HomeMy WebLinkAboutC-2476GAI,IVOR,yj
IM A. M•�•• AMENDMENT NO. 2 TO 2009/2010 TRAFFIC SIGNAL MAINTENANCE
nn s, I
air► r SERVICES CONTRACT BY AND BETWEEN THE CITY OF ARCADIA
AND REPUBLIC INTELLIGENT TRANSPORTATION SERVICES, INC.
(dba REPUBLIC ITS)
This mendment No. 2 ( "Amendment No. 2 ") is hereby entered into this v • day of
2011 by and between the City of Arcadia, a municipal corporation of the
tae of California, and Republic Intelligent Transportation Services, Inc. (dba Republic ITS)
with respect to that certain Contract between the parties dated October 21, 2009 ( "Contract "), as
amended by Amendment No. 1 dated October 26, 2010.
The parties agree as follows:
Pursuant to Section 3.3.4 of the Contract, the term is extended to and including
October 21, 2012.
2. Pursuant to Section 3.3.2 of the Contract, the total compensation is not to exceed
FORTY -SEVEN THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS AND
NO CENTS ($47,965.00).
3. All of the terms and provisions of the Contract not amended by this Amendment
No. 2 are herby reaffirmed.
In witness whereof the parties have executed this Amendment No. 2 on the date set forth below.
CITY OF ARCADIA
Donald Penman
City Manager
Dated: loll 8 [A01 I
APPROVED AS TO FORM
P, U�
Stephen P. Deitsch
City Attorney
REPUBLIC ITS
•VlJ I�.2�
es A. Wagner
VP Engineering
Dated: 106 L _ �, k
CONCUR:
Tom Tait
Public Works Services Director
Bond No. 82202135
FAITHFUL PERFORMANCE BOND
100% of Contract Price
KNOW ALL PERSONS BY THESE PRESENTS:
That Republic Intelligent Transportation Services, Inc. ,
hereinafter referred to as "Contractor" as PRINCIPAL, and
Federal Insurance Ccgmy
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 FORTY -SEVEN THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS
AND NO CENTS ($47,965.00), 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:
2011/2012 TRAFFIC SIGNAL MAINTENANCE SERVICES CONTRACT
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.
IN WITNESS WHEREOF, we have hereunto set our hands and seals
This 21 day of October , 2011. _
Republic Intelligent Transportation Services, Inc. Federal- y
Prin ' al Sure
B By:
( (SE - Stay- ivera, Attorney -I Fact
�y�s �.1nIt3L Yom-✓
BIC -1
CERTIFICATION OF CONTRACTOR
IN ACCORDANCE WITH
LABOR CODE SECTION 4861
The undersigned is aware of the provisions under Section 3700 of the California Labor
Code which requires every employer to be insured against liability for Workers'
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.
��a 12e'D(Jk � v�-c �ZS
Contractor
By --c- -*
Title: VP C-"�Y-)ee In ✓L( �.
RICA
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California
CIVIL COOS $ 1198
County of r
On 10117-111 before me, /"o g I�L.Q J`� C4 9 (V 6
Doll ,Q Nere Inert Name and TWO "Off., '
personally appeared _(� _AQ WS' i 1 �C( � e-1
K ROOKE L. SACHS
mission # 1937262 y Public - California z Marin County . Expires May 20, 2015
6J OI O]�q(taf
b,r) eel#" q c
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
hfs/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 Stale of California that the foregoing
paragraph is true and correct.
WITNESS m d and off se
Signature:
Place Wary Seal Abwo Sgnalurooi 1 teryPu64c
OPTIONAL
Though the information below is not required bylaw, It may prove valuable to persons 4_19 on the document
and could prevent traudulent removal and reallachment of this form to another document.
Description of Attached Document
Tate or Type of Document:
Document Date: Number of Pages:
Signer(s) Other Than Named Above: _
Capacity(les) Claimed by Slgner(s)
Signer's Name:
n Corporate ONlcer —Title(s):
O Individual
O Partner -- G Limited Ci General IT or Etwrl %U Inxe
• Attorney In Fact
• Trustee
• Guardian or Conservator
n Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer -- Tille(s):
Ci Individual
❑ Partner — G Limited f; General TOP of uxxnb here
O Attorney in Fact
O Trustee
❑ Guardian or Conservator
O Other:
Signer Is Representing:
V wry nauunu nvaary nsoaaewn' nauonarnQtary.wy • i- utarv,� nu loot ltem #5907
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State ofd CI'
County of
Hartford
On 10/21/2011 before me, Stacy Rivera, Attorney- -In -Fact
Date Hare insert Name and Tide of tlto offset
personalty appeared Shy Rivera
Name{a) d S.gner(a) .
CIVIL cons § 1186
who proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s) istare
subscribed to the within instrument and acknowledged
to me that he /sheAhey executed the same in
his/herRhelr 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.
AIZA LOPEZ
NOTARY PUBLIC WITNESS my ha an fficia se
MY COMMISSION EXPIRES DEC. 31, 2013
Signature:
Plata Notary Seat Above Spnalur Notary i,
OPTIONAL
Though the information below 1s not required bylaw, if 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(les) Claimed by Signer(s)
Signer's Name:
n Corporate Officer Title(s):
❑ Individual
a r .
