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HomeMy WebLinkAboutC2012-446 - 7/9/2012 - NA AGREEMENT THE STATE OF TEXAS § COUNTY OF NUECES § THIS AGREEMENT is entered into this 9TH day of JULY, 2012, by and between the CITY OF CORPUS CHRISTI of the County of Nueces, State of Texas, acting through its duly authorized City Manager, termed in the Contract Documents as "City," and Grace Paving & Construction, Inc. termed in the Contract Documents as "Contractor," upon these terms, performable in Nueces County, Texas: In consideration of the payment of $1,100,000.00 by City and other obligations of City as set out herein, Contractor will construct and complete certain improvements described as follows: ID/IQ MINOR STREET PAVEMENT IMPROVEMENTS CITY-WIDE FY 2010-2011 CONTRACT RENEWAL #1 - PROJECT NO. E12068 (TOTAL RENEWAL AMOUNT: $1,100,000.00) according to the attached Plans and Specifications in a good and workmanlike manner for the prices and conditions set out in their attached bid proposal supplying at their expense such materials, services, labor and insurance as required by the attached Contract Documents, including overseeing the entire job. The Contract Documents include this Agreement, the bid proposal and instructions, The General and Special Provisions and Requirements for Municipal Construction Contracts of the City of Corpus Christi, plans and specifications, including all maps, plats, blueprints, and other drawings, the Performance and Payment bonds, addenda, and related documents all of which constitute the contract for this project and are made a part hereof. (:2012-446 7/09/12 Page 1 of 3 Grace Paving& Construction Inc. Rev. Jun-2010 SCANNED Contractor shall indemnify, save harmless and defend the City of Corpus Christi in accordance with General Provision B-6-11 and Special Provision A-26 of the General and Special Provisions and Requirements for Municipal Construction Contracts of the City of Corpus Christi, Texas. The Contractor will commence work within ten (10) calendar days from date they receive written work order and agrees to complete individual delivery orders within THE ALLOWABLE WORKING TIME (CALENDAR DAYS) designated by the delivery Work Order. Should Contractor default, Contractor may be liable for liquidated damages as set forth in the Contract Documents. City will pay Contractor in current funds for performance of the contract in accordance with the Contract Documents as the work progresses. Signed in 4 parts at Corpus Christi, Texas on the date shown above. Page 2 of 3 Rev. Jun-2010 ATTEST: CITY OF CORPUS CHRISTI R>1-19-7-0124N—, By: �I �-�, City Secretary Oscar Martinez Assistant City Manager Public Works, Utilities, and Transportation APPROVED AS TO LEGAL FORM: By: ,U 1i 0%- By: Z-00—C2 Asst. City Attorney Daniel Biles, P.E. Director of Engineering Services 530215-1020-12410-E12068 - CONTRACTOR ATTEST: (If Corporation) Grace Paving & Construction, Inc. a l a 7(1` By: C , (Seal Below) . 1 Title: ?OW,.z (Note: If Person signing for corporation is not President, 4237 Baldwin Blvd. attach copy of authorization (Address) to sign) Corpus Christi, TX 78405 (City) (State) (ZIP) 361/883-3232 * 361/883-1296 (Phone) (Fax) o33 AUi111)1y eff MOM 4F(`9FTA,a.Y G'�, ( v ^N` Page 3 of 3 Rev. Jun-2010 Grace Paving and Construction, Inc. 4237 Baldwin Blvd. Corpus Christi, Texas 78405-3324 361-883-3232 May 30, 2012 To: Daniel Biles, P.E. Interim Director Engineering Services City of Corpus Christi 1201 Leopard St. Corpus Christi,Texas 78401 To: Natasha E. Fudge,P.E. Major Projects Engineer Engineering Services City of Corpus Christi 1201 Leopard St. Corpus Christi, Texas 78401 To: Felix H. Ocanas,Jr.,P.E. Engineering& Construction Management Services ECMS, LLC. 5001 Oakmont Drive Corpus Christi,Texas 78413 Re: ID/IQ Minor Street Pavement Improvements—City Wide FY 2010-2011 Project No.E10126 Contract Renewal Attn: Mr. Biles, Attached is our proposal for contract renewal based on your letter dated May 22, 2012. The quantities to be used on the renewal were given to us by ECMS in a meeting where we discussed the overall project. It was decided by ECMS, as we concur,that we should use the bid items which were actually used during the original contract and not use those which do not appear to be intended to be used on the renewal, for maximum efficiency of the pavement repairs intended. We will follow up with the Bonding and Insurance, etc. as soon as an award letter is issued by the City of Corpus Christi, Tx. Sincerely, 6:k; 6P/'5-- Eddie M. Ortiz Grace Paving And Construction, Inc. RIDIU S I REEF PAVEMENT IMPROVEMENTS-CITY WIDE BID SCHEDULE , � PROJECT NO.E10126 (1,11.7c..s-zezel' (7jLniii''I 11 Part "A" - ID/IQ Minor Street Pavement Improvements General Items - City wide IIITEM QTY Description PriceExtended II 1unit1uit 1 Cost A-1 1 Mobilization/Bonds/Insurance; See T-000500 for Mobilization Payment o LS /5 /33 3'7 gi SR:',26, A-2 /,7 Traffic Control, Residential Street Day 0-43.77 g5-45-,w I A-3 1. Traffic Control, Arterial Streets Day x,1/7 3.; . SS/a,_ 29 -. ` Seal Coat, Per Single Course - Standard Spec. _ r,. A-4 SY #025416 - A-5 D Crack Seal, 0-1" wide, Standard Spec.#025410 LF V.5s'9 c I A-6 0 Slurry Seal - Standard Spec.#025419 SY1 �•/A O Planing (Milling) (2") 1,000 to 2, 000 SY 11 A-7 U Minimum per Delivery Order. Standard Spec.# SY .3 g D 25402 Planing (Milling) Additional (1") 1000 to I A-8 0 2,000 SY Minimum per Delivery Order. Standard SYgg O Spec.# 25402 Planing(Milling) (2") , 2,000 to 4,000 SY A-9 9 Minimum per Delivery Order. Standard SY ?. g.2 C Spec.#025402 , Planing(Milling) , Additional (1") 2, 000 to I A-10 0 4,000 SY per Delivery Order. Standard SY 1, 7 L1, Spec.#025402 A-11 0 Ozone Days EA 6,17 35 G Cement stabilized base with 4% cement, A-12 0 existing limestone base, 3-6 inches, complete SY 3 '77 O 1 in place per SY. (See Spec. 025220) A-13 p TX5-475 Triaxial Geogrid, Complete in Place per SY. SY ,3.4''3 O 1 A-14 4 Mandatory Allowance EA $ /,4049 $ p ITOTAL, BASE BID Part "A" (Bid Items Al-A14) : $ c2a07, a LbZ . 32 I I I Proposal Form 3 of 11 I IDIQ STREET PAVEMEN I IM}'KUVtMtl' I S-Ui r wiut P BID SCHEDULE PROJECT NO.E10126 Ce-, fitrna(/ L'47.En,zG Part "AA" -Localized IDIQ Minor Street Pavement Improvements-City Wide Extended ITEM I QTY Description Unit Unit Price Cost PART 1 . 1 to 25 SY - Localized Flexible Pavement Structure Repairs with saw cutting existing roadway; subgrade, base and surface treatment/repair using asphalt concrete (hot/cold mix) . All work will be within one City Block. _ AA-1 /-6-- Subgrade Repair up to 2" Depth (Cold/Hot) HMAC SY " ,l5— 107. g5 s AA-2 (26,3 Base Repair - Upper 2" (Cold/Hot) HMAC SY g.77 2,a,2C?7v .// Base Repair - Additional 1" Depth (Cold/Hot) SY /3y al C' �• G' ' AA-3 �F[o 7 HMAC 4L Surface Treatment - Upper 2" Depth (Cold/Hot) AA-4 jai 3HMAC compliant TXDOT 351 SY X5./.3 3 �/ ti 1 �/ `Surface Treatment - Additional 1" Depth SY /Q2.5 1 ",, AA-5 (Cold/Hot) HMAC compliant TXDOT 351 2 0r15• /9 z,, PART 2. 25 to 100 SY - Localized Flexible Pavement Structure Repairs with saw cutting existing roadway; subgrade and base resotration using limestone and HMAC Type D surface Pyi treatment. All work will be 1/2-Mile Square Area and compliant with TXDOT 351. P+. Subgrade Repair up to 4-6" Depth (lime AA-65SY /8', O © stabilization) if fi AA-7 1 7q Base Repair, Upper 2" Depth (Limestone) SY /1.1n3 13j"gfj,415 AA-8 70 Base Repair, Additional 1" Depth (Limestone) SY 5: <0 N i,D .S O AA-9 Surface Treatment Repair Upper 2" HMAC SY ,70.57 /387412,*/ s. !/ /�./ Surface Treatment Repair Additional 1" Depth SY lG� �/ //!c��/3d'•Lo/ '< AA-10 Y HMAC r PART 3. 100 to 250 SY - Localized Flexible Pavement Structure Repairs with saw cutting existing raodway; subgrade and base using limestone with HMAC Type D surface treatment, compliant with TXDOT 351. All work will be 1-Mile Square Area. Subgrade Repair up to 4-6" Depth (lime AA-11 0 SYstabilization) /k'„S' C AA-12 /36,7 Base Repair, Upper 2" Depth (Limestone) SY /D.lc,3 /'/4 c,99 AA-13 Llqa Base Repair, Additional 1" Depth (Limestone) SY 510 d /99‘-.2.0 AA-14 5 Z j'C) Surface Treatment Repair Upper 2" HMAC SY Q,57 /D$576,0)) AA-15 /0��6r Surface Treatment Repair Additional 1" Depth SY HMAC /0. // /DS;5 3y, �L Proposal Form 4 of 11 IUIUSIKttl fAVtMtNI IMYKUVtIVItPV0-LIIT VVIut BID SCHEDULE PROJECT NO. E10126 Cr 1e 2Ct,c= 4.111.tt`Z4 PART 4. 250 to 1.000 SY - Localized Flexible Pavement Structure Repairs with saw cutting existing raodway; subgrade and base using limestone with HMAC Type D surface treatment, compliant with TXDOT 351. All work will be 3-Mile Square Area. Subgrade Repair up to 4-6" Depth (lime SY 5 �) AA-16 stabilization) /NO Base Repair, Upper 2" Depth (Limestone) SY /0. 4-3 /;?,//z- 3_3 Base Repair, Additional 1" Depth (Limestone) SY 35--(17 /r ,2/ as" A-19 '4570 Surface Treatment Repair Upper 2" HMAC SY 21).5 7 89'7.7? AA-20 T7/� Surface Treatment Repair Additional 1" Depth SY /0,4/ V.2g6„ HMAC PART 5. 1,000 t 5.000 SY - Localized Flexible Pavement Structure Repairs with saw cutting existing raodway; subgrade and base using limestone with HMAC Type D surface treatment, compliant with TXDOT 351. All work will be 5-Mile Square Area. Subgrade Repair up to 4-6" Depth (lime SY _ AA-21 © stabilization) /8d5 AA-22 0 Base Repair, Upper 2" Depth (Limestone) SY AA-23 0 Base Repair, Additional 1" Depth (Limestone) SY AA-25 0 Surface Treatment Repair Upper 2" HMAC SY 0/0. 