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HomeMy WebLinkAboutC-1576Job No. 9697 -3 THIS CONTRACT, made and executed this 19 9% , by and between the City of Arcadia, California, City, and kW" Krol dba Cdfomla Electrical Services hereinafter referred to simply as Contractor. ORIGINAL vwvlfti� c -\S-16 Aay of Q-ry�6L— , hereinafter referred to simply as WITNESSETH: That the parties hereto do mutually agree and covenant as follows: For and in consideration of the payments and covenants hereinafter specified to be made and performed by City, Contractor shall perform and complete the following: STREET LIGHT CONVERSION SANTA ANITA OAKS - WEST (Name of Project) JOB NO. 1996 -97 -3 TWO HUNDRED THIRTY TWO THOUSAND NINE HUNDRED AND NINETEEN DOLLARS ($232,919) (Bid Items Accepted by City and Included Herein) and to perform and complete the same in a good and workmanlike manner all the work pertaining thereto shown on the Plans and Specifications therefor; to furnish at his own cost and expense all tools, equipment, labor, services, and materials necessary therefor (except such materials, if any, as in the said specifications are stipulated to be furnished by the City), and to do everything required by this contract, special provisions, technical specifications, construction plans, drawings and details, and all addenda issued by City to the foregoing prior to the opening of bids. 2. For furnishing all said materials and labor, services, tools, and equipment, and doing all work specified herein, also arising out of the nature of the work aforesaid, or from the action of the elements, or from any unforeseen difficulties which may arise or be encountered in the prosecution of the work until its acceptance by the City, and for all risks of every description connected with the work, for all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as in said specifications are expressly stipulated to be borne by the City and for well and faithfully completing the work in the manner specified in said Plans and Specifications, the City will pay and the Contractor shall receive in full compensation therefor the lump sum price or if the bid is on the unit price basis, the total price for the several items furnished pursuant to the specifications, as set forth in Contractor's bid heretofore filed by him and accepted by City, at the times and manner specified in the Contract Documents. C -1 Job No. 9697 -3 ORIGINAL 3. Contractor agrees to perform the work according to the terms of this Contract for price(s) named in the bid, and City agrees to pay the same at the time, in the manner, and upon the conditions stipulated in the said contract documents. 4. Subject to the provisions of this Contract, all terms, covenants, conditions, and provisions hereof shall inure to and shall bind each of the parties hereto and each of their respective heirs, executors, administrators, successors, and assigns. 5. The Notice Inviting Bids, Information Required of Bidders, Contractor's Bid, Special Provisions, Technical Specifications, Construction Plans, Drawings and Details, and all addenda issued by City to the foregoing prior to the opening of bids, are hereby incorporated in and made part of this contract by reference and are collectively referred to therein and herein as "Contract Documents." 6. Contractor shall be responsible for compliance with the Apprenticeable Occupations Regulations of Labor Code, Section 1777.5, including compliance by all subcontractors. 7. Contractor represents and affirms that it is not affected by any labor dispute, work stoppage or strike; that the labor contracts of its subcontractors are not scheduled to expire for the term of this contract, and that these contracts contain "no strike" provisions. Contractor agrees that should any labor dispute, work stoppage or strike affect it or it's subcontractors or any employees of same, contractor shall continue to perform according to the employees of same, contractor shall continue to perform according to the work schedule and shall not be executed from non - performance and that the contractor is subject to the Liquidated Damage provision of this contract for such non - performance. C -2 Job No. 9697 -3 ORIGINAL IN WITNESS WHEREOF, the parties hereto have caused this contract to be executed the day and year first above written. _ CITY OF ARCADIA By �- - - ATTEST: _ ity Clerk / APPROVED AS TO FORM: ' '-m4VC1 4�/ mu�"a City Attorney C -3 CONTRACTOR