J - BBF Golf Maintenance 2016 Project Manual and Bid Documents

City of Cupertino
Blackberry Farm Golf Course Maintenance 2016 00001 - 1

Title Page

DOCUMENT 00001

RECREATION & COMMUNITY SERVICES DEPARTMENT
10300 TORRE AVENUE
CUPERTINO, CALIFORNIA 95014

PROJECT MANUAL

FOR THE

BLACKBERRY FARM GOLF COURSE
MAINTENANCE 2016

Proposal Due Date:

Monday, Nov. 23, 2015

City of Cupertino
Blackberry Farm Golf Course 2016 00010 - 1 Table of Contents

DOCUMENT 00010

TABLE OF CONTENTS

INTRODUCTORY DOCUMENTS

Document Title
00001 Title Page
00010 Table of Contents

BIDDING DOCUMENTS

Document Title
00100 Advertisement for Bids
00200 Instructions to Bidders
00201 Bid Submittal and Site Map
00210 Indemnity and Release Agreement
00320 Existing Conditions
00400 Bid Form
00430 Subcontractors List
00450 Statement of Qualifications
00481 Non-Collusion Affidavit
00482 Bidder Certifications

CONTRACTING DOCUMENTS

Document Title
00510 Contract
00530
00660
Insurance Forms
Substitution Request Form

GENERAL CONDITIONS DOCUMENTS

Document Title
00700 General Conditions
00800
00820
Special Conditions
Special Environmental Conditions
00821 Insurance
00822 Apprenticeship Program

TECHNICAL PROVISIONS

END OF SECTION

City of Cupertino 00100 - 1 Advertisement for Bids
Blackberry Farm Golf Course Maintenance 2016
DOCUMENT 00100

ADVERTISEMENT FOR BIDS

NOTICE: THE CITY OF CUPERTINO, a Municipal Corporation of the State of California (“City”) hereby gives notice that it will accept Bids for:

BLACKBERRY FARM GOLF COURSE MAINTENANCE 2016

1. BID SUBMISSION: The City uses a two -part Bid process with Bids in Envelope “A” and Statements of Qualification in Envelope “B” . City will accept Envelope “A” and Envelope “B” before 3:00 p.m. on Monday November 23, 201 5 in the City Clerk ’s Office in City Hall, 10300 Torre Avenue . City’s representative will call out the designated time in the City Clerk’s Office, stating that the period for accepting Bids is closed. Bids will be pu blicly read at 3:05 p.m. in the City Hall Lobby. The Bid opening will be in accordance with procedures set forth in Document 00200 (Instructions to Bid ders).

2. CONTACT INFORMATION:

Department of Recreation and Community Services
408 777 3110 general
408 777 3333 fax
[email protected]; [email protected]
City Hall, 10300 Torre Avenue
Cupertino, CA 95014

3. STATEMENT OF QUALIFICATIONS: Each Bidder shall be required to sub mit a “Statement of Qualifications” in accordance with Document 00450 (Statement of Qualifications).

4. DESCRIPTION OF THE WORK: Work includes maintenance of Blackberry Farm Golf Course in the city of Cupertino.

5. CONTRACT TIME: Work shall commence on January 1, 2016 and proceed per the contract requirements.

6. REQUIRED CONTRACTOR’S LICENSE: A California Class “A” General Engineering or Class “C- 27” Landscaping contractor’s license is required to Bid this Contract. Joint ventures must secure a joint venture license prior to award of this Contract. Removal , handling, and/or disposal of hazardous materials may, by law, require hazardous substance removal certification by the Contractor’s State License Board.

7. Required Contractor and Subcontractor Registration

a. Owner shall accept Bids only from Bidders that (along with all Subcontractors listed in Document 00430 (Subcontractor List) are currently registered and qualified to perform public work pursuant to Labor Code Section 1725.5.
b. Subject to Labor Code Sections 1771.1(c) and (d), any Bid not complying with paragraph 1.01a above shall be returned and not considered; provided that if Bidder is a joint venture (Business & Professions Code Section 7029.1) or if federa l funds are involved in the Contract (Labor Code Section 1771.1(a)), Owner may accept a non -complying Bid provided that Bidder and all listed Subcontractors are registered at the time of Contract award.

8. PREVAILING WAGE LAWS: The successful Bidder must co mply with all prevailing wage laws applicable to the Project, and related requirements contained in the Contract Documents.

City of Cupertino
Blackberry Farm Golf Course Maintenance 2016 00200 - 1 Instructions to Bidders

DOCUMENT 00200

INSTRUCTIONS TO BIDDERS

Bids are requested for a general construction contract, or work described in general, as follows:

Blackberry Farm Golf Course Maintenance 2016

1. RECEIPT OF BIDS. Sealed Bids will be received by the City at City’s office (see paragraph 2 below) on the date shown in the Advertisement for Bids . City will receive Bids in two separate opaque sealed 10” x 13” envelopes, label ed Envelope “A” and Envelope “B” each containing the respective items described in paragraphs 4 and 5 below. All Bid envelopes will be time stamped to reflect their submittal time. Envelope “A” and Envelope “B” shall be due before 3:00 p.m. as determined by the clock on the wall of the office of the City Clerk. Bi ds will be publicly read at 3 :05 p.m. in the City Hall Lobby. City will reject all Bids received after the specified time and will return such Bids to Bidders unopened. Bidders must submit Bid s in accordance with this Document 00200.

2. CONTACT INFORMATION.

Mailing address:

City of Cupertino
City Hall
10300 Torre Avenue
Cupertino, CA 95014

City’s Authorized Representative:

Carol Atwood, Director of Recreation and Community Services

Telephone:
(408) 777-3110

Emails:
[email protected]; [email protected]

Fax:
(408) 777-3366

3. BID SUBMISSION. Bidder should mark its Bid envelopes as BID FOR BLACKBERRY FARM GOLF COURSE MAINTENANCE 2016 , Envelope “A” or “Env elope “B,” as appropriate. Bids shall be deemed to include the written responses of the Bidder to any questions or requests for information of City made as part of Bid evaluation process after submission of Bid. Bidder’s failure to submit all required do cuments strictly as required entitles City to reject the Bid as non-responsive.

4. CONTENTS OF ENVELOPE “A” - BID PRICE. Envelope “A” shall include:
a. Document 00400 (Bid Form) completed in accordance with paragraph 6 of this Document 00200. b. Document 00430 (Subcontractors List) in accordance with paragraph 8 of this Document 00200. c. Document 00481 (Non-Collusion Affidavit).

5. CONTENTS OF ENVELOPE “B” – BIDDER STATEMENT OF QUALIFICATIONS. Envelope “B” shall include:
a. Document 00450 (Statement of Qualifications) submitted in accordance with this Document 00200. b. Document 00482 (Bidder Certifications). Bidder must complete this form as indicated.

6. REQUIRED BID FORMS. All Bidders must submit Bids using , where applicable, documents supplied in this Project Manual, incl uding without limitation Document 00400 (Bid Form), Document 00430 (Subcontractors List), Document 00450 (Statement of Qualifications), Document 00481 (Non -Collusion Affidavit), and Document 00482 (Bidders Certifications). City will reject as non -responsive any Bid not submitted on the required forms. Bids must be full and complete. Bidders must complete all Bid items and supply all information City of Cupertino
Blackberry Farm Golf Course Maintenance 2016 00200 - 2 Instructions to Bidders

required by Bidding Documents. Bidder must completely fill our all forms required for the bid. City reserves the right in its sole discretion to reject any Bid as non -responsive as a result of any error or omission in the Bid.

Bidders may not modify the Bid Form or qualify their Bids. Bidders must submit clearly and distinctly written Bids. Bidders must clearl y make any changes in their Bids by crossing out original entries, entering new entries, and initialing new entries. City reserves the right to reject any Bid not clearly written.

7. REQUIRED SUBCONTRACTORS LIST. All Bidders must submit with their Bids the required information on all Subcontractors in Document 00430 (Subcontractors List) for those Subcontractors who will perform any portion of Work, including labor, rendering of service, or specially fabricating and installing a portion of the Work or improv ement, in excess of one half of one percent of total Bid or ten thousand dollars ($10,000), whichever is greater. Violation of this requirement may result in Bid being deemed non -responsive and being rejected.

8. REQUIRED STATEMENT OF QUALIFICATIONS. In ord er for a Bidder to be eligible to Bid on this Contract, it must submit a Statement of Qualifications responsive to the requirements identified in Document 00450 (Statement of Qualification) (“SOQ”), including without limitation qualification information fo r Subcontractors and schedulers , if any. Except as otherwise provided in this Document 00200 or in Document 00450 (Statement of Qualification), City will make final determinations regarding Bidder responsibility based upon the SOQ submitted as part of Envelope “B”. Information in the SOQ shall be current.

No engineering or architectural firm which has provided design services for a project shall be eligible to submit a proposal for the contract to construct the project nor to subcontract for any portion o f the work. The ineligible firms include the prime contractor for design, subcontractors of portions of the design and affiliates of either. An affiliate is a firm which is subject to the control of the same persons, through joint ownership or otherwise.

9. PRE-BID ACTIVITY:

Any Bidder wishing to investigate subsurface conditions or otherwise conduct invasive investigations, explorations, tests, or studies at this Site, must schedule the visit with the City by giving the City at least seven (7) days written notice. Additionally, any such Bidder must deliver an executed Document 00210 (Indemnity and Release Agreement) and provide an insurance certificate as described therein by noon of the Day prior to the examination.

Bidders who intend only to observe exist ing Site conditions and not conduct subsurface examinations are not required to provide an executed Document 00210 (Indemnity and Release Agreement) or an insurance certificate, but are requested to contact the Recreation and Community Services Department to arrange for access to the site.

Bidders are encouraged to submit written questions in connection with the Site Visit. City will post on its website and will transmit to all parties recorded, as having receive d Bidding Documents such information , as Ci ty, in its discretion, considers necessary in response to written questions. Bidders shall not rely on oral statements. Oral statements will not be binding or legally effective.

