HomeMy WebLinkAboutBeylik Drilling, Inc - 1981-08-17 (6).,
DESIGNATION OF SUBCONTRACTORS
In compliance with the "Subletting and Subcontracting Fair Practices Act" being Sections 4100.4113 or the
Government Code of the Stte of California, and any amendments thereto, each bidder shall set forth below ilia name and
location of the place of business of each subcontractor who will perform work or labor or render service to the prime con-
tractor in or about the construction of the work or improvement in an amount in excess of one-half Nit) of one percent 0 %)
of the prime contractor's total bid, and shall further sot forth the portion of the work which will be done b,' each subcon-
tre;ctor. Only one subcontractor for each portion shall be listed.
If the contractor fails to specify a subcontractor for any portion of the work to be performed under the contract, he
shall be deemed to hove agree l to perform such portion himself, and he shall not be permitted to subcontract that portion
of the work except tondei- thu conditions hereinafter set forth.
Subletting of subcontracting of any portion of the work to which no subcontractor was designated in the original bid
shall only be permitted in cases of public emergency or necessity, and then only after a finding reduced to writing as a
public record of the Legislative Body of the owner.
POR i ION
OF MARK
SUBCONTRACTOR'S NAME AND ADDRESS
STATE LICENSE
NUMBER CLASS
By submission of this proposal, the contractor certifies:
1. That he is able to and will perform the balance of all work which is covered in the above subcontractor listing.
Z. That the City will be furnished copies of all subcontracts entered into and bonds furnished by sub -contractor
for this project.
i' -5
ADDW)UM "A„
M
PUBLIC 14ORKS CONTRACT
WIS .ADEO- MUM AG - 0JT to that certain Agreement, titled,
and dated, by and L-etween the CITY Ole' IltJidTII•, TON f'T:frCli, a municipal
corporation of the State of California, therein called "CITY", and
(California coi-poration/ceMcr 3�n/partrm-r�p/je4nt ver-iL=urt/indtvidciil), thereiri
called , Is hereby modified and arnr_nded, effective on the Oi=te
shown below as follows:
The parties hereto agree as follows:
1. TNnEril`JIFICATIQ;NI, DE sNSE, }iOT.D HAR1fiX-,SS :
COMACTOR shall defend, indemnify grid hold harmless CITY, its officers, agents
and employees, fZrom and against any and all liability, judrr,ents, dartia3es, costs,
losses, claims, including Workers' Comrensation claims, and expenses resulting from
or ccr-,nected with COM'f3ACTOR' S negligence or ot-herf t:ort-ious conduct in the performance
of this agreement .
2. WORIERS' COMPUNSAMON:
CONTif C'MrZ' shall coirply with all of the provisions of the Workers' Compensation
Insgw%ance and Safety Act:: of the State of California, the applicable provisions of
Division 11 and 5
of the
California Labor Code and
all amendments thereto; and
all
similar State ov
Federal
acts or laws applicable.
CONTRACTOR shall f)xrrish to
CITY
a certificate of Workers' Compensation insurance. The insurer shall not cancel or
modifj the policy without thirty (30) days' prior ;tiritten notice to the CITY. In the
alternative, the CONTRACTOR may stow proof of a certificate of consent to self -insure
issued by the Director of Industrial Relations according to California Labor Code
Section 3800.
-1-
3. I1I.-I It C
CONTRAC`MR shall obtain a policy of comprehensive bodily irJury and propurty
darmEe liability insuranc -, ana m=tintain such policy in effect for the period
covered by this agreement, providing coverage for bodily irkJvrW and PT-operty dangge
Ili the ininimimi amount of combined single Ulid.t per occurrence. The policy
shall
ncure,
as additional
assLwed,
CI`I.TY and its
officers and
employees, while
acting
within
the
scope of their
duties,
against all
claims, suits,
or other actions
of any
natt.we
brou;ht
for
or
on account of any injuries, damage or loss, including any
deaths
arising
rLlt
of
or connected with the work of CONTRACTOR tinder this contract.
(,'Cd�FITRACTOR shall. furnish CITY a certificate of 1rLstirance from the insurer that the
insurer shall not cancel or modify the policy without thirty (30) days' prior t,.Titten
notice to CITY. CONTRACTOR shall give CITY prompt and timely notice of wiy clalm
made or suit instituted.
11. INDEPENDE^JT COTPI' UCTOR :
It is 1"lirthPr Understood and ap.,eed that CONTIT- ACTOR is, and shall be, acting
at all times as are independent contractor herein and not as an gent of CITY.
.IM ZMIMSS WDMEOF, the parties hereto have executed this agreement this
day of 191
City Clerk
R01IEI-IED AND APPROVED:
City Aftin-istratoid
"CITY"
CITY OF MI'T'INGTON BEACH
• �GGL-�%GG
AFPRJVED AS TO FORM:
City (Aiitorney r�
0
R,
SAFECO INSURANCE COMPANIES fi
SAFECO INSURANCE COMPANY OF AMERICA
GENERAL INSURANCE COMPANY OF AMERICA
FIRST NATIONAL INSURANCE COMPANY OF AMERICA
HOME OFFICE qu BROOrLY►1 AVE N E.. SEATTLE. NASIUNGTON 9d1V.. Bond No..40942$9-=-A-,-_ _
MAINTENANCE BOND
NrV01V A It. r1 fl rV 1f }' TIIF..�f:' f'RF..SF, N7S, That we,—1eylik_ Uril_ljag-, _I. nr. _.. -�_
as Principal, and SAFECO INSURANCE COMI'ANY OF AMERICA, a corporation organized tinder the la%N,s of the State
Of Washington and duly autllorizee to do business is the State of California —�
as Surety, arc held and firmly bound Lint(, The City of Huntington Beach _
as Obligee, in the penal sum of-. One Hundred Thirty Five Thousand Four Hundred Sixty _and no/100ths.
