HomeMy WebLinkAboutGhilotti Construction Company, Inc. 2022-06-01 COu 2122-240
CITY OF UKIAH
Mendocino County, California
AGREEMENT
FOR
DORA ST.OVERLAY PROJECT
SPECIFICATION NO. 21-05
THIS AGREEMENT, made this 1st day of June , 20 22 , by and between the City of
Ukiah, Mendocino County, California, hereinafter called the City and chikotti Construction Company,Inc. hereinafter
called the Contractor,
WITNESSETH:
WHEREAS, the City has caused to be prepared in accordance with law, specifications, drawings and other
contract documents for the work herein described and shown and has approved and adopted these contract
documents,specifications and drawings and has caused to be published in the manner and for the time required
by law a notice to bidders inviting sealed proposals for doing the work in accordance with the terms of this
contract and
WHEREAS, the Contractor, in response to the notice to bidders, has submitted to the City a sealed proposal
accompanied by a proposal guaranty in an amount of not less than 10 percent of the bid price for the construction
of the proposed work in accordance with the terms of this contract and
WHEREAS, the City, in the manner prescribed by law, has publicly opened, examined and canvassed the
proposals submitted and as a result has determined and declared the Contractor to be the lowest and best
regular responsible bidder for the work and for the sums named in the proposal,
NOW,THEREFORE,THIS AGREEMENT WITNESSETH:
Article 1. Work to be Done and Contract Days Allowed.
That the Contractor shall provide all necessary machinery, tools, apparatus and other means of construction;
shall furnish all materials, superintendence, overhead, expenses, all labor and expenses of whatever nature
necessary for completion of the work in conformity with the Special Provisions and other contract documents
hereto attached and according to such instructions as may be given by the Engineer_ The Contractor shall
complete the work within thirty-five (35)working days. Contract days shall be counted starting with the 10th
day following receipt of notice that the contract has been executed by the City. Contractor, at his or her option,
may begin work prior to start of counting contract days, however, in no event shall the Contractor start work
without giving notification to the Engineer at least 72 hours prior to the start of work, without obtaining an
encroachment permit from the City, or without having submitted certificates of insurance that have been
accepted and approved by the Engineer
Dora Street Overlay Project 56 Spec No.21-05
Article II. Contract Prices.
That the City shall pay the Contractor the prices stated in the proposal submitted by the Contractor,for complete
performance of the contract by the Contractor. The Contractor hereby agrees to accept the prices as full
compensation for all material and appliances necessary to the work, for all labor and use of tools and other
implements necessary to execute the work contemplated in this contract; for all loss or damage arising out of
the nature of the work or from the action of the elements, or from any unforeseen obstructions or difficulties
which may be encountered in the prosecution of the work;for all risks of every description connected therewith;
for all expenses of the work, as herein specified; for all liability and other insurance, for all overhead and other
expenses incident to the work; all according to the Contract Drawings, the Special Provisions, the Details, the
instructions and the requirements of the City.
Article Ill. Labor Discrimination.
Attention is directed to Section 1735 of the Labor Code, which reads as follows:
"No discrimination shall be made in the employment of persons upon public works because of the race,
color, national origin or ancestry, or religion of such persons and every contractor for public works
violating this section is subject to all the penalties imposed for a violation of this chapter."
In connection with the performance of work under this contract, the Contractor agrees as follows:
(a) The Contractor will not willfully discriminate against any employee or an applicant for employment
because of race, color, religion, ancestry, or national origin. The Contractor will take affirmative
action to ensure that applicants are employed and that employees are treated during employment
without regard to their race, color, religion, ancestry, or national origin. Such action shall include,
but not be limited to, the following: employment, upgrading, demotion or transfer; recruitment or
recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and
selection for training, including apprenticeship. The Contractor agrees to post in conspicuous
places, available to employees and applicants for employment, notices to be provided by the
awarding authority setting forth the provisions of this Fair Employment Practice section.
(b) The Contractor will send to each labor union or representative of workers with which he or she has
a collective bargaining agreement or other contract or understanding, a notice, to be provided by
the awarding authority, advising the said labor union or worker's representative of the Contractor's
commitments under this section, to employees and applicants for employment.
(c) The Contractor will permit access to his or her records of employment, employment
advertisements, application forms and other pertinent data and records by the Fair Employment
Practices Commission, City of Ukiah or any other appropriate agency of the State of California
designated by the awarding authority, for the purposes of investigation to ascertain compliance
with the Fair Employment Practices section of this contract.
(d) A finding of willful violation of the Fair Employment Practices section of this Contract or of the Fair
Employment Practices Act shall be regarded by the awarding authority as a basis for determining
the Contractor to be not a "responsible bidder' as to future contracts for which such Contractor
may submit bids, for revoking the Contractor's pre-qualification rating, if any and for refusing to
establish, reestablish or renew a pre-qualification rating for the Contractor.
The City of Ukiah shall deem a finding of willful receipt of written notice from the Fair Employment
Practices Act to have occurred upon that it has investigated and determined that the Contractor
Dora Street Overlay Project 56 Spec No.21-05
has violated the Fair Employment Practices Act and has issued an order under Labor Code Section
1426 or obtained an injunction under Labor Code Section 1429.
Upon receipt of such written notice from the Fair Employment Practices Commission,the City shall
notify the Contractor that unless he or she demonstrates to the satisfaction of the awarding
authority within a stated period that the violation has been corrected, his or her pre-qualification
rating will be revoked at the expiration of such period.
(e) The Contractor agrees that should the City determine that the Contractor has not complied with the
Fair Employment Practices section of this Contract,then pursuant to Labor Code Section 1735 and
1775 the Contractor shall, as a penalty to the City, forfeit for each calendar day or portion thereof,
for each person who was denied employment as a result of such non-compliance, the penalties
provided in the Labor Code for violation of prevailing wage rates. Such monies may be recovered
from the Contractor.The City may deduct any such damages from any monies due the Contractor.
(f) Nothing contained in this Fair Employment Practices section shall be construed in any manner of
fashion so as to prevent the City or the State of California from pursuing any other remedies that
may be available at law.
(g) Prior to awarding the Contract, the Contractor shall certify to the awarding authority that he or she
has or will meet the following standards for affirmative compliance, which shall be evaluated in
each case by the awarding authority:
(1) The Contractor shall provide evidence, as required by the City that he or she has notified all
supervisors,foremen and other personnel officers in writing of the content of the anti-discrimination
clause and their responsibilities under it.
(2) The Contractor shall provide evidence, as required by the City, that he or she has notified all
sources of employees' referrals (including unions, employment agencies, advertisements,
Department of Employment) of the content of the anti-discrimination clause.
(3) The Contractor shall file a basic compliance report, as required by the City. Willfully false
statements made in such reports shall be punishable as provided by law. The compliance report
shall also spell out the sources of the work force and who has the responsibility for determining
whom to hire, or whether or not to hire.
(4) Personally, or through his or her representatives, the Contractor shall, through negotiations
with the unions with whom he or she has agreements, attempt to develop an agreement which will:
a. Spell out responsibilities for nondiscrimination in hiring, referral, upgrading and training.
b. Otherwise implement an affirmative anti-discrimination program in terms of the unions'
specific areas of skill and geography to the end that qualified minority workers will be available
and given and equal opportunity for employment.
(5) The Contractor shall notify the City of opposition to the anti-discrimination clause by individuals,
firms or organizations during the period of its pre-qualification.
