2014-292•:� ` � '� i �
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WHEREAS, the City has solicited, received and tabulated competitive bids for the
construction of public works or improvements in accordance with the procedures of State law and
City ordinances; and
WHEREAS, the City Manager ar a designated employee has received and recommended that
the herein described bids are the lowest responsible bids for the canstruction of the public works or
improvements described in the bid invitation, bid proposals and plans and specifications therein;
No VV y 1 i1EdOl.�i' o n 1'.y
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SECTION 1. The following competitive bids for the construction of public works or
improvements, as described in the "Bid Invitations", "Bid Proposals" or plans and specifications on
file in the Office of the City's Purchasing Agent filed according to the bid number assigned hereto,
are hereby accepted and appraved as being the lowest responsible bids:
BID
NUMBER CONTRACTOR AMOUNT
5476 Speiss Construction Company, Inc. $1,604,356
SECTION 2. The acceptance and approval of the above competitive bids shall not constitute
a contract between the City and the person submitting the bid for construction af such public works
or improvements herein accepted and approved, until such person shall comply with all requirements
speciiied in the Notice to Bidders including the timely execution of a written cantract and furnishing
of performance and payrnent bonds, and insurance certificate after notification of the award of the
bid.
SECTION 3. The City Manager is hereby authorized ta execute all necessary written
contracts for the performance of the construction of the public warks or impravements in accardance
with the bids accepted and approved herein, provided that such contracts are made in accordance
with the Notice to Bidders and Bid Proposals, and documents relating thereto specifying the terms,
conditions, plans and specifications, standards, quantities and specified sums contained therein.
�Lt��l'�ON 4. The City Cauncil af the City of Denton, Texas hereby expressly delegates the
authority to take any actions that may be required or permitted to be performed by the City of Denton
under Bid 5476 to the City Manager of the City of Denton, Texas, or his designee.
SECTION 5. Upon acceptance and appraval ofthe abave competitive bids and the execution
of cantracts far the public works and improvements as authorized herein, the City Council hereby
autharizes the expenditure of funds in the manner and in the amaunt as specified in such approved
bids and authorized cantracts executed pursuant thereto.
SECTION 6. This ordinance shall become effective immediately upon its passage and
approval.
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HRIS WATTS, �1�1.YOR
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BY: ���"[� �r�� S'��f_ a�, �''P'�"�:�'��''�, { A,�"��� �
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CONTRACT BY AND BETWEEN
CITY OF DENTON, TEXAS AND SPIESS CONSTRUCTION COMPANY,INC
(IFB 5476)
STATE OF TEXAS
§ COUNTY OF DENTON §
THIS AGREEMENT, made and entered into this 16� day of September A.D., 2014, by
and between Citv of Denton of the County of Denton and State of Texas, acting
through Geor�e C. Campbell thereunto duly authorized so to do, hereinafter termed "OWNER,"
and_'���zc���� (."��°���t°�t�t_i����a ��yr.���� �wa�,���p_Im�J � . �"l��n•tl� �u�, J8'� �� ���r���a ����_��t� �.l� �_���,� of the
City of Santa Maria, County of Santa Barbara, and State of California , hereinafter termed
�._ �
"CONTR.ACTOR,"
WITNESSETH: That for and in consideration of the payments and agreements
hereinafter mentioned, to be made and performed by OWNER, and under the conditions
expressed in the bonds attached hereto, CONTRACTOR hereby agrees with OWNER to
commence and complete performance of the work specified below:
IFB #5476 — 2499 LJTILITY RELOCATION PHASE II
in the amount of $1,604,356 and all extra work in connection therewith, under the terms as stated
in the General Conditions of the agreement; and at his (or their) own proper cost and expense to
furnish all materials, supplies, machinery, equipment, tools, superintendence, labor, insurance,
and other accessories and services necessary to complete the work specified above, in
accordance with the conditions and prices stated in the Proposal and the Performance and
Payment Bonds, attached hereto, and in accordance with all the General Conditions of the
Agreement, the Special Conditions, the Notice to Bidders (Advertisement %r Bids), and
Instructions to Bidders, as referenced herein and on file in the office of the Purchasing Agent,
and in accordance with the plans, which includes all maps, plats, blueprints, and other drawings
and printed or written explanatory matter thereof, and the Specifications therefore, as prepared
by:
City of Denton En ineerin� Services
all of which are referenced herein and made a part hereof and collectively evidence and
constitute the entire contract.
Independent Status
It is mutually understood and agreed by and between City and Contractor that Contractor
is an independent contractor and shall not be deemed to be or considered an employee of the City
of Denton, Texas, for the purposes of income tax, withholding, social security taxes, vacation or
sick leave benefits, worker's compensation, or any other City employee benefit. City shall not
have supervision and control of Contractor or any employee of Contractor, and it is expressly
IFB 5476
understood that Contractor shall perforrn the services hereunder according to the attached
specifications at the general direction of the City Manager of the City of Denton, Texas, or his
designee under this agreement.
Indemnification
CONTRACTOR COVENANTS AND AGREES TO AND DOES HEREBY
INDEMNIFY, HOLD HARMLESS AND DEFEND, AT ITS OWN EXPENSE, OWNER,
ITS OFFICERS, SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND
ALL CLAIMS OR SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL
INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER
KIND OR CHARACTER, WHETHER REAL OR ASSERTED ARISING OUT OF THE
WORK AND SERVICES TO BE PERFORMED HEREUNDER BY CONTRACTOR, ITS
OFFICERS, AGENTS, EMPLOYEES, SUBCONTRACTORS, LICENSEES OR
INVITEES, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY THE
ALLEGED NEGLIGENCE OF THE OFFICERS, SERVANTS, OR EMPLOYEES_OF
THE OWNER. CONTRACTOR LIKEWISE COVENANTS AND AGREES TO, AND
DOES HER.EBY INDEMNIFY AND HOT..A��w HARMLESS OWNER DURING THE
PERFORMANCE OF ANY OF THE TERMS AND CONDITIONS OF THIS
CONTRACT, WHETHER ARISING OUT OF IN WHOLE OR IN PART, ANY AND
ALL ALLEGED ACTS OR OMISSIONS OF OFFICERS, SERVANTS, OR
EMPLOYEES OF THE OWNER. THE 1�"l�C.}"�"�4�ONS OF THIS PARAGRA.PH ARE
SOLELY FOR THE BENEFIT OF THE PARTIES HERETO AND NOT INTENDED TO
CREATE OR GRANT ANY RIGHTS, CONTRACTUAL OR OTHERWISE, TO ANY
OTHER PERSON OR ENTITY.
Choice of Law and Venue
This agreement shall be governed by the law of the State of Texas and venue for its
construction and enforcement shall lie in the courts of Denton County, Texas.
The CONTRACTOR hereby agrees to commence work on or after the date established
for the start of work as set forth in written notice to commence work and complete all work
within the time stated in the Proposal, subject to such extensions of time as are provided by the
General and Special Conditions.
The OWNER agrees to pay the CONTRACTOR in current funds the price or prices
shown in the Proposal, which forms a part of this contract, such payments to be subject to the
General and Special Conditions of the Contract.
Right to Audit
The OWNER shall have the right to audit and make copies of the books, records and
computations pertaining to this agreement. The CONTR.ACTOR shall retain such books,
records, documents and other evidence pertaining to this agreement during the contract period
and five years thereafter, except if an audit is in progress or audit findings are yet unresolved, in
which case records shall be kept until all audit tasks are completed and resolved. These books,
IFB 5476
records, documents and other evidence shall be available, within 10 business days of written
request, Further, the CONTRACTOR shall also require all Subcontractors, material suppliers,
and other payees to retain all books, records, documents and other evidence pertaining to this
agreement, and to allow the OWNER similar access to those documents. All books and records
will be made available within a 50 mile radius of the City of Denton. The cost of the audit will
be borne by the OWNER unless the audit reveals an overpayment of 1% or greater. If an
overpayment of 1% or greater occurs, the reasonable cost of the audit, including any travel costs,
must be borne by the CONTRACTOR which must be payable within five business days of
receipt of an invoice.
Failure to comply with the provisions of this section shall be a material breach of this
contract and shall constitute, in the OWNER'S sole discretion, grounds for termination thereof,
Each of the terms "books", "records", "docurnents" and "other evidence", as used above, shall be
construed to include drafts and electronic files, even if such drafts or electronic files are
subsequently used to generate or prepare a final printed document.
IFB 5476
IN WITNESS WHEREOF, the parties of these presents have executed this agreement in
the year and day first above written,
A'� "�'�:���T:
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Jeff Davidson, Secretary
APPROVED AS TO FORM:
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(.,� ATTORNEY � ��"'
IFB 5476
Citv of 1=i�x���A�
O WNER k ��� �,,,�•���
BY; ��" ��.,�� " � .......
