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HomeMy WebLinkAboutPhoenix Electric Company, Inc. (3)MINOR CONSTRUCTION AGREEMENT BETWEEN THE TOWN OF LOS ALTOS HILLS AND PHOENIX ELECTRIC CO. This Agreement (this "Agreement") is made and entered into between the Town of Los Altos Hills, a General,, aw City ("Town") and Phoenix Electric Company, Inc. ("Contractor") effective as of 2 G Z 20? 3 (the "Effective Date"). Town and Contractor are hereinafter collectively referred to as (the "Parties"). In consideration of their mutual covenants, the Parties hereby agree as follows: 1. Scope of Work. Contractor shall provide the following services and/or materials ("the Work"): Furnish and install an emergency sewage pump system at the O'Keefe Pump Station per Exhibit A "Drawing C-101 O'Keefe Pump Station Emergency Sewage Pump" dated 12/5/2023 SCOPE OF WORK: - Remove and dispose abandoned metal conduits and junction boxes from the wet well - Furnish and install one 1 horsepower manually operated sewage pump, Little Giant 16S -CIM, 230V, I Phase. - Furnish and install 3 -inch PVC (Schedule 80) discharge pipe from the sewage pump and connect to the existing 4 -inch HDPE force main - Furnish and install one 3 -inch backflow check valve - Furnish and install one N9 pull box, with a 12 -in extension and an "Electrical" lid - Furnish and install 3 -inch PVC electrical conduit from the wet well to the N9 pull box - Other work as described on Drawing C-101 Or, as more particularly described in the Scope of Work, attached hereto and incorporated herein as Exhibit A. In the event of a conflict or inconsistency between the text of the main body of this Agreement and Exhibit A, the text of the main body of this Agreement shall prevail. The Work shall commence on 12/18/23 and shall be completed to the satisfaction of the Town by 1/12/24 unless such date is extended or otherwise modified by the Town in writing. 2. Pam. Town shall pay Contractor an amount not to exceed: Twenty -Four Thousand One Hundred Eighty Six Dollars ($24,186) for the full and satisfactory completion of the Work in accordance with the terms and conditions of this Agreement. The calculation of payment for the Work shall be set forth as described in the Compensation Form, attached hereto and incorporated herein as Exhibit B. The amount stated above is the entire compensation payable to Contractor for the Work performed hereunder, including all labor, materials, tools and equipment furnished by Contractor. (A) Invoices. Town shall make monthly payments, based on invoices received, for Work satisfactorily performed. Town shall have thirty (30) days from the receipt of an invoice that complies with all of the requirements above to pay Contractor. (B) False Claims Act. Presenting a false or fraudulent claim for payment, including a change order, is a violation of the California False Claims Act and may result in treble damages and a fine of five thousand ($5,000) to ten thousand dollars ($10,000) per violation. (C) Retention and Final Pam. Town shall retain five percent (5%) of each payment, which shall be paid within sixty (60) days after acceptance of the services, as described in Section 11, and submittal to Town of a final invoice, if all services required have been satisfactorily performed. Contractor may substitute securities or establish an escrow in lieu of retainage, pursuant to Public Contract Code Section 22300. 3. Independent Contractor. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer-employee relationship between the Town and Contractor. At all times Contractor shall be an independent contractor and Contractor is not authorized to bind the Town to any contracts or other obligations without the express written consent of the Town. 4. Indemnification. To the fullest extent permitted by law, Contractor shall indemnify, defend (with counsel acceptable to the Town), and hold harmless the Town and its elected and appointed officers, officials, employees, agents, contractors and consultants (collectively, the "Town Indemnitees") from and against any and all liability, loss, damage, claims, expenses and costs (including, without limitation, attorneys' fees and costs of litigation) (collectively, "Liability") of every nature arising out of or in connection with Contractor's performance of the Work or Contractor's failure to comply with this Agreement, except such Liability caused by the gross negligence or willful misconduct of the Town Indemnitees. 