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HomeMy WebLinkAboutItem No. 18 Amend. No 3 J & S Striping Co. Annual Contract Svs CIP Z10004City Council Agenda Report City of Lake Elsinore 130 South Main Street Lake Elsinore, CA 92530 www.lake-elsinore.org File Number: TMP 21-245 Agenda Date: 6/22/2021 Status: PassedVersion: 1 File Type: Council Consent Calendar In Control: City Council / Successor Agency Agenda Number: 18) Amendment No. 3 to the Agreement with J & S Striping Company for Annual Contract Services (On-Call) - CIP # Z10004 Authorize the City Manager to execute Amendment No. 3 to the Contract with J&S Striping Company for the annual Traffic Striping Maintenance Program extending the term for an additional 12 months and adjusting compensation for Fiscal Year 2021-22 for a not to exceed contract amount of $330,000 in substantially the form attached and in such final form as approved by the City Attorney. Page 1 City of Lake Elsinore Printed on 12/29/2023 CITY _ LADE 7 LSIIYORE �� DREAM EjCTREME REPORT TO CITY COUNCIL To: Honorable Mayor and Members of the City Council From: Jason Simpson, City Manager Prepared by: Rick De Santiago — Public Works Manager Date: June 22, 2021 Subject: Amendment No. 3 to the Contract with J & S Striping Company for Annual Contract Services (On -Call) - CIP # Z10004 Recommendation Authorize the City Manager to execute Amendment No. 3 to the Contract with J&S Striping Company for the annual Traffic Striping Maintenance Program extending the term for an additional 12 months and adjusting compensation for Fiscal Year 2021-22 for a not to exceed contract amount of $330,000 in substantially the form attached and in such final form as approved by the City Attorney. Background On January 8, 2019, City Council approved the award to J&S Striping Company for On -Call Contract Services for the Annual Traffic Striping Maintenance Program, the budgeted compensation amount was $275,000 and the term of the contract was 12 -months with the option to extend three (3) additional twelve (12) month renewal terms. Amendment No. 1 sent out in the form of an extension letter dated June 17, 2019 extended the term of the contract for an additional 12 -months. Amendment No. 2 dated July 1, 2020 extended the contract for an additional 12 -month term for Fiscal Year 2020-21. Discussion As a part of the regular street maintenance service, traffic striping is performed throughout the City. The work to be performed under this contract consists of painting traffic lanes, parking lanes, and thermoplastic directional arrows, crosswalks, and legends. All striping will conform to Caltrans Standard Plans and Specifications. J&S Striping is responsive at short notice, and staff is pleased with their services. Accordingly, staff is recommending an extension of their contract for Fiscal Year 2021-22. Fiscal Imaact Funds in the amount of $330,000 have been allocated for the Annual Traffic Striping Maintenance Program in the Fiscal Year 2021/22 CIP No. Z10004 budget. Exhibits J&S Striping Company - Exhibit A - Amendment No. 3 J&S Striping Company - Exhibit B - Amendment No. 2 J&S Striping Company - Exhibit C - Amendment No. 1 J&S Striping Company - Exhibit D - Original Agreement AMENDMENT No. 3 TO AGREEMENT FOR CONTRACTOR SERVICES (ON-CALL) J&S Striping Company, Inc. Annual Traffic Striping Maintenance Program Project No. Z10004 This Amendment No. 3 to Agreement for Contractor Services (“Amendment No. 3”) is made and entered into as of July 1, 2021 by and between the City of Lake Elsinore, a municipal corporation (“City), and J&S Striping Company, Inc., a Corporation (“Contractor”). RECITALS A. The City and Contractor have entered into that certain Agreement for Contractor Services dated as of January 8, 2019 (the “Original Agreement”). Except as otherwise defined herein, all capitalized terms used herein shall have the meanings set forth for such t erms in the Original Agreement. B. The Original Agreement provided for compensation to Contractor in an amount not to exceed Four Hundred Thirty Five Thousand Eight Hundred Fifty dollars ($435,850) for Fiscal Year 2018/2019. C. The term of the Original Agreement was for seven (7) months and allows the City to extend the term on a 12-month basis, not to exceed three (3) additional 12-month renewals. D. Amendment No. 1 dated June 17, 2019 in the form of an extension letter, extended the agreement a further 12-month term for Fiscal Year 2019/2020. E. Amendment No. 2 dated July 1, 2020 extended the term of the contract an addition 12-month term and adjusted compensation to a not to exceed amount of $275,000 per fiscal year. F. The parties now desire to extend the term for such services as set forth in this Amendment No. 3 for an additional 12-month term and adjust compensation to a not to exceed amount of $330,000. 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, upon approval of Amendment No. 3, the Agreement shall continue in full force and effect for a period of twelve (12) months, commencing on July 1, 2021 and ending on June 30, 2022. 2. Section 3, Compensation, is hereby amended as follows: Compensation to be paid to the Contractor shall be in accordance with the fees set forth in Contractor’s Proposal (Exhibit A to the Original Agreement). In no event shall Contractor’s compensation exceed Three Hundred Thirty Thousand dollars ($330,000) per fiscal year without additional written authorization from the City. Notwithstanding any provision of Contractor ’s Proposal to the contrary, out of pocket expenses 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. Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. [Signatures on next page] IN WITNESS WHEREOF, the parties have caused this Amendment No. 3 to be executed on the respective dates set forth below. “CITY” CITY OF LAKE ELSINORE, a municipal corporation Jason Simpson, City Manager Date: ATTEST: City Clerk APPROVED AS TO FORM: City Attorney Risk Manager “CONTRACTOR” J&S Striping Company, Inc., a Corporation By: Robert Aragon, President Date: EXHIBIT B AMENDMENT NO. 2 [ATTACHED] EXHIBIT C AMENDMENT NO. 1 [ATTACHED] EXHIBIT D ORIGINAL AGREEMENT [ATTACHED] AMENDMENT NO. 2 TO AGREEMENT FOR CONTRACTOR SERVICES (ON-CALL) J&S Striping Company, Inc. Annual Traffic Striping Maintenance Program Project No. Z10004 This Amendment No. 2 to Agreement for Contractor Services (“Amendment No. 2”) is made and entered into as of July 1, 2020 by and between the City of Lake Elsinore, a municipal corporation (“City), and J&S Striping Company, Inc., a Corporation (“Contractor”). RECITALS A. The City and Contractor have entered into that certain Agreement for Contractor Services dated as of January 8, 2019 (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 Four Hundred Thirty Five Thousand Eight Hundred Fifty dollars ($435,850) for Fiscal Year 2018/2019. C. The term of the Original Agreement was for approximately five (5) months through June 30, 2020 and allowed the City to extend the term on a 12-month basis, not to exceed three (3) additional 12 month renewals. D. Amendment No. 1 dated June 17, 2019 in the form of an extended the agreement a further 12-month term for Fiscal Year 2019/2020. E. The parties now desire to extend the term for such services as set forth in this Amendment No 2 for an additional 12-month term for FY2020/2021 and adjust compensation to a not to exceed amount of $275,000 for FY2020/2021. 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, 2020 and ending on June 30, 2021. The City may, at its sole discretion, extend the term of this Agreement on a 12-month basis not to exceed one (1) 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. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 2. Section 3, Compensation, is hereby amended as follows: Compensation to be paid to Contractor shall be in accordance with the fees set forth in Contractor's Proposal (Exhibit A to the Original Agreement). In no event shall Contractor's compensation exceed Two Hundred Seventy-Five Thousand Dollars ($275,000) for Fiscal Year 2020-2021 without additional written authorization from the City. Notwithstanding any provision of Contractor's Proposal to the contrary, out of pocket expenses 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. 3. 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. 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 Risk Manager “CONTRACTOR” J&S Striping Company, Inc., a Corporation By: Date: Attachments: Exhibit A – Amendment No. 1 Exhibit B – Original Agreement DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 6/22/2020 | 9:30 AM PDT 6/22/2020 | 9:47 AM PDT EXHIBIT B EXHIBIT A AMENDMENT NO. 1 [ATTACHED] DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F CITY OF LADE . LSINORE Z DREAM EXTREME June 17, 2019 J&S Striping Company, Inc. Attn: Mr. Robert Aragon 1544 S. Vineyard Avenue Ontario, CA 91761 Dear Mr. Aragon, Re: Extension of City of Lake Elsinore Annual Traffic Striping Maintenance Contract Per the terms of your agreement dated January 8, 2019, the City may at its sole discretion, extend the term of this Agreement on a 12 -month basis not to exceed three (3) additional twelve (12) renewal terms by giving written notice thereof to Contractor, such notice to be exercised the City Manager. This letter shall serve as written notice to extend your contract with the City of lake Elsinore for Traffic Striping Maintenance services for a period of twelve (12) months commencing July 1, 2019 and ending on June 30, 2020. Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. If you have questions or need further assistance, please contact Catherine Eakins, Public Works Administrative Assistant, at (951) 674-5170 ext. 241. Sincerely, Grant es City Manager 951.674.3124 130 S. MAIN STREET LAKE ELSINORE, CA 92530 WWW.LAKE-ELSINORE.ORG DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F EXHIBIT B EXHIBIT B ORIGINAL AGREEMENT [ATTACHED] DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F AGREEMENT FOR CONTRACTOR SERVICES J&S Striping, lnc. FY{8/19 Annual Traffic Striping Maintenance Program, Project No.210004 This Agreement for Contractor Services (the "Agreement") is made and entered into as of January 8, 2019 by and between the City of Lake Elsinore, a municipal corporation ("City") and J&S Striping Company, lnc. ("Contractor"). RECITALS A. The City has determined that it requires the following services: painting traffic lanes, parking lanes and thermoplastic directional arrows, crosswalks, legends and placement of RPM's as required. B. Contractor has submitted to City a proposal, daled 1111512018 attached hereto as Exhibit A ("Contractor's Proposal") 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 servlces and related work as set forth in this Agreement. AGREEMENT 1. Scooe of Services. Contractor shall perform the services and related work described in Contractofs Proposal (Exhibit A). Contractor shall provide such services and related work at the time, place, and in the manner specified in Contractor's Proposal (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 Agreemenl consistent with Contractor's Proposal (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 Proposal (Exhibit A). When requested by Contractor, extensions to the time period(s) specified may be approved in writing by the City Manager. City of Lake Elsinore J&S Striping, lnc. Contract dale: 1/8/2019 Page 1 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F Term. Unless earlier terminated as provided elsewhere in this Agreement, this Agreement shall continue in full force and effect for a period of five (5) months, commencing on January 8, 2019, and ending on June 30, 2019. The City may, at its sole discretion, extend the term of this Agreement on a 12-month basis not to exceed three (3) additional twelve (12) month renewal terms by giving written notice thereof to Contractor not less than thirty (30) days before the end ofthe contract term, such notice to be exercised by the City Manager. [Compensation. Compensation to be paid to Contractor shall be in accordance with the fees set forth in Contractor's Proposal (Exhibit A), which is attached hereto and incorporated herein by reference. ln no event shall Contractor's compensation exceed Four Hundred Thirty-Five Thousand Eight Hundred Fifty dollars ($435,850), without additional written authorization from the City. Notwithstanding any provision of Contractor's Proposal 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. 