HomeMy WebLinkAboutGolden State Constructors - 2018-06-04 (2) RECEIVED BY: CITY CLERK RECEIPT COPY
Return DUPLICATE to
City Clerk's Office
(Name) after signing/dating
(Date)
12) CITY OF HUNTINGTON BEACH
INTERDEPARTMENTAL COMMUNICATION
sit
TO: City Treasurer
FROM: City Clerk
DATE: 5////'/
SUBJECT: Bond Acceptance
I have received the bonds for gt7W-r1'v fr)J rdVISYS
(Company Name)
CAPITAL PROJECTS (Includes CC's and MSC's)
Performance Bond No.
Payment Bond (Labor and Materials) Bond No.
Warranty or Maintenance Bond No. -7.3 501- M
TRACT AND DEVELOPMENT
Faithful Performance Bond No.
Labor and Material Bond No.
Guarantee and Warranty Bond No.
Monument Bond No.
Franchise Bond No.
Letter of Credit Bond No.
Other
Re: Tract No. Approved WI-03/
�y (Council Approval Date)
CC No. C(, - /5Li b Agenda Item No.
MSC No. City Clerk Vault No. LIDO• 5-6
Other No. SIRE System ID No. J08'S7
g:/forms/bond transmittal to treasurer 51,2 4- / o_ 06.2/
Document-6826727-Page-1 Page 1 of 1
Recorded in Official Records,Orange County
} Hugh Nguyen,Clerk-Recorder
t II 111I III III I II1I11III1111111, 1 1111 NO FEE
PLEASE COMPLETE THIS INFORMATION k S R 0 0 1 0 6 7 8 1 3 2
•
RECORDING REQUESTED BY: 2019000068985 3:17 pm 03/05/19
9 406 N12 1
0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00
WHEN RECORDED MAIL TO:
•
• CITY OF HUNTINGTON BEACH
PUBLIC WORKS DEPARTMENT
• Attn:Joe Fuentes
P.O.Box 190—2000 Main Street
Huntington Beach,CA 92648
THIS SPACE FOR RECORDER'S USE ONLY
TITLE OF DOCUMENT
NOTICE OF COMPLETION
NOTICE IS HEREBY GIVEN by the City of Huntington Beach,owner in fee,2000 Main Street,Huntington Beach,CA 92648,that
the contract heretofore awarded to GSCI,who was the company thereon for doing the following work to-wit:
•
Citywide ADA Improvements,Project#CC-1568
That said work was completed 02/28/2019 by said company according to plans and specifications and to the satisfaction of the City
Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on 02/2812 01 9,per City
Council Resolution No.2003-70 adopted October 6,2003.
That upon said contract North American Specialty Insurance Company,was surety for the bond given by the said company as
This document is solely for the official business of the City of Huntington Beach,as contemplated under Government Code Section
27383 and should be recorded free of charge.
•
Dire r of Pu arks Ity Engineer Dat
City of Huntington Beach,California
STATE OF CALIFORNIA)
County of Orange )ss:
City of Huntington Beach
I,the undersigned,say:I am an Agent of the City of Huntington Beach,owner in fee,in the foregoing NOTICE OF COMPLETION. I
have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge.
I declare under penalty of perjury that the foregoing is true and correct,and that said NOTICE OF COMPLETION was duly and
regularly ordered to be recorded in the Office of the County Recorder of Orange unty.
This document is solely the official business of
the City of Huntington Beach,as contemplated � 3
��
r of Pub ""',o/o r City Engineer Daaatt
under Government code section 27383 and
City of Huntington Beach,California
should be recorded free of charge.
•
• THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION •
(Additional recording fee applies)
about:blank 3/5/2019
� -
40.