4+ O AA-26 0Surface Treatment Repair Additional 1" Depth SY /1),(S/ (� TOTAL BASE BID Part "AA" (PARTS 1 thru 5, AA-1 thru AA-26) : $ po�S, 7r7r/• 15 Proposal Form 5 of 11 IDIQ STREET PAVEMLN I IMNKUvtiwtN I ,-u I T VVivC BID SCHEDULE � � PROJECT NO.E10126 C',-i to c i- V�-�_ '-'►'uktZL L Part "B" - ID/IQ Minor Street Pavement Improvements - City Wide • Extended ITEM QTY Description Unit Unit Pricel Cost Removal and Replacement of Curb & Gutter, LF /7 R3% ..F00.-27B-1 a g 7 3 complete in place. _ _ /h Removal and Replacement of driveway SF 3 30 .1� B-2 `1 approaches, complete and in place. New ADA Concrete Curb Ramp: Compliant to TDLR SF /4_5i3 (} B-3 0 requirements, complete in place. Remove and Replace ADA curb ramp: Removal and D B-4 0 Replacement of ADA ramps not in compliance SF /7 33 with TDLR. TOTAL BASE BID Part "B" (Bid Items Bl-B4) : $ tka' * ? 1 ,h' i part "C" - ID/IQ Minor Street Pavement Improvements - City Wide Extended ITEM QTY Description Unit Unit Price Cost Sanitary Sewer Manhole Ring & Cover /�55; .3 1/0•g6 C-1 Adjustment, including New Manhole Ring & Cover Each ' Assembly with new Height Adjustment Rings, Stainless Steel Inflow Inhibitor and with Concrete Collar, complete in place. C-2 / Storm Water manhole Ring & Cover Adjustment, Each /457-Co b 'f2 /7/ with new manhole Ring and Cover assembly with new concrete collar, complete in place. C-3 `f' Water Valve Adjustment with Concrete Collar, Each 7,2 7 II gg,13- 73 complete in place. TOTAL BASE BID Part "C" (Bid Items Cl-C3) : $ 6 76 7, 30 Proposal Form 6 of 11 IDIQ MINOR STREET PAVEMENT IMPROVEMENT PROJECT PROJECT NO.E10126 HYPOTHETICAL SCENARIO 1 Unit Extended ITEM QTY Description Unit Price Cost Hypothetical Scenario No. 1 Williams Drive (250SY to 1,000SY) F" t= a Mobilization/Bonds/Insurance; See T-000500 A-1 1 for Mobilization Payment % LS 1 A-3 12 Traffic Control, Arterial Streets Day AA-17 1,000 Base Repair, Upper 2" Depth (Limestone) SY AA-19 _ 1,000 Surface Treatment Repair Upper 2" HMAC SY +_ Storm Water manhole Ring & Cover t" C-2 1 Adjustment, with new manhole Ring and Cover Each ( assembly with new concrete collar, complete in place. _ tgt TOTAL EXTENDED UNIT PRICES (SCENARIO NO 1) : $ ITEM I QTY I Description 1 Unit I Unit ' Extended Hypothetical Scenario No. 2 South Staples Street (250SY to 1,000SY) Mobilization/Bonds/Insurance; See T-000500 A-1 1 LS for Mobilization Payment % A-3 12 Traffic Control, Arterial Streets Day AA-17 389 Base Repair, Upper 2" Depth (Limestone) SY AA-19 389 Surface Treatment Repair Upper 2" HMAC SY Storm Water manhole Ring & Cover C-2 1 Adjustment, with new manhole Ring and Cover Each assembly with new concrete collar, complete in place. C-3 1 Collar, complete in place. Each ' TOTAL EXTENDED UNIT PRICES (SCENARIO NO 2) : $ f t t I ITEM r QTY I Description I Unit I Unit I Extended I k Hypothetical Scenario No. 3 SAINT ANDREWS DRIVE (250SY to 1,000SY) Mobilization/Bonds/Insurance; See T-000500 A-1 1 LS for Mobilization Payment % t: A-2 10 Traffic Control, Residential Street Day r AA-17 400 Base Repair, Upper 2" Depth (Limestone) SY 1 AA-19 400 Surface Treatment Repair Upper 2" HMAC SY AA-20 400 Surface Treatment Repair Additional 1" SY Depth HMAC . f' TOTAL EXTENDED UNIT PRICES (SCENARIO NO 3) : $ /LJ / f r Proposal Form 7 of 11 it (, I' IUIUSIKttI rAVtIVICIHI IIVIf KUVtIVItIVIJ-UIT WIUC BID SCHEDULE PROJECT NO.E10126 Ct`ti7jllt�,� r-t'Zti CONTRACT SUMMARY TOTAL BASE BID Part "A" (Bid Items Al-A14) : $ TOTAL BASE BID Part "AA" (PARTS 1. thru 5, AA-1 thru AA-26) : $ g 4L4/. 93 TOTAL BASE BID Part "B" (Bid Items B1-B4) : $ ?2 O'S• t TOTAL BASE BID Part "C" (Bid Items Cl-C3) : $ 6,1i 7 3) TOTAL EXTENDED HYPOTHETICAL SCENARIO'S (Scenarios 1 thru 3) : $ — b - TOTAL CONTRACT BID AMOUNT: $ 61 OO,ay. ad Proposal Form 8 of 11 Please note: Bid quantities are for bidding purposes only. Actual quantities may vary and will be determined by actual field conditions encountered during construction. The undersigned hereby declares that he has visited the site and has carefully examined the plans, specifications and contract documents relating to the work covered by his bid or bids, that he agrees to do the work, and that no representations made by the City are in any sense a warranty but are mere estimates for the guidance of the Contractor. Upon notification of award of contract, we will within ten (10) calendar days execute the formal contract and will deliver a I Performance Bond (as required) for the faithful performance of this contract and a Payment Bond (as required) to insure payment for all labor and materials. The bid bond attached to this proposal, in the amount of 5% of the highest amount bid, is to become the property of I the City of Corpus Christi in the event the contract and bonds are not executed within the time above set forth as liquidated damages for the delay and additional work caused thereby. IMinority/Minority Business Enterprise Participation: The apparent low bidder shall, within five days of receipt of bids, submit to the City Engineer, in writing, the names and addresses of MBE firms I participating in the contract and a description of the work to be performed and its dollar value for bid evaluation purpose. Number of Signed Sets of Documents: The contract and all I bonds will be prepared in not less than four counterpart (original signed) sets. Time of Completion: The undersigned agrees to complete I individual delivery orders within the calendar days designated by the delivery Work Order. I The undersigned further declares that he will provide all necessary tools and apparatus, do all the work and furnish all materials and do everything required to carry out the above mentioned work covered by this proposal, in strict accordance with the contract I documents and the requirements pertaining thereto, for the sum or sums above set forth. Receipt of the following addenda is acknowledged (addenda Inumber) : N I A- IRespectfully submitted: Name : Alt a At"c)e A 1A C/l yt ateb c c. I By: 1 (SEAL - IF BIDDER IS (SIGNATUREE) a Corporation) Address : 4/A 3 '7 1te.toc4,, ud I (P.O. Box) (Street) —CILA-t Vic. , 78L/06= 33-25/ C�;ity) (State) (Zip) Proposal Form Page 9 of 11 I PERFORMANCE BOND STATE OF TEXAS § BOND No. 1962844 COUNTY OF NUECES § KNOW ALL BY THESE PRESENTS: That Grace Paving & Construction, Inc. of the City of Corpus Christi , County of Nueces , and State of Texas , as principal ("Principal"), and THE HANOVER INSURANCE COMPANY , a solvent company duly authorized under the laws of the State of Texas to act as surety on bonds for principals ("Surety"), are held and firmly bound unto the City of Corpus Christi, a Home Rule municipal corporation of Nueces County, Texas ("City" or "OWNER"), in the penal sum of ONE MILLION, ONE HUNDRED THOUSAND AND NO/100 U.S. Dollars ($ 1,100,000.00 U.S.) to be paid in Nueces County, Texas, for the payment of which sum well and truly to be made, We, said Principal and Surety, bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: Conditions of this bond are such that, whereas, Principal has entered into a certain written contract with the City of Corpus Christi (OWNER), dated the 9TH of JUNE , 2012, which Agreement is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein, for the construction of: ID/IQ MINOR STREET PAVEMENT IMPROVEMENTS CITY-WIDE FY 2010-2011 CONTRACT RENEWAL #1 - PROJECT NO. E12068 (TOTAL RENEWAL AMOUNT: $1,100,000.00) Now therefore, the condition of this obligation is such, that if said Principal shall faithfully perform said Agreement in accordance with the plans, specifications and contract documents, including any changes, extensions, or guarantees, and including all and singular covenants, conditions, and agreements in and by said contract agreed and covenanted by Principal to be observed and performed, and according to the true intent and meaning of said Agreement hereto annexed, and if the Principal shall repair and/or replace all defects due to faulty materials and/or workmanship that appear within a • period of one (1) year from the date of completion and acceptance of improvements by the City(OWNER), then this obligation shall be void; otherwise to remain in full force and effect. Surety, for value received, stipulates and agrees that no change to the contract time or contract amount, and no alteration or addition to the terms of the contract, or to the work performed thereunder, or to the plans, specifications, drawings, etc., accompanying the same shall in anywise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract, or to the work to be performed thereunder. (Rev. Date May 2011) Performance Bond Page 1 of 3 Provided further, that this bond is executed pursuant to Chapter 2253, Texas Government Code, as amended. Provided further, that if any legal action be filed on this bond, venue shall lie in Nueces County, Texas. The undersigned agent is hereby designated by the Surety as the Resident Agent in Nueces County to whom any requisite notices may be delivered and on whom service of process may be had in matters arising out of such suretyship, as provided by Sections 3503.001 to 3503.005, Texas Insurance Code, as amended. In witness whereof, said Principal and Surety have signed and sealed this instrument in 4 copies, each one of which shall be deemed an original, this the 18TH day of JULY , 2012. PRINCIPAL SURETY GRACE PAVIINNG & CONS UCTION, INC. THE HANOVER INSURANCE COMPANY By: By Attor . ffn-fact MARY ELLEN MQORE Title: . 