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Home My WebLink AboutC-1933o7sv_7v 93 C �� . aact � X 3 ORIGINAL Council Awarded 01/21/03 $3,056,100.00 • CITY OF ARCADIA ST. JOSEPH RESERVOIR NO. 1 PROJECT NO. 6272072 OCTOBER 2002 VOLUME 1 BID AND CONTRACT DOCUMENTS PAT MALLOY PUBLIC WORKS SERVICES DIRECTOR PHILIP A. WRAY CITY ENGINEER SCHEDULED BID OPENING: DECEMBER 19, 2002 CONTRACT FOR THE CITY OF ARCADIA ST. JOSEPH RESERVOIR NO. 1 This Contract is made and entered into this 1. PARTIES AND DATE. o -7 — 7 c) C, -I q�D (PROJECT NO. 6272072) V-1 day ofe,g- , 200 by and between the CITY OF ARCADIA (hereinafter called the "Owner") and PACIFIC HYDROTECH CORPORTATION (hereinafter called the "Contractor"). 2. RECITALS. 2.1 The Owner is a charter City organized under the laws of the State of California, with power to contract for services necessary to achieve its purpose; 2.2 Contractor, in response to a Notice Inviting Bids issued by Owner on OCTOBER, 2002, has submitted a bid proposal for construction the ST. JOSEPH RESERVOIR NO.1 described in the Contract. 2.3 Owner has duly opened and considered the Contractor's bid proposal, and duly awarded the bid to Contractor in accordance with the Notice Inviting Bids and the other Bid Documents, and has given written notice to Contractor on JANUARY 23, 2003. 2.4 Contractor has obtained, and delivers concurrently herewith, Performance and Payment Bonds and evidences of insurance coverage as required by the Contract. 3. TERMS. 3.1 Incorporation of Documents. This Contract includes and hereby incorporates in full by reference the following documents, including all exhibits, drawings, specifications and documents therein, and attachments and addenda thereto: a. Notice Inviting Bids b. Instructions to Bidders C. Contract Bid Forms d. Contract e. Contract Appendix Part "A" Part "B" I Part "C" Part "D" Part "E" Part "F" Part "G" RVPUB\DRD1570015 - General Conditions - Supplementary General Conditions - Special Provisions - Specifications (under separate cover) - Drawings (under separate cover) - Performance Bond - Payment Bond CONTRACT-1 GB - STATE & LOCAL (505/507/660) (7/24100) (PROJECT NO. 6272072) f. ADDENDUM NO.� 2.3 dated The above documents, including the General Conditions, are an integral part of the Contract Documents. In addition to signing this Contract, Contractor shall initial this paragraph immediately below acknowledging that he or she has read, understood and agrees with all of the terms of the Contract Documents, including, but not limited to, provisions of the General Conditions relating to indemnification, insurance, standards of performance, termination, compensation and time of the essence performance. Contractor shall not disclaim knowledge of the meaning and effect of any term or provision of the Contract Documents, and agrees to strictly abide by their meaning and intent. In the event that Contractor fails to initial below, the Owner shall have the right to declare the Contract unexecuted and to award the Contract to another contractor in accordance with state law. ontrac 1 s Initials 3.2 Contractor's Basic Obligation. Contractor promises and agrees, at its own cost and expense, to furnish to the Owner all labor, materials, tools, equipment, services, and incidental and customary work for the construction of Bid Category number(s) listed in Bid Schedule necessary to fully and adequately complete ST. JOSEPH RESERVOIR NO. 1, including any alternates selected by the Owner, and all structures and facilities described in the Contract (hereinafter the "Work "), for a total of THREE MILLION FIFTY SIX THOUSAND ONE HUNDRED DOLLARS AND NO CENTS ($3,056,100.00), as specified in the Contract Bid Forms submitted by the Contractor in response to the above referenced Notice Inviting Bids. Such amount shall be subject to adjustment in accordance with the applicable terms of this Contract. All Work shall be subject to, and performed in accordance with the above referenced documents. 