3. 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 of the monthly invoice by City staff. 4. Reserved. 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 as 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. Ownership of Documents. All plans, studies, documents and other wratings 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 Contractor orto 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 Page 2 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 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, inluries, and liability, direct or indirect (including any and all costs and expenses in connection therein), arising out ofthe City's use ofsuch 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 diskettes, 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, speciflcations, 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 period required by law, from the date of termination or completion of this Agreement. 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 Page 3 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 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. OtheMise, 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 that 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 of the City. 9. PERS Elioibilitv 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 benefits 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 entitled 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 contributions 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, recommendation or counsel independent of the control and direction of the City or of any City official, other than normal agreement monitoring; and b. possesses no authority with respect to any City decision beyond rendition of information, advice, recommendation or counsel. (FPPC Reg. 18700(aX2)) Page 4 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 11. Abilitv of Conhactor. 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. Compliance 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 inlury, 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 strictly liable, or by the quality or character of their work. The foregoing obligation of Contractor shall not apply when (1) the iniury, 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 Conhactor to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the 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, forthe duration of the contract, unless modified bythe City's Risk Manager, the following insurance policies. i. Workers' Compensation Coveraoe. Contractor shall maintain Workers' Compensation lnsurance and Employer's Liability lnsurance for his/her employees in accordance with the laws of the State of California. ln addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance 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 Page 5 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 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 Lrability lnsurance for hisiher 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 Coveraoe. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) 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. 11l88) or lnsurance Services Office form number GL 0002 (ed. 1/73) 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 1 ("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 offlcers, 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 rnsurance 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. iv. The insurer waives all rights of subrogation against the City, its elected or appointed officers, officials, employees or agents. Page 6 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 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. Certificates 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 flle 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 provided in this section. lf to City:City of Lake Elsinore Attn: City Manager 130 South Main Sheet Lake Elsinore, CA 92530 City of Lake Elsinore Attn: City Clerk With a copy to: 130 South Main Street Lake Elsinore, CA 92530 lf to Contractor: J&S Striping Company, [nc. Attn: Mr. Robert Aragon 1544 S. Vineyard Avenue Ontario, CA 9l 76 I 17. Entire Agreement. 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. 19. Assionment and Subcontractinq. The parties recognize that a substantial inducement to City for entering into this Agreement is the reputation, experience and competence 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 Page 7 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F obligations of the Contractor under this Agreement will be permitted only with the express consent of the Cily. 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 provisions of this Agreement shall continue in full force and effect. 22. Controllino 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. Authoritv 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 otherwise 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. Prohibited 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 solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For 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 Page 8 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 27. Eoual 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 Waoes. 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, Title 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] Page 9 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F lN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. "CITY" CITY OF LAKE ELSINORE, a municipal corporation "CONTRACTOR' J&S Striping Company, lnc. ATTEST:Date: /- Ll'l? Page 10 _*= City Clerk DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F EXHIBIT A CONTRACTOR'S PROPOSAL [ATTACHED] EXHIBIT A DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F EXHIBIT B LIST OF SUBCONTRACTORS [ATTACHEDI EXHIBIT B DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F EXHIBIT B PROPOSER'SPROPOSAL AND OTHERDOCUMENTS e Oirt DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSAL PROJECTNO.Z10004 ANNUALIRAFFICSTRIPINGMAINTENANCEPROG RAMF Y 18/19 TOTHEHONORABLEMAYORANDCITYCOUNCIL oft heCityof LakeElsinore,Calif omiaf ro ,(Propo""rl' IW 1. ThisProposalhasbeensubmittedtothe: Location:Cityclerk,CityofLakeElsinorel30 MailingLocation: CityClerk,CigoflakeElsinorel SouthMainStreet LakeElsinore,CA92530 Time: 2:00p.m. Date: November 15, 2018 30SouthMainStreet LakeElsinore, CA92530 2. -Deleted- 3. lncompliancewiththeNoticelnvitingProposals,theundersignedasProposerherebyproposestofurnis hallmaterials,equipmentandallotherlaborandmethodsanddoellthingsnecessaryfortheproperconstructiona ndcompletionofthework,instrictandcompleteaccordwiththeAgreement,SpecialProvisions(whichincludesth eGeneralProvisionsandTechnicalProvisions),Plans,Specifications,andotherContractdocumentsnowonfile inthePublicworksDepartmenloftheCityoflakeElsinoreatthepricessetforthintheProposalSchedulehereinfor theworkgenerallydescribedforthesaidproject. 4. TheundersignedasProposer,herebydeclaresthatheorshehascarefullyexaminedthelocationofthepro posedworkgenerallydescribedaboveandisfamiliarwiththeSpecialProvisions, Plans,Specificationsandlocalc onditionsattheplacetheworkistobedoneandalsounderstandsthatalllabor,materialsandequipmenttobefumis hed,shallbeforthepricesproposed,andthattheundersignedhasalsocheckedfiguressetforthhereinafterinthe ProposalScheduleandunderstandsthatneithertheCftyoflakeElsinore,oranyofficeroremployeethereforewill beresponsibleforanymisunderstandings,errorsoromissionsonthepartofrheundersignedinsubmittingthisPro posal. 5. ThecompleteContractincludesallofrhecontractdocumentsasifsetfortfrinfullherein,towit,theAgreem ent,anyandallContractchangeOrdersissuedaftertheexecutionoftheAgreement,anyandalladdendaissuedp riortotheopeningofrheProposal,theSpecialProvisions,theProjectPlans,theStandardPlans,thestandardSpec ifications,referenceSpecifications,theNoticelnvitingProposals,theNon- CollusionAffidavit,insurance,allofwhichareessentialpartsofthisContract. 7 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 6. -Deleted- 7. -Deleted- 8. . lnsubmlttjngproposal,thePro-posercertifiestotheciq hathe/shehastrainedhis/heremployeesand subcontractors,ifany,forUrbanRunofftnanagementandincludedsufficientsumsintneproposaiprteiocov ersuchcostsofsaidtraining(RegionalWatereualityControlBoardOrderNo.R&2002_ 99111I?_E:!9 cAS618.033(Municiparseparatesto-rmsewersvstemNpDEspermit),SectionXr.r).Th ofanyillegaldischarge( oft heConFa ctor'sworkand/oroperations. 9. . _.lftheProposerismakingachangetotheproposalprlortosubmission,theproposeristolinethrou ghtheexistingscript,addtherevision,andinitia l. 10. -Deleted- a 11 . TheProposershallsetforthforeachitemofi,vork,inclearlylegiblefigures,anitempriceandatotalforth eitem.intherespectivespacesprovidedforthispurpose.lnttrecaieolunitbisisitems,theamountsetforthund erthe"Total"columnshallbetheproductoftheunitpricemultipliedbytheestimatedquantityfortheitem. - 12. lncaseofdiscrepancybetweentheunitpriceandthetotalsetforthfortheitem,theunitpriceshallprevai l,excepthowever,thatiftheamountsetforthasaunitpriceisambiguous,unintelligiUteoruncertaintoi"ffir" e,orifitisomitted,orinthecaseofunitbasisitems, isthesameamountastheentryi;the"Total,boiu.n "orii,in".aseoflumpsumitems,isnotthesameamountastheentryinthe"Total"column,ihentheamountsetforthinihe" Total"columnfortheitemshallprevailinaccordancewiththefollowing: (a) Astothelumpsumitems,theamountsetforthinthe'Total"columnshallbethesamea mountintheu nitpricecolumn. Lumpsumitemsareconsideredtobea unitofone. (b) Astounitbasisitems,theamountsetforthinthe"Total,,columnsha bedivide d bytheestimatedq uantityfortheitemandthepricethusobtainedshallbetheu nitprice. 13, TheProposershallalsosetforth inclearlylegiblefiguresthe'TotalAmount"inthespacesprovidedatt hebottomoft heSchedu le. 8 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 '14. .. lncaseofdiscrepancybetweenthecalculatedsumofthe"TotalCost"columnandthenumberreprese ntingthecumulativetotaloftheitems,thecalculatedsumofthe"TotalCost'columnshallprevailoverthenumb errepresentingthecum ulativetotaloftheitems. 1I,. lnsubmittingtheProposal, rftheProposerfailstoprovideoromitsacostforlineitem,thentheproposal wi llbeconsiderednon-responsivea ndwillberejected. ] 6' .TheCityreservestherighttorejectoracceptaProposal,orpartsoftheProposalandtowaiveanyirregularityorinformalitytotheextentpermitted bylaw. 17 . lnsubmittingtheProposal,theProposeroffersandagreesthatiftheProposalisaccepted,theworksh allbeguaranteedastoqualityofworkmanshipandmaterialsfurnished,foraperiodofuixmonihshomthedate ofacceptanceoft heworkbytheCityCounci l. 18, lnsubmittingtheProposal,theProposerisawarethatthisisaPublicWorksprojectrequiringpayment sofprevailingwagerates,CertifiedPayrollsarerequiredtobesubmtttedweeklybytheContractor, Jubcontrac tor(s),andowneroperators.ContractpaymentswillbewithheldfordelinquentorinadequateCertifiedpayrolls (LC1771.5). 