4. ATTEST: ., td Secretary Address: 4237 BALDWIN BLVD. Address: 10375 RICHMOND AVENUE CORPUS CHRISTI, TEXAS 78409 SUITE 1050 HOUSTON, TEXAS 77042 Telephone: 713-243-7072 Fax: 713_943-7076 E-Mail: jmbrandt@hanover.corn (Rev. Date May 2011) Performance Bond Page 2 of 3 Name and address of Resident Agent of Surety in Nueces County, Texas, for delivery of notice and service of process: Name: RANDAL M. LEE Agency: SWANTNER & GORDON INSURANCE AGENCY Address: 500 N. SHORELINE BLVD. , SUITE 1200 (Physical Street Address) CORPUS CHRISTI TEXAS 78401 (City) (State) (Zip) Telephone: 361-883-1711 E-Mail: rml@s-gins.com Note: Bond shall be issued by a solvent Surety company authorized to do business in Texas, and shall meet any other requirements established by law or by OWNER under applicable law. Note: Surety Agent's Original Power of Attorney must be attached hereto. Note: Date of Performance Bond must not be prior to date of contract. END (Rev. Date May 2011) Performance Bond Page 3 of 3 PAYMENT BOND STATE OF TEXAS § BOND No. 1962844 COUNTY OF NUECES § KNOW ALL BY THESE PRESENTS: That Grace Paving & Construction, Inc. of the City of Corpus Christi , County of Nueces , and State of Texas , as principal ("Principal"), and THE HANOVER INSURANCE COMPANY , a solvent company duly authorized under the laws of the State of Texas to act as surety on bonds for principals ("Surety"), are held and firmly bound unto the City of Corpus Christi, a Home Rule municipal corporation of Nueces County, Texas ("City" or "OWNER"), and unto all Subcontractors, workers, laborers, mechanics and suppliers as their interests may appear, all of whom shall have a right to sue upon this bond in the penal sum of ONE MILLION, ONE HUNDRED THOUSAND AND NO/100 U.S. Dollars ($ 1,100,000.00 U.S.) to be paid in Nueces County, Texas, for the payment of which sum well and truly to be made, We, said Principal and Surety, bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: Conditions of this bond are such that, whereas, Principal has entered into a certain written contract with the City of Corpus Christi (OWNER), dated the 9TH day of JULY, 2012 which Agreement is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein, for the construction of: ID/IQ MINOR STREET PAVEMENT IMPROVEMENTS CITY-WIDE FY 2010-2011 CONTRACT RENEWAL #1 - PROJECT NO. E12068 (TOTAL RENEWAL AMOUNT: $1,100,000.00) Now, therefore, the condition of this obligation is such, that if said Principal shall well and truly pay all Subcontractors, workers, laborers, mechanics and suppliers, all monies to them owing by said Principals for subcontracts, work, labor, equipment, supplies and materials done and furnished for the construction of improvements of said Agreement, then this obligation shall be and become null and void; otherwise to remain in full force and effect. Surety, for value received, stipulates and agrees that no change to the contract time or contract amount, and no alteration or addition to the terms of the contract, or to the work performed thereunder, or to the plans, specifications, drawings, etc., accompanying the same shall in anywise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract, or to the work to be performed thereunder. (Rev. Date May 2011) Payment Bond Page 1 of 3 Provided further, that this bond is executed pursuant to Chapter 2253, Texas Government Code, as amended. Provided further, that if any legal action be filed on this bond, venue shall lie in Nueces County, Texas. The undersigned agent is hereby designated by the Surety as the Resident Agent in Nueces County to whom any requisite notices may be delivered and on whom service of process may be had in matters arising out of such suretyship, as provided by Sections 3503.001 to 3503.005, Texas Insurance Code, as amended. In witness whereof, said Principal and Surety have signed and sealed this instrument in 4 copies, each one of which shall be deemed an original, this the 18TH day of JULY , 2012. PRINCIPAL SURETY GRACE PAVING & CONSTRUCTION, INC. THE HANOVER INSURANCE COMPANY By: 2 (k By: ,— Attorn(4�S sYf1-Tact MARY ELLEN MOORE Title: PA-e-7-1,,.`ci,j ATTES `` Secretary Address: 4237 BALDWIN BLVD. Address: 10375 RICHMOND AVENUE CORPUS CHRISTI, TEXAS 78409 Sf1TTE 1050 HOUSTON, TEXAS 77042 Telephone: 713-243-7072 Fax: 713-243-7076 E-Mail:imbrandt@hanover.com Rev. Date May 2011 Payment Bond Page 2 of 3 Name and address of Resident Agent of Surety in Nueces County, Texas, for delivery of notice and service of process: Name: RANDAL M. LEE Agency: SWANTNER & GORDON INSURANCE AGENCY Address: 500 N. SHORELINE BLVD. , SUITE 1200 (Physical Street Address) CORPUS CHRISTI TEXAS 78401 (City) (State) (Zip) Telephone: 361-883-1711 E-Mail: rml@s-qins.com Note: Bond shall be issued by a solvent Surety company authorized to do business in Texas, and shall meet any other requirements established by law or by OWNER under applicable law. Note: Surety Agent's Original Power of Attorney must be attached hereto. Note: Date of Payment Bond must not be prior to date of contract. END Rev. Date May 2011 Payment Bond Page 3 of 3 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint Steve Addkison,Tami J.Duncan,R.M.Lee,Mary Ellen Moore,Cathleen Hayles and/or Danielle Harris of Corpus,Christi,TX and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for, and on its behalf,and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,undertakings,contracts of indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations in the United States,not to exceed Ten Million and No/100($10,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attorneys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances, contracts of indemnity,waivers of citation and all other writings obligatory In the nature thereof,with power to attach thereto the seal of the Company.Any such writings so executed by such Attorneys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons.'(Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14, 1982- Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents, this 23rd day of January 2012. THE HANOVER INSURANCE COMPANY MASSACHU S BAY INSURANCE COMPANY CITIZENS I CEPANY OF AMERICA • 6 tie)) rats Robert omas,Vice President 410 410 ,- THE COMMONWEALTH OF MASSACHUSETTS ) ra "j', vice P'T" COUNTY OF WORCESTER )ss. On this 23rd day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. BARBARA A.GARLICK Notary PubiC �� w 4. rpmeatos d7Al"Spt.1 1 1�//%�G)�i. 4241 w�pq,��5pC71,M1t -f " Barbara A.Garlick,Notary Public My Commission Expires September 21,2018 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile.' (Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 18TH day of JULY 2012 , THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA 4InMargosian,Vice President Hanover Insurance Groups IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a Para obtener informacion o para someter complaint: una queja: You may call Hanover Insurance Usted puede Ilamar al numbero de Company's toll-free telephone number telefono gratis de Hanover Insurance for information or to make a complaint at: Company para informacion or para someter una queja al: 1-800-608-8141 1-800-608-8141 You may also write: Hanover Insurance Company Usted tambien puede escribir: Premier Place Hanover Insurance Company Suite 850 Premier Place 5910 North Central Expressway Suite 850 Dallas,Texas 75206 5910 North Central Expressway Dallas,Texas 75206 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or Puede communicarse con el complaints at Departamento de Seguros de Texas para obtener informacion acerca de 1-800-252-3439 companias, coberturas, derechos o quejas al You may write the Texas Department of Insurance at: 1-800-252-3439 P.O. Box 149104 Austin,TX 78714-9104 Puede escribir al Departamento de FAX#(512)475-1771 Seguros de Texas Web: httq://www.tdi.state.tx.us P.O. Box 149104 Email: Austin,Texas 78714-9104 ConsumerProtection©tdi.state.tx.us FAX#(512)475-1771 Web: httq://www.tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Email: Should you have a dispute concerning ConsumerProtection@tdi.state.tx.us your premium or about a claim you should contact the agent or the company DISPUTAS SOBRE PRIMAS 0 first. If the dispute is not resolved, you RECLAMOS: Si tiene una disputa may contact the Texas Department of concerniente a su prima o a un reciamo, Insurance. debe comunicarse con el agente o la compania primero. Si no se resuelve la ATTACH THIS NOTICE TO YOUR disputa, puede entonces comunicarse POLICY: This notice is for information con el departamento(TDI). only and does not become a part or condition of the attached document. UNA ESTE A VISO A SU POLIZA: Este aviso es solo para proposito de informacion y n se convierte en parte o condicion del documento adjunto. 221-4828 (7-07) Telephone : City of Corpus Christi NOTE: Do not detach bid from other papers. Fill in with ink and submit complete with attached papers. (Revised August 2000) SUPPLIER NUMBER TO BE ASSIGNED BY CITY PURCHASING DIV CITY OF CORPUS CHRISTI DISCLOSURE OF INTEREST City of Corpus Christi Ordinance 17112, as amended, requires all persons or firms seeking to do business with the City to provide the following information. Every question must be answered. If the question is not applicable, answer with "NA". See reverse side for Filing Requirements, Certifications and definitions. COMPANY NAME: ,476. K< ,4 [1 7Z,2 '2.-w //it Lt 6 P. O. BOX: zi3 `/ P1Gt l d v tm 640-f STREET ADDRESS: La) �t; ,,,L _ CITY: ,1 �s_. ZIP: `J�jzie?:5: 3.32 5/0t t ( FIRM IS: 1. Corporation 2. Partnership3.Sole Owner 0 4. Association L 5. Other 8 DISCLOSURE QUESTIONS If additional space is necessary, please use the reverse side of this page or attach separate sheet. 