CalHomia EEkx***W SWAM Mayor By (SEAL) 0Wnc'y- Title Job No. 9697 -3 Premium is for the Contract term and is subject to adjustment based ORIGINAL on final Contract price. EXECUTED IN DUPLICATE BOPJD NO.: P2725403 FAITHFUL PERFORMAN E BOND PREMIUM: $4.,658.00 100% o- f Contract Price KNOW ALL MEN BY THESE PRESENTS, THAT WE Andrzej KroZ dba CaZifornia EZectricaZ Services hereinafter referred to as "Contractor" as PRINCIPAL, and Relianee NationaZ Indemnity Company A corporation duly organized and doing business under and by virtue of the laws of the State of California and duly licensed for the purpose of making, guaranteeing, or becoming sole surety upon bonds or undertakings as Surety, are held and firmly bound unto the CITY OF ARCADIA, CALIFORNIA, hereinafter referred to as the "City" in the sum of Two Hundred Thirty Two Thousand Nine Hundred Nineteen and 00 /100 * * * * * * * * * * * * * * * * * * * * * * * * ** Dollars ($ 232,919. 00) lawful money of the United States of America for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators, assigns and successors, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH, that whereas said Contractor has been awarded and is about to enter into a Contract with the City to perform all work required pursuant to the contract documents for the project entitled: Street Light Conversion Santa Anita Oaks - West Job No. 1996 -97 -3 (Insert Title Shown on Proposal) which Contract is by this reference incorporated herein, and is required by the City to give this Bond in connection with the execution of said Contract; NOW, THEREFORE, if said Contractor and his Subcontractors shall well and truly do and perform all the covenants and obligations of said Contract on his part to be done and performed at the times and in the manner specified herein including compliance with all Contract specifications and quality requirements, then this obligation shall be null and void, otherwise it shall be and remain in full force and effect; PROVIDED, that any alterations in the work to be done, or in the material to be furnished, which may be made pursuant to the terms of said Contract, shall not in any way release said Contractor or the Surety thereunder, nor shall any extensions of time granted under the provisions of said Contract release either said Contractor or said Surety, and notice of such alterations of extensions of the Contract is hereby waived by said Surety. In the event suit is brought upon this Bond by the City and judgment is recovered, said Surety shall pay all costs incurred by the City in such suit, including a reasonable attorney's fee to be fixed by the Court. . Job No. 9697 -3 ORIGINAL IN WITNESS WHEREOF, we have hereunto set our hands and seals this 9th day of March , 19 98. Andrzej Krol dba CaZifornia EZectrieaZ Services Principal A By: (SEAL C -5 Surety /1 SAL) JOHN D. INGER, Attorney-In-Fact CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of Cal ifornia County of Los Angeles On March 9, 1998 before me, Pi 1 ar M. Landeta, Notary Public Date Name and Ttle of Officer (e.g., "Jane Doe, Notary Public ") personally appeared John D. Hunsinger Name(s) of Signer(s) ® personally known to me – OR – ❑ proved to me on the basis of satisfactory evidence to be the personK4 whose name(so is /axxsubscribed to the within instrument and acknowledged to me that he /gb[er/&A*executed the same in his/Jowkti six authorized capacity(DexX and that by his /ke(& xsignature�4 on the instrument the personoo, or the entity upon behalf of which the person(x) acted, r • ":.,.. PILAR M. LANDETA I executed the instrument. COMM. # 1159393 a `. A NOTARY PUBLIC • CALIFORNIA I LOS ANGELES COUNTY WITNESS my hand and official seal. ... My Comm. Expires Oct. 24, 2001 M/ 1 Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Individual Corporate Officer Title(s): Partner — ❑ Limited ❑ General Attorney -in -Fact Trustee Guardian or Conservator Other: Signer Is Representing RIGHT THUMBPRINT OF SIGNER Signer's Name: I Individual Corporate Officer Title(s): Partner — ❑ Limited ❑ General Attorney -in -Fact Trustee Guardian or Conservator Other: Signer Is Representing RIGHT THUMBPRINT OF SIGNER of thumb here 0 1994 National Notary Association • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309 -7184 Prod. No. 5907 Reorder: Call Toll -Free 1- 800 - 876 -6827 Premium is for the Contract term Job No. 9697 -3 and is subject to adjustment based on final Contract price. ORIGINAL