(h) The Contractor will include the provisions of the foregoing paragraphs 1 through 5 in every first tier
subcontract so that such provisions will be binding upon each such subcontractor.
Dora Street Overlay Project 57 Spec No.21-05
(i) The "Fair Employment Practices Certification" must be completed and signed prior to the time of
submitting the bid.
Article IV. Parts of the Contract.
That the complete contract consists of the following documents, all of which shall be considered a part of this
agreement.
1. Notice to Bidders
2. Wage Rates
3. General Conditions
4. Technical Specifications
5. Proposal
6. Fair Employment Practices Certification
7. Agreement
8. Contract Bonds
9. Contract Drawings and Construction Details
10. Standard Drawings
11. Indemnification Agreement
IN WITNESS WHEREOF, this contract being executed in duplicate and the parties having caused their names
to be signed by authority of their duly authorized office this day of ;{�I/L� , 20 .
CITY OF UKIAH, MENDOCINO COUNTY, CALIFORNIA
By:
CM AN � , CITY�F UKIAH ,
Attest: i`
ai/�
C CLERK, CITY OF UKIAH
By: Brin QnnproSACA
C TO
Attest:
Title; (dy, (L
4h 1
The foregoing contract is approved as to form nd legality this r3 ~day of ri.ry e 20
1
CITY A RN CITY OF U IA
Dora Street Overlay Project 58 Spec No.21-05
rH
FI L 0 T T I
Since 1914
%I YEAS
GHILOTTI CONSTRUCTION COMPANY, INC.
CORPORATE RESOLUTION TO EXECUTE CONTRACTS
WHEREAS, the Board of Directors (the "Board") of Ghilotti Construction
Company, Inc., a California corporation (the "Corporation") deem it desirable and in the
best interests of the Corporation to authorize the following Officers of the Corporation
for the purpose of executing in the name of the Corporation, all bid documents, contract
documents and contract bonds: Richard W. Ghilotti, Chief Executive Officer; Brian W.
Ongaro, President and Secretary; Ali Yazdi, Executive Vice President of Public Works
and Chief Operating Officer; Irving T. Huie, Chief Financial Officer and Treasurer; and
Thomas Smith, Vice President of Estimating.
NOW, THEREFORE, BE IT RESOLVED, that the Directors hereby approve
and appoint Richard W. Ghilotti, Chief Executive Officer; Brian W. Ongaro, President
and Secretary; Ali Yazdi, Executive Vice President of Public Works and Chief Operating
Officer; Irving 1'. Huie, Chief Financial Officer and Treasurer; and Thomas Smith, Vice
President of Estimating for the purpose of executing in the name of the Corporation, all
bid documents, contract documents and contract bonds.
RESOLVED FURTHER, that any and all actions taken by Richard W. Ghilotti,
Brian W. Ongaro, Ali Yazdi, Irving T. Huie and Thomas Smith in executing said bid
documents and Bidder's Bonds be, and they hereby are, ratified and approved, and all
such Proposals and all such contracts and bonds and documents are hereby adopted as
binding obligations of the Corporation.
Secretary's Certification
The Secretary of the Corporation hereby certifies that he is the duly elected and
qualified Secretary of the Corporation and certifies that the above is a true and correct
record of a Board resolution that was duly adopted by the Corporation's Board of
Directors at a special meeting, which was duly and regularly called and held in all
respects as required by law and by the Corporation's bylaws, and which was held on July
15, 2021.
IN WITNESS WHEREOF, I have hereto set my hand as such Secretary and
affixed the corporat seal of the said Corporation, this 151" day of July, 2021.
By:
Brian W. garo, Secretary
— Engineering Contractor —
246 GHILOTTI AVENUE•SANTA ROSA,CA 95407.707-585-1221 •FAX:707-585-0129
www,ghilotti.com
STATE CONTRACTORS LICENSE 46"515
INDEMNIFICATION AGREEMENT
This Indemnification Agreement is made and entered in Ukiah, California, on June 1 20 22 ,
by and between the City of Ukiah (Ukiah) and Ghilotti Construction Company,Inc. (Contractor).
Contractor is
performing work as per Specification No.21-05 Dora Street Overlay Nuject
for Ukiah.
As a condition of issuing the work order, attached hereto, Ukiah requires assurance that Contractor will protect
Ukiah from damage or damage claims which arise from its performance of the work.
Accordingly. Contractor agrees as follows:
1. Indemnification. Contractor shall indemnify and hold harmless Ukiah and its officers, agents, and
employees from and against any claim,loss,or damage, including the legal and other costs of defending against
any claim of damage or loss which arises out of the Contractor's negligent or wrongful performance under the
work order attached hereto, except for claims, losses, or damages resulting from the sole and exclusive
negligence or other wrongful conduct of Ukiah or its officers, agents and employees.
CONTRACTOR
BY: Brian Onre7ro
TITLE: rQ51(7�e�`C
Dora Street Overlay Project 59 Spec No.2105
Premium is for Contract Term Bond#070217461Premium $5,035.00
and is Subject to Adjustment Executed in Duplicate
Based on Final Contract Price
CITY OF UKIAH
Mendocino County, California
PERFORMANCE BOND
BOND No. 070217461
KNOW ALL PERSONS BY THESE PREESNTS-
THAT WHEREAS, the City of Ukiah. organized and operating under the laws of the State of California,
(hereinafter referred toas the"City')has awarded to Ghilotti Construction Company, Inc..(hereinafter referred
to as the "Contractor") an agreement for Contract No. 21-05 (hereinafter referred to as the
"Project')
WHEREAS, the work to be performed by the Contractor is more particularly set forth in the Contract for the
Project dated June 1,2022 , (hereinafter referred to, together with all attachments and exhibits
thereto, as `Contract Documents), the terms and conditions of which are expressly incorporated herein by
reference; and
WHEREAS,the Contractor is required by the Contract Documents to perform the terms thereof and to furnish a
bond for the faithful performance of said Contract Documents.
NOW, THEREFORE, we, Ghilotti Construction Company, Inc, the undersigned Contractor and
Liberty Mutual Insurance Company, as Surety, a corporation organized and duty authorized to transact business
under the laws of the State of California are held firmly bound until the City in the sum of
"See Below ($ 609,866.30 ),for which amount well and truly to be made,we
bind ourselves, our heirs,executors and administrators, successors and assigns,jointly and severally, firmly by
these presents. -Six Hundred Nine Thousand Eight Hundred Six&30/100------
THE CONDITION OF THIS OBLIGATION IS SUCH that, if the Contractor, his or its heirs, executors,
administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and
perform the covenants,conditions and agreements in the Contract Documents and any alteration thereof made
as therein provided, on its part,to be kept and performed at the time and in the manner therein specified,and in
all respects according to their intent and meaning; and shall faithfully fulfill all obligations; and shall indemnify
and save harmless the City, its officials, officers, employees, and authorized volunteers, as stipulated in said
Contract Documents,then this obligation shall become null and void;otherwise it shall be and remain in full force
and effect.
As part of the obligation secured hereby and in addition to the face amount specified therefore, there shall be
included costs and reasonable expenses and fees including reasonable attorneys'fees, incurred by the City In
enforcing such obligation.
