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ZK Construction
•• A This page is part of your document-DO NOT DISCARD 44.o"ot^ 1211 t��`,-� 1�� 11111101111111101011111111111111IIIIIIIII Pg��Z: t '� , {I'��� M + Recordetl/Filed in Official Records (,ry�l ��11. a .1 RecordeYS Office, Los Angeles County, « � California C441f010)1' 09/10/13 AT 11:43AM FEES: 0.00 TAXES: 0.00 OTHER: 0.00 PAID: 0.00 1111 II I I VIII II I III I II I II I I I Inlll HIil II ii it I Ilnl Xi III ill!I IIII LEADSH EET III I I III III II I I II I III III III II III II II 11111 II 201309100080016 00008279097 IIMUINI969IN A n S SEQ: 01 DAR - Counter (Upfront Scan) IIINIIIII�II�IIIII�II�III�IIIIIIIII�IIIIIIIIIIIIIIIIIIIE�III 1111111111111111111111111ENNINBIla - - THIS FORM IS NOT TO BE DUPLICATED RECORDING REQUESTED BY: City QEN+ALiiAI?7%1 O S Verdes r 1 Name City Clerk 09/10/2013 Street City of Rancho Palos Verd=s I' ILIr Address 30940 30940 Hawthorne Blvd. city Rancho Palos Verdes I State I Zip StC A *20131317129* 90275 1- Space above this line for recorder's use NOLCOTTS FORMS INC. SINCE 1893 NOTICE OE 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 Rancho Palos Verdes 3. The full address of the owner is 30940 Hawthorne Blvd. , Rancho Palos Verdes, CA -90275 4. The nature of the interest or estate of the owner is: In fee. (If 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 8/1 4/1 3 .The work done was: 8. The names of the contractor, if any,for such work of improvement was ZK Construction 2/19/13 (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 Rancho Palos Verdes County of Los Angeles ,State of CA ,and is described as follows: 30359 Hawthorne Blvd. Rancho Palos Verdes, CA 90275 (Ryan Park/ Restroom Improvements & Accessibility Proj 10. The street address of said property is 30359 Hawthorne Blvd. , Rancho Palos Verdes, CA 90275 (If no street address has been officially assigned,insert'none'.) cl-9- 13 Dated � / C 4.I L (Signature of Owner or corporate officer of Owner named in paragraph 2,or his agent) City of Rancho Palos Verdes VERIFICATION I,the undersigned,say:I am the C 1 t y Cle r k ___,the Declarant of the foregoingNotice 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 own knowledge. I declare under penalty of perjury that the fore•oing is true and correct. Executed on 4 ' ,203at ,Rancho Palos Verdes CA Ar _ 0( i-C:k /� `� (Personal signature o,the individual who is swearingatK t the c:onten f the Notice of Completion are true) infil Before you use this form fill in all blanks,and make whatever chanes are appropriate and necessary to your particular transaction.Consult a lawyer if you doubt the form s fitness for youru ose and se. :IRMO Wolcotts makes no representation or warranty, express or implied, with respect to the merchantability ,I or fitness of this form for an intended use or purpose. ©2005 WOLCOTTS FORMS,INC. 7 67775 01114 2 FORM 1114 Rev.10-05 DO NOT RECORD THIS PAGE REQUIREMENTS 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 orgiving 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 words "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 to 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. 41) • CITY OF RANCHO PALOS VERDES PUBLIC WORKS AGREEMENT THIS AGREEMENT("Agreement")is made and entered this is day of Fir'j ,2013, by and between the CITY OF RANCHO PALOS VERDES,a California municipal corporation("City") and 2.k Cots S't'iff e'o1u ("Contractor"). Contractor's license number is y' . G 4 81 B. In consideration of the mutual covenants hereinafter set forth,the parties hereto agree as follows: 1. Scope of Services. Contractor shall perform the work and provide all labor, materials, equipment and services in a good and workmanlike manner for the project identified as RYAN PARK RESTROOMS IMPROVEMENT AND ADA COMPLIANCE ("Project"), as described in this Agreement and in the Bid Documents(including the Notice Inviting Sealed Bids, the Instructions to Bidders, the General Provisions, the Special Provisions, the Proposal, Appendices I through IV, all project plans, and all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any said documents), which are attached hereto as Exhibit "A" and incorporated herein by this reference, including miscellaneous appurtenant work. All work shall be performed in accordance with the latest edition of the Standard Specifications for Public Works Construction(commonly known as the"Greenbook"), including supplements,prepared and promulgated by the Southern California Chapter of the American Public Works Association and the Associated General Contractors of California(collectively"Standard Specifications"), as well as in accordance with the Construction Specification Institute's Master Format, both of which are incorporated herein by this reference. In the event of any conflict between the terms of this Agreement and incorporated documents, the terms of this Agreement shall control. 2. Extra Work. Extra work, when ordered in writing by the Director of Public Works and accepted by the Contractor,shall be paid for under written work order in accordance with the terms therein provided. Payment for extra work will be made at the unit price or lump sum previously agreed upon in writing between the Contractor and the Director of Public Works. All extra work shall be adjusted daily upon report sheet furnished by the Contractor, prepared by the Director of Public Works,and signed by both parties, and said daily report shall be considered thereafter the true records of extra work done. 3. Effective Date. This Agreement is effective as of the date listed above,and shall remain in full force and effect until Contractor has rendered the services required by this Agreement. 4. Time. Time is of the essence in this Agreement. 5. Force Majeure. Neither the City nor Contractor shall be responsible for delays in performance under this Agreement due to causes beyond its control, including but not limited to acts of God, acts of the public enemy, acts of the Government, fires, floods or other casualty,epidemics,earthquakes,labor stoppages or slowdowns,freight embargoes, unusually severe weather, and supplier delays due to such causes. Neither economic nor market conditions nor the financial condition of either party shall be considered a cause to excuse delay pursuant to this Section. Each party shall notify the other promptly in writing of each such excusable delay,its cause and its expected delay,and shall upon request update such notice. 6. Compensation. In consideration of the services rendered hereunder, City shall pay Contractor a not to exceed amount oft *Hu. 004**. dollars($ Zia Ito*.•O ) pa•moat 11.0 • C-1 1 1 1 , 1 I • 4111 in accordance with the prices as submitted in Contractor's Proposal, attached hereto as Exhibit"B"and incorporated herein by this reference. 11111 7. Payments. City shall make payments within thirty(30)days after receipt of an undisputed and properly submitted payment request from Contractor.City shall return to Contractor any payment request determined not to be a proper payment request as soon as practicable,but not later than seven (7)days after receipt, and shall explain in writing the reasons why the payment request is not proper. A payment shall be made as the City Council of the City prescribes upon estimates approved by the City Council. However, progress payments shall not be made in excess of ninety-five percent(95%)of the percentage of actual work completed plus a like percentage of the value of material delivered on the ground or stored subject to,or under the control of, the City, and unused. The City shall withhold not less than five percent (5%) of the Agreement price until final completion and acceptance of the Project. However,at any time after fifty percent(50%)of the work has been completed,if the City Council of the City finds that satisfactory progress is being made,it may,at its discretion,make any of the remaining progress payments in full for actual work completed. 8. Substitute Security. a. At the written request and expense of Contractor, securities equivalent to any moneys withheld by the City to ensure performance under this Agreement shall be deposited with the City, or with a state or federally chartered bank in the State of California as the escrow agent,that shall then pay those moneys to Contractor.Upon satisfactory completion of the Agreement, the securities shall be returned to Contractor. b. Alternatively,Contractor may request that the City shall make payment of retentions 410earned directly to the escrow agent at the expense of Contractor.At the expense of Contractor,Contractor may direct the investment of the payments into securities,and Contractor shall receive the interest earned on the investments upon the same terms provided for securities deposited by Contractor.Upon satisfactory completion of the Agreement, Contractor shall receive from the escrow agent all securities, interest, and payments received by the escrow agent from the City, pursuant to the terms of this Section. c. Securities eligible for investment shall include those listed in California Government Code Section 16430, bank or savings and loan certificates of deposit, interest- bearing demand deposit accounts,standby letters of credit,or any other security to which Contractor and the City mutually agree in writing. Contractor shall be the beneficial owner of any securities substituted for moneys withheld and shall receive any interest thereon. d. If Contractor elects to receive interest on moneys withheld in retention by the City,it shall,at the request of any subcontractor performing more than five percent(5%)of Contractor's total bid, make that option available to the subcontractor regarding any moneys withheld in retention by Contractor from the subcontractor. Further mandatory details are provided in Public Contract Code Section 22300(d),which is incorporated herein by this reference. e. The escrow agreement for security deposits in lieu of retention shall be substantially similar to the form provided in Public Contract Code Section 22300(f), which is incorporated herein by this reference. C-2 9. Taxes.Contractor shall calculate payment for all sales,unemployment,old age pension and other taxes imposed by local, State of California and federal law. These payments are included in the total amounts in Exhibit"B." 10.Audit. The City or its representative shall have the option of inspecting and/or auditing all records and other written materials used by Contractor in preparing its billings to the City as a condition precedent to any payment to Contractor. Contractor will promptly furnish documents requested by the City.Additionally, Contractor shall be subject to State Auditor examination and audit at the request of the City or as part of any audit of the City, for a period of three (3)years after final payment under this Agreement. 