5. Excavations. In accordance with Public Contracts Code Section 714, Contractor shall promptly notify the Town in writing of discovery of any material Contractor believes may be hazardous waste as defined in Section 25117 of the Health and Safety Code or of any subsurface or latent physical conditions at the site of any unusual nature differing materially from those generally inherent in the work described in Exhibit A. Upon receipt of such communication, Town shall promptly investigate the conditions and if conditions do materially differ, shall issue a change order providing for additional time or payment of additional costs. 6. Relocation of Utilities. In the event that the completion of the services described in Exhibit A requires the removal or protection of main or trunk line public utility facilities, the Town shall be responsible for removal and protection of such public utilities pursuant to Government Code Section 4215. 7. Insurance. Prior to beginning the Work and continuing throughout the term of this Agreement, Contractor (and any subcontractors) shall, at Contractor's (or subcontractor's) sole cost and expense, furnish the Town with certificates of insurance evidencing that Contractor has obtained and maintains insurance in the following amounts: A. Workers' Compensation that satisfies the minimum statutory limits. B. Commercial General Liability and Property Damage Insurance in an amount not less than TWO MILLION DOLLARS ($2,000,000) combined single limit per occurrence, FIVE MILLION DOLLARS ($5,000,000) annual aggregate, for bodily injury, property damage, products, completed operations and contractual liability coverage. The policy shall also include coverage for liability arising out of the use and operation of any Town -owned or Town -furnished equipment used or operated by the Contractor, its personnel, agents or subcontractors. C. Comprehensive automobile insurance in an amount not less than ONE MILLION DOLLARS ($1,000,000) per occurrence for bodily injury and property damage including coverage for owned and non - owned vehicles. All insurance policies shall be written on an occurrence basis and shall name the Town Indemnitees as additional insureds. The certificates shall contain a statement of obligation on the part of the carrier to notify the Town of any material change, cancellation, termination or non -renewal of the coverage at least thirty (30) days in advance of the effective date of any such material change, cancellation, termination or non -renewal. Further, if the Contractor's insurance policy includes a self-insured retention that must be paid by a named insured as a precondition of the insurer's liability, or which has the effect of providing that payments of the self- insured retention by others, including additional insureds or insurers do not serve to satisfy the self-insured retention, such provisions must be modified by special endorsement so as to not apply to the additional insured coverage required by this agreement so as to not prevent any of the parties to this agreement from satisfying or paying the self-insured retention required to be paid as a precondition to the insurer's liability. Additionally, the certificates of insurance must note whether the policy does or does not include any self-insured retention and also must disclose the deductible. 8. General Warranties and Guarantee. Contractor warrants that: (A) All Work, Products and/or Services are as described in this Agreement, including any exhibits incorporated] conform to all drawings, samples, descriptions and specifications; (B) All Work, Products and/or Services delivered are new and of good merchantable quality, free from material defects of workmanship and fit for the purpose for which sold or provided; (C) Contractor has good title to all Products delivered and all Products delivered are free from liens and other encumbrances; and (D) Contractor's Work will be in strict conformity with all applicable local, state, and federal laws. For purposes of this warranty, any parts not meeting the foregoing quality shall be deemed defective. Contractor shall guarantee the Work to be free of defects in material and workmanship for a period of one (1) year following the Town's acceptance of the Work ("Contractor's Guarantee"), as described in Section 11. As part of Contractor's Guarantee, Contractor agrees to make, at Contractor's own expense, any repairs or replacements made necessary by defects in material or workmanship which become evident within the one-year guarantee period. The Contractor's Guarantee is effective regardless of whether or not a maintenance bond is required by the Town for this Agreement. 9. Contract Bonds. 