C Partner — G Limited 0 General Top of u,, t Iwo
• Attorney In Fact
• Trustee
• Guardian or Conservator
O Other:
Signer Is Representing:
Number of Pages:
Signer's Name:
❑ Corporate Officer — Tiile(s):
❑ Individual
CI Partner — ❑ Limited ❑ General Top or Rxrnb here
❑ Attorney In Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other,
Signer Is Representing:
O 2010 NatlotW Nomy Aswlat$on • 146or Nalary.mg • I-M-US NOTARY (I•ISM- 8766627) qsr F5407
Bond No. 82202135
LABOR AND MATERIAL BOND
(100% of Contract rice)
KNOW ALL PERSONS BY THESE PRESENTS:
That_ Republic Intelligent Transportation Services, Inc.
hereinafter referred to as "Contractor" as PRINCIPAL, and
Federal Insurance Canpany
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 FORTY -SEVEN THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS AND
NO CENTS ($47,965.00), 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:
2011/2012 TRAFFIC SIGNAL MAINTENANCE SERVICES CONTRACT
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.
IN WITNESS WHEREOF, we have hereunto set our hands and seals
This 21 day of October , 2 �;"���.
Republic Intelligent Transportation Services, Inc. F ral �ce Cc y
Principal Surety
t%g�f Jahn e S %� . W Qglfl��/ (S A(c� Stacy Rive
, Attorney -I
J.
BIC -2
CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT
State of California nn
County of MaV1,
On At 1 [2-111 before me, J�c1
DAI ff PN. ano lo3 t
personally appeared A i he
In
BROOKE L. SACHS
Commission #r 1937262
_ Notary Public - California Z
Marin County
My Comm. Ex fires May 20, 2015
CIVIL CODE ¢ 1188
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(les), and that by
his/herRhelr signatures) 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 Slate of California that the foregoing
paragraph is true and correct.
WITNESS mv hand and o ff 'cial al.
Signature:
PI-M Notary 5aa1 AWova r I,, Public
OPTIONAL —
Though the fnformalinn below Is not required by taw, it may prova valuable to person retying 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 Dale: Number of Pages:
Signer(s) Other Than Named Above:
Capaclty(les) Claimed by Signers)
Signer's Name:
• Corporate Officer -- Tille(s):
• Individual EvIgg
• Partner - - ❑Limited ❑General Top o((hvnbWe
• Attorney in Fact
0 Trustee
0 Guardian or Conservator
❑ Other, - ______
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
U Individual
(:t Partner — D Limited 0 General roper lhurcb here
❑ Attorney In Fact
O Trustee
* Guardian or Conservator
0 Other:
Signer Is Representing:
v Fv ry nuw,w, nvsuq naoucwwn • nmArw:j sop • nasu•w rws ors t p- ousrprp•poz,l Item 15907
elv� vl�j
CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT
State of (10mintLxxx Cr
County of Hartford
CEYIL CO08 § 1189 _
On 10/21/2011 before me, Stacy Rivera, Attorney —hr Fact
Dale Nerd Insed Name end Tile of LM Oltioer '
personally appeared Stacy Rivera
Nttme(e) of Sgner(c)
who proved to me on the basis of satisfactory
evidence to be the parsons) whose name(s) Is/are
subscribed to the within instrument and acknowledged
to me that he /she /they executed the same in
his/herAheir authorized capactty(ies), and that by
his/her /their slgnature(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 Calffornia that the foregoing
paragraph is true and correct.
AIZA LOPEZ WITNESS m a and o ' I seal.
NOTARY PUBLIC
MY COMMISSION EXPIRES DEC. 31, 2019
Sfgnatur .
Aler4 Ndary Saal Above rature of Nate Lpez
OPTIONAL
though the Information below Is not required by law, U may prove valuabf to pstsons relying on the document
and could prevent fraudulent removal and readachment of (his form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above: —
Capacity(les) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Tltie(s):
❑ Individual
e ,
• Partner — ❑ Limited ❑ General Top or u,tmv Hera
• Attorney in Fact
• Trustee
L1 Guardian or Conservator
❑ Other:
Signer Is Representing:
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
U individual
f: l Partner — ❑ Limited ❑ Ganeral rep o(tnurnt, Here
❑ Attorney in Fact
❑ Trustee
C. Guardian or Conservator
❑ Other:
Signer Is Representing:
2010 Nagonel Nele,y Assdaletbn • Nstba&Wolaryerg • 1.800•US NOTARY (1 -00. 076-+9027)
Item 15007
Chubb POWER Federal Insurance Company Attn: Surety Department
OF Vigilant Insurance Company 15 Mountain View Road
Surety ATTORNEY pacific Indemnity Company Warren, NJ 07059
CFiU1gIB
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana' corporation, VIGILANT INSURANCE
COMPANY, a New York - corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and
appoint Jeannette Porrini and Stacy Rivera of Farmington, Connecticut ------------------------------------------------ - - - - --
each as their true and lawful Attorney- in- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any
instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations.