As a condition precedent to the satisfactory completion of the Contract Documents, unless otherwise provided
for in the Contract Documents, the above obligation shall hold good for a period of one (1) year after the
acceptance of the work by the City, during which time if Contractor shall fail to make full, complete, and
satisfactory repair and replacements and totally protect the City from loss or damage resulting from or caused
by defective materials or faulty workmanship.The obligations of Surety hereunder shall continue so long as any
obligation of Contractor remains. Nothing herein shall limit the City's rights or the Contractor or Surety's
obligations under the Contract Documents, law or equity, including, but not limited to, California Code of Civ I
Procedure Section 337.15.
Whenever Contractor shall be, and is declared by the City to be, In default under the Contract Documents, the
Surety shall remedy the default pursuant to the Contract Documents, or shall promptly,at the City's opt'on:
i. Take over and complete the Project in accordance with all terms and conditions in the Contract
Documents;or
Dora Street Overlay Project 60 Spec No 21-05
ii. Obtain a bid or bids for completing the Project in accordance with all terms and cond'tions in the
Contract Documents and upon determination by Surety of the lowest responsive and responsible bidder.
arrange for a contract between such bidder, the Surety and the City, and make available as work
progresses sufficient funds to pay the cost of completion of the Project, less the ba;ance of the contract
price, including other costs and damages for which Surety may be liable. The term "balance of the
contract price"as used in this paragraph shall mean the total amount payable to Contractor by the City
under the Contract and any modification thereto, less any amount previously pa:d by the City to the
Contractor and any other set offs pursuant to the Contract Documents.
iii. Permit the City to complete the Project in any manner consistent with Ca.forma law and make
available as work progresses sufficient funds to pay the cost of completion of the Project, less the
balance of the contract price, including other costs and damages for which Surety may be liable. The
term"balance of the contract price" as used in this paragraph shall mean the total amount payable to
Contractor by the City under the Contract and any modification thereto, less any amount previously paid
by the City to the Contractor and any other set offs by the City pursuant to the Contract Documents.
Surety expressly agrees that the City may reject any contractor or subcontractor which may be proposed by
Surety in fulfillment of its obligations in the event of default by the Contractor.
Surety shall not utilize Contractor in completing the Project nor shall Surety accept a b d from Contractor for
completion of the Project if the City, when declaring the Contractor in default, notifies Surety of the City's
objection to Contractor's further participation in the completion of the Project.
The Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the Contract Documents or to the Project to be performed thereunder shall in any way
affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time.
alteration or addition to the terms of the Contract Documents or to the Project.
[REMAINDER OF PAGE LEFT INTENTIONALLY BLANK]
Dora Street Overlay Project 61 Spec No.21-05
IN WITNESS WHEREOF,we have hereunto set our hands and seals this 2nd day of June
2022.
(Corporate Seai) Ghllotti Construction Company, Inc.
Contractor/ ,n
By Brian Onr,?-'�
Title ����7�G1 er1T
(Corporate Seal) Liberty Mutual Insurance Company
Surety
By�
t rney-in- t
(Attach Attorney-in Fact Certificate) Title Kathy Rangel,Attorney-In-Fact
The rate of premium on this bond is $8•86/$5.51 per thousand-The total amount of premium charges
is$ 5,035.00
(The above must be filled in by corporate attorney.)
THIS IS A REQUIRED FORM.
Any claims under this bond may be addressed to:
(Name and Address of Surety) Liberty Mutual Surely Claims
1001 4th Avenue,Suite 3800,Seattle, WA 98124
(Name and Address of Agent or Liberty Mutual Surety
1340 Treat Blvd.,suite 400
Representative for service of process in Walnut Creek, CA 94597
California, if different from above)
Surety: Ed Campos: 925-979-6705
(Telephone number of Surety and Agent A ent: Bob Laux: 916-380-5337
or Representative for service of process in California)
Dora Street Overlay Protect 62 Spec No 21-05
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
validity of that document.
State of California
County of Placer )
On June 2, 2022 before me, K. Hanley, Notary Public
(insert name and title of the officer)
personally appeared Kathy Rangel
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 correct.
WITNESS my hand and official seal.
0m�2
Notary Public CalK. ANL
ifornia
Placer County
Commission 4 Z384942
y Comm,Expires 4a�30,2025
Signature { � - `�� ��� (Seal)
Bond#070217461
Premium is for Contract Term Premium$5,035.00
and is Subject to Adjustment Executed in Duplicate
Based on Final Contract Price,
CITY OF UKIAH
Mendocino County, California
PAYMENT BOND
BOND No. 070217461
KNOW ALL PERSONS BY THESE PRESENTS:
WHEREAS, the City of Ukiah ("City") has awarded to hiloiti Construction Company,CltontractodPrincipal") a
contract (City Agreement No. 21-05 , dated June 1 , 2022 , referred to as the
'Agreement") for the work described as "See Below . The Agreement is incorporated by this
reference into this Payment Bond("Bond'); and *Dora Street Overlay Project, Spec No. 21-05
WHEREAS, Contractor/Principal is required to furnish a bond in connection with the Agreement and pursuant
to California Civil Code section 9550;
NOW, THEREFORE, we Ghilotti Construction Company, Inc. the undersigned
Contractor/Principal, and Liberty Mutual Insurance Company ("Surety"), a corporation organized and existing under the
laws of the State of Massac usetts , and duly authorized to transact business under the laws of the
State of California, as Surety, are held firmly bound until the City, and to any and all persons, companies, or
corporations entitled by law to file stop payment notices under California Civil Code Section 9100.or any person,
company,or corporation entitled to make a claim on this bond, in the sum of$ 609,806.30
forwhich payment will and truly be made,we bind ourselves,our heirs,executors and administrators,successors
and assigns,jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH that if Contractor/Principal, its heirs, executors,
administrators, successors, or assigns,or subcontractor, shall fail to pay any person or persons named in Civil
Code section 9100;or fail to pay for any materials,provisions,or other supplies, used in, upon, for, or about the
performance of the work contracted to be done, or for any work or labor thereon of any kind,or for amounts due
under the Unemployment Insurance Code, with respect to work or labor thereon of any kind; or shall fall to
deduct, withhold, and pay over to the Employment Development Department any amounts required to be
deducted, withheld, and paid over by Unemployment Insurance Code Section 13020 with respect to work and
labor thereon of any kind, then Surety will pay for the same, in an amount not exceeding the amount herein
above set forth,and in the event suit is brought upon this bond,also will pay such reasonable attorneys'fees as
shall be fixed by the court, awarded and taxed as provided in California Civil Code Section 9550, et seq.
It is further stipulated and agreed that the Surety of this bond shall not be exonerated or released from the
obligation of the bond by any change, extension of time for performance, addition, alteration or modification in,
to, or of any contract, plans, or specifications, or agreement pertaining or relating to any scheme or work of
improvement herein above described; or pertaining or relating to the furnishing of labor, materials,or equipment
therefor;nor by any change or modification of any terms of payment or extension of time for payment pertaining
or relating to any scheme or work of improvement herein above described; nor by any rescissions or attempted
rescission of the contract, agreement or bond; nor by any conditions precedent or subsequent in the bond
attempting to limit the right of recovery of claimants otherwise entitled to recover under any such contract or
agreement or under the bond; nor by any fraud practiced by any person other than the claimant seeking to
recover on the bond;and that this bond be construed most strongly against the Surety and in favor of all persons
for whose benefit such bond is give; and under no circumstances shall the Surety be released from liability to
those for whose benefit such bond has been given, by reason of any breach of contract between the Owner and
Contractor/Principal or on the part of any oblige named in such bond; that the sole condition of recovery sha'I
be that the claimant is a person described in California Civil Code section 9100, and who has not been paid the
full amount of his or her claim;and that the Surety does hereby waive notice of any such change, extension of
time, addition, alteration or modification herein mentioned, including but not limited to the provisions of section
2819 and 2845 of the California Civil Code.