10. OTHER REQUIREMENTS PRIOR TO BIDDING. Submission of Bid signifies Bidder’s careful examination of Bidding Documents and complete understanding of the nature, extent, and location of Work to be performed.

11. EXISTING DRAWINGS AND GEOTECHNICAL DATA. Bidders may examine any available existing conditions information (e.g., record documents, specifications, studies, drawings of previous work) by giving City reasonable advance notice, as well as applicable environmental assessment information (if any) regarding the Project.

12. ADDENDA. Bidders must direct all questions about the meaning or intent of Bidding Documents to City (Attention: City’s Authorized Representative ) in writing . Letters, Faxes or emails are acceptable forms of written questions. Interpretations or clarifications considered necessary by City in response to such quest ions will be issued by Addenda mailed, faxed, or delivered to all “Bid List” parties, recor ded by City as having received Bidding Documents . Addenda will be written and will be issued to each Bidder to the address or fax number supplied City by Bidder. C ity may not answer questions received less than ten Days prior to the date for opening Bids. Only questions answered by formal written Addenda will be binding. Oral and other interpretations or clarifications will be without legal effect.
a. Addenda may be issued to modify the Bidding Documents as deemed advisable by City. b. Addenda shall be acknowledged by number with signature in Document 00400 (Bid Form) and shall be part of the Contract Documents. A complete listing of Addenda may be secured from City.

City of Cupertino
Blackberry Farm Golf Course Maintenance 2016 00200 - 3 Instructions to Bidders

13. SUBSTITUTIONS. Bidders must base their Bids on products and systems specified in Contract Documents or Addenda.
a. Except as provided in paragraph 13 .c below, City will consider substitution requests only for “or equal items.”
b. Approved substitutions shall be listed in Addenda and become part of the Contract Documents. c. Substitutions may be requested after submitting Bids and the Award of Contract only in accordance with requirements specified in Document 00700 (General Conditions).

14. WAGE RATES. Copies of t he general prevailing rates of per diem wages for each craft, classification, or type of worker needed to execute the Contract, as determined by Director of the State of California Department of Industrial Relations, are on file at City’s Public Works offi ce or may be obtained of the State of California web site http://www.dir.ca.gov/DLSR/PWD/Northern.html and are deemed included in the Bidding Documents. Upon request, City will make available copies to any interested party. Also, Contractor shall post th e applicable prevailing wage rates at the Site.

15. EQUAL EMPLOYMENT OPPORTUNITY. Contractor shall comply with all applicable federal, state, and local laws, rules, and regulations in regard to nondiscrimination in employment because of race, color, ancestry, national origin, religion, sex, marital status, age, medical conditions, disability, or any other reason.

16. BID OPENING. City will open all Bidders’ Envelopes “A,” at the time and on the date specified in paragraph 1 above, and initially evaluate them for responsiveness. City will not open Envelopes “B” publicly.

17. EVALUATION OF BIDDER RESPONSIBILITY (Envelope “B”). a. Document 00450 sets forth certain criteria for a Bidder to be found responsible. Bidder’s attention is called to the following minimum requirements for a Bidder to be found responsible to perform the Work:
1) Contracting/Subcontracting Prior Experience. Satisfactory experience on similar work, including without limitation no history of default termination, excessively delayed completion or excessi ve defective work.
2) Projects Public Experience. Evidence that Bidder and its team, including without limitation its Subcontractors (hereafter, including Bidder if Bidder performs such Work itself, “designated Subcontractor(s)”), have the human and physical resources of sufficient quantity and quality to perform the Work under Contract Documents in a timely and Specification -compliant manner, to include:
i. Construction and management organizations with sufficient personnel and requisite disciplines, licenses, skills, experience, and equipment for the Project. ii. Minimum licensing requirements including evidence of a valid California contractor’s license as specified for the Bidder and evidence of requisite licenses for Key Personnel of Bidder or any designated Subcontractor(s).
iii. Sufficiency of proposed quality assurance plan to meet the requirements of the Contract Documents.
iv. Bidder’s safety record.
v. Minimum experience requirements of the prime contractor including the completion of a suitable number of projects of similar nature and complexity for contract dollar amounts equal to what is specified in Document 00450 (Statement of Qualification). vi. A field organization with skills, experience, and equipment sufficient to perform all on -Site work and necessary scheduling.
vii. Expertise of Key Personnel to accomplish the duties and responsibilities required to perform the Work under the Contract Documents . Minimum experience requirements of Key Personnel including the completion of projects of similar nature and comple xity and having the number of years of experience on projects of similar nature and complexity as specified in Document 00450 (Statement of Qualifications).

18. BID EVALUATION. City may reject any or all Bids and waive any informalities or minor irregulariti es in the Bids. City also reserves the right, in its discretion, to reject any or all Bids and to re -Bid the Project. City reserves the right to reject any or all nonconforming, non -responsive, unbalanced, or conditional Bids, and to reject the Bid of any Bidder if City believes that it would not be in the best interest of Project to make an award to that Bidder, whether because the Bid is not responsive or the Bidder is not suitably qualified or fails to meet any other pertinent standard or criteria esta blished by City. For purposes of this paragraph, an “unbalanced Bid” is one having nominal prices for some work items and enhanced prices for other work items.

City of Cupertino
Blackberry Farm Golf Course Maintenance 2016 00200 - 4 Instructions to Bidders

a. In evaluating Bids, City will consider Bidders’ qualifications, whether or not the Bids comply with the prescribed requirements, unit prices and other data, as may be requested in Document 00400 (Bid Form) or prior to the Notice of Award.
b. City may conduct reasonable investigations and reference checks of Bidder, proposed Subcontractors, suppliers and other persons and organizations as City deems necessary to assist in the evaluation of any Bid and to establish Bidder’s responsibility, qualifications, financial ability, proposed Subcontractors, suppliers, and other persons and organizations to perfor m and furnish the Work in accordance with the Contract Documents to City’s satisfaction within the prescribed time. Submission of a Bid constitutes Bidder’s consent to the foregoing. City shall have the right to consider information provided by sources other than Bidder.
c. Discrepancies between the multiplication of units of Work and unit prices will be resolved in favor of the unit prices. Discrepancies between the indicated sum of any column of figures and the correct sum thereof will be resolved in fa vor of the correct sum. Discrepancies between written words and figures will be resolved in favor of the words.
d. Quantities stated in the Bidding Documents are approximate only and are subject to correction upon final measurement of the Work, and are subje ct further to the rights reserved by the City to increase or diminish the amount of work under any classification as advantages to design or construction needs require. e. City may determine whether a Bidder is qualified in its sole discretionary judgment. f. Required Contractor and Subcontractor Registration
1) Owner shall accept Bids only from Bidders that (along with all Subcontractors listed in Document 00430, Subcontractors List) are currently registered and qualified to perform public work pursuant to Labor Code Section 1725.5.
2) Subject to Labor Code Sections 1771.1(c) and (d), any Bid not complying with paragraph 20g, above, shall be returned and not considered; provided that if Bidder is a joint venture (Business & Professions Code Section 7029.1) or if feder al funds are involved in the Contract (Labor Code Section 1771.1(a)), Owner may accept a non -complying Bid provided that Bidder and all listed Subcontractors are registered at the time of Contract award.

19. BID PROTEST. Any Bid protest must be submitted in w riting to the City’s offices (Attention: City’s Authorized Representative), before 3:30 p.m. of the third Calendar Day following opening of Bidders’ Envelope “A”s.
a. The initial protest document must contain a complete statement of the basis for the protest . b. The protest must refer to the specific portion of the document that forms the basis for the protest. c. The protest must include the name, address, and telephone number of the person representing the protesting party.
d. Only Bidders who the City otherwise det ermines are responsive and responsible are eligible to protest a Bid; protests from any other Bidder will not be considered. In order to determine whether a protesting Bidder is responsive and responsible, City will evaluate information contained in any p rotesting Bidder’s Envelope “B”. Any such opened Envelope “B” shall also be subject to all provisions of paragraph 2 3. e. The party filing the protest must concurrently transmit a copy of the initial protest document and any attached documentation to all o ther parties with a direct financial interest that may be adversely affected by the outcome of the protest. Such parties shall include all other Bidders who appear to have a reasonable prospect of receiving an award depending upon the outcome of the prote st. f. The procedure and time limits set forth in this paragraph are mandatory and are Bidder’s sole and exclusive remedy in the event of Bid protest. Bidder’s failure to comply with these procedures shall constitute a waiver of any right to further pursue t he Bid protest, including filing a Government Code Claim or legal proceedings. A Bidder may not rely on a protest submitted by another Bidder, but must timely pursue its own protest.

20. POST-NOTICE OF AWARD REQUIREMENTS. After Notice of Award, the successfu l Bidder must execute and submit the following documents as indicated below.
a. Submit the following documents to City by 5:00 p.m. of the 10 th Calendar Day following Notice of Award. Execution of Contract by City depends upon approval of these documents:
1) Contract: To be executed by successful Bidder. Submit four originals, each bearing an original signature.
2) Insurance certificates and endorsements as required Submit one original set.

City of Cupertino
Blackberry Farm Golf Course Maintenance 2016 00200 - 5 Instructions to Bidders

b. Successful Bidder’s failure to submit the documents required herein, in a proper and timely manner, entitles City to rescind its award.

21. MODIFICATION OF COMMENCEMENT OF WORK. City expressly reserves the right to modify the date for the Commencement of Work under the Contract and to independently perform and complete work r elated to the Project. City accepts no responsibility to Contractor for any delays attributed to its need to complete independent work at the Site.

22. WITHDRAWAL OF BIDS. Bidders may withdraw their Bids at any time prior to the Bid opening time fixed in this Document 00200, only by written request for the withdrawal of Bid filed with the City at the City’s office.

Bidder or its duly authorized representative shall execute request to withdraw Bid. The submission of a Bid does not commit the City to award a contract for the Project, to pay costs incurred in the preparation of a Bid, or to procure or contract for any goods or services.