9.1 General. Before the Town executes this Agreement, the Contractor shall file with the Town surety bonds satisfactory to the Town in the amounts and for the purposes noted in this Section 9. Bonds shall be duly executed by an admitted surety insurer, authorized to issue such bonds in the State of California and secured through an authorized agent with an office in California. The Contractor shall pay all bond premiums, costs, and incidentals. Each bond shall be signed by both the Contractor and surety and the signature of the authorized agent of the Surety shall be notarized. The Contractor shall provide two good and sufficient surety bonds: the payment bond and the faithful performance bond. 9.2 Payment Bond. The Payment Bond (material and labor) shall be for not less than one -hundred percent (100%) of the estimated cost of the construction and completion of the Work hereunder, as security for the payment of all persons performing labor and providing materials in connection with this Agreement and to satisfy claims of material suppliers and of mechanics and laborers contracted for the Work. The bond shall be maintained by the Contractor in full force and effect until the completed Work is accepted by the Town, and until all claims for materials and labor are paid. The bond shall provide that if the Contractor fails to pay any of its obligations, the surety will pay the obligation and, if an action is brought to enforce the liability on the bond, reasonable attorney's fees. 9.3 Faithful Performance Bond. The Faithful Performance Bond shall be for 100% of the of the estimated cost of the construction and completion of the Work hereunder to guarantee faithful performance of all Work, within the time prescribed, in a manner satisfactory to the Town. 9.4 Warranty Bond. <Reserved> 9.5 Bond Renewal and Extension If any bond becomes insufficient, the Contractor shall immediately replace the bond with a substitute upon request from the Town, and the effective date of the bond shall be from the beginning of Work. If any surety at any time is unsatisfactory to the Town, the Town will give notice to the Contractor. No further payments shall be deemed due or will be made under the Agreement until a new surety qualifies and is accepted by the Town. Changes in the Work, or extensions of time, made under the Agreement, shall not release the Contractor or surety from their obligations. The surety must waive notice of such changes or extensions. 10. Licenses. Contractor represents and warrants that Contractor possesses all licenses, permits, and qualifications legally required for the performance of the Work, including but not limited to a business license from the Town and payment of any applicable business license tax. Contractor shall, at Contractor's sole cost and expense, maintain all such licenses, permits and qualifications in full force and effect throughout the term of this Agreement. 11. Damage to Town Facilities and Site Safety. Damage to Town or public facilities or private property caused by the Contractor or by its subcontractors during performance of the Work shall be repaired and/or replaced in kind at no cost to the Town. The worksite shall be kept clean and free of hazards at all times during installation. After work is completed at the site, Contractor shall clean the surrounding area to the condition prior to performance of the Work. 12. Final Inspection and Work Acceptance. All Work shall be subject to final inspection and acceptance or rejection by the Town. Contractor shall guarantee the Work to be free of defects in material and workmanship for a period of one (1) year following the Town's acceptance of the Work. 13. Compliance with all Applicable Laws. A. Contractor shall comply with all applicable local, state and federal laws, regulations and ordinances in the performance of this Agreement. B. Contractor shall not discriminate in the provision of service or in the employment of persons engaged in the performance of this Agreement on account of race, color, national origin, ancestry, religion, gender, marital status, sexual orientation, age, physical or mental disability in violation of any applicable local, state or federal laws or regulations. C. Contractor shall comply with the requirements of the Secretary of Labor and the latest amendments to: Executive Orders 11246 and 11375, as supplemented in Department of Labor regulations (41 C.F.R. chapter 60); the Copeland "Anti -Kickback" Act (18 U.S.C. § 847) as supplemented in Department of Labor regulations (29 C.F.R. part 3); Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. §§ 