3.3 Standard of Performance. Contractor shall perform all Work under this Contract in a skillful and workmanlike manner, and consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Contractor represents and maintains that it is skilled in the professional calling necessary to perform the Work. Contractor warrants that all employees and subcontractors shall have sufficient skill and experience to perform the Work assigned to them. Finally, Contractor further represents that it, its employees and subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Work, and that such licenses and approvals shall be maintained throughout the term of this Contract. RVPLIB \DRD\570015 CONTRACT-2 GB - STATE & LOCAL (505/507/660) (7/24/00) w w ■ w w ■ ■ ■ (PROJECT NO. 6272072) 3.4 Period of Performance. Contractor shall perform and complete all Work under this Contract within FOUR HUNDRED (400) Calendar Days, beginning ten (10) Calendar Days after the date on which the Letter of Award is sent by the Owner to the Contractor. Moreover, Contractor shall perform its Work in strict accordance with any completion schedule, construction schedule or project milestones developed pursuant to provisions of the Contract, including but not limited the Project Schedule located in the Specifications. Contractor agrees that if such Work is not completed within the aforementioned period and /or pursuant to any such completion schedule, construction schedule or project milestones developed pursuant to provisions of the Contract, including but not limited to the Project Schedule located in the Specifications, it is understood, acknowledged and agreed that the Owner will suffer damage. Pursuant to Government Code Section 53069.85, Contractor shall pay to the Owner as fixed and liquidated damages the sum of ONE THOUSAND DOLLARS ($1,000.00) PER DAY as provided by the applicable provisions of the General Conditions, found in Part "B" of the Contract Appendix. 3.5 Owner's Basic Obligation. Owner agrees to engage and does hereby engage Contractor as an independent contractor to furnish all materials and to perform all Work according to the terms and conditions herein contained for the sum set forth above. Except as otherwise provided in the Contract, the Owner shall pay to Contractor, as full consideration for the satisfactory performance by the Contractor of the services and obligations required by this Contract, the above referenced compensation in accordance with compensation provisions set forth in the Contract. 3.6 Contractor's Labor Certification. Contractor maintains that he is aware of the provisions of Section 3700 of the California Labor Code which require 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 agrees to comply with such provisions before commencing the performance of the Work. A certification form for this purpose is attached hereto as Exhibit "A" and incorporated herein by reference, and shall be executed simultaneously with this Contract. 3.7 Attorneys' Fees. If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Contract, the prevailing party in such action shall be entitled to have and recover from the losing party reasonable attomeys' fees and all other costs of such action. 3.8 Successors. . The parties do for themselves, their heirs, executors, administrators, successors, and assigns agree to the full performance of all of the provisions contained in this Contract. Contractor may not either voluntarily or by action of law, assign any obligation assumed by Contractor hereunder without the prior written consent of the Owner. RVPUB \DRD\570015 CONTRACT - 3 GB -STATE &LOCAL (505/507/660) (7/24/00)' J (PROJECT NO. 6272072) 3.9 Notices. All notices hereunder and communications regarding interpretation of the terms of the Agreement or changes thereto shall be provided by the mailing thereof by registered or certified mail, return receipt requested, postage prepaid and addressed as follows: Contractor Pacific Hydrotech Corporation 27200 Highway 74 Perris, CA 92570 Attn: J. Kirk Hams, President Owner City of Arcadia 11800 Goldring Rd. P. O. Box 60021 Arcadia, CA 91066 -6021 Attn: Pat Malloy Public Works Services Director Surety ggZS C-r -)�. 