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(SEAL)
Spiess Construction Co., Inc.
CONTR.ACTOR NAME
P.O. Box 2849
Santa Maria, CA 93457
MAILING ADDRESS
805-937-5859
PHONE NUMBER
805-934-4432
^°�1�� (.�I�"�I ��� . .__
BY; ����x� ���, ,� ��..m_.
.���__..
AUTHORIZED AGENT
Scott A. Coleman
PRINTED NAME
President
TITLE
(SEAL)
PERFORMANCE BOND
. � ,
COUNTY OF DENTON
Bond #106123316
KNOW ALL MEN BY THESE PRESENTS: That Spiess Construction Companv, Inc,
whose address is 1110 E. Clarlc Ave, #210, Santa Maria, CA 93455 hereinafter called Principal,
and Travelers Casualty and Surety Company of America � a corporation organized and existing under
the laws of the State of Connecticut , and fully authorized to transact business in the State of
Texas, as Surety, are held and firmly bound unto the City of Denton, a municipal corporation
organized and existing under the laws of the State of Texas, hereinafter called Owner, in the
penal sum of One million, six hundred four thousand, three hundred fift,�DOLLARS
(1,604,356), in lawful money of the United States, to be paid in Denton County, Texas, for the
payment of which sum well and truly to be made, we hereby bind ourselves, our heirs, executors,
administrators, successors, and assigns, jointly and severally, firmly by these presents. This
Bond shall automatically be increased by the amount of any Change Order or Supplemental
Agreement, which increases the Contract price, but in no event shall a Change Order or
Supplemental Agreement, which reduces the Contract price, decrease the penal sum of this
Bond.
THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal
entered into a certain Contract, identified by IFB # 5476, with the City of Denton, the Owner,
dated the 16th day of September A.D.,2014, for Bid # 5476 — 2499 Utilitv Relocation Phase II
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform and fulfill
all of the undertalcings, covenants, terms, conditions and agreements of said Contract in
accordance with the Plans, Specifications and Contract Documents during the original term
thereof and any extension thereof which may be granted by the Owner, with or without notice to
the Surety, and during the life of any guaranty or warranty required under this Contract, and shall
also well and truly perform and ful�ll all the undertalcings, covenants, terms, conditions and
agreements of any and all duly authorized modifications of said Contract that may hereafter be
made, notice of which modifications to the Surety being hereby waived; and, if the Principal
shall repair and/or replace all defects due to faulty materials and worlcmanship that appear within
a period of two (2) years from the date of final completion and final acceptance of the Worlc by
the Owner; and, if the Principal shall fully indemnify and save harmless the Owner from all costs
and damages which Owner may suffer by reason of failure to so perform herein and shall fully
reimburse and repay Owner all outlay and expense which the Owner may incur in malcing good
any default or deficiency, then this obligation shall be void; otherwise, it shall remain in full
force and effect.
IFB 5476
PROVIDED FURTHER, that if any legal action be filed upon this Bond, exclusive venue
shall lie in Denton County, State of Texas,
AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates
and agrees that no change, extension of time, alteration or addition to the terms of the Contract,
or to the Worlc to be performed thereunder, or to the Plans, Specifications, Drawings, etc.,
accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby
waive notice of any such change, extension of time, alteration or addition to the terms of the
Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings,
etc.
This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government
Code, as amended, and any other applicable statutes of the 5tate of Texas.
The undersigned and designated agent is hereby designated by the Surety herein as the
Resident Agent in Denton County to whom any requisite notices may be delivered and on whom
service of process may be had in matters arising out of such suretyship, as provided by Article
7.19-1 of the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas.
IN WIT'NESS WHEREOF, this instrument is executed in four copies, each one of which
shall be deemed an original, this the 18th day of September , 2014
ATTEST;.
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BY; � � �" ,,��"��� �� �; ���`��"�"��,w
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�1�,�`�; l;"�"�ii��r" JEFF vavu�soN
ATTEST:
I:'
PRINCIPAL
��ie�� �r�ar�s�ru � "i�rY Cc�, � +� ���...�.� ................._....
BY� ��'°�����" � ���� �`,�°�" �'���������N
PRESIDENT �TT A. COLrMAN�
SURETY
Travelers Casualty and Surety Company of America
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BY: � �� �, , �f 'r�� � � �`�,� � `�w ,.,�
_._. ��..... ����.........,
�°� �'���'�1 "�-1N-FACT
Erin Bautista
The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of
the process is;
NAME: Willis of Texas, Inc.
STREET ADDRESS: 15305 North Dallas Parkway, Suite 1100, Addison. TX 75001
(NOTE: Date of Performance Bond must be date of Contract. If Resident Agent is not a corporation,
give a person's name.)
IFB 5476
ACKNOWLEDGMENT
State of California
County of _� ara
Santa Bar ......................�..
On �September 19, 2014 before me, , Laura C. Jevne, Notary Public
(insert name and title of the officer) m���mm��m��mIT�
personally appeared � leman
who proved to me on the bas s of satisfa�ctory evidence to be the person(� whose name(�) is/�� a
subscribed to the within instrument and acknowledged to me that he/�/t]��Ly executed the same in
his�i�r/t]��ir authorized capacity(�, and that by his/�c/th� signature(3�) on the instrument the
person�), 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.
��
�� � �ktJ�'A C: JEVNE
WITNESS my hand and official seal. ���.d��
� �,� ,y Commission �► 2026071
� ,I� � � Notary Puhlfc - Calibrnl� �,
� p�""� � �` �� � Santa Barbara County
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� �,.. �' � �;��r���i^�, &�� �� i��� Jun 21, 2017 ��
Signature '�� , � ���� (���I� � �
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State of California
County of Santa Clara
On September 18, 2014
ACKNOWLEDGMENT
before me, Jean L. Neu, Notary Public
mm ......����
(insert name and title of the officer)
personally appeared Erin Bautista
w _......._.�.�� .........����_�� ......................__...�
who proved to me on the basis of satisfactory evidence to be the person(� whose name($) is/�ce
subscribed to the within instrument and acknowledged to me that bradshe/� executed the same in
��/her/#�¢� authorized capacity(ie� and that by�tr�her��r signature(s� on the instrument the
person(�), 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.
WITNESS my hand and official seal,
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Signature ����mmm ^ " a� ����
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�U��� �rd��a�������, � � � � � ��
q � ���� JEAN L. NEU �
���� a � � , " Commission # 2056701 �
«� �� � �o;� Notary Public - Califomia �'
���d� Santa Clara County ""
�' �� ��� Comm. � ����e�re � Mar 1. 2018 �a
�a7eC��� '� ���'�"�'°yy"��i�y"'�re�"""�� ^�,�'"''�� �'�u�w'�d�' �iu�rn �:�a�r� t�y,�'�wo,� �m���r ���n,��
��iwi����w��w�ww�w�ww�w�w���iwiwi�i�i�i�i�MONi�i�i�o WARNING: THIS PiOM�mi�ioR�OF AITORNEY IS INVALI i�ww������w����������ww��,��.���.���� ����������. .....�e
� D WITHOUTTHE RED BORDER
POWER OF ATTORNEY
TRAVELER�' �� Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company 11�avelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters, Inc, lravelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
Attorney-In Fact No. 2234gg Certificate No. 0 0 5 9 8 5 2 3 6
KNOW ALL MEN BY THESE PRESENTS: Th1t Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company, St Paul Mercury Insurince Comp�ny, Travelers Casualty and Surety Company, Travelers Casualty and Sw•ety Company of America, and United St�tes
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a
corporation duly ocganized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the
laws of the State of Wisconsin (herein collectively called the "Companies"), �nd that the Companies do hereby make, constitute and appoint
Bryan D. Martin, Bradley N. Wright, Jean L. Neu, Erin Bautista, and Frances Murphy
of the City of S1I1 JOSO , State of Ca11fOCClla , their [rue and lawful Attorney(s)-in-Fact,
elch in their separate capacity if more thau one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, condition�l undertakings and
other writings obligatory in the niture thereof on behalf of the Compinies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contrlcts and executing or gulranteeing boods �nd undertakings required or permit[ed in any actions or proceedings allowed by law,
IN WITNESS WHEREOF, the Compamies have c�used this instrument to be signed and their coiporate seals to be hereto affixed, this 17th
day of .. July ... . 2014
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
'I%avelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
�r��t,,��, . s�,pi�6Yd�, �� �� v� �y�i`u�"��`�Y� d"'�*� "N:,y�er� M�t rz�u�;�^'r^w .p.,ad.rr ren�� . ,�uuuiar�„� �,�,�11""�
�" �,p i �i,�rRa �. ,�+�� �""`�^a,� r w 4 �. � �, . ,� ,�i
+a r �r �. m.. �.�ay�wacH�r�r � �r .. ���1 � " � � �, �
r + FIN�12�@r 1 �' � � .� �
�` G"a i�r . �. WCORPORATED . r. d �" ev u,P m � �r - : .� n... �w�,�y�,
�w �'�1N �,�'�v � � � 19 �-� �. � � a�.� � x .. ,� .� XAhf��'HtNfB�.. �64N d�r�rJ � �; ��� � .