23. PUBLIC RECORDS ACT REQUESTS.
a. City will make available to the public documentation associated with this process per the Publ ic Records Act as applicable. City will make such information available to the extent required by applicable law, without restriction.
b. Information disclosed in the SOQ and the attendant submissions are the property of City .

24. CONFORMED CONSTRUCTION DOCUMEN TS. Following Award of Contract, City may prepare a conformed set of Contract Documents reflecting Addenda issued during bidding, which will, failing objection, constitute the approved set of Contract Documents.

25. DEFINITIONS. All abbreviations and definitions of terms used in this Document 00200 are set forth in Section 00700.

END OF DOCUMENT
DOCUMENT 0201
BID SUBMITTAL AND SITE MAP Project No. 2010-01
City of Cupertino
BBF Golf Course Maintenance

CITY HALL
10300 TORRE AVENUE

COMMUNITY HALL
10350 TORRE AVENUE

BID SUBMITTAL MAP
0 350 700 1,050 1,400175
Feet ±

STEVENS CREEK BOULEVARD

RODRIGUES AVENUE

PACIFICA DRIVE

DE ANZA BOULEVARD

TORRE AVENUE
Bid Submittal & Site Map00201-1

MCCLELLAN RD

FOOTHILL BLVD

STEVENS CREEK BLVD
M

ANN DR

ORANGE AVE

BYRNE AVE

SCENIC BLVD

PHAR LAP DR

BUBB RD

RAE LN

HYANNISPORT DR

ALPINE DR

PALM AVE
W

EST VALLEY FW
Y

CUPERTINO RD
M

ARY AVE

ALCAZAR AVE

PRESIDIO DR

PENINSULA AVE

STOKES AVENOEL AVE

JANICE AVE PASADENA AVE

HILLCREST RD

SALEM AVE
M

IRA VISTA RD

PALO VISTA RD

VISTA KNOLL BLVD

DEMPSTER AVE
CARM
EN RD

BAHL ST
AINSW

ORTH DR

RIVERSIDE DR

LOMITA AVE

SAN FERNANDO AVE

ADRIANA AVE
W

IINSTON W
AY

OLIVE AVE
ALHAM

BRA AVE

SANTA CLARA AVE

ALMADEN AVE

DOLORES AVE

SANTA PAULA AVE

GRANADA AVE

EMPIRE AVE

HERMOSA AVE

STEVENS CANYON RD

BYRNE CT

CASS PL
IM

PERIAL AVE

WOODBURY DR

SCENIC CIR

RESULTS W
AY

CRESCENT RD

OAKLEAF PL

SHATTUCK DR

GRAND AVE

ST ANDREWS AVE

OAKVIEW LN

AMELIA CT

PARK VILLA CIR
RAM

ONA CT

FORT BAKER DR
MALAGA

TRESSLER CT
W

ALNUT CIR

NOONAN CT

CORTE MADERA LN

BALUSTROL CT
M

ADRID RD

CLUB HOUSE LN

CARNOUSTIE CT

VARIAN WAY

LIBERTY CT

EATON PL

OLD TOW
N CT

OASIS CT

RIVERCREST CT CREEKSIDE CT

BUBB RDM

IRA VISTA RD
IM

PERIAL AVE
Project No. 2010-01
City of Cupertino
BBF Golf Course Maintenance

SITE MAP
±
Bid Submittal & Site Map00201-2

PROJECT SITE

00210-1 Indemnity and Release Agreement

City of Cupertino
Blackberry Farm Golf Course Maintenance 2016

DOCUMENT 00210

INDEMNITY AND RELEASE AGREEMENT

Dated

POTENTIAL BIDDER:

CITY: THE CITY OF CUPERTINO

SITE: 22100 Stevens Creek Blvd, Cupertino, CA 95014

PROJECT: Blackberry Farm Golf Course Maintenance 2016

In consideration of the above -referenced City’s permitting the undersigned potential bidder (“Bidder”) to have access to, and to conduct investigations, tests and/or inspections on, the Site, Bidder hereby agrees as follows:

1. To the greatest extent permitted by law, Bidder hereby releases, and shall defend, indemnify and hold harmless City, and its officers, employees, consultants (including without limitation Consulting Engineer), representatives, and agents, and all other parties having any other interest in the Site, against any claim or lia bility, including attorney’s fees, arising from or relating to any Site-related access, investigation, test, inspection and/or other activity conducted by Bidder or any of Bidder’s officers, employees, consultants, representatives, and/or agents, regardles s of whether claim or liability is caused in part by the negligence of City or by any released and indemnified party.

2. Bidder hereby waives the provisions of California Civil Code Section 1542 which provides as follows:

A general release does not extend to claims that the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him, must have materially affected his settlement with the debtor.

3. Bidder shall repair any damage to the Site or adjacent p roperty resulting from activities authorized hereunder, and comply with and be subject to all other requirements and obligations described or referenced in the bid documents.

4. Attached hereto (or to be delivered separately before Bidder’s visit to the Site ) is a certificate for comprehensive general liability insurance satisfying the requirements of Document 00700 (General Conditions).

5. Although this Indemnity and Release Agreement i s not a Contract Document , it shall be fully effective and binding regard less of whether Bidder submits a Bid for the subject Project, is awarded a contract for the Project, or otherwise.

Name of Bidder

By:

Signature

Its:

Title (If Corporation: Chairman, President or Vice
President)
By:

Signature

Its:

Title (If Corporation: Secretary, Assistant Secretary, Chief Financial Officer or Assistant Treasurer)

Contractor’s Name: __________________________________

City of Cupertino Bid Form
Blackberry Farm Golf Course Maintenance 2016 00400 - 1

DOCUMENT 00400

BID FORM

To be submitted as part of Envelope “A” by the time and date specified in Document 00200 (Instructions to Bidders).

TO THE HONORABLE CITY COUNCIL OF THE CITY OF CUPERTINO

THIS BID IS SUBMITTED BY:

____________________________________________________________________________________ (Firm/Company Name)

Re: Blackberry Farm Golf Course Maintenance 2016

1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into a contract with the City of Cupertino (“City”) in the form included in the C ontract Documents, Document 0051 0 (Contract), to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Sum and within the Contract Time indicated in this Bid and in accordance with all other terms and conditions of the Contract Documents. All portions of this Bid Form must be completed and signed before the bid i s submitted. Failure to do so will result in the bid being rejected as non-responsive.

2. Bidder accepts all of the terms and conditions of the Contract Documents, Document 00100 (Advertisement for Bids), and Document 00200 (Instru ctions to Bidders) . This Bid will remain subject to acceptance for 90 Days after the day of Bid opening.

3. Bidder has vi sited the Site and performed tasks, research, investigation, reviews, examinations , and analysis , regarding the Project and the Site.

4. Bidder has given City prompt written notice of all conflicts, errors, ambiguities, or discrepancies that it has discovered in or among the Contract Documents and actual conditions and the written resolution thereof through Addenda issued by City is acceptable to Contractor.

5. Subcontractors for work included in all Bid items, in accordance with the criteria in the Public Contract Code, are listed on the attached Document 00430 (Subcontractors List).

6. The undersigned Bidder understands that City reserves the right to reject this Bid.

7. If written notice of the acceptance of this Bid, hereinafter referred to as Notice of Award, is mailed or delivered to the undersigned Bidder within the time described in paragraph 2 of this Document 00400 or at any other time thereafter before it is withdrawn, the undersigned Bidder will execute and deliver the documents required by Document 00200 (Instructions to Bidders) within the times specified therein. These documents include, but a re not limited to, Document 00510 (Contract).

8. Notice of Award or request for additional information may be addressed to the undersigned Bidder at the address set forth below on the signature page.

9. The undersigned Bidder agrees to commence Work under the Contract Documents on the date establish ed in Document 00700 (General Conditions) and to complete all work within the time specified in Document 0051 0 (Contract). The undersigned Bidder acknowledges that City has reserved the right to delay or modify the commencement date. The undersigned Bidd er further acknowledges City has reserved the right to perform independent work at the Site, the extent of such work may not be determined until after the opening of the Bids, and that the undersigned Bidder will be required to cooperate with such other wo rk in accordance with the requirements of the Contract Documents.

Contractor’s Name: __________________________________

City of Cupertino Bid Form
Blackberry Farm Golf Course Maintenance 2016 00400 - 2

NOTICE
Required Contractor and Subcontractor Registration

1. Owner shall accept Bids only from Bidders that (along with all Subcontractors listed in Document 00430, Subcontractors List) are currently registered and qualified to perform public work pursuant to Labor Code Section 1725.5.

2. Subject to Labor Code Sections 1771.1(c) and (d), any Bid not complying with paragraph, above, shall be returned and not considered; provided that if B idder is a joint venture (Business & Professions Code Section 7029.1) or if federal funds are involved in the Contract (Labor Code Section 1771.1(a)), Owner may accept a non -complying Bid provided that Bidder and all listed Subcontractors are registered at the time of Contract award.

Contractor’s Name: __________________________________

City of Cupertino Bid Form
Blackberry Farm Golf Course Maintenance 2016 00400 - 3

SCHEDULE OF BID PRICES

All Bid items, including lump sums and unit prices, must be filled in completely. Allowances and Alternative Bid items if applicable are described in Document 00800 (Special Conditions). Quote in figures only, unless words are specifically requested.

ITEM SPEC

REF DESCRIPTION UNIT EST
QTY
UNIT
PRICE
TOTAL
(Qty x Unit Price)
1 Technical
Provisions
& 00800
Provide one month of maintenance at
Blackberry Farm Golf Course, Jan. – June
2016
month 6
2 Technical
Provisions Soil Sample Collection & Testing EA 6

TOTAL BASE BID

Total Bid: ______________________________________________________________________ (words)

SCHEDULE OF ALTERNATES

ALTERNATES

ITEM SPEC

REF DESCRIPTION UNIT EST
QTY.