1701 et seq.); Title VI of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000); Section 109 of Title I of the Housing and Community Development Act of 1974 (42 U.S.C. §§ 5301 et seq.); the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101 et seq.); and Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §§ 701 et seq.) 14. Payment of Taxes; Tax Withholding. Contractor is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. To be exempt from tax withholding, Contractor must provide Town with a valid California Franchise Tax Board form 590 ("Form 590"). Unless Contractor provides Town with a valid Form 590 or other valid, written evidence of an exemption or waiver from withholding, Town may withhold California taxes from payments to Contractor as required by law. Contractor shall obtain, and maintain on file for three (3) years after the termination of this Agreement, Form 590s (or other written evidence of exemptions or waivers) from all subcontractors. Contractor accepts sole responsibility for withholding taxes from any non -California resident subcontractor and shall submit written documentation of compliance with Contractor's withholding duty to Town upon request. 15. Prevailing Wage. A. The wages to be paid for a day's work to all classes of laborers, workmen, or mechanics on the work contemplated by this Agreement, shall be not less than the prevailing rate 4 for a day's work in the same trade or occupation in the locality within the state where the work hereby contemplates to be performed as determined by the Director of Industrial Relations pursuant to the Director's authority under Labor Code Section 1770, et seq. Each laborer, worker or mechanic employed by Contractor or by any subcontractor shall receive the wages herein provided for. The Contractor shall pay two hundred dollars ($200), or whatever amount may be set by Labor Code Section 1775, as may be amended, per day penalty for each worker paid less than prevailing rate of per diem wages. The difference between the prevailing rate of per diem wages and the wage paid to each worker shall be paid by the Contractor to each worker. The Town will not recognize any claim for additional compensation because of the payment by the Contractor for any wage rate in excess of prevailing wage rate set forth. The possibility of wage increases is one of the elements to be considered by the Contractor. NOTE: An error on the part of an awarding body does not relieve the Contractor from responsibility for payment of the prevailing rate of per diem wages and penalties pursuant to Labor Code Sections 1770-1775. i. Posting of Schedule of Prevailing Wage Rates and Deductions. If the schedule of prevailing wage rates is not attached hereto pursuant to Labor Code Section 1773.2, the Contractor shall post at appropriate conspicuous points at the site of the project a schedule showing all determined prevailing wage rates for the various classes of laborers and mechanics to be engaged in work on the project under this contract and all deductions, if any, required by law to be made from unpaid wages actually earned by the laborers and mechanics so engaged. ii. Payroll Records. Each Contractor and subcontractor shall keep an accurate payroll record, showing the name, address, social security number, work week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by the Contractor in connection with the public work. Such records shall be certifies and submitted weekly as required by Labor Code Section 1776. 16. Patents. The Contractor shall assume all costs arising from the use of patented materials, equipment, services, or processes used on or incorporated in the Work, and agrees to indemnify and save harmless the Town of Los Altos Hills, the City Council, and the Engineer, and their duly authorized representatives, for all suits at law, or actions of every nature for, or on account of the use of any patented materials, equipment, services, or processes. 17. Dispute Resolution. Prior to initiating litigation in a court of competent jurisdiction, both Contractor and Town shall undergo alternative dispute procedures as outlined in Public Contract Code Section 20104, et seq. The Parties also expressly agree that such procedures are incorporated as though fully set forth in this Agreement. 18. Prevailing Party_. In the event that either party to this Agreement commences any legal action or proceeding (including but not limited to arbitration) to interpret the terms of this Agreement, the prevailing party in such a proceeding shall be entitled to recover its reasonable attorney's fees associated with that legal action or proceeding. 