--__--_ --- _-__--- — _- __-___------_ ---------------- (S 13514600.00-----------
to which payment well and truly to be made we do bind ourselves, our and each of our heirs, executors, administrators,
successors and assigns jointly and severally. Furnly by these presents.
tingly Y21:�'S, the said Principal entered into a Contract with the
CITY OF HUNTINGTON BEACH ^ d•cd August 17th,_ 1981
for Construction and development of a gravel envelope water well by rotary drilling
at 8851 darner Ave., located at the north side of Warner Avenue, West of Magnolia
Street in the City of Huntington Beach. Specification CC-542.
IIII RIsA.S, said Contract provides that the Principal will furnish a Mond conditioned to guarantee fee the period of
one yeags) after approvA of the final estimate Lin said job, by the owner, against all defects in workmanship and
materials which may become apparent during! said lxriod, anti
ACKNOWLEDGMENT BY SURETY
STATE OF California
ss
County of Los Angeles
On this 26t:h day of AuRtist, , 1981 , before me personally
appeared Ed Griffith known to me to be the Attorney -in -Fact of
SAFECO INSURANCE COMPANY OF AMERICA, GENERAL INSURANCE COMPANY OF AMERICA, FIRST NATIONAL
INSURANCE COMPANY OF AMERICA or SAFECO NATIONAL INSURANCE COMPANY, the corporation that executed the
within instrument, and acknowledged to me that such corporation executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, at my office in the aforesaid County,
tbq-d-ay- wn�yepr irluilis-certificate first above written.
OFFICIAL. SEAL
MARILLI ANNE PREHNy.
,w
Cal NOTARY NOTARY PUBLIC - CALIFORNIA Nota Public in t e State of
)eall LOS ANGELES COUNTY Cou t of Los Angeles
' �'�, .y ggLnm. expires AUG 26, 1933 y
ornia
PRINTED IN U S A
13215 E. Penn Street. Suite 622, Whittier, CA 90602
5-843 R2 1e/72 PRINTED IN U.S.A.
•
zwrr7 4 wh III b A, S
:.AFECO INSURANCE COMPANIES
SAFECO INSURANCE COMPANY OF AMERICA
GENERAL INSURANCE C0161PANY OF AMERICA
FIRST NATIONAL INSURANCE COMPANY OF AMERICA
HOME orftcE 4j4?.'IRL)CtLYk AVE. N E., SEA1ILE, WAS1,101GT001 91106
MAINTENANCE BOND
Bond No. _ 4O9 289 • A
If' ALI- j1JFrV Il Y TIIESE PR1iSEA'TS, Tliat we, ..—.Beylik_D=I ll.ing-.-snc._ _-
as Principal, and SAFECO INSURANCE COMPANY Of AMERICti, a corporation organized L►11.r the laK1s of t11e State
of Washington and duly atitharized to do business in the State of California
as Surety, are held and firmly bound unto The City of Huntington Beach
as Obligee, in the penal sum of_ One Hundred Thirty Five Thousand Four hundred Sixty and no/100ths.
---------------------------- --_--- _(g 1352 60.00-----
to which payment well and truly to be made we uo bind ourselves, our and each of our heirs, executors, administrators,
successors and assigiss jointly and severally, firmly by these presents.
I1111ER.-AS, the said Principal entered into a Contract with the
CITY OF HUNTINGTON BEACH _
for Construction and development of a gravel envelope
at 8851 Warner Ave., located at the north side of
Street in the City of Huntington Beach.
_ dated Airgus t 17 th, 1981
water well by rotary drilling
Warner Avenue, West of Magnolia
Specification CC-542.
lt'11ERI.AS, said Contract provides that the Principal will furnish a bond conditioned to guarantee for the period of
one years) after approval of the final estimate on said job, by the owner, against all defects in workmanship and
matctials which may becunle :apparent during said parind, and
I1111sR1.-'AS, said Contract has been completed, and was-pprovi'd on
(lay of ______
AVIV, TIIEREFORE, TILE C0NIUI'F10,V OF T111S ORLIGATIOA' IS SUCII, 'That, if the Principal shall indemnify the
Obligee for all loss that the Obligee may sustain by reason of nr,j defective niateriL;; or work inanship which becotttc
apparent during the period of'. 1 year(s) from and after_ final.aRprnval of -the--joh--
Own this obligation shall be void, otherwise to remain in full force and effect.
Signed, sealed and dated this 26 th _ day of Augupl_, 19-B_l._ .
_BEYLIrJRILLIN 41,
c a`!':'ED AS TO FORM:
AI1� 11U"' IN
B N L�
y''
9�OutyGcity A orney
SAF
iffit
(Seal)
(Seal)
(Seal)
PANY OF AMERICA
At!orney-in-Fact
S-e43 R2 10/72 s.Nu,.«.....- ....., ........
PRINTED IN U.S.A.
s
s
SAFECO iNSUI;ANCE COMPANIES
SAFECO INSURANCt COAVANY OF AMERICA.
GENERAL INSURANCE COMPANY OF AMERICA
Misr NATIONAL INSURANCE COMPANY OF AMERICA
HOME OFFICE. SAFECO iLA«A, SEATTLE, WASHINGTON 99185
CONTRACT BOND — CALIFORNIA
--? FAITHFUL PERFORMANCE -- PUBLIC WORK
Bond No. 4094289
Initial • premium charged for this bond is
$19151. 00 subject to
aUc ustment upon comp at ono contract at
applicable rate on fint,l contract price,
M'ONALLAIENBYTIfEWEPREX-ATS, ThatIIMLlg DRTT.T,ING, 7rNr- _
of _ „— as Principal,
and the SAFECO INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the
State of Washington and authorized to transact surety business in the State of California, as Surety, are held and firmly
bound unto JEE CITY OE HUNTING o ny-ACH
in the sum of ONE HUNDRED THIRTY FIVE THOii,SAln FOjjR HuNnRm STXTY ANp NQj rj t-hs
-------------------------------------------------------- Dollars (S 1 35.4611- QD---- ),
for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators,
successors and assigns, jointly and severally, firmly by these presents,
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, That {UIIEREAS, the above -bounden Principal has
entered into a Contract, dated August 17th , 198j_, with the CTTY OF iH 1NTjN , N gig_
to do and perform the following wotk, to -wit: CONSTRUCTION AND DEVELOPMENT OF A GRAVEL ENVELOPE
WATER WELL BY ROTARY DRILLING AT 8851 WARNER AVE., LOCATED ON THE NORTH SIDE OF
WARNER AVENUE, WEST OF ML4GNOLIP STREET 1N THE CITY OF HUNTINGTON BEACH. SPIJ,'IFICATIO
CC-542.
