C Original Agreement Page1 of 2 City of Lake Elsinore Amendment No. 2 – DM Contracting, Inc. July 1, 2017 AMENDMENT NO. 2 TO AGREEMENT FOR CONTRACTOR SERVICES (ON-CALL) DM Contracting, Inc. Citywide Annual Curb, Gutter, and Sidewalk Repair Program Project No. Z10001 This Amendment No. 2 to Agreement for Contractor Services (“Amendment No. 2”) is made and entered into as of July 1, 2017 by and between the City of Lake Elsinore, a municipal corporation (“City), and DM Contracting, Inc (“Contractor”). RECITALS A.The City and Contractor have entered into that certain Agreement for Contractor Services dated as of August 25, 2015 (the “Original Agreement”). Except as otherwise defined herein, all capitalized terms used herein shall have the meanings set forth for such terms in the Original Agreement. B.The Original Agreement provided for compensation to Contractor in an amount not to exceed $55,000 per fiscal year. C.The term of the Original Agreement was for ten (10) months and allows the City to extend the term on a 12-month basis, not to exceed two (2) additional 12-month renewals. D. Amendment No. 1 dated July 1, 2016 extended the term of the agreement an additional 12-month term. E.The parties now desire to extend the term services as set forth in this Amendment No 2. NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, City and Contractor agree as follows: 1.Section 2, subpart C, Term, of the Original Agreement is hereby amended to add the following: Unless earlier terminated as provided elsewhere in the Original Agreement, this Amendment No. 2 shall continue in full force and effect for a period of twelve (12) months, commencing on July 1, 2017 and ending on June 30, 2018. 2.Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. Page2 of 2 City of Lake Elsinore Amendment No. 2 – DM Contracting, Inc. July 1, 2017 IN WITNESS WHEREOF, the parties have caused this Amendment No. 2 to be executed on the respective dates set forth below. “CITY” CITY OF LAKE ELSINORE, a municipal corporation Grant Yates, City Manager Date: ATTEST: City Clerk APPROVED AS TO FORM: City Attorney “CONTRACTOR” DM Contracting, Inc. a California corporation DM Contracting, Inc., a corporation Date: Attachments: Amendment No. 1 – 7.1.2016 Original Agreement – 8.24.2015 EXHIBIT B EXHIBIT B ORIGINAL AGREEMENT [ATTACHED] AMENDMENT NO. 1 TO AGREEMENT FOR CONTRACTOR SERVICES (ON -CALL) DM Contracting, Inc. Citywide Annual Curb, Gutter, and Sidewalk Repair Program Project No. Z10001 This Amendment No. 1 to Agreement for Contractor Services (On -Call) ( "Amendment No. 1 ") is made and entered into as of July 1, 2016 by and between the City of Lake Elsinore, a municipal corporation ( "City), and DM Contracting, Inc., a California corporation ( "Contractor "). RECITALS A. The City and Contractor have entered into that certain Agreement for Contractor Services dated as of August 25, 2015 (the "Original Agreement "). Except as otherwise defined herein, all capitalized terms used herein shall have the meanings set forth for such terms in the Original Agreement. B. The Original Agreement provided for compensation to Contractor in an amount not to exceed Fifty -Five Thousand dollars ($55,000). C. The term of the Original Agreement was for ten (10) months and allows the City to extend the term on an annual basis, for a total of two (2) years. D. The parties now desire to extend the term for such services as set forth in this Amendment No 1. NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, City and Contractor agree as follows: 1. Section 2, Time of Performance, of the Original Agreement is hereby amended to add the following: Unless earlier terminated as provided elsewhere in the Original Agreement, this Amendment No. 1 shall continue in full force and effect until June 30, 2017. The City may, at its sole discretion, extend the term of this Agreement on an annual basis not to exceed one (1) additional renewal term, such notice to be exercised by the City Manager. 2. Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties have caused this Amendment No. 1 to be executed on the respective dates set forth below. CITY" CITY OF LAKE ELSINORE, a municipal corporation Grant Yyifoi, City Manager Date: i ATTEST: City CIewR r CONTRACTOR" DM Contracting, Inc., a Attachments: Exhibit B — Original Agreement 0 RACT C) FEBRUARY 13. DM Contracting, Inc., a corporation Date: R 2002 EXHIBIT A CONTRACTOR'S BID SCHEDULE ATTACHED] EXHIBIT A MAEU. t .. 9 . r 1065 HARBER DRIVE, COLTON, CA 92324 PHONE (909) 824-70-11 FAX (909) 824 -1547 California State License #771187 To: Mr. Julian Perez Streets Senior Lead Worker Public Works Department City of Lake Elsinore 521 North Langstaff Street Lake Elsinore, Ca 92530 Bus. (951) 674- 5170 Re: Citywide Annual Curb, Gutter, and Sidewalk Repair Program. Project no. Z10001, Contract Services Agreement Contract renewal for fiscal year 2016 -2017. Petition for 10% increase on all bid schedule unit prices. D M Contracting, Inc. respectfully submit's their request for additional 10% increase on all bid schedule unit prices for the new forthcoming fiscal year contract services agreement. Partial items to justify increase are diesel fuel, gasoline, truck driver, dump fee, concrete material, insurance, and AB- 219 assured cost. Thank you for your consideration in this matter. I look forward to hearing from you. ' Sincerely, lohnny 1,( 11'107 Sr. Estimator /Project Manager D M Contracting, Inc. AIr 'tooz/v P•;k ?. / 08%23%2° I r N.5g x.35r 1 EXHIBIT A BID FORM City of Lake Elsinore Public Works Department FY 15116 Annual Curb, Gutter and Sidewalk Repair Program prA 1(v Item Description Quantity Unit Total Price 1. Remove existing and construct 6" curb and 200 LF utter per Ci Standard No. 200 2. Remove existing and construct 8" curb and 200 LF 1 D qi Oeutterp±r Standard No. 201 ff 3. Remove existing concrete and construct 4" 5000 SF concrete sidewalk over compacted sub- L 2 SooraderCStandardNo. 210 4. Remove existing concrete and construct 2 Fro 1 handicap rams r CI Standard No. 214A 7 j A Q 5. Remove existing concrete and construct 2 EA 44dhandicapramps per City Standard No. 2148 Contractor Name Contractor Signature Al Date Total Amount in words and figures (payment bond required in this amount — no personal checks will be accepted): Zf Sce o0 seven{ - two "housr. Fve- 6tri4r 41(ar5y d I Notice Inviting Bids: FY 15/16 Annual Curb, Gutter and Sidewalk Repair Program City of Lake Elsinore 8 1 °° 5. a DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 09/02/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACTJONETTE PHILLIPSNAME: JONETTE PHILLIPS INSURANCE AGENCY 3452 E FOOTHILL BLVD STE 320 PASADENA CA 91107 INSURED DM CONTRACTING, INC DM CONSTRUCTION 1065 HARBER DR COLTON CA 92324 -2622 PHONE 626 - 795 -3227 FAX 026- 795 -3070 jpy1C. Nb..II! }_ 1AIC. Ney: - E -MAIL JONETTE@JONETTEPHILLIPS.NETADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :State Farm Mutual Automobile Insurance Company f 25178 INSURER 8: INSURER C: INSURER D: INSURER E: INSURER F rnvoDAr-De c1= 0TICICATI= Nllnnal =la- REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR D POLICY NUMBER MM DIYYY MMIDDNYYY LIMITS COMMERCIAL GENERAL LIABILITY Tel# 951 - 674 -3124 ext 298 AUTHORIZED REPRESENTATIVE EACH OCCURRENCE CLAMS-MADE FI OCCUR P AI: ES._[EB OGfAlrf4RG Y f i