19. Termination. Town may terminate or suspend this Agreement at any time and without cause upon written notification to Contractor. Upon receipt of notice of termination or suspension, Contractor shall immediately stop all work in progress under this Agreement. The Town's right of termination shall be in addition to all other remedies available under law to the Town. 20. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 21. Entire Agreement. This Agreement represents the entire and integrated agreement between the Parties. This Agreement may be modified or amended only by a subsequent written agreement signed by both Parties. 22. Non -Liability of Officials, Employees and Agents. No officer, official, employee or agent of Town shall be personally liable to Contractor in the event of any default or breach by Town or for any amount which may become due to Contractor pursuant to this Agreement. 23. Execution in Counterparts. This Agreement may be executed in counterparts and/or by facsimile or other electronic means, and when each Party has signed and delivered at least one such counterpart, each counterpart shall be deemed an original, and, when taken together with other signed counterpart, shall constitute one Agreement, which shall be binding upon and effective as to all Parties. 24. Choice of Law; Venue. The applicable law shall be that of the State of California 25. Notice. All notices and other communications which are required or may be given under this Agreement shall be in writing and shall be deemed to have been duly given (i) when received if personally delivered; (ii) when received if transmitted by telecopy, if received during normal business hours on a business day (or if not, the next business day after delivery) provided that such facsimile is legible and that at the time such facsimile is sent the sending Party receives written confirmation of receipt; (iii) if sent for next day delivery to a domestic address by recognized overnight delivery service (e.g., Federal Express); and (iv) upon receipt, if sent by certified or registered mail, return receipt requested. In each case notice shall be sent to the respective Parties as follows: Contractor: Town: PHOENIX ELECTRIC COMPANY, INC. 1350 Van Dyke Ave San Francisco, CA 94124 DANIEL LIANG, UTILITY ENGINEERING MANAGER Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date written above. TO By: 2 Peter Pim6d City Manager C CONTRACTOR: Print Name: Eugene Briody Title: Project Manager 191 Date: 12/05/23 Attn: Daniel Liang 'QMPANY 1350 Van Dyke Ave. San Francisco, CA 94124 PROPOSAL Project: Emergency 1 HP Sewage Pump @ O'Keefe Lift Station Tel: 415-671-3858 License No. Fax: 415-671-3827 811031 We are pleased to offer our proposal for the scope of work outlined below and per drawing C-101 dated 12/04/23: Total Bid: $24,186.00 Clarfications - F/I sewage pump with 40' power chord to (n) N09 Pullbox - Coring of wet well @ (2) locations - F/I 3" conduit from wet well and connect to (e) 4" HDPE main - F/I 3" backflow valve - Trenching to expose 4" HDPE Main, assumes 4" HDPE main is in softscape - Backfill with native material to rough grade - Sand bedding - Traffic control as needed Standard Exclusions: 1. Any work not specifically listed in inclusions above is hereby excluded. 2. Hydrovac potholing/trenching 3. Planting/Landscaping 4. Does not include multiple mobilizations, assumes all work to be done at once. 5. Work in or around hazardous material, and abatement thereof is excluded 6. SWPPP is excluded 7. Traffic Control Plans are excluded 8. On-site safety officer is excluded 9. Any dewatering or dewatering plan is excluded 10. All Permits, including but not limited to environmental permits, DBI Permits, encroachment permits, special traffic permit, and excavation permits, are excluded unless otherwise noted. 11 Utility fees (engineering, construction and permits incl.) are excluded. 12. Painting or plastering restoration 13. All third -party testing fees and special inspection services are excluded (i.e. soils testing, structural testing, concrete compressive testing, compaction testing etc.) 14. Concrete x-ray or digital scanning services are excluded. 15. Surveying and layout are excluded. 16. Public outreach and/or relations Page 1 of 2 PH �� 1350 Van Dyke Ave. Tel: 415-671-3858 License No. San Francisco, CA 94124 Fax: 415-671-3827 811031 ELEC7iitG COMPANY 17. Site security and/or temporary fencing 18. Pavement Striping and signage are excluded. 19. Clearing and grubbing is excluded. 