ACKNOWLEDGMENT BY SURETY
STATE OF California
ss
Coultty of_ Los Angeles
On this 26th day of August 1981 , before me personally
appeared Ed Griffith , known to me to be the Attornw.-In-Fact of
SAFECO INSURANCE COMPANY OF AMERICA, GENERAL INSURANCE COMPANY OF AMERICA, FIRST NATIONAL
INSURANCE COMPANY OF AMERICA or SAFECO NATIONAL INSURANCE COMPANY, the corporation that executed the
within instrument, and acknowledged to me that such corporation executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, at my office in the aforesaid County,
the stay z nd year in -this -certificate first above written,
OFFICIAL SEAL
MARILU ANNE PREHN
d NOTARY PUBLIC - CALIFORNIA
�A
LOS ANGELES COUNTY , gaM comm, expires AUG 25, 1933
13215 E. Penn Street, Sulte 672, Whltlier, CA 90602
S-815 RI 10/72
No c ry Public irf the State of California
C unty of Los Angeles
PRINTED IN U.S A.
PRINTED IN U.S.A. `'I
•
0
SAFECO INSURANCE COMPANIES
SAFECO INSURANCE COMPANY OF AMERICA
GENERAL INSURANCE COMPANY OF AMERICA
FIRST NATIONAL INSURANCE COMPANY Or AMERICA
'/JME OFFICE. SAFECO PLAZA, SEATTLE, W45HINGtON Q%I85
CONTRACT BOND --- CALIFORNIA
FAITHFUL PERFORMANCE— PUBLIC WORK
Bond No. 4094289
Initial premium charged for this bond is
$1,151. 00 sublect to
a uatmont upon comp et oontract at
applicable rate on final contract price.
KA�0W ALL MEN BY THESE PRESENTS, That. BEILIK 1)RT7,LTNr.- TNr. -
of as Principal,
and the SAFECO INSURANCE COMPANY OF AMERICA, a corporation organized and exciting under the laws of the
State of Washington and authorized to transact Surety business in the State of California, as Surety, are field and firmly
bound unto 111E CITY OF IIUNTIHG10 BEACH _
in the sum of ONE31INPRED THIRTY FIVE. TH(21jSAND FOUR 111, ]REJ) STXTY
----------------------------------------------------------- Dollars, (S 135 . / 0 _ nt7—_
for the payment whereof, well and truly to be made, said Principal and Surety bind themselves, their heirs, administrators,
successors and assigns, jointly a.-d severally, ftt;*ily by these presents.
THF. CONDITION OF THE FOREGOING OBLIGATION 1S SUCH, That I ERF.AS, [lie above -bounden Principal has
entered into a Contract, dated Au tr. t 1, l th , 19B]_, with the_ CITY OF HjINTINGTON.,HEACH
to do and perform the following work, to -wit: CONSTRUCTION AND DEVELOPMENT OF A GRAVEL ENVELOPE
14ATER WELL BY ROTARY DRILLI:;u AT 8851 WARNER AVE., LOCATED ON THE NORTH SIDE OF
WARNER AVENUE, WEST OF MAGNOLIA STREET IN THE CITY OF HUNTINGTON BEACH. SPECIFICATI
CC-542.
C
q NOW, THEREFORE, if the above -bounden Principal shall faithfully perform all the provisions of said Contract, then this
obligation shall be void; otherwise to remain in full force and effect.
Signed and sealed this 26th day of August
AS TO ':'ORltiis
!/ Ci:, is :
is /!
D .put , ty .k L0I'21ey
,
i Principal
t,= �,,//
SA
By
. 5•815 R1 10/72
PRINTED IN U.S.A.
9) 0 0
SAFECO
SAFECO INSURANCE COMPANY OF AMERICA
GENERAL INSURANCE COMPANY OF AMERICA
FIRST NATIONAL INSURANCE COMPANY OF AMERICA
HOY[ r)FFICr. %AIECOFLA7A, SEATTLf.MIAkiNINGTON OS1E!:
Bond No. 40_9_4__2U_
CONTRACT BOND -- CALIFORNIA
-' PAYMENT BOND
Kh'OIVALl. That we, ,_Beylik
and the SAFECO INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the
State of Washington and authorized to transar;t sltrety business in the State of California,, as Surety, are held and firmly
bound unto The City of Huntington Beach
_ -.as Obligee,
in the siren of_ Sixty seven thousand seven hundrp,d thirtydgllars andnoJ_MQ.t hs-------
------------------------- -- - - -- ---- -- Duflars (S 6Z,.7-30.. 00----------------
for the payment whereof, well and truly to be made. said Principal and Surety hind Ihemselves. their hems, administrators,
successors and assipts, jointly and sevetally, firstly by these presents.
T11J, CONDITION OF TI/G F0RF.G0ING OBI.lCf1T1011' IS .SUcu, That 41111-RE'AS, the above -bounden Principal has
entered into a contract, -Dated _ 17th day ofAugliat , 19_81, witli the Obligec to do and
perform the following wortc, to -wit: Construction and development of a gravel envelope water
well by rotary drilling at 8851 Warner Ave., located at the north side of Warner
Avenue, Vest of Magnolia Street in the City of Huntington Beach. Specification CC-542.