MED EXP (Any one person) PERSONAL & ADV INJURY f r4'1_ AGGREGATE LIMIT +4f'(PLII S PER: GENERAL AGGREGATE POLICY JECT LOG PRODUCTS - COMPIOPAGG A AUTOMOBILE LIABILITY Y Y 492 0981- A14 -75D -001 07/ 14/2016 01/1412017 COMBINED s _. t,EIJWi Ea w9denl 1.000,000 ANY AUTO 492 0983- A14 -75 07/14/2016 01/14/2017 BODILY INJURY (Per person) ALL OWNED SCHEDULED f. BODILY INJURY (Per accident) AUTOS AUTOS 492 0980- A14 -75 07114/2016 01/14/2017 RTY GEPROPERTY HIRED AUTOS NONNOSWNED 492 0984- A14 -75 07/ 14/2016 rOa01/14/2017 UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB 4LA {tilS MA0£I AGGREGATE DEC} RETENTIONS - - WORKERS COMPENSATION PER STATUTE kR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER/ EXECUTIVE E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYES OFFICERIMEMBER EXCLUDED? NIA Mandatory in NH) If yes, describe under DE=SCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached If more space Is required) Certificate Holder has been named as Additional Insured per written contract THIS INSURANCE IS PRIMARY AND NONCONTRIBUTORY WITH RESPECTS TO CLAIMS ARISING OUT OF THE OPERATION OF THE DESCRIBED VEHICLE c131INrlr ATC un1 nGD rAMr'FI I ATION City of Lake Elsinore SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 130 S. Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lake Elsinore CA 92530 ACCORDANCE WITH THE POLICY PROVISIONS. Tel# 951 - 674 -3124 ext 298 AUTHORIZED REPRESENTATIVE f U 19P- ZU16VAGUKU I:UK1 -UKAI IUN. All rlgnLs reserVeo. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02 -04 -2014 DATE CERTIFICATE OF LIABILITY INSURANCE 12/23/2015 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CER NAME, Adrian Cisneros CISNEROS INSURANCE AGENCY PHONE 951 3 3_3443 FA" ,,.(909) 497 -7315 5750 Division St Ste 100 - acisnerosCfarmersa ent.com Riverside, CA 92506 INSURER(s) AFFORDING COVERAGE NAIL # INSURED DM Contracting, Inc. 1065 Harbor Drive Colton, CA 92324 INSU • Mid-CerItUry Insurance Co. 2 168 7 INSURERB: Truck Insurance Exchange 21709 INSURE2 C: INSURER D . INSURERE S T?s= 1/ICIf'1hl MI IRARFR- vv THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY B P(! YYY MMIIDD /Y XP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1:1 I m ECLAIMS -MADE OCCUR MED EXP An one. arson S PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE S POLICY [D PRO [D LOCJE PRODUCTS - COMPIOPAGG OTHER: Ca Icci ED SIN I.E MITAUTOMOBILELIABILITY BODILY INJURY (Per person) ANYAUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS PTYR'Y DAMAGEPROM ipurAcaldentlHIREDAUTOSAUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE 5HCLAIMS-MADE AGGREGATEEXCESSLIAB DED 15ETENTION ER 0TH WORKERS COMPENSATION 5P TaTUTE IA09476499 12/28/ 15 1:./28/16 I...EACH ACCIDENT 1, 0007 000ANY PROPREEORIPIARTNI R /EXECUTIVE OFFICER /MEMBER EXCLUDED? Y N/A Y 1 (1 r) O (1( I1. 'I Mandatory In NH) E.I. DISEASE - EA EMPLOYEE r + r Y I'P 1 00(, (1()oItyes, describe under JES R T R Business Personal 605885857I 12/28/ 15 12/28/ 16I Limit: 10, 000 Pr(?lDerty I Deductible: 500 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Certificate of Workers' Compensation coverage. Waiver of Suit- )rogation applies per attached WC990619 endorsement. City of Lake Elsinore SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 130 S. Main Street ACCORDANCE WITH THE POLICY PROVISIONS Lake Elsinore, CA 92530 AUTHORIZED REPRESENTATIV 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD FARMERS INSURANCE WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY Named . DM CONTRACTING INC. Insured , 1065 HARBER DRIVE COLTON CA 92324 Effective Date 12/28/15- Agent 97 -45 -345 A0947 -64 -99 Policy Number of the Company WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET WC 99 06 19 20 15 Policy Year We have the right to recover our payments from anyone liable for an injury coverod by this policy. We will not enforce our right against the person or organization for which you perform work under a written contract that requires you to obtain this agreement from us. The additional premium for this endorsement shall be 3.0 % of the Workers' Compensation premium otherwise due for the state(s) listed below on such remuneration, subject to a minimum charge of All written contracts in the state(s) of: CA This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all the terms of the policy. Countersigned Authorized Representative 9U369 1ST EMON 9 -07 J6369111 PAGE l OF 1 WC990619A RCS CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/ 8/30/201616 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Gina Galvas _ NAME: Business & Contractors Insurance Services Inc. PHONE (619) 592 -4440 FAX (619)592 -4449LkCNo _(A/C, No,_Ext)= 1941 Friendship Dr E-MAIL Gina @bcisinc. net Suite F INSURER(S) AFFORDING COVERAGE NAIC # El Cajon CA 92020 INSURER AAssociated Industries Insurance Co INSURED INSURERB:National Fire & Marine Insurance CD 20079 Dm Contracting Inc INSURER C.. INSURER D: 1065 Harber INSURER E: Colton CA 92324 INSURER F: nnvconr_cc f`CDTICIf`ATC All IIIARCD•CT.1 F,51 -4nA7R4 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL:§UBR POLICY EFF I POLICY EXP LTR POLICY NUMBER MMIDD/YYYY. MMIDD/YYYY , LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 A CLAIMS -MADE Fx OCCUR DAMAGE URENTED PRE ISES,[100,000Iaouc -nce MED EXP (Any one person) X AES1038324 -00 4/21/2016 4/21/2017 5,000 PERSONAL & ADV INJURY 1,000, 000 GENERAL AGGREGATEGEN'L AGGREGATE LIMIT APPLIES PER: 2,000, 000 PRODUCTS - COMP /OP AGGPOLICYLOC 2,000,000 OTHER: Property damage - single limit AUTOMOBILE LIABILITY COMBNED SINGLE l Ea a idgnl] BODILY INJURY (Per person) ANY AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS NON-OWNED ROA raoERT Y DAMAGE Pe accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 1 000,,000 AGGREGATE B EXCESS LIAB CLAIMS-MADE_ 11000,000 DFID RETENTION$ EBU025401671 5/12/2016 5/12/2017 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? Mandatory In NH) N /'` OTHETAUTEJJR E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder has been named as Additional Insured per written contract. RE: Various Locations. Endorsement is attached. f`FRTIGIrATr- wni nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Lake Elsinore THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 130 South Main St. ACCORDANCE WITH THE POLICY PROVISIONS. Lake Elsinore, CA 92530 AUTHORIZED REPRESENTATIVE Josh Schwartz /JMR 1988 -2014 ACORD GUKNUKA I IUN. AU rlgnts reservea. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INSn25 r9manii POLICY NUMBER: AES1038324 -00 COMMERCIAL GENERAL LIABILITY NX GL 093 08 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT - AGGREGATE LIMITS OF INSURANCE PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Schedule Subject to an Overall Policy Aggregate Limit: $ 5,000,000 Information required to complete this Schedule, if not shown above, will be shown in Declarations.) A. Paragraphs 2. and 3. of SECTION III — LIMITS OF INSURANCE are replaced by the following: 2. The Overall Policy Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard "; and c. Damages under Coverage B. 3. The Products - Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products- completed operations hazard" to each of your projects away from premises owned by or rented to you. B. The following is added to SECTION III — LIMITS OF INSURANCE: 8. Subject to Paragraph 2. and 3. above, the General Aggregate Limit is the most we will pay under for the sum Coverage A, Coverage B, or Coverage C to each of your projects away from premises owned by or rented to you. NX GL 093 08 09 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission POLICY NUMBER: AES1038324 -00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 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 Organ ization s : Locations Of Covered Operations All persons or organizations where required by written contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — 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) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: AES1038324 -00 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addi- tional insured on your policy. Such person or or- ganization is an additional insured only with re- spect 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. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are com- pleted. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed; or b. 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 subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: AES1038324 -00 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations where written contract with the Named Insured requires completed Operations coverage. This form does not apply to your work on residential property ". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to 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 © ISO Properties, Inc., 2004 Page 1 of 1 [ POLICY NUMBER: AES1038324 -00 COMMERCIAL GENERAL LIABILITY NX GL 009 08 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON- CONTRIBUTING INSURANCE THIRD-PARTY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Third Party: All persons or organizations where required by written contract with the Named Insured Absence of a specifically named Third Party above means that the provisions OT zrns enaorsernern dg.)Jny as required by written contractual agreement with any Third Party for whom you are performing work.) Paragraph 4. of SECTION IV: COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance: With respect to the Third Party shown above, this insurance is primary and non - contributing. Any and all other valid and collectable insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for loss covered by this policy, shall in no instance be considered as primary, co- insurance, or contributing insurance. Rather, any such other insurance shall be considered excess over and above the insurance provided by this policy. NX GL 009 08 09 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission POLICY NUMBER: AES1038324 -00 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO LAS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations where required by written contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 BUSINESS LICENSE This business license is issued for revenue purposes only and does not grant authorization to operate a business. This business license Is Issued Nithuut verNication that the holder is subject to or exempted from licensing by the state, county, federall government, or any other governmental agency. Business Name: DM CONTRACTING, INC. Business Location: 1065 HARBER DR COLTON, CA 92324 -2622 Owner Name(s): DAVID MAGANA, JR CITY Ot LAKE ELSINORE ADMINISTRATIVE SERVICES- LICENSING 130 South Main Street Lake Elsinore, CA 92530 951.674.3124 i TO BE POSTED IN A CONSPICUOUS PLACE BUSINESS LICENSE NO. 022393 Business Type: GENERAL ENGINEERING CONTRACTOR DM CONTRACTING, INC, 1065 HARBER DR COLTON, CA 92324 -2622 Issue Date: 9/1012015 Expiration Date: 9/30/2016 THIS IS YOUR LICENSE • NOT TRANSFERABLE Form Request for Taxpayer Give Form to the Rev.Decemb2014) Identification Number and Certification requester. I not send to the IRS. D parhmi rrt oft e Treasury ntFrnal Revenue Service 1 Name (as shown on your income tax return). Name is required on this Ilne; do not leave this line blank. DM CONTRACTING INC 2 Business name /disregarded entity name, if different from aboveN amrnCaa- c 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to certain entities, not individuals; see Individual /sole proprietor or C Corporation S Corporation Partnership Trust/estate instructions on page 3): CL e u single- member LLC Limited liability company. Enter the tax classification (C =C corporation, S =S corporation, P= partnership) Exempt payee code (if any) from FATCA p ` Note. For a single- member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for Exemption reporting N the tax classification of the single- member owner. code (if any) d e Other(seeinstructions) Applies to accounts maintained outside the us) R 5 Address (number, street, and apt. or suite no.) Requester's name and address (opilonal) U a 1065 HARBER DRIVE 6 City, state, and ZIP code u) COLTON, CA 92324 7 List account number(s) here (optimal) 11111113MI11111117—Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TlN ,provided must match the name given on line 1 to avoid backup wlthholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see Now to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Certification Under penalties of perjury, I certify that: Social security number m T or fmolavor identification number i7101eM101©MUME The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Signature or— Here I U.S, person General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W -9 (such as legislation enacted after we release it) is at www.irs.gov/fw9. Purpose of Form An individual or entity (Form W -9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer idenWflcation number (ATIM, or employer IdantIncathon number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include. but are not limited to, the following: Form 1099 -INT (interest earned or paid) Form 1099 -DIV (dividends, including those from stocks or mutual funds) Form 1099 -MISC (various types of income, prizes, awards, or gross proceeds) Form 1099 -B (stock or mutual fund sales and certain other transactions by brokers) Form 1099 -S (proceeds from real estate transactions) Form 1099 -K (merchant card and third party network transactions) Date 7//// r/ Form 1098 (home mortgage interest), 1098 -E (student loan interest), 1098 -T tuition) Form 1099 -C (canceled debt) Form 1099 -A (acquisition or abandonment of secured property) Use Form W -9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do nod rerurn Form W -9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U,S. exempt payee. If applicabie, you are also certifying that as a U.S, person, your allocable share of any partnership Income from a U.S. trade or business Is not subject to the withholding tax on foreign partners share of etfectively connected Income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat. No. 10231X Form W-9 (Rev. 12 -2014) AGREEMENT FOR CONTRACTOR SERVICES DM Contracting, lnc. Citywide Annual Curb, Gutter, and Sidewalk Repair Program Project No. 210001 This Agreement for Contractor Services (the "Agreemenf') is made and entered into as of August 25,2015 by and between the City of Lake Elsinore, a municipal corporation ("City,,) and DM Contracting lnc., a Construction Contractor ("Contractor"). RECITALS A. The City has determined that it requires the following