11. Unresolved Disputes. In the event that a dispute arises between the City and Contractor regarding whether the conditions materially differ, involve hazardous waste, or cause a decrease or increase in Contractor's cost of or time required for performance of any part of the work, Contractor shall not be excused from any scheduled completion date provided for by the Agreement, but shall proceed with all work to be performed under the Agreement. Contractor shall retain any and all rights provided that pertain to the resolution of disputes and protests between the parties. In the event of any dispute or controversy with the City over any matter whatsoever,Contractor shall not cause any delay or cessation in or of work, but shall proceed with the performance of the work in dispute. This includes disputed time extension requests and prices for changes. The disputed work will be categorized as an "unresolved dispute"and payment, if any,shall be as later determined by mutual agreement or a court of law. Contractor shall keep accurate, detailed records of all disputed work, claims and other disputed matters. Public Contract Code Sections 20104 et seq. and Rancho Palos Verdes Municipal Code chapter 3.24("Claims Against the City")shall govern the procedures of the claim process, and these provisions are incorporated herein by this reference. • 12.Termination. This Agreement may be canceled by the City at any time with or without cause without penalty upon thirty(30)days'written notice. In the event of termination without fault of Contractor,City shall pay Contractor for all services satisfactorily rendered prior to date of termination, and such payment shall be in full satisfaction of all services rendered hereunder. 13. Incorporation by Reference. All of the following documents are attached hereto and incorporated herein by this reference: City of Rancho Palos Verdes Instructions for Execution of Instruments; Insurance Requirements for the City of Rancho Palos Verdes Public Works Contract; Workers' Compensation Certificate of Insurance; Indemnification and Hold Harmless Agreement and Waiver of Subrogation and Contribution; Additional Insured Endorsement(Comprehensive General Liability);Additional Insured Endorsement (Automobile Liability); and Additional Insured Endorsement(Excess Liability). 14.Antitrust Claims. In entering into this Agreement,Contractor offers and agrees to assign to the City all rights,title,and interest in and to all causes of action it may have under Section 4 of the Clayton Act(15 U.S.C.Sec. 15)or under the Cartwright Act(Chapter 2(commencing with Section 16700)of Part 2 of Division 7 of the California Business and Professions Code) arising from purchases of goods, services, or materials pursuant to the Agreement. This assignment shall be made and become effective at the time the City tenders final payment to Contractor without further acknowledgment by the parties. 15. Trenching and Excavations. If the project involves trenching more than four(4)feet deep, Contractor shall promptly and before the following conditions are disturbed notify the City in writing of any:material that Contractor believes may be material that is hazardous waste,as defined in California Health and Safety Code Section 25117,that is required to be removed • C-3 • to a Class I, Class 11, or Class Ill disposal site in accordance with provisions of existing law; subsurface or latent physical conditions at the site differing from those indicated;or unknown • physical conditions at the site of any unusual nature,different materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in the Agreement. The City shall promptly investigate the conditions,and if the City finds that the conditions do materially differ or do involve hazardous waste and cause a decrease or increase in Contractor's cost of or the time required for performance of any part of the work, the City shall issue a change order. 16. Utilities. The City acknowledges its responsibilities under Government Code Section 4215 and incorporates that Section herein by this reference. 17. Location of Existing Elements. The methods used and costs involved to locate existing elements, points of connection and all construction methods are Contractor's sole responsibility. Accuracy of information furnished,as to existing conditions,is not guaranteed by the City. Contractor, at its sole expense, must make all investigations necessary to determine locations of existing elements, which may include,without limitation, contacting U.S.A. Alert and other private underground locating firm(s), utilizing specialized locating equipment and/or hand trenching. 18. Lead Abatement Requirements. a. Contractor shall provide: i. Proof of Contractor and all supervisors' certification(s) under the Environmental Protection Agency's Renovation,Repair and Painting("RRP") program; ii. For every worker engaged in lead abatement activities,his or her blood lead level (BLL) records over the past six months and/or extending backward to that employee's hire date; iii. A written statement that a current written respiratory protection plan is in place and available for review; and iv. A copy of every worker's current fit test for PAPR and APR respirators, medical clearance to wear a respirator,and current certificate of lead worker training complying with California lead worker training requirements. b. Five days prior to the commencement of work and throughout the duration of the work, Contractor shall complete and post at all entrances to work areas and structures with the form called "Abatement of Lead Hazards Notification," also referred to as California Department of Public Health form 8551,which is attached hereto and incorporated herein by this reference. 19. Independent Contractor. Contractor is and shall at all times remain,as to the City,a wholly independent contractor. Neither the City nor any of its agents shall have control over the conduct of Contractor or any of the Contractor's employees,except as herein set forth,and Contractor is free to dispose of all portions of its time and activities which it is not obligated to devote to the City in such a manner and to such persons, firms, or corporations at the Contractor wishes except as expressly provided in this Agreement.Contractor shall have no power to incur any debt, obligation, or liability on behalf of the City, bind the City in any manner,or otherwise act on behalf of the City as an agent. Contractor shall not,at any time or in any manner, represent that it or any of its agents, servants or employees, are in any 411 C-4 z . r • ' • manner agents,servants or employees of City. Contractor agrees to pay all required taxes on amounts paid to Contractor under this Agreement, and to indemnify and hold the City • harmless from any and all taxes,assessments,penalties,and interest asserted against the City by reason of the independent contractor relationship created by this Agreement. Contractor shall fully comply with the workers'compensation law regarding Contractor and its employees. Contractor further agrees to indemnify and hold the City harmless from any failure of Contractor to comply with applicable workers' compensation laws. The City shall have the right to offset against the amount of any compensation due to Contractor under this Agreement any amount due to the City from Contractor as a result of its failure to promptly pay to the City any reimbursement or indemnification arising under this Section. 20. Prevailing Wages. City and Contractor acknowledge that this project is a public work to which prevailing wages apply. The Agreement to Comply with California Labor Law Requirements is attached hereto and incorporated herein by this reference. Eight hours of labor constitutes a legal day's work. 21. Workers'Compensation. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861, the Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to under take self-insurance in accordance with the provisions of that code,and I will comply with such provisions before commencing the performance of the work of this contract." 22. Subcontracting. Contractor shall adhere to all provisions of the Subletting and Subcontracting Fair Practices Act, Public Contract Code Section 4100 et seq., which is • incorporated herein by this reference. 23. Nondiscriminatory Employment. Contractor shall not unlawfully discriminate against any individual based on race, color, religion, nationality, gender, sex,sexual orientation, age or condition of disability. Contractor understands and agrees that it is bound by and will comply with the nondiscrimination mandates of all statutes and local ordinances and regulations. 24. Debarred,Suspended or Ineligible Contractors. Contractor shall not be debarred throughout the duration of this Agreement. Contractor shall not perform work with debarred subcontractor pursuant to California Labor Code Section 1777.1 or 1777.7. 25. Compliance with Laws. Contractor shall comply with all applicable federal, state and local laws,ordinances,codes and regulations in force at the time Contractor performs pursuant to this Agreement. 26. Bonds. Contractor shall obtain faithful performance and payment bonds,each in an amount that is not less than the total compensation amount of this Agreement, and nothing in this Agreement shall be read to excuse this requirement. The required forms entitled Payment Bond (Labor and Materials)and Performance Bond are attached hereto and incorporated herein by this reference. 27. Contractor's Representations. Contractor represents, covenants and agrees that: a) Contractor is licensed,qualified,and capable of furnishing the labor,materials,and expertise necessary to perform the services in accordance with the terms and conditions set forth in this Agreement; b)there are no obligations, commitments, or impediments of any kind that will limit or prevent its full performance under this Agreement;c)there is no litigation pending C-5 40 • against Contractor, and Contractor is not the subject of any criminal investigation or proceeding; and d) to Contractor's actual knowledge, neither Contractor nor its personnel 40 have been convicted of a felony. 