Bond No.: 2273501-M
(9 e of Three Originals)
Two
MAINTENANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS:
That Golden State Constructors (contractor's name)
208 E.Orangethorpe Ave.,Placentia.CA 92870
(contractor's street address,city and state and zip code)
as Principal(hereinafter called Contractor),and:
North American Specialty Insurance Company (surety's name)
6 Hutton Centre Drive,Suite 850,Santa Ana,CA 92707
(surety's street address,city and state and zip code)
a corporation organized and existing under the laws of the State of New Hampshire with its principal office
in the City of Overland Park,Kansas as Surety(hereinafter called Surety),are held firmly bound unto CITY OF
HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of
Five Hundred Thirty Four Thousand Sixty Seven and 00/100 Dollars ($ 534,067.00 ), equivalent to the entire
contract amount including all orders, for the payment whereof Contractor and Surety bind themselves, their heirs,
executors, administrators,successors,and assigns,jointly and severally,firmly by these presents,
WHEREAS,Surety is a duly admitted surety insurer under the laws of the State of California;and
Surety is certified and listed in the U.S. Department of the Treasury Circular 570,and able to provide proof of bonding
limitation shown in said circular is sufficient to provide bonds in the amount required by said Contract;and
Surety has provided financial strength ratings from reputable companies, such as from A.M. Best, Moody's, Standard
&Poor's,to validate that Surety has positive ratings of being secure or stable;and
Surety is registered and listed with the California Department of Insurance;and
Contractor has by written agreement dated — •— ,20/d,entered into a contract with Owner for the
City-Wide ADA Improvements Project(CC-1568)
in accordance
with drawings and specifications prepared by City of Huntington Beach which contract is by
reference made a part hereof(hereinafter referred to as the Contract);and
The Contract provides that the principal will guarantee, for a period of one year, the work performed as part of the
Contract from and against all defects in materials and workmanship;and •
The Contract also provides that the Contractor shall secure Contractor's obligations during the one-year period with a
bond executed by a surety duly admitted in the state of California;and
The Contract has been completed, and the Owner, Contractor and Surety agree that the commencement date for this
Guarantee and Bond shall be March 4th ,2019,
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one
year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and
all defects arising in the Work, whether resulting from defective materials or defective workmanship, then this
obligation shall be null and void;otherwise it will remain in full force and effect.
The Surety hereby waives notice of any alteration or extension of time made by the Owner.
Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within
thirty (30) days following Owner's written notice of default, either: (a) remedy the default, or (b) shall promptly
complete the Contract in accordance with its terms and conditions.
Surety shall save the Owner harmless from any claims,judgments, liens or losses arising from the Surety's failure to
either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner.
15-4584/118138 1
Whenever the Principal shall be, and declared by the Owner to be in default under the Contract,which shall include
without limitation, any breach or default of the Contract, then, after written notice from the Owner to the Surety, as
provided for below,the Surety shall either: (a)remedy the default or breach by the Principal;or(b)shall promptly and
faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a
contractor other than the Principal,at its own expense,and make available as work progresses sufficient funds to pay
the cost of completion less the unpaid balance of the Contract including other costs and damages for which the
surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge
its obligations under this Bond shall be subject to the advance written approval of the Owner.
Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the
Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's
election to(a)remedy the default(s)of the Principal promptly,or(b)arrange for performance of the Contract promptly
by a contractor other than the Principal, time being of essence to this Bond. In said Notice of Election, the Surety
shall state the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the
Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and
completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or
failure to act; and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages
caused by delayed performance or non-performance by the Principal). The Surety shall give prompt written notice to
the Owner upon completion of the cure or remedy of the Principal's default(s)of its performance of the Contract.
If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its
performance of the Work within thirty(30) days after receipt of a written notice from Owner, Surety shall be deemed
to be in default on this bond,and the Owner shall be entitled to enforce any remedy available to Owner.
No right of action shall accrue on this bond to or for the use of any person or corporation other than the owner named
herein or the successors of Owner.
Signed and sealed this 10th day of April , 20 19
Principal Raised Corporate Seal Golden Sta Constructors
[MUST BE AFFIXED] ( o actor Name)
By: (Seal)
Principal Raised Corporate Seal (0. cAL,C't ,
[MUST BE AFFIXED]
(Title)
North American Specialty Insurance Company
ety Name)
By: `� �-' eal)
Matthew R. Dobyns,Attorney-in-Fact
APPROVED AS RM.
B •
NOTES: ichael E. Ga es, City Attorney
1. Acknowledgments must be completed and returned
as part of the bond. 3 D ZA1
2. Raised Corporate Seals are mandatory.
3. Please attach Power of Attorney.
15-4584/118138 2
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance
Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland
Park,Kansas,each does hereby make,constitute and appoint:
RANDY SPOHN and MATTHEW R.DOBYNS
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 9th of May,2012:
"RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
elllllHtllp///, ,u�waam„
a' SEAS :O c Steven P.Anderson,Senior Vice President of Washington International Insurance Compant .f• SEAL %
y4t°.Zm 1973 4to,: &Senior Vice President of North American Specialty Insurance Company v 0-• m
l•..AMP40,4 ,./ ' s y' SOFT
h s
aF'
Michael A.Itto,$enioor i entt o as ington ntn ions assurance ompany oNuiWnr�
&Senior Vice President of North American Specialty Insurance Company
IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 14 day of FEBRUARY ,2018 ,
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 14 day of FEBRUARY ,20,before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito,
Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance
Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
OFFIOAL SEAL 1
M.KENNY
I Notary Public-State of!Din<$s • V t V-v
MyCommission 1 104,2021 M.Kenny,Notary Public
1, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington
International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 10th day of April ,20 19 .