22 0 SN.y Attn: With Copies To: MWH Americas, Inc. 301 North Lake Avenue Pasadena, CA 91101 Attn: Ashok Dhingra Any notice so given shall be considered received by the other party three (3) days after deposit in the U.S. Mail, first class postage prepaid, addressed to the party at the above address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. CONTRACTOR By: ame V-- �..cL. Title Tax I.D. Number.• gs - yNa -7 Q� Number Contractor, s License: N Class Sl°21� Number CITY OF ARCADIA By: 44ho William R. Kelly Date City Manager ATTES By: �' z u,�, ne D. Alford Date City Clerk Approved as to Form: By: AY&L P., 4w—�Ze Stephen P. Deitsch City Attorney RVPUB \DRD\570015 CONTRACT-4 GB - STATE & LOCAL (505/507/660) (7/24/00) i ■ CALIFORNIA ALL - PURPOSE ACKNewi onnuca r State of California County of Riversi-de ss. On at , before me, Kris tine-. B rt uco 'Notary � i bl-i-c2. - Name and Title of Officer (e.g., "Jane Doe, Notary Public ") personally appeared J. Kirk Harns Name(s) of Signer(s) IN personally known to me to be the person(I)c whose nameft is /Me subscribed to the within instrument and KRISTINE 6ERTUCO acknowledged to me that he /&bft executed _ Commission# 124" the same in his /bn( authorized $ Notary PUblk - Q*Mrnfo Z Riverside County capacity*g*, and that by his/ signature(k) on the instrument the person* or the entity upon behalf of which the person(*) acted, executed the instrument. W N m han and I se I. Place Notary Seal Above i ature 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 & 0i Title or Type of Document: % _ � Document Date: 1(p I rG�- Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: J. Kirk Harns ❑ Individual X Corporate Officer— Title(s): President ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 1997 Natin i Kj Yn o.. ,;__ _ .,o f. Pacific Hydrotech RIGHT THUMBPRINT OF SIGNER -••• • •• ��r +�� • iswonn, cH `11313 -2402 Prod. No. 5907 Reorder: Call Toll -Free 1- 800 - 876 -6827 (PROJECT NO. 6272072) EXHIBIT "A" CERTIFICATION LABOR CODE - SECTION 1861 I, the undersigned Contractor, am aware of the provisions of Section 3700 et seg. of the California Labor Code which require every employer to be insured against liability for Worker's Compensation or to undertake self - insurance in accordance with the provisions of the Code. I agree to and will comply with such provisions before commencing the Work governed by this Contract. CONTRACTOR: Name of Contractor: PACIFIC HYDROTECH CORPORATION By: Signature Name Title -z-/ Date } RVPUB\DRD\570015 CONTRACT (EXHIBIT A) ■ • : '.. ... ..:' :.,:...owe:: :::;;:::3: .................... DATE MM/ / 1 r.. J( { : ....>:::::.�::::::::::::::: PRoOUCER 619- 238 -1828 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DRIVER ALLIANT INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1620 FIFTH AVENUE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SAN DIEGO, CA 92101 COMPANIES AFFORDING COVERAGE LICENSE #OC36861 COMPANY A North American Capacityk� INSURED Pacific Hydrotech Corp COMPANY B Royal Insurance Company 27200 Highway 74 Perris, CA 92570 COMPANY Jo C Lincoln General Ins. Co. 6 COMPANY D Fireman's Fund Ins. Co. Vk ::.:.. i...;'.. i'. .... . i. 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. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM /DD/YY) POLICY EXPIRATION DATE (MM /DD/YY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7 OCCUR PNG000039600 7/01/02 7/01/03 GENERAL AGGREGATE $ 2000000 X PRODUCTS • COMP/OP AGG $ 2000000 PERSONAL & ADV INJURY $ 1000000 EACH OCCURRENCE $ 1000000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 50000 MED EXP (Any one person) $ 5000 C AUTOMOBILE LIABILITY ANY AUTO 2510001298 7/01/02 7/01/03 COMBINED SINGLE LIMIT $ 1000000 X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS X X BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: _ - EACH ACCIDENT $ AGGREGATE $ B EXCESS LIABILITY P2HA207073 8/06/02 7/01/03 EACH OCCURRENCE $ 4000000 AGGREGATE $ 4000000 UMBRELLA FORM X OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND LIABILITY WC STATU- 024 T RY LIMITS ER EL EL EACH ACCIDENT S THE PROPRIETOR/ INCL PARTNERS /EXECUTIVE REXCL EL DISEASE - POLICY LIMIT $ EL DISEASE - EA EMPLOYEE $ OFFICERS ARE: fl OTHER MX198303666 12/07/01 2/01/03 BUILDERS RISK $3,056,100 SPECIAL PERILS DEDUCTIBLES $2,500 DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /SPECIAL ITEMS RE: ST.JOSEPH RESERVOIR. ADDITIONAL INSURED PER ATTACHED. ALL POLICIES INCLUDE WAIVER OF SUBROGATION IN FAVOR OF THE CITY OF ARCADIA. ALL POLICIES ARE PRIMARY AND ANY INSURANCE MAINTAINED BY THE CITY SHALL BE EXCESS. :. ...:,:. .... '<:.::::;. �i .�Y...!E'�:ii; <.::< >:: >.` >::>:: CITY OF ARCADIA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED/ BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ) MI0ft MAIL 11800 GOLDRING ROAD 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ARCADIA, CA 91006 AUTHORIZED E T IVE ,. CC �{ �ys .. ... � ...........:........... ........................................ ..........:...,:,.::::::::::.:. ,:: :.::..::.::::..::.::.:.:::::::: :.:::::::::::::::::::<!:•:::.::: i>:;.>::> ri::•; ii: aii: a: �> R! f.. �M. ��:: !M�Ftf;V:fH,.!.��W1�:;;��f�o;: CL 246 (11 -85) POLICY NUMBER: PNG0000396 -00 PACIFIC HYDROTECH CORP. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 11 85 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: THE CITY OF ARCADIA, ITS OFFICIALS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS. 11800 GOLDRING ROAD ARCADIA, CA 91006 JOB: ST. JOSEPH RESERVOIR (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. Coverage provided by this policy to the Additional Insureds shown in the Schedule shall be primary insurance and any other insurance maintained by the Additional Insureds) shall be excess and non- contributory, but only as respects any claim or liability determined to be the result of the sole negligence or responsibility of the Named Insured and only if required of the Named Insured by written contract. We waive any right of recovery we may have against the person or organization shown in the schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products= completed operations hazard. This applies only to the perWn or organization shown in the schedule above. Agent: Date. Dri3O�VjAjliant Insurance Services, Inc. F Copyright, Insurance Services Office, Inc., 1984 h1a 02/06/2003 14:51 FAX 6196991369 DRIVER ALLIANT INS SVCS INSURED; Pacific Hydrotech Corp. POLICY NO: 2510001298 THIS ENDORSEMENT CHANCES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION 01002 COMMERCIAL AUTO This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART GARAGE COVERAGE: PART TR JCKERS COVERAGE PART. SCHEDULE Name of Person or Organization: THE CITY OF ARCADIA, ITS OFFICIALS, OFFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS 11800 GOLDRING ROAD ARCADIA, CA 91006 JOB: ST. JO;�EPH RESERVOIR A. WHO IS AN INURED is changed to include as an "insured" the person or organization shown in the Schedule but only for liability arising out of your use of a covered "auto" for such person or organization. S. CANCELLATION 1. If we cancel the policy, we will mail notice to such person or organization in accordance with the Common Policy Condition. _ 2. If you cancel the policy, we will mail notice to such person or organization. 3. Cancellation ends this agreement. AGENT: Drivj:r/-"liant Insurance Services, Inc. BY: DATE: Includes copyrighted material of Insurance Services Office, Inc. with its permission. Copyright, Insurance Services Office, Inc., 1985 CI JCA 99 09 03 83 .r DATE MM /DD Y ?' ) D :::::> .. ...:....: ::: .::: 7M .. ? :i:: ::g!t 2T ;?v,;;:i:::L t;:g;:;: ::::; .> ....1. 1. • .,..:::.:: .:::.:. : : : : : :...... : : :::.. :. : :. i 1/31/03 :;:i:c :;; i::::; : s:;:5::;:; ;:::k: ;t;;: ;ip: {:g:::::4:;i:i::: :.... <:;i: <; ..... +x:: +;r::::; :n;:. >;::.;:;;i" `i: i:a::;5i:::;:::::i:::i : :::;:: »;;:;;:::::;::;::: 619 238 ri:.'