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Contract - GCI Construction - 2012-05-14
CONTRACT THIS AGREEMENT is made and entered into this 14th day of May, 2012 , by and between the COSTA MESA SANITARY DISTRICT, hereinafter referred to as "DISTRICT" and, GCI Construction, Inc., a California Corporation, hereinafter referred to as "CONTRACTOR." WITNESSETH That for and in consideration of the promises and agreements hereinafter made and exchanged, DISTRICT and CONTRACTOR mutually agree as follows: 1. Scope of the Work. That CONTRACTOR shall perform all the work and shall provide and furnish all the labor, materials, necessary tools, expendable equipment, and all utility and transportation services required to construct: PROJECT #190 CANYON FORCE MAIN REHABILITATION 2. Labor and Materials. All of said work to be performed and materials to be furnished shall be in strict accordance with the plans and specifications entitled Specifications for PROJECT #190 CANYON FORCE MAIN REHABILITATION, and CONTRACTOR agrees to do everything required by this Contract and the Contract Documents including the plans and specifications and any general conditions. All labor, materials, tools, equipment and services shall be furnished on work performed, and under the direction, administration and subject to the approval of DISTRICT or its authorized representatives. CONTRACTOR warrants that it will not purchase mined construction material for this PROJECT except from a mining operation that is currently identified in the list published pursuant to subdivision (b) of Section 2717 of the Public Resources Code. Refer to the current 3098 list for qualified mining operations at www. consrv. ca .gov /OMR /ab_3098_list/current_ list. 3. Time of Completion. CONTRACTOR agrees to commence the work to be performed under this Contract within five (5) days of receipt of the "Notice to Proceed" and to diligently prosecute the work to completion before the expiration of THIRTY (30) WORKING DAYS from the date of commencement. "Working days" means all calendar days except Saturdays, Sundays, and legal holidays. 4. Time of the Essence. Time is of the essence of this Contract. 5. Liquidated Damages /Delay Damages. It is agreed by the parties hereto that in case the total work called for hereunder in all parts and requirements is not finished or completed within the number of working days as set forth herein, damage will be sustained by the DISTRICT, and that it is and will be impractical and extremely difficult to ascertain and determine the actual damage which the DISTRICT will sustain in the event of and by reason of such delay; and it is therefore agreed the CONTRACTOR will pay to the DISTRICT the sum of TWO HUNDRED FIFTY and 00/100 Dollars ($250.00) per calendar day for each and every day of delay in finishing the work in excess of the number of days prescribed in paragraph 3 and the CONTRACTOR agrees to pay said liquidated damages herein provided for, and further agrees that the DISTRICT may deduct the amount thereof from any monies due or that may become due the CONTRACTOR hereunder. The CONTRACTOR will be granted an extension of time and will not be assessed with liquidated damages for any portion of the delay in completion of the work beyond the time named herein for the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of the CONTRACTOR, including but not restricted to acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strike, and unsuitable weather, or delays of subcontractors due to such causes, provided CONTRACTOR submits timely notification and a written Request for Change Order as required herein. The CONTRACTOR shall within ten (10) days from the beginning of any such delay (unless the DISTRICT shall grant a further period of time prior to the date of final settlement of the Contract) notify the District Engineer in writing of the cause of the delay, and the District Engineer shall extend the time for completing the work if in the District Engineer's judgment the cause so merits. The District Engineer's determination on this matter shall be final and conclusive on the parties hereto. CONTRACTOR shall also be required to submit a written Request for Change Order to District Engineer within fifteen (15) days of the date of such delay. No adjustment shall be allowed for such delay unless strict compliance with this contractual provision is effected. CONTRACTOR's remedy shall be limited to the extra days granted and to any damages that he may be entitled to using the formula agreed to by the parties for all damages as provided in Paragraph 28. 6. The Contract Sum. DISTRICT agrees to pay and CONTRACTOR agrees to accept in full payment for the work above agreed to be done the sum of: one hundred four thousand five hundred forty dollars ($104,540.00). 7. Progress Payments. Prior to the 25th day of the month next following the commencement of the work, there shall be paid to CONTRACTOR a sum equal to 95 percent of the value of the work completed since the commencement of the work as determined by the District Engineer and thereafter prior to the fifteenth day of each successive month as the work progresses. CONTRACTOR shall be paid such sum as will bring the payments up each month to 95 percent of the value of the work completed since the commencement of the work as determined by the District Engineer, less all previous payments, provided that CONTRACTOR submits his request for payment prior to the 25th day of each preceding month. DISTRICT shall make the final payment, if unencumbered, or any part thereof unencumbered, 35 days after the acceptance of the work and the filing of a Notice of Completion. Payments shall be made on demands drawn in the manner required by law, accompanied by a certificate signed by the District Engineer, stating that the work for which payment is demanded has been performed in accordance with the terms of the Contract, and that the amount stated in the certificate is due under the terms of the Contract. Partial payments on the Contract price shall not be considered as an acceptance of any part of the work. 8. Prompt Payments. DISTRICT agrees to promptly make progress payments on undisputed and properly submitted payment requests within thirty (30) days and to comply with the provisions of Public Contract Code Section 20104.50. 9. Retention Securities Pursuant to California Contract Code Section 22300, CONTRACTOR will be entitled to post approved securities with the DISTRICT or an approved financial institution in order to have the DISTRICT release funds retained by the DISTRICT to insure performance of the Contract. 10. Specifications. The Standard Specifications for Public Works Construction, also known as the Greenbook, latest edition, shall be controlling unless a different specification is called out in the Contact Documents, including the Costa Mesa Sanitary District's Standard Plans and Specifications for the Construction of Sanitary Sewers and the PROJECT #190 CANYON FORCE MAIN REHABILITATION. 11. Change Orders. Change order requests shall be submitted to the District Engineer in writing who shall have discretion to determine the merit of the change order request. The District Engineer may approve or disapprove change orders in his discretion except that any change order resulting in an increase of the Contract price shall be co- signed by the District Manager and /or approved by the Board of Directors. No amendments, modifications, or waivers of Contract terms or the Contract Documents, including additional compensation for extra work, will be allowed absent a written Change Order signed by both parties. 12. Prevailing Wage Rates. DISTRICT has ascertained the general prevailing rate of per diem wages and the general prevailing rate for legal holidays and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Contract; and the same has been placed on file with the District Clerk at the District's principal office. Said per diem wages can be obtained on the Internet at http: / /www. dir. ca .gov /disr /DPreWageDetermination htm. Said per diem wages are deemed to include employer payments for health and welfare, pension, vacation, and travel time and subsistence pay, all in accordance with sections 1773.1 and 1773.8 of the Labor Code of the State of California. 13. Discrimination, Minorities, Aliens. The CONTRACTOR shall not unlawfully discriminate nor allow its employees, agents, principals, or subcontractors to unlawfully discriminate against any employee or applicant for employment on the basis of race, religious creed, national origin or sex. 14. Compliance with Davis -Bacon Act. This provision does not apply to this Contract. 15. Payroll Records. The provisions of section 1776 of the Labor Code of the State of California regarding the preparation, maintenance and filing of payroll records are applicable to this Contract. Specifically, each CONTRACTOR and subcontractor shall keep an accurate payroll record, showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by him in connection with the public work. THE CONTRACTOR'S AND SUBCONTRACTOR'S PAYROLL RECORDS SHALL BE SUBMITTED TO THE DISTRICT ENGINEER FOR REVIEW ON A WEEKLY BASIS. THE CONTRACTOR SHALL BE RESPONSIBLE FOR SUBMITTAL OF SUB - CONTRACTOR'S PAYROLL RECORDS. 16. Penalty. CONTRACTOR shall, as a penalty to the DISTRICT, forfeit up to $50.00 for each calendar day or portion thereof for each workman paid (either by him or any subcontractor under him) less than the prevailing rate set forth herein on the work provided for in this Contract, all in accordance with section 1775 of the Labor Code of the State of California. 17. Apprentices. If applicable, the provisions of Labor Code Section 1777.5 requiring the use of apprentices in certain ratios to journeymen are hereby imposed upon CONTRACTOR. 18. Legal Day's Work. In the performance of this Contract, not more than eight (8) hours shall constitute a day's work, and the CONTRACTOR shall not require more than eight (8) hours of labor in a day from any person unless the CONTRACTOR complies will all applicable Labor laws. CONTRACTOR shall conform to Article 3, Chapter 1, Part 7 (section 1810, et seq.) of the Labor Code of the State of California, and it is agreed that the CONTRACTOR shall forfeit to the DISTRICT as a penalty the sum of $25.00 for each workman employed in the execution of this Contract by the CONTRACTOR or any subcontractor for each calendar day during which any workman is required or permitted to labor more than eight (8) hours in any one calendar day and forty (40) hours in any one week in violation of said article. 19. Subcontracting. CONTRACTOR acknowledges that he is aware of the provisions of the "Subletting and Subcontracting Fair Practices Act" (Public Contract Code Section 4100 et seq.) and that he agrees to comply with all applicable provisions thereof. If any part of the work to be done under this Contract is subcontracted, the subcontract shall be in writing and shall provide that all work to be performed thereunder shall be performed in accordance with this Contract. Upon request, certified copies of any or all subcontracts shall be furnished to the District Engineer or DISTRICT. The subcontracting of any or all of the work to be done will in no way relieve the CONTRACTOR of any part of his responsibility under the Contract. Breach of any of the above provisions will be considered a violation of the Contract, and the DISTRICT may: cancel the Contract, assess the CONTRACTOR a penalty of not more than 10 percent of the subcontract involved, or cancel the Contract and assess the penalty. All persons engaged in the work, including subcontractors, will be considered employees of the CONTRACTOR. He will be held responsible for their work. The DISTRICT will deal directly with and make all payments to the CONTRACTOR. 20. Workers' Compensation. CONTRACTOR shall carry Workers' Compensation Insurance and require all subcontractors to carry Workers' Compensation Insurance as required by the Labor Code of the State of California. CONTRACTOR, by executing this Contract, hereby certifies: "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." 