Dora Street Overlay Project 63 Spec No.21-06
Any notice to Surety may be given in the manner specified in the Agreement and delivered or transmitted to
Surety as follows:
Attn: Ed Campos,Liberty Mutual Insurance Co.
Address: 1 340 Treat Blvd.,Suite 400
City/State/Zip: walnut Creek,CA 94597
Phone: 925-979-6705
Fax: 925.979-6754
Email: eduardo.camposeibertymutual.com
IN WITNESS WHEREO,two identical counterparts of th s Bond, each of which shall for all purposes be deemed
an original thereof, have been duly executed by Contractor/Principal and Surety above named,on the2ndday of
June ,202 2 .
Ghilotti Construction Company, Inc. (SEAL)
Contractor/Principal p
By Brian 0nraro -i're s t c�ea:- -
ract Representative
246 Ghilotti Avenue
Contractor/Principal's Address
Santa Rosa, CA 95407
City,State,Zip
Liberty Mutual Insurance Company (SEAL)
Surety
By ..
Su ety's R resentati
Kat`ty Rangel, orney-In- act
175 Berkeley Street
Si,!rety's Address
Boston, MA 02116
City,State,Zip
Ed Campos-925-979-6705
Telephone Number
NOTE: Signatures of those executing for Surety must be properly acknowledged, The bond must be
accompanied by a properly acknowledged Power of Attorney from the Surety authorizing its agent to bind it to
this bond.A copy of such Power of Attorney must be in file with the City
Dora Street Overlay Project 64 Spec No 21-05
DIRECTIONS FOR PREPARATION OF PERFORMANCE AND MATERIAL AND LABOR BOND
1. Individual sureties, partnerships, or corporations not in the surety business will not be acceptable.
2. The name of the Principal shall be shown exactly as it appears in the Contract.
3. The penal sum shall not be less than required by the Specifications.
4. If the Principals are partners or joint venturers, each member shall execute the bond as an individual
and state his place of residence.
5. If the Principal is a corporation, the bond shall be executed under its corporate seal.
If the corporation has no corporate seal, it shall so state and affix a scroll or adhesive seal following the
corporate name.
6. The official character and authority of the person(s)executing the bond for the Principal,if a corporation,
shall be certified by the Secretary or Assistant Secretary thereof under the corporate seal, or copies
attached to such records of the corporation as will evidence the official character and authority of the
officer signing, duly certified by the Secretary or Assistant Secretary, under the corporate seal, to be
true copies.
7. The current power-of-attorney of the person signing for the surety company must be attached to the
bond.
8. The date of the bond must not be prior to the date of the Contract
9. The following information must be placed on the bond by the surety company:
a. The rate of premium in dollars per thousand,and
b. The total dollar amount of premium charged.
10. The signature of a witness shall appear in the appropriate place attending to the signature of each party
of the bond.
11. Type or print the name underneath each signature appearing on the bond.
12. An executed copy of the bond must be attached to each copy of the Contract (original counterpart)
intended for signing.
Dora Street Overlay Project .15 Spec No_21-05
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
validity of that document.
State of California
County of Placer )
On June 2, 2022 before me, K. Hanley, Notary Public
(insert name and title of the officer)
personally appeared Kathy Rangel
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 correct.
WITNESS my hand and official seas.
ry K.HANLEY
z, = Notary Public•Ca.ifornia 1
- Pacer County
Commission 4 2384942
Signature _ Y r (Seal) °'-l} My C'in m.Expires Vov 30,2025
This Power of Attorney Ilmits the acts of those named herein,and they have no authortty to
bind the Company except In the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual The Ohio Casualty Insurance Company Certificate No:8205493-977442
SURETY West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the Stale of New Hampshire,that
Liberty Wlual Insurance Company s a corporation duly organized under the laws of the Slate of Massachusetts,and West American Insurance Company is a oorporation duwy organized
under the laws of the Slate of Indiana(herein collectively caged the'Companies-),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Alexis
Estrada,Dona Lisa Buschmann,Edward D.Johnson,J.Buschmann,Jana B.Pill ard,Julie A.Shlromra,Ka1hy Ran gel,Lisa Bracero,Margie Bender-Johnson,Roben D.
Laux,Stephen D.Bender
all of the ply of Sacramento stale of CA each individually if there be more than one named,its true and lawful attorney-in-fact to make,
execute,seal,acknowledge and deliver,for and on its behalf as surety and as cis act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance
of these presents and shall be as binding upon the Companies as it they have been duty signed by the president and attested by the secretary of the Companies in then own proper
persons.
IN WITNESS WHEREOF,[his Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
therelothis 281h dayof April , 2021
vtV IwaU Pou Liberty Mutual Insurance Company
P�INS(r� 4 -,I The Ohio Casually lnsurameCompany
J ,�iPO1yre�� a�`c,0.-4rog4y- �4POo A+r West American insurance Company
�1912 � o a 1919 1991cli
A /f
F a O 4 O ! y
� Ydplya'e4e NLLS�.aa; y°�hAres+aaa By:
_— a
David M.Carey,Assistant Secretary C 7
�fu State ofPENNSYLVANIA ss
N&County of MONTGOMERY
o
On this 28rh da of April 2021 before me� y p personally appeared David M.Carey who acknowledged himself to be the Ass slant Secretary of Liberty Mutual Insurance
m Company,The Ohio Casually Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes -
Q therein contained by signing on behalf of the corporations by himself as a duly authorized officer
-20 IN WITNESS WHEREOF,I have hereunto subscribed my name and affxed my notarial seal at King of Prussia.Pennsylvania,on the day and year first above written.
d.2
M d 5N 04sr il
ONW, ri:— &nhd PemsyNano-Nalary Sear rrll))��
0I esa 0 r�'ec° Ors V Ter Pwtela.Notary Public � /� AN
OF My ommissIm expires March 28.2025 rYl'/
C ro 9. �v Camfissom nun*w 1126ae Sy' _
ra Vora M&nter,Per„,y ania u ocialm of Na,ries en sa Pastella,Notary Public q
This Power of Atlomey is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casually Insurance Company,liberty Mutual Insurance aQ
O•E Company,and Wes[American Insurance Company which resolutions are now in full force and effect reading as follows:
o ARTICLE IV-OFFICERS:Section 12.Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or l he President
v may prescribe,shall appoint such atlomeys-in.fad,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety any and all
>LD undertakings,bonds,recognizarwes and other surety obligations.Such attorneysin-fad,subject b the imitations set forth in their respective powers of attorney,shall have
0 7 power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such instruments shall
Z V be as binding as if signed by the President and attested to by the Secretary.Any power or authodly granted to any representative or attorney-in-facl under the provisions of this
article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority.
ARTICLE XIII-Execution of Contracts:Section 5.Surely Bonds and Lindertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe,
shad appotnl such allomeys-in-fact,as may be necessary to ad in behalf of the Company io make,execute,seal,acknowledge and deliver as surety any and all undertakings
bonds,recognizances and ogler surety obligations.Such agomeys-in-fact subject to the imitations set forth in their respective powers of attorney,shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company when so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation-The President of the Company,acting pursuant to lie Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such allorneysAn-
fad as may be necessary to ad on behalf of the Company to make,execute,seal,acknowledge and deliver as surely any and all undertakings,bonds,recognizarices and other surety
obligations.