• <i:g:: i:>ja p;:is>::;::::i::::i::i:;::>::;: .....: ...... : -1828 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DRIVER ALLAINT INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1620 FIFTH AVENUE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SAN DIEGO, CA 92101 COMPANIES AFFORDING COVERAGE x LICENSE #OC36861 COMPANY A STATE COMPENSATION IN$: FUND COMPANY Pacific Hydrotech Corp B 27200 Highway 74 COMPANY Perris CA 92570 C COMPANY ;s. D �a.. ..:.. , _ ._.... 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MM /DD/YY) DATE (MM /DD/YY) 499NEIRAL LIABILITY GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ COMMERCIAL GENERAL LIABILITY Y PERSONAL & ADV INJURY $ CLAIMS MADE 17 OCCUR EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO P •�, ALL OWNED AUTOS BODILY INJURY X° SCHEDULED AUTOS (Per person) $ BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 8 OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ - UMBRELLA FORM $ OTHER THAN UMBRELLA FORM WpRKERS COMPENSATION AND 80390102 7/01/02 7/01/03 X WC STATU- oTH- T DRY LIM T R ' EMPLOYERS' LIABILITY EL EACH ACCIDENT $ 1000000 THE PROPRIETOR/ INCL PARTNERS /EXECUTIVE EL DISEASE - POLICY LIMIT $ 1000000 EL DISEASE - EA EMPLOYEE S 1000000 OFFICERS ARE: EXCL s. OTHER ±H RIPTION OF OPERATIONS /LOCATIONSNEHICLES /SPECIAL ITEMS RE: ST.JOSEPH RESERVOIR. 3 INCLUDES WAIVER OF SUBROGATION IN FAVOR OF THE CITY OF ARCADIA. ` POLICY IS PRIMARY AND ANY INSURANCE MAINTAINED BY THE CITY SHALL BE EXCESS. ................................................................................................................................. .:..:.:...:..:.::::::::.:..::.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF ARCADIA Y EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 1NbKMK)b§ MAIL 11800 GOLDRING ROAD 30 ARCADIA, CA 91006 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AUTHORI ATIV �: 1 .::::::::.:.:::..:.:::::.::::::.::.:::.::::::::::::::::..:::::::::::..:::::::::::::::.::::::::::::...:::......................................................... . ::; ;_,= > i °: ` : >:>i} i sins ii iisii ii <i '. iiiii i2ii: 'iii i ii iiii i %i ii ;r iii iii i i i iii; :[<;i' ';:i iE :; ? :'iii ............................... ..................... _.. iii2'• i i:? ii;i i i`: ii ic; :::`: ° ;: iij i'iiii iiii ii: i i iii i i iiii iiiiii i..... w;: :.:,.: ::.:..::.....: ,. State Uompensation lnsura Io:6164462991, 11 Feb 03, 08:56 Page:001 CERTIFICATE HOLDER COPY .STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142 -0807 COMPKNSATION I N S U R A N C E FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE FEBRUARY 11, 2003 GROUP: POLICY NUMBER: 803901 -2002 CERTIFICATE ID: 36 CERTIFICATE EXPIRES: 07 -01 -2003 07 -01- 2002/07-01-2003 CITY OF ARCADIA 11800 GOLDRING ROAD ARCADIA CA 91006 ST. JOSEPH RESERVOIR This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated- This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also. give you.1.0 days advance notice should this policy be cancelled prior to its. normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or after the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance 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. AUTHORZEDREPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE ENDORSEMENT ##2570 ENTITLED WAIVER OF SUBROGATION EFFECTIVE 02 -11 -2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: CITY OF ARCADIA SCIF 10265 fEPF•Ul: R1 1 RECORDING REQUESTED L. CITY OF ARCADIA AND WHEN RECORDED MAIL TO VIDA TOLMAN, CHIEF DEPUTY CITY CLERK CITY OF ARCADIA 240 WEST HUNTINGTON DR PO BOX 60021 ARCADIA, CA 91066 -6021 04 2183688 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. (if other than Fee, strike "In fee" an 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 ^.o 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 JULY 20, 2004. The work done was: CONSTRUCTION OF ST