services: Removal and replacement of curbs, gutters, sidewalks, and other miscellaneous concrete throughout the city. B. Contractor has submitted to City a bid, dated July 23,2015 attached hereto as Exhibit A ("contractors Bid schedule") and incorporated herein, to provide services and related work to the City pursuant to the terms of this Agreement. C. Contractor possesses the skill, experience, ability, background, certification and knowledge to perform the services and related work described in this Agreement on the terms and conditions described herein. D. City desires to retain Contractor to perform the services and related work as provided herein and Contractor desires to provide such services and related work as set forth in this Agreement. AGREEMENT '1. Scooe of Services. Contractor shall perform the services and related work described in Contractor's Bid Schedule (Exhibit A). Contractor shall provide such services and related work at the time, place, and in the manner specified in Contractor,s Bid Schedule (Exhibit A), subject to the direction of the city through its staff that it may provide from time to time. 2. Time of Performance. a. Time of Essence. Time is of the essence in the performance of this Agreement. The time for completion of the services and related work to be performed by Contractor is an essential condition of this Agreement. Contractor shall prosecute regularly and diligently the services and related work contemplated pursuant to this Agreement consistent with contractor's Bid schedule (Exhibit A) and shall provide, furnish and pay all labor, materials, necessary tools, expendable equipment, and all taxes, utility and transportation services required to perform such the services and related work. b. Performance Schedule. Contractor shall commence the services and related work pursuant to this Agreement upon receipt of a written notice to proceed and shall perform all services and related work within the time period(s) established in the Contractor's Bid schedule (Exhibit A). when requested by contractor, extensions to the time period(s) specified may be approved in writing by the City Manager. Dl Contracting CGS Conlract Page 1 c. Term. Unless earlier terminated as provided elsewhere in this Agreement, this Agreement shall continue in full force and effect, commencing on August 25, 2015 and ending on June 30, 2016. The City may, at its sole discretion, extend the term of this Agreement on a 12-month basis not to exceed two (2) additional twelve (12) month renewal terms by giving written notice thereof to Contractor not less than thirty (30) days before the end of the contract term, such notice to be exercised by the City Manager. Contractor hereby agrees and acknowledges that any and all work or services performed pursuant to this Agreement shall be based upon the issuance of a project task order by the City. Contractor acknowledges that it is not guaranteed any minimum or specific amount of work or services as all work or services shall be authorized through task order issued by the City. 3. Compensation. Compensation to be paid to Contractor shall be in accordance with the fees set forth in Contractor's Bid Schedule (Exhibit A), which is attached hereto and incorporated herein by reference. ln no event shall Contractor's compensation exceed FIFTy FIVE THOUSAND dollars ($55,000) without additional written authorization from the City. Notwithstanding any provision of Contractor's Bid Schedule to the contrary, out of pocket expenses set forth in Exhibit A shall be reimbursed at cost without an inflator or administrative charge. Payment by City under this Agreement shall not be deemed a waiver of defects, even if such defects were known to the City at the time of payment. 4. Method of Pavment. Contractor shall promptly submit billings to the City describing the services and related work performed during the preceding month to the extent that such services and related work were performed. Contractor's bills shall be segregated by project task, if applicable, such that the City receives a separate accounting for work done on each individual task for which Contractor provides services. Contractor's bills shall include a brief description of the services performed, the date the services were performed, the number of hours spent and by whom, and a description of any reimbursable expenditures. City shall pay Contractor no later than forty-five (45) days after receipt ofthe monthly invoice by City staff. 5. Suspension or Termination. a. The City may at any time, for any reason, with or without cause, suspend or terminate this Agreement, or any portion hereof, by serving upon the Contractor at least ten (10) days prior written notice. Upon receipt of such notice, the Contractor shall immediately cease all work under this Agreement, unless the notice provides otherwise. lf the city suspends or terminates a portion of this Agreement such suspension or termination shall not make void or invalidate the remainder of this Agreement. b. ln the event this Agreement is terminated pursuant to this Section, the City shall pay to Contractor the actual value of the work performed up to the time of termination, provided that the work performed is of value to the city. upon termination of the Agreement pursuant to this Section, the Contractor will submit an invoice to the City, pursuant to Section entitled "Method of Payment" herein. 6. Ownershio of Documents. All plans, studies, documents and other writings prepared by and for Contractor, its officers, employees and agents and subcontractors in the course of implementing this Agreement, except working notepad internal documents, shall become the property of the City upon payment to Contractor for such work, and the City shall have the sole right to use such materials in its discretion without further compensation to Page 2 Contractor or to any other party. Contractor shall, at Contractor's expense, provide such reports, plans, studies, documents and other writings to City upon written request. City acknowledges that any use of such materials in a manner beyond the intended purpose as set forth herein shall be at the sole risk of the City. City further agrees to defend, indemnify and hold harmless Contractor, its officers, officials, agents, employees and volunteers from any claims, demands, actions, losses, damages, injuries, and liability, direct or indirect (including any and all costs and expenses in connection therein), arising out of the City's use of such materials in a manner beyond the intended purpose as set forth herein. a. Licensino of lntellectual Propertv.This Agreement creates a nonexclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskeftes, which are prepared or caused to be prepared by Contractor under this Agreement ("Documents & Data"). Contractor shall require that all subcontractors agree in writing that City is granted a nonexclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were prepared by design professionals other than Contractor or provided to Contractor by the City. City shall not be limited in any way in its use of the Documents & Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. b. Confidentialitv. All ideas, memoranda, specifications, plans, procedures, drawings, descriptions, computer program data, input record