21. Drug -Free Work. CONTRACTOR agrees to provide a drug -free workplace in accordance with 24 CFR part 24, sub -part F. Under 24 CFR part 24 sub -part F., the CONTRACTOR will provide certification in writing that it will provide a drug -free workplace by: (a). Publicizing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the action it will take against employees for violation of such prohibition; (b). Establish an ongoing drug -free awareness program to inform employees about - 1. Degrees of drug abuse in the workplace; 2. The policy of maintaining a drug -free workplace; 3. Any available drug counseling, rehabilitation and employee assistance programs; 4. The penalties which may be imposed on employees for drug abuse violations occurring in the workplace. (c). Making it a requirement that every employee to be engaged in the performance of the Contract be given a copy of the statement required by paragraph (a); (d). Notifying employees in the statement required by paragraph (a) that as a condition of employment under the Contract the employee will - 1. Abide by the term of the statement; and 2. Notify the employer in writing of any conviction for a violation of a criminal drug statute occurring in the workplace no later than five (5) calendar days after such conviction. (e). Notify the DISTRICT in writing, within ten (10) calendar days after receiving notice under subparagraph (d) (2) from an employee or otherwise receiving actual notice of such conviction. Employer of said convicted employee must provide notice, including conviction title, to the DISTRICT; (f). Taking one of the following actions, within thirty (30) calendar days of receiving notice under subparagraph (d) (2), with respect to any employee who is so convicted - 1. Taking appropriate action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or 2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State or local health, law enforcement, or other appropriate agency. (g). Making a good faith effort to continue to maintain a drug -free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). 22. Bonds. CONTRACTOR shall, prior to the execution of the Contract, furnish bonds approved by DISTRICT, one in the amount of one hundred percent (100 %) of the Contract price, to guarantee the faithful performance of the work, and the other in the amount of one hundred percent (100 %) of the Contract price to guarantee payment of all claims for labor and materials furnished. This Contract shall not become effective until such bonds are supplied to and approved by DISTRICT. All bonds shall be issued by an admitted surety insurer and the DISTRICT reserves the right to object to any such surety, in accordance with Code of Civil Procedure Section 995.660. 23. CONTRACTOR'S Affidavit. After the completion of the work contemplated by this Contract, CONTRACTOR shall file with the District Engineer his affidavit stating that all workmen and persons employed, all firms supplying materials, and all subcontractors upon the project have been paid in full, and that there are no claims outstanding against the project for either labor or material, except certain items, if any, to be set forth in an affidavit covering disputed claims, or items in connection with a Notice to Withhold, which have been filed under the provisions of the statutes of the State of California. 24. CONTRACTOR'S Waiver. CONTRACTOR agrees to execute a Final Close Out Agreement and Release of All Claims. The execution by CONTRACTOR of the Final Close Out Agreement and Release of All Claims shall constitute a waiver of all claims against DISTRICT under or arising out of this Contract unless otherwise stated in said document. 25. Notice to Proceed. No work, services, material or equipment shall be performed or furnished under this Contract unless and until a "Notice to Proceed" has been given to the CONTRACTOR by the District Engineer and all bonds and certificates of insurance required pursuant hereto have been furnished to and approved by DISTRICT. 26. Termination. A. If CONTRACTOR should fail to comply with any of the provisions hereof, or in the event CONTRACTOR should become the subject of a proceeding under state or federal law for relief of debtors, or if CONTRACTOR makes an assignment for the benefit of creditors, DISTRICT shall have the right to hold CONTRACTOR in default and cancel this Contract in whole or in part. B. Should CONTRACTOR, at any time during the progress of the work, refuse or neglect to supply sufficient material or labor, or fail to comply with any provision of this Contract, DISTRICT shall have the right, without prejudice to any other right or remedy it may have, to provide such materials and labor, or make good such deficiencies as DISTRICT may deem expedient after three (3) days notice in writing, delivered or mailed to CONTRACTOR at his last address on file with DISTRICT, and CONTRACTOR shall be liable for the cost and expense thereof which may be deducted by DISTRICT from any money that may be due CONTRACTOR. C. Without limiting any rights which DISTRICT may have by reason of any default by CONTRACTOR hereunder, DISTRICT reserves the right to terminate this Contract in whole or in part at its convenience. In such event DISTRICT shall compensate CONTRACTOR, subject to deduction for previous payments (i) by reimbursing CONTRACTOR for all actual expenditures and costs incurred in performing under this Contract (ii) by reimbursing CONTRACTOR for all expenditures made and costs incurred with DISTRICT'S prior written approval in settling or discharging outstanding commitments entered into by CONTRACTOR in performing under this Contract and (iii) by paying CONTRACTOR as a profit, insofar as a profit is realized hereunder, an amount equal to the profit on the entire Contract estimated at the time of termination, multiplied by the percentage of completion of the work. In no event, however, will the compensation to CONTRACTOR exceed the total Contract price less payments previously made and less the Contract price of work not terminated. Upon receipt of any notice of termination, CONTRACTOR shall, unless the notice otherwise directs, (i) immediately discontinue the work and the placing of all orders and subcontracts in connection with this Contract, (ii) immediately cancel all existing orders and subcontracts made hereunder and (iii) immediately transferto DISTRICT all materials, supplies, work -in- process, appliances, facilities, equipment, machinery and tools acquired by CONTRACTOR in connection with the performance of this Contract. 27. CONTRACTOR'S Independent Investigation. No plea of ignorance of conditions that exist or that may hereafter exist, or of conditions or difficulties that may be encountered in the execution of the work under this Contract, as a result of failure to make the necessary independent examinations and investigations, and no plea of reliance on initial investigations or reports prepared by District Engineer and /or DISTRICT for purposes of letting this Contract out to bid, will be accepted as an excuse for any failure or omission on the part of the CONTRACTOR to fulfill in every detail all requirements of the Contract Documents. Nor will such reasons be accepted as a basis for any claims whatsoever for extra compensation or for an extension of time. 28. Damages /Extra Work Compensation. The parties have agreed to modify the formula for damages set forth in the Standard Specifications for Public Works Construction. The parties agree that the damage formula shall be used to measure all of CONTRACTOR's damages or extra work required by this job. CONTRACTOR shall be limited to the following: Direct costs Labor Materials Equipment Rental Other Items Subcontracted work Subcontracted work Specialty Subcontracting (required by extra work) Mark -up 20% 15% 15% 15% 10% (first $5000) 5% (work in excess of first $5000) 5% (Provided at least three competitive bids are obtained and contractor selected the lowest bidder) Excluded from recovery shall be so- called "Eichleay damages" including, but not limited to, home office overhead, insurance and bonding costs, lost bonding capacity, lost profits, and lost interest. CONTRACTOR acknowledges that his recovery for damages or. extra work is limited as provided in this paragraph. CONT Initials *14Ki- 29. Other Documents Included. It is further agreed by the parties hereto that the following documents are incorporated into this Contract by reference and are to be read and construed together as the full, complete and integrated terms of this Contract: A. Notice Inviting Bids B. Supplementary Bid Addenda or Bulletins, if applicable C. Proposal Packet D. Standard Specifications for Public Works Construction "Greenbook," latest edition E. Costa Mesa Sanitary District Standard Plans and Specifications for the Construction of Sanitary Sewers F. Construction Plans and Specifications for Project #190 Canyon Force Main Rehabilitation G. Standard Drawings (Costa Mesa Sanitary District Drawings and City of Costa Mesa Drawings) H. Soils Report I. City of Costa Mesa Encroachment Permit J. Faithful Performance Bond K. Payment Bond L. Approved Change Orders, if applicable M. Contractor's Affidavit N. Final Closeout Agreement (if requested by District) and Release of All Claims The documents listed in this Paragraph, including this Contract, shall be known and referred to collectively as the "Contract Documents." 30. Interpretation. In the event of any conflict, inconsistency or incongruity between the provisions of this Contract and the provisions of any of the Contract Document(s) referenced in Paragraph 29 hereof, or amendments thereto, the provisions of this Contract shall control in all respects. 31. Attorney's Fees. If any action at law or in equity is necessary to enforce or interpret the terms of this agreement, the prevailing party shall be entitled to reasonable attorney's fees, costs and necessary disbursements in addition to any other relief to which he may be entitled. If any action is brought against the CONTRACTOR or any subcontractor to enforce a Stop Notice or Notice to Withhold, which names the DISTRICT as a party to said action, DISTRICT shall be entitled to reasonable attorney's fees, costs and necessary disbursements. 32. Additional Costs. CONTRACTOR shall be responsible to reimburse DISTRICT a sum equal to the expenses of administration and legal services required to be expended by DISTRICT in processing Notices to Withhold, Stop Notices, or similar legal documents arising out of a failure of the CONTRACTOR to pay for labor or materials. Said obligation shall be provided for in the payment bond required by the CONTRACTOR. The DISTRICT shall further have the right to offset any such costs and expenses incurred by DISTRICT against any sums owing to CONTRACTOR. 