In Witness whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested
these presents and affixed their corporate seals on this 9th day of October, 2009
X7i-
Kenneth C. Wendel, Assistant Secretary D Norris, Jr., Vice Pre ' t
STATE OF NEW JERSEY
County of Somerset ss.
On this 9th day of October, 2009 before me, a Notary Public of New Jersey, personally came Kenneth C. Wendel, to me
known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which
executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly swom, did depose and say that he is Assistant Secretary_ of FEDERAL
INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the
foregoing Power of Attorney are such corporate seals and were thereto affixed, by authority of the By- Laws of said Companies; and that he signed said Power of Attomey as
Assistant Secretary of said Companies by like authority; and that he is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the
signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr., and was thereto subscribed by authority of said By-
Laws and in deponent's presence.
Nota ' I� STEP14t:N IL BRADT
�rGl1 B • ..p
(yOlRfjl PtA*, Still OI NOW .{Y"
trio. 2321007.
`D Cor W*Mion Eq*88 Oct 25, 2014
PU Bt- 0 Not ry Public
JEPg CERTIFICATION
Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:
"All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the
President or a Vice President or an Assistant Vice President, Jointly with the Secretary or an Assistant Secretary, under their respective designations. The
signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any
Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any -
certificate relating thereto appointing Assistant Secretaries or Attorneys- in- Fact for purposes only of executing and attesting bonds and undertakings and other
writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding
upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company
with respect to any bond or undertaking to which it is attached.'
1, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY
(the "Companies ") do hereby certify that
(i) the foregoing extract of the By- Laws of the Companies is true and correct
(ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are
authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rioo and the U.S- Virgin Islands, and Federal is licensed in
American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and
(tir) the foregoing Power of Attomey is true, correct and in full force and effect
Given under my hand and seals of said Companies at Warren, NJ this October 21 2011
�suMNC,F ycuuurr r .'1`S`isnKC�,,o
v
Y
Y- Y r �•�: It �� i a
WY
Kenneth C, endel, sistant Secretary
IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER
MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903- 3656
e -mail: sure chubb.com
Form 15-10- 02256- U (Ed. 5- 03) CONSENT
FEDERAL INSURANCE COMPANY
STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS
ASSETS
Cash and Short Term Investments .......... ......
United States Govemment, State and
Municipal Bonds ........... ...............................
OtherBonds ................ :.................................
Stocks............................ ...............................
Other Invested Assets .... ...............................
Statutory Basis
DECEMBER 31, 2010
(n thousands of dollars)
LIABILITIES
AND
SURPLUS TO POLICYHOLDERS
$ 235,579 Outstanding Losses and (_oss Expenses..... $ 12,051,257
Unearned Premiums ...... ............................... 3,331,654
10,931,173 Ceded Reinsurance Premiums Payable....... 329,476
4,110,731 Provision for Reinsurance ............................ 70,491
837,803 Other Liabilities .............. ............................... 962,493
1,909,914
TOTAL INVESTMENTS .............................. 18,025,200
TOTAL LIABILITIES .... ............................... 16,745,371
Investments in Affiliates:
Special Surplus Funds ... ............ ....................
174,400
Chubb Investment Holdings, Inc ........... ......
3,002,346
Capital Stock................. ...............................
20,980
n
Pacific Indemn Company .......... .......... . ...
Chubb Insurance Investment Holdings Ltd....
1,275,789
l
Unassigned Funds .........................................
3,106,808
11,015,075
Executive Risk Indemnity Inc ......................
1,111,774
CC Canada Holdings Ltd- z ...... ...................
Great Northern Insurance Company...........
752,455
459,252
SURPLUS TO POLICYHOLDERS .............
14,317,263
Chubb Insurance Company of Australia Limited
313,107
Chubb European' Investment Holdings SLP...
234,636
Vigilant Insurance Company... ....................
212,646
Other Affiliates ............. ...............................
381,791
Premiums Receivable ...: ........................ :......
1,441,826
1,427,670
TOTAL LIABILITIES AND SURPLUS
Other Assets ............................................. :....
TO POLICYHOLDERS ............................
$ 31,062,634
TOTAL ADMITTED ASSETS ..................... $ 31,062,634
Investments are valued in accordance with requiremerits . of the National Association_ of Insurance Commissioners.
Investments with a carrying value of $452,427,638 are deposited with government authorities as required by law.
State, County & City of New York, — ss:
Yvonne Baker, Assistant Secretary of the Federal Insurance Company
being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said
Federal Insurance Company on December 31, 2010 is true and correct and is a true abstract of the Annual Statement of said
Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31, 2010.
Subscribed and sworn to before me
this
� °40
,
t Notary Public
Form 1510- 0313A.(Rev. 3111)
DOROTHY R BAKER Assistant Secretary
Notary Public, State of New York
No. 31- 4904994
Qualified in New York County
Commission Expires Sept 14, 2013
No-eo
C_ay76 -1
........... AMENDMENT NO. 1 TO 2009/2010 TRAFFIC SIGNAL MAINTENANCE
A.pn"1903
SERVICES CONTRACT BY AND BETWEEN THE CITY OF ARCADIA
4�ii1�• ;ems+ AND REPUBLIC INTELLIGENT TRANSPORTATION SERVICES, INC.