EXECUTED IN DUPLICATE LABOR AND MAT RIAI BOND BOND NO.: P2725403 100% of Contract Price KNOW ALL MEN BY THESE PRESENTS, THAT WE Andrzej KroZ dba CaZifornia Electrical Services hereinafter referred to as "Contractor" as PRINCIPAL, and Reliance National Indemnity Company a corporation duly organized and doing business under and by virtue of the laws of the State of California, and duly licensed for the purpose of making, guaranteeing, or becoming sole Surety upon bonds or undertakings as surety, are held and firmly bound unto the CITY OF ARCADIA, CALIFORNIA, hereinafter referred to as the "City" in the sum Of Two Hundred Thirtu Two Thousand Nine Hundred N-ineteen and 00/100 * * * * * * * * * ** Dollars ($232,91, lawful money of the United States of America for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators, assigns and successors, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH, that whereas said Contractor has been awarded and is about to enter into a Contract with the City to perform all work required pursuant to the contract documents for the project entitled: Street Light Conversion Santa Anita Oaks We-qt Tnh No 7996-97-3 (Insert Title Shown on Proposal) which Contract is by this reference incorporated herein, and is required by the City to give this Bond in connection with the execution of said Contract; NOW, THEREFORE, if said Contractor or subcontractor in said Contract fails to pay for any materials, equipment, tools, provisions, provender or other supplies, or teams, or services, or for rental of same, 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 applicable law with respect to any work or labor thereon, said Surety will pay for the same in an amount not exceeding the sum specified above, and also, in case suit is brought upon this Bond, a reasonable attorney's fee, to be fixed by the Court. This Bond shall inure to the benefit of any and all persons, companies, or corporations entitled to file claims under applicable law; PROVIDED, that any alterations in the work to be done, or the materials, equipment, tools, provisions, provender or other supplies, or teams, or services to be furnished, which may be made pursuant to the terms of said Contract, shall not in any way release either said Contractor or said Surety thereunder, nor shall any extensions of time granted under the provisions of said Contract release either said Contractor or said Surety, and notice of such alterations or extensions of the Contract is hereby waived by said Surety. C -6 Job No. 9697 -3 ORIGINAL IN WITNESS WHEREOF, we have hereunto set our hands and seals this 9th day of March 19 98 Andrzej KroZ dba CaZifornia Electrical Services Reliance do Z Principal By:__ LJ--- �VA 1� (SEAL) C -7 Z Surety By: %,_ JOHN D. , Attorney -In -Fact CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of Cal ifornia County of Los Angeles On March 9, 1998 before me, Pi 1 ar M. Landeta, Notary Public Date Name and Title of Officer e. ' ( g., "Jane Doe, Notary Public ") personally appeared John D. Hunsinqer Name(s) of Signer(s) ' ® personally known to me – OR – ❑ proved to me on the basis of satisfactory evidence to be the personM whose name(so is /am(subscribed to the within instrument and acknowledged to me that he /gtxertWexecuted the same in his/J0ecJth0 xauthorized capacity(baX and that by his / XsignatureQ4 on the instrument the person0j, ••' PILAR M. LANDETA or the entity upon behalf of which the person(s) acted, T COMM. #1159393 executed the instrument. NOTARY PUBLIC - CALIFORNIA I LOS ANGELES COUNTY m WITNESS h . „ ..,• My Comm. Expires Oct. 24, 2001 y and and official seal. Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: I ■ ■ ■ ■ Individual Corporate Officer Title(s): Partner — ❑ Limited ❑ General Attorney -in -Fact Trustee Guardian or Conservator Other: Signer Is Representing RIGHT THUMBPRINT OF SIGNER .. of Signer's Name: 0 Number of Pages: Individual Corporate Officer Title(s): Partner — ❑ Limited ❑ General Attorney -in -Fact Trustee Guardian or Conservator Other: Signer Is Representing RIGHT THUMBPRINT OF SIGNER .. of �•� , ����� �• � - ���� — -ilr, non., r— ooa r i o4 - Canoga rank, GA 91309 -7184 Prod. No. 5907 Reorder: Call Toll -Free 1- 800- 876 -6827 RELIANCE SURETY COMPANY RELIANCE INSURANCE COMPANY UNITED PACIFIC INSURANCE COMPANY RELIANCE NATIONAL INDEMNITY COMPANY ADMINISTRATIVE OFFICE, PHILADELPHIA, PENNSYLVANIA POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that