19. lnsubmittingtheProposal,theProposeroffersandagreesthatifaccepted,workshallbeperformedin accordancewiththeprojectPlansandSpecifications,includingallstipulationsdesignedtomeetdiversifiedFe deralEnvironmental,Architecturalandrelatedlawsandregulations. 20. lnsubmittingtfieProposal, theProposer offersand agreesto allowaccess to the workarea,fiscal,payroll,materials,andotherrelevantcontractrecords.Alkelevantrecordsshallberetainedf oratleastthreeyearsorlonger,asrequiredbylaw,fromthedateoftheNoticeofcompletion. 21. -Deleted- 22. lnsubmittingtheProposal,theProposeroffersandagreesthatifiheproposalisaccepted,thecontrac torandsubcontractor(s)shallcomplywithalllaws,ordinances,andregulationsapplicabletothework.lftheCon traclorascertainsatanytimethatanyoftherequirementsofthecontractareatvariancewithapplicablelaw(s), ordinances,regulations,orbuildingcoderequirements,heorsheshallprompflynotMhecitioflakeElsinor ePublicworksDepartment, andshallnotproceedwiththeworkin question, eiceptat nis orher own risk, until theEflgineerhashadanopportunitytodeterminetheextentoftheresponsibilityforthevariance,andtheappro priateconectiveactionstobeundertaken. 23. -Deleted- 9 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 24. 25. 26. Thecontractorshallsubmitthe'Non-CollusionAffi davitliviththeproposal. RECEIPTOFTOTALADDENDANO(S1 O ISHEREBYACKNoWLEoGED. PROPOSALMAYBEREJECTEDIFANYISSUEDADDENT}AISNOTACKNOWLEDGED. ThePropos€r -- I&s 'TRIPING coMpANy, INC lfanindividual,stateindividual'sname.lfapartnership,statenamesofallindividuals,co- partners,composingthefirm.lfacorporation, statenamesofpresident,secretary,treasurer andchiefexecutiveofficerthereof,lftheProposerfailstoprovidetherequestedinformation,thepropojiwttUeco nsiderednon-responsiveandwillberejected. ROBERT ARAGON - PRESIDENT, SECRXTARY, TREASURER 27 . lnsubmittingthisProposal,theundersignedagree€toperform,withitsownorganization,workamounting toatleastfiftypercent(50%)ofiheamountexceptthatanydesignated,'specialq/ibms;mayuepertormeooysuuc ontractandmaybededuc{edfrom theamountbeforeiompuiingthe amountofworkrequiredtobeperformedbytheContractor.lftheProposer,aftercomputingt6eamountoftvorkrequired,fails tomeetatleastfiflyperce. nt(50%)oftheamountofworkrequiredwithitsownforcis,theproposalwitrueionsioere dnon-responsiveandwillberejectedwithnofurtherconsideration. cent(0.5%o)ofthetotalProposal,theproposershallbedeemedtohaveagreedtoperformsuchportionhimselforhe rself,andthatheorsheshallnotbepermittedtosubletorsubcontracfthat-portionorurev,rc*ex&:ptiJr"yO"orfy" (ContractorsName) CORPOMTION (lndividual,partnership,orcorporation) lfacorporalion,incorporatedunderthelawsoflfpstateof CALIFORNIA onsentedtobythecitypursuanttotheprovisionsofsection4l0T,ofthepublicconhactcode(pic41o6i 29. -Deleted- AF-A.GON . VICE PRES]DENT l0 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 30. lncompliancewiththeprovisionsofihePublicContractoode,section4l04,theundersignedherewithset sforththenameandlocationoflheplaceofbusinessofeachsubcontractorwhowillperformworkorlabororrendet servicetotheprimeContractorinorabouttheconstructionofrheworkorimprovement,orasubcontractorlicensed bythestateof Californiawho,undersubcontracttotheprimeContractor,speciallyfabricatesandinstallsaportionoftheworkori mprovementaccordingtodetaileddrawingscontainedinthePlansandSpeciflcations,inanamountinexcessofo ne- halfofonepercent(0.5%)oftheprimeContraclo/stotalproposal,orinthecaseofProposalsfortheconstructionof streets, highways, i ncludingbridges,inexcessofone- halfofonepercent(0.5%)oftheprimeContractor'stotalProposalortenthousanddollars($ 10,000),whicheverisg reater,andtheportionoftheworkwhichwillbedonebyeachsubcontractor.TheProposershallnotlistmoretha nonesubcontractorf orthesameportlonohrork. Alladditionalinformationrequiredbyth6CityregardinganysubcontractonrhotheProposer isrequiredtolistundertheProvblonsofsections4l O4and4l0TofthePubliccontractcode,otherthanth esubcontracto/snameandlocation(city)ofbusinessorstatecontractor'sLicensenumber,maybesub mittedbytheProposerupto24hoursafterthedeadlinetimeanddateforreceiptofProp06als.Failuretotlm elyprovideallrequiredsubcontractorinformationshallresultintheProposalbelngdeterminednon- responsive. ll DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 REOUI REDSUBCONTR ACTORSINFORMATIOH t2 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 REOUTREpSUBCONTRACTORSTNFORMATTON l3 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 REOUI REpSUBCONTRACII}RS|NFORMAION Duplicatethisformasnecessarytoreportproposerandallsubcontracto(s)(DBEsandnon-DBEs)information. l4 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F cIwoFLAKEELStNOREe ROPOSAL€CHEDULE PROJECTNO.ZI0004 ANNUALTRAFFICSTRI PI NGMAINTENANCEP ROG RAMF Y 18/19 PRoPosER f { S 9rr/P/^tt' ( PROPOSALITEMSAS FOLLOWS : ITEM NO.CODE DESCRIPTIONOFITEMS ESTIMATED QUANTITY UNITPRIC E(FTGURE s) TOTALCO sT(FrcuR ES) 1 S 4"CenterlineYellowCaltransStd Detai I l,4"CenterlineWhiteCaltransStd 97,000 L.F. $0.0s $4,8s0 2 S 4"SolidLi neWhiteCaltransStd Deta i 12TB,4"SolidLineYellowCattransStd 10,000 L.F. $0.06 $600 3 S NoPassingZon+. Twodirection(NoRPM)CaltransStdDetait2 1 130,000 L.F. $0,14 $ 18,200 4 S NoPassingZon* Twod irectionwithRPMCaltransStd Detail22 10,000 L.F. $0.2e $2.900 5 S BikeLaneLine6"SolidLineCaltransStd. Det ail39 28,000 L.F. $0.1 I $3,080 6 S S"Solid LineCaltra nsStdDeta il38A 20,000 L.F.$0.13 $2,600 7 S 8"Sol id Linewith RPMCaltransStd38 4,000 L.F.$0.23 $920 I Therm oplastic 1 2"Solid Line,Wh iteorYell owCrosswalka ndLimitLineCa ltran sStdDet atlA24E 32,000 L.F, $2.2s $72,000 I 4" Sol idlinew/ski pYellowperCaltransStd Detaill5 15,000 L.F. $0.12 $ 1,900 10 4"So lid I inew/ski pYellowand R PMCalt ransStdDetaill6 5,000 L.F. $0.23 $1,150 11 ThermoplasticPavementMarkingWo rdsC altransStdA24D,A24E 15,000 S.F $2.8s $42,750 12 Thermoplastic PavementMarkingSy mbolsa nd NumeralsCaltransStdA24C 75,000 S.F $2.85 s213.750 13 ThermoplasticPavementMarkingAnowsC altransStdA24A,A24B 25,000 SF $2.8s $71,250 TOTALFORITEMS (Basedonestimatedq uantitiesofitems I throu gh 1 3 $ $43s.850.00 l5-A DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F CITYOFLAKEELSINOREPR OPOSAL€CHEDULE PROJECTNO.Z10004 ANNUALTRAFFICSTRI PI NG MAINTENANCEPROG RAMF Y 18/19 PROPOSER: J&S STRIPINGCOMPANY, INC N'TE: (ContractorName) a. ThelowestresponsibleProposenrillbedeterminedbycomparingthecumulativetotalofallitems (PCC20103 8b), b. TheCityhasthediscretiontoselectanyorallltemsfortheAwardoftheContract. c. TheCityreservestherighttoaddorsubtractitemsbyContractChangeOrderatthepricespropose d. Estimatedquantitiesareforthepurposeofcomparisononly,andpaymentswillbemadeonabasisofactua I m easurementofirorkcompleted. Thelineitemcostincludes,butnotbelimitedto,salestaxandallotherapplicabletaxesandfees.Codes. UnitsofMeasurement:(q) Deduct LF tinealfoot(f) FinalPayQuantities SF squarefoot(S) Specialtyltem TotalamountinWORDSforltemsonly(BasedinEstimatedQuantitiesofltemslthrough 13: FOUR HUNDRED THIRTY FIVE THOUSAND EIGHT HUNDBID FIFTYDOLLARS ONLY I 5-B DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.z10004 PROPOS ER'SSIGNATU REPAGE CONTRACTO RSSTATELICENSE:Number: 538211 Classification(s): ExpirationDate: 0813U2019 (Business&ProfessionsCodeT02S. 1 5) FEDERALIDENTIFICATIONNO.: 95-34f.3i575 PRESENTCITYBUSI N ESSLICENS E: ( Notreq uiredattimeProposa lissubmitted) ExpirationOate: c32 &S STRIPING COMPANY, INC (ContractorName) ADDRESS: 1544 S. VINEYARD AVE, ONTARIO, CA 91261 TELEPHONENUMBER(S PRINTNAME:ROBERT ARAGON SIGNATURE: TITLE: PRESIDENT DATE: 11/t5i l8 PRlNTNAME: SIGNATURE: UDY ARAGON TITLE: VI TE: I1/15/18 SIGNINGI NSTRUCTI ONSTOTHECONTRACTOR SignaturePagem ustbeaccompaniedbynotarycertificatesforEAcHsignature.Notethedescriptionoft hedocumentonthenotarycertificate.AttachALLnotarycertificatesimmediatelyfollowingthispage. GeneralPartnersm ustsignonbehalfofthepartnership. Itfl8c9ntracti,FsfirrnisAgornorefirU:.twolllcfrroornteoflirelshavirrcauthorit]rfrrlJrltheco{qorafio,nIU le.,... ,, . *utnorizeO tq,-ffi thalf ofal loffi cere"attachcpf'poralereaol *inn imm eai*etytoii eSealmaybeaffixedhe reto. lftheproposerfailstoproperlysignoromitsrequiredsignatures,theproposalwillbeconsiderednon- res ponsiveandwill berejected. NorE: Nam eon statecontractorLicensemustag reewith proposer'sna me. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or of that document. State of California County of SAN BERNARDINO ) on ll / ls/17 before me, JEREMY LEE, A NOTARY PUBLIC (insert name and title of the officer) personally appeared ROBERT AMGON who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certifiT under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and officialseal.Cofinl..lon ,2ltgtlt f{ohry Pulllc . Crlllornlr Srn tunrrdlm Gounly sisnature Q f (sear) DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or of that document. State of California County of San Bernardino ", tr/ iS lra berore me,Marissa Rodriguez, Notary Public (insert name and title of the officer) personally appeared ,."ot who proved to me on the basis of executed the' the instrument the the instrument. I certiff under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and WITNESS my officialseal. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 STATEOFCALIFORNIA COUNTYOF SAN BERNARDINO NO N.COLLUSIOTTTAFFIDAVIT PROJECTNO.Zl0004 ANNUALTMFFICSTRIPINGMAINTENANCEPROG RAMF Y 18119 ) )SS ) ROBERT ARAGON Thatheorsheis affiantbeingfirstdulysworn, deposesandsays: PRESIDEN, SECRETARY, TREASURER ' I&S STRIPING COMPANY, INC tneoartymakingdreforegoingproposal(C ontractorName) thattheProposalisnotmadeintheinterestof,oronbehalfof,anyundisclosedperson,partnership,company,asso ciation,organization,orcorporation;thattheProposalisgenuineandnotcollusiveorsham;thattheProposerhasn otdirectlyorindirectlyinducedorsolicitedanyotherProposertoputinafalseorshamProposal,andhasnotdirectly orindirectlycolluded,conspired,connived,oragreedwithanyProposeroranyoneelsetoputinashamProposal,ort hatanyoneshallrefrainfromproposing;thattheProposerhasnotinanymanner,directlyorindirectlysoughtbyagr eement,communication,orconferencewithanyonetofixthepriceoftheProposeroranyotherProposer,ortofixan yoverhead,profit,orcostelementoftheprice,orofthatofanyother Proposer,or to secure anyadvantage againstthepublicbodyawardingtheContractofanyoneinterestedintheproposedContract;thatallstatementsco ntainedintheProposalaretrue;and,further,thattheProposerhasnot,directlyorindirectly,submittedhisorherpric eoranybreakdownthereof,orthecontentsthereof,ordivulgedinformationordatarelativethereto,orpaid,andwill notpay,anyfeetoanycorporation,partnership,companyassociations,organization,biddepository,ortoanyme mberoragentthereoftoeffectuateacollusive orshamProposal.(PublicContractCodeSectionTl06) Address: 1544 S. VINEYARD AVE, ONTARIO, CA 9176I TelephoneNo.' (909)947'8073 Title:PRESIDENT Date: 11i l5l18 srG UNctNSTRUcTtoNST0THECONTRACTOR Non- CollusionAffidavitmustbsaccompaniedbynotarycertificatesforsignature.Notethedescrip tionofthedocumentonthenotarycertificate.Attachnotarycertificateimmediatelyfollowlngt hispage.lftheProposerfailstoproperlysignoromitstherequiredsignature,theproposalwillb eco nslderednon -res ponsiveandwi I I bereJected. soleowner, partn erorotherpropertitle) ROBERT ARAGON DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F ACKNOWLEDGMENT A notary public or other officer eompleting this certificate verifies only the identi$ of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or of that document. State of California County s1 SAN BERNARDINO I o^ il {gh{ before me, IEREMY LEE, A NOTARY PUBLIC (lnsert name and title of the officer) personally appeared ROBERT AMGON who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and conect. WITNESS my hand and offtcialseal. JEBEMY LEE Commllrloa tt 2t89118 ilohry Pullc - Cdfornlr Srn Brrnrrdlno Sisnature {?