(dba REPUBLIC ITS)
This Amendment No. 1 ( "Amendment No. 1") is hereby entered into by and
between the City of Arcadia, a municipal corporation of the State of California, and
Republic ITS, with respect to that certain Contract between the parties dated October
21, 2009, as heretofore amended ( "Contract ").
The parties agree as follows:
1. The term of the Contract is extended to and including October 21, 2011.
2. For the period of the Extension of the Contract, the total compensation
payable by the City to the Contractor shall not exceed FORTY -SEVEN
THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS AND NO CENTS
($47,965.00).
3. All of the terms and provisions of the Contract not amended by this
Amendment No. 1 are herby reaffirmed.
In witness whereof the parties have executed this Amendment No. 1 on the date
set forth below.
CITY OF ARCADIA
Donald Penman
City Manager
Dated: % • (a b j 10
(SEAL)
- Ir. -
r
APPROVED AS TO FORM
kglu� P - )�&�
Stepheh P. Deitsch
City Attorney
REPUBLIC ITS
In
Dated: Iv�lj 90
CONCUR:
Tom Tait
Public Works Services Director
(PROJECT NO. 09/10 Traffic Signal Maintenance Services)
hoo .. -80
CONTRACT FOR THE C- Dq-:4)
CITY OF ARCADIA
2009/2010 TRAFFIC SIGNAL MAINTENANCE SERIVCES
1. PARTIES AND DATE.
This Contract is made and entered into this day of 20dl, by and
between the CITY OF ARCADIA (hereinafter called the "City ") and REPUBLIC INTELLIGENT
TRANSPORTATION SERVICES, INC (dba REPUBLIC ITS), (hereinafter called the "Contractor ").
2. RECITALS.
2.1 The City 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 City on AUGUST 24,
2009, has submitted a bid proposal for the 2009/2010 TRAFFIC SIGNAL MAINTENANCE
SERVICES described in the Contract.
2.3 City 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 OCTOBER 9, 2009.
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"
- General Conditions
Part "B"
- Supplementary General Conditions
Part "C"
- Special Provisions
Part "D"
- Specifications (under separate cover)
Part "E"
- Drawings (under separate cover)
Part "F"
- Performance Bond
Part "G"
- Payment Bond
RVPUB\DRD\570015 CONTRACT-2 GB - STATE & LOCAL (505/507/660) (7/24/00)
(PROJECT NO. 09/10 Traffic Signal Maintenance Services)
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 City shall have the right to declare
the Contract unexecuted and to award the Contract to another contractor in accordance with
state law.
C dpir a or, s Initials
3.2 Contractor's Basic Obligation.
Contractor promises and agrees, at its own cost and expense, to furnish to the City all labor,
materials, tools, equipment, services, and incidental and customary work for the construction of Bid
Category number(s) necessary to fully and adequately complete the 2009/2010 TRAFFIC SIGNAL
MAINTENANCE SERVICES, including any alternates selected by the City, and all structures and
facilities described in the Contract (hereinafter the "Work "), for a total of FORTY -SEVEN
THOUSDAND, NINE HUNDRED SIXTY -FIVE DOLLARS AND NO CENTS, ($47,966.00), 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.
3.4 Period of Performance.
The term of this Contract shall be from date of execution and for the following year, unless
terminated as provided herein. Contact shall complete the Services within the term of this Contract,
and shall meet any other established schedules and deadlines.
RVPUB\DRn\570015 CONTRACT-3 GB - STATE & LOCAL (505/507/660) (7/24/00)
(PROJECT NO. 09/10 Traffic Signal Maintenance Services)
Contractor shall perform the Services expeditiously, within the term of this Contract, and in
accordance with the Schedule of Services set forth in the project specifications. In order to facilitate
Contractor's conformance with the Schedule, City shall respond to Contractor's submittals in a timely
manner. Upon request of City, Contractor shall provide a more detailed schedule of anticipated
performance to meet the Schedule of Services.
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 City will suffer
damage. Pursuant to Government Code Section 53069.85, Contractor shall pay to the City as fixed
and liquidated damages the sum of ONE HUNDRED DOLLARS ($100.00) PER DAY as provided by
the applicable provisions of the General Conditions, found in Part "A" of the Contract Appendix.
3.5 City's Basic Obligation.
City 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 City 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 attorneys' 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 City.
RVPUB\DRD \570015 CONTRACT-4 GB - STATE & LOCAL (505/507/660) (7/24/00)
(PROJECT NO. 09/10 Traffic Signal Maintenance Services)
ii
ICI
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:
it
Cont
= r.
Republic Intelligent Transportation Services, Inc.