RELIANCE SURETY COMPANY is a corporation duly organized under the laws of the State of Del- aware, and that RELIANCE INSURANCE COMPANY and UNITED PACIFIC INSURANCE COMPANY, are corporations duly organized under the laws of the Commonwealth of Pennsylvania and that RELIANCE NATIONAL INDEMNITY COMPANY is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called "the Companies ") and that the Companies by virtue of signature and seals do hereby make, constitute and appoint John D. Hunsinger, of South Pasadena, California their true and lawful Attorney(s) -in -Fact, to make, execute, seal and deliver for and on their behalf, and as their act and deed any and all bonds and undertakings of suretyship and to bind the Companies thereby as fully and to the same extent as if such bonds and undertakings and other writings obligatory in the nature thereof were signed by an Executive Officer of the Companies and sealed and attested by one other of such officers, and hereby ratifies and confirms all that their said Attorney(s) -in -Fact may do in pursuance hereof. This Power of Attorney is granted under and by the authority of Article VII of the By -Laws of RELIANCE SURETY COMPANY, RELIANCE INSURANCE COMPANY, UNITED PACIFIC INSURANCE COMPANY, and RELIANCE NATIONAL INDEMNITY COMPANY which provisions are now in full force and effect, reading as follows: ARTICLE VII - EXECUTION OF BONDS AND UNDERTAKINGS 1. The Board of Directors, the President, the Chairman of the Board, any Senior Vice President, any Vice President or Assistant Vice President or other officer designated by the Board of Directors shall have power and authority to fa) appoint Attorneyfs) -in -Fact and to authorize them to execute on behalf of the Company, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and (b) to remove any such Attorney (s) at any time and revoke the power and authority given to them. 2. Attorney(s)-in -Fact shall have power and authority, subject to the terms and limitations of the Power of Attorney issued to them, to execute deliver on behalf of the Company, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The corporate seal is not necessary for the validity of any bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. 3. Attorney(s)-in -Fact shall have power and authority to execute affidavits required to be attached to bonds, recognizances, contracts of indemnity or other conditional or obligatory undertakings and they shall also have power and authority to certify the financial statement of the Company and to copies of the By -Laws of the Company or any article or section thereof. This Power of Attorney is signed and sealed by facsimile under and by authority of the following resolution adopted by the Executive and Finance Committees of the Boards of Directors of Reliance Insurance Company, United Pacific Insurance Company and Reliance National Indemnity Company by Unanimous Consent dated as of February 28, 1994 and by the Executive and Financial Committee of the Board of Directors of Reliance Surety Company by Unanimous Consent dated as of March 31, 1994. "Resolved that the signatures of such directors and officers and the seal of the Company may be affixed to any such Power of Attorney or any certificates relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company and any such Power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company, in the future with respect to any bond or undertaking to which it is attached." IN WITNESS WHEREOF, the Companies have caused these presents to be signed and their corporate seals to be hereto affixed, this July 19, 1996. �� � RELIANCE SURETY COMPANY p�� RELIANCE INSURANCE COMPANY UNITED PACIFIC INSURANCE COMPANY " SEA See fL� r RELIANCE NATIONAL INDEMNITY COMPANY STATE OF Washington } COUNTY OF King } ss. On this, July 19, 1996, before me, Janet Blankley, personally appeared Mark W. Alsup, who acknowledged himself to be the Vice President of the Reliance Surety Company, and the Vice President of Reliance Insurance Company, United Pacific Insurance Company, and Reliance National Indemnity Company and that as such, being authorized to do so, executed the foregoing instrument for the purpose therein contained by signing the name of the corporation by himself as its duly authorized officer. In witness whereof, I hereunto set my hand and official seal. Notarl Public in and for the State of Washin ton Residing at Puyallup I, Robyn Layng, Assistant Secretary of