28. Conflicts of Interest. Contractor agrees not to accept any employment or representation during the term of this Agreement or within twelve(12)months after completion of the work under this Agreement which is or may likely make Contractor "financially interested," as provided in Government Code Section 1090 and 87100, in any decisions made by City on any matter in connection with which Contractor has been retained pursuant to this Agreement. 29.Third Party Claims. City shall have full authority to compromise or otherwise settle any claim relating to the Agreement at any time.City shall timely notify Contractor of the receipt of any third-party claim relating to the Agreement. City shall be entitled to recover its reasonable costs incurred in providing this notice. 30. Non-Assignability;Subcontracting. Contractor shall not assign or transfer any interest in this Agreement nor any part thereof,whether by assignment or novation,without the City's prior written consent. Any purported assignment without written consent shall be null,void,and of no effect,and Contractor shall hold harmless,defend and indemnify the City and its officers, officials,employees,agents and representatives with respect to any claim,demand or action arising from or relating to any unauthorized assignment. 31.Applicable Law. The validity, interpretation, and performance of this Agreement shall be controlled by and construed under the laws of the State of California,excluding California's choice of law rules. Venue for any such action relating to this Agreement shall be in the Los Angeles County Superior Court. • 32.Attorneys' Fees. If any legal action or other proceeding, including action for declaratory relief, is brought for the enforcement of this Agreement or because of an alleged dispute, breach,default or misrepresentation in connection with this Agreement,the prevailing party shall be entitled to recover reasonable attorneys' fees, experts' fees, and other costs, in addition to any other relief to which the party may be entitled. 33.Titles. The titles used in this Agreement are for convenience only and shall in no way define, limit or describe the scope or intent of this Agreement or any part of it. 34.Authority. The person executing this Agreement on behalf of Contractor warrants and represents that he or she has the authority to execute this Agreement on behalf of Contractor and has the authority to bind Contractor to the performance of its obligations hereunder. 35. Entire Agreement.This Agreement, including any other documents incorporated herein by specific reference, represents the entire and integrated agreement between City and Contractor. This Agreement supersedes all prior oral or .written negotiations, representations or agreements. This Agreement may not be modified or amended,nor any provision or breach waived,except in a writing signed by both parties which expressly refers to this Agreement. 36. Construction. In the event of any asserted ambiguity in, or dispute regarding the interpretation of any matter herein,the interpretation of this Agreement shall not be resolved by any rules of interpretation providing for interpretation against the party who causes the uncertainty to exist or against the party who drafted the Agreement or who drafted that portion of the Agreement. C-6 41, 4110 37. Non-waiver of Terms, Rights and Remedies. Waiver by either party of any one or more of the conditions of performance under this Agreement shall not be a waiver of any other 40 condition of performance under this Agreement. In no event shall the making by the City of any payment to Contractor constitute or be construed as a waiver by the City of any breach of covenant,or any default which may then exist on the part of Contractor,and the making of any such payment by the City shall in no way impair or prejudice any right or remedy available to the City with regard to such breach or default. 38. Notice. Except as otherwise required by law,any notice or other communication authorized or required by this Agreement shall be in writing and shall be deemed received on (a)the day of delivery if delivered by hand or overnight courier service during Contractor's or City's regular business hours or(b)on the third business day following deposit in the United States mail, postage prepaid,to the addresses listed below,or at such other address as one party may notify the other: To CITY: Les M.Jones II, Interim Director of Public Works City of Rancho Palos Verdes 30940 Hawthorne Blvd. Rancho Palos Verdes, CA 90275 To CONTRACTOR: The address listed in Exhibit"B." 39. Counterparts. This Agreement may be executed in counterpart originals,duplicate originals, or both, each of which is deemed to be an original for all purposes. 40 40. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction,the remaining provisions of this Agreement shall continue in full force and effect. [signatures on next page] C-7 IN WITNESS WHEREOF, the parties hereto have executed the within Agreement the day and • year first above written. CITY OF • CHO PALOS VERDES By: 011) Mayor AT TEST' (-- APPROVED AS TO FORM: By: � By: City clerk. City Attorney Dated: 3 ("CONTRACTOR") By: /� Printed Name: r/ eciq Title: 0-Yr14..0 By: • Printed Name: Title: • C-8 IP 1 • I:l 0 CITY OF RANCHO PALOS VERDES INSTRUCTIONS FOR EXECUTION OF INSTRUMENTS 0 THIS IS INSTRUCTION ONLY-IT IS NOT TO BE SIGNED OR USED IN CONJUNCTION WITH THE AGREEMENT OR ANY OTHER FORMS THAT MUST BE TURNED INTO THE CITY OF RANCHO PALOS VERDES -IT IS SIMPLY A FORMAT TO USE WHEN FILLING OUT DOCUMENTS. 1. By an Individual. The individual must sign the instrument, and if he/she is doing business under a fictitious name,the fictitious name must be set forth. The signature must be acknowledged before a Notary Public,using the proper form of acknowledgment. 2. By a Partnership. The name of the partnership must be set forth followed by the signatures of less than all of the partners will be acceptable only if submitted with evidence of authority to act on behalf of the partnership. The signatures must be acknowledged before a Notary Public,using the proper form of acknowledgment. 3. By a Corporation. The name of the corporation must be set forth, followed by the signatures of the President or Vice President and Secretary or Assistant Secretary. The signatures must be acknowledged before a Notary Public,using in substance the following form of acknowledgment. 4. By a Surety. The name of the surety must be set forth, followed by an authorized signature. The signatures must be acknowledged before a Notary Public,using the proper form of acknowledgment. STATE OF ) ) SS. 1111 COUNTY OF ) On ,20 , before me,the undersigned, appeared known to me to be the President or Vice President and known to be to be the Secretary or Assistant Secretary of the corporation that executed the within instrument,and acknowledged to me that such corporation executed the within instrument pursuant to its by-laws or a resolution of its City Council. WITNESS my signature and seal. Notary Public (Seal) 411 C-9 SO INSURANCE REQUIREMENTS FOR CITY OF RANCHO PALOS VERDES PUBLIC WORKS CONTRACT 411 The Contractor shall at all time during the term of this Agreement carry,maintain,and keep in full force and effect,with an insurance company admitted to do business in California and approved by the City(1)a policy or policies of broad-form comprehensive general liability insurance with minimum limits of$2,000,000.00 combined single limit coverage against any injury,death,lose,or damage as a result of wrongful or negligent acts by the Contractor,its officers,employees,agents,and independent contractors in performance of services under this Agreement;(2)property damage insurance with a minimum limit of$1,000,000.00;(3)automotive liability insurance with a minimum combined single limits coverage of$1,000,000.00; and (4) workers' compensation insurance in the amount required by law. The City, its officers, employees, attorneys, and volunteers shall be named as additional insured on the policy(ies) as to comprehensive general liability, property damage, and workers' compensation coverages. 1. Acceptable insurance coverage shall be placed with carriers admitted to write insurance in California, or carriers with a rating of, or equivalent to, A:VII by A.M. Best& Company. Any deviation from this rule shall require specific approval, in writing, from the City. 2. All insurance policies shall provide that the insurance coverage shall not be non-renewed, canceled,reduced,or otherwise modified(except through addition of additional insured to the policy)by the insurance carrier without the insurance carrier giving the City thirty(30)days prior written notice thereof. The Contractor agrees that it will not cancel,reduce or otherwise modify said insurance coverage. 3. The Contractor agrees that if it does not keep the aforesaid insurance in full force and effect, and such insurance is available at a reasonable cost, the City may take out the necessary insurance and pay the premium thereon, and the repayment thereof shall be deemed an obligation of the Contractor and the cost of such insurance may be deducted,at the option of the City, from payments due the Contractor. 4. The Contractor shall submit to the City(1)insurance certificates indicating compliance with the minimum workers'compensation insurance requirements above,and(2)insurance policy endorsements above,not less than one(1)day prior to beginning of performance under this Agreement. Endorsements must be executed on the City's appropriate standard forms entitled "Additional Insured Endorsement," copies of which are attached hereto. 