data, written information, and other Documents & Data either created by or provided to Contractor in connection with the performance of this Agreement shall be held confidential by Contractor. Such materials shall not, without the prior written consent of City, be used by Contractor for any purposes other than the performance of the services under this Agreement. Nor shall such materials be disclosed to any person or entity not connected with the performance of the services under this Agreement. Nothing furnished to Contractor which is otherwise known to Contractor or is generally known, or has become known, to the related industry shall be deemed confidential. Contractor shall not use City's name or insignia, photographs relating to project for which Contractor's services are rendered, or any publicity pertaining to the Contractor's services under this Agreement in any magazine, trade paper, newspaper, television or radio production or other similar medium without the prior written consent of City. 7. Contractor's Books and Records. a. Contractor shall maintain any and all ledgers, books of account, invoices, vouchers, canceled checks, and other records or documents evidencing or relating to charges for services, or expenditures and disbursements charged to City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Contractor to this Agreement. b. Contractor shall maintain all documents and records which demonstrate performance under this Agreement for a minimum period of three (3) years, or for any longer peliod required by law, from the date of termination or completion of this Agreement. Page 3 c. Any records or documents required to be maintained pursuant to this Agreement shall be made available for inspection or audit, at any time during regular business hours, upon written request by the City Manager, City Attorney, City Auditor or a designated representative of these officers. Copies of such documents shall be provided to the City for inspection at City Hall when it is practical to do so. Otherwise, unless an alternative is mutually agreed upon, the records shall be available at Contractor's address indicated for receipt of notices in this Agreement. d. Where City has reason to believe that such records or documents may be lost or discarded due to dissolution, disbandment or termination of Contractor's business, City may, by written request by any of the above-named officers, require that custody of the records be given to the City and that the records and documents be maintained in City Hall. Access to such records and documents shall be granted to any party authorized by Contractor, Contractor's representatives, or Contractor's successor-in-interest. 8. lndependent Contractor. lt is understood thal Contractor, in the performance of the work and services agreed to be performed, shall act as and be an independent contractor and shall not act as an agent or employee ofthe City. 9. PERS Eliqibilitv lndemnification. ln the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this Agreement claims or is determined by a court of competent jurisdiction or the California Public Employees Retirement System (PERS) to be eligible for enrollment in PERS as an employee of the City, Contractor shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benelits on behalf of Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City. Notwithstanding any other federal, state and local laws, codes, ordinances and regulations to the contrary, Contractor and any of its employees, agents, and subcontractors providing service under this Agreement shall not qualify for or become entifled to, and hereby agree to waive any claims to, any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in PERS as an employee of City and entitlement to any contribution to be paid by City for employer contribution and/or employee contrlbutions for PERS benefits. 10. lnterests of Contractor. Contractor (including principals, associates and management employees) covenants and represents that it does not now have any investment or interest in real property and shall not acquire any interest, direct or indirect, in the area covered by this Agreement or any other source of income, interest in real property or investment which would be affected in any manner or degree by the performance of Contractor's services hereunder. Contractor further covenants and represents that in the performance of its duties hereunder no person having any such interest shall perform any services under this Agreement. Contractor is not a designated employee within the meaning of the Political Reform Act because Contractor: a. will conduct research and arrive at conclusions with respect to his/her rendition of information, advice, recommendat,on or counsel independent of the control and direction of the City or of any City official, other than normal agreement monitoring; and Page 4 b. possesses no authority with respect to any City decision beyond rendition of information, advice, recommendation or counsel. (FPPC Reg. 18700(a)(2).) 11. Abilitv of Contractor. City has relied upon the training and ability of Contractor to perform the services hereunder as a material inducement to enter into this Agreement. Contractor shall therefore provide properly skilled personnel to perform all services under this Agreement. All work performed by Contractor under this Agreement shall be in accordance with applicable legal requirements and shall meet the standard of quality ordinarily to be expected of competent contractors in Contractor's field of expertise. 12. Comoliance with Laws. Contractor shall use the standard of care in its profession to comply with all applicable federal, state and local laws, codes, ordinances and regulations. 13. Licenses. Contractor represents and warrants to City that it has the licenses, permits, qualifications, insurance and approvals of whatsoever nature which are legally required of contractor to practice its profession. contractor represents and warrants to city that contractor shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this Agreement, any licenses, permits, insurance and approvals which are legally required of contractor to practice its profession. contractor shall maintain a city of Lake Elsinore business license. 14. lndemnitv. Contractor shall indemnify, defend, and hold harmless the City and its officials, officers, employees, agents, and volunteers from and against any and all losses, liability, claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts or omissions of Contractor or its employees, subcontractors, or agents, by acts for which they could be held shictly liable, or by the quality or character of their work. The foregoing obligation of Contractor shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful misconduct of the City or its officers, employees, agents, or volunteers and (2) the actions of Contractor or its employees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage to property, or violation of law. lt is understood that the duty of Contractor to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 ot lhe California Civil Code. Acceptance by City of insurance certificates and endorsements required under this Agreement does not relieve Contractor from liability under this indemnification and hold harmless clause. This indemnification and hold harmless clause shall apply to any damages or claims for damages whether or not such insurance policies shall have been determined to apply. By execution of this Agreement, Contractor acknowledges and agrees to the provisions of this Section and that it is a material element of consideration. 