-A (sear) DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F PROPOSALPROJECT NO.210004 TotheCityofl akeElsinore, The Proposerguaranteesthei nstallationofirvorkfortheCity- \AitRepaintingofTrafficStripingandshouldanymaterialsbedefectivewithinsixmonthsofirhichtheworkisacce ptedbytheCity,theProposerdoesguaranteewithinfifteen(15)daysuponreceiptofdemandbylefteroftheCitytoc orrectthedeficiency. lntheeventoffailuretoperform,theCitymaytakecorrectiveactionandtheProposershallreimbursetheCityofnee, dedrepairs. Proposer:Date I& S STRIPING COMPANY,INC 1t/15/18 Tit|e: PRESIDENT l8 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F Followingarethenames,addressesandtelephonenumbersforthree(3)publicagenciesfonnrhichPROpOsER h as performedsimila rworkwith i nthepasttwo(2 )years: L!STOFREFERENCES PROJECTNO.ZI0004 ANNUALTRAFFICSTRI PI NGMA! NTENANCEPROGRAMF Y 18/19 PR9PSSER: J&SSTRIPINGCOMPANY,INC (ContractorName) REFERENCES 1. CITY OF I9SIIN, 300 CENTENNIAL \ rY, TUSTIN 92780 KATY LEE,7t4-573-3t77 2.CITY OF CHINO,5O5O SCHAEFERAVE, CHINO 91710 VINCE LEDESMA, 9 09 -9 17 -2248 $180,000.00 ANNUAL MAINTENANCE 3.$CITY OF GARDEN GROVE, 13802 NEWHOPE ST, GARDEN GROVE 92843 N a meandAddressofAgency $PEGGY SNYD 714-74t-5372 NotetoPronoser: PreparedlistsgJProJegtscompletedmaybeincludedasapartoftheProposat,butwillnotbeacceptedinli euofthisform,f illedout. ANNUAL MAIN'IENANCE DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 3/30/2020 Patriot Risk & Insurance Services2415 Campus Drive, Suite #200Irvine, CA 92612 (949) 486-7900 (949) 486-7950 www.patrisk.com 0K07568 Dave Jacobson J & S Striping, Inc.1544 S. Vineyard AvenueOntario CA 91761 54854321 ✓✓ ✓✓ ✓ City of Lake Elsinore, its elected or appointed officers, officials, employees, agents and Liability per endorsement attached where required by written contract.Waiver of subrogation applies to GL, Auto and Workers' City of Lake Elsinore130 S. Main StreetLake Elsinore CA 92530 Re: CIP Project No.Z10051 / JSJN 4267-S / SB 821 Machado Street and Lakeshore Drive Signing and Striping Project - Lake Elsinore, CA volunteers are named as Additional Insured, includes Primary and Non-contributory respects to General Liability and Auto Compensation per attached endorsements. 30 days notice of cancellation, 10 days for non-payment of premium. A 1,000,000GL0027665503 3/29/2020 3/29/2021 500,000 ✓ 10,000 ✓ 1,000,000 ✓$10,000 Deductible 2,000,000 2,000,000✓ A BAP027665603 3/29/2020 3/29/2021 1,000,000 ✓ Uninsured motorist comb 1,000,000 B SE20EXCZ04UG1IV 3/29/2020 3/29/2021 4,000,000✓✓ 4,000,000 0 A WC027665703 3/29/2020 3/29/2021 ✓ 1,000,000 1,000,000 1,000,000 Zurich American Insurance Company 16535 Navigators Insurance Company 42307 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 1 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F J & S Striping, Inc. GL0027665503 3/29/2020 3/29/2021 1544 S. Vineyard Avenue Ontario CA 91761 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 2 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 3 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F Coverage Extension Endorsement U-CA-424-E CW (04-11) Page 1 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1.The following is added to the Who Is An Insured Provision in Section II – Liability Coverage: The following are also "insureds": a.Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. b.Anyone volunteering services to you is an "insured" while using a covered "auto" you don’t own, hire or borrow to transport your clients or other persons in activities necessary to your business. c.Anyone else who furnishes an "auto" referenced in Paragraphs a.and b.above. d.Any person(s) or organization(s) where required by written contract or written agreement executed prior to any "accident" provided the "accident" arises out of operations contemplated by such contract or agreement. 2.The following is added to the Other Insurance Provision in the Conditions Section: Coverage for any person(s) or organization(s) where required by written contract or written agreement executed prior to any "accident" will apply on a primary basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the coverage form. B. Amendment – Supplementary Payments Paragraphs a.(2) and a.(4)of the Coverage Extensions Provision in Section II – Liability Coverage are replaced by the following: (2)Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4)All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II – Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1.The following is added to the Racing Exclusion in Section II – Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 3/30/2020BAP0276656033/29/2020 3/29/2021 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 4 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F U-CA-424-E CW (04-11) Page 2 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2.The following is added to Paragraph 2.in the Exclusions of Section III – Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b.in the Exclusions of Section IV – Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a.Any amount paid under the Physical Damage Coverage Section of the coverage form; and b.Any: (1)Overdue lease or loan payments at the time of the "loss"; (2)Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3)Security deposits not returned by the lessor; (4)Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5)Carry-over balances from previous leases or loans. F. Towing and Labor The following is added to Paragraph A.2.of the Physical Damage Coverage Section: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a.of the Physical Damage Coverage Section: If glass must be replaced, the deductible will be $100 or the deductible shown in the Declarations, whichever is less. If glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage – Increased Loss of Use Expenses The Loss Of Use Expenses Provision of the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: (1)Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2)Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3)Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a.We will pay up to $750 for "loss" to personal effects which are: (1)Personal property owned by an "insured"; and 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 5 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F U-CA-424-E CW (04-11) Page 3 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (2)In or on a covered "auto". b.Subject to Paragraph a.above, the amount to be paid for "loss" to personal effects will be based on the lesser of: (1)The reasonable cost to replace; or (2)The actual cash value. c.The coverage provided in Paragraphs a.and b.above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following: (1)Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2)Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3)Paintings, statuary and other works of art. (4)Contraband or property in the course of illegal transportation or trade. (5)Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss". J. Tapes, Records and Discs Coverage 1.The Exclusion in Paragraph B.4.a.of Section III – Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.2.c.of Section IV – Physical Damage Coverage in the Motor Carrier Coverage Form do not apply. 2.The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a)Are the property of an "insured"; and (b)Are in a covered "auto" at the time of "loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". K. Airbag Coverage The Exclusion in Paragraph B.3.a.of Section III – Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.4.a.of Section IV – Physical Damage Coverage in the Motor Carrier Coverage Form do not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or coverage form and by another policy or coverage form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1.If the deductible on this policy or coverage form is the smaller (or smallest) deductible, it will be waived; or 2.If the deductible on this policy or coverage form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. M. Physical Damage – Comprehensive Coverage – Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is $5,000. 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 6 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F U-CA-424-E CW (04-11) Page 4 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. N. Temporary Substitute Autos – Physical Damage 1.The following is added to Section I – Covered Autos: Temporary Substitute Autos – Physical Damage If Physical Damage Coverage is provided by this coverage form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto" you do own but is out of service because of its: 1.Breakdown; 2.Repair; 3.Servicing; 4."Loss"; or 5.Destruction. 2.The following is added to the Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos – Physical Damage We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a.of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a.In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable: (1)How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2)The "insured’s" name and address; and (3)To the extent possible, the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos – Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f.of the Other Insurance – Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 7 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F U-CA-424-E CW (04-11) Page 5 of 5 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (1)Any covered "auto" you lease, hire, rent or borrow; and (2)Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's" employment by you or that elected or appointed official’s duties as respect their obligations to you. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this coverage form if you unintentionally: (1)Fail to disclose any hazards existing at the inception date of this coverage form; or (2)Make an error, omission, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto – World Wide Coverage Paragraph (5)(a)of the Policy Period, Coverage Territory Condition is replaced by the following: (a)A covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less; and T. Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. All other terms and conditions of this policy remain unchanged. 