UNIT
PRICE
TOTAL
(Qty x Unit Price)
BID ALTERNATE 1: Provide Maintenance at Blackberry Farm Golf Course, July 2016 - June 2017
3 Technical
Provisions
& 00800
Provide maintenance, each month, July
2016-June 2017 month 12
4 Technical
Provisions Soil Sample Collection and Testing EA 12

BID ALTERNATE 1, TOTAL, ITEMS 3 + 4

BID ALTERNATE 2: Provide Maintenance at Blackberry Farm Golf Course, July 2017 - June 2018
5 Technical
Provisions
& 00800
Provide maintenance, each month, July
2017-June 2018 month 12
6 Technical
Provisions Soil Sample Collection and Testing EA 12

BID ALTERNATE 2, TOTAL, ITEMS 5 + 6

Unit Legend
LS = Lump Sum AL = Allowance
EA = Each SF = Square Feet
LF = Linear Feet
TON = Ton or 2,000 Pounds
CY = Cubic Yards
LB = Pounds

Contractor’s Name: __________________________________

City of Cupertino Bid Form
Blackberry Farm Golf Course Maintenance 2016 00400 - 4

ACKNOWLEDGEMENT OF RECEIPT OF ADDENDUMS
Bidder herby acknowledges receipt and examination of all Contract Documents and the following Addenda:

Addendum No. Addendum Date

Bidder proposes and agrees to fully perform the Work within the time stated and in strict accordance with the Contract Documents for the sums of money listed in this Bid Form.

NAME OF BIDDER:

licensed in accordance with an act for the registration of Contractors, and with license number:

Expiration Date: .

Where incorporated, if applicable

Principals

I certify (or declare) under penalty of perjury under the laws of the State of California that the fore going is true and correct.

Signature of Bidder

NOTE: If Bidder is a corporation, set forth the legal name of the corporation, state where incorporated, together with the signature of the officer or officers authorized to sign contracts on behalf of the corporation. If Bidder is a partnership, set forth the name of the firm together with the signature of the partner or partners authorized to sign contracts on behalf of the partnership.

Business Address:

Officers authorized to sign contracts:

Typed Full Name:

Telephone Number(s):

Fax Number(s):

E-Mail Address:

END OF DOCUMENT
Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 1 Statement of Qualifications

DOCUMENT 00450

STATEMENT OF QUALIFICATIONS
FOR

BLACKBERRY FARM GOLF COURSE MAINTENANCE 2016

Bidder’s Full Corporate Name: _______________________________________________________________________ Bidder’s Legal Structure
 _____ Sole Proprietor
 _____ Partnership
 _____ Non-Profit 501 C3
 _____ Corporation
 _____Other, please explain____________________________________________________________________

Bidder’s Federal I.D. Number_________________________________________________________________________ Bidder’s Mailing Address____________________________________________________________________________ Bidder’s Street Address______________________________________________________________________________ Owner of Bidder’s Company _________________________________________________________________________ Bidder’s Contact Person _____________________________________________________________________________ Bidder’s Address __________________________________________________________________________________ Bidder’s Phone _________________, Fax _________________, Email________________________________________ (Bidder shall identify each partner and / or member of the Joint Venture, and their roles and responsi bilities, if a Joint Venture is proposed.)

INSTRUCTIONS FOR THE SUBMITTAL OF THE STATEMENT OF QUALIFICATIONS

 Place the Statement of Qualifications Document, with all required materials, in a separate envelope labeled “Envelope B”, “STATEMENT OF QUALIFICATIONS” (SOQ) with the project title and Contractors name and address. Do Not place the SOQ in the same envelope as the Bid Proposal. The envelope will not be opened if only one is received; it will be returned to the Contractor.  Submittal of the Statement of Qualifications envelope is required at the same time as the Bid Proposal. The Bid Proposal, Envelope “A”, will not be opened if the Statement of Qualifications, Envelope B, is not received on time.
 The City will open only Bid Proposals, Envelope “A”, at the public bid opening. Statement of Qualifications, Envelope “B”, will be opened by the City thereafter to check contents for compliance with the requirements.

GENERAL BIDDER EXPERIENCE

Any explanation requested by a Bidder regarding the meanin g or interpretation of this Document must be requested in writing and with sufficient time allowed for a reply to reach Bidder before the submission of its SOQ. Oral explanations or instructions will not be binding. Any information provided to any prospe ctive Bidder concerning this Document will be furnished to all prospective Bidders as an Addendum to the Bidding Documents.

Except as set forth herein, all abbreviations and definitions of terms used in this Document 00450 are as set forth in Document 00700 (General Conditions).

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 2 Statement of Qualifications

Bidders shall complete the entire Statement of Qualification. Failure to complete the questionnaire or the inclusion of any false statement(s) shall be grounds for immediate disqualification.

The SOQ shall be clear and concise t o enable management-oriented personnel to make a thorough evaluation and arrive at a sound determination as to whether the SOQ meets City’s criteria . To this end, the SOQ should be so specific, detailed and complete as to demonstrate clearly and fully tha t the Bidder has a thorough understanding of and has demonstrated knowledge of the requirements to perform the Work (or applicable portion thereof).

Bidder’s compliance with the qualification requirements of this Document, will also be measured by the exp erience of the supervisory personnel who will have responsible charge of the various major components of the Work.

If Bidder subcontracts portions of the Work, City, in its determination of whether the qualification requirements have been met, will also consider the qualifications of the Subcontractor’s supervisory personnel.

The Contract will require Bidder to implement the Project, all in accordance with the scope of Work set forth in the Contract. City will accept Bids only from Bidders duly licensed i n accordance with the California Business & Professions Code. Additionally, Bidder must meet the following general requirements, at a minimum, in order to be considered by City to be qualified for award of the Contract:

Per the Public Records Act, City w ill make available to the public documentation associated with this process as applicable.

City will make such information available to the extent required by applicable law, without restriction.

Information disclosed in the Statement of Qualifications and the attendant submissions are the property of City.

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 3 Statement of Qualifications

PART A
BIDDER’S GENERAL QUALIFICATIONS

1. Does Bidder have at least seven years of experience as a continuously operating entity engaged in the performance of similar work? Yes__________ No________

2. Has Bidder, within the past seven years, completed two or more projects, of similar nature and complexity, with a contract amount of at least $ 175,000 each? Yes__________ No________

3. Does Bidder possess a valid and current California Clas s “A ” Gen eral Engineering or Class C -27 Landscaping Contractor’s License for the work proposed? Yes__________ No________

4. Does Bidder have a minimum of $2,000,000 in the aggregate liability insurance coverage? Yes__________ No________

5. Has Bidder’s Contractor’s l icense been revoked at any time in the last five years? Yes__________ No________

6. Has Bidder been “default terminated” by an owner (i.e. not for convenience), or has a Surety completed a contract for Bidder, or has Bidder failed to complete a contract, within the last five years? Yes__________ No________

7. Has Bidder had, within the last four years prior to the date of bid opening, any outstanding convictions or enforcement agency findings for failure to pay prevailing wages in the State of California? Yes__________ No________

8. Has Bidder been determined to have violated any environmental or safety laws giving rise to civil or criminal penalties in excess of $50,000 for each violation during the last four years while performing contracting duties of the ty pe specified for the contract within the State of California? Or has bidder had more than four civil penalties of $50,000 or less during the last four years while performing contracting duties of the type specified for the contract within the State of California? Yes__________ No________

9. Has Bidder been convicted of violating a state or federal law respecting the employment of undocumented aliens within the preceding five years from the date of bid opening? Yes___________ No__________

Bidder will be immediately disqualified if any answer to questions 1, 2, 3, or 4 is No.

Bidder will be immediately disqualified if any answer to questions 5, 7, 8, or 9 is Yes.

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 4 Statement of Qualifications

PART B
BIDDER’S SAFETY, PREVAILING WAGE, LICENSES, DISPUTES, AND INSURANCE

SAFETY
The following statements as to safety experience of Bidder are submitted with Bid, as part thereof, and Bidder guarantees the truthfulness and accuracy of the information.

1. Has Cal/OSHA, Federal OSHA, the EPA or any Air Quality Management District cited Bidd er in the past five years? Yes _____No _____ If yes, attach description of each citation.

2. How often does Bidder require documented safety meetings be held for:

 Field Supervisor Weekly ____ Biweekly ____ Monthly ____ Less than monthly ____  Employees Weekly ____ Bi-weekly ____ Monthly ____ Less than monthly ____  New Hires Weekly ____ Bi-weekly ____ Monthly ____ Less than monthly ____  Subcontractors Weekly ____ Bi-weekly ____ Monthly ____ Less than monthly ____

3. How often does Bidder conduct documented safety inspections? Quarterly , Semi-annually _____, Annually____, Other______

4. Does Bidder have home office safety representatives who visit/audit the job site? Quarterly____, Semi - annually____, Annually _____, Other_____

5. What is Bidder’s Interstate Experience Modification Rate? _________. (A rating in excess of 1 may constitute grounds for disqualification as non-responsible.)

6. List Bidder’s Interstate Experience Modification Rate for the three calendar years listed below.  2011:________
 2012:________
 2013:________

7. Use Bidder’s last year’s Cal/OSHA log to fill in the following:
 Number of lost workday cases _______________
 Number of medical treatment cases _______________
 Number of fatalities _______________
 Employee hours worked last year _______________

8. State the name of Bidder’s safety engineer/manager or Site Safety Officer and attach a resume or outline of this individual’s safety and health qualifications and
experience._______________________________________________

PREVAILING WAGE PROVISIONS

Has Bidder been fined, penalized or otherwise found to have violated any prevailing wage or labor code provision? If yes, attach description of each occurrence.

Yes_____ No_____
Description:_______________________________________________________________________________________ _________________________________________________________________________________________________ Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 5 Statement of Qualifications

LICENSE PROVISIONS

Has Bidder changed names or license numbers in the past seven years? If so, please state reas on for change.

Yes_____No_____Reason:___________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________

DISPUTES

Has Bidder had any claims, litigation, or disputes ending in mediation or arbitration, or termination for cause associated with any project in the past seven years? If yes, attach description of each such instance including details of total claim amount, settlement amount, and owner’s name and phone number.