NUIt', T11L.RCFORL•', if tht. above -bounden Principal o! his subcontractors fail to pay any of the persons named in Section
3181 of the Civil Code of the State of California, or amounts due under the Unemployment Insurance Code with respect
to work or labor performed by any such claimant, or tiny amounts required to be deducted, withheld and paid over to the
Franchise Tax Board from thI! wages of employees of the Principal or Iris sub -con tractors pursuant to Section 18806 of the
Revenue and Taxation Code, with respect to such work,• and labor, Surety will pay IoT the same, in ant amount not
exceeding the amount specified in this bond, and also, in case suit is brought upon this bond, a reasonable attorney's fee,
to be fixed by the court.
ACKNOWLEDGMENT BY SURETY
STATE OF California
ss
County of Los Angeles
On this 26th day of August 1981 , before me personally
appeared Ed Griffith , known to me to be the Attorney -In -Fact of
SAFECO INSURANCE COMPANY OF AMERICA, GENERAL INSURANCE COMPANY OF AMERICA, FIRST NATIONAL
INSURANCE COMPANY OF AMERICA or SAFECO NATIONAL INSURANCE COMPANY, the corporation that executed the
within instrument, and acknowledged to me that such corpora:ion executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affi,-id my official seal, at my office in the aforesaid County,
1hto first above written.
eeal)OFFICIAL SEAL
MI
MARILU ANNE PREHNNOTARY PUBLIC - CALIFORMALOS ANGELES COUNTYNot
comm. eaplres AUG 26, 1983 COL
Public in thA State of California
Y of Los Angeles
13215 E. Penn Street, Sate f?), MIllicr, CA S00O2
S-816 R3 1,1/72
PRIN?ED IN U.S A.
PRI14TED IN U.S.H.
(B 0 0
SA,FECD
SAFECO INSURANCE COMPANY OF AMERICA
GENERAL INSURANCE COMPANY OF AMERICA
FIRST NATIONAL INSURANCE COMPANY OF AMERICA
HOME CFFICE 3AFECD PLAZA. SLA17LE. riAS :1NGiUN 9HI135
ElandNo. 4094289 _
CONTRACT BOND -CALIFORNIA
PAYMENT BOND
lV1►Olt'�1/,1.,1Ui:1'!JS' Tlll::Sli PRIiSI:i�'T.S, That sac. Beylik Driilin�,_-Inc, ___
and tI,_ SAFECO INSURANCE; COAIPANY OF AMERICA, a corporation organized and existing under the Laws of the
State of Washington and authorized to transact surety business in the State of California, as Surety, are held ar.d firmly
bound unto The Citv of Huntington Beach
as Oblivec,
in the sum cif' Sixty seven thousand seven hundred__yhj_r_ty dollars and noA00-ths ------
------------------------- ----- — ---_— --- Dollars (c 67-730 - 0 0 — — — — ------
for the pavment whereof, well and truly to he made, said Principal and Surety bind themselves, their heirs, administrators.
successor% all(] assigns. )ointfy and seer ,1111% firmly by these presents.
THE COND17MV OF T//F_ FORF,GO!NG 0111.1G.47 0A11.5.SUCH, That It1111-Rh'AS, the above -bounden Principal has
c►tteted into a contract, dated 17th _day of u .uat_ , 19BI, with the Obligee to do and
perform the following work, to -wit: Construction and development of a gravel envelope water
well by rotary drilling at 8851 Warner Ave., located at the north side of Warner
.Avenue, West: of Magnolia Street in the City of Huntington Beach. Specificaticn CC-542.
NOW. T111:Rf:'FORE, if the above -bounden Principal or his subcontractors fail to pay any of the persons named in Section
3181 of the Civil Code of the State of California, )r amounts due under the Unemployment Insurance Cede with respect
to work or labor performed by any such claimant, or all), amounts required to be deducted, withheld and paid over to the
Franchise Tax Hoard from the wages of employees of the Principal or his sub -contractors pursuant to Sectior 18806 of the
Revenue ar,d Taxation Code, with respect to such work and labor, Surety will pay for the sank, in an amount not
exceeding the .amount specified in this bond, and also, in case suit is brought upon this bond, a roasonable attorllcy's fee,
to r.: fixed by the court.
'rhis bond shall inure to the benefit of any and all persons, companies or corporations entitled !o file claims under Section
31.41 of the Civil Code of the State of California, so as to give ,I right of action I.I then: or their assigns in any suit brought
upon this bond.
Signed, scaled and dated this _26th _ day t)f August
No preinhan is charged for this bond. It is executed
in connection with a bond for the performance of the
contract.
Fff5au W1001,VzAF/W4WW_,
. W2_-, �je � Z 4 7
WAW-affiox mmi
SAF1 C Y?E C� 1 OF AMERICA
. 1 /9.
ley _
d rii :it Attorney -in -Fact
cr;;:•1 CU7 A:.,torney
�416 R9 10/72
PRINTED IN U.S.A.
t ffeturn original ano three copies of
completed certif Icon to-,
` City of Humington Beech
r Dept. P. 0. Bore 190
Huntington Beach, California 92640
;stributio
C►cRTIFICATE OF INSUaANCE Aft��roval
TO by City 11.170rney
CITY Or' HUNTiNGTON BEACH, CALIFIJRNIA
A MUNICIPAL. CORPORATION
Original — Driginating tfpt.
Yoltnve — Rt:tt Wrossl it
Pink — Cht Clark
Gold — City Anc►ney
This is to crrtify that tho poll-,ies of insurance as described below stave been issued to the infured by We under-
signed and are in force at this time. If these policies are cancelled or changed in such a manner that will affect this certificate, the
Insurance company agrees to give 30 days prior writteco notice, by mail, to City of Huntington Beach, P. O. Box 190, Huntington
Beach, California 92648.
Name of Insured Beylik Drilling Inc. , a California Corporation
Address of Insured 591 S. Walnut, La Habra, Ca. 90631
Location of Insured Operation.- 8851 Warner Ave . , l untington Beach, Ca.