(dba Republic ITS)
371 Bel Marin Keys Boulevard, Suite 200
Novato, CA 94949
Attn: James A. Wagner
City i
'I
City of Arcadia
Public Works Services Department j
11800 Goldring Road
Arcadia, CA 91066 -3021
Attn: Da ve McVey, General Services Superintendent
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.
CITY OF ARCADIA
By:
Donald Penman
City Manager
ATTEST:
By: d t
Ci y Cl Ark
i.
Approved as to Form:
l�
By: 'St�
Stephen P. Deitsch
City Attorney
REPUBLIC INTELLIGENT
TRANSPORTATION SERVICES, INC.
EM10emyU
nnNTRACT - 5 __ __. m .. �neimvecm ivneinm
■
(PROJECT NO. 09/10 Traffic Signal Maintenance Services)
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:
By:�
ature
Jom-,-,,�, A. Q
Name
VP LN .i wr)
Title
t0I15�0�
Date
RVPUB\DRD \570015 CONTRACT (EXHIBIT A)
GB -STATE &LOCAL (505 /507 /660) (7/24/00)
�*:....t INl
ti
G ity Ger k
COPY
AMENDMENT NO. 3 TO 200912010 TRAFFIC SIGNAL MAINTENANCE
SERVICES CONTRACT BY AND BETWEEN THE CITY OF ARCADIA
AND SIEMENS INDUSTRY, INC.
This Amendment No. 3 ( "Amendment No. 3 ") is hereby entered into this day of
201,� by and between the City of Arcadia, a municipal corporation of the
State of talifornia, and Siemens Industry, Inc. (formerly Republic ITS) with respect to that
certain Contract between the parties dated October 21, 2009 ( "Contract'), as amended by
Amendment No. 1 dated October 26, 2010, and further amended by Amendment No. 2 dated
October 18, 2011.
The parties agree as follows:
1. Pursuant to Section 3.3.4 of the Contract, the term is extended to and including
October 21, 2013.
2. Pursuant to Section 3.3.2 of the Contract, the total compensation is not to exceed
FORTY -SEVEN THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS AND
NO CENTS ($47,965.00).
3. Assignment and Assumption Agreement which assigns and transfers to Siemens
Industry, Inc. all of Republic ITS rights and obligations under that certain
Agreement dated October 21, 2009.
4. All of the terms and provisions of the Contract not amended by this Amendment
No. 3 are herby reaffirmed.
In witness whereof the parties have executed this Amendment No. 3 on the date set forth below.
CITY OF ARCADIA
By:
Dominic Lazzare
City Manager
Dated:
(SEAL)
ATTE T.
AAA AAA Av,
ity I k Da
SIEMENS I
By:
Title:
Dated:
APPROVED ASp NORM CONCUR:
Stephen P. Deitsch Tom Tait
City Attorney Public Works Services Director
IN WITNESS WHEREOF, the parties thereto have duly executed this
Assignment Agreement as of the dates set forth hereinbelow.
Republic Intel
Services, Inca
By:
Title:
Date:
Transportation
n.. (G
City of Arcadia,
a Municipal Corporation
By: ��
Dominic Lazzare o
City Manager
Date:53-
ATTEST:
By:
City prk
APPROVED AS TO FORM:
By: '
Stephen P. Deitsch
City Attorney
Siemens Industry, Inc.
TVIe: <_QFj,
Date: _I�u� � IZ
CERTIFICATION OF SIGNATURE AUTHORIZATION
SIEMENS INDUSTRY, INC.
I, Daniel W. Hislip, the undersigned Secretary, do hereby certify that.
DARYL D. DULANEY
HELMUTH LUDWIG
AXEL MEIER
DANIEL W. HISLIP
President & CEO
Executive Vice President
Executive Vice President,
Chief Financial Officer and
Treasurer
Vice President,
General Counsel & Secretary
of SIEMENS INDUSTRY, INC. (the "Corporation'), a corporation duly organized and existing
under the State of Delaware, are duly authorized to execute any and all Agreements without
limitation regarding the amount, subject to the requirement of dual signature authorization.
I further certify that the above named Officers are authorized to execute on behalf of the
Corporation, without regard to amount, bids, proposals, requests for proposals or quotations, bid
bonds, payment bonds, performance bonds, maintenance bonds, change orders, Technical
Support Program Agreements, and work orders and their signatures on these documents are
binding on the Corporation.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed the corporate
seal of the Corporation, on this 1st day of October 2011.
ACKNOWLEDGEMENT OF APPOINTED SIGNATURE AUTHORITY FROM
PRESIDENT AND CHIEF EXECUTIVE OFFICER DARYL DULANEY
AND CHIEF FINANCIAL OFFICER AXEL MEIER
OF THE INFRASTRUCTURE & CITIES SECTOR OF
SIEMENS INDUSTRY, INC.