�� ��a�� �� 51 � � �u �tl��.r�°° � SJ"�� Y �' �rarwr� „° ��°`�� �,'� �,�
e �raw����v�r� w � � o � � � � � r
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� � ,„ � �`�� �b�' "°� ����'� �r� �„�+x nm� "�"'"� � � v i"y�" �" , " �"�"' � � ° ��°" AiP� �
,.�,�,«�^ "'"�_
State of Connecticut
City of Hartford ss.
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By: ��` ob�L�,�e ,
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_ , .... . p''� .m.,,,,,, . ----- -
y �a iiui Vice President
On this the 17th day of Ju�Y 2014 before me personally appeared Robert L. Raney, who acknowledged himself to
be the Senior Vice President of Farmington Casualty Compiny, Fidelity and Gulranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul
Fire and Marine Insurince Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers
Clsualty and Surety Comp�ny of America, and United States Fidelity and Guarinty Company, and that he, as such, being �uthorized so to do, executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly autha�ized officer.
��"���"
In Witness Whereof, I hereunto set my hand 1nd official seal. ��
My Commission expires the 30th day of June, 2016. � p� �� �
� ��� �
58440-8-12 Printed in U.S.A,
'h�f����IIP��:'k'R-V4":3 POWER ��d•" ,�'p'iC�P�ri�fl�:`�"
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,__
�M�rie C, Tetieault, Notaiy Public
PAYMENT BOND
STATE OF TEXAS
COUNTY OF DENTON
Bond #106123316
KNOW ALL MEN BY THESE PRESENTS: That Spiess Construction Companv, Inc,
whose address is „1110 E. Clarlc Ave, #210, Santa Maria, CA 93455,hereinafter called Principal,
elers Casualty and Surety Company of �o������ corporation organized and existing under the
andTrav.... _...... ��.� ......
laws of the State of Connecticut_ _, and fully authorized to transact
business in the State of Texas, as Surety, are held and firmly bound unto the City of Denton, a
municipal corporation organized and existing under the laws of the State of Texas, hereinafter
called Owner, and unto all persons, firms, and corporations who may furnish materials for, or
perform labor upon, the building or improvements hereinafter referred to, in the penal sum of
One million, six hundred four thousand, three hundred fift.v six DOLLARS (1,604,356) in lawful
money of the United States, to be paid in Denton, County, Texas, for the payment of which sum
well and truly to be made, we hereby bind ourselves, our heirs, executors, administrators,
successors, and assigns, jointly and severally, firmly by these presents. This Bond shall
automatically be increased by the amount of any Change Order or Supplemental Agreement
which increases the Contract price, but in no event shall a Change Order or Supplemental
Agreement which reduces the Contract price decrease the penal sum of this Bond.
THE OBLIGATION TO PAY SAME is conditioned as follows; Whereas, the Principal
entered into a certain Contract, identified by IFB # 5476, with the City of Denton, the Owner,
dated the 16th day of September A.D.,2014, for Bid # 5476 — 2499 Utilitv Relocation Phase II
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties
and make prompt payment to all persons, firms, subcontractors, corporations and claimants
supplying labor and/or material in the prosecution of the Work provided for in said Contract and
any and all duly authorized modifications of said Contract that may hereafter be made, notice of
which modifications to the Surety being hereby expressly waived, then this obligation shall be
void; otherwise it shall remain in full force and effect.
PROVIDED FURTHER, that if any legal action be filed on this Bond, exclusive venue
shall lie in Denton County, Texas.
AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates
and agrees that no change, extension of time, alteration or addition to the terms of the Contract,
or to the Worlc to be performed thereunder, or to the Plans, Specifications, Drawings, etc.,
accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby
waive notice of any such change, extension of time, alteration or addition to the terms of the
Contract, or to the Worlc to be performed thereunder, or to the Plans, Specifications, Drawings,
etc.
IFB 5476
This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government
Code, as amended, and any other applicable statutes of the State of Texas.
The undersigned and designated agent is hereby designated by the Surety herein as the
Resident Agent in Denton County to whom any requisite notices may be delivered and on whom
service of process may be had in matters arising out of such surety, as provided by Article 7.19-1
of the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas.
IN WIT'NESS WHEREOF, this instrument is executed in four copies, each one of which
shall be deemed an original, this the 18th day of September , 2014 ,
ATTEST:
� � � �, � �^�
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BY: � ���;� � ���"��� � � ��. �-,����"*�„�_
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���^;t� 1;'1""ARY-�FF 1��nso�t
ATTEST:
:
PRINCII'AL
Spiess Construct� �o Inc. �
.
'
BY: a�� .� �� .�, ��,�.,,��.m..
PRESIDENT Sco�r7 A. Lo�EMAN
SURETY
Travelers Cas���lt��,�r and S���r���y� Com�a�r�y� of America
� _."�'
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BY: �,��:,� �4 ��r� ��,�� �,�.�����.
'" ti d�a ���� �' �,
A""1� 4.�I���t �`-IN-FACT
Erin Bautista
The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of
the process is:
NAME: Willis of Texas, Inc.
STREET ADDRESS; 15305 North Dallas Parkway, Suite 1100, Addison, TX 75001
(NOTE: Date of Payment Bond must be date of Contract. If Resident Agent is not a
corporation, give a person's name.)
IFB 5476
ACKNOWLEDGMENT
State of California
County of � w _ Barbara
S ant a ....................�„
On P 19, 2014 before me, Laura C. Jevne, Notary Public
Se tember � �,�,�� m
(insert name and title of the officer)
personally appeared Scott A. Coleman
who proved to me on the basis of satisfacto�� evidence to be the� erson whose na mmmmmm�����
rY p �� ....w_...�me(�) is/�8�
subscribed to the within instrument and acknowledged to me that he/�/t]d�Iy executed the same in
his�i�r/t}��ir authorized capacity(�), and that by his/b�t/th�ir signature(i�) on the instrument the
person�), or the entity upon behalf of which the person(�j 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.
z�
WITNESS my hand and official seal. �"� ru����� �"" "�����
,b �,,, Commission #� 2026071
� , , +� � � Notary Public - Californle �
� ''� '"" �"'o � "�«� Santa Barbara County �'
� . � ��.." y .� �� � .,��. �+y� Comm. q���p9a�r� Jun 21. 2017 �
� � �� (Seal) �� „�,
9 �"... . _ ���....���.....mm
Si nature
State of California
County of mmmmmmmmmmm mmmmmITIT Santa Clara
On September 18, 2014
ACKNOWLEDGMENT
before me, Jean L. Neu, Notary Public
(insert name and title of the officer)
personally appeared Erin Bautista
p .._.__� y �...�..�� p �� ...�� .�
who roved to me on the basis of satisfactor evidence to be the erson whose name(s) is/�:e
subscribed to the within instrument and acknowledged to me that lx�she/� executed the same in
#��/herf� authorized capacity(ies� and that by�her��r signature(s� on the instrument the
person(�), 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.
WITNESS my hand and official seal.
"` � ' �
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.. � �'� ,� � � �' �,� � �''� �,..
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i1 ., JEAN L. NEU �
�; � � Commission # 2056701 �
d�� �" fd° � r`� Notary Public - Calitornia �
��'�� , , ���� Santa Clara County �"
��+ � � M,� Comm E�p����� Mar 1 2018�
a7eC��� �na;��.,�!,r�°TM'rl�'°�� �„�',y�'�qT� nr�+'�^rr^'"u��"ax��,u'"�"�"�'?�'",�d�'w°�iPW'�'+�"�
THIS POWER OF ATTORNEY IS INVALID WITHOUTTHE R
ED BORDER
POWER OF ATTORNEY
T' `^�` ��' `�' "� Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company T]�avelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters, Inc. T�avelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
Attorney-In Fact Nox 2234gg Cert,f�ate No. 0 0 5 9 8 5 2 3 7
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine InsurTnce Coinpany, St. Paul Guardian Insurance
Company, St. P1ul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers C�sualty and Surety Company of America, and United Stltes
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Comlecticut, that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the
laws of the St1te of Wisconsin (herein collectively called the "Compinies"), and thlt the Compinies do hereby m�ke, constitute and appoint
Bryan D. Martin, Bradley N. Wright, Jean L. Neu, Erin Bautista, and Frances Murphy
of the City of San T�ce: , St1te of California , their true and ]�wful Attorney(s)-in-Fact,
e�ch in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditiona] undertakings and
other writings obligatory in the nature [hereof on behalf of the Compinies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts 1nd executing or guaranteeing bonds 1nd undertakiugs required or permitted in any ac[ioi�s or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies hlve c�used this instrument to be signed ��nd their coiporate seals to be hereto affixed, this 17th
day or July 2014 ..