33. Insurance. CONTRACTOR agrees to provide insurance in accordance with the requirements set forth herein. If CONTRACTOR uses existing coverage to comply with these requirements and that coverage does not meet the requirements set forth herein, CONTRACTOR agrees to amend, supplement or endorse the existing coverage to do so. The following coverages will be provided by CONTRACTOR and maintained on behalf of the DISTRICT and in accordance with the requirements set forth herein. Commercial General Liability /Umbrella Insurance. Primary insurance shall be provided on ISO - CGL form No. CG 00 01 11 85 or 88 or equivalent, as determined by District Counsel. Total limits shall be no less than one (1) million dollars per occurrence for all coverages and three (3) million dollars general aggregate. DISTRICT and its employees and agents shall be added as additional insured using ISO additional insured endorsement form CG 20 10 with an edition date prior to 1992 or equivalent, as determined by District Counsel. Coverage shall apply on a primary non- contributing basis in relation to any other insurance or self- insurance, primary or excess, available to DISTRICT or any employee or agent of DISTRICT. Coverage shall not be limited to the vicarious liability or supervisory role of any additional insured. Umbrella Liability Insurance (over primary) shall apply to bodily injury /property damage, personal injury /advertising injury, at a minimum, and shall include a "drop down" provision providing primary coverage above a maximum $25,000.00 self- insured retention for liability not covered by primary policies but covered by the umbrella policy. Coverage shall be on the following form to any underlying coverage. Coverage shall be provided on a "pay on behalf' basis, with defense costs payable in addition to policy limits. There shall be no cross liability exclusion. Policies shall have concurrent starting and ending dates. District Counsel shall have the authority to make determinations on the acceptability of forms of insurance coverage. A determination that the form of coverage is not acceptable shall cause the award to go to the next lowest responsible bidder. Business Auto /Umbrella Liability Insurance. Primary coverage shall be written on ISO Business Auto Coverage form CA 00 01 06 92 including symbol 1 (Any Auto) or equivalent, as determined by District Counsel. Limits shall be no less than one (1) million dollars per accident. Starting and ending dates shall be concurrent. If CONTRACTOR owns no autos, a non -owned auto endorsement to the General Liability policy described above is acceptable. Workers' Compensation /Employers' Liability shall be written on a policy form providing workers' compensation statutory benefits as required by law. Employers' liability limits shall be no less than one (1) million dollars per accident or disease. Employers' liability coverage shall be scheduled under any umbrella policy described above. Unless otherwise agreed, this policy shall be endorsed to waive any right of subrogation as respects the DISTRICT, its employees or agents. CONTRACTOR and DISTRICT further agree as follows 1. This Section supersedes all other sections and provisions of this Contract to the extent that any other section or provision conflicts with or impairs the provisions of this Section. 2. Nothing contained in this Section is to be construed as affecting or altering the legal status of the parties to this Contract. The insurance requirements set forth in this Section are intended to be separate and distinct from any other provision in this Contract and shall be interpreted as such. 3. All insurance coverage and limits provided pursuant to this Contract shall apply to the full extent of the policies involved, available or applicable. Nothing contained in this Contract or any other agreement relating to the DISTRICT or its operations limits the application of such insurance coverage. 4. Requirements of specific coverage features or limits contained in this Section are not intended as a limitation on coverage, limits or other requirements, or a waiver of any coverage normally provided by any insurance. Specific reference to a given coverage feature is for purposes of clarification only and is not intended by any party to be all inclusive, or to the exclusion of other coverage, or a waiver of any type. 5. For purposes of insurance coverage only, this Contract will be deemed to have been executed immediately upon any party hereto taking any steps that can be deemed to be in furtherance of or towards, performance of this Contract. 6. All general or auto liability insurance coverage provided pursuant to this Contract, or any other agreements pertaining to the performance of this Contract, shall not prohibit CONTRACTOR, and CONTRACTOR'S employees, or agents, from waiving the right of subrogation prior to a loss. CONTRACTOR hereby waives all rights of subrogation against DISTRICT. 7. Unless otherwise approved by DISTRICT, CONTRACTOR'S insurance shall be written by insurers authorized to do business in the State of California and with a minimum "Best's" Insurance Guide rating of "AMI ". Self- insurance will not be considered to comply with these insurance specifications. 8. In the event any policy of insurance required under this Contract does not comply with these requirements or is canceled and not replaced, DISTRICT has the right but not the duty to obtain the insurance it deems necessary and CONTRACTOR will promptly reimburse any premium paid by DISTRICT. 9. CONTRACTOR agrees to provide notarized evidence of the insurance required herein, satisfactory to DISTRICT, consisting of certificate(s) of insurance evidencing all of the coverages required and an additional insured endorsement to CONTRACTOR'S general liability and umbrella liability policies (if any) using ISO form CG 20 10 with an edition prior to 1992 or equivalent, as determined by the District Counsel. Certificate(s) are to reflect that the insurer will provide 30 days notice of any cancellation of coverage. CONTRACTOR agrees to require its insurer to modify such certificates of any cancellation of coverage. CONTRACTOR agrees to require its insurer to modify such certificates to delete any exculpatory wording stating that failure of the insurer to mail written notice of cancellation imposes no obligation, and to delete the word "endeavor" with regard to any notice provisions. "'CONTRACTOR agrees to provide complete copies of policies to DISTRICT upon request. 10. CONTRACTOR shall provide proof that policies of insurance required herein expiring during the term of this Contract have been renewed or replaced with other policies providing at least the same coverage. Such proof will be furnished within 72 hours of the expiration of the coverages. 11. Any actual or alleged failure on the part of DISTRICT or any other additional insured under these requirements to obtain proof of insurance required under this Contract in no way waives any right or remedy of DISTRICT or any additional insured, in this or any other regard. 12. CONTRACTOR agrees to require all subcontractors or other parties hired for this project to provide general liability insurance naming as additional insured all parties to this Contract. CONTRACTOR agrees to obtain certificates evidencing such coverage and make reasonable efforts to ensure that such coverage is provided as required here. CONTRACTOR agrees to require that no contract used by any subcontractor, or contracts CONTRACTOR enters into on behalf of DISTRICT, will reserve the right to charge back to DISTRICT the cost of insurance required by this Contract. CONTRACTOR agrees that upon request, all agreements with subcontractors or others with whom CONTRACTOR contracts with on behalf of DISTRICT, will be submitted to DISTRICT for review. Failure of DISTRICT to request copies of such agreement will not impose any liability on DISTRICT, or its employees. 13. If CONTRACTOR is a Limited Liability Company, general liability coverage must be amended so that the Limited Liability Company and its managers, affiliates, employees, agents, and other persons necessary or incidental to its operation are insured. 14. CONTRACTOR agrees to provide immediate notice to DISTRICT of any claim or loss against CONTRACTOR that includes DISTRICT as a defendant. DISTRICT assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve DISTRICT. 34. Indemnification. CONTRACTOR and DISTRICT agree that DISTRICT should, to the fullest extent permitted by law, be fully protected from any loss, injury, damage, claim, lawsuit,_ cost, expense, attorneys fees, litigation costs, defense costs, court costs or any other cost arising out of or in any way related to the performance of this Contract. Accordingly, the provisions of this indemnity provision are intended by the parties to be interpreted and construed to provide the fullest protection possible under the law to the DISTRICT, except for liability attributable to the DISTRICT'S active negligence. CONTRACTOR acknowledges that DISTRICT would not enter into this Contract in the absence of this commitment from CONTRACTOR to indemnify and protect DISTRICT as set forth here. To the fullest extent permitted by law and excepting only the active negligence of DISTRICT, established by a court of competent jurisdiction or written agreement between the parties, CONTRACTOR shall defend, indemnify and hold harmless DISTRICT, its employees, agents and officials, from any liability, claims, suits, actions, arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, actual attorney fees incurred by DISTRICT, court costs, interest, defense costs including expert witness fees and any other costs or expenses of any kind whatsoever without restriction or limitation incurred in relation to, as a consequence of or arising out of or in any way attributable actually, allegedly or impliedly, in whole or in part to the performance of this Contract. All obligations under this provision are to be paid by CONTRACTOR as incurred by DISTRICT. Without affecting the rights of DISTRICT under any provision of this Contract or this Section, CONTRACTOR shall not be required to indemnify and hold harmless DISTRICT as set forth above for liability attributable to the active negligence of DISTRICT, provided such active negligence is determined by agreement between the parties or the findings of a court of competent jurisdiction. This exception will apply only in instances where the DISTRICT is shown to have been actively negligent and not in instances where CONTRACTOR is solely or partially at fault or in instances where DISTRICT'S active negligence accounts for only a percentage of the liability involved. In those instances, the obligation of CONTRACTOR will be for that portion or percentage of liability not attributable to the active negligence of DISTRICT as determined by written agreement between the parties or the findings of a court of competent jurisdiction. The obligations of CONTRACTOR under this or any other provision of this Contract will not be limited by the provisions of any workers' compensation act or similar act. CONTRACTOR expressly waives its statutory immunity under such statutes or laws as to DISTRICT, its employees and officials. CONTRACTOR agrees to obtain executed indemnity agreements with provisions identical to those set forth in this section from each and every subcontractor, sub -tier contractor or any other person or entity involved by, for, with, or on behalf of CONTRACTOR in the performance of the subject matter of this Contract. In the event CONTRACTOR fails to obtain such indemnity obligations from others as required here, CONTRACTOR agrees to be fully responsible according to the terms of this section. Failure of DISTRICT to monitor compliance with these requirements imposes no additional obligations on DISTRICT and will in no way act as a waiver of any rights hereunder. This obligation to indemnify and defend DISTRICT as set forth herein is binding on the successors, assigns, or heirs of CONTRACTOR and shall survive the termination of this Contract or this section. 35. Permits. The CONTRACTOR shall obtain from DISTRICT, City, County, State, Federal or other responsible public agencies all licenses and permits, and pay all fees related thereto, necessary to complete the job. 36. Assignment. No assignment by the CONTRACTOR of this Contract or any part hereof, or of funds to be received hereunder, will be recognized by the DISTRICT unless such assignment has had prior written approval and consent of the DISTRICT and the Surety. 37. Safety and Site Condition. CONTRACTOR shall perform all operations with due regard for safety and in strict compliance with all applicable laws relating thereto. It shall be CONTRACTOR'S responsibility to keep the site in a clean, neat and orderly condition. It shall also be CONTRACTOR'S duty to dust - palliate all working areas and access routes, if applicable. All operations shall be conducted by CONTRACTOR so that no fire hazards are created. 