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 8 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F WHERE REQUIRED BY WRITTEN CONTRACT WHERE REQUIRED BY WRITTEN CONTRACT WC027665703 3/29/2020 3/29/2021 54854321 | 20/21 GL/AU/UMB/WC | Annette Romero | 3/30/2020 2:32:45 PM (PDT) | Page 9 of 9 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F CITY OF LAKE ELSINORE TO BE POSTED IN A CONSPICUOUS PLACE Business Name: Business Location: Owner Name(s): BUSINESS LICENSE NO. Issue Date: Description: Expiration Date: BUSINESS LICENSE THIS IS YOUR LICENSE • NOT TRANSFERABLE 1544 S VINEYARD AVE Business Type: ONTARIO, CA 91761-7756 J & S STRIPING COMPANY INC 1544 S VINEYARD AVE ONTARIO, CA 91761-7756 This business license is issued for revenue purposes only and does not grant authorization to operate a business. This business license is issued without verification that the holder is subject to or exempted from licensing by the state, county, federal government, or any other governmental agency. Administrative Services - Licensing 130 South Main Street, Lake Elsinore, CA 92530 PH (951) 674-3124 J & S STRIPING COMPANY INC ROBERT ARAGON P/H IMPROVEMENT CONTRACTOR PARKING & HIGHWAY IMPROVEMENT 022371 10/1/2019 9/30/2020 DocuSign Envelope ID: EDA85A48-220D-4457-AB60-3472671A0C4F CITY OF LADE . LSINORE Z DREAM EXTREME June 17, 2019 J&S Striping Company, Inc. Attn: Mr. Robert Aragon 1544 S. Vineyard Avenue Ontario, CA 91761 Dear Mr. Aragon, Re: Extension of City of Lake Elsinore Annual Traffic Striping Maintenance Contract Per the terms of your agreement dated January 8, 2019, the City may at its sole discretion, extend the term of this Agreement on a 12 -month basis not to exceed three (3) additional twelve (12) renewal terms by giving written notice thereof to Contractor, such notice to be exercised the City Manager. This letter shall serve as written notice to extend your contract with the City of lake Elsinore for Traffic Striping Maintenance services for a period of twelve (12) months commencing July 1, 2019 and ending on June 30, 2020. Except for the changes specifically set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. If you have questions or need further assistance, please contact Catherine Eakins, Public Works Administrative Assistant, at (951) 674-5170 ext. 241. Sincerely, Grant es City Manager 951.674.3124 130 S. MAIN STREET LAKE ELSINORE, CA 92530 WWW.LAKE-ELSINORE.ORG AGREEMENT FOR CONTRACTOR SERVICES J&S Striping, lnc. FY{8/19 Annual Traffic Striping Maintenance Program, Project No.210004 This Agreement for Contractor Services (the "Agreement") is made and entered into as of January 8, 2019 by and between the City of Lake Elsinore, a municipal corporation ("City") and J&S Striping Company, lnc. ("Contractor"). RECITALS A. The City has determined that it requires the following services: painting traffic lanes, parking lanes and thermoplastic directional arrows, crosswalks, legends and placement of RPM's as required. B. Contractor has submitted to City a proposal, daled 1111512018 attached hereto as Exhibit A ("Contractor's Proposal") 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 servlces and related work as set forth in this Agreement. AGREEMENT 1. Scooe of Services. Contractor shall perform the services and related work described in Contractofs Proposal (Exhibit A). Contractor shall provide such services and related work at the time, place, and in the manner specified in Contractor's Proposal (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 Agreemenl consistent with Contractor's Proposal (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 Proposal (Exhibit A). When requested by Contractor, extensions to the time period(s) specified may be approved in writing by the City Manager. City of Lake Elsinore J&S Striping, lnc. Contract dale: 1/8/2019 Page 1 Term. Unless earlier terminated as provided elsewhere in this Agreement, this Agreement shall continue in full force and effect for a period of five (5) months, commencing on January 8, 2019, and ending on June 30, 2019. The City may, at its sole discretion, extend the term of this Agreement on a 12-month basis not to exceed three (3) additional twelve (12) month renewal terms by giving written notice thereof to Contractor not less than thirty (30) days before the end ofthe contract term, such notice to be exercised by the City Manager. [Compensation. Compensation to be paid to Contractor shall be in accordance with the fees set forth in Contractor's Proposal (Exhibit A), which is attached hereto and incorporated herein by reference. ln no event shall Contractor's compensation exceed Four Hundred Thirty-Five Thousand Eight Hundred Fifty dollars ($435,850), without additional written authorization from the City. Notwithstanding any provision of Contractor's Proposal 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. 3. 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 of the monthly invoice by City staff. 4. Reserved. 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 as 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. Ownership of Documents. All plans, studies, documents and other wratings 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 Contractor orto 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 Page 2 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, inluries, and liability, direct or indirect (including any and all costs and expenses in connection therein), arising out ofthe City's use ofsuch 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 diskettes, 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, speciflcations, 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 period required by law, from the date of termination or completion of this Agreement. 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 Page 3 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. OtheMise, 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 that 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 of the City. 9. PERS Elioibilitv 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 benefits 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 entitled 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 contributions 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, recommendation or counsel independent of the control and direction of the City or of any City official, other than normal agreement monitoring; and b. possesses no authority with respect to any City decision beyond rendition of information, advice, recommendation or counsel. (FPPC Reg. 18700(aX2)) Page 4 11. Abilitv of Conhactor. 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. Compliance 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 inlury, 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 strictly liable, or by the quality or character of their work. The foregoing obligation of Contractor shall not apply when (1) the iniury, 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 Conhactor to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the 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, forthe duration of the contract, unless modified bythe City's Risk Manager, the following insurance policies. i. Workers' Compensation Coveraoe. Contractor shall maintain Workers' Compensation lnsurance and Employer's Liability lnsurance for his/her employees in accordance with the laws of the State of California. ln addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance 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 Page 5 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 Lrability lnsurance for hisiher 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 Coveraoe. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) 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. 11l88) or lnsurance Services Office form number GL 0002 (ed. 1/73) 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 1 ("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 offlcers, 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 rnsurance 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. iv. The insurer waives all rights of subrogation against the City, its elected or appointed officers, officials, employees or agents. Page 6 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. Certificates 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 flle 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 provided in this section. lf to City:City of Lake Elsinore Attn: City Manager 130 South Main Sheet Lake Elsinore, CA 92530 City of Lake Elsinore Attn: City Clerk With a copy to: 130 South Main Street Lake Elsinore, CA 92530 lf to Contractor: J&S Striping Company, [nc. Attn: Mr. Robert Aragon 1544 S. Vineyard Avenue Ontario, CA 9l 76 I 17. Entire Agreement. 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. 19. Assionment and Subcontractinq. The parties recognize that a substantial inducement to City for entering into this Agreement is the reputation, experience and competence 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 Page 7 obligations of the Contractor under this Agreement will be permitted only with the express consent of the Cily. 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 provisions of this Agreement shall continue in full force and effect. 22. Controllino 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. Authoritv 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 otherwise 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. Prohibited 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 solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For 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 Page 8 with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 27. Eoual 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 Waoes. 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, Title 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] Page 9 lN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. "CITY" CITY OF LAKE ELSINORE, a municipal corporation "CONTRACTOR' J&S Striping Company, lnc. ATTEST:Date: /- Ll'l? Page 10 _*= City Clerk EXHIBIT A CONTRACTOR'S PROPOSAL [ATTACHED] EXHIBIT A EXHIBIT B LIST OF SUBCONTRACTORS [ATTACHEDI EXHIBIT B EXHIBIT B PROPOSER'SPROPOSAL AND OTHERDOCUMENTS e Oirt PROPOSAL PROJECTNO.Z10004 ANNUALIRAFFICSTRIPINGMAINTENANCEPROG RAMF Y 18/19 TOTHEHONORABLEMAYORANDCITYCOUNCIL oft heCityof LakeElsinore,Calif omiaf ro ,(Propo""rl' IW 1. ThisProposalhasbeensubmittedtothe: Location:Cityclerk,CityofLakeElsinorel30 MailingLocation: CityClerk,CigoflakeElsinorel SouthMainStreet LakeElsinore,CA92530 Time: 2:00p.m. Date: November 15, 2018 30SouthMainStreet LakeElsinore, CA92530 2. -Deleted- 3. lncompliancewiththeNoticelnvitingProposals,theundersignedasProposerherebyproposestofurnis hallmaterials,equipmentandallotherlaborandmethodsanddoellthingsnecessaryfortheproperconstructiona ndcompletionofthework,instrictandcompleteaccordwiththeAgreement,SpecialProvisions(whichincludesth eGeneralProvisionsandTechnicalProvisions),Plans,Specifications,andotherContractdocumentsnowonfile inthePublicworksDepartmenloftheCityoflakeElsinoreatthepricessetforthintheProposalSchedulehereinfor theworkgenerallydescribedforthesaidproject. 4. TheundersignedasProposer,herebydeclaresthatheorshehascarefullyexaminedthelocationofthepro posedworkgenerallydescribedaboveandisfamiliarwiththeSpecialProvisions, Plans,Specificationsandlocalc onditionsattheplacetheworkistobedoneandalsounderstandsthatalllabor,materialsandequipmenttobefumis hed,shallbeforthepricesproposed,andthattheundersignedhasalsocheckedfiguressetforthhereinafterinthe ProposalScheduleandunderstandsthatneithertheCftyoflakeElsinore,oranyofficeroremployeethereforewill beresponsibleforanymisunderstandings,errorsoromissionsonthepartofrheundersignedinsubmittingthisPro posal. 5. ThecompleteContractincludesallofrhecontractdocumentsasifsetfortfrinfullherein,towit,theAgreem ent,anyandallContractchangeOrdersissuedaftertheexecutionoftheAgreement,anyandalladdendaissuedp riortotheopeningofrheProposal,theSpecialProvisions,theProjectPlans,theStandardPlans,thestandardSpec ifications,referenceSpecifications,theNoticelnvitingProposals,theNon- CollusionAffidavit,insurance,allofwhichareessentialpartsofthisContract. 7 PROPOSALPROJECT NO.210004 6. -Deleted- 7. -Deleted- 8. . lnsubmlttjngproposal,thePro-posercertifiestotheciq hathe/shehastrainedhis/heremployeesand subcontractors,ifany,forUrbanRunofftnanagementandincludedsufficientsumsintneproposaiprteiocov ersuchcostsofsaidtraining(RegionalWatereualityControlBoardOrderNo.R&2002_ 99111I?_E:!9 cAS618.033(Municiparseparatesto-rmsewersvstemNpDEspermit),SectionXr.r).Th ofanyillegaldischarge( oft heConFa ctor'sworkand/oroperations. 