Description o/ operatipns Construction and developer. t of it wate-c well CC542
POLICIES IN FORCE
POLICY
NUMBER
_Q
LIMITS OF LIABILITY
EFFECTIVE
EXPIRATION
A. Workers Compensation
Statutory
Employers' Liability
$
" $300,000 combined single
B. Public L.iabill!y:
SLP 9
1-1-8i
1-1--82
Bodily Injury:
467092
limit per occurrence.
Manufacturers and
Contractors Q
S ` Each Person
Cc-mrrehensive
Genernl T
S —Eac'- Accident
(Including products completed
npe-rations)
$ • Each Accident
Property Dainago
C. Automobile Liability:
Bodily Injury
5 ` Each Person
$ 0 '.ach Accident
Property Damage
$ Each Accident
Does policy cover:
All owned automobiles
Non -owned automobiles
Hired automobiles
s
f E. Hold Harmless Agreement
If Corporation, President
and Secretary must sign.
(Pleasa check at Imst qua)
( X) Yes
( ) No
( X) !as
( ) Per
( -t ) Yes
( ) No
AlHuntington Beach and its City Council, and/or all City Council Appointed groups,
P4 any other City Council appointed body, and/or elective and appointive'officers,
of Huntington Beach, when acting as such are additional insureds hereunder, for the
q�e sltali be primary to any insurance of the City of Huntington Beach.
uretl:
/ The Insured agrees to protect, defe n fy altid+ 14 barn e s the y � u"91 ea=inst lo�a or
Q� IPI expanse by reason of any suits, claims, d mands, judgments and causes of action caused by insured, his employees, agents
or any subcontractor or by any third party arising out of or in consequence of the performance of all or any operations
covered by tho certificate of insurance.
F. Remarks:
Date August 25, 1981 AUTHORIZED
INSURANCE COMPANY By
Name Great American Insurance Co. natu
(,--'Ed Grif f
Address One City Blvd. West, Ste.1700 Address
APPROVED AS TO FORM:
GAI L HUTTON
City Attorney
By: l/
Deputy City Attorne ;
TAT4VE,OF iNSUkANCE COMPANY
'rr
6tharlied Renrescnutive,Agent
Insurance Agency
nn St.. Whittier. Ca. 90602
City Orange, Ca. 92668 Telephone __(213) 698-9776
I
Return otiginat and throe espies of
completed certificate to:
City of Huntington Beach
rapt.
P. 0. Box 190
Huntington nusch, California 02648
0 0i1tribution:
CERTIFICATE OF INSURANCE A.tor Approval
TO By City Attorney
CITY OF HUNTINGT-ON BEACH, CALIFORNIA
A MUNICIPAL CORPORATION
Original — Originating Dept.
Mallow — Risk Manager
Pink — City Clerk
Gold — C;ty Attorney
This is to certify that the policies of insurance as described below have boon issued to thu insured by the under-
signed and are in force at this tine. If these policies are cancelled or changed in such a manner that will affect this certificate, the
Insurance company agrees to give 30 days prior written notice, by mail, to City of Huntington [leach, P. 0. Box 190, Huntington
Ueach, California 92648.
Name of Insured Beylik Drilling Inc. , a California- Corporation
Address of Insured 591 S. Walnut, La Habra, Ca. 90631
Location of Insured Operations 8851 Warner Ave. , Huntington Beach . Ca.
Descriptionof Operations Construction and development of a water ;yell CC542 -_
P00CIES IrJ ronCE
POLICY
NUMBFR
_ __O IE_.-—
LIMITS OF LIABILITY
Ef•FECTK--
I EXPIRATION
A. Workers Coinpens:rti(v.
Statutory
Employers' Liability
B. Public Liability:
SLP 9
1-1-81
1-1-82
$300,000 combined single
Bodlll, Injury:
.-
rh7092
limit per occurren :e.
Manufactmers and
Contractors U
$ Each Person
Comprehensive
General
S Each Accident
(Including Inoducts completed
operations)
Property Damage
S Each Accident
C. Automobile Liability:
Bodily Injury
S Each Person
S Each Accident
Property Vantage
S Each Accident
Does policy cover:
All owned automobiles
Non -owned automobiles
Hired automobiles
Wloase chock at lust one)
1 X) Yes 1 ) No
( X) Yes ( 1 No
( X 1 Yes ( ) No
D. Additional insured E;-,dorserncnt:
The insurer agrees that the City of Huntington Beach and its City Council, and/or all City Council appointed groups,
committees, commissions, hoards and any other City Council appointed body, and/or elective and appointive officers,
servants or employees of the City of Iuntington Beach, when a;ting as such are additional insureds hereunder, for the
acts of the insured, and such insurance shall be primary ,o any insurance of the City of Huntington Beach.
r. E. Held Harmless Agreement: By Insured:
�J /1 aturo) wue,40-�-In The insured agrees to protect, deferd �i )njfy and 7ve ltarrn ess'tlte y o Beach against loss, dama or
expanse by reason of any suits, claims, dirnands, judgments and causes of action caused by insured, his crttployees, agents
or any subcontractor or by any third party arising out of or in consequence of the performance of all or any operations
covered by the certificate: of insurance.
F. Romarics: APPROVED AS TO FORM:
GAIL HUTTON
-- City Attorney
BY;
Deputy City Attorne
Data - August 25, 1981 AUTHOR12kDR,0,ESF,NTA VE OF INSURANCE COMPANY
INSURANCE COMPANY
Name Great American Insurance Co.