411 C-10 , • EXECUTED IN DUPLICATE Bond No, 1000957105 41111 PAYMENT BOND pREmiuM INCLUDED IN PERFORMANCE BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the CITY OF RANCHO PALOS VERDES ("Public Agency"),has awarded to Z K CQNS TRUCT ION 18031 SAN FERNANDO MISSION BOULEVARD GRANADA HILLS, CA 91344 (Name and address of Contractor) ("Principal"), a contract(the"Contract")for the work described as follows: RYAN PARK RESTROOMS IMPROVEMENT AND ADA COMPLIANCE. WHEREAS,Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers,mechanics,materialmen,and other persons as provided by law. NOW,THEREFORE,we,the undersigned Principal, and AMERICAN CONTRACTORS INDEMNITY COMPANY, 625 THE CITY DRIVE SOUTH, SUITE 130, ORANGE, CA 92868 (Name and address of*Surely) ("Surety")a duty admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Agency in the penal sum of TWO HUNDRED FORTY THOUSAND TWO HUNDRED AND NO/100 • Dollars ($ 240,200.00 j,this amount being not less than one hundred percent (100%)of the total contract price,in 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,successors,and assigns, jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her or its heirs,executors, administrators,successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 9100 of the California Civil Code,or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract,or for any amounts required to be deducted, withheld, and paid over to the Employment.Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code,with respect to work or labor performed under the Contract,the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond;otherwise, this obligation shall become null and void. This bond shall inure to the benefit of any of the personsnamed in Section 9100 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys'fees in an amount fixed by the court. Further, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration,addition or modification to the terns of the Contract,or of the work to be performed thereunder,or the specifications for the sate,shall in anyway affect its obligations under this bond,and it does herebywaive notice of any such_change,extension of time,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code sections 2845 and 2849. 411/ C-11 • • • ISI WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof,have been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: FEBRUARY 27, 2013 "Principal" "Surety" Z K CONSTRUCTION AMERICAN CONTRACTORS INDEMNITY COMPANY By: By: Aa,i its ZVI KUR, OWNER Its MARK D. IATAROLA, ATTORNEY-IN-FACT By:_ By: Its Its • (Seal) (Seal) APPROVED AS TO SURETY AND APPROVED AS TO FORM: PRINCIPAL AMOUNT RICHARDS,WATSON&GERSHON A Professional Corporation By: By: Insurance Administrator Public Agency Attorney Note: This bond insist be executed in duplicate and dared,all signatures must be notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached. 411 C-1z , • • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT a7,'_ 7g•�, ���- • ` ""*';-y.`viz' `&d' a7' _`"- •a7"•,ar - '47 •,er ar'• •��.�-�,.'t►-:417"-. -7a7. - .7 • STATE OF CALIFORNIA County of SAN DIEGO On 2/27/2013 before me, DEBORAH D. DAVIS, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(e) whose name() is/are subscribed to the within instrument and acknowledged to me that he/strethey executed the same in hisftTitheir authorized capacityfies}, DEBORAH D.DAVIS and that by hisAitetitheir signature(e) on the instrument the �, .,. sem., COMM-#19�2��IFO personO, or the entity upon behalf of which the person(s) np",' NOTARY PUBLIC-CALIFORNIA 2 SAN DIEGO COUNTY acted, executed the instrument. - My Comm.Exp. APRIL 21,2015 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature Place Notary Seal Above ignature of Notary Public 411 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: MARK D. IATAROLA Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer Title(s): ❑ Corporate Officer Title(s): ❑ Partner ❑ Limited❑General ❑ Partner ❑ Limited❑ General Attorney in Fact RIGHTTHUMBPRINT ❑ Attorney in Fact RIGHTTHUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 410 - A". - _�er ►e9''`. ,- t-•-e,''•.— ._ ."- •d'" ay- 7- _ • e7'— ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 111 • POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY —KNOW ALL MEM3Y THESE PRESENTS:That American Contractorsemnity Com&lalifornia corporation,Unite States surety Coir a Maryland corporation and U.S. Specialty Insumice Compal a1Texas corporation (collectively, the --- "Companies"),do by these presents make,constitute and appoint: John G.Maloney,Mark D.Iatarola or Helen Maloney of Escondido,California its true and lawful_Attorney(s)-in-fact,each in their se capacity if more than one is named above, with full power and_authority ---hereby conferred its name, placnd stead,toe,adknowledge and deliver any and all bonds, recognizancesde _gs r other instruments or contracts of suretyshde riders, amendments, and consents of surety, imvidft bon - penalty does not exceed Fifteen Million****** Dollars ($* -00W0.00**). This Power of Attorney shall expire without further action on December 08,2016. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved,that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full mower and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represffrtak-for4thrlbtrtalf of the Company subject to the following provisions: Attorr n-Fact may be given full power and authority for and in the name of and on behalf the may,taex ,acknowledge and deliver,any anchill bonds, recogthzances, contracts, agreements or indemnity and other conditional or obligatory undertakings including any and all consents for the releas bf retained percentages and/or final estimates on engineering and construction contracts,and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved,that the signature of any authorized officer andseattifthe Company heretofore or hereafter affixed to any power of attorney or any certificate rekttit thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the=Company with s - any bond or undertaking to which it is attached. IN WITNESS WHEREOF,The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 10th day of December,2012. AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY Corporate Seals ,,,,;,r,,:r,r;,,,, ,t>tt►s,tr„rrrr,, v5,5";:,,rtrrr,, -o,� Qla cif,'•i � •'•• '`T fi � 'D�'' '•i :mss ��:• =+•'.i 411 """•`""..s SEPF.Z5.'.944:<` =��• - � .� s Daniel P.Aguilar,Vice President State of California una;n County of Los Angles SS: On 10th day of December,2012,before meanessa Wright,a notary public,personally appeared Daniel P.Aguilar,Vice President of American Contractors Indemnity Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person(s),or the entity upon behalf of which the rson s)acted,executed the instrument. -1 certify und_er-_PT.NALTY OF PERJURY under the laws of the State of Calfonat the agoing paragraph is true and-correct. WITNESS my hand and official seal. V WRIGHT u ommes*On*19913319 Signature - ,...:. .,. (Seal) , �, .:, Nutoiy P r5lc'California x 43, los Angeles coirty - I, Jeannie Lee,Assistant Secretary of Americart,611WEbars Indemnity Company, United States Surety Company and-U.S. 4tecialty Insurance Company, do hereby certify that tabave and foregoing is a true and correct copy of a Power of Attorney, cted by said Companies, which is still in full force and effect; furthermore,the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof,I have hereunto set my hand and affixed the seals of said Companies-at Los Angeles,California this 2 7TH day FEy , 2 013 el Corporate Seals tt1111f1tif[lfrrrrr' `,5t511'„r+Jr„� `tttttlllllltlltrrrt C7QRs`.,,�. . � S U......f �`t�i� Bond No. 100095 7105' 'o:” ,4 '411\c'0% =0g � � = Jeannie Lee, ssistant Secretary ITER ~ - :Z= _;n ./ 1;12 Agency No. 4013 � ,SEPT 25,.90 = -- `irr4C 1FOt9 tc ytl ''''rrhrrrtr ttttt`` • . . EXECUTED IN DUPLICATE Bond No, 1000957105 PAYMENT BOND PREMIUM INCLUDED IN PERFORM ME BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the CITY OF RANCHO PALOS VERDES ("Public Agency"),has awarded to Z K CONSTRUCTION 18031 SAN FERNANDO MISSION BOULEVARD GRANADA HILLS, CA 91344 _ 1 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows: RYAN PARK RESTROOMS IMPROVEMENT AND ADA COMPLIANCE. WHEREAS,Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers,mechanics,rnaterialmen,and other persons as provided by law. NOW, THEREFORE,we,the undersigned Principal, and AMERICAN CONTRACTORS INDEMNITY COMPANY, 625 THE CITY DRIVE SOUTH, SUITE 130, ORANGE, CA 92868 (Name and address of Surely) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Agency in the penal sum of,TWO HUNDRED FORTY THOUSAND TWO HUNDRED AND NO/100 • Dollars ($ 240,200 .00 W._ -j,this amount being not less than one hundred percent (100%)of the total contract price,in 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,successors,and assigns, jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her or its heirs,executors, administrators,successors or assigns,or subcontractors shall fail to pay any of the persons named in Section 9100 of the California Civil Code,or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract,or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code,with respect to work or labor performed under the Contract,the Surety will pay for the same in an amount not exceeding the penal sum specified in this bond;otherwise, this obligation shall become null and void. This bond shall inure to the benefit of any of the personsnamed in Section 9100 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond. In case suit is brought upon this.bond,Surety further agrees to pay all court costs and reasonable attorneys'fees in an amount fixed by the court. Further, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed thereunder,or the specifications for the sante,shall in any way affect its obligations under this bond,andit does herebywaive notice of any such.change,extension of tine,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code sections 2845 and 2849. 1111 C-11 • • • IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof,have been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: FEBRUARY 27, 2013 "Principal" "Surety" Z K CONSTRUCTION AMERICAN CONTRACTORS INDEMNITY COMPANY By: By: riot4i6 --ntrob Its ZVI KUR, OWNER Its MARK D. IATAROLA, ATTORNEY-IN-FACT By:_ By: Its Its (Seal) (Seal) APPROVED AS TO SURETY AND APPROVED AS TO FORM: PRINCIPAL AMOUNT RICHARDS,WATSON&GERSHON A Professional Corporation By: By: Insurance Administrator Public Agency Attorney Note: This bond trust be executed in duplicate and dated,all signatures must be notarized,and evidence of the authority of any person signing as cuiorney-in fact must be attached. 410 C-12 • �I • I. 1110 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT • _ _ n94'1 .11' e!9• 'PS! � an'ai a/ -7Q►7"Wrl'ey'•d` - ,tY. _ • STATE OF CALIFORNIA County of SAN DIEGO On 2/27/2013 before me, DEBORAH D. DAVIS, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(e3 whose name(e) is/'are subscribed to the within instrument and acknowledged to me that he/sheitftey executed the same in hisauthorized capacityfies)}, DEBORAH D.DAVIS and that by his signature(e)on the instrument the . emA comm.