9. . _.lftheProposerismakingachangetotheproposalprlortosubmission,theproposeristolinethrou ghtheexistingscript,addtherevision,andinitia l. 10. -Deleted- a 11 . TheProposershallsetforthforeachitemofi,vork,inclearlylegiblefigures,anitempriceandatotalforth eitem.intherespectivespacesprovidedforthispurpose.lnttrecaieolunitbisisitems,theamountsetforthund erthe"Total"columnshallbetheproductoftheunitpricemultipliedbytheestimatedquantityfortheitem. - 12. lncaseofdiscrepancybetweentheunitpriceandthetotalsetforthfortheitem,theunitpriceshallprevai l,excepthowever,thatiftheamountsetforthasaunitpriceisambiguous,unintelligiUteoruncertaintoi"ffir" e,orifitisomitted,orinthecaseofunitbasisitems, isthesameamountastheentryi;the"Total,boiu.n "orii,in".aseoflumpsumitems,isnotthesameamountastheentryinthe"Total"column,ihentheamountsetforthinihe" Total"columnfortheitemshallprevailinaccordancewiththefollowing: (a) Astothelumpsumitems,theamountsetforthinthe'Total"columnshallbethesamea mountintheu nitpricecolumn. Lumpsumitemsareconsideredtobea unitofone. (b) Astounitbasisitems,theamountsetforthinthe"Total,,columnsha bedivide d bytheestimatedq uantityfortheitemandthepricethusobtainedshallbetheu nitprice. 13, TheProposershallalsosetforth inclearlylegiblefiguresthe'TotalAmount"inthespacesprovidedatt hebottomoft heSchedu le. 8 PROPOSALPROJECT NO.210004 '14. .. lncaseofdiscrepancybetweenthecalculatedsumofthe"TotalCost"columnandthenumberreprese ntingthecumulativetotaloftheitems,thecalculatedsumofthe"TotalCost'columnshallprevailoverthenumb errepresentingthecum ulativetotaloftheitems. 1I,. lnsubmittingtheProposal, rftheProposerfailstoprovideoromitsacostforlineitem,thentheproposal wi llbeconsiderednon-responsivea ndwillberejected. ] 6' .TheCityreservestherighttorejectoracceptaProposal,orpartsoftheProposalandtowaiveanyirregularityorinformalitytotheextentpermitted bylaw. 17 . lnsubmittingtheProposal,theProposeroffersandagreesthatiftheProposalisaccepted,theworksh allbeguaranteedastoqualityofworkmanshipandmaterialsfurnished,foraperiodofuixmonihshomthedate ofacceptanceoft heworkbytheCityCounci l. 18, lnsubmittingtheProposal,theProposerisawarethatthisisaPublicWorksprojectrequiringpayment sofprevailingwagerates,CertifiedPayrollsarerequiredtobesubmtttedweeklybytheContractor, Jubcontrac tor(s),andowneroperators.ContractpaymentswillbewithheldfordelinquentorinadequateCertifiedpayrolls (LC1771.5). 19. lnsubmittingtheProposal,theProposeroffersandagreesthatifaccepted,workshallbeperformedin accordancewiththeprojectPlansandSpecifications,includingallstipulationsdesignedtomeetdiversifiedFe deralEnvironmental,Architecturalandrelatedlawsandregulations. 20. lnsubmittingtfieProposal, theProposer offersand agreesto allowaccess to the workarea,fiscal,payroll,materials,andotherrelevantcontractrecords.Alkelevantrecordsshallberetainedf oratleastthreeyearsorlonger,asrequiredbylaw,fromthedateoftheNoticeofcompletion. 21. -Deleted- 22. lnsubmittingtheProposal,theProposeroffersandagreesthatifiheproposalisaccepted,thecontrac torandsubcontractor(s)shallcomplywithalllaws,ordinances,andregulationsapplicabletothework.lftheCon traclorascertainsatanytimethatanyoftherequirementsofthecontractareatvariancewithapplicablelaw(s), ordinances,regulations,orbuildingcoderequirements,heorsheshallprompflynotMhecitioflakeElsinor ePublicworksDepartment, andshallnotproceedwiththeworkin question, eiceptat nis orher own risk, until theEflgineerhashadanopportunitytodeterminetheextentoftheresponsibilityforthevariance,andtheappro priateconectiveactionstobeundertaken. 23. -Deleted- 9 PROPOSALPROJECT NO.210004 24. 25. 26. Thecontractorshallsubmitthe'Non-CollusionAffi davitliviththeproposal. RECEIPTOFTOTALADDENDANO(S1 O ISHEREBYACKNoWLEoGED. PROPOSALMAYBEREJECTEDIFANYISSUEDADDENT}AISNOTACKNOWLEDGED. ThePropos€r -- I&s 'TRIPING coMpANy, INC lfanindividual,stateindividual'sname.lfapartnership,statenamesofallindividuals,co- partners,composingthefirm.lfacorporation, statenamesofpresident,secretary,treasurer andchiefexecutiveofficerthereof,lftheProposerfailstoprovidetherequestedinformation,thepropojiwttUeco nsiderednon-responsiveandwillberejected. ROBERT ARAGON - PRESIDENT, SECRXTARY, TREASURER 27 . lnsubmittingthisProposal,theundersignedagree€toperform,withitsownorganization,workamounting toatleastfiftypercent(50%)ofiheamountexceptthatanydesignated,'specialq/ibms;mayuepertormeooysuuc ontractandmaybededuc{edfrom theamountbeforeiompuiingthe amountofworkrequiredtobeperformedbytheContractor.lftheProposer,aftercomputingt6eamountoftvorkrequired,fails tomeetatleastfiflyperce. nt(50%)oftheamountofworkrequiredwithitsownforcis,theproposalwitrueionsioere dnon-responsiveandwillberejectedwithnofurtherconsideration. cent(0.5%o)ofthetotalProposal,theproposershallbedeemedtohaveagreedtoperformsuchportionhimselforhe rself,andthatheorsheshallnotbepermittedtosubletorsubcontracfthat-portionorurev,rc*ex&:ptiJr"yO"orfy" (ContractorsName) CORPOMTION (lndividual,partnership,orcorporation) lfacorporalion,incorporatedunderthelawsoflfpstateof CALIFORNIA onsentedtobythecitypursuanttotheprovisionsofsection4l0T,ofthepublicconhactcode(pic41o6i 29. -Deleted- AF-A.GON . VICE PRES]DENT l0 PROPOSALPROJECT NO.210004 30. lncompliancewiththeprovisionsofihePublicContractoode,section4l04,theundersignedherewithset sforththenameandlocationoflheplaceofbusinessofeachsubcontractorwhowillperformworkorlabororrendet servicetotheprimeContractorinorabouttheconstructionofrheworkorimprovement,orasubcontractorlicensed bythestateof Californiawho,undersubcontracttotheprimeContractor,speciallyfabricatesandinstallsaportionoftheworkori mprovementaccordingtodetaileddrawingscontainedinthePlansandSpeciflcations,inanamountinexcessofo ne- halfofonepercent(0.5%)oftheprimeContraclo/stotalproposal,orinthecaseofProposalsfortheconstructionof streets, highways, i ncludingbridges,inexcessofone- halfofonepercent(0.5%)oftheprimeContractor'stotalProposalortenthousanddollars($ 10,000),whicheverisg reater,andtheportionoftheworkwhichwillbedonebyeachsubcontractor.TheProposershallnotlistmoretha nonesubcontractorf orthesameportlonohrork. Alladditionalinformationrequiredbyth6CityregardinganysubcontractonrhotheProposer isrequiredtolistundertheProvblonsofsections4l O4and4l0TofthePubliccontractcode,otherthanth esubcontracto/snameandlocation(city)ofbusinessorstatecontractor'sLicensenumber,maybesub mittedbytheProposerupto24hoursafterthedeadlinetimeanddateforreceiptofProp06als.Failuretotlm elyprovideallrequiredsubcontractorinformationshallresultintheProposalbelngdeterminednon- responsive. ll PROPOSALPROJECT NO.210004 REOUI REDSUBCONTR ACTORSINFORMATIOH t2 PROPOSALPROJECT NO.210004 REOUTREpSUBCONTRACTORSTNFORMATTON l3 PROPOSALPROJECT NO.210004 REOUI REpSUBCONTRACII}RS|NFORMAION Duplicatethisformasnecessarytoreportproposerandallsubcontracto(s)(DBEsandnon-DBEs)information. l4 cIwoFLAKEELStNOREe ROPOSAL€CHEDULE PROJECTNO.ZI0004 ANNUALTRAFFICSTRI PI NGMAINTENANCEP ROG RAMF Y 18/19 PRoPosER f { S 9rr/P/^tt' ( PROPOSALITEMSAS FOLLOWS : ITEM NO.CODE DESCRIPTIONOFITEMS ESTIMATED QUANTITY UNITPRIC E(FTGURE s) TOTALCO sT(FrcuR ES) 1 S 4"CenterlineYellowCaltransStd Detai I l,4"CenterlineWhiteCaltransStd 97,000 L.F. $0.0s $4,8s0 2 S 4"SolidLi neWhiteCaltransStd Deta i 12TB,4"SolidLineYellowCattransStd 10,000 L.F. $0.06 $600 3 S NoPassingZon+. Twodirection(NoRPM)CaltransStdDetait2 1 130,000 L.F. $0,14 $ 18,200 4 S NoPassingZon* Twod irectionwithRPMCaltransStd Detail22 10,000 L.F. $0.2e $2.900 5 S BikeLaneLine6"SolidLineCaltransStd. Det ail39 28,000 L.F. $0.1 I $3,080 6 S S"Solid LineCaltra nsStdDeta il38A 20,000 L.F.$0.13 $2,600 7 S 8"Sol id Linewith RPMCaltransStd38 4,000 L.F.$0.23 $920 I Therm oplastic 1 2"Solid Line,Wh iteorYell owCrosswalka ndLimitLineCa ltran sStdDet atlA24E 32,000 L.F, $2.2s $72,000 I 4" Sol idlinew/ski pYellowperCaltransStd Detaill5 15,000 L.F. $0.12 $ 1,900 10 4"So lid I inew/ski pYellowand R PMCalt ransStdDetaill6 5,000 L.F. $0.23 $1,150 11 ThermoplasticPavementMarkingWo rdsC altransStdA24D,A24E 15,000 S.F $2.8s $42,750 12 Thermoplastic PavementMarkingSy mbolsa nd NumeralsCaltransStdA24C 75,000 S.F $2.85 s213.750 13 ThermoplasticPavementMarkingAnowsC altransStdA24A,A24B 25,000 SF $2.8s $71,250 TOTALFORITEMS (Basedonestimatedq uantitiesofitems I throu gh 1 3 $ $43s.850.00 l5-A CITYOFLAKEELSINOREPR OPOSAL€CHEDULE PROJECTNO.Z10004 ANNUALTRAFFICSTRI PI NG MAINTENANCEPROG RAMF Y 18/19 PROPOSER: J&S STRIPINGCOMPANY, INC N'TE: (ContractorName) a. ThelowestresponsibleProposenrillbedeterminedbycomparingthecumulativetotalofallitems (PCC20103 8b), b. TheCityhasthediscretiontoselectanyorallltemsfortheAwardoftheContract. c. TheCityreservestherighttoaddorsubtractitemsbyContractChangeOrderatthepricespropose d. Estimatedquantitiesareforthepurposeofcomparisononly,andpaymentswillbemadeonabasisofactua I m easurementofirorkcompleted. Thelineitemcostincludes,butnotbelimitedto,salestaxandallotherapplicabletaxesandfees.Codes. UnitsofMeasurement:(q) Deduct LF tinealfoot(f) FinalPayQuantities SF squarefoot(S) Specialtyltem TotalamountinWORDSforltemsonly(BasedinEstimatedQuantitiesofltemslthrough 13: FOUR HUNDRED THIRTY FIVE THOUSAND EIGHT HUNDBID FIFTYDOLLARS ONLY I 5-B PROPOSALPROJECT NO.z10004 PROPOS ER'SSIGNATU REPAGE CONTRACTO RSSTATELICENSE:Number: 538211 Classification(s): ExpirationDate: 0813U2019 (Business&ProfessionsCodeT02S. 1 5) FEDERALIDENTIFICATIONNO.: 95-34f.3i575 PRESENTCITYBUSI N ESSLICENS E: ( Notreq uiredattimeProposa lissubmitted) ExpirationOate: c32 &S STRIPING COMPANY, INC (ContractorName) ADDRESS: 1544 S. VINEYARD AVE, ONTARIO, CA 91261 TELEPHONENUMBER(S PRINTNAME:ROBERT ARAGON SIGNATURE: TITLE: PRESIDENT DATE: 11/t5i l8 PRlNTNAME: SIGNATURE: UDY ARAGON TITLE: VI TE: I1/15/18 SIGNINGI NSTRUCTI ONSTOTHECONTRACTOR SignaturePagem ustbeaccompaniedbynotarycertificatesforEAcHsignature.Notethedescriptionoft hedocumentonthenotarycertificate.AttachALLnotarycertificatesimmediatelyfollowingthispage. GeneralPartnersm ustsignonbehalfofthepartnership. Itfl8c9ntracti,FsfirrnisAgornorefirU:.twolllcfrroornteoflirelshavirrcauthorit]rfrrlJrltheco{qorafio,nIU le.,... ,, . *utnorizeO tq,-ffi thalf ofal loffi cere"attachcpf'poralereaol *inn imm eai*etytoii eSealmaybeaffixedhe reto. lftheproposerfailstoproperlysignoromitsrequiredsignatures,theproposalwillbeconsiderednon- res ponsiveandwill berejected. NorE: Nam eon statecontractorLicensemustag reewith proposer'sna me. ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or of that document. State of California County of SAN BERNARDINO ) on ll / ls/17 before me, JEREMY LEE, A NOTARY PUBLIC (insert name and title of the officer) personally appeared ROBERT AMGON who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certifiT under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and officialseal.Cofinl..lon ,2ltgtlt f{ohry Pulllc . Crlllornlr Srn tunrrdlm Gounly sisnature Q f (sear) ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or of that document. State of California County of San Bernardino ", tr/ iS lra berore me,Marissa Rodriguez, Notary Public (insert name and title of the officer) personally appeared ,."ot who proved to me on the basis of executed the' the instrument the the instrument. I certiff under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and WITNESS my officialseal. PROPOSALPROJECT NO.210004 STATEOFCALIFORNIA COUNTYOF SAN BERNARDINO NO N.COLLUSIOTTTAFFIDAVIT PROJECTNO.Zl0004 ANNUALTMFFICSTRIPINGMAINTENANCEPROG RAMF Y 18119 ) )SS ) ROBERT ARAGON Thatheorsheis affiantbeingfirstdulysworn, deposesandsays: PRESIDEN, SECRETARY, TREASURER ' I&S STRIPING COMPANY, INC tneoartymakingdreforegoingproposal(C ontractorName) thattheProposalisnotmadeintheinterestof,oronbehalfof,anyundisclosedperson,partnership,company,asso ciation,organization,orcorporation;thattheProposalisgenuineandnotcollusiveorsham;thattheProposerhasn otdirectlyorindirectlyinducedorsolicitedanyotherProposertoputinafalseorshamProposal,andhasnotdirectly orindirectlycolluded,conspired,connived,oragreedwithanyProposeroranyoneelsetoputinashamProposal,ort hatanyoneshallrefrainfromproposing;thattheProposerhasnotinanymanner,directlyorindirectlysoughtbyagr eement,communication,orconferencewithanyonetofixthepriceoftheProposeroranyotherProposer,ortofixan yoverhead,profit,orcostelementoftheprice,orofthatofanyother Proposer,or to secure anyadvantage againstthepublicbodyawardingtheContractofanyoneinterestedintheproposedContract;thatallstatementsco ntainedintheProposalaretrue;and,further,thattheProposerhasnot,directlyorindirectly,submittedhisorherpric eoranybreakdownthereof,orthecontentsthereof,ordivulgedinformationordatarelativethereto,orpaid,andwill notpay,anyfeetoanycorporation,partnership,companyassociations,organization,biddepository,ortoanyme mberoragentthereoftoeffectuateacollusive orshamProposal.