38. Utility Location. DISTRICT acknowledges its responsibilities with respect to locating facilities pursuant to California Government Code Section 4215. 39. Trenching. If this Contract involves digging trenches or other excavations that extend deeper than four feet below the surface, CONTRACTOR shall promptly, and before the following conditions are disturbed, notify the District Engineer in writing, of any: (a) Material that the CONTRACTOR believes may be material that is hazardous waste, as defined in Section 25117 of the Health and Safety Code, that is required to be removed to a Class I, Class Il, or Class III disposal site in accordance with provisions of existing law. (b) Subsurface or latent physical conditions at the site differing from those indicated. (c) 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 Contract. (d) The District Engineer shall promptly investigate the conditions, and if he finds that the conditions do materially so differ, or do involve hazardous waste, and cause a decrease or increase in the CONTRACTOR'S cost of, or the time required for, performance of any part of the work, shall issue a change order in accordance with the procedures described in this Contract. (e) In the event that a dispute arises between District Engineer and the CONTRACTOR whether the conditions materially differ, or involve hazardous waste, or cause a decrease or increase in the CONTRACTOR's cost of, or time required for, performance of any part of the work, the CONTRACTOR shall not be excused from any scheduled completion date provided for by the Contract, but shall proceed with all work to be performed under the Contract. The CONTRACTOR shall retain any and all rights provided either by contract or by law, which pertain to the resolution of disputes and protests between the contracting parties. 40. Notices. The parties hereto agree that all formal notices required by this Contract may be provided to the following persons at the following addresses by sending the same by certified or registered mail as follows: DISTRICT: District Engineer Costa Mesa Sanitary District 628 W. 19th Street Costa Mesa, California 92627 -2716 CONTRACTOR: GCI Construction, Inc. 245 Fisher Ave., Suite B3 Costa Mesa, CA 92626 41. Effect of Invalidity. The invalidity in whole or in part of any provisions hereof shall not affect the validity of any other provision. 42. Gratuities. CONTRACTOR warrants that neither it nor any of its employees, agents or representatives has offered or given any gratuities to DISTRICT'S employees, agents or representatives with a view toward securing this Contract or securing favorable treatment with respect thereto. 43. Conflict of Interest. CONTRACTOR warrants that he has no blood or marriage relationship, and that he is not in any way associated with any architect, engineer or other preparer of the plans and specifications for this project. 44. Copeland "Anti- Kickback" Act. If applicable to this Contract, CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti- Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations, which Act provides that each Contractor shall be prohibited from requiring, by any means, any person employed in the construction, completion or repair of any public work, to give up any part of the compensation to which he is otherwise entitled. 45. Final Closeout Agreement and Release of All Claims. Prior to filing the Notice of Completion the CONTRACTOR and DISTRICT shall execute and record a Final Closeout Agreement and Release of All Claims. 46. Guarantees. CONTRACTOR shall and hereby does guarantee all work for a period of one (1) year after the date of filing of the Notice of Completion and shall repair and replace any and all such work, together with any other work which may be displaced in so doing that may prove defective in workmanship and /or materials within the one (1) year period from date of the filing of the Notice of Completion, without expense whatsoever to the DISTRICT, ordinary wear and tear and usual abuse or neglect excepted. In the event of failure to comply with the aforementioned conditions within five (5) days after being notified in writing, the DISTRICT is hereby authorized to proceed to have the defects repaired and made good at the expense of the CONTRACTOR, who shall pay the cost and charges therefore immediately on demand. 47. Job Progress. CONTRACTOR agrees to maintain a critical path analysis throughout the project. CONTRACTOR agrees to meet with the District Engineer on a weekly or other periodic basis, or as requested by the District Engineer to review job progress. CONTRACTOR agrees to provide District Engineer with critical path analysis documentation wheneverjob progress is impacted so that the completion date may be affected orwhenever delays or other impacts may give rise to CONTRACTOR'S claim for additional days or additional damages. Delay and other claims of damages based on CONTRACTOR'S planned early completion are prohibited. 48. Resolution of Claims. For all claims that are less than Three Hundred and Seventy Five-Thousand Dollars ($375,000.00), the provisions of Public Contracts Code Section 20104 et seq. (Article 1.5 — Resolution of Construction Claims) shall be followed. 49. Notice to Contractor of Claims. DISTRICT shall provide notice to CONTRACTOR upon receipt of any third -party claim related to the Contract. IN WITNESS WHEREOF, the parties hereto have entered into this agreement the date and year first above written. ATTEST: Scott Carroll Clerk of the District APPROVED AS TO FORM: Colin R. Burns Associate District Counsel COSTA MESA SANITARY DISTRICT Scott Carroll General Manager CONTRACTOR Name: GCI Construction, Inc. A California Corporation Address: 245 Fischer Ave . , Ste. B3 sta Mes , CA 92626 APPROVED AS TO CONTENT: By: pe-'iv // T6r D. Gillespie- President Robifflh. fiamers District Engineer STATE OF CALIFORNIA) ss (INDIVIDUAL) /(CORPORATION) COUNTY OF On �l 2012, before me, t e undersigned, a Notary Public in and for said state, personally appeared who proved to me on the basis of satisfactory _ evidence to be the person (481who e name(8) is /ar6 subscribed to the within.- _- instrument and acknowledged to me that heh%hel14rey executed the same in his /her/tbeir authorized capacity(i -_ �, and that by his /lam /their signature,() on the instrument the person(,' or the entity on behalf of which the personKacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public) JANET L. RUSSELL Commission # 1872135 a = -r Notary Public - California Orange County My Comm. Expires Dec 21, 2013 FAITHFUL PERFORMANCE BOND BOND NUMBER 0474330 PAGE 1 PREMIUM: $1,505.00 Bond No. 0474330 EXECUTED IN TRIPLICATE COSTA MESA SANITARY DISTRICT FAITHFUL PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: THAT, WHEREAS, the COSTA MESA SANITARY DISTRICT, a municipal corporation and sanitary district, under the authority of the General Manager, has awarded to CONTRACTOR GCI Construction, Inc. 245 Fisher Ave., Suite B3, Costa Mesa, CA 92626 hereinafter designated as the "Principal ", Contract No. CMSD #190 for the work described as follows: PROJECT #190 CANYON FORCE MAIN REHABILITATION. Said Contract and all of its obligations, covenants, terms and conditions are fully incorporated herein by reference. WHEREAS, the said Principal is required under the terms of said Contract to furnish a bond for the faithful performance of said Contract, including a one year guarantee of the work performed. NOW, THEREFORE, WE, the undersigned CONTRACTOR, as Principal and International Fidelity Insurance Company One Newark Center, 201h Floor, Newark, New Jersey 07102 -5207 (973) 624 -7200 (NAME AND ADDRESS OF SURETY) Duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the Costa Mesa Sanitary District, in the penal sum of: one hundred four thousand five hundred forty dollars ($104,540.00), said sum being not less than one hundred (100°/x) percent of the Contract price for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that, if the above burdened Principal, his 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 the undertakings, terms, covenants, conditions and agreements in the said Contract and any alteration thereof made as therein provided, on his or their part, to be kept and performed, at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the Costa Mesa Sanitary District, its offices and agents, as therein stipulated, then this obligation shall become null and void, otherwise it shall be and remain in full force and virtue. This obligation covers a one year guarantee on work performed after said work has been completed. The one year period shall commence on the date the Notice of Completion has been recorded. In case suit is brought upon this bond, Surety further agrees to pay all court costs and reasonable attorneys' fees as fixed by the court. CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange O before me, Janet L. Russell - Notary Public ate Here Insert Name and T la of the Olficer personally appeared Terry D. Gillespie Names) of Signer(s) JANET L. RUSSELL Commission # 1872135 Notary Public - California z Z ' v D Z `"'' Orange County My Comm. Expires Dec 21, 2013 who proved to me on the basis of satisfactory evidence to be the person( whose name(X) is /t r� subscribed to the within instrument and acknowledged _ to me that he/Mt/X4 executed the same in his/W /tW authorized capacityW), and that by hisJXXM W signature(�o on the instrument the person(, or the entity upon behalf of which the personN) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official V Signatur Place Notary Seal Above 9155nature of Lary Publfc 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: Signer's Name: • Individual ❑ Individual • Corporate Officer — Title(s): ❑ Corporate Officer- Title(s): ❑ Partner -- ❑ Limited ❑ General ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Attorney in Fact ❑ Trustee Top of thumb here ❑ Trustee . Top of thumb here ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: I I Signer Is Representing: 02007 National Notary Assodat on• 9350 De Solo Ave., P.O.Box 2402 -Chatsworth, CA 91313 -2402• %"YmNaganalNotary.or9 Item 45907 Reorder. Call Toll-Free 1- 800.8766827 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of RIVERSIDE On 5 ac' -t )- personally appeared before me, R. NAPPI MICHAEL D. STONG "NOTARY PUBLIC." (Here,inser name and title oftheofficer) who proved to me on the basis.of satisfactory evidence to be the persoR(ga whose name(sf is /are. subscribed to the within instrument and acknowledged to. me that he /sheA4tey+ executed the same in his/Iier�64 -t authorized capacit}�ic4 and that by his/lier/t }eir signature(<on the instrument the personX, or the entity upon behalf of which the person acted, executed the instrument. I .certify under. PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. R. NAPPI WITNESS my hand and official seal. COMM. #1 C Ll 9 Le NOTARYPUBLIC- CALIFORNIA RIVERSID es�une COUNTY My Comm. Expires Signature of Notary Public (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description ofattachcd document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER 0 Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s). ❑ Other 2008 Version CAPA v12.10.07 800 - 873 -9865 www.Notarydassmeom INSTRUCTIONS FOR COMPLETING THIS FORM Any acknotrledgnnent completed in California must contain verbiage .exactly as appears above in the notary, section or a separate acknmviedgment form inust be properly completed and attached to that document. The only exception is if 'a document is to be recorded outside of California. In such instances. an }, alrernathw acknowledgment verbiage as may be printed on.such a docrmnent so long as the verbiage does not require the notary to do something that is illegal fora notary in California (i.e. certifying the aurhoriced capacity of -tire signer). Please check the document carefully for proper notarial wording and attach this form f required • State and County information must be the State and County where the document signer(s) personally appeared before