1. State the names of each "employee" of the City of Corpus Christi having an `ownership interest" constituting 3% or more of the ownership in the above named "firm." Name / A Job Title and City Department (if known) 2. State the names of each "official" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name I Title 3. State the names of each "board member" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Board, Commission or Committee /4 4. State the names of each employee or officer of a "consultant" for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Namedk) ! Consultant Proposal Form Page 10 of 11 I FILING REQUIREMENTS If a person who requests official action on a matter knows that the requested action will confer an economic benefit on any City official or employee that is distinguishable from the effect that the action will have on members of the public in general or a substantial segment thereof, you shall disclose that fact in a signed writing to the City official, employee or body that has been requested to act in the matter, unless the interest of the City official or employee in the matter is apparent. The disclosure shall also be made in a signed writing filed with the City Secretary. [Ethics Ordinance Section 2-349 (d)] CERTIFICATION I certify that all information provided is true and correct as of the date of this statement, that I have not I knowingly withheld disclosure of any information requested; and that supplemental statements will be promptly submitted to the City of Corpus Christi, Texas as changes occur. • Certifying Person: t c: /11 ok'i i Title: h �i eCk,Z - (Type or Print) Signature of Certifying 11�v, Date: ,?'l h Person: DEFINITIONS a. "Board member." A member of any board, commission, or committee appointed by the City Council of the City of Corpus Christi, Texas. b. "Economic benefit". An action that is likely to affect an economic interest if it is likely to have an effect on that interest that is distinguishable from its effect on members of the public in general or a substantial segment thereof. ' c. "Employee." Any person employed by the City of Corpus Christi, Texas either on a full or part-time basis, but not as an independent contractor. d. "Firm." Any entity operated for economic gain, whether professional, industrial or commercial, and whether established to produce or deal with a product or service, including but not limited to, entities operated in the form of sole proprietorship, as self-employed person, partnership, corporation, joint stock company, joint venture, receivership or trust, and entities which for purposes of taxation are treated as non-profit organizations. e. "Official."The Mayor, members of the City Council, City Manager, Deputy City Manager, Assistant City ' Managers, Department and Division Heads, and Municipal Court Judges of the City of Corpus Christi, Texas. ' f. "Ownership Interest." Legal or equitable interest, whether actually or constructively held, in a firm, including when such interest is held through an agent, trust, estate, or holding entity. "Constructively held" refers to holdings or control established through voting trusts, proxies, or special terms of 1 venture or partnership agreements." g. "Consultant."Any person or firm, such as engineers and architects, hired by the City of Corpus Christi for the purpose of professional consultation and recommendation. Proposal Form Page 11 of 11 I -..mIN GRAPACI OP ID: TERE '►collo~ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/18/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 361-883-1711 CONTACT Swantner&Gordon Ins Agcy-CC r ONE Renee Terrell -- _---.TFAX A Higginbotham Company 361-844-0101 (AIc.No E :361-883-1711 _ J(NC,N.&361-844-0_101 _ PO Box 870 MASS: s- ins.com __ Corpus Christi,TX 78403-0870 -- g -- Steve Addkison INSURER(S)AFFORDING COVERAGE NAIC# National Fire Ins Co--Hartford INSURER A: 20478 INSURED Grace Paving&Construction, INSURER B:American Cas Co Reading PA ____ _ 20427_--- INSURER Continental Casualty Co. 4237 Baldwin Blvd. INSURE ._ ___—__ —_-- 20443__ _ Corpus Christi,TX 78405-3324 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ' ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INS pRANCE INSR I5ND POLICY NUMBER (MM/DDM'YY) (MM/DD/YYYY) LIMITS GENERAL UABILITY ,V EACH OCCURRENCE I$ 1,000,000 A X COMMERCIAL GENERAL LIABILITY INS5084615983 07/12/12 07/12/13 DAMAGE TO REN rhoPREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE X OCCUR 7 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 __ __ GENERAL AGGREGATE $ . 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER r PRODUCTS_COMP/OP AGG $ 2,000,000 POLICY I JECO- ^LOC Y — - - -,$ ---- AUTOMOBILE UABILITY COMBINED SINGLE LIMIT (Ea accident) , $ 1,000,000 A X ANY AUTO BA5084615949 07/12/12 07/12/13 BODILY INJURY(Per person) $ / ALL OWNED I SCHEDULEDBODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) X UMBRELLA LIAB X OCCUR 17— EACH OCCURRENCE $ 5,000,000 C EXCESS UAB CLAIMS-MADE CUP5084615952 07/12/12 07/12/13 AGGREGATE $ V 5,000,000 10,000 DED X RETENTIONS � ----- -------- --__.__._—._a_-- _-- WORKERS COMPENSATION WC STATU- I I0TH- AND EMPLOYERS'UABILITY X TORY LIMITSl_�_ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE WC5084615966 07/12/12 07/12/13 E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N NIA -- - --- ------ (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ / 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) �eim^'i-1 / RE: Project No. E12068 Minor Street Pavement Improvements City-Wide FY 2010-2011 Complete Certificate Holder name: City of Corpus Christi, its officers, officials, employees, volunteers & elected representatives. See attached addendum for additional policy provisions including 30DNOC. CERTIFICATE HOLDER CANCELLATION CICC-CO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Corpus Christi ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Services Contract Administrator AUTHORIZED REPRESENTATIVE P.O.Box 9277 ,Corpus Christi,TX 78469-9277 eet.. ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD GRAPACI PAGE 2 NOTEPAD INSUREDS NAME Grace Paving&Construction, OP ID: TERE DATE 07/18/12 The General Liability policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a ritten contract between the insured and certificate holder that requires it. (Contractors General Liability Extenstion Endorsement - Form G18652I 07/09) . The General Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the insured and certificate holder that requires such status. (Blanket - .ditional Insured - Owners, Lessees or Contractors - With Products - Completed Operations Coverage - Form G140331C 10/10) . The General Liability policy includes Primary 6 Non-Contributory on the Contractors General Liability Extension endorsement - Form G18652I 07/09. The Auto Liability policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a ritten contract between the insured and certificate holder that requires it. (Waiver of Transfer of Rights of Recovery - Form CA 04 44 03/10) . The Auto Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the insured and certificate holder that requires such status. (Texas ditional Insured - Form CA 04 03 06/04) . The Workers' Compensation policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the insured and certificate holder that requires it. (Texas Waiver of Our Right to Recover From Others Endorsement - Form C 42 03 04 A 01/00) . D !NOTEPAD: NDLDERCODE CICO-CO GRAPAC1 -- - PAGE 3—INSURED'S NAME Grace Paving&Construction, OP ID:TERE DATE 07/18/12 The Workers'Compensation policy includes an endorsement providing that 30 days notice of cancellation will be furnished to the(certificate holder except 10 days notice of nonpayment 07 premium.(Texas Notice of Material WG Change Endorsement-Form ( )-001. The Gengral Liability policy includes an endorsement providing that 30 days notice of cancellation will be furnished to the certificate holder except 10 days notice of nonpayment of premium.(Texas Changes-Amendment of Cancellation Provisions or Coverage Change-Form CG 02 05 12/04). The Auto policy incl des an endorsement providing that 30 days notice of cancellation will be furnished to the certificate holder except 10 days notice of nonpayment of premium.(Texas Cancellation Provision or Coverage Change Endorsement-Form CA 02 44 06104). Grace Paving&Construction, Inc. G-140331-C CNA Policy aINS5084615983 (Ed.10/10) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. \/ BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE endorsement modifies insurance provided under the foNowing:7us : COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by"written contract'per Paragraph A. below.) i Locations of Covered Operations (As per the'written contract,'provided the location is within the'coverage territory"of this Coverage Part) A. Section II-Who is An Insured is amended to include 2. We will not provide the additional insured any as an additional insured: broader coverage or any higher limit of insurance 1. Any person or organization whom you are than the least that is: required by "written contract" to add as an a. Required by the"written contract": additional insured on this Coverage Part;and b. Described in 8.1.above;or 2. The particular person or organization, if any, . scheduled above. c. Afforded to you under this policy. B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance A limited as foNows: available to the additional insured whether on a primary, excess, contingent or any other basis. 1. The person or organization is an additional But if required by the 'written contract,' this insured only with respect to liability for "bodilyinsurance will be primary and non-contributory 1 injury," 'property damage,' or "personal and relative to insurance on which the additional advertising injury"caused in whole or in part by: insured Is a Named Insured. a. Your acts or omissions;or 4. The insurance provided to the additional insured does not apply to "bodily injury." 