(PublicContractCodeSectionTl06) Address: 1544 S. VINEYARD AVE, ONTARIO, CA 9176I TelephoneNo.' (909)947'8073 Title:PRESIDENT Date: 11i l5l18 srG UNctNSTRUcTtoNST0THECONTRACTOR Non- CollusionAffidavitmustbsaccompaniedbynotarycertificatesforsignature.Notethedescrip tionofthedocumentonthenotarycertificate.Attachnotarycertificateimmediatelyfollowlngt hispage.lftheProposerfailstoproperlysignoromitstherequiredsignature,theproposalwillb eco nslderednon -res ponsiveandwi I I bereJected. soleowner, partn erorotherpropertitle) ROBERT ARAGON ACKNOWLEDGMENT A notary public or other officer eompleting this certificate verifies only the identi$ of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or of that document. State of California County s1 SAN BERNARDINO I o^ il {gh{ before me, IEREMY LEE, A NOTARY PUBLIC (lnsert name and title of the officer) personally appeared ROBERT AMGON who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and conect. WITNESS my hand and offtcialseal. JEBEMY LEE Commllrloa tt 2t89118 ilohry Pullc - Cdfornlr Srn Brrnrrdlno Sisnature {?-A (sear) t7 PROPOSALPROJECT NO.210004 TotheCityofl akeElsinore, The Proposerguaranteesthei nstallationofirvorkfortheCity- \AitRepaintingofTrafficStripingandshouldanymaterialsbedefectivewithinsixmonthsofirhichtheworkisacce ptedbytheCity,theProposerdoesguaranteewithinfifteen(15)daysuponreceiptofdemandbylefteroftheCitytoc orrectthedeficiency. lntheeventoffailuretoperform,theCitymaytakecorrectiveactionandtheProposershallreimbursetheCityofnee, dedrepairs. Proposer:Date I& S STRIPING COMPANY,INC 1t/15/18 Tit|e: PRESIDENT l8 Followingarethenames,addressesandtelephonenumbersforthree(3)publicagenciesfonnrhichPROpOsER h as performedsimila rworkwith i nthepasttwo(2 )years: L!STOFREFERENCES PROJECTNO.ZI0004 ANNUALTRAFFICSTRI PI NGMA! NTENANCEPROGRAMF Y 18/19 PR9PSSER: J&SSTRIPINGCOMPANY,INC (ContractorName) REFERENCES 1. CITY OF I9SIIN, 300 CENTENNIAL \ rY, TUSTIN 92780 KATY LEE,7t4-573-3t77 2.CITY OF CHINO,5O5O SCHAEFERAVE, CHINO 91710 VINCE LEDESMA, 9 09 -9 17 -2248 $180,000.00 ANNUAL MAINTENANCE 3.$CITY OF GARDEN GROVE, 13802 NEWHOPE ST, GARDEN GROVE 92843 N a meandAddressofAgency $PEGGY SNYD 714-74t-5372 NotetoPronoser: PreparedlistsgJProJegtscompletedmaybeincludedasapartoftheProposat,butwillnotbeacceptedinli euofthisform,f illedout. ANNUAL MAIN'IENANCE - .aconif GERTIFICATE OF LIABILITY INSURANGE DATE (MMIDD/YYYY) 1t1812019 THIS CERTIFICATE IS ISSUED AS A MATTER OF IT{FORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ATUIET{D, EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTTFTCATE OF TNSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE TSSUTNG TNSURER(S), AUTHORTZED REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRooucER Patriot Risk & lnsuranCe ServiCes 2415 Campus Drive, Suite #200 lrvine, CA 92612 www.patrisk.com 0K07568 INSUREO J&SStrioino. lnc. 1544 S Vinelard Avenue Ontario CA 91761 ggNtAgt NAi,IE: - |Ignif. *'- (%e) 480-taoo "-.=ffi"---(g4!)1!Q-7$q E.MAIL ADOFESS: _ |NSURER{S}AIFORDTNG COVERAGE __-_ NA|C f TNSURERA: Zurich American lnsulance tSlnp3!y___ _]_ 16535 INSURERB: _ INSURER C : INSURER D : ___ rNtrrEEE I : INSURER F: COVERAGES CERTIFICATE NUMBER: 46638160 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSUMNCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTMCT OR OTHER DOCUMENT WTH RESPECT TO \^/l-IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUMNCE 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 CLAIMSlNsR tt"a oa 'ntr**"t PoLiCY EFF FoLrct ExPIMM/DDMT IMM'NN/ T ADDL SUBRINsn Wn POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS.[,ADE "/ oCCUR $10,000 Deductible i GEN'L AGGREGATE LIMIT APPLIES PER _ PoLrcY / I[c"; _ Loc : ^trao G1O027665501 3t29t2018 3t29t2019 EACH OCCURRENCE DAM-AGE=TOFENTET' PREMISES (Eqo@rene) ,it! E e_EIP_(4!y gne pq!9!1.._ PERSONAL &AOf/ INJURY GENERAL.AGGREGATE - PRODUCTS . COMP/OP AGG s 1,000,000 s 500,0Q0 s 10,000 s 1,000,000 s 2,000,000 s 2,00Qpoo s / AUTOMOAILE LIABILITY 7 ANY AUTO O!^AED SCHEDULED -. AUTOS ONLY AUTOSHIRED NON-OVII\EO AUTOS ONLY AUTOS ONLY /, BAP027665601 3t2912018 3t29t2019 CSMENED STNGLE LrMrr s 1,OOO,OOO.- ,T, BODILY INJURY (Per pemn) .- $ BOOILY INJURY (Per acident) $ PRoPERTY DAMAGE - .(Per accrdenl) I lninsr rred mnlorisl nnmd $ I nnn ono A AUC0276671 01 3t29t2018 3t29t2019 !49!p99!!!Etce s4,!9qpQ0 AGGREGATE-, $4,000,000 s UMBRELLA LIAB ,/ EXCESS LIAB OCCUR CLAIMS.MADE tr tNCo27665701 3t29t2018 3t29t2019A AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mendato.y in NH) lf yes, descnbe under DESCRIPTION OF OPERATIONS belm Y/Nl-l rrr . PER OTH-y' STATUTE ER EL EAcH AccrD-EN.l I $ 1,000,000 E L prsEAs_E_- EA EMPLoILEJI_000JoO E.L DISEASE. POLICY LIMIT S 1.OOO.OOO OESCRIPTION OF OPERATIONS / LOCAIONS / VEHICLES (ACORD '101, Additional Remrks Schedule, may b€ attached if more space B rcquiEd) Re: Job #210004 Amendment No. 4 / JSJN #4232-5, FY18-19 Annual Traffic Striping Maintenance Program / Lake Elsinore, CA City of Lake Elsinore, its elected or appointed officers, officials, employees, agents and volunteers are named as Additional lnsured, includes Primary and Non-contributory respects lo General Liability and Auto Liability per endorsement attached where required by written contract.Waiver of subrogation applies to GL, Auto and Workers' Compensation per attached endorsements. 30 days notice of cancellation, 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION Citv 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 WILL BE DELIVEREO IN ACCORDAT{CE WITH THE POLICY PROVISIONS. AUTH.RTZEDREPRESENTAn,E V, / x../^ Dave Jacobson A @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 46618i60 I 18/19 GL/AU/LI4B/wC hnerEe Romero I l/18/2019 L0:44:4s N (PSr) I Page I of 9This certificate cancels and supersedes ALL prevrously issued cerEificates. @ ZURICHAdditional Insured - Automatic - Orvners, Lessees Or Contractors Policy No.Ell. Dab ol Pol.Exp. Dab ol Pol.E f. Date ot End.Producer No.Add'|. Prem Folurn Pr6m. G1O027665501 3t29t2018 3t29t2019 THIS ENDORSETI'ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. l15''Ed lnsurcd: .J & S Striping. lnc Address (lncludlng ZIP Code): '1544 S. Vineyard Avenue Ontario CA 91761 This endorsenent modifies insurance provided under the: Corrrercht Qneral ljablltty Corcrage Part A Section !l - Who ls An tnsurcd is anended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreennnt' -Such person or orginization is an additional insured only wlth respeci to liability for "bodily iniury", "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 ol those acting on your behalf, in the performance of your ongoing operations or "your work' as included in the "products+ompleted operations hazard'i, which is the subject ol the written contract or written agreernent. However, the insurance aflorded to such additional insured: 1. Only applies to the extent permitted W law;and 2. Wll not be broader than that which you are required S the written contract or writtsn agreemsnt to provide for such additional insured. B. With respect to the insurance atforded to these additional insureds, the following additionalexclusion applies: This insurance does not apPlY to: "Bodily injury', 'property damage" or "personal and advertising injury" arising out of the rendering of, or failure lo render, any professionalarchitectural, engineering or surveying services including: a. The preparing, approving or tailing to prepare or approve rnaps, shop drawings, opinions, reports' sun/eys' field orders, change orders or drawings and specifications; or b. Su pervisory, inspection, architectural or engineering activities. This exclusion applies even if th6 claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "pioperty damag-e", or the otfinse which caused the 'personal and advertising injury", involved the rend-ering of oi ttrd f ailure to render any professionalarchitectural, engineering or surveying services. u€L-l17ffCW(04/13) Page 1 ol 2 lncludes copyrighted matorial ol lnsurance Services Oflice, lnc., wilh its permission. 46638160 I8. t9 3L AU UMB fa I AnneEre Romelo | 1, r3'2019 10:14:45 AM rPSTj Page 2 cf 9This certifiaaEe aancels lnd supersedes ALL previausly issued certificaces- C. The following is added to Paragaph 2 Duties ln The Errent Of Occurrence, Offense, Claim Or Suit ol Section lV -Corrrnrcbl Coneral llabllty Condl0ons: The additional insured must see to it that: 1. ll1b are notified as soon as practicable ol an "occurren@" or offense that may result in a claim; Z We receive written notice of a claim or "suit'as soon as practicable; and & A request for defense and indemnity of the claim or 'suit'will promplly be brought against any policy issued by anothar insurer under which the additional insured may be an insured in any capacity. This provision does not appty to insurance on which the additional insured is a Naned lnsured if the written contract or written agreement requires that this coverage be prirnary and noncontributory. D. For the purposes of the coverage provided $t this endorsenent: 1. The lollowing is added to the Other lnsurance Condition of Section lV-CorurerchlGercral LhUmy Condltbns: Prlrary and iloncontlbubry lnsurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Narned lnsured under such other insurance; and b. You are required by written contract or written agreenEnt thal this insurance be prirnary and not s€ek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other lnsurance Condition of Section lV- Comrercbl Ccneral Lbbimy Condl0ons This insurance is excess over: Any ol the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our poliry is also covered as an additional insured on another policy providing coverage lor the same "occurrence', offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Narned lnsured on such olher policy and where our policy is required by a written contract or written agreenEnt to provide coverage to the additional insured on a primary and non' contributory basis. E. This endorsenBnt does not apply to an additional insured which has been added to this Ooliry 6y an endorsenrgnt showing the additional insured in a Schedula of additional insureds, and which endorsernent applies specilically to that identif led addilional insured. F. Wth respect to the insurance atforded to the additional insureds under lhis endorsement, the following is added to Section lll -Llmlts Of lnsurance: The most ws will pay on behall of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Pangraph A of this endorse,rEnt; or 2 Available under the applicable Limits of lnsurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of lnsurance shown in the Declarations. All other terms and conditions of this policy rernain unchanged. UGL-I17$FCW (04/13) Page2ol2 lncludes copyrighted male,ial ol lnsurance Services Otlice, lr,c., with ils permission. Coverage Extension Endorsement @ ZURICH Policy No Eff. Date of Pol Exp. Date of Pol Eff. Date of End Producer No.Add'|. Prem Return Prem. BAP027665601 3t29t2018 3129t2019 1t18t2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who ls An lnsured Provision in Section ll- Liability Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activrties necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs a. and b. above. d. Any person(s) or organization(s) where required by written contract or written agreement executed prior to any "accident" provided the "accident" arises out of operations contemplated by such contract or agreement. 