Authorization-By unanimous consent of the Company's Board of Directors,the Compamyconsents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,wherever appearing upon a ceflified copy of any paver of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
1,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Irsurarxxr Company,and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attlxrey,1*cuted by Said Companies,is to full face and effect and
has not been revoked.
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 2nd day of JmY. 2022
tiJP�aPO��4'fn+ yid*` OR, I
J3 eo sr e3 b [r a3° "o en
r 1912 0 0 1919 s 1991 0 t.�5•
B
rd�s�ds�cMog ba O N4Mrs yL r� 'No 0 .4b Renne C.Llewellyn.Assistant Secretor
gzT • �� �Ht • t o �M . I, Secretary
LMSI2873 LMIC OCIC WAIC Milli Co 02al
A`oREW CERTIFICATE OF LIABILITY INSURANCE 06102/202Y'r)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 a.
PRODUCER CA LIC OB29370 1-925-798-3334 CONTACT
NAME: Sara Dorrisay
Edgewood Partners Insurance Center (EPIC) PHONE Eli 925-822-9009 925-887
FAX -6815
[Concord - Branch ID 15469] No:
P.O. Box 5668 E DRESS: sara.dorrisey@epicbrokozo.com
INSURERS AFFORDING COVERAGE NAIC N
Concord, CA 94524 INSURERA: NATIONAL UNION FIRE INS CO OF PITTS 19445
INSURED INSURERB: NAVIGATORS SPECIALTY INS CO 36056
Ghilotti Construction Company, Inc.
INSURER C.
246 Ghilotti Avenue INSURER0:
INSURER E:
Santa Rosa, CA 95407 INSURERF:
COVERAGES CERTIFICATE NUMBER: 65705762 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL UBR POLICY EFF POLICY EXP
.LTRTYPE OF INSURANCE POLICY NUMBER MMID M D LIMITS
A TMERCIAL GENERAL LIABILITY X X GL9894974 04/01/22 04/02/23 EACHOCCURRENCE s 2,000,000
DAMAGE TO RENTFU__
CLAIMS•MADE X OCCUR PREMISES ED rrang4l $ 500,000
MED EXP(Any one person) s 25,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 4,000,000
POLICY n PROJECT D LOC PRODUCTS-COMPIOP AGG s 4,000,000
OTHER: s
A AUTOMOBILE LIABILITY X X CA2970066 04/01/22 04/01/23 COMBINED ISINGLE LIMIT i S 2,000,000
X ANY AUTO BODILY INJURY(Per person) s
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per eccide I) s
X HIRED X NON-OWNED PROPERTY DAMAGE s
AUTOS ONLY AUTOS ONLY Per accident
s
B UMBRELLA LIM X OCCUR LA22EXCZOAXPDIC 04/02/22 04/01/23 EACH OCCURRENCE s 5,000,000
X EXCESS LL48 CLAIMS-MADE AGGREGATE s 5,000,000
DED I I RETENT12NI s
A WORKERSCOMPENSAT10N X WC80878253 04/02/22 04/01/23 X STATUTE ERH
AND EMPLOYERS'LIABILITY YIN
ANYPROPRIETORIPARTNERIEXECUTIVE N!A E.L.EACH ACCIDENT S 2,000,000
OFFICER(MEMBEREXCLUDED9
(Mandatory 1.NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If Yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remw*s Schedule,may be attached If more apaos Is required)
RE: GCC #6029. Dora Street Overlay Project- Project #21-05.
Additional Insured: The City of Ukiah, its officers, officials, employees and volunteers.
When required by written contract, Additional Insured status with Primary i Non-Contributory coverage
applies to General Liability and Auto Liability and Waiver of Subrogation applies to General Liability,
Auto Liability and Workers Compensation, all as per the attached endorsements.
30 days notice of cancellation, as per the attached endorsements.
CERTIFICATE HOLDER CANCELLATION
GCC #6029
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE:CANCELLED BEFORE
City of Ukiah THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
300 Seminary Ave AUTHO REPRESENTAT
Ukiah, CA 95482
USA
0 1988-2M 5 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are regi d marks of ACORD
DorriseyS
65705762
DATE
SUPPLEMENT TO CERTIFICATE OF INSURANCE 06/02/2022
NAME OF INSURED: Ghilotti construction company, Inc.
Additional Description of OoerationslRemarks from Paae 1:
Additional Information:
SUPP(05104)
POLICY NUMBER: CA 297-00-66 COMMERCIAL AUTO
CA26481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement identifies persons? or organizations? who are "insureds" for Covered Autos Liability Co-
verage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter
coverage provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
Named Insured:
GHILOTTI CONSTRUCTION COMPANY, INC.
Endorsement Effective Date: 04/01/2022
SCHEDULE
Name Of Persons] Or Organization(s): '
AS REQUIRED PER WRITTEN CONTRACT
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule of Section II - Covered Autos Liability Coverage in
is an "insured" for Covered Autos Liability Cover- the Business Auto and Motor Carrier Coverage
age, but only to the extent that person or organ- Forms and Paragraph D.2. of Section I - Covered
ization qualifies as an "insured" under the Who Is Autos Coverages of the Auto Dealers Coverage
An Insured provision contained in Paragraph A.1. Form.
CA 20 48 10 13 ® Insurance Services Office, Inc., 2011 Page 1 of 1
ENDORSEMENT #
This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of
Policy No.CA 297-00-66 issued to GHILOTTI CONSTRUCTION COMPANY, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL
TO ENTITIES OTHER THAN THE FIRST NAMED INSURED
This policy is amended as follows:
In the event that the Insurer cancels this policy for any reason other than non-payment of premium,
and
1. the cancellation effective date is prior to this policy's expiration date;
2. the First Named Insured is under an existing contractual obligation to notify a certificate
holder when this policy is canceled (hereinafter, the "Certificate Holder(s)") and has
provided to the Insurer, either directly or through its broker of record, the email address
of a contact at each such entity; and
3. the Insurer received this information after the First Named Insured receives notice of
cancellation of this policy and prior to this policy's cancellation effective date, via an
electronic spreadsheet that is acceptable to the Insurer,
the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate
Holders within 30 days after the First Named Insured provides such information to the Insurer;
provided, however, that if a specific number of days is not stated above, then the Advice 'will be
provided to such Certificate Holder(s) as soon as reasonably practicable after the First Named
Insured provides such information to the Insurer.
Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured,
will serve as proof that the Insurer has fully satisfied its obligations under this endorsement.
This endorsement does not affect, in any way, coverage provided under this policy or the
cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights
in any entity not insured under this policy.
The following Definitions apply to this endorsement:
1. First Named Insured means the Named Insured shown on the Declarations Page of this
policy.
2. Insurer means the insurance company shown in the header on the Declarations page of this
policy.
All other terms, conditions and exclusions shall remain the same.
Authorized Nepresentative
107414 (03/11) Page 1
ENDORSEMENT
This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of
policy No. CA 297-00-66 issued to GHILOTTI CONSTRUCTION COMPANY, INC.
by NATIONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is
amended by the addition of the following sentence:
The insurance afforded under this policy to an additional insured will apply as primary insurance
for such additional insured where so required under an agreement executed prior to the date of
accident. We will not ask any insurer that has issued other insurance to such additional insured to
contribute to the settlement of loss arising out of such accident.