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
11�avelers Casualty and Surety Company
navelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
K M�„.dp� ��"4Y �:.��?��. w5�ue`"��m'"� ��'� �M ���..� n u �"^'��r � '�aauntlr"i . r�1"fqry
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� � � .951 ,�� f / �,4 � y "�C J4,I� ,CaWaN � i "w,y� J� � L CONN. � �u 'dMl� �i�'AWIY A ��'� ��,.w�:.
w ��,y
"��,��+w���:r����� � ��, ��,M �''�',.,s��i��°u� ^�`aa „`h;a��,N` ���,m�'�w�'� ��`��...���� " � ?4'� '�Akk?��`"
� .,, +rm,v..�.+r� � .
State of Connecticut
City of Htu•tford ss
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Y° . _
Robert L. Raney ,�r�ai�r Vice Piesident
On this the l,�th � day of July 2014 before me personally appeared Robert L. Raney, who acknowledged himself to
be the Seuior Vice President of Farmington C�sualty Comp�ny, Fidelity and Guaranty Insurance Company, Fidelity 1nd Guar�nty Insurance Underwriters, Inc., St. Paul
Fire and M�rine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury InsurTnce Company, Travelers Casualty and Surety Company, Travelers
Casullty �nd Surety Company of Americl, and United States Fidelity and Guaranty Compiny, �nd that he, as such, being authorized so to do, executed the foregoing
instrument for Ute purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
�w��In Witness Whereof,I hereunto set my hand �nd officialseal. ��
My Commission expires the 30th day of June, 2016. �p ������ '
�
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58440-8-12 Printed in U.S.A.
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Mai ie ;,, ,, _ ___
C. Tetreault, Notaiy Public
INSURANCE REQUIREMENTS AND
WORKERS' COMPENSENTATION REQUIREMENTS
Upon contract execution, all insurance reguirements shall become contractual obligations, which the
successful contractor shall have a duty to maintain throughout the course of this contract.
STANDARD PROVISIONS:
Without limiting any of the olher obligations or liabilities of the Contractor, the Contractor shall
provide and maintain unlil lhe contracted work has been completed and accepted by the City of
Denton, Owner, the `ninimurre insurance coverage as indicated hereinafter.
Contractor shall file with the Purchasing Department salisfactory certificates of insurance including
any applicable addendum or endorsements, containing the contract number and title of the projec�
Contractor rnay, upon written request lo the Purchasing Deparl`nent, ask for clarification of any
insurance requirements at any time; however, Contractor shall not commence any work or deliver any
material until he or she receives notificalion that the contract has been accepted, approved, and signed
by lhe City ofDenton.
All insurance policies proposed or obtained in salisfaction of these requiremenls shall comply with lhe
following general specifications, and shal[ be maintained in cornpliance with these general
specifications throughoul the duration of the Contracl, or longer, if so noted:
• Each policy shall be issued by a company authorized to do business in the State of Texas with an
P Y g •
A.M. Best Com an ratm o at east A- VII or better
• Any deductibles or self-insured retentions shall be declared in the proposal. If requested by the
City, the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect
to the City, its officials, agents, employees and volunteers; or, the contractor shall procure a bond
guaranteeing payment of losses and related investigations, claim administration and defense
expenses.
• Liability policies shall be endorsed to provide the following:
Name as Additional Insured the City of Denton, its Officials, Agents, Employees and
volunteers.
� That such insurance is primary to any other insurance available to the Additional Insured
with respect to claims covered under the policy and that this insurance applies separately
to each insured against whom claim is made or suit is brought. The inclusion of more
than one insured shall not operate to increase the insurer's limit of liabil ity.
• Cancellation: City requires 30 day writ[en notice should any of the policies described on the
certificate be cancelled or materially changed before the expiration date.
� Should any of the required insurance be provided under a claims made form, Contractor shall
maintain such coverage continuously throughout the term of this contract and, without lapse, for a
period of three years beyond the contract expiration, such that occurrences arising during the
contract term which give rise to claims made after expiration of the contract shall be covered.
IFB 5476
• Should any of the required insurance be provided under a form of coverage that includes a
general annual aggregate limit providing for claims investigation or legal defense costs to be
included in the genera] annual aggregate limit, the Contractor shall either double the occurrence
limits or obtain Owners and Contractors Protective Liability Insurance.
• Should any required insurance lapse during the contract term, requests for payments originating
after such lapse shall not be processed until the City receives satisfactory evidence of reinstated
coverage as required by this contract, effective as of the lapse date. If insurance is not reinstated,
City may, at its sole option, terminate this agreement effective on the date of the lapse.
SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS:
All insurance policies proposed or obtained in satisfaction of this Contract shall aalditionally comply
with the following marked specifications, and shall be rnaintained in correpliance with these additional
specifications throughoul the duralion of the Contract, or longer, if so noled:
[X] A. General Liability Insurance:
General Liability insurance with combined single limits of not less than $1,000,000.00 shall
be provided and maintained by the Contractor. The policy shall be written on an occurrence
basis either in a single policy or in a combination of underlying and umbrella or excess
policies.
If the Commercial General Liability form (ISO Form CG 0001 current edition) is used:
• Coverage A shall include premises, operations, products, and completed operations,
independent contractors, contractual liability covering this contract and broad form
property damage coverage.
• Coverage B shall include personal injury.
• Coverage C, medical payments, is not required.
If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition
and ISO Form GL 0404) is used, it shall include at least:
� Bodily injury and Property Damage Liability for premises, operations, products and
completed operations, independent contractors and property damage resulting from
explosion, collapse or underground (XCU) exposures.
. Broad form contractual liability (preferably by endorsement) covering this contract,
personal injury liability and broad form property damage liability.
[X] Automobile Liability Insurance:
Contractor shall provide Commercial Automobile Liability insurance with Combined Single
Limits (CSL) of not less than $500,000 either in a single policy or in a combination of basic and
umbrella or excess policies. The policy will include bodily injury and property damage iiability
arising out of the operation, maintenance and use of all automobiles and mobile equipment used
IFB 5476
in conjunction with this contract.
Satisfaction of the above requirement shall be in the form of a policy endorsement for:
• any auto, or
• all owned hired and non-owned autos.
[X] Workers' Compensation Insurance
Contractor shall purchase and maintain Workers' Compensation insurance which, in addition to
meeting the minimum statutory requirements for issuance of such insurance, has Employer's
Liability limits of at least $100,000 for each accident, $100,000 per each employee, and a
$500,000 policy limit for occupational disease. The City need not be named as an "Additional
Insured" but the insurer shall agree to waive all rights of subrogation against the City, its officials,
agents, employees and volunteers for any work performed for the City by the Named Insured.
For building or construction projects, the Contractor shall comply with the provisions of
Attachment 1 in accordance with §406.096 of the Texas Labor Code and rule 28TAC 110.110 of
the Texas Workers' Compensation Commission (TWCC).
[] Owner's and Contractor's Protective Liability Insurance
The Contractor shall obtain, pay for and maintain at all times during the prosecution of the work
under this contract, an Owner's and Contractor's Protective Liability insurance policy naming the
City as insured for property damage and bodily injury which may arise in the prosecution of the
work or Contractor's operations under this contract. Coverage shall be on an "occurrence" basis
and the policy shall be issued by the same insurance company that carries the Contractor's
liability insurance. Policy limits will be at least $500.000.00 combined bodily injury and
property damage per occurrence with a$1,000,000.00 aggregate.
[] Fire Damage Legal Liability Insurance
Coverage is required if Broad form General Liability is not provided or is unavailable to the
contractor or if a contractor leases or rents a portion of a City building. Limits of not less than _
.......................mmm.�mm�m���m��� � each occurrence are required,
[ ] Professional Liability Insurance
Professional liability insurance with limits not less than $1,000,000.00 per claim with respect to
negligent acts, errors or omissions in connection with professional services is reGuired under this
Agreement.
[ ] Builders' Risk Insurance
Builders' Risk Insurance, on an All-Risk form for 100% of the completed value shall be provided.
Such policy shall include as "Named Insured" the City of Denton and all subcontractors as their
interests may appear.