15. lnsuranceReouirements. a. lnsurance. Contractor, at Contractor's own cost and expense, shall procure and maintain, for the duration of the contract, unless modified by the City's Risk Manager, the following insurance policies. i. Workers' Comoensation Coveraoe. Contractor shall maintain Workers' Compensation lnsurance and Employels Liability lnsurance for hisiher employees in accordance with the laws of the State of California. ln addition, Contractor Page 5 shall require each subcontractor to similarly maintain Workers' Compensation lnsurance and Employer's Liability lnsurance in accordance with the laws of the State of California for all of the subcontractor's employees. Any notice of cancellation or non-renewal of all Workers' Compensation policies must be received by the City at least thirty (30) days prior to such change. The insurer shall agree to waive all rights of subrogation against City, its officers, agents, employees and volunteers for losses arising from work performed by Contractor for City. ln the event that Contractor is exempt from Worker's Compensation lnsurance and Employer's Liability lnsurance for his/her employees in accordance with the laws of the State of California, Contractor shall submit to the City a Certificate of Exemption from Workers Compensation lnsurance in a form approved by the City Attorney. ii. General Liabilitv Coveraqe. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars (91,000,000) per occurrence for bodily injury, personal injury and property damage. lf a commercial general liability insurance form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Agreement or the general aggregate limit shall be at least twice the required occurrence limit. Required commercial general liability coverage shall be at least as broad as lnsurance Services Office Commercial General Liability occurrence form CG 0001 (ed. 11/88) or lnsurance Services Office form number GL 0002 (ed. 1f3) covering comprehensive General Liability and lnsurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. No endorsement may be attached limiting the coverage. iii. Automobile Liabilitv Coveraqe. Contractor shall maintain automobile liability insurance covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with the work to be performed under this Agreement, including coverage for owned, hired and non-owned vehicles, in an amount of not less than one million dollars ($1,000,000) combined single limit for each occurrence. Automobile liability coverage must be at least as broad as lnsurance Services Office Automobile Liability form CA 0001 (ed. 12190) Code 'l ("any auto"). No endorsement may be attached limiting the coverage. b. Endorsements. Each general liability and automobile liability insurance policy shall be with insurers possessing a Best's rating of no less than A:Vll and shall be endorsed with the following specific language: i. The City, its elected or appointed officers, officials, employees, agents and volunteers are to be covered as additional insured with respect to liability arising out of work performed by or on behalf of the Contractor, including materials, parts or equipment furnished in connection with such work or operations. ii. This policy shall be considered primary insurance as respects the City, its elected or appointed officers, officials, employees, agents and volunteers. Any insurance maintained by the City, including any self-insured retention the City may have, shall be considered excess insurance only and shall not contribute with it. iii. This insurance shall act for each insured and additional insured as though a separate policy had been written for each, except with respect to the limits of liability of the insuring company. Page 6 iv. The insurer waives all rights of subrogation against the City, its elected or appointed officers, officials, employees or agents. v. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its elected or appointed officers, officials, employees, agents or volunteers. vi. The insurance provided by this Policy shall not be suspended, voided, canceled, or reduced in coverage or in limits except after thirty (30) days written notice has been received by the City. c. Deductibles and Self-lnsured Retentions. Any deductibles or self-insured retentions must be declared to and approved by the City. At the City's option, Contractor shall demonstrate financial capability for payment of such deductibles or self-insured retentions. d. Certiflcates of lnsurance. Contractor shall provide certificates of insurance with original endorsements to City as evidence of the insurance coverage required herein. Certiflcates of such insurance shall be filed with the City on or before commencement of performance of this Agreement. Current certification of insurance shall be kept on file with the City at all times during the term of this Agreement. 16. Notices. Any notice required to be given under this Agreement shall be in writing and either served personally or sent prepaid, first class mail. Any such notice shall be addressed to the other party at the address set forth below. Notice shall be deemed communicated within 48 hours from the time of mailing if mailed as provlded in this section. lf to City:City of Lake Elsinore Attn: City Manager 130 South Main Street Lake Elsinore, CA 92530 City of Lake Elsinore Attn: City Clerk 130 South Main Street Lake Elsinore, CA 92530 With a copy to: lf to Contractor: DM Contracting, lnc. Attn: David *lagraan V\a5on<- 1065 Harber Drive Colton, CA. 92324 17. Entire Aoreement. This Agreement constitutes the complete and exclusive statement of Agreement between the City and Contractor. All prior written and oral communications, including correspondence, drafts, memoranda, and representations, are superseded in total by this Agreement. 18. Amendments. This Agreement may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney. Page 7 '19. Assionment and Subcontractino. The parties recognize that a substantial inducement to City for entering into this Agreement is the reputation, experience and compelence of Contractor and the subcontractors listed in Exhibit B. Contractor shall be fully responsible to City for all acts or omissions of any subcontractors. Assignments of any or all rights, duties or obligations of the Contractor under this Agreement will be permitted only with the express consent of the City. Contractor shall not subcontract any portion of the work to be performed under this Agreement except as provided in Exhibit B without the written authorization of the City. lf City consents to such subcontract, Contractor shall be fully responsible to City for all acts or omissions of those subcontractors. Nothing in this Agreement shall create any contractual relationship between City and any subcontractor nor shall it create any obligation on the part of the City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise is required by law. 20. Waiver. Waiver of a breach or default under this Agreement shall not constitute a continuing waiver of a subsequent breach of the same or any other provision under this Agreement. 