All other terms and conditions remain unchanged.
C
Authorize'4d Representative or
Countersignature (in States Where
Applicable)
74445 (10199)
ENDORSEMENT
This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of
policy No. CA 297-00-66 issued to GHILOTTI CONSTRUCTION COMPANY, INC.
by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery
Against Others to Us, is amended to add:
However, we will waive any right of recover we have against any person or organization with whom you have
entered into a contract or agreement because of payments we make under this Coverage Form arising out of
an "accident" or"loss" if:
(1) The "accident" or "loss" is due to operations undertaken in accordance with the contract existing
between you and such person or organization; and
(2) The contract or agreement was entered into prior to any"accident' or"loss".
No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the
person or organization, and we reserve our rights or lien to be reimbursed from any recovery funds obtained
by any injured employee.
L�
AUTHO IZED REPRESENTATIVE
62897 (6195)
ENDORSEMENT
This endorsement, effective 12:01 A.M. 04/01/2022 forms a part of
policy No.GL 989-49-74 issued to GHILOTTI CONSTRUCTION COMPANY, INC.
by NATIONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF LIMITS OF INSURANCE
(Per Project or Per Location Aggregate Limit)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
I. Your policy is amended to include either a Per Project General Aggregate Limit, a Per Location
General Aggregate Limit or a Per Project and Per Location General Aggregate Limit. Please select
only one of the following:
I X] Per Project General Aggregate Limit $ 4,000,000
I ] Per Location General Aggregate Limit $
j Per Project and Per Location General Aggregate Limit $
IF NEITHER OF THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID. IF MORE THAN ONE
OF THE THESE BOXES ARE CHECKED, THIS ENDORSEMENT IS VOID.
II. SECTION III - LIMITS OF INSURANCE , is amended to include the following:
1. The Limits of Insurance and the rules below fix the most we will pay regardless of the
number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits".
2. The General Aggregate Limit is the most we will pay for the sum of:
a. Medical expenses under CoverageC;
b. Damages under Coverage A, except damages because of "bodily injury" or "property
damage" included in the products-completed operations hazard"; and
c. Damages under Coverage B.
3. The Products-Completed Operations Aggregate Limit is the most we will pay under
Coverage A for damages because of "bodily injury" and "property damage" included in the
"products-completed operations hazard".
4. Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under
Coverage B for the sum of all damages because of all "personal and advertising injury"
sustained by any one person or organization.
S. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will
pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under CoverageC
86681 (9/04) Page 1 of 2
because of all "bodily injury" and "property damage" arising out of any one "occurrence".
6. Subject to 5. above, the Damage to Premises Rented To You Limit is the most we will pay
under Coverage A because of "property damage" to any one premises, while rented to you,
or in the case of damage by fire, while rented to you or temporarily occupied by you with
permission of the owner.
7. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C
for all medical expenses because of "bodily injury" sustained by any one person.
8. Subject to 2., 4., 5., 6., and/or 7. above, the Per Project Aggregate Limit is the most we
will pay under Coverages A, B, and C combined for the sum of:
a. Damages under Coverage A;
b. Damages under Coverage B; and
c. Medical Expenses under Coverage C
arising out of any single Project described above.
9. Subject to 2., 4., 5., 6., and/or 7. above, the Per Location Aggregate Limit is the most we
will pay under Coverages A, B, and C combined for the sum of:
a. Damages under Coverage A;
b. Damages under Coverage B; and
c. Medical expenses under Coverage C
arising out of the any single Location described above.
The Limits of Insurance of this Coverage Part apply separately to each consecutive annual
period and to any remaining period of less than 12 months, starting with the beginning of the
policy period shown in the Declarations, unless the policy period is extended after issuance for
an additional period of less than 12 months. In that case, the additional period will be deemed
part of the last preceding period for purposes of determining the Limits of Insurance.
III. The Limits of Insurance shown in the Declarations are deleted in their entirety and replaced by
the Limits of Insurance set forth below.
Limits of Insurance
General Aggregate Limit $ 10,000,000
Each Occurrence Limit $ 2,000,000
Products-Completed Operations Aggregate Limit $ 4,000,000
Personal & Advertising Injury Limit $ 1 ,000.000
Damage to Premises Rented to You $ 500,000
Medical Expense Limit $ 25,000
Per Project General Aggregate Limit, Per Location $ 4,000,000
General Aggregate Limit or Per
Project and Per Location General Aggregate Limit
IV. SECTION V - DEFINITIONS, is amended to include the following:
23. "Location" means premises involving the same or connecting lots, or premises whose
connection is interrupted only by a street, roadway, waterway, or right-of-way railroad.
All other terms and conditions of this policy remain the same.
Authoriz Representative or
Countersi&nature fin States Where
Applicable)
86681 (9/04) Page 2 of 2
POLICY NUMBER: GL989-49-74 COMMERCIAL GENERAL LIABILITY
CG20101219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
I
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT.
BECOME OBLIGATED TO INCLUDE AS AN
ADDITIONAL INSURED AS A RESULT OF ANY
CONTACT OR AGREEMENT YOU HAVE ENTERED
INTO.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following additional
organizations) shown in the Schedule, but only exclusions apply:
with respect to liability for "bodily injury", This insurance does not apply to "bodily injury"
"property damage" or "personal and advertising or "property damage" occurring after:
injury" caused, in whole or in part, by: 1. All work, including materials, parts or
1. Your acts or omissions; or equipment furnished in connection with such
2. The acts or omissions of those acting on work, on the project (other than service,
your behalf; maintenance or repairs) to be performed by
in the performance of your ongoing operations or on behalf of the additional insured(s) at
for the additional insured(s) at the location(s) the location of the covered operations has
designated above. been completed; or
However: 2. That portion of "your work" out of which
1. The insurance afforded to such additional the injury or damage arises has been put to
insured only applies to the extent permitted its intended use by any person or
by law; and organization other than another contractor or
subcontractor engaged in performing
2. If coverage provided to the additional operations for a principal as a part of the
insured is required by a contract or same project.
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
CG 20 10 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 2
C. With respect to the insurance afforded to these 2. Available under the applicable limits of
additional insureds, the following is added to insurance;
Section III — Limits Of Insurance: whichever is less.
If coverage provided to the additional insured is This endorsement shall not increase the
required by a contract or agreement, the most applicable limits of insurance.
we will pay on behalf of the additional insured
is the amount of insurance:
1. Required by the contract or agreement; or
Page 2 of 2 0 Insurance Services Office, Inc., 2018 CG 20 10 12 19
POLICY NUMBER: GL989-49-74 COMMERCIAL GENERAL LIABILITY
CG 20 37 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person{sl
Or Organization(s) Location And Description Of Completed Operations
ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT
BECOME OBLIGATED TO INCLUDE AS AN
ADDITIONAL INSURED AS A RESULT OF ANY
CONTRACT OR AGREEMENT YOU HAVE ENTERED
INTO.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following is� added to
organization(s) shown in the Schedule, but only Section III Limits Of Insurance:
with respect to liability for "bodily injury" or If coverage provided to the additional insured is
"property damage" caused, in whole or in part, required by a contract or agreement the most
by "your work" at the location designated and we will pay on behalf of the additio al insured
described in the Schedule of this endorsement is the amount of insurance:
performed for that additional insured and 1. Required by the contract or agreement; or
included in the "products-completed operations
hazard". 2. Available under the applicable limits of
However:
insurance;
1. The insurance afforded to such additional whichever is less.
insured only applies to the extent permitted This endorsement shall not increase the
by law; and applicable limits of insurance.