'property b. The acts or omissions of those acting on your damage." or "personal and advertising in)ury behalf arising out of: WINS in the performance of your ongoing operations a. The rendering of,or the failure to render, any specified in the'written contract";or professional architectural, engineering, or ale c. "Your work" that is specified in the "written surveying services,including: as contract' but only for `bodily injury" or aiss "property damage" included in the "products- (1) The preparing, approving, or failing to completed operations hazard,"and only if: prepare or approve maps,shop drawings, opinions, reports, surveys, field orders, ems (1) The "written contract' requires you to change orders or drawings and provide the additional insured such specifications;and ow coverage;and (2) Supervisory, inspection, architectural or MN MN (2) This Coverage Part provides such engineering activities;or coverage. G-140331-C includes copyngrted material of Insurance Services Office.inc..with its permrseion Page 1 of 2 (Ed. 10/10) Y G-140331-C (Ed. 10/10) b. Any premises or work for which the additional We have no duty to defend or indemnify an insured is specifically fisted as an additional additional insured under this endorsement until we insured on another endorsement attached to receive from the additional insured written notice this Coverage Part. of a claim or"suit' C. SECTION IV-COMMERCIAL GENERAL UABILITY 2. With respect only to the insurance provided by this CONDITIONS is amended as follows: endorsement, the first sentence of Paragraph 4.a. of the Other Insurance Condition is deleted and 1. The Duties In The Event of Occurrence, replaced with the following: Offense, Claim or Suit condition is amended to add the following additional conditions applicable 4. Other Insurance to the additional insured: a. Primary Insurance An additional insured under this endorsement wit This insurance is primary and non- as soon as practicable: contributory except when rendered (1) Give us written notice of an "occurrence" or excess by endorsement G-140331-C, or an offense which may result in a claim or when Paragraph b.below applies_ "suir under this insurance, and of any claim d or'suit'that does result Only for the Pu rpose of the insurance provided by this endorsement. SECTION V - DEFINITIONS is (2) Except as provided in Paragraph 8.3 of this amended to add the following definition: endorsement, agree to make available any "Written contract" means a written contract or written other insurance the additional insured has for a loss we cover under this Coverage Part; agreement that requires you to make a person or organization an additional insured on this Coverage (3) Send us copies of all legal papers received, Part,provided the contract or agreement: and otherwise cooperate with us in the investigation, defense, or settlement of the 1. Is currently in effect or becomes effective during daim or"suit';and the term of this policy;and (4) Tender the defense and indemnity of any 2. Was executed prior to: daim or "suit' to any other insurer or self a. The"bodily injury"or'property damage":or insurer whose policy or program applies to a b The offense that caused the loss we cover under this Coverage Part. But 'personal and if the'written conlracr requires this insurance advertising injury" to be primary and non-contributory, this for which the additional insured seeks coverage provision (4) does not apply to insurance on under this Coverage Part. which the additional insured is a Named Insured. G-140331-C Includes copyrighted matertal of Insurance Services office,Inc.,with its permission Page 2 of 2 (Ed. 10/10) Grace Paving 8 Const ction, Inc. G-18652-I CNA Policy* INS5084615983 (Ed.07109) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' GENERAL LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part. SCHEDULE Coverages are summarized below. For particulars and limitations affecting each coverage. please refer to the corresponding policy provisions in the body of this endorsement 1. Miscellaneous Additional Insureds 13. Liberalization Clause 7 additional insured extensions. 14. Unintentional Failure To Disclose Hazards 2.• Employees As insureds-Health Care Services 15. Notice of Occurrence 3. Joint VenturestPartnership/Llmlted Ltablllty 16. Broad Knowledge of Occurrence Companies Coverage for your interest in such terminated or ended 17. Aggregate Limits Per Project organizations. 18. Bodily injury-Extension of Coverage 4. Expanded Personal And Advertising Injury 19. Expected Or Intended injury 5. Medical Payments Reasonable force-bodily injury or property damage. Limits increased to$15,000. Reporting increased to three years from the .20. Wrap-Up Extension date of accident. 21. Contractual Uabllity-Railroads 6. Legal Uabillty And Borrowed Equipment Expanded definition of'insured contract.' Extended perils. 22 Blanket Waiver of Subrogation Limit increased to$200,000 for Damage to Premises (/Waiver of subrogation where required by written Rented To You contract or written agreement. 7. Non-owned Watercraft 23. In Rem Actions Increased to 55 feet. 8. Non-owned Aircraft Coverage E9. Contractual Liability For Personal And Advertising injury 10. Supplementary Payments Cost of bail bonds increased to$2,500. Daily loss of earnings Increased to$1,000. 11. Liquor Uability Coverage Extension 12. Newly Formed Or Acquired Organizations Coverage extended to the end of the policy period. MUM alts OMNI Miss m. Tato MEI G-18652-I Indudee copyrighted material of insurance Services office.Inc.,wail its permission. Page 1 of 8 (Ed.07/09) G-18652-1 (Ed.07109) 1. MISCELLANEOUS ADDITIONAL INSUREDS b. Controlling Interest Section II Who Is An Insured is amended to Include Any persons or organizations with a as an insured any person or organization (called controlling interest in you but orgy with additional insured) described in Paragraphs 2.a. respect to their liability arising out of: through 2.g. below whom you are required to add as (1) Their financial control of you;or an additional insured on this policy under a written contract or written agreement. However, the wntten (2) Premises they own, maintain or contract or written agreement must be: control while you lease or occupy 1. Currently in effect or becoming effective these premises. during the term of this policy;and This insurance does not apply to structural alterations, new construction 2. Executed prior to the "bodily injury,""property and demolition operations performed by damage" or "personal injury and advertising or for such additional Insured. injury.'but c. Managers or Lessors of Premises Only the following persons or organizations are additional insureds under this endorsement and A manager or lessor of premises but only coverage provided to such additional insureds is with respect to liability arising out of the limited as provided herein: ownership, maintenance or use of that a. State or Governmental Agency or specific part of the premises leased to Subdivision or Political Subdivisions cu and subject to the following additional exclusions: A state or governmental agency or This insurance does not apply to: subdivision or political subdivision subject to the following provisions: (1) Any "occurrence" which takes place after you cease to be a tenant in that (1) This insurance applies only with pfem1SeS;Or respect to the following hazards for which the state or governmental (2) Structural alterations, new agency or subdivision or political construction or demolition operations subdivision has issued a permit or performed by or on behalf of such authorization in connection with additional insured. premises you own, rent, or control d. Mortgagee,Assignee or Receiver and to which this insurance applies: (a) The existence, maintenance. A mortgagee, assignee or receiver but repair, construction, erection, or only with respect to their liability as removal of advertising signs, mortgagee, assignee, or receiver and awnings, canopies, cellar arising out of the ownership, g p maintenance, or use of a premises by entrances,coal holes,driveways, you. manholes, marquees, hoistaway openings, sidewalk vaults, street This insurance does not apply to banners, or decorations and structural alterations. new construction or similar exposures;or demolition operations performed by or for (b) The construction, erection, or such additional insured. removal of elevators;or e. Owners/Other Interests - Land Is Leased (2) This insurance applies only with respect to operations performed by An owner or other interest from whom you or on your behalf for which the land has been leased by you but only with state or governmental agency or respect to liability arising out of the subdivision or political subdivision ownership, maintenance or use of that has issued a permit or authorization. specific part of the land leased to you and This insurance does not apply to "bodily sublect to the following additional exclusions: injury,' "property damage" or "personal and advertising injury" arising out of This insurance does not apply to: operations performed for the federal (1) Any government,state or municipality. "occurrence" which takes place after you cease to lease that land;or G-18652-I Includes copyrighted material of Insurance Services Office.Inc,wit its permission. Page 2 of 8 (Ed.07109) G-18652-I (Ed.07/09) (2) Slnictural alterations, new required by written contract or written construction or demolition operations agreement, we will consider any performed by or on behalf of such other