Yes_____ No_____

INSURANCE

Demonstrate Ability to Provide Required Insurance . Bidder shall provide a letter from an insurance unde rwriter(s), having a financial rating from A. M. Best Company of A, Class 7 or better or that is otherwise acceptable to the City, confirming that the insurer will provide Bidder the required coverages and amounts specified in Document 00700 (General Conditions).

In order to register to undertake work for the City of Cupertino, Bidder must provide the following:
1) Fill out this registration form completely.
2) Provide certificates of insurance complying with Document 00700 (General Conditions).

Workers’ Compensation:

Carrier:

Address:

Phone and Fax:

Policy Number:

Policy Limits: $

Coverage Amount: Per Occurrence: $____________________________ A.M. Best Rating: ___________________________

General Liability:

Carrier:

Address:

Phone and Fax:

Policy Number:

Policy Limits: $

A.M. Best Rating:

Coverage Amount: Per Occurrence: ___________________________ Per Aggregate: ___________________________ Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 6 Statement of Qualifications

Excess Liability: If Contractor has this Coverage

Carrier:

Address:

Phone and Fax:

Policy Number:

Policy Limits: $

A.M. Best Rating:

Coverage Amount: Per Occurrence: ___________________________ Per Aggregate: ___________________________ Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 7 Statement of Qualifications

Automotive Liability:

Carrier:

Address:

Phone and Fax:

Policy Number:

Policy Limits: $

A.M. Best Rating:

Coverage Amount Per Occurrence: ____________________________________________________________________ If Bidder has had the general liability carrier identified in this Document (Bidder Registration and Saf ety Experience Form) for less than 5 years, please provide additional information below for balance of the past 5 years

Agency Name:

Contact Name:

Phone Number:

Carrier: A.M. Best Rating
Carrier: A.M. Best Rating
Carrier: A.M. Best Rating
Has Bidder ever had insurance terminated by a carrier? Yes _____ No _____ If yes, explain on separate signed sheet marked with correlating cross-reference to this paragraph of the questionnaire.

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 8 Statement of Qualifications

PART C

DETAILED BIDDER EXPERIENCE

The unique nature of this Project requires prior similar experience maintaining golf courses by the firm and the Key Personnel assigned. Contractor must have completed, within the last seven years, at least two contracts of at least two years duration with an annual value of $175,000 or more.

Contractor is expected to have successful experience in maintaining a golf course that is adjacent to or drains to a creek, river or fresh water body with a population of State- or Federally-protected salmonids such as steelhead trout or chinook salmon. Note your firm’s related experience and note how your work is conducted to accommodate presence of such protected species. Familiarity with SalmonSafe standards is desirable.

The irrigation system at the project site is over 50 years old and much of it is original. It is desirable to have experience operating a golf course with an old irrigation system that employs hydraulic valves, for which parts are no longer available, and that involves manual operation of similarly old valves and an old system.

Contractor shall describe any related experience in successfully operating a similar irrigation system for a golf course or similar facility.

The irrigation system at the project is old and no record drawings exist. Portions of the course do not receive adequate watering via the existing system. Some areas of the course require hand watering year round; supplemental hand watering during warm weather is needed for greens and other areas. The irrigation system is prone to breaks or failures, which are unpredictable but estimated to be at least monthly, and necessitate immediate repair. Related experience is desirable. Contractor shall describe any related experience in successfully operating a golf course or similar facility, with a comparable undocumented and/or aging irrigation system that involves similar efforts to operate.

Contractor must have a licensed Pest Control Advisor on staff to review and recommend pesticide applications. Contractor must have a staff member with a current Qualified Applicator License or Qualified Applicator Certificate that will personally oversee application of acceptable herbicides or pest control applications.

Contractor must provide evidence of having received training on current Integrated Pest Management (IPM) techniques and ability to comply with City of Cupertino IPM program goals, objectives and reporting.

Knowledge of City of Cupertino’s specific IPM program and procedures is desirable. Indicate your firm’s knowledge/experience as applicable.

Contractor must employ a Golf Course Superintendents Association of America (GCSAA) Class “A” golf superintendent with 5 or more years of successful experience in managing daily maintenance operation of a golf course in a climate that is similar to Cupertino’s. It is desirable to have training equivalent to graduation from an accredited 4-year college or university, preferably with major course work in management, horticulture, or a related field. Provide information regarding the superintendent’s professional education and experience and provide a current resume.

It is desirable that Contractor have a golf irrigation auditor on staff to monitor irrigation operations. Indicate your firm’s golf irrigation auditor if applicable.

Summarize similar project experience below and provide the detailed project information requested:

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 9 Statement of Qualifications

CONTRACTOR is encouraged to provide additional project and experience references if available.

Attach extra pages to provide the requested information as needed.

Project No. 1, Golf Course Maintenance Contract, at or above $ 175,000 in annual cost.

Project name Annual Cost ($) Year completed

Location:

Owner name, address and phone no:

Owner’s Project Mgr./Course Mgr. (name and phone number):

Work Performed Similar to Project:

Project No. 2, Golf Course Maintenance Contract, at or above $ 175,000 in annual cost.

Project name Annual Cost ($) Year completed

Location:

Owner name, address and phone no:

Owner’s Project Mgr./Course Mgr. (name and phone number):

Work Performed Similar to Project:

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 10 Statement of Qualifications

Project No. 1, Experience Maintaining Golf Course Adjacent/Draining to Creek/River/ Water Body with Chinook/Steelhead/protected fish species.

Project name Annual Cost ($) Year completed

Location:

Owner name, address and phone no:

Owner’s Project Mgr./Course Mgr. (name and phone number):

Work Performed Similar to Project; describe related experience & practices that accommodate protected fish; describe familiarity with Salmon Safe standards if applicable:

Project No. 1, Desirable Experience: Maintaining Golf Course or Similar Facility with Hydraulic Valves and Manual Operation of Irrigation System
Project name Annual Cost ($) Year completed

Location:

Owner name, address and phone no:

Owner’s Project Mgr./Course Mgr. (name and phone number):

Similar Work Performed; describe related experience operating an old golf irrigation system with hydraulic valves and manual operation of old valves/old system or a similar one; describe related practices to accommodate this:

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 11 Statement of Qualifications

Project No. 1, Desirable Experience: Maintaining Golf Course or Similar Facility with Old / Failing Irrigation System (requires hand watering year round; prone to failure; undocumented layout/equipment/material)
Project name Annual Cost ($) Year completed

Contractor shall describe any related experience in successfully operating a golf course with a similar undocumented and/or aging irrigation system that involves similar efforts to operate.

Location:

Owner name, address and phone no:

Owner’s Project Mgr./Course Mgr. (name and phone number):

Similar Work Performed; describe related experience operating an old or failing golf irrigation system that is undocumented, prone to frequent breaks and failures, involves significant ongoing hand-watering due to system deficiencies, or similar system; describe related practices to accommodate this:

TRAINING ON CURRENT INTEGRATED PEST MANAGEMENT TECHNIQUES Describe your staff’s recent training/education and knowledge of current appropriate Integrated Pest Management (IPM) techniques suitable for the setting:

Describe your firm’s knowledge of or experience with City of Cupertino’s IPM program and procedures. Discuss yo ur ability to support Cupertino’s IPM goals, objectives and reporting:

Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 12 Statement of Qualifications

BIDDER’S PROPOSED KEY PERSONNEL
Bidder shall provide a current detailed resume, and specific information, as listed below, for each named Key Personnel of Bidder.

Project Manager: _________________________________________________________________________________ Years of Employment with Bidder’s Firm: ______________________________________________________________ Years of experience: ________________________________________________________________________________ Education – degrees obtained, schools and years _________________________________________________________

Professional registrations, licenses, certifications, GCSAA membership status__________________________________

Two client reference names, firm/organization, location/project, and phone nos:________________________________

Project Superintendent:

Years of Employment with Bidder’s Firm: _____________________________________________________________ _ Years of experience:________________________________________________________________________________ Education – degrees obtained, schools and years:_________________________________________________________

Professional registrations, licenses, certifications, GCSAA membership status__________________________________

Two client reference names and phone nos:______________________________________________________________

Staff Member that is licensed Pest Control Advisor:_____________________________________________________

Staff Member with current Qualified Applicator License or Certificate: ____________________________________ Contractor’s Name: _________________________________

City of Cupertino
Blackberry Farm Golf Maintenance 2016 00450 - 13 Statement of Qualifications

PART D

BIDDER REGISTRATION

BIDDER CERTIFIES, UNDER PENALTY OF PERJURY, THAT THE FOREGOING INFORMATION IN THIS DOCUM ENT 00450 IS CURRENT AND ACCURATE AND

AUTHORIZES THE CITY OF CUPERTINO AND ITS AGENTS AND

REPRESENTATIVES TO OBTAIN A CREDIT REPORT AND/OR VERIFY ANY OF THE ABOVE INFORMATION.

_________________________________________
Printed name

__________________________________________
Signature

___________________________________________
date

END OF DOCUMENT

City of Cupertino 00481 - 1 Non-Collusion Affidavit
Blackberry Farm Golf Course Maintenance 2016
DOCUMENT 00481

NON-COLLUSION AFFIDAVIT
PUBLIC CONTRACT CODE §7106

NON-COLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID

STATE OF CALIFORNIA )
) ss.

COUNTY OF _________________)

_________________________________, being first duly sworn, deposes and says that he or she is _________________________________ [Office of Affiant] of _________________________________ [Name of Bidder], the party making the foregoing Bid, that the Bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the Bid is genuine and not collusive or sham; that Bidder has not direct ly or indirectly induced or solicited any other bidder to put in a false or sham Bid, and has not directly or indirectly colluded, conspired, connived or agreed with any bidder or anyone else to put in a sham Bid, or that anyone shall refrain from bidding, and that the Bidder has not in any manner, directly or indirectly, sought by contract, communication or conference with anyone to fix the Bid price of Bidder or any other bidder, or to fix any overhead, profit or cost element of the Bid price, or of that of any other bidder, or to secure any advantage against the City of Cupertino, or anyone interested in the proposed contract; that all statements contained in the Bid are true; and further, that Bidder has not, directly or indirectly, submitted its Bid pri ce or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, Bid depository, or to any member or agent thereof to effectuate a collusive or sham Bid.