Jeffrey Goldberg,Vice President&Assistant Secretary of
Washington International Insurance Company&North American Specialty Insurance Company
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached, and not the truthfulness,
accuracy, or validity of that document.
State of CALIFORNIA
County of ORANGE
On April 10th, 2019 before me, ASHLEY MARIE SPOHN, NOTARY PUBLIC,
personally appeared MATTHEW R. DOBYNS ,
® who proved to me on the basis of satisfactory evidence to be the person(s)
whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity (ies), and that by his/her/their signature(s)on the
,.0 ASHLEY MARIE SPOHNIF instrument the person(s), or the entity upon behalf of which the person(s)
�;, acted, executed the instrument.
cv _, i, COMM.#2188665
2 1°`;` %4^ NOTARY PUBLIC CALIFORNIA 5
`,tom I ORANGE COUNTY o I certify under PENALTY OF PERJURY under the laws of the State of
'I My comm.expires Mar.27,2021 jr California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Si , ii(Aew/f.
ature of Notary
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
CALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California }
County of Orange _ }
On 4/16/2019 before me, Claudia Cochran, Notary Public
)Here insert rame and title of the officer)
personally appeared -Ronnie D. Cochran -------------
who proved to me on the basis of satisfactory evidence to be the person($whose
name(&) is/tee subscribed to the within instrument and acknowledged to me that
he/3hc/they executed the same in his/hor/their authorized capacity(ies), and that by
his/hcr/their signature(&) on the instrument the person(.&)-, or the entity upon behalf of
which the person() acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
1 +�"'•<<� CLAUDIA COCHRAN
��,. t, COMM. #2277167 z
WITNESS my hand and official seal. 4 ,11ti. Notary Public -California
z ; � Orange County
9 • Mt Comm.Ejpires Feb. 10,2023 t
_�—
Notary Parke Signature (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM
This form complies with current California statutes regarding notary wording and,
DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to die document.Acknowledgments
from other states may be completed for documents being sent to that state so long
as the wording does not require the California notary to violate California notary
law.
(Title or description of attached document) • State and County information must be the State and County where the document
signer(s)personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s)personally appeared which
(Tile or description of attached document continued) must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
Number of Pages Document Date commission followed by a comma and then your title(notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
_ notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e.
lie/sheAhey;-is/ere)or circling the correct forms.Failure to correctly indicate this
Individual (s) information may lead to rejection of document recording.
11 Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges,re-seal if a
(Title) sufficient area permits,otherwise complete a different acknowledgment form.
❑ Partner(s) • Signature of the stoutly public must match the signature on file with the ofliec of
the county clerk.
❑ Attorney-in-Fact P Additional information is not required but could help to ensure this
Trustee(s) acknowledgment is not misused or attached to a different document.
Other • indicate title or type ot'attached document,number of pages and date.
• Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer,indicate the title(i.e.CEO,CFO,Secretary).
• Securely attach this document to the signed document with a staple.
Certification of Compliance with Prevailing Wage Laws
To: City of I Iuntington Beach
Department of Public Works
2000 Main Street/P.O. Box 190
Huntington Beach, CA 92648
Re: Certification of Compliance with Prevailing Wage Laws
Contract: CC-1568
Project: ----Citywide ADA Improvements
The undersigned contractor on the above-referenced project ("Project")hereby certifies that all
laborers, mechanics, apprentices,trainees, watchmen and guards employed by him or by any
subcontractor performing work under the contract for the Project have been paid pursuant to the
minimum wage and bona fide fringe benefit requirements specified for each particular
classification of work, as set forth in the wage-rate determinations of the State of California.
Department of Industrial Relations, and/or the United States Department of Labor.
I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct.
Executed this 15 day of April , 2019 , at Placentia , California.