Address One City Blvd. West, Ste.1700
City Orange, Ca. 92668
e�, -
natu rthorr set Representative/Agent
VI'E Gr'ifff
t� Insurance Agency
Address 17215 E. Penn St., Whittier Ca. 9060
Telephone 213) 698-9776
t l nor 11111 YI1 v'•t11 a1t.11111M.[I,110 Yi 1111!1, 11n ,tit w Q, be �t.r11 /' •V
eo1r1v1ars+tunitu►cat°' CERTIfICAI' OF INSURANCE he A ar&I r I
/ Yellow •• ILIk tvL+ruger
City of slunhnelon gaach TO Y nnrnaz doI l'11y At+k
Nord - City Allan,y
DeptCITY OF HUNTINGION BEACH, CALIFOFINIA e
P.O. Sall Inr
S�tenIIucA, Cahrolnia Bleat A MUNICIPAL CORPORATION
I
This is to earthy that the p)iiciet of Insurance al described below have been iuued to the insured by the under' ' • ` I.
signed and are in force at this time. If these pulides are coinulled or rhengonl In such a onannor that will affect this cartifiate, Ilia ��� ! �" • ` Cc ' ..
insurance company sure,:%to give 30 days prior written notice. by null, to City of Huntingtor. [leach, P. O. [lox 190. Huntington 1; ;
Beach, California 02648.Is
NarneolInsured lluylik 11{'1l1lnK Llc., h Caillfl+rui:, 01I1'11• r i,. ✓� ,�
Address of Insured 591 SI Will [I'll , LA ll,'6fs, Cm ':11b'I'
LtxationofInsured Operations 4/:51 Wit I'm!r rive., iluto.Itlt,con li.";ti,,
Description of OperatiunsCotletru t ioii mild .itiyt_I i :,seal v I it It + 1 i 1 1 t'
POLICIES IN FORCE
NUMIIER
LIMITS OF LIABILITY
EFFECTIVE
EXPIRATION
A Woo kets Q)rnpansation
Employees' Liability
/r/,.: C-2
'
Statutory
S
B. fubli. Liability:
SIX r
1. 1 -:Il
I I-•h?
• fill9tr000'Ccned single
tbdily Injury:
4G7n•12
limit per occurrance. el,l ,
•r- ,J
.� l7�eA
Manufactures and
Contractors
S e Each Person
Comprehensive
General a
S Each Accident
(lndudlin F• )ducts completed
operations)
'
Prolrorty Menage
S • Etch Accident
LLi.RIJ.r•r'/•tasa/Mr•r•/.Irrr �saa..aR
C. Automobile Liability:
.O <\LValJ..srf[
'isirVM�'rr
.1fAfVirlal.•
Ya.[Ataati.Ml�.:i�sSf.wtSl�r• 'R'a"wra��:SY
Bodily Injury
[
�� �
$ Each Parson
S • Each Accident
" ati,
Property Damage
$ • Each Accident
Does policy corer:
(Pea IV check e1 least one)
All owned automooiles
( ' I yes l I No
Non -owned automobiles
(;' I Yet ( I No
hires automobiles
1 1 Yes 1 i No
D. Additional Inturod Endorsement:
The Insurer agrees that the City of Huntington Beach mid its City Council, and/or all Oty Council appointer: groups,
committees, commissions, boards and any other City Council appointed body, and/or olective and appointive officers,
sorra,s:: or employees of Ilse City of Huntington 81mch, when acting as such are additional insureds hereunder, for the
acts of tho Inturod, and such Intursrtco shall be primary to any Insurance of the City of Ifunfington Beach.
I��ti.�iii^.V�YYr11.fL�1,sYsf.a..�b.ytfTay.rs�-rtiP �a�.�/i•asft7�r.rf �A7rr.YRI.R\f.>r/.r1 �.t•.M�'L '� �a�.Lite�Y
/ I
E. Hold Nterm)ess Agreement: B•y Insured: �'/ / _� t� �� r �•
f
• , 1. , /�• • �_ ' �. , !••.;.- //
I The insured agrees to protect, defend, )r4eMn)fy and save huitlfcu the,"of'il CIty untington Beach against loss, damage or
t expvnte by reason of any tufts, claims, doin3nds, judgnmits and causes of action caused by Inturod, his rmployees, agents
or any subcontractor or by sny third (tarty arising out of or in consequence of the performance of all or any operation&
covered by the certificate of Insurance.
us..a...r-.tr.n:.,�>..-•ari.r-�..K•r..r�aa-a.,re.,-.-ter..•. n.•.r+�.Ra.0 i...,.-.--.a r.1. r.....�--_-arca�n.�•...v�.:r.a,a.�.a.u,•asn..
F. Remerks: APPROVED AS
CAI L HUTTO7
Oty Attorney I
By: ..
Deputy Clty
rr• w.r�.-=M+wrrrrarvrari-...r-races ace.r•-.r-.,r«rr•r..,-�F..a..w.a<r>.aas.a earn~-�ar.r averr a-. wrs r.:n+vs>....re.r au/rv� rrwr.r:�rw
Date _ Att;ua t 25, 1161 / AUTtIOf11ZED CgNTATjVE OF; INSURANCC' '
INSURANCE COMPANY
Name GrnAt /1.uarii:vr1 tn.at retire Cu.
Address Ono Ctry 131vol 1: tat, Fto.111:0
City Orarl,tta, U. 9:6(id '
Irk
� lr
In
t�
NY''�'0cR r,rrt; r ry
r,r
i
%r 1'k;r09^alurio4` utrtorI nop,rsenlative/Ap,nl 1 , t, • r\ i
f•.Iyvreif L i't/ N.71111
m
Addrate 11?1) I.. fs-nn
Telephone 1?11L �,r�t_U7 If
By
1 � .. ., -fII �.J J::'%! r ,1j�'�1�1..•I< .� 1j ri �, •-«�.� , -, ,1 t=, .'
tt � `. a.l Vt A. i + •� �,a �1�� I.,1 �. 1 Ir f'•j w�� :�� r• ,fd•a
"'�'7 ��_ �� �tf�;1'';���j,�i��. 71,•f: t{."J !"�i.'�•`i.�r :� rr[.9!,, �lijl��l! �!il.�!�► � f,!j!111��,( t•i•i~�e�!!1+.�.i1S�� s �,�••'�ilE-{t�r7;•1 �tl'r1�.7' j !1. •��,
.E tiTV� � �� � •7�I�+'lilt tiT"�•a��'�i�t�ll"i.���'ti ;�ii!rs; ��,5�•.�i l•'J r'.��1, 1i� ".'rf ,,�.1 �/I!��• ►rl�( Iarl►�1.'11r� 5'�%7�t��� ,�•� �:.kjs'�/%'�' r'`i1
�, ��� i• ui srti .,,..It►,� dr.�_, .. ., •►,z ..� �. .ii._ J i., _•is•a�l:,.,_ ....,.., ..:..�.. .. .� .�..k.. .. .,.a'..,nl.st� �,+:.�... «. 1.� ,
:r
COMPANIE'S trFORI7111C, C0vc %,1t;1S
` Ed Griffith Insu•-anae Agency
P.O. Box 690
f ... Great American
CiAi!