insurance maintained by the additional insured. additional Insured for injury or f. Co-owner of Insured Premises damage covered by this endorsement to be excess and noncontributing A co-owner of a premises co-owned by with this insurance. you and covered under this insurance but 2. EMPLOYEES AS INSUREDS - HEALTH CARE only with respect to the co-owners liability SERVICES as co-owner of such premises. Paragrapg. Lessor of Equipment Insured is ddeleted d) of Section II - Who Is An Any person or organization from whom 3. JOINT VENTURES 1 PARTNERSHIP / LIMITED you lease equipment. Such person or LIABILITY COMPANY COVERAGE organization are insureds only with respect to their liability arising out of the A. The following is added to Section II- Who Is An maintenance, operation or use by you of Insured: equipment leased to you by such person 4. You are an insured when you had an interest or organization. A person's or in a joint venture, partnership or limited organization's status as an insured under liability company which terminated or ended this endorsernent ends when their written contract or written agreement with you for prior to or during this policy period but only to such leased equipment ends. the extent of your interest in such joint venture, partnership or limited liability With respect to the insurance afforded company.This coverage does not apply: these additional insureds, the following a. Prior to the termination date of any joint additional exclusions apply: venture, partnership or limited liability This insurance does not appy: company:or (1) To any "occurrence" which takes b. If there Is other valid and collectible place after the equipment lease Insurance purchased specifical y to insure expires;or the partnership, joint venture or limited (2) To"bodily injury""property damage,' liability company. • or "personal and advertising injury' c. To a joint venture, partnership or limited arising out of the sole negligence of liability company which is or was insured such additional insured. under a "consolidated (wrap-up) I Any insurance provided to an additional insured insurance program.' § designated under Paragraphs a.through g.above 'Consolidated (wrap-up) insurance program" does not appy to "bodily injury" or "property means a construction, erection or demolition damage'included within the 'products-completed project for which the prime contractodproject operations hazard,' manager or owner of the construction project As respects the coverage provided under this has secured general liability insurance r provision, Paragraph 4.b.(1) of Section IV - subcontractorssucntr some or all involvedf the contractors t Commercial General Liability Conditions Is otherwise ref tasin the nrojecd deleted and replaced with the following: Insurance rPrograd to O. .In Owner Controlled Insurance Program (O.C.LP.) or Contractor MN mom 4. Other Insurance Controlled Insurance Program(C.C.I.P•). =Et b. Excess Insurance B. The last paragraph of Section II - Who Is An NISInsured is deleted and replaced by the foltowing: = (1) This insurance is excess over: t Except as provided in Paragraph 4. above, no — Any other insurance naming the person or organization is an insured with respect Is .es additional insured as an Insured to the conduct of any current or past partnership, awhether primary, excess, contingent joint venture or imited liability company that is not S or on any other basis unless a written shown as a Named Insured in the Declarations. sum contract or written agreement EOM specifically requires that this r insurance be either primary or primary and noncontributing. Where G-18652-I Includes copyrighted material or Insurance Services Office,inc.,with its permission. Page 3 of 8 (Ed.07109) G-18652-I (Ed,07/09) 4. EXPANDED PERSONAL AND ADVERTISING (1) $15,000;or INJURY (2) The amount shown in the A. The following is added to Section V-Definitions, Declarations for Medical Expense the definition of"Personal and advertising injury': Limit. h. Discrimination or humiliation that results in B. This provision S. (Medical Payments) does not injury to the feelings or reputation of a natural apply if Section I - Coverage C Medical person, but only if such discrimination or Payments is excluded ether by the provisions of humiliation is: the Coverage Part or by endorsement. (1) Not done intentionally by or at the C. Paragraph 1.a.(3)(b)of Section I-Coverage C- direction of Medical Payments,is replaced by the following: (a) The insured:or (b) The expenses are incurred and reported to us within three years of the date of the accident; (b) Any "executive officer," director. and stockholder, partner, member or manager(if you are a limited liability 6. LEGAL UABILITY AND BORROWED EQUIPMENT company)of the Ensured;and A. Under Section I - Coverage A- Bodily Injury (2) Not directly or indirectly related to the and Property Damage 2. Exclusions. Exclusion employment, prospective employment. j.is replaced by the following_ past employment or termination of employment of any person or persons by "Property damage"to: any insured. (1) Property you own,rent,or occupy; B. Exclusions of Section I-Coverage B-Personal (2) Premises you sell, give away or and Advertising Injury Liability is amended to abandon, if the 'property damage" include the following: arises out of any part of those Discrimination Relating To Room, Dwelling premises; or Premises (3) Property loaned to you: Caused by discrimination directly or indirectly (4) Personal property in the care, related to the sale, rental, lease or sub-lease custody or control of the insured; or prospective sale, rental,lease or sub-lease of any room,dwelling or premises by or at the (5) That particular part of real property direction of any insured. on which you or any contractors or subcontractors working directly or Fines Or Penalties indirectly on your behalf are Fines or penalties levied or imposed by a performing operations,if the"property governmental entity because of damage' arises out of those discrimination. operations;or D. This provision 4. (EXPANDED PERSONAL AND (6) That particular part of any property ADVERTISING INJURY COVERAGE) does not that must be restored, repaired or apply if Section I-Coverage B-Personal And replaced because "your work" was Advertising Injury Liability is excluded either by incorrectly performed on it. the provisions of the Coverage Part or by Paragraph (2) of this exclusion does not endorsement. apply if the premises are"your work" and 5. MEDICAL PAYMENTS were never occupied, rented or held for rental by you. A. Paragraph 7. Medical Expense Limit,of Section IN-Limits of Insurance is deleted and replaced Paragraphs (1), (3) and (4) of this by the following exclusion do not apply to: 7. Subject to Paragraph 5. above (the Each (i) 'property damage"to tools or Occurrence Limit), the Medical Expense Limit equipment loaned to you if is the most we will pay under Section - 1 - the tools or equipment are Coverage C for all medical expenses not being used to perform because of "bodily injury" sustained by any operations at the time of one person.The Medical Expense Limit is the loss•or greater of: G-18652-I Induces copyrighted material ol insurance Services Office.Inc-.with its permission. Page 4 of 8 (Ed.07109) G-18652-I (Ed.07/09) (6) "property damage' (other (ii) That Is property insurance than damage by fire) to for premises rented to you or premises rented to you or temporarily occupied by you temporarily occupied by you with the permission of the with the permission of the owner;or owner, or to the contents of E. This provision 6. (LEGAL LIABILITY AND premises rented to you for a BORROWED EQUIPMENT) does not apply if period of 7 or fewer Damage To Premises Rented To You Liability consecutive days. A under Section I-Coverage A is excluded either separate limit of insurance by the provisions of the Coverage Part or by applies to Damage To Premises Rented To You as endorsement described in Section III - 7. NON-OWNED WATERCRAFT Limits Of Insurance. Under Section I - Coverage A, Exclusion 2.g., Paragraphs (3), (4), (5) and (6) of this subparagraph (2) is deleted and replaced by the exclusion do not apply to liability following. assumed under a sidetrack agreement. (2) A watercraft you do not own that is: Paragraph (6) of this exclusion does not apply to 'property damage' Included in (a) Less than 55 feet long:and the "products-completed operations (b) Not being used to carry persons hazard." or property for a charge. B. Under Section I - Coverage A - Bodily Injury 8. NON-OWNED AIRCRAFT and Property Damage the last paragraph of 2. Exclusions is deleted and replaced by the Exclusion 2.g. of Section I - Coverage A - Bodily following. Injury and Property Damage, does not apply to an aircraft you do not own,provided that: Exclusions c. through n. do not apply to damage by fire to premises while rented to you or 1. The pilot in command holds a currently temporarily occupied by you with permission of effective certificate issued by the duly the owner or to the contents of premises rented to constituted authority of the United States of you for a period of 7 or fewer consecutive days. America or Canada, designating that person as a commercial or airline transport pilot; A separate limit of insurance applies to this coverage as described in Section III - Limits Of 2. It is rented with a trained,paid crew;and Insurance. 