IFB 5476
ATTACHMENT 1
[X] Workers' Compensation Coverage for Building or Construction Projects for
Governmental Entities
A. Definitions:
Certificate of coverage ("certificate")-A copy of a certificate of insurance, a
certificate of authority to self-insure issued by the commission, or a coverage
agreement (TWCC-81, TWCC-82, TWCC-83, or TWCC-84), showing statutory
workers' compensation insurance coverage for the person's or entity's employees
providing services on a project, for the duration of the project.
Duration of the project - includes the time from the beginning of the work on the
project until the contractor's/person's work on the project has been completed and
accepted by the governmental entity.
Persons providing services on the project ("subcontractor" in §406.096) - includes all
persons or entities performing all or part of the services the contractor has
undertaken to perform on the project, regardless of whether that person contracted
directly with the contractor and regardless of whether that person has employees.
This includes, without limitation, independent contractors, subcontractors, leasing
companies, motor carriers, owner-operators, employees of any such entity, or
employees of any entity which furnishes persons to provide services on the project.
"Services" include, without limitation, providing, hauling, or delivering equipment or
materials, or providing labor, transportation, or other service related to a project.
"Services" does not include activities unrelated to the project, such as food/beverage
vendors, office supply deliveries, and delivery of portable toilets.
B. The contractor shall provide coverage, based on proper reporting of classification
codes and payroll amounts and filing of any overage agreements, which meets the
statutory requirements of Texas Labor Code, Section 401.011(44) for all employees
of the Contractor providing services on the project, for the duration of the project.
C. The Contractor must provide a certificate of coverage to the governmental entity
prior to being awarded the contract.
D. If the coverage period shown on the contractor's current certificate of coverage ends
during the duration of the project, the contractor must, prior to the end of the
coverage period, file a new certificate of coverage with the governmental entity
showing that coverage has been extended.
E. The contractor shall obtain from each person providing services on a project, and
provide to the governmental entity:
1. a certifcate of coverage, prior to that person beginning work on the project, so
IFB 5476
the governmental entity will have on file certificates of coverage showing
coverage for all persons providing services on the project; and
2. no later than seven days after receipt by the contractor, a new certificate of
coverage showing extension of coverage, if the coverage period shown on the
current certificate of coverage ends during the duration of the project.
F. The contractor shall retain all reyuired certificates of coverage for the duration of the
project and for one year thereafter.
G. The contractor shall notify the governmental entity in writing by certified mail or
personal delivery, within 10 days after the contractor knew or should have known, of
any change that materially affects the provision of coverage of any person providing
services on the project.
H. The contractor shall post on each project site a notice, in the text, form and manner
prescribed by the Texas Workers' Compensation Commission, informing all persons
providing services on the project that they are required to be covered, and stating
how a person may verify coverage and report lack of coverage.
I. The contractor shall contractually require each person with whom it contracts to
provide services on a project, to:
1. provide coverage, based on proper reporting of classification codes and payroll
amounts and filing of any coverage agreements, which meets the statutory
requirements of Texas Labor Code, Section 401.011(44) for all of its employees
providing services on the project, for the duration of the project;
2. provide to the contractor, prior to that person beginning work on the project, a
certificate of coverage showing that coverage is being provided for all employees
of the person providing services on the project, for the duration of the project;
3. provide the contractor, prior to the end of the coverage period, a new certificate of
coverage showing extension of coverage, if the coverage period shown on the
current certificate of coverage ends during the duration of the project;
4. obtain from each other person with whom it contracts, and provide to the
contractor:
a. a certificate of coverage, prior to the other person beginning work on the
project; and
b. a new certificate of coverage showing extension of coverage, prior to the end
of the coverage period, if the coverage period shown on the current certificate
of coverage ends during the duration of the project;
IFB 5476
5. retain all required certifcates of coverage on file for the duration of the project
and for one year thereafter;
6. notify the governmental entity in writing by certified mail or personal delivery,
within 10 days after the person knew or should have known, of any change that
materially affects the provision of coverage of any person providing services on
the project; and
7. Contractually require each person with whom it contracts, to perform as required
by paragraphs (1) -(7), with the certificates of coverage to be provided to the
person for whom they are providing services.
By signing this contract or providing or causing to be provided a certificate of
coverage, the contractor is representing to the governmental entity that all employees
of the contractor who will provide services on the project will be covered by
workers' compensation coverage for the duration of the project, that the coverage
will be based on proper reporting of classification codes and payroll amounts, and
that all coverage agreements will be filed with the appropriate insurance carrier or, in
the case of a self-insured, with the commission's Division of Self-Insurance
Regulation. Providing false or misleading information may subject the contractor to
administrative penalties, criminal penalties, civil penalties, or other civil actions.
K. The contractor's failure to comply with any of these provisions
contract by the contractor which entitles the governmental entity
contract void if the contractor does not remedy the breach within
receipt of notice of breach from the governmental entity.
IFB 5476
is a breach of
to declare the
ten days after
IFB 5476 - Pricing Sheet for FM 2499 Utility Relocation P���ect - Phase II
1 Respondent's Name;
'Principal Place of Business
Respondent is a Corporation, Partnership, sole
2 'Proprietorship, Individual?
Total working days (Monday - Friday/Saturday) after
Notice to Proceed is issued by City for substantial
3 completion:
Construction of the FM 2499 shall be scheduled to be
completed within 270 Calander Days. If this date cannot
be met, please insert the date that your firm can complete
3a the prolect. :
Total working days (Monday - Friday/Saturday) after
4 Notice to Proceed is issued by City for project start:
5 Base Bid amount to construct project per specifications:
���l�wN�d Pricing: � �� � �
Spiess
Construction Co.,
Inc.
' Santa Maria, CA
Corporation
150
� � �,;zois
20
$1,604,356.00
em uan i y Description ni ' ni rice Total
103.3-S 1 Surety Bonds L,S $25,000.00 $25,000.00
107.19.3 3,727 Excavation Protection L,F� $1.00 $3,727.00
107.20-S 1 Project Signs �,4 $1,500.00 $1,500.00
'201 j 3,641 Temporary Erosion Control L.N $2.00 $7,282.00
'202.6 12,100 SeedingTurfGrass SY $0.50 $6,050.00
_
203.3-S 1 General Site Preparation L,S $50,000.00 $50,000.00
203.7 150 Embankment CY $30.00 $4,500.00
301.2 328 Lime Treatment SY $12.00 $3,936.00
.