21. Severabilitv. lf any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provislons of this Agreement shall continue in full force and effect. 22. Controllinq Law Venue. This Agreement and all matters relating to it shall be governed by the laws of the State of California and any action brought relating to this Agreement shall be held exclusively in a state court in the County of Riverside. 23. Litiqation Expenses and Attornevs'Fees. lf either party to this Agreement commences any legal action against the other party arising out of this Agreement, the prevailing party shall be entitled to recover its reasonable litigation expenses, including court costs, expert witness fees, discovery expenses, and attorneys' fees. 24. Mediation- The parties agree to make a good faith attempt to resolve any disputes arising out of this Agreement through mediation prior to commencing litigation. The parties shall mutually agree upon the mediator and share the costs of mediation equally. lf the parties are unable to agree upon a mediator, the dispute shall be submitted to JAMS or its successor in interest. JAMS shall provide the parties with the names of five qualified mediators. Each party shall have the option to strike two of the five mediators selected by JAMS and thereafter the mediator remaining shall hear the dispute. lf the dispute remains unresolved after mediation, either party may commence litigation. 25. Autho tv to Enter Aoreement. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Agreement. Each party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to make this Agreement and to bind each respective party. The City Manager is authorized to enter into an amendment or otheMise take action on behalf of the City to make the following modifications to the Agreement: (a) a name change; (b) grant extensions of time; (c) non- monetary changes in the scope of services; and/or (d) suspend or terminate the Agreement. 26. Prohlbited lnterests. Contractor maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Contractor, to solicit or secure this Agreement. Further, Contractor warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working Page 8 solely for Contractor, any fee, commission, percentage, brokerage fee, gift or consideration contingent upon or resulting from the award or making of this Agreement. breach or violation of this warranty, City shall have the right to rescind this Agreement without liability. For the term of this Agreement, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 27. Equal Opportunitv Emplovment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. 28. Prevailino Waqes. Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Ti e 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Contractor agrees to fully comply with all applicable federal and state labor laws (including, without limitation, if applicable, the Prevailing Wage Laws). lt is agreed by the parties that, in connection with the Work or Services provided pursuant to this Agreement, Contractor shall bear all risks of payment or non-payment of prevailing wages under California law, and Contractor hereby agrees to defend, indemnify, and hold the City, and its officials, officers, employees, agents, and volunteers, free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The foregoing indemnity shall survive termination of this Agreement. 29. Execution. This Agreement may be executed in several counterparts, each of which shall constitute one and the same instrument and shall become binding upon the parties when at least one copy hereof shall have been signed by both parties hereto. ln approving this Agreement, it shall not be necessary to produce or account for more than one such counterpart. [Signatures on next page] other For Page 9 lN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. "ctTY" CITY OF LAKE ELSINORE, a municipal corporation ,CONTRACTOR' DM Contracting, lnc., a corporation r5 Attachments: Exhibit A - Contractor's Bid Schedule Exhibit B - List of Subcontractors Page 1 0 efij EXHIBIT A CONTRACTOR'S BID SCHEDULE [ATTACHED] EXHIBIT A EXHIBIT A BID FORIU City of Lake Elsinore Public Works Department FY 15/16 Annual Curb, Gutter and Sidewalk Repair Program Item Description Quantity Unit Price Total L Remove existing and construct 6" curb and gutter per Gity Standard No. 200 2OO LF 3E-7,oo 2.Remove existing and construct 8" curb and gutter per Standard No. 201 2OO LF ttg -4,oo 3.Remove existing concrete and construct 4" concrete sidewalk over compacted sub. grade per City Standard No. 210 5000 sF 3,So 1t;*' 4.Remove exlsting concrcte and construct handicap ramps per City Standard No. 214A 2EA lla315@ :/t@e- 5.Remove existing concrete and construct handicap ramps per Gity Standard No. 2148 2EA 3,goo 7'w Contractor Signature Total Amount in words and figures (payment bond required in this amount - no personal checks wiu be accepted): $TZ, SW .gg-.. e erentJ - t ua tlvusa,Q I fine,'hunQrry' ftolla,s * 'ft;> { Notice Inviting Bids: Fy LS/16 Annual Curb, Gutter and Sidewalk Repair Program City of Lake Elsinore Contractor Name N/A EXHIBIT B LIST OF SUBCONTRACTORS [ATTACHED] EXHIBIT B -- COVERAGES CERTIFICATE NUMBER:cL1 ss130s0s2 REVISION NUMBER: ACORif\--'CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DO/YYYY) 9/70/201s THIS CERTIFICATE IS ISSUED AS A i,IATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGANVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TH|S CERnFTCATE OF TNSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE ISSUTNG TNSURER(S), AUTHORTZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIONAL lllSURED, the policy(ies) must be endoFed. lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Business & Contractors Insurance Services, Inc. 131 East Main St. Suite 203 EJ. Cajon CA 92O2O 'fifl'' eina Galvas fjJP\1 -*,. l6L9) s92-4440 lil^,. (61e) se2-{4{e ,q3. GinaGbcisinc. net INSURER(S} AFFORDING COVERAGE NAIC # tNsuRERACo].ony Insurance Cotlpan.y 3 9993 INSURED DM Contracting Inc 1065 Earber Colton CA 92324 INSURER B : INSURER C : INSURER O : INSURER E r INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSRITR TYPE OF INSURANCE \DOt- INSD POLICY NUMBER POLICY EXP(MM/DD/YYYYI LIMITS A x I coMMERCTAL GENERAL LtABtL|TY l l ".o,r.-rooe l"l occunr-x 101GL001552501 5/!2/20L5 s/L2/20L6 EACH OCCURRENCE 1 .000,000 DAMAGE TO RENTED PRFMISFS /Fa o.drrr s 100 ,000 MED EXP (Anv one person)s 5,000 PERSONAL & ADV INJURY s 1,000,000 GEI x '1,1AGGREGATE LIMIT APPLIES PER i ,o.,"' [l  lf yes, desqibe under DESCRIPTION OF OPFRATIONS below N/A I PER OTH.STATL'TE FR E.L, EACH ACCIDENT s E.L, DISEASE - EA EMPLOYEI s E.L DISEASE - POLICY LIMIT $ OESCRIPIION OF OPERATIONS / LOCATIONS / VEHICLES (ACORO l0'1, Additional Rem*s Schedule, may be attached if more space is required) Certificate Holder has been named as Additional Insured per written contract. R.E: Various Locations. * Endorsement is attached. CANCELLATION City of Lake Elsinore 130 South Main St. Lake Elsinore, CA 92530 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATVE ACORD 2s (2014tO1) lNS025 ruoraol @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I 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 COVEMGE PART SCHEDULE A. SECTION ll - WHO lS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional lnsured Contractual Liability "Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations at Work "Bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the prolect (other than service, maintenance or repairs) to be performed by or on behalf of the 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. U156-0310 lncludes copyrighted material of ISO Properties, lnc., Page 1 of 1 with its permission. Name of Additional lnsured Person(s) or Organization(s) (Additional lnsured):Location(s) of Covered Operations: ALL PERSONS OR ORGANIZATIONS AS REQUIRED BY WRITTEN CONTRACT WITH THE INSURED VARIOUS THIS INSURANCE IS PRIMARY AND NON- CONTRIBUTORY,BUT ONLY IN THE EVENT OF THE NAMED INSURED'S SOLE NEGLIGENCE Negligence of Additional lnsured "Bodily injury" or "property damage" arising directly or indirectly out of the negligence of the additional insured(s). ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U156-0310 lncludes copyrighted material of ISO Properties, lnc., Page2ol 1 with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section lV - Conditions: We waive any rights of recovery we may have againsl any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard" it'. a. you agreed lo such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERI\,S AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047-0310 lncludes copyrighted material of ISO Properties, lnc., Page 1 of 1 with its permission. CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an AODITIONAL INSURED, the policy(ies) must be endorsed. lf SUBROGATION lS WAIVED, subiect to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the PRODUCER CISNEROS I NSURANCE AGENCY 5750 Division St, Ste 100 Riverside, CA 92506 TNSUREo D MContracting, lnc. 1065 Harbor Drive Colton, CA92324 Truck lnsurance E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wlTH RESPECT TO ffiICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONSOF SUCH POLICIES, LIMITSSHOVI/N MAYHAVEBEEN REDUCED BYPAIDCLAIMS- NSR LTR TYPE OF INSURANCE F.Y LIMITS COMMERCIAL GENERAL LIABILITY ] "*,r"-roo, ! o..r* EACH OCCURRENCE UAMAUE IU KI PREMISES (Ea MED EXP (AnY PERSONAL & ADV IN.]IIRY .L AGGREGATE LIMITAPPLIES PER: ,o,,.' ! !E"oi f] 'o" GENERAL AGGREGATE PRODUCTS. COMP/OP AGG AU i"ll'l:::^"* I ruowreo l-I scneouleo I euros l_I AUroS | ,,*.oo,,o, H 13+53*'" $ BODILY INJURY (Per person)$ BODILY INJURY (Ps a€ident) PROPIRTY DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE AGGREGATE DFD I I *.r.*t,.r. A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y'NANY PROPRIETOR/PARTNERiEXECUTIVE I:'- OFFICERMEMBER EXCLUDED? I Y (Mandatory in NH) lfyes, desqibe under N/A A09476499 1228t14 2t28t15 X EACH ACCIDFNT 1.000.000 NISFA 100 1(m00c) B Business Personal Pronertv 605885857 1228t14 2t28t15 Limit: $10,000 Deductible: $ 500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD '101, AdditionalRemarks Schedule, may be attached if more space is required) Certificate of Workers' Compensation coverage. Waiver of Subrogation applies per attached WC99061 9 endorsement. CtrRTIF :ATF HOI DtrR @'1988-2014 ACORD CORPOMTION. All rights reserved. The ACORD name and logo are registered marks of ACORD CANCtrI IATION City of Lake Elsinore 130 S. Main Street Lake Elsinore, CA 92530 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATE THEREOF. NOTICE WLL BE DELIVERED IN ACCOROANCE WTH THE POLICY PROVISIONS AUTHORIZED REPRESE ACORD 25 (2014t01) onr lav f,r rriotro FARMERS INSURANCE WOR KER S' (OMPENSATION AND EIUIPIOYIRS' I.IABITITY INSURAN(E PO[I(Y Named . DM C9NTMST1NG, tNc. Insured . . 1065 HARBER DRIVE . CoLToN c492324 Agent 97 -45-345 w( 99 06 I9 A0947-64-99 20 L4 Poliry Number Policy of the Company Year Effective Date WAIVER OT OUR RIGHT TO RE(OVER TROffI OTHERS ENDORSEilIENT. BI.ANKET \7e have the right to recover our payments from anyone liable for an injury covered by this policy. \7e will not enforce our right against the person or organization for which you perform work under a written contract that requires you to obtain this agreement from us. The additiond premium for this endorsement shall be 3 .0 Vo of the \Torkers' Compensation premium otherwise due for the state(s) listed below on such remuneration, subject to a minimum charge of $250 All written contracts in the state(s) of: CA This endorsement is part of your policy. It supersedes and controls an1'thing to the contrary. It is otherwise subject to all the terms of the policy. Countersigned 93.6369 ISI tDtTloil 9{7 w(990619A Authorized Representative t6369I1 PAGI I 0t 1 COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: ,qi<>nif CERTIFICATE OF LIABILITY INSURANCE OATE (MM/DDIYYYY) 09/09/201 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER JONETTE PHILLIPS INSURANCE AGENCY 3452 E FOOTHILL BLVD STE 3205ratefa#n PASADENA cA 91102 @ xxxliu' JONETTE PHTLLTPS lllP\E* =-.,.020-79s-3227 l# "^,.626-z9s-3020 iilHE"", JoNETTE@JoNETTEpHTLLTpS.NET INSURER(S) AFFORDING COVERAGE NAIC # lxsupEp a.State Farm Mutual Automobile lnsurance Company 25178 TNSURED DM CONTRACTING, INC 1065 HARBER DR coLToN cA92324-2622 INSURER B : INSURER C : INSURER D: INSURER E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRITR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITYL .LA,M.-MADE I oaar* -I EACH OCCURRENCE DAMAGE TO RENTED PREMISES f Ea occurence)$ MED EXP (Any one peEon) PERSONAL & ADV INJURY GEt i::::Xffr#^ff':'J GENERAL AGGREGATE $ PRODUCTS. COMP/OP AGG $ $ A AUI.OMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS [-l ScHEDULED| ^ | AUTosT-'l NoN-owNEDI I rurosft 492 0981-A14-75 -001 492 0983-A14-75 492 0980.A14-75 492 0984-A14-75 07t14t2015 07t't412015 07t't4t2015 07t14t2015 01t14t2016 f,MBINED SINGLE LIMIT $ 1,000,000 01t14t2016 01t1412016 0'U14t2016 BODILY INJURY (Per person)$ BODILY INJURY (Per accident)$ PROPERTY DAMAGE {Per accident}$ $ UMBRELLA L|,AB I occun ExcESs L.AB -l a*,ra-rooa EACH OCCURRENCE AGGREGATE $ oeo I ]nerrrurror$$ WORKERS COMPENSATION ANDEMPT_OYERS'LtABtLtTY Y/il ANY PROPRIETOFYPARTNER,/EXECUTIVE T- OFFICER,,MEMBER EXCLUDED? L(Mandatory in NH) lf yes, describe under OESCRIPTION OF OPERATIONS below N/A R I OTH. ATUTE I I ER E.L, EACH ACCIDENT $ E,L, DISEASE. EA EMPLOYE $ nlsFAsF - pnt tcY I tMtT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached lf more space is requlred) Certificate Holder has been named as Additional lnsured per written contract. THIS INSURANCE IS PRIMARY AND NONCONTRIBUTORY WITH RESPECTS TO CLAIMS ARISING OUT OF THE OPERATION OF THE DESCRIBED VEHICLE Project: Cityride Annual Curb, Gutter, and Sidewalks Repair Program, Project No.210001 ,TE City of Lake Elsinore 130 S. Main Street Lake Elsinore CA 92530 Tel# 951 -674 -31 24 ext 298 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "uo Grajeda, Lic. Agent starr ACORD 25 (20141011 The ACORD name and logo ar 014 ACORD CORPORATION. All rights reserved. ts of ACORD ,1001486 132849.9 O2-O4-20j4 CANCELLATION PUBLIC WORKS ROUTING Once the attached documents have been reviewed, please sign and return to Public Works, at ext. 241 Reviewing Department Public Works Review Signature Date q.tl-t5 City Attorney City Manager City Clerk NAME OF VENDOR: SUPPORT DOCUMENTS: lnsurance(s) Proposa!: Bonds: COMMENTS: altbl6 ^/zqlf DM Contracting N/A RECEIVED sEP I { 2015 CITY CLERK'S OFFICE