A. We, the undersigned, Daryl Dulaney, President and Chief Executive Officer and, Axel Meier, Chief
Financial Officer of the Infrastructure & Cities Sector of Siemens Industry, Inc. (the "Corporation ")
a corporation duly organized and existing under the laws of the State of Delaware, by virtue of the
authority vested by the Board of Directors of Siemens Industry, Inc. and in accordance with the By-
Laws of the Corporation and the laws of said State, do hereby acknowledge tnat the following
individuals: (1) have been appointed to their respective offices as set out herein below in
accordance with the By -Laws of the Corporation; and (2) are hereby authorized to sign or
countersign and otherwise execute in the name, or on behalf of their respective Divisions or
Business Units of the Corporation, any bids, proposals, bonds, releases and waivers of liens, and
any certificates, affidavits, or ancillary documents in connection therewith; any licensing
qualification or registration filings, returns, certifications or questionnaires; any contracts, leases,
agreements, guarantees and any certificates, affidavits, or ancillary documents in connection
therewith, up to and including a transactional limit of $10,000,000.00; and any releases,
compromises or settlements in connection with claims or disputes arising out of any such
transaction.
- Authorized Signatories - -�
Business Operations
!
FinancelCentral Support Function
(Name /Office)
(Name /Office)
Matthias Rebellius
Mark Evans
President, Building Technologies Division
Vice President, Finance and Business
Administration, Building Technologies
Division
Kevin Yates
Anton Duvall
President, Low and Medium Voltage Division
Vice President, Finance and Business
Administration, Low and Medium Voltage
Division
Terry Heath
Martin Schultz
President, Mobility and Logistics Division
Vice President, Finance and Business
Administration, Mobility and Logistics
Division
Thierry Godart
Martin Schultz
President, Smart Grid Division
Vice President. Finance and Business
Administration Smart Grid Division
Michael Cahill
Christopher Halleus
President, Rail Systems Division
Vice President, Finance and Business
Administration, Rail Systems Division
Tom Kopanski
Steve Monetta
Sr. Vice President, Industry Sales
Vice President, Finance and Business
Administration Industry Sales
Alex Stuebler
Mitch Flanagan
I Vice President, Strategy
Vice President, Corporate Controller
B. We further acknowledge that each of the signatures of the persons referred to in paragraph A is
binding upon the Corporation.
C. We further acknowledge that any document shall require the signature of two (2) of the above
Authorized Signatories, one each from Business Operations and Finance /Central Support Function,
whom shall have the requisite signature authority to be legally binding upon the Corporation.
' of 2
D. We further acknowledge that each of the persons referred to herein Is authorized to delegate such
person's authority hereunder to additional members of his or her management team up to the limit
of such person's delegation of authority, provided that such delegation is in written form signed by
the delegator and filed with the Legal Department,
E. We further acknowledge that the Secretary or an Assistant Secretary of the Corporation Is
authorized to issue certifications attesting to the Incumbency, authority and status of any of the
persons referred to In this resolution.
IN WITNESS WHEREOF, we have hereunto subscribed our names and affixed the corporate seal
of the said Corporation, on this 1" day of June, 2012.
Daryl Dulaney
President & CE
Siemens Indus 4c.
c.
_ Axel Meier - --
Executive VP, CFO
Siemens Industry, Inc,
2 of 2
DELEGATION OF APPROVAL AUTHORITY FROM
AND VICE PRESIDENT FINANCE PRESIDENT BUSINESS ADMINISTRATION MARTIN SCHULTZ
SIEMENS INDUSTRY, INC. — MOBILITY AND LOGISTICS DIVISION
A. We, the undersigned, Terry Heath, President and Martin Schultz, Vice President, Finance and
Business Administration of the Mobility and Logistics Division of Siemens Industry, Inc. (the
"Corporation% a corporation duly organized and existing under the laws of the State of Delaware, by
virtue of the authority vested in us as President and Vice President Finance & Business
Administration to sign or countersign and otherwise execute in the name, or on behalf of the
Corporation, any bids, projects, contracts, agreements and any certificates, affidavits or ancillary
documents in connection therewith for and on behalf of the Corporation, do hereby delegate to and
acknowledge that the following person(s) may exercise such authority for and on our behalf up to $2
million.
B. We further acknowledge that the following individuals are hereby authorized to sign or countersign
and otherwise execute in the name, or on behalf of the Corporation, the same documents as
referenced in paragraph A, up to and including a transactional limit of $500,000. Any such delegation
extends to but is limited to the same scope, documents and subject matter as referenced and granted
in Paragraph A, limited to the monetary amount stated in this Paragraph.
C. We further acknowledge that each of the signatures of the persons referred to in paragraphs A and B
are binding upon the Corporation.
91
D. We further acknowledge that any document shall require the signature of two (2) of the above
Authorized Signatories, one each from Business Operations and from Finance /Central Support
Functions, whom shall have the requisite signature authority to be legally binding upon the
Corporation.
E. We further acknowledge that each of the persons referred to herein is authorized to delegate such
person's authority hereunder to additional members of his or her management team up to the limit of
such person's delegation of authority, provided that such delegation is in written form signed by the
delegator and filed with the Legal Department.
F. We further acknowledge that the Secretary or an Assistant Secretary of the Corporation is authorized
to issue certifications attesting to the incumbency, authority and status of any of the persons referred
to in this resolution.