Golden State Constructors
(Contractor Name)
APPROVED TO FO
By:
M. ael E. Gates
y Attorney
1
CONTRACTOR'S CERTIFICATE
I, Ronnie D. Cochran , state and certify that:
(Name of Declarant)
1. Golden State Constructors is the general contractor to the City of
Huntington Beach("City") on Contract No. CC-1568 (the "Contract")
for the construction of the public work of improvement entitled:
----Citywide ADA Improvements
(the"Project").
2. All work to be performed pursuant to the Contract has been completed in accordance
with the Contract Documents(as such term is defined in the Contract).
3. Except for the claims listed below and the disputed claims listed in paragraph five (5), all
persons supplying labor, services, materials and equipment to the Project, including all
claims against the contractor arising from the performance of the Contract, have been
paid and satisfied(list unpaid debts and claims; if none, write "NONE"):
NONE
4. Attached hereto are the lien waivers required by the Contract Documents, which lien
waivers have been executed by all persons who performed work on or supplied labor,
services, materials, and/or equipment for use at the Project.
5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to
Withhold filed pursuant to the Civil Code of the State of California(list all disputed
claims; if none, write "NONE").
NONE
I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct.
Executed at Placentia on this 15 day of April , 20 19 .
(Signature of Declarant)
APPROVED AS 'CORM
Michael . Gates
City Attorney
1
Certification of Compliance with Title VII of the Civil Rights Act
and Equal Employment Opportunity Act of 1972
To: City of Huntington Beach
Department of Public Works
2000 Main Street/P.O. Box 190
Huntington Beach, CA 92648
Re: Certification of Compliance with Title VII of the Civil Rights Act
and Equal Employment Opportunity Act of 1972
Contract: CC-1568
Project: ----Citywide ADA Improvements
The undersigned contractor on the above-referenced project ("Project") hereby certifies that it
has complied with title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and
Executive Order 11246, and has not discriminated against any employee or applicant for
employment because of race, color, religion, sex, sexual orientation, gender identity, national
origin, age or disability. The undersigned contractor also certifies that it has not maintained any
segregated facilities at its establishments on the basis of race, color, religion, sex, sexual
orientation, gender identity, national origin, age or disability (with the exception of access for the
disabled).
I declare under penalty of perjury under the laws of the State of California that the foregoing is
true and correct.
Executed this 15th day of April , 20 19 , at Placentia , California.
Golden State Constructors
(Contractor Name)
APPROVED j F
By:
Mictlael E. Gates
City Attorney
1
•
Al CI
CONTRACTOR'S RECYCLABLE MATERIAL
TRACKING SHEET
(FOR NON-HAZARDOUS MATERIAL)
PLEASE TYPE OR PRINT LEGIBLY IN INK
CONTRACTOR I COLLECTOR INFORMATION
Business Name. Golden State Constructors
Address: 208 E. Orangethorpe Ave. Placentia, CA 92870
Phone: 714-625-8758 Fax: 714-625-8295
Contact Name: Ron Cochran Quarter Reporting: 1
Recycling Type of Tonnage
Source Location Permit# Material Removed Destination/Disposition
K4r / Cy Ice( ,. -fL /5ciSt
Ci4 704. 4,
THIS FORM SHALL BE SUBMITTED QUARTERLY FOR EACH PERMIT ISSUED. Reports are due by the last day of the
month following quarter end (1st Qtr.=April 30, 2°d Qtr.=July 31, 3'd Qtr.=October 31, 4th Qtr.=January 31). Please call
(714) 374-S321 with questions.
Please attach copy of weight ticket(s) from certified recycler and return completed form via mail or fax to:
CITY OF HUNTINGTON BEACH DEPT OF PUBLIC WORKS
ATTN: RECYCLING COORDINATOR
DEPT. OF PUBLIC WORKS—MAINTENANCE DIV.
2000 MAIN ST.
HUNTINGTON BEACH,CA 92643
FAX: (714)375-5099
( of Three Originals)
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
CONSENT OF SURETY
PROJECT: City-Wide ADA Improvements
TO (OWNER)
City of Huntington Beach Bond No. 2273501
2000 Main Street Job / Bid No.: CC - 1568
Huntington Beach, CA 92648 Contract For: $534,067.00
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated
above, the North American Specialty Insurance Company, SURETY COMPANY, on bond of
Golden State Constructors hereby approves the release of final payment to the Contractor.
The Surety agrees that such release of final payment to the Contractor shall not relieve the Surety of
any of its obligations to City of Huntington Beach, Owner, as set forth in the said Surety's bond.