Executed under penalty of perjury under the laws of the State of California:

(Name of Bidder)

(Signature of Principal)

Subscribed and sworn before me

This _______ day of _________________, 20___

Notary Public of the State of ________________________________ In and for the County of____________________________________ My Commission expires____________________________________ (Seal)

(If Bidder is a partnership or a joint venture, this affidavit must be s igned and sworn to by every member of the partnership or venture.)

(If Bidder [including any partner or venturer of a partnership or joint venture] is a corporation, this affidavit must be signed by the Chairman, President, or Vice President and by the S ecretary, Assistant Secretary, Chief Financial Officer, or Assistant Treasurer.)

(If Bidder’s affidavit on this form is made outside the State of California, the official position of the person taking such affidavit shall be certified according to law.)

END OF DOCUMENT

City of Cupertino 00482- 1 Bidder Certifications
Blackberry Farm Golf Course Maintenance 2016
DOCUMENT 00482

BIDDER CERTIFICATIONS

CITY OF CUPERTINO
BLACKBERRY FARM GOLF COURSE MAINTENANCE 2016

The undersigned Bidder certifies to the City of Cupertino as set forth in sections 1 through 7 below.

1. STATEMENT OF CONVICTIONS

By my signature hereund er, I hereby swear, under penalty of perjury, that no more than one final, unappealable finding of contempt of court by a Federal Court has been issued against Bidder within the past two years because of failure to comply with an order of a Federal Court or to comply with an order of the National Labor Relations Board.

2. CERTIFICATION OF WORKER’S COMPENSATION INSURANCE

By my signature hereunder, as the Bidder, I certify that I am aware of the provisions of Section 3700 of the Labor Code which require eve ry employer to be insured against liability for worker's compensation or to undertake self - insurance in accordance with the provisions of that Code, and I will comply with such provisions before commencing the performance of the work of this Contract.

3. CERTIFICATION OF PREVAILING WAGE RATES AND RECORDS

By my signature hereunder, as the Bidder, I certify that I am aware of the provisions of Section 1773 of the California Labor Code, which requires the payment of prevailing wage on public projects. Also, that the Bidder and any sub bidders under the Bidder shall comply with California Labor Code §1776, regarding wage records, and with California Labor Code §1777.5, regarding the employment and training of apprentices. It is the Bidder’s responsibility to ensure compliance by any and all subcontractors performing work under this Contract.

4. CERTIFICATION OF COMPLIANCE WITH PUBLIC WORKS CHAPTER OF LABOR CODE

By my signature hereunder, as the Bidder, I certify that I am aware of Sections 1777.1 and 1777.7 of th e California Labor Code and Bidder and Subcontractors are eligible to bid and work on public works projects.

5. CERTIFICATE OF NON-DISCRIMINATION

By my signature hereunder, on behalf of the Bidder making this Bid, the undersigned certifies that there will be no discrimination in employment with regard to race, color, religion, gender, sexual orientation, age or national origin; that all federal, state, and local directives and executive orders regarding non -discrimination in employment will be complied with ; and that the principle of equal opportunity in employment will be demonstrated positively and aggressively.

6. CERTIFICATION REGARDING PREVIOUS DISQUALIFICATIONS

By my signature hereunder, I hereby swear, under penalty of perjury, that the below indica ted Bidder, any officer of such Bidder, or any employee of such Bidder who has a proprietary interest in such Bidder, has never been disqualified, removed or otherwise prevented from bidding on, or completing a Federal, State, or local government project b ecause of a violation of law or a safety regulation except as indicated on the separate sheet attached hereto entitled “Previous Disqualifications.” If such exceptions are attached, please explain the circumstances.

City of Cupertino 00482- 2 Bidder Certifications
Blackberry Farm Golf Course Maintenance 2016

7. CERTIFICATION OF ADEQUACY OF CONTRACT AMOUNT

By my signature hereunder, as the Contractor, pursuant to Labor Code Section 2810(a), I certify that, if awarded the Contract based on the undersigned’s Bid, the Contract will include funds sufficient to allow the Contractor to comply with all applicable local, state, and federal laws or regulations governing the labor or services to be provided. I understand that the City will be relying on this certification if it awards the Contract to the undersigned.

BIDDER:
(Name of Bidder)

Date: _________________, 2015 By:
(Signature)

Name:
(Print Name)

Its:
(Title)

END OF DOCUMENT

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Contractor Agreement
Blackberry Farm Golf Course Maintenance 2016

DOCUMENT 00510

SAMPLE CONTRACT

AGREEMENT BETWEEN THE CITY OF CUPERTINO AND ______________

FOR BLACKBERRY FARM GOLF COURSE MAINTENANCE

THIS AGREEMENT, for reference dated___________, 2015, is by and between CITY OF CUPERTINO, a municipal corporation (hereinafter referred to as "City"), and , a (California corporation, partnership, sole proprietor, individual) whos e address is hereinafter called the Contractor, and is made with reference to the following:

RECITALS:

A. City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the Constitution and the statutes of the State of California and the Cupertino Municipal Code.

B. City and Contractor desire to enter into an agreement for Blackberry Farm Golf Course Maintenance , in accordance with the Technical Provisions, General and Special Conditions, and Special Environmental Conditions (Exhibit A).

NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows:

1. TERM:

The Contractor shall begin work within ten (10) working days after receiving notice from the Engineer to commence the work, and shall diligently prosecute the work to completion.

2. SERVICES TO BE PERFORMED:

Contractor agrees, at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all work strictly in accordance with the Technical Provisions, General and Special Conditions, and Special Environme ntal Conditions are hereby referred to and expressly made a part hereof with the same force and effect as if the same were fully incorporated herein.

3. COMPENSATION TO CONTRACTOR:

Contractor shall be compensated for services perfor med pursuant to this Agreement in the amount and manner set forth in Contractor's bid, which is attached hereto as Exhibit "A" and incorporated herein by this reference. Payment will be made in the same manner that claims of a like character are paid by t he City, with checks drawn on the treasury of the City, to be taken from the fund as indicated in the city’s adopted budget.

Page 2 of 10 ends

Contractor Agreement
Blackberry Farm Golf Course Maintenance 2016

4. TIME IS OF THE ESSENCE:

Contractor and City agree that time is of the essence regarding the performance of this Agreement.

5. STANDARD OF CARE:

Contractor agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City nor have any contractual relationship with City.

6. INDEPENDENT PARTIES:

City and Contractor intend that the relationship between them created by this Agreement is that of employer -independent contractor. The manner and means of conducting the work are under the control of Contractor, except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of C ontractor's services. None of the benefits provided by City to its employees, including but not limited to unemployment insurance, workers' compensation plans, vacation and sick leave are available from City to Contractor, its employees or agents. Deduct ions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer -employee relationship from any fees due Contractor.

Payments of the above items, if required, are the responsibility of Contractor.

7. IMMIGRATION REFORM AND CONTROL ACT (IRCA):

Contractor assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Contractor shall indemnify and hold City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Contractor.

8. NON-DISCRIMINATION:

Consistent with City's policy that harassment and discrimination are unacceptable employer/employee conduct, Contractor agrees that harassment or discrimination directed toward a job applicant, a City employee, or a citizen by Contractor or Contractor's employee on the basis of race, religious creed, color, national origin, ancestry, handicap, disability, marital status, pregnancy, sex, age, or sexual orientation will not be tolerated. Contractor agrees that any and al l violations of this provision shall constitute a material breach of this Agreement.

9. HOLD HARMLESS:

Contractor shall, to the fullest extent allowed by law, indemnify, defend, and hold harmless the City and its officers, officials , agents, employees and volunteers against any and all liability, claims, stop notices, actions, causes of action or demands whatsoever from and against any of them,

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Blackberry Farm Golf Course Maintenance 2016

including any injury to or death of any person or damage to property or other liability of any nature, arising out of, pertaining to, or related to the performance of this Agreement by Contractor or Contractor’s employees, officers, officials, agents or independent contractors. Contractor shall not be obligated under this Agreement to indemnify City to the extent that the damage is caused by the sole or active negligence or willful misconduct of City, its agents or employees. Such costs and expenses shall include reasonable attorneys’ fees of counsel of City’s choice, expert fees and all other costs and fees of litigation.

Contractor agrees to obtain executed indemnity agreements with provisions identical to those set forth here in these sections from each and every subcontractor or any other person or entity involved by, for, with, or on be half of Contractor in the performance of this agreement. If Contractor fails to obtain such indemnity obligations from others as required here, Contractor agrees to be fully responsible according to the terms of this section.

10. INSURANCE:

On or before the commencement of the terms of this Agreement, Contractor shall furnish City with certificates showing the type, amount, class of operations covered, effective dates and dates of expiration of insurance covera ge in compliance with paragraph 10A, B, C and D. Such certificates, which do not limit Contractor's indemnification, shall also contain substantially the following statement: "Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expi ration date thereof, the insurer affording coverage shall provide thirty (30) days' advance written notice to the City of Cupertino by certified ma il, "Attention: City Manager." It is agreed that Contractor shall maintain in force at all times during the p erformance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming the City as additional insured shall be submitted with the insurance certificates. Contractor to complete the attached Document 00530 Insurance Forms.

A. COVERAGE:

Contractor shall maintain the following insurance coverage:
(1) Workers' Compensation:

Statutory coverage as required by the State of California; Employers’ Liability $1,000,000 per occurrence
(2) General Liability:

Commercial general liability coverage in the following minimum limits:

Bodily Injury: $500,000
each occurrence
$1,000,000
aggregate - all other
Property Damage: $500,000 each occurrence
$1,000,000 aggregate
If submitted, combined single limit of $1,000,000 per occurrence; $2,000,000 in

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the aggregate will be considered equivalent to the required minimum limits shown above.
(3) Automotive:

Comprehensive automobile liability coverage in the
following minimum limits:

Bodily injury: $500,000 each occurrence
Property Damage: $500,000 each occurrence
or
Combined Single Limit: $1,000,000 each occurrence

B. SUBROGATION WAIVER:

Contractor agrees that in the event of loss due to any of the perils for which it has agreed to provide comprehensive general and automotive liability insurance, Contractor shall look solely to its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Contractor or City with respect to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of said Contractor may acquire ag ainst City by virtue of the payment of any loss under such insurance.