IN WITNESS WHEREOF, we have hereunto subscribed our names and affixed the corporate seal of
the said Corporation, as of the 1st day of October, 2012.
f-� -
LN
Terry Heath
President
Siemens Industry, Inc.
Mobility and Logistics Division
Marti c ultz
Vice President, Finance and Business Administration
Siemens Industry, Inc.
Mobility and Logistics Division
2
T-bnd No. 822D2135
LABOR AND MATERIAL BOND
(100% of Contract Price)
KNOW ALL PERSONS BXTTHESE PRESENTS:
That Siemens Industry,
hereinafter referred to as "Contractor" as PRINCIPAL, and
Federal Insurance
R 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 FORTY -SEVEN THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS AND
NO CENTS ($47,965.00), 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:
2019/2012 TRAFFIC SIGNAL MAINTENANCE SERVICES CONTRACT
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.
IN WITNESS WHEREOF, we have hereunto set our hands and seals
This 8. day of
October
Siemens Industry, Inca
By:
BIC -2
201M 12.
CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT
State ofd( CT
County of Hartford
On 101, /E 2 before me, A-I za Lopez, Notary Public
Data Here Nsat Name and 7nb d the grrrcer
personally appeared Stacy Rivera
Hnme(a}e(Sgnor(al
CIYLL COOS § 1 isa
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 /shelthey executed the same in
hisfier/thelr authorized capacity(les), and that by
his/her /their slgnature(s) on the instrument the
AIZA LOPEZ person(s), or the entity upon behalf of which the
NOTARY PUBLIC person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of Callfornla that the foregoing
paragraph Is true and correct.
WITNESS my hand- a10'ltiicial seal. \ }
Signature;
Places Notary Sbmd AbOW S>pnatura d Notary P W]I
OPTIONAL
Though tha Information below Is not required by lax; it may prove valuable to persons ralykw on the document
and could prevent fraudulent removal and reallachment of this form to another docvment.
Description of Attached Document
Title or Type of Document:
Document bate:
Signer(s) Other Than Named Above: _
Capacity(ies) Claimed by Signer(s)
Signer's Name:
n Corporate Officer -- Tille(s):
❑ Individual
a a
11 Partner — G limited Q General Top of ukar>b here
❑ Attorney In Faol
• Trustee
• Guardian or Conservator
❑ Other-
Signer is Representing:
Number of Pages:
Signer's Name:
❑ Corporate Otficer — Tilte(s):
Li Individual
WEEMM
❑ Partner — ❑ Limited ❑ General Top ortt"nb here
❑ Attorney In Fact
❑ Trustee
* Guardian or Conservator
0 Other:
Signer Is Representing:
0:070 NeOD" NGery Assaeutbn - NaeoralWaiary.mq • 1- Abo•Us NOTARY [I.fto-S766a27 - — - �Y Zgw
1 nar lsao7
FAITHFUL PERFORMANCE BOND
100% of Contract Price
KNOW ALL PERSONS BY THESE PRESENTS:
RECD
That Sienens Industry, Inc,
hereinafter referred to as "Contractor" as PRINCIPAL, and
Federal Insurance 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 FORTY -SEVEN THOUSAND, NINE HUNDRED SIXTY -FIVE DOLLARS
AND NO CENTS ($47,965.40), 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:
2011/2012 TRAFFIC SIGNAL MAINTENANCE SERVICES CONTRACT
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.
IN WITNESS WHEREOF, we have hereunto set our hands and seats
This 8 day of October , 20VL 12.
Fed Insurance Car4any
Sur
By:
(SEAL) S vera, Attorney- Irr-Fact
BIC -1
201?
CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT
State ofd CT
County of Hartford
On 1 %/ before me, Aim Lopez, Notary Public
UdE kae kiwi Hum a.d "Do of the CW=r
personally appeared Stacy Rivera
Nft"%) d SgAOr(eJ
who proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s) istare
subscribed to the within Instrument and acknowtedged
to me that helshe/they executed the same in
hisfiar/their authorized capacity(les), and that by
his/her /their signatures) on the instrument the
AIZA LOPEZ person(s), or the entity upon behnif of which the
NOTARY PUBLIC 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 an fftclal eal.
Signature: ___ r
Plata BOW/ SEW Above Sgaalun d Noury PL"k
OPTIONAL
Though the fnlormation below is not required bylaw, it may prove valuable to persons relying on the
arid 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(les) Claimed by Signer(s)
Signer's Name: _.._� Signer's Name:
n Corporate Officer — Titfe(s):
LI Individual
. Loalklij r •
C Partner — G limited L1 General Top of IN )b fwa
t7 Attorney in Fact
D Trustee
O Guardian or Conservator
U Other:
Signer Is Representing:
Number of Pages:
❑ Corporate Officer — Title(s):
U Individual
❑General Top of ftxan6 he e
C Guardian or Conservator
Cl Partner — ❑ Limited
❑ Attorney In Fact
CJ Trustee
Ct Other:
Signer Is Representing_
0 2010 NslkvW Wary Assm wim • NallaralNalarv.ora • f -hW.US NOTARY li.aon.nrcrs�r�
i
Chubb rl OF K Federal Insurance Company Attn: Surety Department
Surety ATTORNEY Vigilant Insurance Company 15 Mountain View Road
Pacific Indemnity Company Warren, NJ 07059
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE
COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and
appoint Aiza Lopez, Jeannette Porrini and Stacy Rivera of Hartford, Connecticut
each as their true and lawful Attorney- in- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any
instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations.