IN WITNESS WHEREOF,
the Surety has hereunto set its hand this 26th
day of April, 2019
North American Specialty Insurance Company
Sure
'1 (1A, (64----__
Rand Spohn , tto ey-in-fact
Jo
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance
Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland
Park,Kansas,each does hereby make,constitute and appoint:
RANDY SPOHN and MATTHEW R.DOBYNS
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 9th of May,2012:
"RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
\\\\���y IpLIITY rrr +µwru�uaunmye
o i SEAL :O= Steven P.Anderson,Senior Vice President of Washington International Insurance Company 2r SEAL
W• 8,Z 1 73 PW,q &Senior Vice President of North American Specialty Insurance Company €0 :r„gp
ors . �/{� d� .,�taniD
r�rnnulnm���\ By as p �c Michael A.Ito,Senior Vice President of ashmgton International Insurance Company issoutn'
&Senior Vice President of North American Specialty Insurance Company
IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 14 day of FEBRUARY ,2018
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 14 day of FEBRUARY ,20,before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito,
Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance
Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
OFFICIAL SEALM.KENNY
Notary Public-State of Y h.
My Commission Espires M.Kenny,Notary Public
12/0412021
I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington
International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 26 day o�f� April _ ,2.0 19
Jeffrey Goldberg,Vice President&Assistant Secretary of
Washington International Insurance Company&North American Specialty Insurance Company
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached, and not the truthfulness,
accuracy, or validity of that document.
State of CALIFORNIA
County of ORANGE
On April 26th, 2019 before me, ASHLEY MARIE SPOHN, NOTARY PUBLIC,
personally appeared RANDY SPOHN ,
❑ who proved to me on the basis of satisfactory evidence to be the person(s)
whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity
31(AirtliAscHoLiim.#EY MARIE—SPOHN IF . , and that by his/her/their signature(s) on the
, r, 1 2188665 instrument the person(s)), or the entity upon behalf of which the person(s)
m,�`�� _r.., NOTARY PUBLIC CALIFORNIA 5 acted, executed the instrument.
1 / ORANGE COUNTY o
it "''"" ' My comm.expires Mar.27,2021 is I certify under PENALTY OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
,
Sin ture of Notary
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
( e of Three Originals)
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
CONSENT OF SURETY
PROJECT: City-Wide ADA Improvements
TO (OWNER)
City of Huntington Beach Bond No. 2273501
2000 Main Street Job / Bid No.: CC - 1568
Huntington Beach, CA 92648 Contract For: $534,067.00
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated
above, the North American Specialty Insurance Company, SURETY COMPANY, on bond of
Golden State Constructors hereby approves the release of final payment to the Contractor.
The Surety agrees that such release of final payment to the Contractor shall not relieve the Surety of
any of its obligations to City of Huntington Beach, Owner, as set forth in the said Surety's bond.
IN WITNESS WHEREOF,
the Surety has hereunto set its hand this 26th
day of April, 2019
North American Specialty Insurance&Company
Sure /
Randy pohn , or ey-in-fact
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas,and Washington International Insurance
Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland
Park,Kansas,each does hereby make,constitute and appoint:
RANDY SPOHN and MATTHEW R.DOBYNS
JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: FIFTY MILLION($50,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on the 9th of May,2012:
"RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
omittnito
VQG1ApOY d/,,: '"Q.UrPRPoA���YS
y:p'4 Rt G !�
'It
By €ti*,oe Rar:GA
sat�,s P
, :rn- Steven P.Anderson,Senior Vice President of Washington International Insurance Company 'z' SEAL
:m= ,rn
s� 1973 �:O &Senior Vice President of North American Specialty Insurance Company O: m
Z 4'O .a t~9
rP4••�.!t4 �:used
w, .. ....*Michael A.IItto,Senior Vice President of ashmgton International Insurance Companyawn*ixtmM`&Senior Vice President of North American Specialty Insurance Company
IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Companyhave their
official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 14 day of FEBRUARY ,2018
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois
County of Cook ss:
On this 14 day of FEBRUARY ,2018 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito,
Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance
Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and
acknowledged said instrument to be the voluntary act and deed of their respective companies.
OFFICIAL SEAL
N. ate
I Notary Public-State ul Illinois (
My Commission Expires M.Kenny,Notary Public
1214412021
I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington
International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North
American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 26 day of April ,20 19
Jeffrey Goldberg,Vice President&Assistant Secretary of
Washington International Insurance Company&North American Specialty Insurance Company
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached, and not the truthfulness,
accuracy, or validity of that document.