C. FAILURE TO SECURE:

If Contractor at any time during the term hereof should fail to secure or maintain the foregoing insurance, City shall be permitted to obtain such insurance in the Contractor's name or as an agent of the Contractor and shall be compensated by the Contractor for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.

D. ADDITIONAL INSURED:

City, its City Council, boards and commissions, officers, employees, and volunteers shall be named as an additional insured under all insurance coverages, except worker ’s compensation insurance. The naming of an addition al insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.

E. SUFFICIENCY OF INSURANCE:

The insurance limits required by City are not represented as being sufficient to protect Contractor. Contractor is advised to consult Contractor's insurance broker to determine adequate coverage for Contractor.

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11. BONDS:

Not applicable.

12. PROHIBITION AGAINST TRANSFERS:

Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so without said consent shall be nu ll and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money by Contractor from City under this Agreement may be assigne d to a bank, trust company or other financial institution without prior written consent. Written notice of such assignment shall be promptly furnished to City by Contractor.

The sale, assignment, transfer or other disposition of any of the issued and outs tanding capital stock of Contractor, or of the interest of any general partner or joint venturer or syndicate member or cotenant, if Contractor is a partnership or joint venture or syndicate or cotenancy, which shall result in changing the control of Contr actor, shall be construed as an assignment of this Agreement. Control means fifty percent (50%) or more of the voting power of the corporation.

13. SUBCONTRACTOR APPROVAL:

Unless prior written consent from City is obtained, only th ose people and subcontractors whose names are listed in Contractor's bid shall be used in the performance of this Agreement.

Requests for additional subcontracting shall be submitted in writing, describing the scope of work to be subcontracted and the name of the proposed subcontractor. Such request shall set forth the total price or hourly rates used in preparing estimated costs for the subcontractor's services.

Approval of the subcontractor may, at the option of City, be issued in the form of a Work Order.

In the event that Contractor employs subcontractors, such subcontractors shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general and automobile liability insurance in reasonable conformity to the insurance carried by Contractor. In addition, any work or services subcontracted hereunder shall be subject to each provision of this Agreement.

14. PERMITS AND LICENSES:

Contractor, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City Business License, that may be required in connection with the performance of services hereunder.

15. REPORTS:

Each and every report, draft, work product, map, record and other document reproduced, prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement shall be the exclusive property of City. Consultant may retain a copy of any report fur nished to the City pursuant to this Agreement.

No report, information nor other data given to or prepared or assembled by Contractor

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pursuant to this Agreement shall be made available to any individual or organization by Contractor without prior approval by City.

Contractor shall, at such time and in such form as City may require, furnish reports concerning the status of services required under this Agreement.

16. RECORDS:

Contractor shall maintain complete and accurate records with respect to sales, costs, expenses, receipts and other such information required by City that relate to the performance of services under this Agreement.

Contractor shall maintain adequate records of services provided in sufficient detail to permit an evaluation of services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Contractor shall provide free access to such books and records to the representati ves of City or its designees at all proper times, and gives City the right to examine and audit same, and to make transcripts therefrom as necessary, and to allow inspection of all work, data, documents, proceedings and activities related to this Agreement . Such records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained for a period of three (3) years after receipt of final payment.

If supplemental examination or audit of the records is nece ssary due to concerns raised by City's preliminary examination or audit of records, and the City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of contract or fai lure to act in good faith, then Contractor shall reimburse City for all reasonable costs and expenses associated with the supplemental examination or audit.

17. NOTICES:

All notices, demands, requests or approvals to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personally or on the second business day after the deposit thereof in the United States Mail, postage prepaid, registered or certified, addressed as hereinafter provided.

All notices, demands, requests, or approvals from Contractor to City shall be addressed to City at:

City of Cupertino
10300 Torre Avenue
Cupertino CA 95014
Attention: Carol Atwood, Director of Recreation and Community Services

All notices, demands, requests, or approvals from City to Contractor shall be addressed to Contractor at:
____________________________
____________________________
____________________________
____________________________

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18. URBAN RUNOFF MANAGEMENT:

The Contractor shall avoid creating excess dust when breaking asphalt or concrete and during excavation and grading or other activities that may create dust or erosion. If water is used for dust control, contractor shall use as little as necessary. Contractor shall take all steps necessary to keep wash water out of the streets, gutters and storm drains.

The Contractor shall develop and implement erosion and sediment control to prevent pollution of storm drains. Such control includes but is not limited to:

A. Use storm drain inlet protection devices such as sand bag barriers, filter fabric fences, block and gravel filters. (Block storm drain inlets prior to the start of the rainy season (October 15), in site de -watering activities and saw -cutting act ivities; shovel or vacuum saw -cut slurry and remove from the site).

B. Cover exposed piles of soil or construction material with plastic sheeting. All construction materials must be stored in containers.

C. Sweep and remove all materials from paved surfac es that drain to streets, gutters and storm drains prior to rain as well as at the end of the each work day. At the completion of the project, the street shall be washed and the wash water shall be collected and disposed of offsite in an appropriate location.

D. After breaking old pavement, Contractor shall remove all debris to avoid contact with rainfall or runoff.

E. Contractor shall maintain a clean work area by removing trash, litter, and debris at the end of each work day. Contractor shall also clean up any leaks, drips, and other spills as they occur.

The objective is to ensure that the City and County of Santa Clara County -Wide Clean Water Program is adequately enforced. These controls should be implemented prior to the start of construction, up-graded as required, maintained during construction phases to provide adequate protection, and removed at the end of construction.

These recommendations are intended to be used in conjunction with the State ’s Best Management Practices Municipal and Constructi on Handbooks, local program guidance materials from municipalities, Section 7.1.01 of the Standard Specifications and any other appropriate documents on storm water quality controls for construction.

Failure to comply with this program will result in the i ssuance of noncompliance notices, citations, project stop orders or fines. The fine for noncompliance of the above program is two hundred and fifty dollars ($250.00) per occurrence per day. The State under the Federal Clean Water Act can also impose a fine on the contractor, pursuant to Cal. Water Code '13385.

19. TERMINATION:

In the event Contractor fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Contractor shall be deemed in default in the performance of this Agreement. If such default is not cured within a period of two (2) days after receipt by Contractor from City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, City may termi nate the Agreement forthwith by giving to the

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Contractor written notice thereof.

City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days' prior written notice to Contractor as provided he rein. Upon termination of this Agreement, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination.

20. COMPLIANCES:

Contractor shall comply with all state or federal laws and all ordinances, rules and regulations enacted or issued by City. Specifically, and without limitation, Contractor shall comply with all state, federal, or local regulation regarding the removal and disposal of hazardous waste.

A. PREVAILING WAGES: To the extent applicable, Contractor shall comply with the City’s Labor Compliance Program and all other requirements set forth in Labor Code section 1770 et seq. Contractor shall pay prevailing wages. Contractor will submit monthly certified payroll records to the City for all employees and subcontractors in a preapproved format or a City provided form. Any delay in remitting certified payroll reports to the City upon request from the City will result in either delay and/or forfeit of outstanding payment to Contractor.

B. WORKING DAY: Contractor shall comply with California Labor Code Section 1810, et seq. which provides that work performed by employees of contractors in excess of 8 hours per day, and 40 hours during any one week, must be compensated as overtime, at not less than 1 ½ times the basic rate of pay, to the extent applicable.

C. PAYROLL RECORDS: Contractor shall comply with California Labor Code Section 1776 which requires certified payroll records be maintained with the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice, worker, or other employee employed by him or her in connection with this Agreement , to the extent applicable . The Payroll Records shall be made available for inspection as provided in California Labor Code Section 1776.

D. APPRENTICES: Contractor shall comply with California Labor Code Se ction 1777.5 regarding apprentices, to the extent applicable.

21. CONFLICT OF LAW:

This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought purs uant to this Agreement shall be filed with the courts of the County of Santa Clara, State of California.

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22. ADVERTISEMENT:

Contractor shall not post, exhibit, display or allow to be posted, exhibited, displayed any signs, advertising, show bills, lithographs, posters or cards of any kind pertaining to the services performed under this Agreement unless prior written approval has been secured from City to do otherwise.

23. WAIVER:

A waiver by City of any breach of any term, covenant, or condition co ntained herein, shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character.

24. INTEGRATED CONTRACT:

This Agreement represents the full a nd complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the prov isions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Contractor.

25. INSERTED PROVISIONS:

Each provision and clause required by law to be inserted into the Agreement shall be deemed to be e nacted herein, and the Agreement shall be read and enforced as though each were included herein. If through mistake or otherwise, any such provision is not inserted or is not correctly inserted, the Agreement shall be amended to make such insertion on app lication by either party.

26. CAPTIONS:

The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.

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P.O. No.: _________________

IN WITNESS WHEREOF, the parties have caused the Agreement to be executed on the day and year first above written.

CONTRACTOR CITY OF CUPERTINO
[Name of Contractor] A Municipal Corporation

By By ___________________________ Timm Borden, Director of Public Works
Name_______________________
Date __________________________
Title

Date________________________
RECOMMENDED FOR APPROVAL:

By ____________________________

Address______________________
______________________________ Title

APPROVED AS TO FORM:

By
Carol Korade, City Attorney

ATTEST:

_________________________________
Grace Schmidt, City Clerk

Contract Amount: _________________
Account No. : ___________________

DOCUMENT 00510

City of Cupertino 00530 - 1 Insurance Forms
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DOCUMENT 00530

INSURANCE FORMS

INSURANCE FORMS INSTRUCTIONS

FOR ITEMS 3, 4 AND 5, THE FORMS PROVIDED BY THE CITY OF CUPERTINO MUST BE USED. FORMS OTHER THAN THESE WILL NOT BE ACCEPTED.