:•J1iiCtier, Ca 90608-•---... .__.
Integrity Insurance Com ny J
t �( �;r.:�i a:l •,Ilr-'I,r ••, c l cr ;,111 •, _/t„i"'
r�"'' ! t' 'M ''I° 1�Tes tern Employers v/J
4�� i•11••
r►,i Beylik Drilling, Inc.
591 S. Walnut St.
La Habra, Ca 90631
r:.l ,. . lc7 CI!rt�r� ! !:. ;. � u', �' 'r ,I. I'Sh �' I i"h 1 ... ,! 'G :L • Ir•';!t!! 1':t;•.r:! ;I11 jn ii,.1 Ili , e;!' .. ,I: , I .! "I' •. ,� I' I ?'
r:1 crlr t ! r r,lrll u, , j r ,'I �r•., t� -hill, II .'ll r`. 1 - .111' nr rit Ir
I• I • . P•C1.: a."tl u'jl t j,! ' h,h I•�''': C.'• •—'-
t'inits r1) LI.tl,llll` 11: t'ilous.�r1�1 1(16U►
•- CUt! r'r'IV I I v1'I r1i INSII ,, tvt 1 l!r' • :i'ir!i •: I. I I aI II. V `... _._...._ _- _ _-. .. . _ ..
•+X' it tilu - I 1A: I e
X
! ' SLP 9 46 70 92
r ! A , 1 t4.'.
CX I I 1
w X ! ;. 1500 500
., (1 500
1_ ILIAC:; ,
1 tt; A I(X1 ' SIP 9 46 70 92 1 /1 /82 1 t, :'' oiZl 1.
'� cxc•t.ss 1.1J1C�jL1i'r � I
B �L�{� •!';'''[ 1�`:"•' I lsx 105908 i i�/Z<1/82 t,,!,. I 3,000 3j000
t—._ .. I
'tom' ,r.•• �t •' �--
' C ""`� 14C01-0581-10466 5/1/8
11,000
! 1•r'r'-.oYf l_S' Llr,;• LIT _� .. • I Y I.
r '�
odic(,'
c RECEIVED
111' Oil liVii41"I`, ..SE �•V �.JV 1 ,
r•�, JOB: Construction and development of �i' L ll�•1!it
E•:� p gravel. -io � �w[ rotary
drillingocated at t d J !}"t• i ,4a
g at 8851 Warner Ave.,Ave. , �.lY fide o •t�ia ner Avenue,
w' 9._... West of Magnolia. Street in the City- of Hunt het Beach..-'NS7 ' iEication CC-5
.;.i rat'IC i)1i�; 1.,: 11• �.}1[1.1�`i II t', .1. i. n" ,j j,-1 yr� r�l .. I'ib' I:I 111 Il IJ, Un.' ,.� I, 1.!-! •11 ! r>>�I ,1, 1' !• t:•�'.J!T -' I I
J '?^•1T1'I;� 'I1r['1I 1't;l I 1;' `'iTl l'il r,.,'I �I 1 1 1 I1 ` 'Ii r; ' .! II1;' ,[Il•f„T IIJ: f 11111 1' I:,
Si_ I � 1r•t111),Illy"
(flr:'1!'4)/.I1u'1•�ful_tl:tlll',tit!1r11''l11
September_ 17, 1981
! City of Huntington Beach
P.O. Box 711
1 i w
Huntington Beach, Ca 92648
4 Gritf'
ACORU 7'• c 1 191 I
1't?L'1114 �•T0�'fT'!71w1 �t� lv�'7MT�D'I►SP►�►'ttA FIT. +!-IV 7, % f I..-.^.ir!+taCR�►trl'77I'Vr'7!C'!'.'!•r•R..., oryt �^r•.�r ^,•-.w fin;` ..•�'.........�qr^T•-.T'�": .. •i.'-;I
Return original and three copies of
completed certificate to:
City of Huntington Beach
inept. .
P. C.I. Box Igo
Huntingien Beach, California 92648
CERTIFICATE OFINSURANCE
TO
CITY OF HUNTINGTON BEACH, CALIFOPNIA
A MUNICIPAL CORPORATION
� ittribution;
After Approval
By City Attorney
Original — Originating Dept.
Yellow — Risk fWnager
Pink — City Clark
Gold — City Attorney
This is to certify that the policies of insurance as described below have bean issued to the insured by the under.
:ignad and are in force at this time. If these policki are cancelled or changed in such a r.ianner that will affect this certificate, the
Insurance company agrees to give 30 days prior written notice, by mail, to City of Huntir gton Beach, P. 0. Box 190, Huntington
Beach, California 92648.
Name of Insured Beylik Drilling Company
Address of Insured 591 South Walnut St., La Habra, Ca, 90631
Locatiolt of Insured Operations State of California
Description of Operations CAntuction & development Qf water well, #CC542 _
POLICIES IN FORCE
POLICY
NUMBER
LIMITS OF LIABILITY
EFFECTIVE
EXPIRATION
A Workers Compensation
1C010580
5-1-81
5-1-82
Statutory and
Employers' Liability
10466
$ 100 000 1nKpr t a i.i ahl 1
B. Public Liability:
' $300,000 combined single
limit per occurrerlco.