301.5 203 Flexible Base SY $15.00 $3,045.00
302.9 328 Asphalt Pavement SY $100.00 $32,800.00
305.1 85 Concrete Curb & Gutter L,F $30.00 $2,550.00
502.1-A 4 4' I.D. Concrete Manhole (0-6 ft deep) �� $7,000.00 $28,000.00
502.1-61 1 8' I.D. Fiberglass Manhole (0-6 ft deep) �A $15,000.00 $15,000.00 i
502.1-62 2 6' I.D. Fiberglass Manhole (0-6 ft deep) Et� $13,000.00 �26,000.00
_ _
502.1-B3 4 5' I.D. Fiberglass Manhole (0-6 ft deep) �A $10,000.00 $40,000.00
1502.1-C 16 Additional Concrete MH Depth (> 6 ft deep) VF $300.00 $4,800.00
502.1-D 42 Additional Fiberglass MH Depth (> 6 ft deep) �IF $300.00 $12,600.00
IFB 5476
em uan i Descriptiom m �i rlce Total
502.12.4 2 Core Into Existing Manhole EA $750.00 $1,500.00
503.1-A 147 �6" C900 PVC Force Main In Casing L,�� $80.00 $11,760.00
503.1-B 120 48" Sanitarv Sewer In Casinq L,F� $260.00 $31,200.00
503.1-C 90 8" Sanitarv Sewer In Casinq I,� $60.00 $5,400.00
503.3-C 90 16" Steel Casing by Bore/Tunnel I,F' $600.00 $54,000.00
�, . �
504.5 103 Concrete Encasement �,F $200.00 $20,600.00
�
505-A 120 60" Steel Casing by Open Cut LF $350.00 $42,000.00
_
I505-C 147 12" Steel Casina bv Ooen Cut I,F $100.00 $14,700.00
507-A 422 48" Sanitary Sewer- Unpaved I,� $370.00 $156,140.00
507-B 555 36" Sanitary Sewer - Unpaved LF $270.00 $149,850.00
507-C 1177 27" Sanitary Sewer - Unpaved LF $170.00 $200,090.00
507-D 46 8" Sanitary Sewer - Paved LF $200.00 $9,200.00
507-E 942 8" Sanitarv Sewer - Unpaved LF $90.00 $84,780.00
507-F 265 6" C900 PVC Force Main - Unpaved LF $90.00 $23,850.00
801-S 1 Barricades, Warning Signs and Detours LS $15,000.00 $15,000.00
SS01 10 Cut and Plug Existing Sanitary Sewer Line EA $500.00 $5,000.00
_
SS02 14 Abandon Existinq Manhole EA $500.00 $7,000.00
SS03 1 Remove Existinq Manhole �t� $500.00 $500.00
SSO4 412 Remove Asphalt Pavement SY $5.00 $2,060.00
SS05 23 'Parkina Stall Restoration �/� $250.00 $5,750.00
SS06 1 Bvpass Pumpinq L.S $25,000.00 $25,000.00
SS07 1 18" Reuse Line & Valve Adjustment LS $60,000.00 $60,000.00
SS08 1 8" Temporary Sewer Line Adjustment LS $700.00 $700.00
SS09 1 6" Force Main Cut In Connection EA $500.00 $500.00
'SS10 53 18" Steel Split Casing by Open Cut L,F $210.00 $11,130.00
WASTEWATER SUBTOTAL: $1,204,500.00
Item Quantity Description Unit Unit Price Total
103.3-W 1 Surety Bonds LS $]0,000.00 $10,000.00
107.19.3 1,484 Excavation Protection LF $1.00 $1,484.00
IFB 5476
em uan i y Description ni ni rice Total
107.20-W 1 Project Signs EA $1,500.00 $1,500.00
201 1,466 Temporary Erosion Control LF $2.00 $2,932.00
202.6 4,900 Seeding TurF Grass SY $0.50 $2,450.00
_
203.3-W 1 General Site Preparation LS $15,000.00 $15,000.00
502.3 1 Fire Hydrant Assembly �A $8,000.00 $8,000.00
502.6.2-A 1 16" Gate Valve EA $15,000.00 , $15,000.00
502.6.2-B 1 12" Gate Valve �A $3,000.00 $3,000.00
502.6.3 ] 2" Combination Air Valve EA $5,000.00 $5,000.00
503.1-W I, ]35 12" C900 PVC Water In Casing LF $70.00 $9,450.00
503.1-X 140 16" DIP Class 52 Water In Casing LF $120.00 $16,800.00
503.3-A 140 24" Steel Casing by Bore/Tunnel , L,�' $500.00 $70,000.00
503.3-B 135 20" Steel Casing by Bore/Tunnel L,F $500.00 $67,500.00
505-B 12 24" Steel Casing by Open Cut LF $180.00 $2,160.00
506-A 18 16" DIP Class 52 Water - Paved I.F' $600.00 $10,800.00
I506-B 38 16" DIP Class 52 Water - Unpaved LF $1,040.00 $39,520.00
506-C 1428 12" C900 PVC Water - Unpaved LF $70.00 $99,960.00
801-W 1 Barricades, Warning Signs and Detours LS $5,000.00 $5,000.00
W01 2 12" Tapping Sleeve Connection ��t $2,000.00 $4,000.00
W02 1 14" Tapping Sleeve Connection (Concrete) EA $2,200.00 $2,200.00
W03 1 12" Cut-In Connection E� $600.00 $600.00
W04 4 Cut & Plug Existing Water Line EA $500.00 $2,000.00
W05 5 Remove Fire Hydrant Assembly �A $500.00 $2,500.00
W06 2 Remove Air Valve / Cutoff Valve EA $500.00 $1,000.00
W07 4 Remove Valve Stack EA $500.00 $2,000.00
WATER SUBTOTAL: �399,856.00
WASTEWATER SUBTOTAL:
WATER SUBTOTAL:
TOTAL PROJECT COST:
IFB 5476
$1,204,500.00
$399,856.00
$1,604,356.00
IFB 5476
PR.�POSAL
TO
THE CITY OF DENTON, '�'EXAS
FOR THE CONSTRUCTION OF
FM 2499 UTILITY' RELOCATION PHASE II
IN
D�N'TON, TEXAS
The undersigned, as bidder, declares that the only person or parties interested in this proposal as
principals are those named herein, that this proposal is made without collusion with any ot�er
person, firm, ox coXporaiion; that he has carefully examined the form of contract, Notice to Bidders,
specifications and the plans therein re£erred to, and has carefully exarnir�ed the locations, conditions,
and classes of materials of the proposed work and agrees that he wi11 provide all the necessary labor,
machinery, tools, a�paraius, and other iterns incidental to construcfiion., and will do all the work and
fi,u��ish all the zx�aterials called for in the contract and specifications in the manner prescribed herein
az�d acaording to the requirernents of the City as therein set forth.
It is understood that the followin�g quantities of woxk to be done at unit prices are approximate only,
and are intended principally to serve as a guide in evaluating bids.
It is agreed that the quantities of work to be done at unit prices and material to be furnished may be
increased or d'uninished as may be considered necessaiy, in the opinion of the City, to eomplete the
work fully as planned and contemplated, and that all quantities of work whether increased or
decreased are to be performed at the unit prices set forth below except as pxovided for in the
specifications. The contractor shall provide the unit price and the total price in both numeric and
words %r each quantity, listed in Exhibit 1. Unit price governs over the total numeric price given.
It is further agreed that ehange orders may be n.egotiated between the contractor an.d City to cover
additional work ordered by the City, but not shown on the plans or required by the specifications, it�
accordance with the General Provisiox�s and the limitations prescribed by the Texas Loeal
Governnnent Code. Similarly, change orders may be negotiated to cover deletion of work so
ordexed.
f.'�I
IFB 5476
It is understood and agreed that the work is to be coznpleted in full within the tizx�,e specified in thc
Genera� Yrovisions, Accoznpanying this pro�osal is a certified or cashier's check or Bid Bond,
payable io the Owner, in the amount of �ve perce�at of the total bid.
It is understood that the bid security accompanying this proposal shall be returned to the bidder,
unless in case of the acceptance of the proposal, the bidder shall fail to execute a contract and file a
performance bond anei a payment Uond within fifteen days after its acceptance, in which case the bid
security shall become the property of the Owzier, and shall be considered as a payment for damages
due to delay and other inconveniences suffered by the Owiaer o;n account of such failure of the
bidder. Ownec resexves the right ta reject any and all bids, Ownex may investigate the prior
pexfozmance of bidder or► otlier contracts, eithet• public or private, in. evaluating bid proposals,
Should bidder alter, change, or qualzfy any specification of the bid, Owner may automa�lzcally
disqualify bidder,
The undersigned hereby proposes and agrees to perform a11 work of whatever nature required, in
strict aecord�ice with ihe plrzns azid specifications, for the following sum or prices, to wit:
Not�ce:
• Proposer shall complete Ex�ibit 1— �ricing Sheet and subn�it with bid proposal in hard
copy (papex) �or�at.
� Additionally, the proposer shall email the pricing sheet to ebids(a�citvofdenton.com in
electronic 1V�S Offica — Excel foz•�nat, �rior to the bid submission deadline.
The award of the contract will be based on the T'otal Base Bid. Tl�e J�owest z'esponsive proposal for
pwposes of award shall be the conforming responsrble bidder offering the lowest cost for the base
bid, The undersigned certifies that the bid prices contained in this proposal have been carefully
checked and are submitted as correct and final. Unit and lurnp siun prices as shown for each item
listed in this proposal shall control over extensions.
In the event of the awarci of a contract to the undersigned, the undersigned will fiunish a
performuxce bond and a payrnent Uond for the full amount of the contract, to secure proper
cornpliance with the terms and proviszons of the contract, to insure and gtYarantee the work until
final completion and acceptance, and to guarantee payment fox all lawful claims for labor perforrned
and materials furnished in the fi.tliillment of the contract.
It is understood that the work proposed to be done shall be accepted, when �ully completed and
finished in accordance with the plans and specifications, to the satisiaction of the Engineer.
The undersigned affirms that they are duly authorized to execute this coiitract, that this IFB has
not been prepaxed in collusion with any other Proposer, nor any eznployee of the City of Denton,
and that the contents of this IFB have not been. connmunicated to any other proposer or to any
employee of the City of Denton prxor to tk�e official opez�ing of this bid. The undersigned agrees
this bid becomes t�.e property of the City of Denton after the official opening.
P-2
IFB 5476
Vendor hereby assigns to owner any and all claims for overcharges associated with this contract
which arise under the antitrust laws of ihe United States, 15 �(JSCA Section 1 et se ., and which
arise under the antitrust laws of the State of Texas, Tex. Bus. & Com. Code,
Section 15.01, et se .
The undersigiied agrees, if this proposal is accepted, to furnish any and all items/sezvices upon
which priees are offexed, at the price(s) and upon the terms and conditions contained in the
specification. The �eriod for acceptance of this Proposal will be one-hundred and twenty (120)
calendar days unless a different period is noted.
The unde�•signed af�rms that they have read and do uiiderstand the specifications and any
attachments contained in this IFB package.
The undersigned agrees that the IFB posted on the website axe the official specifications and shall
not alter the electronic copy of the specifications and/or pz'icing sheet (Exhibit 1}, without clearly
ideniifying changes.