2. If coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the contract
or agreement to provide for such additional
insured.
CG 20 37 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1
ENDORSEMENT#
This endorsement, effective 12:01 A.M.04/01/2022 forms a part of
Policy No.GL 989-49-74 issued to GHILOTTI CONSTRUCTION COMPANY, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL
TO ENTITIES OTHER THAN THE FIRST NAMED INSURED
This policy is amended as follows:
In the event that the Insurer cancels this policy for any reason other than non-payment of premium,
and
1. the cancellation effective date is prior to this policy's expiration date;
2. the First Named Insured is under an existing contractual obligation to notify a certificate
holder when this policy is canceled (hereinafter, the "Certificate Holders)") a�d has
provided to the Insurer, either directly or through its broker of record, the email address
of a contact at each such entity; and l
3. the Insurer received this information after the First Named Insured receives notice of
cancellation of this policy and prior to this policy's cancellation effective date, via an
electronic spreadsheet that is acceptable to the Insurer,
the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate
Holders within 30 days after the First Named Insured provides such information to the Insurer;
provided, however, that if a specific number of days is not stated above, then the Advice will be
provided to such Certificate Holders) as soon as reasonably practicable after the First Named
Insured provides such information to thelnsurer.
Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured,
will serve as proof that the insurer has fully satisfied its obligations under this endorsement.
This endorsement does not affect, in any way, coverage provided under this policy or the
cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights
in any entity not insured under this policy.
The following Definitions apply to this endorsement:
1. First Named Insured means the Named Insured shown on the Declarations Page of this
policy.
2. Insurer means the insurance company shown in the header on the Declarations page of this
policy.
All other terms, conditions and exclusions shall remain the same.
Authorize Representative
107414 (03/11) Page 1
POLICY NUMBER: GL 989-49-74 COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance (2)You have agreed in writing in a contract or
Condition and supersedes any provision to the agreement that this insurance would be
contrary: primary and would not seek contribution
Primary And Noncontributory Insurance from any other insurance available to the
This insurance is additional insured.
primary to and will not Seek
contribution from any other insurance available
to an additional insured under your policy
provided that:
(1)The additional insured is a Named Insured
under such other insurance; and
CG 20 01 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1
POLICY NUMBER: GL 989-49-74 COMMERCIAL GENERAL LIABILITY
CG24171001
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTUAL LIABILITY - RAILROADS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Scheduled Railroad: Designated Job Site:
ANY RAILROAD ORGANIZATION WHOM HAS
GRANTED YOU AN EASEMENT FOR ANY JOB
SITE TO PERMIT YOU TO PERFORM WORK AS
A RESULT OF ANY CONTRACT OR AGREEMENT
YOU HAVE ENTERED INTO.
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
With respect to operations performed for, or another party to pay for "bodily injury" or
affecting, a Scheduled Railroad at a Designated "property damage" to a third person or
Job Site, the definition of "insured contract" in the organization. Tort liability means a liability
Definitions section is replaced by the following: that would be imposed by la in the
9. "Insured Contract" means: absence of any contract or agree ent.
a. A contract for a lease of premises. However, Paragraph f. does not include that part of any
that portion of the contract for a lease of contract or agreement:
premises that indemnifies any person or
organization for damage by fire to premises 11)That indemnifies an architect, engineer or sur-
while rented to you or temporarily occupied veyor for injury or damage arising out of:
by you with permission of the owner is not (a) Preparing, approving or failing to prepare or
an "insured contract"; approve maps, shop drawings, opinions, re-
b. A sidetrack agreement; ports, surveys, field orders, change orders
or drawings and specifications; or
c. Any easement or license agreement;
d. An obligation, as required b ordinance, to (b) Giving directions or instructions, or failing to
g q Y give them, if that is the primary cause of the
indemnify a municipality, except in injury or damage;
connection with work for a municipality;
(2) Under which the insured, if an architect,
e. An elevator maintenance agreement; engineer or surveyor, assumes liability for an in-
f. That part of any other contract or agreement jury or damage arising out of the insured's
pertaining to your business (including an in- rendering or failure to render professional
demnification of a municipality in connection services, including those listed in Paragraph (1)
with work performed for a municipality) above and supervisory, inspection, architectural
under which you assume the tort liability of or engineering activities.
CG 24 17 10 01 0 ISO Properties, Inc., 2000 Page 1 of 1 CJ
Policy#GL 989-49-74
primary, our obligations are not affected un- self-insured amounts under all that
less any of the other insurance is also other insurance.
primary. Then, we will share with all that 141 We will share the remaining loss, if any,
other insurance by the method described in with any other insurance tl1at is not
Paraaranh c. below. described in this Excess Insurance pro-
b. Excess Insurance vision and was not bought specifically to
apply in excess of the Limits of Insurance
(1)This insurance is excess over: shown in the Declarations of this
(a) Any of the other insurance, whether Coverage Part.
primary, excess, contingent or on any c. Method Of Sharing
other basis:
If all of the other insurance permits contri-
(i) That is Fire, Extended Coverage, bution by equal shares, we will follow this
Builder's Risk, Installation Risk or method also. Under this approach each
similar coverage for "your work"; insurer contributes equal amounts until it
(ii) That is Fire insurance for premises has paid its applicable limit of in�urance or
rented to you or temporarily occu- none of the loss remains, whichever comes
pied by you with permission of the first.
owner; If any of the other insurance does not permit
(i!!)That is insurance purchased by contribution by equal shares, we will contri-
you to cover your liability as a bute by limits. Under this met�od, each
tenant for "property damage" to insurer's share is based on the atio of its
premises rented to you or tempo- applicable limit of insurance to� the total
rarily occupied by you with per- applicable limits of insurance of al insurers.
mission of the owner; or 5. Premium Audit
(iv)If the loss arises out of the main- a. We will compute all premiums for this
tenance or use of aircraft, "autos" Coverage Part in accordance with our rules
or watercraft to the extent not and rates.
subject to Exclusion g. of Section
- Coverage A - Bodily Injury And b. Premium shown in this Coverage Part as
Property Damage Liability. advance premium is a deposit premium only.