the notary, public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally. appear at the time of notarization. • Indicate.the correct singular or plural forms by crossing off incorrect forms (i.e. #e�shgdwy- is /are) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must oot cover text or lines.. If seal impression smudges, re-seal if 'a .sufficient'area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. ? Additional information is not required but could help to 'ensure this acknowledgment is not misused or attached to ,a different document. Indicate tide ortype of attached document, number of pages and date. 4.6 Indicate the capacity claimed by the signer. if the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document PAYMENT BOND PAGE 1 Bond No. 0474330 BOND NUMBER 0474330 PREMIUM INCLUDED IN PERFORMANCE BOND EXECUTED IN TRIPLICATE COSTA MESA SANITARY DISTRICT PAYMENT BOND (LABOR AND MATERIAL BOND) KNOW ALL MEN BY THESE PRESENTS: THAT, WHEREAS, the COSTA MESA SANITARY DISTRICT, a municipal corporation and sanitary district, under the authority of the General Manager, has awarded to CONTRACTOR GCI Construction, Inc. 245 Fisher Ave., Suite B3, Costa Mesa, CA 92626 hereinafter designated as the "Principal ", Contract No. CMSD PROJECT NO. 190 for the work described as follows: PROJECT #190 CANYON FORCE MAIN REHABILITATION. Said Contract and all of its obligations, covenants, terms and conditions are fully incorporated herein by reference. WHEREAS, said Principal is required by the provisions of said Contract and of the Civil Code to furnish a bond in connection with said Contract, as hereinafter set forth ... NOW, THEREFORE, WE, the undersigned CONTRACTOR, as Principal and International Fidelity Insurance Company One Newark Center, 20th Floor, Newark, New Jersey 07102 -5207, (973) 624 -7200 (Name and Address of Surety) Duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the Costa Mesa Sanitary District, in the penal sum of: one hundred four thousand five hundred forty dollars ($104,540.00), said sum being not less than one hundred (100 %) percent of the estimated amount payable under the terms of the Contract for which payment well and truly be made, we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that, if said Principal or his subcontractors, or the heirs, executors, administrators, successors or assigns thereof, shall fail to pay any of the persons named in Section 3181 of the Civil Code of the State of California for any materials, provisions, provender or other supplies used in, upon, for or about the performance of the work contracted to be done, or for any work or labor performed by any such claimant or any amounts required to be deducted, withheld, and paid over to the Franchise Tax Board from the wages of employees of the CONTRACTOR and his subcontractors pursuant to Section 18806 of the Revenue and Taxation Code, with respect to such work and labor, then said Surety will pay for the same, in an amount not exceeding the sum set forth hereinabove, and in addition, in case suit is brought upon the bond, will pay a reasonable attorney's fee to be fixed by the court. This bond shall inure to the benefit of any and all persons named in the aforesaid Civil Code Section 3181 so as to give a right of action to them or their assigns in any suit brought upon the bond. PAYMENT BOND PAGE 2 0474330 Bond No. Further, the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or modification of the Contract Documents or of the work to be performed thereunder shall in any way affect its obligation on this bond; and it hereby waives notice of any and all such changes, extensions of time, and alterations or modifications of the Contract Documents and /or of the work to be performed thereunder. IN WITNESS WHEREOF, we have hereunto set our hands and seals this 29th day,of MAY '2012. GCI CONSTRUCTION, INC. Contractor Name 245 FISHER AVENUE STE. B -3 Street Address COSTA MESA, CA 92626 City, State, Zip Code PRINCIPA G I C STRUCT ON, INC. By: Compariy Re resentativePXC� pie In accordance with the Contract for PROJECT #190 CANYON FORCE MAIN REHABILITATION, all bonds shall be issued by an admitted surety insurer and the DISTRICT reserves the right to object to any such surety, in accordance with Code of Civil Procedure Section 995.660. By signing below, Surety certifies that the bonds are issued by an admitted surety. INTERNATIONAL FIDELITY INSURANCE COMPANY Name ONE NEWARK CENTER 20TH FLOOR Street Address NEWARK, NEW JERSEY 07102 City, State, Zip Code SURETY INTERNATIO L FIDELITY INSURANCE COMPANY By' Comp•, n Representati MICHAEL/ D. STONG, ATTORNEY -IN- CT APPROVED�AS TO FORM: ?Colin R. Burns, Associate District Counsel Costa Mssa Sanitary District By /s/ CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange ate before me, Janet L. Russell - Notary Public Here Insert Name and Tnle of the Officer personally appeared Terry D. Gillespie Name(s) of Signer(s) JANET L. RUSSELL Commission # 1872135 Notary Public - California z Z ' ' Orange County My Comm. Expires Dec 21, 2013 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person( whose name(X) is /M subscribed to the within instrument and acknowledged to me that he /Mb/Gtr executed the same in his/W /0W authorized capacity ^), and that by his/MtMOt signature( on the instrument the personN, or the entity upon behalf of which the personN) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my qand and off"J�7 e Sign ature C ) Signature of NothW Pubilc OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner -- ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT.THUMBPRINT "�,: =OF SIGNER r.s: Number of Pages: Signer's Name: • Individual • Corporate Officer — Title(s): _ ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact 0 Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: AIGHTTHUMBPRINT .p of thumb here 02007 National Notary Association- 9350 De Solo Ave., P.O.Bm 2402 -Chatsworth, CA 91313- 2402• wwor.NationalNotary.org`Item 95907 Reorder. Cali Toil -Free 1- 800.8766827 CALIFORNIA ALL - PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of "California 'County of RIVERSIDE On S a �� /� before me, R. NAPPI "NOTARY PUBLIC" (Here:insert name and title orthe omcer) personally appeared MICHAEL D. STONG. who proved to me on the basis of satisfactory evidence to be the persoR(g� whose name(>s�ris /are- subscribed to the within instrument and acknowledged to me that he /she*tey+ executed the same in his /hek4wir authorized capacity(ic4 and that by his/MAUoir signatureWon the instrument the personf a , orthe entity upon behalf of Which the personWacted, executed the instrument. I certify "under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. R. NAPP1 WITNESS my hand and official seal. COMM. #1796916 ¢ `a°� NOTARYPUBLIC- CALIFORNIA ` ? My Comm. es COUNTY 2012 Signature of Notary Public (Notary Seal . •' ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached "document) (Title or description ofattached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER Q Iridividual (s) ❑ Corporate Officer (Title) ❑ Partner(s) O Attorney -in =Fact ❑ Trustee(s) ❑ Other 2008 Version CAPA'v12.10.07 800.873 -9865 .vww.No1aTyCIasses.com INSTRUCTIONS FOR - COMPLETING THIS FORM Airy acknotrledgnrent completed in California must contain verbiage exactly as appears abm•e in the notary section or a separate acknowledgment form nntst be properly completed and attached to that document. The oity exception is,if a document is to be recorded outside of California. 'In such instances.. any alternative ackno-tedgnrent verbiage as niav be printed on such a document so long as Lire verbiage does not require die noran. to do something that is illegal for a notary,in, California (i.e. certifying the authorized capacit}, of the signer). Please check =lire document carefully for proper notarial wording and attach this form if regriired. a State and County information must be the State and County where the document signers) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission,fallowed by a comma and then your title (notary public). • Print the name(s) of document signers) who'person6lly, appear at the time of notarization. • Indicate the.correct singular or plural. forms by crossing off incorrect forms (i.e. helshrAher is lace ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary" seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, to -seal if a sufficiencarea permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. -} Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages'and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,'indicate the title'(i:e. CEO, CFO, Secretary). • Securely attach this document to the signed document INORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 Of WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract Project: #190 Canyon Force Main Rehabilitation, GCI Job No. 377. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Endorsement Effective 3/17/2012 Policy No. SWC1008815 Endorsement No. WC 04 03 08 Insured GCI Construction, Inc. Premium $ Insurance Company Security National Insurance Company Countersigned by Best's Credit Rating Center - Company Information for Zurich Insurance Company Limited Ratings & Analysis Center jol For ratings and product access Login I Sign -up Ratings & Analysis v » Home P Methodology » Best's Credit Ratings + • Financial Strength Rating • Issuer Credit Rating • Debt Rating » Advanced Search » About Best's Credit Ratings + N Get a Credit Rating + » Best's Special Reports » Add Best's Credit Ratings Search To Your Site » BestMark for Secure -Rated Insurers » Contact an Analyst » Awards and Recognitions News & Analysis Products & Services Industry Information r Corporate v Regulatory Affairs a Support & Resources s Conferences and Events Find a Best's Credit Rating lEnter a Company Name )� » Advanced Search View Rating De frnitions 1Selectone.. Zurich Insurance Company Limited A.M. Best #: 085095 AIIN #: AA1460190 Address: Mythenquai 2 8002 Zurich, Switzerland Web: www.zurich.com Phone: 41 -44- 625 -25-25 Based on A.M. Best's analysis, 050457 - Zurich Insurance Group Ltd is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Page 1 of 2 Print this page I Assigned to "nant:418bength hating] (companies BEST that have, in A. Superior our opinion, a superior ability to meet their ongoing insurance obligations. View all of the related companies assigned this rating as a single Best's Credit Rating Analyst entity. — Financial Strength Rating View Definition Represents financials for the Japan Branch of this legal entity. Oce: A.M. Best Europe - Rating Services Limited ffi Represents Composite business of this legal entity. 085148 Zurich Insurance Company Ltd CAB Associate Director- Analytics: Samuel Dobbyn Rating: A+ (Superior) Represents financials for the Italy Branch of this legal entity. Senior Director - Analytics: Carlos Wong -Fur Financial Size Category : XV ($2 Billion or greater) Outlook: Stable Action: Affirmed Effective Date: November 18, 2011 U Denotes Under Review Best's Rating Issuer Credit Rating View Definition Long -Term: aa- Outlook: Stable Action: Affirmed Date: November 18, 2011 Related Financial and Analytical Data The following links provide access to related data records that A.M. Best utilizes to provide financial and analytical data on a consolidated or branch basis. 084687 Zuerich IT Service AG Niederlassung fuer Represents financials for the Germany Branch of this legal entity. 091612 Zurich Insurance Co (Beiling Branch) Represents financials for the China Branch of this legal entity. 090544 Zurich Insurance Company JPB Represents financials for the Japan Branch of this legal entity. 085096 Zurich Insurance Company Limited Represents Composite business of this legal entity. 085148 Zurich Insurance Company Ltd CAB Represents financials for the Canada Branch of this legal entity. 