2. The following is added to the Other lnsurance Provision in the Conditions Section: Coverage for any person(s) or organization(s) where required by written contract or written agreement executed prior to any "accident" will apply on a primary basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the coverage form. B. Amendment - Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section Il - Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section ll- Liability Goverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section ll- Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. u-cA424-E CW (04-11) Page 1 of 5 46G38r50 | 18/1e GL,/AU/uMB/wc I M.errelqgl#"q€stcQPyJEb[EdrB1qF{?l8f l&tq5"l.6l$."ryigpqoffice, lnc., with its permission This cerEificaEe cancels and supersedes ALL previously issued cerEificates. 2. The following is added to Paragraph 2. in the Exclusions of Section ltl - Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section lV - Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage ln the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Goverage Section of the coverage form; and b. Any: (1) Overdue lease or loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor The following is added to Paragraph A.2. of the Physical Damage Coverage Section: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: lf glass must be replaced, the deductible will be $100 orthe deductible shown in the Declarations, whichever is less. lf glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage - Increased Loss of Use Expenses The Loss Of Use Expenses Provision of the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. l. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Goverage a. We will pay up to $750 for "loss" to personal effects which are: (1) Personal property owned by an "insured"; and u-cA-424-E CW (04-1 1) Page 2 of 5 46Gr81Go I iB/1e 6LIAU/r,Blwc r,.".."lrlgl#.d.EsrQPytrBbtEornqterietSI l61q5a19"p.eqvigpqoffice, lnc., with its permission This certificate cancels and supersedes ALL previously issued cerLificales- (2) ln or on a covered "auto". b. Subject to Paragraph a. above, lhe amount to be paid for "loss" to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securilies, or commercial paper or other documents of value. (2) Bullion, gold, silver, plalinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph 8.4.a. of Section lll - Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 8.2.c. of Section lV - Physical Damage Coverage in the Motor Carrier Coverage Form do not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured"; and (b) Are in a covered "auto" at the time of "loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". K. Airbag Coverage The Exclusion in Paragraph 8.3.a. of Section lll - Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 8.4.a. of Section lV - Physical Damage Coverage in the Motor Canier Coverage Form do not apply to the accidental discharge of an airbag. L. Two or More Oeductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: lf an accident is covered both by this policy or coverage form and by another policy or coverage form issued to you by us, the following applies for each covered "aulo" on a per vehicle basis: 1. lf the deductible on this policy or coverage form is the smaller (or smallest) deduclible, it will be waived; or 2. lf the deductible on this policy or coverage form is nol the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. M. Physical Damage - Comprehensive Coverage - Deductible The following is added to the Oeductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is S5,000. u-cA424-E CW (04-11) Page 3 ol 5 458,a160 1s/1e CL/AU,wB,.(c *"....1r#il4ts capuphlqdLnqleqelsflrltqFf$,Ffytpqomce, lnc., with its permission. This ce.riricate cancels and superse.les ALL previously issued.ertiracaEes N. Temporary Substitute Autos - Physica! Damage 1. The following is added to Section I - Covered Autos: Temporary Substitute Autos - Physical Damage lf Physical Damage Coverage is provided by this coverage form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto" you do own but is out of service because of its: 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction. 2. The following is added to the Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos - Physical Damage We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. lf we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties ln The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties ln The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. ln the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. lnclude, as soon as practicable: (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. lf you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a wriften contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos - Physical Damage Paragraph b. of the Other lnsurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance - Primary and Excess lnsurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: u-cA424-E Cw (04-11) Page 4 of 5 46638150 r8l1e GL,,AU,/wB,/wc *."...1ed#.4E.reprdEhlEormqFriqtnf l[b$laTqF".teryigpEoffice, lnc., with its permission. This cerEificate cancels and supersedes ALL previousty issued certificates. (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a wriften contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's" employment by you or that elected or appointed official's duties as respect their obligations to you. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentiona! Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this coverage form if you unintentionally: (1 ) Fail to disclose any hazards existing at the inception date of this coverage form; or (2) Make an error, omission, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto - World Wide Coverage Paragraph (5)(a) of the Policy Period, Coverage Territory Condition is replaced by the following: (a) A covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less; and T. Bodily lnjury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. All other terms and conditions of this policy remain unchanged. u-cA424-E CW (04-11) Page 5 of 5 465i8150 | 18/1e cLlAU/uMB/wc *,....1u81#udg"rcQPyflAbiEormqpqelSf l1pUFlqF"F."6riSp$ffice, lnc., with its permission. Thi.s certifica!e cancels and supersedes ALL previously issued cer!ificates. WANER OF OUR RIGHT TO RECOI'ER FROil OTHERS ENDORSEilENT . CALIFORIIIA We have the rlght to r€covor our payments Fom anyone llable for an lnjury covered by thls pollcy. We wffl not enforce our rlght agalnst the person or organEa0on nanrd ln the Sdtedule. (Ihh agreement applhs only to fio extent that you parbrm unrk under a wrltten conbacl that requhBa you to obtaln thls agreement liom us.] YcxJ muet malntaln pa)rroll Ecords accurately Bogtrcgptng lhe remunera$on of your ernployees wille engaged ln Ote work deacrlbed ln the Stfiedule. The addl0onalpremlum br thb endoraement shall be % of fi€ Callfornla urorkere'compencation premium othetwls€ due on sucfi remunsratlon. Schoduh Person or Omenlzation Job Descrlgtlon WHERE REQUIRED BY WRITTEN CONTRACT WHERE REQUIRED BY WRITTEN CONTRACT Thlc endonsnsnt ls oreorted by the Prcmlum $ Efioch,B Date 3/2912018 Erplratlon Dato 312912019 For attadrment to Pollcy pe. WC027665701 rc0a030c ED: tU198l 46618160 | 18/19 GLIAU,/IMB,'wc MeEEe Romero l7/L8,2019 10:44:15 M (psr) I Page 9 of 9 This cerf,ificate cancels and supersedes ALL previously i.ssued cerLificates. Page 1 of I ,",. lllf-9 (Bev. December 201 1 ) Department of the Treasury lnternal Revenue Service Name (as shown on your income tax return) J&S ,lnc. Business name/disregarded entity name, if different from above List account numbe(s) here (optional) Identification Number Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line to avoid backup withholding. For individuals, this is 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 (ElN). lf you do not have a number, see How to get a I/N on page 3. Note. lf the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Request for Taxpayer Identification Number and Gertification Give Form to the requester, Do not send to the IRS. Exempt payee oi oo)(! o- cooo<ctoaroiZi o.o '6 ooo ooa Requester's name and address (optional) City of Lake Elsinore mm Under penalties of perjury, I certify that: 1. 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. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the lnternal Revenue Service (lRS) 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. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subiect 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 (lRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TlN. See the instructions on paqe 4. Here General Note. lf a requester gives you a form other than Form W-9 to request Section references are to noted. Revenue Code unless otherwise Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number [lN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an lRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 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. lf applicable, 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 effectively connected income. your TlN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: o An individual who is a U.S. citizen or U.S. resident alien, o A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, . An estate (other than a foreign estate), or . A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. Check appropriate box for tederal tax classification: fl tndividuat/sote proprietor fl C Corporation I S Corporation ! Partnership ! TrusVestate ! t-imiteO liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) > Address (number, street, and apt. or suite no.) City, state, and ZIP code Cat. No. 10231X rorm W-9 (Rev. l2-2011) BUSINESS LICENST This bu5inese li(ense i5 issued for retrenue purposes otly nnd does nul $rlnt authoriznti$f, to cDerate a bus,ness. This bu5ine59 liqerrst is rsrr.ied withoul verificndon thst th* ho,dor i, tuDjecl to 6r e<*mFf*d fronl liceiiin!) by the stals, (orilty' f€dtral goverrlir)ert or any other governmeri+i agen<y. Business Name: J & S STRIPING COMPANY INC Business Location: 1 544 S VINEYARD AVE oNTARIO. CA 91761-7756 OwnerName(s): ROBERTARAGON J & S STRIPING COMPANY INC 1544 S VINEYARD AVE oNTARTO, CA 91761-7756 CITY OF LAKE TLSINORE A0MIN lsTRAfiVi SIRVI(ES-u(ti.lSl NS ll0 S0!th Main Street Lake [.lsinort, fi 9]510 95i.6i4.J 1:4 T0 BE P05IrD lN S (0}ISP!(U0US pmff BUSINESS LICENSE NO. 022371 Eusiness Type: P/H IMPROVEMENT CONTRACTOR Doscription: PARKING & HIGH\flAY III4PROVEMENT lssue DatE: 9/61201 I Expiration Date: 9i30/201 I THIS 15 Y0UR Ll(ENSt " !{0T TRAI'ISI tRABtE