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested
these presents and affixed their'corporate seals on this 5th day of October, 2011.
nenrro[n �,. wen @rl� As.,tant $gp
B. Norris, Jr., Vice President
STATE OF NEW JERSEY
County of Somerset ss.
On this Sth day of October, 2011 before me, a Notary Public of New Jersey, personally came Kenneth C. Wendel, to me
known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which
executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL
INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the
foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By- Laws of said Companies; and that he signed said Power of Attorney as
Assistant Secretary of said Companies by like authority; and that he is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the
signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr., and was thereto subscribed by authority of said By-
Laws and in deponent's presence.
Notarial Seal
J. KATHERINE J. ADEUAR
F NOTARY PUBLIC OF NEW JFkSFI
Nt)TARY No. 2316685
�•° CommiWon hor"July 14, 2014
PUBII�
y JERS� CERTIFICATION
Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:
"All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the
President or a Vice President or an Assistant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The
signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any
Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any
certificate relating thereto appointing Assistant Secretaries or Attorneys- in- Fact for purposes only of executing and attesting bonds and undertakings and other
writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding
upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company
with respect to any bond or undertaking to which it is attached!
I, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY
(the "Companies ") do hereby certify that
(i) the foregoing extract of the By- Laws of the Companies is true and correct,
(ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are
authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands, and Federal Is licensed in
American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and
(iii) the foregoing Power of Attorney is true, correct and in full force and effect.
Given under my hand and seals of said Companies at Warren, NJ this 8 day of October, 2012.
o
W t
� � Y
Kenneth C. W ndel, Assistant Sex retary
IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER
MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903 - 3656
e -mail: suretyQchubb.com
Form 15 -10- 02258- U (Ed. 5- 03) CONSENT
FEDERAL INSURANCE COMPANY
STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS
Statutory Basis
DECEMBER 31, 2011
(in thousands of dollars)
TOTAL INVESTMENTS ............................... 17,315,154 TOTAL LIABILITIES..... ............................... 17,019,066
Investments in Affiliates:
222,832
LIABILITIES
3,212,072
ASSETS
2,440,763
AND
SURPLUS TO POLICYHOLDERS
Cash and Short Term Investments ................
United States Government, State and
$ 151,942
Outstanding Losses and Loss Expenses..... $
12,300,432
Municipal Bonds .......... ...............................
10,312,572
Unearned Premiums ...... ...............................
Ceded Reinsurance Premiums Payable.......
3,395,082
320,332
Other Bonds ................... ...............................
Stocks
4,146,378
Provision for Reinsurance ............................
80,930
............................ ...............................
Other Invested Assets .... ...............................
779,367
1,924,895
Other Liabilities.............. ...............................
922,290
TOTAL INVESTMENTS ............................... 17,315,154 TOTAL LIABILITIES..... ............................... 17,019,066
Investments in Affiliates:
222,832
Chubb Investment Holdings, Inc ................
3,212,072
Pacific Indemnity Company ........................
2,440,763
Chubb Insurance Investment Holdings Ltd....
1,237,556
Executive Risk Indemnity Inc ......................
1,076,901
CC Canada Holdings Ltd ............................
747,660
Great Northern Insurance Company ..........
436,665
Chubb Insurance Company of Australia Limited
404,315
Chubb European Investment Holdings SLP..
251,756
Vigilant Insurance Company .......................
233,604
Other Affiliates ............. ...............................
409,535
Premiums Receivable .... ...............................
1,470,010
Other Assets .................. ...............................
1,490,621
TOTAL ADMITTED ASSETS ...................... $ 30,726,612
Special Surplus Funds .. ...............................
222,832
CapitalStock ................. ...............................
20,980
Paid -In Surplus .............. ...............................
3,106,808
Unassigned Funds ........ ...............................
10,356,926
SURPLUS TO POLICYHOLDERS .............. 13,707,546
TOTAL LIABILITIES AND SURPLUS
TO POLICYHOLDERS ............................. $ 30,726,612
Investments are valued in accordance with requirements of the National Association of Insurance Commissioners.
Investments with a carrying value of $431,309,571 are deposited with government authorities as required by law.
State, County & City of New York, — ss:
Yvonne Baker, Assistant Secretary of the Federal Insurance Company
being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said
Federal Insurance Company on December 31, 2011 is true and correct and is a true abstract of the Annual Statement of said
Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31, 2011.
Subscribed and sworn to before me
this March 31, 2012
DOROTHY M. BAKER Assistant Secretary
--- - -� - -- — - -- Notary Public, State of New York
Notary Public No. 31- 4904994
Qualified in New York County
_ Commission Expires Seot. 14. 2013
`orm 15- 1n- (1913A (P. zn 0