RELIANCE SURETY COMPANY, RELIANCE INSURANCE COMPANY, UNITED PACIFIC INSURANCE COMP- ANY, and RELIANCE NATIONAL INDEMNITY COMPANY do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 9th day of March 19 98. ry `o�,roe,�`O' Ems+` r ol�ni�r�g V EA` 4 $r r111lr �14w ,r0 �w. • Assistant Secretary r CERTIFICATE OF LIABILITY INSURANCE DATE YY) 03/6/98 116 /98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE John W. Knight Ins. Agency PO Box 1351 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 104 N.Maryland Ave., Glendale CA 91209 -1351 COMPANIES AFFORDING COVERAGE COMPANY A GOLDEN EAGLE INS CORP INSURED COMPANY California Electrical Services B 5924 San Fernando Rd. COMPANY Glendale CA 91201 C COMPANY D COVERAGES 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. Go TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM /DD/YY) POLICY EXPIRATION DATE (MM /DD/YY) LIMITS A GENERAL LIABILITY CCP55535400 01/01/98 01/01/99 GENERAL AGGREGATE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7 OCCUR PRODUCTS - COMP /OP AGG $ 1,000,000 PERSONAL & ADV INJURY $ 11000,000 OWNER'S 6 CONTRACTOR'S PROT EACH OCCURRENCE $ 1 '000,000 FIRE DAMAGE (Any one fire) $ 56, 00 MED EXP (Any one person) $ 5,000 A AUTOMOBILE LIABILITY ANY AUTO CCP55535400 01/01/98 01/01/99 COMBINED SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS /EXECUTIVE NNC33844502 01/01/98 01/01/99 X I TWRY LIMIT ER EL EACH ACCIDENT $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 OFFICERS ARE: EXCL OTHER GENEIRALGNLIAeILIfYNI /NCLUDES AH$1000 DEDUCTIBLE FOR BODILY INJURY AND PROPERTY DAMAGE COMBINED PER CLAIM, SUBJECT TO A $5000 MAXIMUM PER OCCURENCE. ATTACHED: GECG840 (11/95) AUTOMATIC ADDITIONAL INSUREDS - CONSTRUCTION CONTRACTS 10 DAY CANC NOTICE FOR NON- PAYMENT OF PREMIUM OR NON- SUBMISSION OF PAYROLL. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City Of Arcadia/Development Serv. Dept. Engineering Divison PO BOX 60021 Arcadia CA 91066 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILUR IL UCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON HqCOMPANA I S A4NTA OR REPRESENTATIVES. AUTHORIZEVEPRE ACORD 25-S (1/95) © ACORD CORPORATION 1988 GOLDEN EAGLE INSURANCE CORPORATION P.O. BOX 85826 - SAN DIEGO, CA 92186 -5826 AUTOMATIC ADDITIONAL INSUREDS - Policy No: CCP- 538883 -00 CONSTRUCTION CONTRACTS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Endorsement Effective: (At 12:01 A.M. Standard Time) Named Insured: This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above. The following provision is added to Section II (WHO IS AN INSURED). 5. Any person(s) or organizations (s) (hereinafter called "Additional Insured ") with whom you agree in a written contract to name as an Insured is an Insured but only with respect to liability arising out of your ongoing (as opposed to completed) operations for the Additional Insured on the project specified in the contract, including acts or omissions of the Additional Insured in connection with the general supervision of your ongoing (as opposed to completed) operations. However, the insurance provided to the Additional Insured does not apply to: a. "Property damage" to: 1) Property owned, used or occupied by or rented to the Additional Insured; 2) Property in the care, custody, or control of the Additional Insured or over which the Additional Insured is for any purpose exercising physical control; or b. "Bodily injury," "property damage," or "personal injury" arising out of an architect's, engineer's, or surveyor's ren- dering of or failure to render any professional services for you, for the Additional Insured, or for others, including: 1) The preparing, approving, or failing to approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and 2) Supervisory, inspection, or engineering services. These exclusions apply in addition to those contained in the Commercial General Liability Coverage Part. Premium: The premium for this endorsement is five percent (5 l) of the annual general liability premium, subject to a minimum premium of $250.00. The advance premium charged at this time is subject to the audit provisions of the policy. GECG540 1111951 IGEr"971 Includes copyrighted material of Insurance Sernces Office. Inc . 