Bodily Injursr:
Manufacturers and
Contractors F-1
Each Person
Comprehensive
General M
Each Accident
(Including products completed
operations)
Property Damage
S Each Accident
C. Automobile Liability:
Bodily injury
S Each Person
^� Each Accident
Property Damage
$ Each Accident
Does policy cover:
All owned automobiles
Non -owned automobiles
Hired automobiles
i'i
c. Hold Harmless Agreement
If Corporation, President
and `'acretary must sign.
The insured agrees to protect, defe
expense uy reason of any suits, cla
or any subcontractor or by any third party arising nut of or in consequence of the performance of all or any operations
covered by the certificate of insuratce.
IPloase check at mast one)
( ) Yes 1 ) No
( 1 Yes ( 1 No
( 1 Yes ( 1 No
i
jHuntington Beach and its City Council, and/or all City Council appointed groups,
Ind any other City Council appointed body, and/or elective and appointive, officers,
,of Huntington Beach, when acting as such are additional Insureds hereunder, for the
ico shall be primary to any insurance of the City of Huntington Beach.
F. Remarks: APPROVED AS TO FORM.
GAIL HUTTON
City Atto nay
_ BY
Deputy City Attorn�
Date August 25, 1981 AUTHORIZED kkr ft7'ATlyf INSURANCE COMPANY
INSURANCE COMPANY By q'fPi:t0n
I—
ued Repr entatiro/Agent
Name We.tern Em,nloyers Insurance Co. d il3urance Agency
Address 1400 N. Harbor Blvd. Address 3915 Et. , Whittier, Ca. 00602
City . Fullerton, Ca. 92635 Telephone (213) 698-9776
Return original and three copies of
completed artiflcate to:
City of Huntington Beach
Dept.
P. 0. Box 190
Huntinrtan Beach, California 92648
CERTIFICATE OF INSURANCE
TO
CITY OF HUNTiNGTON BEACH, CALIFORNIA
A MUNICIPAL CORPORATION
�Istrlbutlon:
After Approval
BY City Attorney
Original — Originating Dept.
Yellow — Risk Manager
Pink — City Clerk
Gold — City Attorney
This is to certify that the policies of insurance as described below have been issued to the Insured by the under-
signed and are In force at this time. If those policies are cancelled or rhaigad in such a manner that will affect this certificate, the
Insurance company agrees to give 30 days prior written notice, by mail, to City of Huntington Beach, P. 0. Box 190, Huntington
Beach, California 92648.
Name of Insured Beylik Drilling Company
Address of Insured 591 South Walnut St. , La Habra, Ca. 90631
Location of Insured Operations State of California
Description of Operations Constr.urtion F_ dgye gRr,tentgf wnteer well #CC,542
POLICIES IN FORCF.
POLICY NUMBER
LIMITS OF LIAOILiTY
EFFECTIVE
EXPIRATION
A. Workers Compensation
RC010580
5-1-81
5-1-82
Statutory and
Employers' Liability
10466
S JQ2.000 Emr)lnverg Li nhj 3 1 t•y
B. Public Liability:
• $300,000 combinsd single
limit per occurrence.
Bodily Injury:
Manufacturers and
Contractors M
Each Parson
Comprehensive
General U
$ #Each Accident
(Including products completed
operations)
Property Damage
5 Each Accident
C. Automobile Liability:
Bodily Injury
S Each Person
$ _, 0 Each Accident
Property Damage
$ ' Each Accident
Does policy cover.
All owned automobiles
Non -owned automobiles
Hired automobiles
D. Additional Insured Endorsement:
(Ploasu check at loast unel
( ) Yes ( ) NO
( ) Yes ( ) No
( ) Yes ( ) No
The insurer agrees that the City of Huntington Beach and its City Council, and/or all City Council appointed groups,
committees, commissions, boards and any other City Council appointed body, and/or elective and appointive, officers,
servants or employees of the City of Huntington Beach, when acting as such are additional insureds hereunder, for the
acts cf the insured, and such insurance shall be primary to any insurance of the Chy of Huntington Beach.
E. Hold Harmless Agreement: By Insured:
The insured agrees to protect, defend, i
expense by reason of any suits, claims,
or any subcontractor or by any third party arising out of or in consequonco of the performance of all or any operations
covered by the certificate of insurance.
F. Remarks: APPROVED AS TO FORM:
GAI L HUTTON
City Atto noy
LBy: -
Deputy City Attorn
Date August 25, 1981 AUThORIZED Rje l ATI _Yf�,F INSURANCE COMPANY
INSURANCE COMPANY ByM;difftt
7141
Au rlied Repr ntative/Agent
Name Western Employers Insurance Co. ;IPnn
nsurance Agency
Address 1400 N, Harbor Blvd. Address St. , Whittier, Ca. 90602
City Fullerton, Ca._ _92635 Telephone (213) 698--9776
,� ..
REQ UE* FOR CITY COUNCIPACTKION
/ _
Date November 5, 1981
Submitted to: Honorable Mayor and City Council
Submitted by: C. W. Thompson, City Administrato aY JaT
cOVNCZL
Prepared by: Paul E. Cook, Director of Public Work
Subject: tiiater Well #9; CC 542
crr�• ct
RI �`
Statement of Issua, Recommendation, Analysis, Funding Source, Alternative Actions, attachments: b CI-1
STATEMENT OF ISSUE:
Beylik Drilling, Inc. has completed the drilling of City Water Well #9.
RECOMMENDATION:
Accept the drilling of Water Well #9 and instruct the City Clerk to file
the Notice of Completion.
ANALYSIS:
On September 17, 1981, the Ci.ty entered into a contractual agreement with
Beylik Drilling, Inc. for the drilling of Water Well #9. The drilling
of this well is complete, per City requirements, and, therefore, the
Public Works Department recommends acceptance of the work and requests
that the Notice of Completion be filed by the City Clerk.
The following is a summary of the contract costs:
Original Contract Bid: $135,460.00
Actual Contract Coat: $135,232.00
FUNDING SOURCE:
Water Division Capital Outlay Account-.
ATTACHMENT:
None.
C14T : PEC : DRN : j y
i
PIO 4/81