ALL DOCUMENTS MUST BE ORIGINALS - SUBMIT IN TRIPLICATE

1. Insurance Agreement - Must be signed by Contractor.

2. Certificate of Insurance to the City of Cupertino - must be completed by the insurance agent or must provide a certificate on the company’s form. They must contain the same information.

3. Endorsement of Additional Insured and Primary Insurance and Notice of Cancellation - must be signed by the insurance agent for general liability and automobile liability only.

4. Comprehensive general liability/commercial general liability endorse ment of aggregate limits of insurance per project - must be signed by the insurance agent for general liability only.

5. Waiver of subrogation endorsement worker’s compensation insurance - must be signed by the insurance agent for worker’s compensation only.

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INSURANCE AGREEMENT

A. Contractor is aware of the provisions of Section 3700 of the Labor Code, which requires every employer to be insured against liability for worker’s compensation or undertake self - insurance in accordance with the provisions of that Code, and will comply with such provisions before commencing the performance of the work of this Contract.

B. Contractor and all subcontractors will carry worker’s compensation insurance for the protection of its employees during the progress of the work. The insurer shall waive its rights of subrogation against the City, the City’s officers, agents and employees and shall issue an endorsement to the policy evidencing same.

C. Contractor shall carry at all times, on all operatio ns hereunder, commercial general liability insurance, and automobile liability insurance. All insurance coverage shall be in amounts required by the City and shall be evidenced by the issuance of a certificate in a form prescribed by the City and shall be underwritten by insurance companies satisfactory to the City for all operations, sub - contract work, contractual obligations, product or completed operations, all owned vehicles and non-owned vehicles. Said insurance coverage obtained by the Contractor, e xcepting worker’s compensation coverage, shall name the City, its engineer, and each of its directors, officers, agents and employees, as determined by the City, as additional insureds on said policies . Insurers must be licensed to do business in the Stat e of California. The Insurers must also have an “A” policyholder’s rating and a financial rating of at least Class VII in accordance with the current Best’s Guide Rating or that is otherwise acceptable to the City.

D. Before Contractor performs any work at, or prepares or delivers materials to, the site of construction, Contractor shall furnish certificates of insurance evidencing the foregoing insurance coverages and such certificates shall provide the name and policy number of each carrier and policy and that the insurance is in force and will not be canceled or modified without thirty (30) days written notice to the City. Contractor shall maintain all of the foregoing insurance coverages in force until the work under this Contract is fully completed. The requirement for carrying the foregoing insurance shall not derogate from the provisions for indemnification of the City by Contractor under this Contract and for the duration of the warranty period. Notwithstanding nor diminishing the obligations of Contractor with respect to the foregoing, Contractor shall maintain in full force and effect during the life of this Contract, the following insurance in amounts not less than the amounts specified and having a Best’s Guide Rating of A, Class VII or better or that is otherwise acceptable to the City.

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LIMITS

Worker’s Compensation In accordance with the Worker’s Compensation & Employers’ Liability Act of the State of California – Worker’s comp “statutory” per CA Law; Employers’ Liability
$1,000,000 per occurrence.

General Liability - commercial general liability;
including provisions for contractual liability,
personal injury, independent contractors and
products – completed operations hazard.

Combined single limit of $1.0 million per
occurrence; $2.0 million in the aggregate

Automobile Liability - comprehensive covering
owned, non-owned and hired automobiles.

Combined single limit of $1.0 million per
occurrence.

_________________________________ By:________________________________ (Contractor’s Name)
Dated:_________________________20___

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CERTIFICATE OF INSURANCE TO THE CITY OF CUPERTINO

This certifies to the City of Cupertino that the following described policies have been issued to the insured named below and are in force at this time.

Insured: _______________________________________
Address: _______________________________________
_______________________________________________
Description of operations/locations/products insured (show contract name and/or number, if any):
______________________________________________________________________________ ______________________________________________________________________________ ===================================================================== WORKER’S COMPENSATION * Statutory Min.
* Employer’s
___________________________ Liability
(name of insurer)
$ _____________ $ _____________ $ ___________ Insurance Company’s State License No. _____________________________________________ ===================================================================== Check Policy Type: Each Occurrence $_________________

COMPREHENSIVE GENERAL

LIABILITY
[ ] Premises/Operations General Aggregate $__________________ (if applicable)
[ ] Owners & Contractors
Protective Aggregate $__________________
[ ] Contractual for Specific
Contract Personal Injury $__________________
[ ] Products Liability
[ ] XCU Hazards
[ ] Broad Form P.D. Fire Damage (any one fire) $__________________ [ ] Severability of Interest
Clause
[ ] Personal Injury with Medical Expense $__________________ Employee Exclusion Removed (any one person)
or Self-Insured
COMMERCIAL GENERAL LIABILITY Retention $__________________

________________________________________________________ (name of insurer)
Policy No. ____________________ Expiration Date_________________

=====================================================================

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AUTOMOTIVE/VEHICLE LIABILITY BODILY INJURY PROPERTY DAMAGE Commercial Form Each Person Each Accident Liability Coverage
$________________ $__________________
Each Accident
______________________________
(name of insurer)
$________________ or

Combined Single Limit $_________________

Policy No. __________________ Expiration Date ______________

=====================================================================

BUILDER’S RISK “ALL RISK”
This is to certify that the following policy has been issued by the below-stated company in conformance with the requirements of the project documents and is in force at this time.

_______N/A_________________________________________________ (Name of insurer)
Policy No. ____________________ Expiration Date_________________ Limits of Liability: ___________________ Deductible: ____________________ ===================================================================== ________________ A copy of all Endorsements to the policy(ies) which in any way (agent’s initial) limit the above-listed types of coverage are attached to this

Certificate of Insurance.

This Certificate of Insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or any other document with respect to which this Certificate of Insurance may be issued or may pertain, th e insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies.

IT IS HEREBY CERTIFIED that the above policy(ies) provide liability insurance as required by the Agreement between the City and the insured.

By:________________________________ Dated:________________________20____

Attach Certificate of Insurance and Additional Insured Endorsement on company forms.

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ADDITIONAL INSURED ENDORSEMENT
and

ENDORSEMENT OF PRIMARY INSURANCE
and

NOTICE OF POLICY

CANCELLATION ENDORSEMENT

Project Title and Number:______________________________________________________

In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attach ed or any other Endorsement attached thereto, it is agreed as follows:

The City of Cupertino (“City”) and its directors, officers, engineers, agents and employees, and all public agencies from whom permits will be obtained and their directors, officers, engineers, agents and employees, and the State of California, and its officers, agents and employees, are hereby declared to be additional insureds under the terms of this policy, but only with respect to the operations of the Contractor at or upon any of the premises of the City in connection with the Contract with the City, or acts or omissions of the additional insureds in connection with, but limited to its general supervision or inspection of said operations.

The insurance afforded by this policy i s primary insurance, and no additional insurance held or owned by the designated additional insured(s) shall be called upon to cover a loss under said additional policy.

Cancellation Notice. The insurance afforded by this policy shall not be suspended, voided, canceled, reduced in coverage or in limits, or materially altered, except after thirty (30) days’ prior written notice by certified mail, return receipt requested, has been given to the City of Cupertino (“City”). Such notice shall be addressed to the City as indicated below.

POLICY INFORMATION

1. Insurance Company:__________________________________________________________

2. Insurance Policy Number:________________________________________________

3. Effective Date of this Endorsement:________________________________________20____

4. Insured:____________________________________________________________________

All notices herein provided to be given by the Insurance Company to the City in connection with this policy and these Endorsements, sh all be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014.

I, ___________________________________________________________(print/type name) warrant that I have authority to bind the below listed Insurance Company and b y my signature hereon do so bind this Company.

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Signature of Authorized Representative:____________________________________________ (Original signature required on all Endorsements furnished to the District)

Names of
Agent/Agency:_________________________________ Title:_________________________

Address:______________________________________ Telephone: _____ _____ _________

_______________________________________ Facsimile: _____ _____ _________

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COMPREHENSIVE GENERAL LIABILITY

COMMERCIAL GENERAL LIABILITY

ENDORSEMENT OF AGGREGATE LIMITS OF

INSURANCE PER PROJECT

Project Title and Number:______________________________________________________

In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is as follows:

This Endorsement modifies the insurance provided under the General Liability Coverage part of the below-referenced policy of insurance.

The ge neral aggregate limit under LIMITS OF INSURANCE applies separately to the project described as ___________________________________________________________________

POLICY INFORMATION

1. Insurance Company:__________________________________________________________

2. Insurance Policy Number:______________________________________________________

3. Effective Date of this Endorsement:________________________________________20____

4. Insured:____________________________________________________________________

5. Additional Insured: City of Cupertino, its directors, officers, agents and employees.

All notices herein provided to be given by the Insurance Company to the City in connection with this policy and this Endorsement, shall be mailed to or delivered to the City at 10300 Torre Avenue; Cupertino, California 95014.

Signature of Authorized Representative:____________________________________________ (Original signature required on all Endorsements furnished to the District)

Names of
Agent/Agency:_________________________________ Title:_________________________ Address:______________________________________ Telephone: _____ _____ _________ _______________________________________ Facsimile: _____ _____ _________

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WAIVER OF SUBROGATION ENDORSEMENT
WORKER’S COMPENSATION INSURANCE

Project Title and Number:______________________________________________________

In consideration of the policy premium and notwithstanding any inconsistent statement in the policy to which this Endorsement is attached or any other Endorsement attached thereto, it is agreed as follows:

It is agreed that with respect to such insurance as is afforded by the policy, the Insurance Company waives any right of subrogation against the City of Cupertino, and each of its directors, officers, agents, consultants and employees by reason of any payment made on account of injury, including death resulting therefrom, sustained by any employee of the insured, arising out of the performance of the above-referenced Contract.