#1929979person(s), or the entity upon behalf of which the person(ss) -f---4.,s7 NOTARY PUBLIC-CALIFORNIA SAN DIEGO COUNTY acted, executed the instrument. '. MyComm.Exp. APRIL 21,2015 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature A — Place Notary Seal Above Signature of Notary Public 41) 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: MARK D. IATAROLA Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer Title(s): ❑ Corporate Officer Title(s): ❑ Partner ❑ Limited❑General ❑ Partner ❑ Limited❑ General Attorney in Fact RIGHTTHUMBPRINT 0 Attorney in Fact RIGHTTHUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 40VV-• VV ♦ � •..�. � vim' �. �� . �/ \�• \�" . ♦ e7- ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 0 • t POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY 411, KNOW ALL MEN BY THESE PRESENTS:That American ContractorsInclermnpapY,a California corporation,United States Surety Company, a Maryland corporation and U.S. Specialty InsumcW Com y, a Texas corporation ollectively, the "Companies"),do by these presents make,constitute and appoint: John G.Maloney,Mark D.Iatarola or Helen Maloney of Escondido,California its true and lawful Attorney(s)-in-fact, eachin their separate capacity if more than one is named above, with full power and authority hereby conferred in its name,place an _ eTctcute, elcnowledge and deliver any and all bonds, recogniz es Mertaldn = or other instruments or contractV- Oretyshide riders, amendments, and consents of surety, proved the bond penalty does not exceed =_ ******Fifteen Million****** Dollars ($**1 5.0000.00**). This Power of Attorney shall expire without further action on December 08,2016. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and alAority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent—and act for and on behalf of the Company subject to the following provisions: -_=-- _ rney-in-Fact may be given full power and authority for and in the name of and on behanTh Company,to este,acknowledge and deliver,any and all bonds, ecbgnizances, contracts, agreements or indemnity and other conditional or obligatory unkings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts,and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved,that the signature of any authorized officer and sea ofihe Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney ertificate bearing fa vile signature or facsimile seal shall be valid and binding upon the Company with res__ to any bond or undertaking to which it is attached. IN WITNESS WHEREOF,The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 10th day of December,2012. AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY - -___s o -. -Seais -_ .`VACplRtsrsi „,\‘5716`4,„, `,‘a SlUr ,r ,,\'vtntstur:,"'rr , - E`i ::".-.1%: _ S.�. a,%,..., , + -.- ,-:,,: WORPORATEG , =Q ''' I :g s -.r •""`„-. ;o c •: �„ .. SEPT.25,1944 i n- "Y '�,..:2,:',.- ,- ,7`a '�c z:.-- '-?.-..;., «. -;b,. ,ti.•. �� S Daniel P.Aguilar, Vice President State of California '-��a<<oR,A< ,,,fr * """",,,,,rt*,;,,,,���`. - County of Los Angeles SS: ---- On 10th day of December,2012,befog mesa Wight,a notary Public,personally appeared Daniel P.Aguilar,Vice Presdentof American Contractors Indemnity Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person(s),or the entity upon behalf of which the perkn(s)acted,executed the instrument. A mortify unc r PENALTY OF PERJURY under the laws of the State of California ,.,going paragraph is true-and correct. WITNESS my hand and official seal. Signature IMA.,,,,,.,,):_.. .. (Seal) ;i :*;- Notary f'ttbl.c-CalFtor�€s ' . i ,. '''�: Los Angeles Casty - �t. �.,• I, Jeannie Lee, Assistant Secretary of American Contractors Indemnity Company, United States Surety Company and U.S. Specialty Insurance Company, do hereby cerhat tabove and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are in full force and effect. In Witness Whereof,I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this 27TH day of F EB RUA = , 2013 4111 Corporate Seals - ittlltitiltlrllJJ ,,titlfllfllfl/JJ,r ,,,,'`;','=".,, Bond No. 1000957 105 '"/A- '�.\.-.a= ;moi.. ' 4- \3 Jeannie Lee,Issistant Secretary ..:*Kf.TEO :=ti !y2j if, 3= _0: ''��A :m= Agency No. 4013 1:=3,..„,;.,SEPT:2L ,../.47/ - _a. "/� '"��Htlt�tttti�� ","rf�JrJllfl:itS��i`�``,, �'"'JtJJ/7111*tliit`���``` • EXECUTED IN DUPLICATE Bond No. 100::::::Term PREMIUM: $ 00 PERFORMANCE BOND �rt� �ttf is l'ar �ctl�;eot'l'o r��� Based On Final Conti KNOW ALL PERSONS BY THESE PRESENTS that: aC WHEREAS the CITY OF RANCHO PALOS VERDES ("Public Agency"),has awarded to Z K CONSTRUCTION 18031 SAN FERNANDO MISSION BOULEVARD GRANADA HILLS, CA 91344 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows: RYAN PARK RESTROOMS IMPROVEMENT AND ADA COMPLIANCE. WHEREAS, Principal is required under the terms of the. Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE,we,the undersigned Principal, and AMERICAN CONTRACTORS INDEMNITY COMPANY, 625 THE CITY DRIVE SOUTH, SUITE 130, ORANGE, CA 92868 (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held • and firmly bound unto the Public Agency in the penal sum of TWO HUNDRED FORTY THOUSAND TWO HUNDRED AND No _ 00 Dollars ($,24 0,2 0 0 .0 0 ),this amount being not less than the total contract price,in lawful money of theUnited States of America,for the payment ofwhich sum well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors,and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her or its heirs,executors,administrators,successors or assigns,shall in all things stand to and abide by,and well and truly keep and perform all theundertakings,terms,covenants,conditions and agreements in the Contract and any alteration thereof made as therein provided,on the Principal's part to be kept and performed,all within the time and in the manner therein specified,and in all respects according to their true intent and meaning,and shall indemnify and hold.harmiess the Public Agency,its officers,agents,and others as therein provided;then this obligation shall become null and void;otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys'fees in an amount fixed by the court. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change,extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed thereunder,or the specifications for the same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications thereunder. Surety hereby waives the provisions of California Civil Code sections 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. C-13 IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof,have been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: FEBRUARY 27, 2013 "Principal" "Surety" Z K CONSTRUCTION AMERICAN CONTRACTORS INDEMNITY COMPANY 1). By: By: MARK D D. IA'T'AROLA Its ZVI KUR, OWNER its ATTORNEY-IN-FACT By: By: Its Its (Seal) (Seal) • APPROVED AS TO SURETY AND APPROVED AS TO FORM: PRINCIPAL AMOUNT RICHARDS,WATSON&GERSHON A Professional Corporation By: By:. Insurance Administrator Public Agency Attorney Note: This bond must be executed in duplicate and dated all signatures must he notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached C-14 • 4110 , • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT = 7er,49 yr_ _ :177, ar-e� e�• S. -4 a7r..eYi` :sr er er" 4 9•tr.ar, - 74, - e7 STATE OF CALIFORNIA County of SAN DIEGO On 2/27/2013 before me, DEBORAH D. DAVIS, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(} whose name(e) isierre subscribed to the within instrument and acknowledged to me that he/sheitrey executed the same in his/her/their authorized capacityf ies}, DEBORAH D.DAVIS _ and that by his signature(e) on the instrument the _ sem., COMM-#1929IFO persons, or the entity upon behalf of which the person(s) NOTARY PuBLIGGALIFORNIA COUNTY acted, executed the instrument. `1C SAN.Exp. lay Comm.Exp. APRIL 21,2015 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature Place Notary Seal Above 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: MARK D. IATAROLA Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer Title(s): 0 Corporate Officer Title(s): ❑ Partner ❑ Limited❑General ❑ Partner ❑ Limited❑General E1 Attorney in Fact RIGHTTHUMBPRINT ❑ Attorney in Fact RIGHT THUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: • `x''`76''' ~ �'-er• Ye' -. -6"- ;� `•_ - e7 6'rJ?.eY' "!�' • e'- ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 1110 • s • POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS:That American Contractors Indemnity Company,a California corporation,United States Surety Company, a Maryland corporation and U.S. Specialty Insurce Co a Texas corporation (collectively, the "Companies"),do by these presents make,constitute and appoint: John G.Maloney,Mark D.Iatarola or Helen Maloney of Escondido,California its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above,with full power and authority Y P p Y tY hereby conferred in its name, plae .nd ngteadAo execute, acknowledge and deliver any and all bonds,recogniztuireaUlgs or other instruments or contracts of sureto include riders, amendments, and consents of surety, providing the bond -- penalty penalty does not exceed ******Fifteen Million****** Dollars ($**15,00W0.00**). This Power of Attorney shall expire without further action on December 08,2016. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved,that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and rity v`appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for =elf of the Company subject to the following provisioner Attorney-in-Fact may given full power and authority for and in the name of and on behalf of the Company, nceetde,acknowledge and deliver,any and all bonds, recognizances,Contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts,and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved,that the signature of any authorized officer and seatof_the Company heretofore or hereafter affixed to any power of attorney or any certificate relating-- thereto elating_--_ thereto byfacsimile,and anypower of attorneya to bearing facs mile signature or facsimile seal shall be valid and bindingupon the Com - g � P y any bond or undertaking to which it is attache€i IN WITNESS WHEREOF,The Comfit-flies-hive caused this instrument to be signed and their corporate seals to be hereto axed,-this 10th day of December,2012. AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY -- - COrpoMte Sdals tiitlttNtiritfltt� `III;SltltlllrfJrrrrr \`IIIIfIltrrl;ttrri p . s% S Tom. ,oti. ?ca. ;Ncn�cc>Rnr1=r• -_ -O� ':' �i ��- =cn- ��-.r \% SEPT.25.19Y) c- 1 TI- S �. Daniel P.Aguilar, Vice President State of California /'"";,,f,i,g h :```\• ���rrfrr1ln*X11�1`��\,\ ''���t��lrtrrt County of Los Angeles SS: On 10th day of December,2012,bei me,Vanessa Wright,a notary public,personally appeared Daniel P.Aguilar- Vice President of-- American f-American Contractors Indemnity Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person(s),or the entity upon behalf of which the per acted,executed the instrument. certify-unr PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. -WITNESS my hand and official seal. .'4: ccafn ca}on s 19913-319 Signature j � --— (Seal) . .: Notary Pboiic Cilifor 11 � Lcsdint I, Jeannie Lee, Assistant Secretary of American Contractors Indemnity Company, United States Surety Compan nd U.S. Scialty Insurance Company, do hereby ceitfy thaie above and foregoing is a true and correct copy of a Power of Attorney, ex€ ed by said Companies, which is still in full force and effect; furthermore,the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles,California this 27TH day of FEBRUARY 2013 Corporate Seals ly:tll7(r Ilt1!fft(3J! 11111itiftft �' ,ji ti"Rp...... � \``.;ti�S U R , � 0 11......ri888 ...0s:._ Q; a Bond No. Q-• .oer e :3' Jeannie Lee,Vssistant Secretary 0 10 0 0^9(�5 710 5 _ : #1 �-•r Agency No. 40I �y SEPT 25.499 ;:�_ Y: :moi ''irc4Lf1FQRltit``. /'/jrrrrJrtrl*:tle`tl`,`` /'/'rJr'rr1,*tttlll ``*`\ J • EXECUTED IN DUPLICATE 11 BondNo. 1000957105 PREMIUM: $T05, 804.00 PERFORMANCE BOND ��, �.� ' �, �ium Is#;or Contract Term flu eS Sul3ieot Adiu rnert Bad On Final Coni t KNOW ALL PERSONS BY THESE PRESENTS that: aCt WHEREAS the'CITY OF RANCHO PALOS VERDES ("Public Agency"),has awarded to Z K CONSTRUCTION 18031 SAN FERNANDO MISSION BOULEVARD GRANADA HILLS, CA 91344 (Name and address of Contractor) ("Principal"),a contract(the"Contract")for the work described as follows: RYAN PARK RESTROOMS IMPROVEMENT AND ADA COMPLIANCE. WHEREAS, Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW, THEREFORE,we,the undersigned Principal, and AMERICAN CONTRACTORS INDEMNITY COMPANY, 625 THE CITY DRIVE SOUTH, SUITE 130, ORANGE, CA 92868 (frame and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Agency in the penal sum of TWO HUNDRED FORTY THOUSAND TWO HUNDRED AND NO/_1 0 0... Dollars($ 24 0,2 0 0 .0 0 ), this amount being not less than the total contract price,in lawful money of the United States of America,for*payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors,and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,her or its heirs,executors,administrators,successors or assigns,shall in all things stand to and abide by,and well and truly keep and perform all theundertakings,terms,covenants,conditions and agreements in the Contract and any alteration thereof made as therein provided,on the Principal's part to be kept and performed,all within the time and in the manner therein specified,and in all respects according to their true intent and meaning,and shall indemnify and hold harmless the Public Agency,its officers,agents,and others as therein provided,then this obligation shall become null and void;otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys'fees in an amount fixed by the court.. FURTHER, the Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed thereunder,or the specifications for the same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications thereunder, Surety hereby waives the provisions of California Civil Code sections 2845 and 2849. The City is the principal beneficiary of this bond and has all rights of a party hereto. 411 C13 • IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original hereof,have been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated: FEBRUARY 27, 2013 "Principal" "Surety" Z K CONSTRUCTION AMERICAN CONTRACTORS INDEMNITY COMPANY By: By. MARK D. IATAROLA, Its ZVI KUR, OWNER Its a4.,(b- -v, P5PPP-- ATTORNEY-IN-FACT By: By: Its Its (Seal) (Seal) APPROVED AS TO SURETY AND APPROVED AS TO FORM: PRINCIPAL AMOUNT RICHARD S,WATSON&GERSHON A Professional Corporation By: By Insurance Administrator Public Agency Attorney Note: This bond must be executed in duplicate and dated,all signatures must he notarized,and evidence of the authority of any person signing as attorney-in-fact must be attached C-14 • WORKERS' COMPENSATION CERTIFICATE OF INSURANCE I/ WHEREAS,the City of Rancho Palos Verdes has required certain insurance to be provided by: NOW THEREFORE,the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insureds and that the same are in force at this time: 1. This certificate is issued to: City of Rancho Palos Verdes City Hall 30940 Hawthorne Boulevard Rancho Palos Verdes,California 90275 2. The insureds under such policy or policies are: 3. Workers' Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insureds as follows: Policy Number Effective Date Expiration Date • 4. Said policy or policies shall not be canceled,nor shall there be any reduction in coverage or limits of liability,unless and until thirty days'written notice thereof has been served upon the City Clerk of the City of Rancho Palos Verdes By: Its Authorized Representative NITH C GRTIcICATh o � L ��4�� 'ry ItiSQJA�c6� 4111) C-15 t fP4( YIHOY' L !r viJi ti •, ...,----- . AW 'D CERTIFICATE OF LIABILITY ii„ _ _ 03/13/2013 PRL�bIICER �� �� �� _� THIS CER'YIFICATE IS ISSUED A9 A MATTER or INFORAAATIa Allen&Associates Insurance Service ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE t 5 i 30 Ventura Blvd.,Suite 230 HOLDER,THIS CERI1FICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Sherman Oaks,CA 91403 •-�--- INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A; Security National Insurance Company .710.... ZK Construction 3UI�ER B: Infin ty insurance C mparly �" - 18031 San Fernando Mission Blvd. ,�,,,• INSURER C: State Fund INSURER D; National Union Fire Insurance Company of PA �.1,Granr�da Hills CA 91 344 —INSUPEP g; COVERAGES _ ---- TME POLICIES OF INSURANCE Lf8TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTW ITHSTANDINO 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IINSR AWL LTA INS ., TYPE OF INSURANCE POLICY NUMBER '�' a A GENERAL LIABILITY E j 0 Y LIMITS kil EACH OCCURRENCE $ 1,000,000 Q COMMERCIAL GENERAL LIABILITY ^3 `'L IV RENT � • PREMISES(_Ea occurr�enaa) $ 100,000 0 CLAIMS MADE OCCUR MED EXP(Any arm person) $ 5,000 111 NA105096500 03/19/2013 03/19/2014 ... PEflSONAL 6 AIN INJURY $ 1,000,000 „" GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCYS-COMP/OP AGO $ 2,000,000 4 POLIQ' n PROJECT n LOG i — �•. B II, AUTOMOBILE LIABILITY �` `� 1--•.i . ANY AUTO QMEIINED SINGLE LIMIT 1,000.000 ( a scOcenl) II ALL OWNED AUTOS '. " �� .--•- 4 SCHEDULED AUTOS 504610022282001 03/08/2013 03/08/2014 (PODI �)URY . HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accIdornt) 1In PROPERTY DAMAGE $ • —_ (Par AC�;Mentl GARAGE LIABRITY v-r� �� AUTO ONLY-EA ACCIDENT $ ANY AUTO ' OTHER THAN EA ACC $ I A.—,., `� AUTO ONLY: AGG $r,—.. .--� D EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1.000,000 Z OCCUR 0 CLAIMS MADE ' AGGREGATE 1,000,400 EBI 035809120 03/05/2010 03/19/2014 , ...i., •$ DEDUCTIBLE S RETENTION W._„, I C WORKERS COMPENSATION AND �---�i TltILR;NVII_ItTIN:8 'Eq._ EMPLOYERS'LIABILrrY V/N ANY PROPRIETOR/PARTNER/EXECUTIVE{ •— OFFICER/MEMBER EXCLUDED? I E.L.EACH ACCIDENT $ 1,000 00p OFFICER/MEMBER(Mandatory In MH) 1736295 04/14/2012 04/14/2013 E.L.DISEASE.EA EMPLOYEE $ 1,000,000 If yel3,det�crlbr under �.. S-CCIAL PROVISIONS bc,Iow E,L.DISEASE-POLICY UMI 1,000,000 OTHER •-.--. "� 6— 1 '• • •• •?, • -j • • •,• T a- _ 5• .!.' •o o . •' ' ,'4 ". • -•• �7 r, -_■. --,e, � The City,Its officers,employees,and volunteers are named as Additional Insureds on the General Liability policy. "10 Days notice of cancellation for non-payment of premium. CERTIFICI�`TE HOLDER AIVOELLAI`IOh1 ~—.., — `~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Manager DATE THEREOF,THE ISSUING INSURER WILL,ENDEAVOR TO NAIL DAYS WRrTTL.;N City of Rancho Palos Verdes NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SMALL 30940 Hawthorne Blvd. IMI�b�E NO OBLIGATION OR LIABILITY ANY KIND UPON THE INSURER,ITS AGLL:NTS OR Rancho Palos Verdes CA 90275 REFN TATfVEB. AUTHORIZED REPRESENTATIVE 4111LL_ _ epidehhahremnpour ACORD 25(2009/01) page 1 pt 198 0 8.2009 ACORD CORPORAt1ON. All rights reserved. The ACORO name and logo are registered marks of ACORD C~1 5 c-'7 c- i 9 G tt c- 2.I C-2.L.- -t. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSUREDS - OWNERLESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Policy Number; NA 105 0915500Endorse Endorsement Effectiv3/19/2013 12:01 Countersigned By: Named Insured ZVT KT,R..DBA:Z K CONSTRUCTION Ate4411'1. SCHEDULE Name of Person or Organization:Any person or organization that the named insured is obligated by virtue of a written contract or agreement to provide insurance such as is afforded by this policy. Location: �' — � �• • (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section 11—Who is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds,the following exclusion is added: 2. Exclusions This insurance does not apply to"bodily injury"or"property damage"occurring after; (1) All work, including materials, parts or equipment furnished in connection with such work,on the project(other than service, maintenance or repairs)to be performed b or on behalf of the additional insured(s)at the site of the covered operations has been completed; or P sen (2) That portion of"your work"out of which the injury or damage arises has beenut to its intended use by any person or organization other than another contractorp or subcontractor engaged in performing operations for a principal as a part of the same project. C. The words"you"and"your„refer to the Named insured shown in the Declarations. D. Your work"means work or operations performed by you or on your behalf; and materials, arts or equipment furnished in connection with such work or operations. p Prin Wordin„ If required by written contract or agreement:Such insurance as is afforded bythis policy shall be primary insurance,and any insurance or self-insurance maintained by the above additional insured(s)shall be excess of the insurance afforded to the named insured and shall not contribute to it. Waiveg f Subrog ji_on If required by written contract or agreement: We waive arty right of recovery we may have against an entity that is an additional insured per the terms of this endorsement because of a g make for injuryor damage arisingout of payments we 9 "your work" done under a contract with that person or organization. 