JOSEPH RESERVOIR NO 1 REPLACEMENT (RESERVOIR NO 31 PROJECT 6272072 8. The names of the contractor, if any, for such work of improvement was PACIFIC HYDROTECH CORPORATION JANUARY 21 2003 (If no contractor for work of improvement as a whole, insert "None ") (Date of Contract) 9. The property on which said work of improvement was completed is in the City of ARCADIA. County of LOS ANGELES, State of CA, and is described as follows: PORTIONS OF LOT 7 BLOCK 84 SANTA ANITA TRACT IN CITY OF ARCADIA COUNTY OF LOS ANGELES STATE OF CALIFORNIA 10. The street address of said property is 230 N SECOND AVENUE Dated AUGUST 12, 2004 no street address has been ire of Owner or co e officer of Owner named in paragraph 2, or R. KELLY, CITY MANAGER VERIFICATION I, the undersigned, say: I am the ARCADIA CHIEF DEPUTY CITY CLERK 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 to my knowledge, I declare under penalty of perjury that the foregoing is true and correct. Executed on AUGUST 12, 2004, ARCADIA, VIDA TOLMAN, CHIEF DEPUTY CITY CLERK DO NOT RECORD REQUIREMENT AS TO NOTICE OF COMPLETION Notice of completion must be filed for record WITHIN 10 DAYS after the completion of the work of improvement (to be computed exclusive of the day of completion) as provided in Civil Code Section 3093. The "owner" who must file for record a notice of completion of a building or other work of improvement means the owner (or his successor in- interest at the date the notice is filed) on whose behalf the work was done, though his ownership is less than the fee title. For example, if A is the owner in fee, and B, lessee under a lease, causes a building to be constructed, then B, or whoever has succeeded to his interest at the date the notice is filed, must file the notice. If the ownership is in two or more persons as joint tenants or tenants in common, the notice may be signed by any one of the co- owners (in fact, the foregoing form is designed for giving of the notice by only one co- tenant), but the names and addresses of the other co- owners must be stated in paragraph 5 of the form. Note that any Notice of Completion signed by a successor in interest shall recite the names and addresses of his transferor or transferors. In paragraphs 3, 5 and 6, the full address called for should include street number, city, county and state As to paragraphs 7 and 8, this form should be used only where the notice of completion covers the work of improvement as a whole. If the notice is to be given only of completion of a particular contract, where the work of improvement is made pursuant to two or more original contracts, then this form must be modified as follows: (1) Strike the works "A work of improvement" from paragraph 7 and insert a general statement of the kind of work done or materials furnished pursuant to such contract (e.g., "The foundation for the improvements "); (2) Insert the name of the contractor under the particular contract in paragraph 8. In paragraph 8 of the notice, insert the name of the contractor for the work of improvement as a whole. No contractor's name need be given if there is no general contractor, e.g. on so- called `owner - builder jobs." In paragraph 9, insert the full, legal description, not merely a street address or tax description. Refer to deed or policy of title insurance. If the space provided for description is not sufficient, a rider may be attached. In paragraph 10, show the street address, if any, assigned to the property by any competent public or governmental authority. RECEIVED - This page is part of your document - DO NOT DISCARDSEP 9 2004 CITY OF ARCADIA CITY CLERIC 04 2188688 TITLE(S) : FEE FREE 1 p CODE 20 CODE 19 CODE 9 RECORDED/FILED IN OFFICIAL RECORDS RECORDER'S OFFICE LOS ANGELES COUNTY CALIFORNIA 2:01 PL/1 AUG 24 200", 1111111111111111 1111.�-- 11111111 " III -' .111 Assessor's Identification Number (AIN) To be completed by Examiner OR Title Company in black ink. - THIS FORM NOT TO BE DUPLICATED �"j Number of AIN's Shown i