The undersigned understands they will be responsible fox monitoring the City of Denton Purck�asing
Websiie at: htt�;//www.citvofdenton,com/index,aspx7pa�e-397 to ensure they have downloaded
and signed all addendum(s) required for suhmission with their proposal.
I certify that I have znade no willful xnisrepresex�tations in this Proposal Submissxon, nox have I
withheld information in my statements and answers to questions, I am awara that the information
given by me in this proposal wi11 be investigated, with my full pertnission, and that any
misxepresentations or omissions may cause xny proposal to be rejected.
Acknowledge receipt of following addenda to the proposal;
Flddendun�a No. 1 ciated u�� �, �� ��,���� Received ''
-._ w.....� ._
Addendum No. 2 dated Received
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Addendum No. 3 dated Received
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Addendum. No. 4 dated Reeeived
NAME AND ADDRESS OF COMPANY:
REPRESENTATIVE:
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l,arar�,.�l . ....� � ��.����� �.,'.�.'�. ks ��
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P-3
IFB 5476
AUTHORIZED
� �
�-��
� �� �
Szgnature,...�� ,. �....��_ _ ..,�,�.�._.....� . .�.��s�.V......�
Date ,_. ��-� � . .� �..�"..� �'�� �µ'� I �� ... � ._ ..... .. �
Name a_ �����'.�.....Q < ����1�']AN
. �" N"T
Title .�.� m . _.^�.,.:. . e... � ....�..�.�. ,. ��.n ... _�_._._ .._,._,..
Fax No � �� ��..�3�- '��� �,
V�ND�R COMPLIANCE TO STATE LAW
The 1985 Session of the Te�as Legislatiu•e passed House Bi11620 relative to the award of contracts
to non-resident bidders. This law provides that, izi order to Ue awarded a contract as low bidder,
non-resident biddexs (out-of-state coniractors whose corporate offices or principal place of business
are outside of the State of Texas) bid projects fox constxuction, improvements, supplies or services
in Texas at an amount lower than the lowest Texas resident bidder by the same amount that a Texas
resident bidder would be required to underbid a non-resident bidder in order 1:0 obtain a coniparabla
contract in the state in which ihe non-resident's principal place of business is located. The
appropriate blanks in Section A below must be filled out by all out-of-state or non-resident bidders
in order for your bid to meet sp.eci�cations. The failure of out-of state or non-resident contractors to
do so will automatically disqualify that bidder. Resident bidders rnust check the blank in Section B,
A. Non-resident bidders in mm (give state), our principal place of business,
are required to be percent lower than resident bidders by state law.
A copy of the statute is attached.
Non-xesident bidders in C�L 1,�=b�l �___ a(give state), oLtr principal place o� business,
are not required to undexbid resident bidders.
n, Our principal place of business or corporate offices are in the State of Texas; �
BIDDER:
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S � � �� � �" � �f;��� �'�1,�"��� C������" �"�
�Jµ��...�.' �(,HR.K �1'1/�.�..,.#��� .
Street Address
�P�/1t-��w �A�1:°1�4� G� ���� �
City and State
� ; ' ' 1 ! �.
P-4
IFB 5476
CQNFLICT OF INTEREST QUESTIONNAIRE
For vendor or other person doing business with focal governmental entifiy
7hls questlonnalre reflects changes made to the law by H.B. 1491, 8oth Leg„ Rogular Session.
This questionnaire is being filed In accordance with Chapter 176, Local Government Code
by a person who has a buslness relationship as defined by Section 176.001(1-a) with a local
governmental entity and the person meets requirements under Section 176,006(a),
By law thls questionnaire must be filed with the records administrator ofthe local governmentaf
entity not later than the 7th business day after the date the person becomes aware of facts
that require the statement to be filed. See Section 176.006, Local Government Code.
A person commits an offense if the person knowingly violatos Section 17s,006, Lacal
Government Code. An offense under this section is a Class C misdemeanor.
Name of person who has a business relationship with local governmenfal entlty.
Checkthls box Ifyou are filing an update to a previously filed questionnalre.
FORM CIQ
OFFICE USE ONLY
Dafe Received
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not
later than the 7th business day after the date the origlnally filed questlonnalre becomos Incomplate or inaccurate,)
Name of local government o�cer with whom filer has employment or buslness relationship,
�,a�ro�.� �a.� ..... ����.�,��.�.�.�.� � �.,ri�,�,�..�,�.,..,_.,,.�,.
Name of Offlcer
This section (item 3 including subparts A, B, C& D) must be completed for each officer with whom the filer has an
employment or other business relationship as defined by Section 176.U01(1-a), l.ocal Government Code, Atfach additional
pages to lhls Form CIQ as necessary.
A, Is the local government officer named in this section receiving or likely to recelve taxable income, other than investment
Income, from the filer of ihe questionnalre?
� Yes ��� ��i�r
B. Is the filer of 1he questionnalre recelving or Ilkely to recelve taxable Income, other than investment income, from or at the
direction of the local government officer named in this section AND the taxable income is not received from the local
governmental entlty?
y.. .w.
I.�. � Yes �_�._ � Il�c�
C. Is the filer of thls questlonnaire employed by a corporation or other business entlty with respect to whlch the local
government officer serves as an officer or director, or holds an ownership of 10 percent or mors?
��°'
� w � Yea � ,�No
D, Descrlbe each employment or business relationshlp with the local government offlcer named In this sectlon.
���� � ��
�°„�� �
Sf�n�$urar of �a�����a� p���6���� business wlth l�MS�� �,��crv�t��m�wr��ntal entlty
�
IFB 5476
r11 .. . /
�r�,
Adopied OGI2Bl2007
SPIECON-01 YADAVYO
��'�'";�".�.."�Y� . . � "': DATE (MMIDDlYYYY�.....
CERTIFICATE OF LIABILITY INSURANCE g/23/2014
.�..... _ _.._.....
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER .... ...... . C4'S'W�'AC"I �� ... .. ... .... ...
Willis Insurance Services of California, Inc. �'����� ���. (g'��°�_945 7376 ���
c/o 26 Centu Blvd . 4��� �����]����� ������� ���� ..,_..__�4��.��'�� ����� 467 2378
P.O. Box 305 91 �-v��tl � - �- _
a� � ���s�� __— m . �.. ........_
Nashville. TN 37230-5191 �" " _' � "��� �
INSURED
Spfess Construction Co., Inc.
PO Box 2849
Santa Maria, CA 93457
iNSUaeRa:Starr Ind
INSURER B :
INSURER C :
INSURER D ;
INSURER E t.
INSURER F :
C � C#
tv & Liabil�ty Company 38318'
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.
---- ..... .... .. _...e���. _,. � _.__.—_.�._ m,... .. w ..
i..�� .................. ._..—.... .........----- F�C��C'ki. slY��k —.._...— ........ ,...,.., P�LI�T EF�.,. �. POLICYEXP LIMITS
T� TYPE OF INSURANCE ,�,: POLICV Nl1M9ER !MM/DfIIVWVI IMMIOD/WVYI
A � COMMERCIAL GENERAL LIABILITY � EACH OCCURRENCE ,$ 'I ,OOO,OO
- T5A'R�°�4�".oF"��'J e�E'Py&�"CC� ---
� C�,IMS-MADE X oCCU� X X 1000025275 09/0112014 09/0112015 pR��� �� �� �r��,������, � g � 300,00 '�
_.. �... _ .�
-- � " � nn. , . . n ,. , , . .
MED EXP (Any one person) S 10,OOQ
— —. ...---- -- -._ --- � ...
�...;�._. .._....�
PERSONAL 8 ADV INJURY 5 'I ,OOO,OO
. . _ _..._
GEN'L AGGREGATE LIMIT APPLIES ER:
_ —
p GENERALAGGREGATE $ Z,OOO,OO '
POLICY l JEC7 I X LOC ' PRODUCTS COMP/OPAG $ Z,OOO,OO '
��X..1 PRO !.. .� � ---
G
_� � --- � m . .,� � ..
�T'tti��.k`�.:.
� AUTOMOBILE LIABILITY L���''�����U '��"'�'� d w� 5 'I OOO OO ���
rF6 �uCCIF��"rLl�_..... � r
A X... _,=_ ..___...........__ _._..
ANY aUTO X X SISIPCA08304314 09101/2014 09101/2015 BODILY INJURY (Per person) $
_ .-------.— .... ...... ....._ _ _,.
"" ALL OWNED �" SCHEDULED BODILY INJURY (Per accidenQ $
AUTOS AUTOS . ,..... ........ ..........—.— ......
� '��� HIREDAUTOS � AUTOS �P�� ������ �����
N6N-OWNED WP�.�bf�
.. _ cri�vrcb� ...