49-0108 07 11 May Include Copyrighted Materiel of Insurance Services Offices, inc. Page aft Used with permission AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS [Labor Code 1720, 1773.8, 1775, 1776, 1777.5, 1813, 1860, 1861,3700] The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the following provisions of California law: 1. Contractor acknowledges that this contract is subject to the provisions of Division 2,Part 7,Chapter 1 (commencing with Section 1720) of the California Labor Code relating to public works and the awarding public agency("Agency")and agrees to be bound by all the provisions thereof as though set forth in full herein. 2. Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3. Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages. The Contractor shall,as a penalty to the Agency,forfeit not more than one hundred dollars($100)for each calendar day,or portion thereof,for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4. Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to(1)keep accurate payroll records, (2)certify and make such payroll records available for inspection as provided by Section 1776,and(3)inform the Agency of the location of the records.The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. • 5. Contractor agrees to comply with the provisions of California Labor Code Section 1777.5 concerning the employment of apprentices on public works projects, and further agrees that Contractor is responsible for compliance with Section 1777.5 by itself and all of its subcontractors. 6. Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours. The Contractor shall,as a penalty to the Agency,forfeit twenty-five dollars($25)for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in any one calendar day and 40 hours in any one calendar week in violation of the provisions of Division 2,Part 7,Chapter 1,Article 3 of the California Labor Code. 7. California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees. In accordance with the provisions of California Labor Code Section 1861,Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code,and I will comply with such provisions before commencing the performance of the work of this contract." to 3 Signature ri Da l 0 C-16 • INDEMNIFICATION AND HOLD HARMLESS AGREEMENT • AND WAIVER OF SUBROGATION AND CONTRIBUTION Contract/Agreement/Licens- 'ermit No or description: C o Y't�,is The 10 p + ty3041m.04 (very., b thetA 3‘tt Indemnitor(s)(list all names): To the fullest extent permitted by law, Indemnitor hereby agrees, at its sole cost and expense, to defend,protect,indemnify,and hold harmless the City of Rancho Palos Verdes and its elected officials, officers,attorneys,agents,employees,volunteers,successors,and assigns(collectively"Indemnitees")from and against any and all damages,costs,expenses,liabilities,claims,demands,causes of action,proceedings, expenses,judgments, penalties, liens, and losses of any nature whatsoever, including fees of accountants, attorneys, or other professionals and all costs associated therewith (collectively "Liabilities"), arising or claimed to arise,directly or indirectly,out of,in connection with,resulting from,or related to any act,failure to act, error, or omission of Indemnitor or any of its officers, agents, servants, employees, subcontractors, materialmen,suppliers or their officers,agents,servants or employees,arising or claimed to arise,directly or indirectly,out of,in connection with,resulting from,or related to the above-referenced contract,agreement, license,or permit(the "Agreement")or the performance or failure to perform any term,provision,covenant,or condition of the Agreement, including this indemnity provision. This indemnity provision is effective regardless of any prior, concurrent, or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence. This indemnity provision shall survive the termination of the Agreement and is in addition to any other rights or remedies which Indemnitees may have under the law. Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision, and an entry of judgment against an Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision. Indemnitor shall pay Indemnitees for any • attorney's fees and costs incurred in enforcing this indemnification provision. Notwithstanding the foregoing, nothing in this instrument shall be construed to encompass (a) Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying Agreement is subject to Civil Code 2782(a)or(b)the contracting public agency's active negligence to the limited extent that the underlying Agreement is subject to Civil Code 2782(b). This indemnity is effective without reference to the existence or applicability of any insurance coverages which may have been required under the Agreement or any additional insured endorsements which may extend to Indemnitees. Indemnitor, on behalf of itself and all parties claiming under or through it, hereby waives all rights of subrogation and contribution against the Indemnitees,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor regardless of any prior, concurrent, or subsequent active or passive negligence by the Indemnitees. In the event there is more than one person or entity named in the Agreement as an Indemnitor, then all obligations, liabilities,covenants and conditions under this instrument shall be joint and several. "indemnitor" Name Z4X'I& Name By: By: Its Its • C-17 r ' • ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY • Name am e and address v f named insured("Named Insured'): Name and address of Insurance Company("Company'): General description of agreement(s),pernzit(s), license(s), and/or activity(ies) insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: 1. The ("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are additional insureds(the above named additional insureds are hereafter referred to as the"Additional Insureds")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured • against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall be covered as third- party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s)contained in or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation,change in coverage, reduction of limits(except as the result of the payment of claims), or non-renewal except after written notice to Public Agency,by certified mail,return receipt requested,notless than thirty(30)days prior to the effective date thereof. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation,and enforcement of this contract of insurance. C-18 • 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: • 10. Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: o Contractual Liability o Explosion Hazard o Owners/Landlords/Tenants o Collapse Hazard o Manufacturers/Contractors o Underground Property Damage o Products/Completed Operations o Pollution Liability o Broad Form Property Damage o Liquor Liability o Extended Bodily injury o o Broad Form Comprehensive o General Liability Endorsement o 12. A❑deductible or o self-insured retention(check one)of$ applies to all coverages)except: (if none,so state). The deductible is applicable o per claim or o per occurrence(check one). 13. This is an o occurrence or o claims made policy(check one). 14. This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number I, (print name), hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only; no,facsimile signature Telephone No.: ( } or initialed signature accepted) C-19 1111 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured("Warned Insured"): Name and address o fInsurance Company("Company'): General description of agreement(s),permit(s), license(s), and/or activity(ies) insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the "Policy")or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The ("Public Agency"), its elected officials, officers,attorneys,agents,employees,and volunteers are additional insureds(the above named additional insureds are hereafter referred to as the"Additional Insureds")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. 41113. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall be covered as third- party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. S. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s)contained or executed in conjunction with the written ag eeement(s)or pennit(s)designated above,between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation,change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency,by certified mail,return receipt requested,not less than thirty(30)days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the 111 validity,construction,interpretation,and enforcement of this contract of insurance. C-20 • 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes 30940 Hawthorne Boulevard Rancho Palos Verdes,California 90275 10. Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROMITO LIABILITY 11. Scheduled items or locations are to be identified on an attached sheet. The following inclusions relate to the above coverages. Includes: A• ny Automobiles 1 T• ruckers Coverage 1 A• ll Owned Automobiles I Motor Carrier Act 1 N• on-owned Automobiles 1 B• us Regulatory Reform Act H• ired AutomobilesPublic Livery Coverage A A Scheduled Automobiles A p Garage Coverage 12. A o deductible or o self-insured retention(check one)of applies to all coverage(s)except:, (if none,so state). The deductible is applicable G per claim or G per occurrence(check one). 13. This is an o occurrence or o claims made policy(check one). 14. This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number 1, (print name), hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only;no facsimile signature Telephone No.: ( } or initialed signature accepted) 411 C-21 11111 ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY Name and address of named insured("Named Insured"): Name and address of Insurance Company("Company"): General description of'agreement(s),permit(s), license(s), and/or activity(ies) insured: • Notwithstanding any inconsistent statement in the policy to which this endorsement is attached(the "Policy")or in any endorsement now or hereafter attached thereto, it is agreed as follows: 1. The ("Public Agency"),its elected officials,officers,attorneys, agents,employees,and volunteers are additional insureds(the above named additional insureds are hereafter referred to as the"Additional Insureds")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured. The Additional Insureds have no liability for the payment of any premiums or assessments under the Policy. 