At the close of each audit period we will
(b)Any other primary insurance available
compute the earned premium for that period
to you covering liability for damages and send notice to the first Named Insured.
arising out of the premises or opera- The due date for audit and retrospective
tions, or the products and completed premiums is the date shown as the due date
operations, for which you have been on the bill. If the sum of the advance and
added as an additional insured. audit premiums paid for the policy period is
12)When this insurance is excess, we will greater than the earned premium, we will
have no duty under Coverages A or B to return the excess to the first Named Insured.
defend the insured against any "suit" if c. The first Named Insured must keep records
any other insurer has a duty to defend of the information we need fo� premium
the insured against that "suit". If no computation, and send us copies at such
other insurer defends, we will undertake times as we may request.
to do so, but we will be entitled to the
insured's rights against all those other 6. Representations
insurers. By accepting this policy, you agree:
(3)When this insurance is excess over other a. The statements in the Declarations are accu-
insurance, we will pay only our share of rate and complete;
the amount of the loss, if any, that b. Those statements are based upon re-
exceeds the sum of: presentations you made to us; and
(a)The total amount that all such other c. We have issued this policy in reliance upon
insurance would pay for the loss in your representations.
the absence of this insurance; and
7• Separation Of Insureds
(b)The total of all deductible and
Except with respect to the Limits of Insurance,
and any rights or duties specifically assigned in
Page 12 of 16 0 Insurance Services Office, Inc., 2012 CG 00 01 04 13
this Coverage Part to the first Named Insured, 4. "Coverage territory" means:
this insurance applies: a. The United States of America (including its
a. As if each Named Insured were the only territories and possessions), Puerto Rico and
Named Insured; and Canada;
b. Separately to each insured against whom b. International waters or airspace, but only if
claim is made or "suit" is brought. the injury or damage occurs in the course of
8. Transfer Of Rights Of Recovery Against Others travel or transportation between Any places
To Us included in Paragraph a. above; or`
If the insured has rights to recover all or part of c. All other parts of the world if the injury or
any payment we have made under this damage arises out of:
Coverage Part, those rights are transferred to MI Goods or products made or sold by you
us. The insured must do nothing after loss to in the territory described in Paragraph a.
impair them. At our request, the insured will above;
bring "suit" or transfer those rights to us and (2)The activities of a person whose home is
help us enforce them. in the territory described in Paragraph a.
9. When We Do Not Renew above, but is away for a short time on
If we decide not to renew this Coverage Part, your business; or
we will mail or deliver to the first Named In- (3)"Personal and advertising injury" offenses
sured shown in the Declarations written notice that take place through the Internet or
of the nonrenewal not less than 30 days before similar electronic means of communi-
the expiration date. cation;
If notice is mailed, proof of mailing will be suffi- provided the insured's responsibility to pay
cient proof of notice. damages is determined in a "suit" on the me-
SECTION V - DEFINITIONS rits, in the territory described in Pairagraph a.
1. "Advertisement" means a notice that is broad- above or in a settlement we agree to.
cast or published to the general public or speci- 5. "Employee" includes a "leased worker".
fic market segments about your goods, pro- "Employee" does not include a ',temporary
ducts or services for the purpose of attracting worker".
customers or supporters. For the purposes of 6. "Executive officer" means a person Folding any
this definition: of the officer positions created by your charter,
A. Notices that are published include material constitution, bylaws or any other similar
placed on the Internet or on similar elec- governing document.
tronic means of communication; and 7. "Hostile fire" means one which becomes un-
b. Regarding web sites, only that part of a web controllable or breaks out from where it was in-
site that is about your goods, products or tended to be.
services for the purposes of attracting custo- 8. "Impaired property" means tangible property,
mers or supporters is considered an adver- other than "your product" or "your work", that
tisement. cannot be used or is less useful because:
2. "Auto" means: a. It incorporates "your product" or "your
a. A land motor vehicle, trailer or semitrailer work" that is known or thought to be defec-
designed for travel on public roads, including tive, deficient, inadequate or dangerous; or
any attached machinery or equipment; or b. You have failed to fulfill the terms,of a cont-
b. Any other land vehicle that is subject to a ract or agreement;
compulsory or financial responsibility law or if such property can be restored to yse by the
other motor vehicle insurance law where it is repair, replacement, adjustment or removal of
licensed or principally garaged. "your product" or "your work" or yoI r fulfilling
However, "auto" does not include "mobile the terms of the contract or agreeme t.
equipment". 9. "Insured contract" means:
3. "Bodily injury" means bodily injury, sickness or a. A contract for a lease of premises. However,
disease sustained by a person, including death that portion of the contract for a lease of
resulting from any of these at any time. premises that indemnifies any person or
CG 00 01 04 13 0 Insurance Services Office, Inc., 2012 Page 13 of 16 ❑
POLICY NUMBER:GL 989-49-74 COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organ izationls):
PURSUANT TO APPLICABLE WRITTEN CONTRACT OR AGREEMENT YOU ENTER INTO.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV — Conditions:
We waive any right of recovery against the
person(s) or organization(s) shown in the Schedule
above because of payments we make under this
Coverage Part. Such waiver by us applies only to
the extent that the insured has waived its right of
recovery against such person(s) or organization(s)
prior to loss. This endorsement applies only to the
person(s) or organizations} shown in the Schedule
above.
I
CG 24 04 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 1
PHIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different
date is indicated below.
(The following"attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy).
This endorsement, effective 12:01 AM 04/02/2022 forms a part of Policy No. WC 808-78-253
Issued to GHILOTTI CONSTRUCTION COMPANY, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA.
LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL
TO ENTITIES OTHER THAN THE NAMED INSURED
(WORKERS' COMPENSATION ONLY)
This policy is amended as follows:
In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and
1. the cancellation effective date is prior to this policy's expiration date;
2, the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an
existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the
"Certificate Holder(s)') and the Named Insured has provided to the Insurer, either directly' or through its
broker of record, the email address of a contact at each such entity; and
3. the Insurer received this information after the Named Insured receives notice of cancellation of this policy and
prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer,
the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 30 days
after the Named Insured provides such information to the Insurer; provided, however, that if a specific number of days
is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable
after the Named Insured provides such information to the Insurer.
Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured, will serve as
proof that the Insurer has fully satisfied its obligations under this endorsement.
This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or
the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy.
The following definitions apply to this endorsement:
I
1. Named Insured means the insured first named employer in Rem 1 of the Information Page of this policy.
i
2. Insurer means the insurance company shown in the header on the Information Page of this policy.
All other terms, conditions and exclusions shall remain the same.
"45ct—
THORADREPRESENTATIVE
WC 99 00 5$
(Ed. 04111)
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different
date is indicated below. I
he following *attaching clause" need be completed only when this endorsement is Issued subsequent to preparation of thB policy).
R 9 9 P Y �1
This endorsement, effective 12:01 AM 04/02/2022 forms a part of Policy No. WC 808-78-253
Issued to GHILOTTI CONSTRUCTION COMPANY, INC.
By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA.
We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against any person or organization with whom you have a written contract that requires you to obtain this
agreement from us, as regards any work you perform for such person or organization.
The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium
for this policy.
WC040361 Countersigned by_ _ _ _ _ _ _ _ _ _ _ _
(Ed. 11190)
Authorized Representative
Business License
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Issued to Issued by
Richard Ghilod CRY of Ukiah
GhIbW Constnlcfbon Co 300 Seminary Avenue
246 WHO Avenue Ukiah,CA 95482
Santa Rosa,CA 95407
(707)463-6215 phone
(707)463-6204 tax
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City of Ukiah
i+I Richard GhIIoU
300 Seminary Avenue
Ukiah,CA 95492 Ghiforff Consnuoiion Co
This Iasuad rn compliance wilh the 246 Ghilotti Avenue
Winanou of the City of Ukiah and Santa Rosa,CA 95407
Subject to the provisions thereof.
Valid From
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This Issued In compllanse with the Ordinanoas of the City Valid From Issued To
of UkM and subject to the provialons thereof. I M1121-12MI122 Richard Ghfioti
Number Ghilold Construction Co
BSN5458402 2480hiloei Avenue
Santa Rosa,CA 95407
Issued 15y
city of Ukiah
300 Seminary Avenue
Ukiah,CA 954Q
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