20. Tree trimming and tree protection is excluded 21. Grading is excluded. 22. Planting/tree, irrigation, and landscaping removal and restoration is excluded. 23. Patching and/or painting of finished surfaces is excluded 24. Waterproofing and Fireproofing is excluded. 25. CAD As -built drawings are excluded General Conditions: 1. Work to be performed during normal business hours (M -F, 7am — 3:30pm). No overtime is included. 2. Bonding is excluded. 3. Phoenix Electric Co. Carries Workmen's Compensation ($1,000,000) and General Liability Insurance ($2,000,000 per occurrence; $4,000,000 aggregate; $6,000,000 excess liability). Any additional insurance or special coverage required shall be considered and additional cost. 4. CSLB License No. 811031; C-10 5. PEC is signatory to the Laborers International Union Local 261, and the Operating Engineers Local 3 6. SF Business Tax Registration No. 358809 7. Federal Tax ID No. 71-0900458 8. State of Calif. SB Certification No. 55289 9. DIR No. 1000004281 10. This proposal is valid for Thirty (30) days from date of quotation. Thank you for the opportunity to quote this project. Should you have any questions or require additional information or if we can be of any further assistance to you, please contact me at 415-509-9272. Sincerely, PHOENIX ELECTRIC CO. 1 Eugene Briody 415-509-9272 Page 2 of 2 F01*T*�I�iI _I:[11]11- 7�l CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11 /20/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Panorama Risk & Insurance Solutions, LLC 52 S 1 st Street, #310 San Jose, CA 95113 ACT NAME: Shanel Hudson PHONE FAX (AIC, No, Ext): (A/C, No): EDDRIL shudson@panorama360.com INSURERS AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR INSURER A: Travelers Indemnity Company Of Connecticut (The) 25682 X INSURED INSURER B: Travelers Indemnity Company Of America the 25666 INSURER C: Homesite Insurance Company Of Florida 11156 Phoenix Electric Co. INSURER D: Travelers Property Casualty Company of America 25674 1350 Van Dyke Ave. San Francisco, CA 94124 INSURER E: Ironshore Specialty Ins Co 25445 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR D POLICY NUMBER POLICY EFF MM/DD YY POLICY EXP DD Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X DT22-CO-4X12122A-TCT-23 11/2/2023 11/2/2024 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED $00,000 PREMISES Ea occurrence $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY Fx-] jE o [::] LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ BODILY INJURY Perperson) $ X ANY AUTO X X 810 -4X004641 -23-26-G 11/2/2023 11/2/2024 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ HIRF�D F NUON-OWNED MRS ONLY A TOS ONLY $ C UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000 X AGGREGATE $ 5'0001000 EXCESS LIAB CLAIMS -MADE CXP-011888-01 11/212023 11/2/2024 DED I I RETENTION $ $ D WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY YIN ANY PROPRIMBIW EXCLUDE( Mandatory in NER EXCLUDED? H) N / A X UB -4X172697 -23-26-G 11/2/2023 11/2/2024 STATUTE ORH 1,000,000 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below 1,000,000 E.L. DISEASE - POLICY LIMIT $ E Pollution/Mold ICELLUW00148274 5/19/2023 5/19/2024 Each occurrence 2,000,000 E Pollution/Mold ICELLUW00148274 5/19/2023 5/19/2024 General Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Westwind Community Barn. Per written contract with the Named Insured. The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers"s are an Additional Insured, as respects general liability, per form CG D2 46 04 19 attached. General Liability Primary and Non-contributory applies per form CCG T1 00 02 19 attached. General Liability waiver of subrogation applies per form CG D316 0219 attached. Auto Additional Insured and Auto Primary Non-contributory wording applies per form CA T4 99 02 16 attached. Auto waiver of subrogation applies per form CA T363 0215 attached. Workers Compensation waiver of subrogation applies per form WC 99 03 76 (A) attached. 30 day notice of cancellation, except 10 day notice of cancellation for non-payment of premium. CIR form attached. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016103) @ 1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Los Altos Hills -Contracts TownFremont THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Road Los Altos Hills, CA 94022 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) @ 1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD" AGENCY CUSTOMER ID: PHOEELE-01 LOC #: ADDITIONAL REMARKS SCHEDULE SHUDSON Page 1 of 1 AGENCY NAMED INSURED Panorama Risk & Insurance Solutions, LLC Phoenix Electric 1350 Van Dyke Ave. San Francisco, CA 94124 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Contractual Insurance Requirements - CIR Form The attached Certificate of Insurance is provided as part of our service, to our client, the insured. If special endorsements have been provided, they are also indicated attached. You may find that these documents do not comply with all the terms and conditions of the underlying contract between the Certificate Holder and the Insured due to the insurance company's insuring conditions, limitations, exclusions and other terms. If you have any questions, please contact the undersigned. Panorama Risk & Insurance Solutions 52 S. First St., #310 San Jose, CA 95113 CA License #6001592 ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3" PVC (Sch 80) 3" Backflow Check Valve 3" PVC (Sch 80) 4" to 3" PVC Reducer 4" HDPE Transition 4" PVC Fitting (Male) 4" HDPE WYE EC 4" PVC Terminal Adapter (Female) 4" HDPE FM (E) 4" HDPE FM (E) Electrofusion EC Coupling (EC) DETAIL A QUANTITIES (PLUMBING) QUANTITIES (ELECTRICAL) ITEM UOM QTY Little Giant 16S—CIM Sewage Pum 514630 EA 1 4" HDPE WYE fusable connection, SDR17 EA 1 4" Electrofusion Coupling EA 3 4" HDPE Inte riFuse Transition Fitting (Male), SDR11 EA 1 4" PVC Terminal Adapter Female EA 1 1 4" PVC Pipe EA 3 4" to 3" PVC Reducer EA 1 3" Backflow Check Valve EA 1 3" PVC Pie Sch 80 LF 40 3" PVC Terminal Adapter Male EA 1 3" PVC Elbow, 45 degrees Sch 80 EA 6 3" PVC Elbow, 22.5 degrees Sch 80 EA 2 3" PVC Coupling EA 10 Quickset Mortar Mix, 50 Lbs EA 2 QUANTITIES (ELECTRICAL) REV.I DATE DESCRIPTION DATE I i CONTROL PANEL (E) To 1 HP i Pump Remove Abandoned Junction Box Remove Abandoned Metal Conduit N9 with 1—ft extension "ELECTRICAL" 40—ft power cord 3" Conduit Wet Well Depth, 15' Capacity at 10' = 2,115 Gallon Wet Well Sewage Pump = 160 gal/min Run time = 13 min ITEM UOM QTY N9 Pullbox with 12—inch extension EA 1 N9 Lid "ELECTRICAL" EA 1 3" PVC Conduit LF 10 3" PVC Elbow, 45 degrees EA 4 3" PVC Bell End EA 1 3" PVC Coupling EA 3 REV.I DATE DESCRIPTION DATE I i CONTROL PANEL (E) To 1 HP i Pump Remove Abandoned Junction Box Remove Abandoned Metal Conduit N9 with 1—ft extension "ELECTRICAL" 40—ft power cord 3" Conduit Wet Well Depth, 15' Capacity at 10' = 2,115 Gallon Wet Well Sewage Pump = 160 gal/min Run time = 13 min Remove Abandoned Junction Box I i i i I I �\ ESP i 16 i i 1 HP Emergency Sewage Pump Penetrate i i LITTLE GIANT 16S—CIM 1 hp See DETAIL A Wall i 230V, 11A, MANUAL with 40—ft Bollard (E) i _________________ i i power cord (#514630) 3" PVC �� ��� 3" PVC (E) 0.5% Discharge ,' Discharge ----------------------------------- A---------------------1----- ---1----------- --- C.O. To Gravity Manhole i 1 4" HDPE Force Main 3 PVC (E) WYE Connection Discharge NOTES: SP — Sewage Pump ESP — Emergency Sewage Pump SCOPE OF WORK 4hp 4hp 1. Remove and dispose abandoned metal conduit and junction boxes from the wet well. SP i SP Furnish and install one 1 horsepower manually operated sewage pump with a 40—ft power L_T_J Amp. 3. i r0 0 and install 3—inch PVC discharge pipe from the sewage pump and connect to the existing 4—inch HDPE force main with a WYE connection. 4. Furnish Remove Abandoned Junction Box I i i i I I �\ ESP i 16 i i 1 HP Emergency Sewage Pump Penetrate i i LITTLE GIANT 16S—CIM 1 hp See DETAIL A Wall i 230V, 11A, MANUAL with 40—ft Bollard (E) i _________________ i i power cord (#514630) 3" PVC �� ��� 3" PVC (E) 0.5% Discharge ,' Discharge ----------------------------------- A---------------------1----- ---1----------- --- C.O. To Gravity Manhole i 1 4" HDPE Force Main 3 PVC (E) WYE Connection Discharge NOTES: SP — Sewage Pump ESP — Emergency Sewage Pump SCOPE OF WORK 1. Remove and dispose abandoned metal conduit and junction boxes from the wet well. 2. Furnish and install one 1 horsepower manually operated sewage pump with a 40—ft power cord, Little Giant 16S—CIM, 230V, 11 Amp. 3. Furnish and install 3—inch PVC discharge pipe from the sewage pump and connect to the existing 4—inch HDPE force main with a WYE connection. 4. Furnish and install one 3—inch backflow check valve. 5. Penetrate the wet well at two locations. One for the 3—inch PVC discharge pipe, and the other for a 3—inch conduit for the power cord. 6. Furnish and install one N16 pull box with a 1—ft extension, and one "ELECTRICAL" lid. EXHIBIT A ESS�oQR�FENI`N9l�c TOWN OF LOS ALTOS HILLS O'KEEFE PUMP STATION DRAWING 3 EMERGENCY SEWAGE PUMP C-101 No. C 68845 409-30-25 * 26379 FREMONT ROAD, LOS ALTOS HILLS, Jp9� CIVI�p��`P Of CAl1F CALIFORNIA 94022 IMPROVEMENT PLAN SHEET 1 of , DESCRIPTION DATE: 12/5/23