____ $ _ ...,..
�( Comp Ded $1,000 X Coll Ded $1,000 $
' UMBRELLA LJAB pCCUR ��� EACH OCCURRENCE 5
.,.,,,, ,...___ �...._..._ _._..... __..
EXCESS IJAe CIAIMS-MADE AGGREGATE 3
nGn. .R., _. . . ____.__ __..._ — ..—....._ -
ETENTION ffi $
WORKERS COMPENSATION � �
X � 4TATI ITF ���.. � FR�
A Q�FF�ER�'M H}/E CBU ED7ECUTIVE �Y� N/A X 1000001459 10/01/2014 10101/2015 E.L.DS ASECBAEMPLOYE $ �,���,D��a
I�
�B�I:���'�R'�'d'I�NOFC�h'�r#a�TV�C��&; I��Rcwa� � �� � EL�DISEASE-POLICYLIMIT $ ,mm� �,OOO,OO �
� . ..... ...... . .... .... .. ....
��._._.._. __�._. .............. ... .. .... ... ...._........ _ ...._.......
DESCRIPTION OF OPERATIONS / LOCAT10N5/ VEHICL.ES (ACORD 101, Additlonal Remarks Sehedule, may be attached if more space Is requlred)
SCCI Job :#21433 City of Denton IFB #54760-2499 Utility Relocation Phase II.
The City of Denton, its Officials, Agents, Employees and Volunteers are included as Additional Insureds as respects to General Liability and Auto Liability, as
required by written contract or agreement.
The General Liability and Auto Liability policies shall be Primary and Non-Contributory with any other insurance in force for or which may be purchased by
Additional Insureds.
SEE ATTACHED ACORD 101
CERTIFICATE HOLDER
City of Denton
901 B Texas Street
ACORD 25 (2014/01)
�1�ftV��;IL
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTAi1VE
�
,���, N ��„.� �`' �
���
O 198$-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
�" ��~��
M°
� ����� Starr lndemnifiy & L�ability Company
DalEas, TX 1-868-519-2522
ADDITIONAL INSURED- OWNERS, LESSEES, �R
CONTRACTORS - SCHEDULED PERS4N OR
ORGANIZATI4N
Policy Nuinber: 1000d25275 Effective Date: 09-01-14 at 12:01 A.M.
Named Insured: Spiess Construction Co., Inc.
This endorsement modifies insurance provided under the following;
COMMERCIAL GENERAL L{ABILITY COVERAGE FORM
SCHEDUL�
NAME OF PERSON OR ORGANIZATION: WHERE REQUIRED BY WRITTEN CONTRACT
(If no entry appears above, informafion required to complete this endorsement will be shown in
the Declarations as applicable to the endorsement,)
A. SECTION II -WHO IS AN INStJRED is amended to include as an insured;
The person or organization shown in the schedule, but only with respect to liability
arising out of your ongoing operations performed for that additional insured.
B. With respect to the insurance aiforded to these additional insureds, SECiION I-
COVERAGES, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE
LIABILlTY, 2. -Exclusions, is amended to include the following additionaf exclusion;
7his insurance does not apply to "bodily injury" or "property damage" occurring after:
(1) all work, including materials, parts or equipment furnished In connection with
such work, on the project (other than service, maintenance or repairs) to be
performed by or on behalf of the additional insured(s) at the site of the covered
operations has been completed; or,
(2) that portion of "your work" out of which the injury or damage arises has been put to
its intended use by any person or organization other than another
confractor or subcontractor engaged in performing operations for a principal
as a part of !he same project. .
All other terms and conditions remain unchanged.
OG 180 (04/12) Page 1 of 4
Copyright (�9 C. V. Starr & Company and Starr Indemnity & Lfabllity Company. All rights reserved.
(ncludes copyrighled maferial of ISO Properties, Inc., used wifh its permissbn.
I���'"' � �� '
'��: �� ,��Starr lncfemnify & Liabitity Company
Dallas, TX 1-866-519-2522
Primary and Non-Contributory Condi�ion
Policy Number: ].00Oa25275 Effective Date: 09-01-14 at 12:01 A.M,
Named Insured: Spiess Construction Co., Inc.
This endorsement modi�ies insurance provided under the:
Commercial General Liabfllty Coverage Park
A. SECTION IV — CONDITIONS, condition 4. Other Insurance is amended as follows:
9. The following is added to paragraph 4.a. of the Other Insurance condition:
This insurance is primary insurance as �espects our coverage to the addifional insured, where the written
contract or written agreement requires that this insurance be primary and non�ontributory. In that
event, we will not seek contribution from any other insurance policy avaifable to the additional insured
on which the additional insured is a Named Insured.
ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
OG 707 (04119) Page 1 of 1
Copyright� C, V. Starr & Company and Starr lndemnity 8 Llabflity Company, All righis reserved.
Includes copyrighted materlal of I50 Propertles, inc., used with its permission.
�� ;�
�� ��
�� �::�� S�df'�'
lndemnify &:Lia�i(it�y Company
Dalfas, TX 1-866-519-2522
TMIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Palicy Number: SISIPCA08304314 Effective Date: 09-01-14 at 12:01 AM
Named Insured: Spiess Construction Co., Inc.
ADDITIONAL INSURED - WHERE REQUIRED UNDER
C�NTRACT OR AGREEMENT
Thfs pollcy Is amended as follows:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
ADDI710NAL INSURED
ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVkDE
ADDITIONAL INSUREd STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR
OFtGANIZATION5 LIABILITY ARISING OU7 OF THE USE OF A COVERED "AUTO"
I. SECTION II — LIABILITY COVERAGE A. Coverage, 1. Who is Insured, is amended to add:
Any person or organization, shown in the schedule above, to whom you become obligated to
include as an additional insured under thls policy, as a result of any contract or agreement
you enter into which requires you to furnish insurance to that pe�son or organization of the
type provided by this poliey, but only wiih respect to liabillty arising out of use of a covered
°auto". However, the insurance provided will not exceed the lesser of:
(1} The coverage and/or limifs of ihis policy, or
(2} The coverage and/or limifs required by said contract or agreement.
SICA 1616 {02112) Page 1 of 1
Copyright� C. V, Starr & Company and Starr Indemnity & Llabllky Company. All rlghts reserved.
Includes copyrighted materlal of ISO Propertles, Ine., used wlth its permisslon.
POLICY NUMBER; SISIPCA08304314 COMMERCIAL AU70
CA 04 44 03 10
THlS ENDORSEMENT CHANGES THE POLICY. PLEASE. READ IT CAREFULLY.
WAIVER OF TRANSFER �F RIGHTS OF REC4VERY
AGAINST OTHERS TO US (WAtVER OF SUBR�GATION}
This endorsement modifies insurance provided under khe following:
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by
the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless anoiher date is indicated
below.
Named Insured; SPIESS CONSTRUCTION CO., INC.
Endorsement Effective Date: 09-01-14
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
ANY PERSON OR ORGANIZATION TO WHOM YOU B�COME OBLIGATED TO WAIV� �C7�.1�;�,
RIGHTS OF RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER
1NT0 PRTOR TO THE OCCURRENCE OF LOSS.
Information ���aa�ired to ccrrw��lete this ��h��l��l�,, if nok shown �k��v�„ will be shown in the ���I<°ac�t��ar�s.
The 7ransfer Of Rights Of Recavery Agafnst Others
To Us Condition does not apply to the person(s) or
organizaiion(s) shown in the Schedule, but only to the
extent that subrogation is waived prior ta the "accident"
or the "loss" under a contract with that person or or-
ganization.
CA 04 � 03 10 O lnsurance Services Office, Inc., 2009 Page 1 of 1
113t29.FRM
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
OKLAHOMA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
WC 00 03 13
(Ed. 4-84)
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.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Where required by written contract
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 09-01-14
Insured Spiess Construction Co., Inc.
Insurance Company
Starr Indemnity & Liability Company
WC 00 03 13
(Ed. 4-84)
O 1963 National Council on Compensation Insurance.
Policy No. 1000001459 Endorsement No.
Premium
Countersigned by
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 04 03 06
( Ed. 4-84)
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 pertorm 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
otherwise due on such remuneration.
Person or Organization
Where required by written contract
Schedule
% of the California workers' compensation premium
Job Description
Notes:
1. This endorsement may be used to waive the company's right of subrogation against named third parties who may be responsible for an
injury.
2. The sentence in () is optional with the company. It limits the endorsement to apply only to specific jobs of the insured, and only to the
extent that the insured is required to obtain this waiver.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 09-01-14 Policy No. 1000001459 Endorsement No.
Insured Spiess Construction Co., Inc. Insurance Company Starr Indemnity & Liability Company
Countersigned By
01998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved.
From the WCIRB's California Workers' Compensation Insurance Forms Manual 02001.