2. The insurance coverages afforded the Additional Insureds under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insureds shall be called upon to contribute with the insurance coverages provided by the Policy. • 3. Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought,except with respect to the limits of the Company's liability. 4. Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy. All such claims shall be covered as third- party claims, i.e., in the same manner as if separate policies had been issued to each insured. Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s)contained in or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insureds. 6. The policy to which this endorsement is attached shall not be subject to cancellation,change in coverage, reduction of limits (except as the result of the payment of claims), or non-renewal except after written notice to Public Agency,by certified mail,return receipt requested,not less than thirty(30)days prior to the effective date thereto. In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7. Company hereby waives all rights of subrogation and contribution against the Additional Insureds,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,or subsequent active or passive negligence by the Additional Insureds. 8. It is hereby agreed that the laws of the State of California shall apply to and govern the validity, construction, interpretation, and enforcement of this contract of insurance. C-22 • 9. This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes 30940 Hawthorne Boulevard Rancho Palos Verdes,California 90275 10. Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OF THIS ENDORSEMENT ATTACHES FROM/TO LIABILITY o Following Form o Umbrella Liability 11. Applicable underlying coverages: INSURANCE COMPANY POLICY NO. AMOUNT 1110 12. The following inclusions, exclusions, extensions or specific provisions relate to the above coverages: 13. A o deductible or o self-insured retention(check one)of$ applies to all coverage(s)except: (if none,so state). The deductible is applicable o per claim or o per occurrence(check one). 14. This is an o occurrence or o claims made policy(check one). 15. This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number (print name), hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20 Signature of Authorized Representative (Original signature only,no jhcsimile signature Telephone No.: ( ) or initialed signature accepted) 40 C-23 • CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT _ tl .., .9,',: . ay'', r17,`t4.-147 r 'ire!, 49,' `r'- • - er• M "'er .49:"a7-~er•err-• - • STATE OF CALIFORNIA County of SAN DIEGO On 2/27/2013 before me, DEBORAH D. DAVIS, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person* whose name(e) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his authorized capacityftes}, DEBORAH D.DAVIS and that by hisAteti7itheic signature(e) on the instrument the cm COMM.#1929979 `,"4:‘,_:.7 � person(, or the entity upon behalf of which the person(s) d 7 NOTARY PUBLIC CALIFORNIA ;�; SAN DIEGO COUNTY acted, executed the instrument. My Comm.Exp. APRIL 21,2015 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature A A-- Place Notary Seal Above 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: MARK D. IATAROLA Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer Title(s): El Corporate Officer Title(s): ❑ Partner ❑ Limited El General ❑ Partner ❑ Limited❑ General Attorney in Fact RIGHTTHUMBPRINT ❑ Attorney in Fact RIGHTTHUMBPRINT ❑ Trustee OF SIGNER El Trustee OF SIGNER El Guardian or Conservator Top of thumb here El Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 IV 1110 POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY LL,ME3Y THESE PRESENTS: That American Contractors Indemnity company,a California corporation,United States 0 . tpa a Maryland corporation and U.S. Specialty Insuce Con a Texas corporation (collectively, the "C ani&),do by these presents make,constitute and appoint: = — John G.Maloney,Mark D. Iatarola or Helen Maloney of Escondido,California its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, with fullpower and authority P Y Y here_conferred in its name,place and stead,to execute, acknowledge and deliver any and all bonds, recognizance*,undertakings or other instruments or contracts sure ip to include riders, amendments, and consents of surety-, pro the d penalty does not exceed - ******Fifteen Million****** Dollars (S**15,0 .0f `). — This Power of Attorney shall expire without further action on December 08,2016. This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent acct for and on,behalf of the Company subject to the following provision -- --- Attorney-in-Fact may be given full power and authority for and in the name of and on beharrof the Company,execute,acknowledge and deliver,any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory uncle kings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts,and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved,that the signature of any authorized officer and-seal-of the Company heretofore or hereafter affixed to any power of attorney or any certificate relatii thereto by facsimile,ant any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Compt any bond or undertaki -to which it is attached. IN WITNESS WHEREOF,The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 10th day of December,2012. AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY rp�e Se -_ 1`t��1li'.1117i11/1�//, ``,`i11Ii;1tlJlfl!// olt11111l111p/////' 111V 's:-V-, <\N'';'.''. .--?:'-'---.. S:o.‘','"'''''''''..'.F.F.A S, r ,„t,SEP7.25,1944 -c E. F.,-,::.=w� � T�1_ `'� !�� j� I � Ac2........_, =sb' :••:e .1.••• ',. �S� Daniel P.Aguilar,Vice President State of California "''•,,��'c;fla;;,P,t�' �''',/,,,,r11*t,,,,�,,,''� ���1,��gt*►,,,,tt,�'`, County of Los Angeles SS: - _-On 10th day of December,2012,berme me,Vanessa Wright,a notary public,personally appeared Daniel P.Aguilar,Vice President of American Contractors Indemnity Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity,and that by his signature on the instrument the person(s),or the entity upon behalf of ---whieh-theracted,executed the instrument. - t un r SALTY OF PERJURY under the laws of the State of California that tht foregoing paragraph is true and correct. WITNESS my hand and official seal. V WRIGHT gm N,,nr o 19913319Signature e - (Seal) ii, ..„.., L,,,,,z,:,:..;.„...=.9...a.j4);..6.1-- 121" Les Angeles Co-unty - I, Jeannie Lee, Assistant Secretary fAmerican=Contractors Indemnity Company, United States Surety Compan and U.S. Specialty Insurance Company, do hereby certify that the-above and foregoing is a true and correct copy of a Power of Aty, exerted by said Companies, which is still in full-force and effect; furthermore,the resolutions of the Boards of Directors, set our in the Power of Attorney are in full force and effect. In Witness Whereof,I have hereunto set my hand and affixed the seals of said Companies-at LosAngeles, California this 2 7TH day of FEBRUARY ,2013, 4111 Corporate Seals f i ib). . „ \a j.4.,. `\''Si11"6"'!!// `,01111111////// . �,.` (R6`C..... Rs � %, .\• f;� / �S sT, ,��'` lil5tt /a ��i�� Bond No. 1000957105 ,= '.�;' �� '47:74 .•0" \4.- It= Jeannie Lee,assistant Secretary _ - Agency No. 4013 ._SEPT 25.144Q :', �,� p. ,,. Y .:� - - .1 '/rf�/1133��}tt�, '///f/.lillt�llfl`t`ty`\ J 1111 10 State of California—Health and Human Services Agency California Department of Public Health ABATEMENT OF LEAD HAZARDS NOTIFICATION POST AT ALL ENTRANCES TO WORK AREA AND STRUCTURE Work is being conducted to abate lead-based paint or lead hazards in or on this structure. For more information, please contact the individuals or agencies listed below. Section 1—Structure Where Abatement of Lead-Based Paint or Lead Hazards is Scheduled 0 Address[number,street,apartment(if applicable}] City County Zip Code 30359 Hawthorne Blvd Rancho Palos Verdes Los Angeles 90275 Type of structure(check one box only) Single family dwelling ri Multi-family building School,daycare,or other child-occupied facility Ri Other(specify) City Park Facility Women's and Men's Res trooms Section 2—Summary of Specific Work and Locations)Where Lead-Based Paint or Lead Hazards Will Be Abated Lead ceramic wall/baseboard tile approximate 120 SF in Women's and Men's Restroom Description of work to be performed: ✓ Interior Exterior Both interior and exterior Type of Abatement(check all that apply): ✓ Permanent(>20 years) Temporary(<20 years) Do any children reside on the premises? Yes ✓ No Don't know Section 3 Projected starting date Projected ending date March 19,2013 March 22,2013 0 Section 4—Restrictions on Entering Work Area List specific times and/or dates residents are not allowed to enter work areas, if applicable. March 18,2013 through June 30,2013 If you would like more information,please contact the following: Section 5—Property Owner or Manager Name Telephone number Bindu Vaish,Project Manager 310-544-5252 Address[number,street,apartment(if applicable)] City State Zip Code 30940 Hawthorne Blvd Rancho Palos Verdes California 90275 Section 6—Individual Conducting Abatement(Supervisor or Company and Supervisor) Name and company(if applicable) Telephone number CDPH certification number(if applicable) Lorenzo Zaman�ipa,SERVICE FIRST CONTRACTORS NETWORK dba SERVICE FIRST (626)638-2298 556812 Address[number,street,apartment(if applicable)] City State Zip Code 3505 CADILLAC AV') V BLD F-9 , COSTA MESA CA 92626 Section 7—Local Environmental Health Agency Telephone number ((626) ) 430-5200 This form shall be mailed or faxed to: California Department of Public Health a€ i hil h L vioYtL ,.„.:,,,.,1:,„!::.,,,:il! .,,..,...1!;:;.:.:.:.:1::.!.-..-,:- C f oiaLead Poi on>n r v n' n : ....::...::4::, ::>::.:::>::>::>::>::::: :::::;::. :::.>::::>:.:..:::::>::::::>::.>:;;::::::.::::::<:;::::.::..::::>:::>::>::..::::::::: s P e e bo Branch Reports °:.:.::.;:::.: . 850 Manna Bay Parkway,Building P,3rd Floor ,: - Richmond,CA 94804-6403 LI i,Q)at o'..f th�::::.f � :,,,, 0 Fax (510)620-5656 ,,' :: .,: ........:.. Card r CDPH 8551(6/07) :::;::: : C" ZAP