3. It does not transport persons or cargo for a C. Paragraph 6. Damage To Premises Rented To charge. You Limit of Section ill-Limits Of Insurance is 9. CONTRACTUAL LIABILITY FOR PERSONAL AND replaced by the following: ADVERTISING INJURY 6. Subject to Paragraph 5. above, (the Each Exclusion e. Contractual Liability of Section I - Occurrence Limit), the Damage To Premises Coverage B is deleted. Rented To You Limit is the most we will pay under Section-I-Coverage A for damages 10. SUPPLEMENTARY PAYMENTS because of "property damage" to any one A. Under Section I - Supplementary Payments - premises while rented to you or temporarily Coverages A and B, Paragraph Lb.,the limit of occupied by you with the permission of the owner, including contents of such premises $250 shown for the cost of bail bonds is replaced rented to you for a period of 7 or fewer by$2,500: consecutive days. The Damage To Premises B. In Paragraph 1.d.,the limit of$250 shown for daily mom Rented To You Limit is the greater of loss of earnings is replaced by$1,000. ems MIN a. $200.000;or 11. LIQUOR UABIUTY s b. The Damage To Premises Rented To Exclusion c.of Section I-Coverage A is deleted. arass You Limit shown in the Declarations. 12. NEWLY FORMED OR ACQUIRED D. Paragraph 4.b.(1KaX11) of Section IV - ORGANIZATIONS Commercial General Liability Conditions Is Paragraph 3.a.of Section II-Who Is An Insured is deleted and replaced by the following: deleted and replaced by the following: G-18652-I Includes copmghled material of Insurance Services Office,Inc.,with its pemnseion. Page 5 of 8 (Ed.07/09) • G-18652-1 (Ed.07/09) Coverage under this provision is afforded only until the under Section I - Coverage C, which can be end of the policy period or the next anniversary of this attributed only to ongoing operations at a single policy's effective date after you acquire or form the construction project away from premises owned organization,whichever is earlier. by or rented to the insured: 13. LIBERALIZATION CLAUSE 1. A separate Single Construction Project N we adopt a change in our forms or rules which would General Aggregate. Limit applies to each broaden coverage for contractors under this oonstruction project away from premises endorsement without an additional premium charge, owned by or rented to theinsured, and that your policy will automatically provide the additional limit is equalthe amount of theaGeneral coverages as of the date the revision is effective in Aggregate Limit t shown in the Declarations. your state. 2. The Single Construction Project General 14. UNINTENTIONAL FAILURE TO DISCLOSE Aggregate Limit is the most we will pay for the HAZARDS sum of alt damages under Coverage A, except damages because of'bodily injury"or Based on our reliance on your representations as to "property damage' included in the 'products- existing hazards, if unintentionally you should fail to completed operations hazard," and for disclose all such hazards at the inception date of your medical expenses under Coverage C policy,we will not deny coverage under this Coverage regardless of the number of: Part because of such failure. a. Insureds; 15. NOTICE OF OCCURRENCE b. Claims made or"suits"brought;or The following is added to Paragraph 2.of Section IV- c. Persons or organizations making claims Commercial General Liability Conditions - Duties or bringing"suits." In The Event of Occurrence,Offense,Claim or Suit: Your rights under this Coverage Part will not be 3. Any payments made under Coverage A for prejudiced if you fail to give us notice of an damages or undershCoverage C for medicalS 'occurrence;offense,claim or'suit"and that failure is Construction expenses Projectll reduce the Single. solely due to your reasonable belief that the 'bodily for thatac General Aggregate Limit injury'or"property damage'is not covered under this for owned bydion rented project away from Coverage Part. However, you shall give written notice Such premises rented to the Gineneral of this 'occurrence,' offense, claim or "suit" to us as ay Limit shall not reduce the General soon as you are aware that this insurance may apply shall tAggregate rduce in the Declarations nor to such'occurrence;offense claim or"suit." shall reduce ce any other Single Construction Project General Aggregate Limit 16. BROAD KNOWLEDGE OF OCCURRENCE for any other separate construction project The followingis added to Paragraph 2.of Section IV- away from premises owned by or rented to the insured. Commercial General Liability Conditions - Duties In The Event of Occurrence,Offense,Claim or Suit: 4. The limits shown in the Declarations for Each us or our authorized representative Occurrence,Damage To Premises Rented To You must giveYou and Medical Expense continue to apply. notice of an'occurrence,'offense. claim,or"suit'only However, instead of being subject to the when the 'occurrence,' offense, claim or 'suit" is General Aggregate Limit shown in the known to: Declarations, such limits will be subject to the (1) You,if you are an individual; applicable Single Construction Project General Aggregate Limit (2) A partner,if you are a partnership; B. For all sums which the insured becomes legally (3) An executive officer or the employee obligated to pay as damages caused by designated by you to give such "occurrences"under Section I-Coverage A,and notice,if you are a corporation;or for all medical expenses caused by accidents (4) A manager, if you are a limited under Section I- Coverage C, which cannot be liability company. attributed only to ongoing operations at a single construction project away from premises owned 17. AGGREGATE UNITS PER PROJECT by or rented to the insured: A. For all sums which the insured becomes legally 1. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences"under Section I-Coverage A,and expenses shall reduce the amount available for all medical expenses caused by accidents under the General Aggregate Limit or the G-18652-1 Includes copyrighted matwiar of Insurance Services Office,Inc..with its permission. Page 6 of 8 (Ed.07/09) G-18652-1 (Ed.07/09) Products-Completed Operations Aggregate Controlled Insurance Programs (O.C.I.P.) or Limit,whichever is applicable;and Contractor Controlled Insurance Programs 2. Such payments shall not reduce any Single (C.C.LP.) is attached to this policy, then it is Construction Project General Aggregate Limit. amended to add the following: C. When coverage for liability arising out of the With respect lo a "consolidated (wrap-up) 'products-completed operations hazard" is were involved,nvo program' projectoin which applyyou are or provided, any payments for damages because of were this exclusion does not to: 'bodily injury' or "properly damage" included in 1. Your liability for "bodily injury,"" "property the "products-completed operations hazard' will damage," or "personal or advertising injury" reduce the Products-Completed Operations that occurs during your ongoing operations at Aggregate limit, and not reduce the General the project, or during such operations of Aggregate Limit nor the Single Construction anyone acting on your behalf. Project General Aggregate Limit. 2. Your liability for "bodily injury' or 'property 0. If a single construction project away from damage' included within the "products- premises owned by or rented to the insured has completed operations hazard'that arises out been abandoned and then restarted, or if the of those portions of the project that are not authorized contracting parties deviate from plans. "residential structures." blueprints, designs, specifications or timetables, the project wilt still be deemed to be the same B. The following is added to Paragraph 4.b.(1) of construction project. Section IV-Commercial General Liability Conditions E. The provisions of Section III - Limits Of This Insurance is excess over: Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. (c) Any of the other insurance whether 18. EXPANDED BODILY INJURY primary, excess, contingent or any other basis that is insurance available to you as Section V - Definitions, the definition of 'bodily a result of your being a participant in a injury"is changed to read: 'consolidated (wrap-up) insurance "Bodily injury"means bodily injury,sickness or disease program; but ony as respects your involvement in that "consolidated (wrap- sustained by a person, including death, humiliation, up)insurance program.' shock, mental anguish or mental injury by that person at any time which results as a consequence of the C. The following is added to Section V - bodily injury,sickness or disease. Definitions: 19. EXPECTED OR INTENDED INJURY "Consolidated (wrap-up) insurance program' means a construction, erection or demolition Exclusion a. of Section I - Coverage A - Bodily project for which the prime contractor/project Injuryry and Property Damage Liability Is replaced by the following: manager or owner of the construction project has secured general liability insurance covering some a. "Bodily injury" or 'property damage" or all of the contractors or subcontractors involved expected or intended from the standpoint in the project,otherwise referred to as an Owner of the insured. This exclusion does not Controlled Insurance Program (O.C.I.P.) or apply to `bodily injury" or 'property Contractor Controlled Insurance Program damage" resulting from the use of (C.C.I.P.). reasonable force to protect persons or "Residential structure`means any structure where MIN prosy. 