1954 r. -ith its permission Agent's Copy Job No. 9697 -3 ORIGINAL GOLDEN EAGLE INSURANCE CORP Name of Insurance Company CCP55535400 Policy Number 01 irn /g8 -01 101199 Effective Date The following endorsements are hereby incorporated by reference onto the attached Certificate of Insurance as though fully set forth thereon: 1. The naming of an additional insured as herein provided shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured, and 2. The additional insured named herein shall not be held liable for any premium or expense of any nature on this policy or any extensions thereof, and 3. The additional insured named herein shall not by reason of being so named be considered a member of any mutual insurance company for any purpose whatsoever, and 4. The provisions of the policy will not be changed, suspended, canceled or otherwise terminated as to the interest of the additional insured named herein without first giving such additional insured twenty (20) days written notice. 5. Any other insurance held by the additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance which is referred to by this certificate. It is agreed that the City of Arcadia, its officers and employees. are included as Additional Insured. Authorized Insurance Agent 8/77 C -8 Job No. 9697 -3 CERTIFICATION OF CONTRACTOR IN ACCORDANCE WITH LABOR CODE SECTION 1861 M The undersigned is aware of the provisions under Section 37nn of the California L��.,, Code which requires every employer to be insured against liability for Worker's Compensation or to undertake self - insurance in accordance with the provisions of that Code, and it will comply with such provisions before commencing the performance of the work of this Contract. Andrzej Krol dba Callfomla Electrical SOMME Contractor By: Title C -9 RECORDING REQUESTED BY CITY OF ARCADIA AND WHEN RECORDED MAIL TO: NAME JUNE D. ALFORD, CITY CLERK STREET CITY OF ARCADIA ADDRESS 240 W. HUNTINGTON DRIVE CITY, STATE d P.O. BOX 60021 ZIP CODE L ARCADIA, CA 91066 -6021 ogJ0 -o 98 1853206 RECORDED/FILED IN OFFICIAL RECORDS LOS RECORDER'S COUNTY ;IAN 13109"1 CALIFORNIA 4:It1V or 0%"PAP)A 11:01 AM OCT 09 1998 CITY GL,ERK EiiiE i S SPACE ABOVE THIS LINE FOR RECORDER'S USE NOTICE OF COMPLETION Notice pursuant to Civil Code Section 3093, must be filed within 10 days after completion. (See reverse side for Complete requirements.) Notice is hereby given that: 1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereinafter described: 2. The full name of the owner is CITY OF ARCADIA 3. The full address of the owner is 240 WEST HUNTINGTON DRIVE, ARCADIA, CALIFORNIA 91007 4, The nature of the interest or estate of the owner is: In fee. F OTHER THAN FEE, STRIKE IN FEE AND INSERT, FOR EXAMPLE, PURCHASER UNDER CONTRACT OF PURCHASE, OR LESSEE 5. The full names and full addresses of all persons, if any, who hold title with the undersigned as joint tenants or as tenants in common are: NAMES ADDRESSES 6. The full names and full addresses of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the work or improvements herein referred to: NAMES ADDRESSES 7. A work of improvement on the property hereinafter described was completed on SEPTEMBER 1, 1998 The work done was: STREET LIGHT CONVERSION. SANTA ANITA OAKS — WEST JOB NO. 1996 -97 -3 8. The name of the contractor, if any, for such work of improvement was �CALIFORNIA ELECTRICAL SERVICES MARCH 23, 1998 (IF NO CONTRACTOR FOR WORK OF IMPROVEMENT AS A WHOLE, INSERT -NONE-) ATE OF CONTRACT) 9. The property on which said work of improvement was completed is in the City of ARCADIA County of LOS ANGELES Stateof CA ,and is described asfollows: SANTA ANITA OAKS AREA — WEST, WITHIN THE CITY OF ARCADIA, STREET LIGHT CONVERSION PROJECT 10. The street address of said property is VARIOUS ADDRESSES UNDER PROJECT NO. 1996 -97 -3 (F NO STREET E AS BEEN OFFICIALLY ASSIGNED, INSERT "NONE ".) Dated: SEPTEMBER 2, 1998 CITY MANAGER PRO TEMPORE /POLICE CHIEF (SIGNATURE OF OWNER OR CORPORATE OFFICER OF OWNER NAMED IN PARAGRAPH 2 OR HIS AGENT) WILLIAM R. KELLY, CITY MANAGER VERIFICATION I, the undersigned, say: I am the CITY CLERK OF THE CITY OF ARCADIA the declarant of the foregoing notice of completion; ("PRESIDENT OF ", "MANAGER OF", "PARTNER OF "OWNER OF ", ETC.) I have read said notice of completion and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct. Executed on SEPTEMBER 2 , 1998 at ARCADIA CA t, _ (CITY) (STATE) PERSONAL SIGNATURE OF THE E D. ALFORD,k WOLCOTTS FORM 1114 - Rev. 8 -94 (price class 3A NOTICE OF COMPLETION 01994 WOLCOTTS FORMS, INC. IL WHO IS SWEARING THAT THE CONTENTS OF THE NOTICE OF COMPLETION ARE TRUE.) CLERK (See reverse side for additional Information) 7 67775 39114 5