084886 Zurich Insurance Co S.A. ITB Represents financials for the Italy Branch of this legal entity. Reports and News Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M. Best Group. I AMB Credit Report - Insurance Professional - includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 5/17/2012 (represents the latest significant change). �� =1r Historical Reports are available in AMB Credit Report - Insurance Professional Archive. Best's Statement File - Global Best's Insurance Reports- Non -US Best's Corporate Changes and Retirements - Life & Non Life, Non -US Best's Corporate Changes and Retirements - UK http: / /www3.ambest.com/ ratings/ entities /CompanyProfile .aspx ?AMBNum= 85095&UR... 6/15/2012 * 8:14:11 AM Best's Credit Rating Center - Company Information for Zurich Insurance Company Ltd CAB Ratings & Analysis Center jai For ratings and product access Login I Sign-up Ratings & Analysis a • Home • Methodology • Best's Credit Ratings + • Financial Strength Rating • Issuer Credit Rating • Debt Rating • Advanced Search » About Best's Credit Ratings + » Get a Credit Rating + • Best's Special Reports • Add Best's Credit Ratings Search To Your Site • BestMark for Secure -Rated Insurers • Contact an Analyst • Awards and Recognitions News & Analysis Products & Services Industry Information s Corporate Regulatory Affairs v Support & Resources v Conferences and Events v Find a Best's Credit Rating Enter a Company Name Jmj » Advanced Search View Rating Definitions Select one... Zurich Insurance Company Ltd CAB A.M. Best M: 085148 AIIN tl: AA1560999 Address: 400 University Avenue Toronto, ON M5G 1 S7 Canada Web: www.zurichcanada.corn Phone: 416 -586 -3000 Fax: 416 -586 -2990 This company is a data record that A.M. Best utilizes to represent the financials for the Canada Branch of 085095 Zurich Insurance Company Limited. Page 1 of 2 kPrint this page Assigned to lananeisil Si—mirigib Hatut companies qcessT that have, in A+ Suporior our opinion, a superior ability to meet their ongoing insurance obligations. View all of the related companies assigned this rating as a single Best's Credit Rating Analyst entity. Financial Strength Rating V iew Definition Office: A.M. Best Europe - Rating Services Limited Associate Director - Analytics: Samuel Dobbyn Rating: A+ (Superior) Senior Director - Analytics: Carlos Wong -Fupuy Financial Size Category : XV ($2 Billion or greater) Outlook: Stable Action: Affirmed Effective Date: November 18, 2011 u Denotes Under Review Best's Ratino Issuer Credit Rating View Definition Long -Term: aa- Outlook: Stable Action: Affirmed Date: November 18, 2011 Reports and News Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M. Best Group. AMB Credit Report - Insurance Professional - includes Best's Financial Strength Rating and rationale along with _ Ib comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 6/14/2012 (represents the latest significant change). tj= I HistoricaV Reports are available in AMB Credit Report - Insurance Professional Archive. 1� Y 10Best's Key Rating Guide Presentation Report - includes Best's Financial Strength Rating and financial data as ) provided in the most current edition of Best's Key Rating Guide products. (Quality Cross Checked). Best's Key Rating Guide - P /C, US & Canada Best's Statement File - Global Best's Insurance Reports - P /C, US & Canada Best's Insurance Reports - Non -US Best's Statement File - P/C Canada Best's Key Rating Guide - Canada Best's Corporate Changes and Retirements - P /C. US /CN Best's Insurance Reports - Online - P /C, US & Canada Best's Insurance Reports - Online - Non -US European Union Disclosures A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) In the European Union (EU). Credit ratings issued by A.M. 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Important Notice: Best's Ratings reflect our independent opinion, based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength, operating performance and business profile. These ratings are neither a warranty of a company's financial strength nor its ability to meet its financial obligations, including those to policyholders. View our entire notice for complete details. http: / /www3.ambest.com/ ratings/ entities /Com panyProfile .aspx ?AMBNum= 85148&UR... 6/15/2012 * 8:14:33 AM Best's Credit Rating Center - Search Results Page 1 Page 1 of 1 Rating Center Home Search Results Page 1 of 1 Results Per Page 20 8 Rated or non -Rated companies found, results sorted by Company Name Criteria Used: Company Name: Company names starting with Zurich Insurance Company Please note: information was found regarding the following company name change: 085096 Zurich Insurance Company was changed to 085096 Zurich Insurance Comoany Ltd on 5/2712009. Information on name changes, mergers, liquidations, and more is available in Best's Corporate Changes and Retirements database. To refine your search, please use our Advanced Search or view our Online Help for more information. I, New Search .I Zurich Insurance Company View results starting with: A B C D E F G H I J K L M N O P O R S T U V W X Y Z[ Reset Ust Company Information Financial Strength Ratings Issuer Credit Ratings Outlook If ` t� Outlook/ AMB# Company Name Rating I C Implication Long -Term Implication Short -Term Domicile 091612 Zurich Insurance Co Bei in Branch NR Not Applicable NR Not Applicable China Insurance - Property/ Casualty (Operating Company - Branch) .... ......._ ... 090544 .. ....... ...... ._.,..... .. ........ ..... .... Zurich Insurance Company JPB NR ... .... ............... Not Applicable ..,.... ...... NR Not Applicable .... .......,._...... ...... -,.... Japan Insurance - Property/ Casualty (Operating Company - Branch) 085095 Zuricii Insurance Company Limited A+ Stable aa- Stable Switzerland Insurance - Property/ Casualty (Operating Company) 085096 Zurich Insurance Company Limited Not Applicable Not Applicable Switzerland Insurance - Composite (Operating Company- Company Consolidated Sub-Group) 085148 Zurich Insurance Company Ltd CAB A+ Stable aa- Stable CA: Ontario Insurance - Property/ Casualty (Operating Company- Branch) 084886 Zurich Insurance Co S.A. ITB NR Not Applicable NR Not Applicable Italy Insurance - Property/ Casualty (Operating Company - Branch) 085260 Zurich Insurance Co South Afica Ltd NR Not Applicable NR Not Applicable South Africa Insurance - Property/ Casualty (Operating Company) 085261 Zurich Ins Company South Africa Ltd NR Not Applicable NR Not Applicable South Africa Insurance - Property/ Casualty (Operating Company - Company Consolidated Sub-Group) Note: Financial Strength Ratings as of 06/13/2012 04:13 PM ES. T. Financial Strength Ratings (FSR) are sometimes assigned to Property /Casually - A.M. Best Consolidated Groups. Please note that Life/Health - A.M. Best Consolidated Groups and $ Company Consolidated Financial Statements are not assigned FSR ratings. * Denotes Under Review Best's Ratings Visit Best's Rating Center for a complete overview of our rating process and methodologies. A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and Its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/48/EC. European Union Disclosures A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006 /48 /EC. Australian Disclosures A.M. Best Credit Ratings are statements of opinion and not statements of fact. They are not recommendations to buy, hold or sell any securities or any other form of financial product, including insurance policies and are not a recommendation to be used to make investment /purchasing decisions. A.M. Best Asia - Pacific Ltd is registered as a Credit Rating Agency in Australia and holds a Financial Services Licence number 411055 under the Corporations Act of 2001. A.M. Best Asia - Pacific Ltd credit ratings and any other related research are not intended for and must not be distributed to any person in Australia other than a wholesale client, as defined in the Corporations Act of 2001, Chapter 7. The A.M. Best websites are not intended for use by Australian users who are not defined as wholesale users. Important Notice: Best's Ratings reflect our independent opinion, based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength, operating performance and business profile. These ratings are neither a warranty of a company's financial strength nor its ability to meet its financial obligations, including those to policyholders. View our entire notice for complete details. Customer Service I Product Support I Member Center I Contact Info I Careers About A.M. Best I Site Map I Privacy Policy I Security I Terms of Use I Legal & Licensing Copyright © 2012 A.M. Best Company, Inc. ALL RIGHTS RESERVED. A.M. Best Worldwide Headquarters, Ambest Road, Oldwick, New Jersey, 08858, U.S A. http: / /www3.ambest.com /ratings /RatingsSearch.asp 6/13/2012 * 1:14:21 PM Best's Credit Rating Center - Company Information for Security National Insurance Company Ratings & Analysis Center jW For ratings and product access Login I Siqn -up Ratings & Analysis a • Home • Methodology • Best's Credit Ratings + • Financial Strength Rating • Issuer Credit Rating • Debt Rating • Advanced Search • About Best's Credit Ratings + • Get a Credit Rating + » Best's Special Reports • Add Best's Credit Ratings Search To Your Site • BestMark for Secure -Rated Insurers • Contact an Analyst • Awards and Recognitions News & Analysis Products & Services Industry Information x Corporate v Regulatory Affairs Support & Resources a Conferences and Events v Find a Best's Credit Rating Enter a Company Name j� » Advanced Search View Rating Definitions [Select one... _ J ] Security National Insurance Company A.M. Best #: 002522 NAIC #: 19879 FEIN #: 756020448 Address: P.O. Box 650771 Dallas, TX 75265 -0771 United States Web: www.amtrustgroup.com Phone: 214- 360 -8000 Fax: 214-360-8097 Page 1 of 2 Print this page Assigned to Firanc'Ial strength Rating) companies 4C .BEST JI that have, in A Eacellant our opinion, an excellent ability to meet their { ongoing insurance obligations_ J Based on A.M. Best's analysis, 051002 - AmTrust Financial Services. Inc is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. View all of the related companies assigned this rating as a single Rest's Credit Rating Analyst entity. Financial Strength Rating View Definition Office: A.M. Best Company Senior Financial Analyst: Brian O'Larte Rating: A (Excellent) Assistant Vice President: Michael J. Lagomarsino, CFA Financial Size Category: IX ($250 Million to $500 Million) Outlook: Stable Action: Affirmed Effective Date: May 29, 2012 u Denotes Under Review Best's Rating Issuer Credit Rating View Definition Long -Term: a Outlook: Stable Action: Affirmed Date: May 29, 2012 ews Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M. Best Group. (� AMB Credit Report - Insurance Professional - includes Best's Financial Strength Rating and rationale along with V comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 6/5/2012 (represents the latest significant change). =i Historical Reports are available in AMB Credit Report - Insurance Professional Archive. i Best's Executive Summary Reports (Financial Overview) - available in three versions, these presentation style `n+ reports feature balance sheet, income statement, key financial performance tests including profitability, liquidity and reserve analysis. Data Status: 2012 Best's Statement File - P /C, US Contains data compiled as of 6/8/2012 Quality cross Checked. Single Company - five years of financial data specifically on this company. Comparison - side -by -side financial analysis of this company with a peer group of up to five other companies you select. Composite - evaluate this company's financials against a peer group composite. Report displays both the average and total composite of your selected peer group. VIBest's Key Rating Guide Presentation Report - includes Best's Financial Strength Rating and financial data as D; provided in the most current edition of Best's Key Rating Guide products. (Quality Cross Checked). AMB Credit Report - Business Professional - provides three years of key financial data presented with colorful charts and tables. Each report also features the latest Best's Ratings, Rating Rationale and an excerpt from our Business Review commentary. Data Status: Contains data compiled as of 6/8/2012 Quaiity Cross checked. Financiafand Analytical Products Al Best's Key Rating Guide - P/C US & Canada Best's Statement File - P /C. US Best's Statement File - Global Best's Insurance Reports- P/C US & Canada Best's State Line - P /C, US Best's Insurance Expense Exhibit (IEE) - P /C, US Best's Schedule F (Reinsurance) - P /C. US Best's Schedule D (Municipal Bonds) - US Best's Corporate Changes and Retirements - P /C, US /CN Best's Schedule P (Loss Reserves) - P /C, US hffp: / /www3.ambesf.com/ ratings/ entities /CompanyProfile .aspx ?AMBNum= 2522&UR... 6/15/2012 * 8:13:02 AM Best's Credit Rating Center - Search Results Page 1 Page 1 of 1 Rating Center Home Search Results Page 1 of 1 Results Per Page 20 4 Rated or non -Rated companies found, results sorted by Company Name Criteria Used: Company Name: Company names starting with Security National Insurance Co To refine your search, please use our Advanced Search or view our Online Help for more information. New Search -I Security National Insurance t View results starting with: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z t Reset List I Company Information � Financial Strength Ratings Issuer Credit Ratings Outlook/ _' (L Outlook/ ' AMB# i Company Name Rating Implication . Long -Term Implication 1' Short-Temt I L Domicile CA: Quebec 087089 Security National Insurance Company NR Not Applicable NR Not Applicable Insurance - Property/ Casualty (Operating Company) ..... ....... ... ............ .. _.,...... .. ....,........... a ............_....,..... 010796 Security National Insurance Company ..... ....'A' ........... a .,.......... ....,............. A Stable ..... ....... _.. ....,........ a Stable _ _................_._ ... US: Florida Insurance - Property/ Casualty (Operating Company) 002522 Security National Insurance Company A Stable a Stable US: Texas Insurance - Property/ Casualty (Operating Company) 067648 Security National Insurance Company Not Applicable Not Applicable CA: Quebec Insurance - Property/ Casualty (Data Consolidation - Company Consolidation) Note: Financial Strength Ratings as of 0611312012 04:12 PM E. S. T. Financial Strength Ratings (FSR) are sometimes assigned to Property /Casualty - A.M. Best Consolidated Groups. Please note that Life /Health - A.M. Best Consolidated Groups $ and Company Consolidated Financial Statements are not assigned FSR ratings. ` Denotes Under Review Best's Ratings Visit Best's Rating Center for a complete overview of our rating process and methodologies. A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/48/EC. European Union Disclosures A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/481EC. Australian Disclosures A.M. Best Credit Ratings are statements of opinion and not statements of fact. They are not recommendations to buy, hold or sell any securities or any other form of financial product, including insurance policies and are not a recommendation to be used to make investment /purchasing decisions. A.M. Best Asia - Pacific Ltd is registered as a Credit Rating Agency in Australia and holds a Financial Services Licence number 411055 under the Corporations Act of 2001. A.M. Best Asia - Pacific Ltd credit ratings and any other related research are not intended for and must not be distributed to any person in Australia other than a wholesale client, as defined in the Corporations Act of 2001, Chapter 7. The A.M. Best websites are not intended for use by Australian users who are not defined as wholesale users. Important Notice: Best's Ratings reflect our independent opinion, based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength. operating performance and business profile. These ratings are neither a warranty of a company's financial strength nor its ability to meet its financial obligations, including those to policyholders. View our entire notice for complete details. Customer Service I Product Support I Member Center I Contact Info I Careers About A.M. Best I Site Map I Privacy Policy I Security I Terms of Use I Legal & Licensing Copyright © 2012 A.M. Best Company, Inc. ALL RIGHTS RESERVED. A.M. Best Worldwide Headquarters, Ambest Road, Oldwick, New Jersey. 08858, U.S.A. http: / /www3.ambest.com /ratings /RatingsSearch.asp 6/13/2012 * 1:13:23 PM Company Profile Page 1 of 2 Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer NAIC #: COMPANY PROFILE California Company ID #: Company Profile Date Authorized in California: 09/27/1943 Company Search Company Information ............................................. ................ ...... ... ....... .... ... ....._. .._ .. ... ......_ Company Search State of Domicile: TEXAS Results SECURITY NATIONAL INSURANCE COMPANY --)Company Information 12790 MERIT DRIVE, SUITE 200 DALLAS, TX 75251 Old Company Names 800 - 777 -2249 Agent for Service Reference Information Old Company Names Effective Date NAIC Group List SECURITY NAIL F INS CO 12/20/1954 Lines of Business i Workers' Compensation Agent For Service Complaint and Request for Action /Appeals KAREN HARRIS Contact Information C/O CORPORATION SERVICE COMPANY 2710 GATEWAY OAKS DRIVE, SUITE 150N Financial Statements PDF's SACRAMENTO CA 95833 -3505 Annual Statements Quarterly Statements Reference Information Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer NAIC #: 19879 California Company ID #: 0857 3 Date Authorized in California: 09/27/1943 License Status: UNLIMITED NORMAL Company Type: Property & Casualty State of Domicile: TEXAS back to top NAIC Group List NAIC Group #: 2538 Amtrust Grp Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AUTOMOBILE BURGLARY COMMON CARRIER LIABILITY FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION back to top Workers' Compensation Complaint and Requests for Action Contact Information Part 1, Complaints and Requests for Action (CRA) If you are seeking information about your workers' compensation insurance policy, you must first submit a Complaint and http: / /interactive.web. insurance. ca. gov /companyprofile /companyprofile ?event =co... 6/13/2012 * 1:20:23 PM Company Profile Page 2 of 2 Request for Action (CRA) to the workers' compensation insurance company using the address below. Phone Number: 212 -220 -7120 Ext: FAX: 212- 220 -7130 E -Mail: elee @amtrustgroup.com WEB Address: www.amtrustgroup.com Mailing Address: [New iden Lane, 6th Floor ork NY 10038 Department Name: Contact Notes: Part 2: Appeals to the Department of Insurance You may contact the department if you disagree with your workers' compensation insurance company's written decision on your CRA. You also must mail a copy of what you send us to your workers' compensation insurance company using the address below. Phone Number: 212 -220 -7120 Ext: FAX: 212- 220 -7130 E -Mail: elee @amtrustgroup.com WEB Address: www.arntrustgroup.com Mailing Address: 59 Maiden Lane, 6th Floor New York NY 10038 Department Name: Appeals Notes: back to top @ 2008 California Department of Insurance http: / /inferactive.web. insurance. ca. gov /companyprofile /companyprofile ?event =co... 6/13/2012 * 1:20:23 PM Best's Credit Rating Center - Company Information for Wesco Insurance Company 1 Ratings & Analysis Center ,j' For ratings and product access Login I Sign -up Ratings & Analysis a • Home • Methodology • Best's Credit Ratings + • Financial Strength Rating • Issuer Credit Rating • Debt Rating • Advanced Search • About Best's Credit Ratings + • Get a Credit Rating + • Best's Special Reports • Add Best's Credit Ratings Search To Your Site • BestMark for Secure -Rated Insurers • Contact an Analyst • Awards and Recognitions News & Analysis Products & Services Industry Information x Corporate a Regulatory Affairs v Support & Resources is Conferences and Events v Find a Best's Credit Rating (Enter a Company Name � ,> Advanced Search ,Vieiv Rating Definitions _- - - . Select ones. Wesco Insurance Company A.M. Best #: 002468 NAIC A: 25011 FEIN ft: 850165757 Address: 59 Maiden Lane 6th Floor New York, NY 10038 United States Web: www.amtrustgroup.com Phone: 212-220-7120 Fax: 212- 220 -7130 Page 1 of 2 L-=.IPnnt this page Assignedto Fi —clitift -9th 1 companies BesT that have, in A Btcaikrd 4 our opinion, an excellent ability to meet their I ongoing insurance obligations. Outlook: • Stable Action: Affirmed Effective Date: May 29, 2012 u Denotes Under Review Best's Relft Issuer Credit Rating View Definition Long -Term: a Outlook: Stable Action: Affirmed Date: May 29, 2012 Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M. Best Group. I AMB Credit Report - Insurance Professional - includes Best's Financial Strength Rating and rationale along with 1! comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 6/5/2012 (represents the latest significant change). Historical Reports are available in AMB Credit Report - Insurance Professional Archive. F—"_, Best's Executive Summary Reports (Financial Overview) - available in three versions, these presentation style hwll reports feature balance sheet, income statement, key financial performance tests including profitability, liquidity and reserve analysis. Data Status: 2012 Best's Statement File - P /C, US Contains data compiled as of 6/8/2012 ouallty cross checked. Single Company - five years of financial data specifically on this company. Comparison - side -by -side financial analysis of this company with a peer group of up to five other companies you select. Composite - evaluate this company's financials against a peer group composite. Report displays both the average and total composite of your selected peer group. Best's Key Rating Guide Presentation Report - includes Best's Financial Strength Rating and financial data as provided in the most current edition of Best's Key Rating Guide products. (Quality Cross Checked). B B B B B B B B B B AMB Credit Report - Business Professional - provides three years of key financial data presented with colorful charts and tables. Each report also features the latest Best's Ratings, Rating Rationale and an excerpt from our Business Review commentary. Data Status: Contains data compiled as of 6/8/2012 ouarty cross Checked. est's Key Rating Guide - P /C, US & Canada est's Statement File - P /C, US est's Statement File - Global est's Insurance Reports - P /C, US & Canada est's State Line - P /C, US est's Insurance Expense Exhibit (IEE) - P /C, US est's Schedule F (Reinsurance) - P /C, US est's Schedule D (Municipal Bonds) - US est's Corporate Changes and Retirements - P /C, US /CN est's Schedule P (Loss Reserves) - P /C, US http: / /www3.ambest.com/ ratings/ entities /Search Results. aspx ?SR =1 6/15/2012 * 7:52:14 AM Best's,Credit Rating Center - Search Results Page 1 1 Page 1 of 1 Search Results Page 1 of 1 Results Per Page 20 1 Rated or non -Rated companies found, results sorted by Company Name Criteria Used: Company Name: Company names starting with Wesco Insurance Company To refine your search, please use our Advanced Search or view our Online Help for more information. New Search ,I Wesco Insurance Company r Company Information AMB #� Company Name 002468 Wesco Insurance Company Insurance - Property/ Casualty (Operating Company) ... .._..........._ . ... ........... _.. 1111.. _...,...... ......... ........ .,.. .11.11 -1-111, ,.......,, Rating Center Home View results starting with: A B C D E F G H I J K L M N O P O R S T U V W X Y Z I Reset List ��Financial Strength Ratings Issuer Credit Ratings r �. Outlook / I� Outlook/ ��� )��Rating�flmplication � Long -Term �� Implication I Short -Term ` Domicile A Stable a Stable US: Delaware .............. ..........._,._. Note: Financial Strength Ratings as of 06/13/2012 04.12 PM E.S.T. Financial Strength Ratings (FSR) are sometimes assigned to Property /Casualty - A.M. Best Consolidated Groups. Please note that Life/Health - A.M. Best Consolidated Groups $ and Company Consolidated Financial Statements are not assigned FSR ratings. ` Denotes Under Review Best's Ratings Visit Best's Rating Center for a complete overview of our rating process and methodologies. A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/481EC. European Union Disclosures A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/48/EC. Australian Disclosures A.M. Best Credit Ratings are statements of opinion and not statements of fact. They are not recommendations to buy, hold or sell any securities or any other form of financial product, including insurance policies and are not a recommendation to be used to make investment /purchasing decisions. A.M. Best Asia - Pacific Ltd is registered as a Credit Rating Agency in Australia and holds a Financial Services Licence number 411055 under the Corporations Act of 2001. A.M. Best Asia - Pacific Ltd credit ratings and any other related research are not intended for and must not be distributed to any person in Australia other than a wholesale client. as defined in the Corporations Act of 2001, Chapter 7. The A.M. Best websites are not intended for use by Australian users who are not defined as wholesale users. Important Notice: Best's Ratings reflect our independent opinion, based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet strength, operating performance and business profile. These ratings are neither a warranty of a company's financial strength nor its ability to meet its financial obligations, including those to policyholders. View our entire notice for complete details. Customer Service i Product Support i Member Center I Contact Info i Careers About A.M. Best i Site Map ( Privacy Policy i Security I Terms of Use i Legal & Licensing Copyright © 2012 A.M. Best Company, Inc. ALL RIGHTS RESERVED. A.M. Best Worldwide Headquarters, Ambest Road, Oldwick, New Jersey, 08858, U.S.A. http: / /www3.ambest.com /ratings /RatingsSearch.asp 6/13/2012 * 1:12:54 PM Company Profile Company Profile Company Search Company Search Results -4 Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business -� Workers' Compensation Complaint and Request for Action /Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information Old Company Names Agent For Service KAREN HARRIS C/O CORPORATION SERVICE COMPANY 2710 GATEWAY OAKS DRIVE, SUITE 150N SACRAMENTO CA 95833 -3505 Reference Information WESCO INSURANCE COMPANY 59 MAIDEN LANE NEW YORK, NY 10038 800 - 443 -7187 Effective Date NAIC #: 25011 California Company ID #: 4378 -6 Date Authorized in California: 09/24/1996 License Status: UNLIMITED NORMAL Company Type: Property & Casualty State of Domicile: DELAWARE back to top NAIC Group List NAIC Group #: 2538 Amtrust Grp Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY CREDIT DISABILITY FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION back to top Workers' Compensation Complaint and Requests for Action Contact Information Page 1 of 2 http: / /interactive. web. insurance. ca. gov /companyprofile /companyprofile ?event =co... 6/13/2012 * 1:17:29 PM Best's Credit Rating Center - Company Information for Great American Assurance Company Ratings & Analysis Center 0;1 For ratings and product access Login I Sign -up Ratings & Analysis v • Home • Methodology • Best's Credit Ratings + • Financial Strength Rating • Issuer Credit Rating • Debt Rating • Advanced Search • About Best's Credit Ratings + • Get a Credit Rating + • Best's Special Reports • Add Best's Credit Ratings Search To Your Site • BestMark for Secure -Rated Insurers • Contact an Analyst • Awards and Recognitions News & Analysis Products & Services Industry Information Y Corporate v Regulatory Affairs . Support & Resources a Conferences and Events Find a Best's Credit Rating Enter a Company Name » Advanced Search View Rating Definitions i Seled one.. Great American Assurance Company A.M. Best #: 002004 NAIC #: 2644 FEIN #: 156020948 Address: 301 E. Fourth Street Cincinnati, OH 45202 United States Web: www.greatamericaninsurance.com Phone: 513369 -5000 Fax: 513369 -3600 Based on A.M. Best's analysis, 058317 - American Financial Group Inc is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Page 1 of 2 1Print this page Assigned to FranciaIstivinW+Rati+gl companies �1 that have, in A Brcollant our opinion, . an excellent ability to meet their ongoing insurance obligations. View all of the related companies assigned this rating as a single Best's Credit Rating Analyst entity. Financial Strength Rating View Definition Office: A.M. Best Company Senior Financial Analyst: Gordon McLean Rating: A (Excellent) Managing Senior Financial Analyst: Jennifer Marshall, Financial Size Category: XIII ($1.25 Billion to $1.5 Billion) CPCU, ARM Outlook: Positive Action: Affirmed Effective Date: March 29, 2012 u Denotes Under Review Best's Rating Issuer Credit Rating View Definition Long Term: a+ Outlook: Positive Action: Affirmed Date: March 29, 2012 FPO s., .... Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M. Best Group. —1 AMB Credit Report - Insurance Professional - includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 6/15/2012 (represents the latest significant change). II Historical Reports are available in AMB Credit Report - Insurance Professional Archive. f� Best's Executive Summary Reports (Financial Overview) - available in three versions, these presentation style t – reports feature balance sheet, income statement, key financial performance tests including profitability, liquidity and reserve analysis. Data Status: 2012 Best's Statement File - P /C, US Contains data compiled as of 6/8/2012 Quality Cross Checked. Single Company - five years of financial data specifically on this company. Comparison - side -by -side financial analysis of this company with a peer group of up to five other companies you select. Composite - evaluate this company's financials against a peer group composite. Report displays both the average and total composite of your selected peer group. Gr Best's Key Rating Guide Presentation Report - includes Best's Financial Strength Rating and financial data as ill• provided in the most current edition of Best's Key Rating Guide products. (Quality Cross Checked). AMB Credit Report - Business Professional - provides three years of key financial data presented with colorful charts 1974 and tables. Each report also features the latest Best's Ratings, Rating Rationale and an excerpt from our Business Review commentary. Data Status: Contains data compiled as of 6/8/2012 Quality Cross Checked. Best's Key Rating Guide - P/C US & Canada Best's Statement File - P /C. US Best's Statement File - Global Best's Insurance Reports - P/C US & Canada Best's State Line - P/C US Best's Insurance Expense Exhibit (I EE) - P /C, US Best's Schedule F (Reinsurance) - P /C, US Best's Schedule D (Municipal Bonds) - US Best's Schedule D Common Stocks - US Best's Corporate Changes and Retirements - P /C, US /CN http: / /www3.ambest. com/ ratings/ entities/ CompanyProfile .aspx ?ambnum= 2004&UR... 6/15/2012 * 7:51:34 AM Best's Credit Rating Center - Search Results Page 1 Page 1 of 1 Rating Center Home Search Results Page 1 of 1 Results Per Page 20 1 Rated or non -Rated companies found, results sorted by Company Name Criteria Used: Company Name: Company names starting with Great American Assurance Co To refine your search, please use our Advanced Search or view our Online Help for more information. r New Search 1 Great American Assurance C View results starting with: A B C D E F G H I J K L M N O P O R S T U V W X Y Z Reset List FI Comparry Information i Fr Financial Strength Ratings Issuer Credit Ratings I � 11 OuUook/ I'T Outlook/ I AMB# Company Name Rating Implication Long -Term Implication :1 Short Term << Domicile T - L L_..._ -- i_ -_ -- 002004 - Great American Assurance Company A Positive a+ Positive US: Ohio Insurance - Property/ Casualty (Operating Company) Note., Financial Strength Ratings as of 06/13/2012 03:55 PM E.S.T. Financial Strength Ratings (FSR) are sometimes assigned to Property /Casualty - A.M. Best Consolidated Groups. Please note that Life/Health - A.M. Best Consolidated Groups $ and Company Consolidated Financial Statements are not assigned FSR ratings. Denotes Under Review Best's Ratings Visit Best's Rating Center for a complete overview of our rating process and methodologies. A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/48/EC. European Union Disclosures A.M. Best Company and its subsidiaries are not registered as External Credit Assessment Institutions (ECAI) in the European Union (EU). Credit ratings issued by A.M. Best Company and its subsidiaries can not be used for regulatory purposes in the EU as per Directive 2006/48 /EC. Australian Disclosures A.M. Best Credit Ratings are statements of opinion and not statements of fact. They are not recommendations to buy, hold or sell any securities or any other form of financial product, including insurance policies and are not a recommendation to be used to make investment /purchasing decisions. A.M. Best Asia - Pacific Ltd is registered as a Credit Rating Agency in Australia and holds a Financial Services Licence number 411055 under the Corporations Act of 2001. A.M. Best Asia - Pacific Ltd credit ratings and any other related research are not intended for and must not be distributed to any person in Australia other than a wholesale client, as defined in the Corporations Ad of 2001, Chapter 7. The A.M. Best websites are not intended for use by Australian users who are not defined as wholesale users. 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New Jersey, 08858, U.S.A. http: / /www3.ambest.com /ratings /RatingsSearch.asp 6/13/2012 * 1:09:20 PM Company Profile Company Profile Company Search Company Search Results iCompany Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business i Workers' Compensation Complaint and Request for Action /Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE ;,_,Company Information GREAT AMERICAN ASSURANCE COMPANY 301 E. FOURTH STREET CINCINNATI, OH 45202 -4201 Old Company Names Effective Date AGRICULTURAL INSURANCE COMPANY 12/04/2000 AMERICAN EMPIRE INSURANCE COMPANY OF SOUTH DAKOTA 08/11/1972 QUEEN CITY INSURANCE COMPANY 06/23/1960 Agent For Service NANCY FLORES C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET LOS ANGELES CA 90017 Reference Information NAIC #: 26344 California Company ID #: 1472 -0 Date Authorized in California: 03/01/1955 License Status: UNLIMITED - NORMAL Company Type: Property &Casualty State of Domicile: [OHIO back to top NAIC Group List NAIC Group #: 0084 American Financial Grp Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY CREDIT FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION back to top Page 1 of 2 http: / /interactive.web. insurance. ca. gov /companyprofile /companyprofile ?event =co... 6/13/2012 * 1:23:58 PM Company Profile Page 2 of 2 Workers' Compensation Complaint and Requests for Action Contact Information Part 1: Complaints and Requests for Action (CRA) If you are seeking information about your workers' compensation insurance policy, you must first submit a Complaint and Request for Action (CPA) to the workers' compensation insurance company using the address below. Phone Number: 925- 988 -2274 Ext: FAX: 513-412 -4790 E -Mail: dkorab @GAIC.com WEB Address: www.greatamericancaptive.com Mailing Address: 1350 Treat Blvd, Suite 300 Walnut Creek CA 94587 Department Name: Contact Notes: Part 2: Appeals to the Department of Insurance You may contact the department if you disagree with your workers' compensation insurance company's written decision on your CRA. You also must mail a copy of what you send us to your workers' compensation insurance company using the address below. Phone Number: 925- 988 -2274 Ext: FAX: 513- 412 -4790 E -Mail: dkorab @GAIC.com WEB Address: w— greatamericancaptive.com Mailing Address: 1350 Treat Blvd, Suite 300 Walnut Creek CA 94587 Department Name: IF Appeals Notes: back to top @ 2008 California Department of Insurance http: / /interactive.web. insurance. ca. gov /companyprofile /companyprofile ?event =co... 6/13/2012 * 1:23:58 PM