30%or more of the square foot area is used or is NilII 20. OWNER CONTROLLED INSURANCE PROGRAM, intended to be used for human residency including CONTRACTOR CONTROLLED INSURANCE but not limited to single or multifamily housing, age PROGRAM OR CONSOLIDATED (WRAP-UP) apartments, condominiums, townhouses, co- INSURANCE PROGRAMS operatives or planned unit developments and also m The endorsement EXCLUSION - CONSTRUCTION includes their common areas and/or appurtenant WRAP-UP PROGRAM which is attached to thispolicystructures (including pools, hot tubs, detached es-11711 garages, guest houses or any similar structures). is amended as follows: When there is no individual ownership of units, A. If the endorsement EXCLUSION - residential structure does not include military — CONSTRUCTION WRAP-UP or another housing,college/university housing or dormitories, exclusionary endorsement pertaining to Owner long term care facilities, hotels, or motels. G-18652-I Includes copyrig ried material of Insurance Services Office.Inc.,with Its permission. Page 7 of 8 (Ed.07108) G 18652-I (Ed.07/09) Residential structure also does not include surveys, field orders, change hospitals or prisons. orders or drawings and 2L CONTRACTUAL LIABILITY-RAILROADS specifications;or With respect to operations performed within 50 feet of (b) Giving directions or instructions, railroad property,the definition of"insured contract'in or failing to give them,of the if that is Section V-Definitions is replaced bythe followi the primary cause of injury or D n9 damage; "Insured Contract"means: (2) Under which the insured. if an a. A contract for a lease of premises. architect, engineer or surveyor, However,that portion of the contract for a assumes liability for an injury or lease of premises that indemnifies any damage arising out of the insured's person or organization for damage by fire rendering or failure to render to premises wide rented to you or professional services, including those temporarily occupied by you with listed In (1) above and supervisory, permission of the owner is not an"insured inspection, architectural or contract"; engineering activities. b. A sidetrack agreement; 0:LANKET WAIVER OF SUBGROGATION c. Any easement or license agreement: The Transfer Of Rights Of Recovery Against Others To Us Condition (Section IV-Commercial General d. An obligation, as required by ordinance, Liability Conditions) is amended by the addition of to indemnify a municipality, except in the following connection with work fOr a municipality, We waive any right of recovery we may have against e. An elevator maintenance agreement: any person or organization because of payments we 1. That part of any other contract or make for injury or damage arising out of: agreement pertaining to your business 1. Your ongoing operations;or (including an indemnification of a municipality in connection with work 2. 'Your work' included In the "products- performed for a municipality)under which completed operations hazard.' you assume the tort liability of another However, this waiver applies only when you have party to pay for"bodily injury"or"property agreed in writing to waive such rights of recovery in a damage"to a third person or organization. contract or agreement, and only if the contract or Tort liability means a liability that would agreement: be imposed by law in the absence of any contract or agreement 1. Is in effect or becomes effective during the Paragraph f.does not include that part of term of this policy;and any contract or agreement: 2. Was executed prior to bss. (1) That indemnifies. an architect, 23. IN REM ACTIONS engineer or surveyor for injury or Any action in rem against any vessel owned,operated damage arising out of: by or for, or chartered by or for you will be treated in (a) Preparing, approving or failing to• the same manner as though the action were in prepare or approve maps, shop personam against you, drawings, opinions, reports, G-18652-I Includes copyrighted material of Insurance Services Office,fnc.,with ils permission. Page 8 of 6 (Ed.07/09) POUCY NUMBER: BA5084615949 COMMERCIAL AUTO CA 04 44 0310 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endowment modifies insurance provided under the foibwingr BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect b coverage provided by this wrdomonent,the provisions of the Coverage Farm appy unless modified by the endorsement. This endorsement changes the poacy slfedlw on the inception date of the policy unless another dais is indicated below. Mooed Irnsure& Grace Paving&Construction,Inc. Endorsement EfMaiire Die 07/12112 SCHEDULE Name(a)Of Periwigs)Or may: / AMY PERSON OR ORGANIZATIOrf FOR WHCK / OR WHICH YOU ARE MOM= SY mimes J CONTRACT OR AGRZOIENT TO OBTAIN THIS WAWHR FROM US. YOU MUST AGREE TO THAT R RSOVIRRKIRT PRIORI TO LOSS, 1 Intimation required to complete this Schedule.If not shown above,will be shown in the Declarations. The Transfer Of Nights Of Reodraiy Ambit Mere To de Condition dose not apply to the person(e) or organiztgon(s) shown in the Schedule, but only to the. e xtant that subrogation Is waived prior to the 'accident' or the loss' under a contract with that person or Organization. WWIII 111 Ili go SEEMi allM CA 04 44 0510 Copyright,insurance Services Office,Inc.,2000 Page 1 at 1 POLICY NUMBERS BA5084615949 / COMMERCtAL AUTO CA 04030004 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I TEXAS ADDITIONAL INSURED 7 endorsement modftas Insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement This endorsement changes the policy effective on the Inception date of the policy unless another dale is Indicated below_ Endorsement Effective:07112/12 Countersigned By Named insured: Grace Paving&Construction,Inc. i � (Authorized Representative} SCHEDULE Name and Address of Additional insured ' Any person or organization for whom or which you are required by written contract or agreement. (it no entry appears above, information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) A. Who is An Insured(Section II)is amended to include C. You are authorized to act for the additional Insured as an 'insured' the person(a) or organization(s) named In the Schedule or Declarations In all matters shown In the Schedule,but only with respect to their pertaining to this k!urance. legal llablNly tar ads or omissions of a perewn to D. We wilt mall the irritations, insured named in the whom UabYat}r Coverage la afforded under this Schedule or Declaration,notice of any cancellation Policy. of this poky. If we cancel. we MN give 10 days B. The addlnona, Insured named in the Schedule or notice to the additional Insured, Dedarattone Is not required to pay for any premiums E. The additional insured named in the Sahedttle or policy.stated in the policy or earned from the Any Declarations will retain any right of recovery as a return premium and any dividend, if applicable, claimant under this policy. declared by us shaft be paid to you. CA 0403 0004 Copyright,ISO Properties,Inc.,2003 Pape 1 of 1 POLICY NUMBER: INS5084615983 COMMERCIAL GENERAL LIABILITY CG 02 0512 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS CHANGES - AMENDMENT OF CANCELLATION J PROVISIONS OR COVERAGE CHANGE This endorsement modifies insurance provided under the following: JCOMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part, we agree to mail prior written notice of cancellation or material change to: SCHEDULE 1. Name: Applies Per List Maintained On 2. Address: File By Company 3. Number of days advance noti :3 0 Information required to complete thi Sc dule,if not shown above,will be shown in the Declarations. I = I RIM EEE Mai WM CG 02 0512 04 Copyright, ISO Properties, Inc.,2003 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 A (Ed, t-00) TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the Insurance provided by the policy because Texas Is shown in Item 3.A. ci the Information Page. We have the right to recover our payments from anyone liable for an Injury covered by this policy.We will not enforce our right against the person or organization named In the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described In the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or Indirectly to benefit anyone not named In the Schedule. The premium for this endorsement Is shown In the Schedule. Schedule 1. ( )Specific Waiver Name of person or organization (x)Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations:TEXAS OPERATIONS 3. Premium The premium charge for this endorsement shall be 2 percent of the premium developed on payroll In connection with work performed for the above person(s)or organization(s)arising out of the operations described. 4. Advance Premium I I am II This endorsement changes the policy to which It Is attached and le effective on the date Issued unless otherwise stated. (The Information below la required only when this endorsement Is Issued subeequ.nt to preparation of the policy.) WIR Endorsement Effective 07/12/12 Policy No. WC5084615966 t+ Endorsement No. insured Grace Paving &Construction, Inc. / premium^$ �/IInsurance Company n;ountorsignse by C"Iaitral:1 WC420304A (Ed. 1-00) City of Corpus Christi ENGINEERING Memo To: Veronica Ocanas, Asst. City Attorney From: Sylvia Arriaga, Contract Administrator Re: Construction Contract Documents Project No. E12068 ID/IQ Minor Street Pavement Improvements City-Wide FY 20120-2011 Contract Renewal#1 Date: July 31, 2012 Note this is a Contract Renewal—there is no "Contract Book"for this project Attached are the 4 contract document sets for the above referenced project for your review and execution. The contractor, Grace Paving&Construction, Inc., has an original Power of Attorney on file. Also included is a certificate of insurance,with the required coverages and endorsements. As of July 31, 2012 the bonding company is listed as treasury-certified (Circular 570). And thus, H.B. 3158 requirements are satisfied. The performance and payment bonds will be verified and record of the verification will be filed. 1