State of CALIFORNIA
County of ORANGE
On April 26th, 2019 before me, ASHLEY MARIE SPOHN, NOTARY PUBLIC,
personally appeared RANDY SPOHN ,
❑ who proved to me on the basis of satisfactory evidence to be the person(s)
whose name(s) is/arc subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their
1 " A authorized capacity
t�^ ,-ix . ASHLEY MARIE SPOHN i� P ty (- ), and that by his/her/their signatures} on the
�, /�'. 1 COMM.#2188665 instrument the person(s), or the entity upon behalf of which the person(s)
R;exi, -. NOTARY PUBLIC CALIFORNIA o acted, executed the instrument.
< .i' ORANGE COUNTY N
it My comm.expires Mar.27,2021 )t I certify under PENALTY OF PERJURY under the laws of the State of
California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
ii t,
Sig a ure of Notary
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
El INDIVIDUAL
❑ CORPORATE OFFICER
❑ PARTNER(S) ❑ LIMITED
® ATTORNEY-IN-FACT
El TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
�, in CITY OF HUNTINGTON BEACH
INTERDEPARTMENTAL COMMUNICATION
DATE: 4/29/2019
TO: THOSE LISTED HEREON
FROM: Joseph Dale, PW Construction Manager
SUBJECT: Retention Release Payment- PO#24008 OJ Supplier#33040 Co.#215
Citywide ADA Improvements, Project#CC-1568
Contractor's Name: GSCI
Address: 208 E. Orangethorpe Ave
City, State and Zip Code: Placentia, CA, 92870
Phone Number: (714)625-8758
City Business License Number: (City Lic#Here)
Notice of Completion (Date by City Clerk): 3/5/2019
The conformed copy of the Notice of Completion for the above contract has been filed. The thirty-five (35) day
waiting period has elapsed or will elapse before payment is made. Processing of the retention payment is
recommended so long as no stop notices or outstanding invoices are on file with the City.
I certify that no stop notices are on file.
(Vzqto
D Travis K. Hopkins, Director of Public Works
I certify that there are no outstanding invoices on file.
C)kitC-14_, Je
Date Joyc acks, Deputy City Treasurer
I certify that no stop notices are on file, and that guaranty bond has been filed with the City Clerk's Office.
,
Vy(-75,
Date sobi stanisl u, ity Clerk
7D �t/5/0/r
Attachments U
1. Notice of Completion
2. Maintenance Bond
3. Certificate of Compliance with Prevailing Wage Laws
4. Contractor's Certificate
5. Certificate of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972
6. Consent for Release letter from the Surety Company
Document-6826727-Page-1 Page 1 of 1
Recorded in Official Records,Orange County
Hugh Nguyen,Clerk-Recorder
II II II III I II II III II III II II NO FEE
PLEASE COMPLETE THIS INFORMATION * s R 0 0 1 0 6 7 8 1 3 2 $ *
• RECORDING REQUESTED BY: 2019000068985 3:17 pm 03/05119
9 406 N12 1
0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00
WHEN RECORDED MAIL TO:
CITY OF HUNTINGTON BEACH
PUBLIC WORKS DEPARTMENT •
Attn:Joe Fuentes
P.O.Box 190—2000 Main Street
Huntington Beach,CA 92648
•
THIS SPACE FOR RECORDER'S USE ONLY
TITLE OF DOCUMENT
• NOTICE OF COMPLETION
•
NOTICE IS HEREBY GIVEN by the City of Huntington Beach,owner in fee,2000 Main Street,Huntington Beach,CA 92648,that
the contract heretofore awarded to GSCI,who was the company thereon for doing the following work to-wit:
Citywide ADA Improvements,Project#CC-1568
That said work was completed 02/28/2019 by said company according to plans and specifications and to the satisfaction of the City
Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on 02/28/2019,per City
Council Resolution No.2003-70 adopted October 6,2003.
•
That upon said contract North American Specialty Insurance Company,was surety for the bond given by the said company as
This document is solely for the official business of the City of Huntington Beach,as contemplated under Government Code Section
27383 and should be recorded free of charge.
•
3/¢ i y
•
Dire r of Pu orks ity Engineer Dat
City of Huntington Beach,California
STATE OF CALIFORNIA)
County of Orange )ss:
City of Huntington Beach
I,the undersigned,say:I am an Agent of the City of Huntington Beach,owner in fee,in the foregoing NOTICE OF COMPLETION. I
have read said NOTICE OF COMPLETION and know the contents thereof;the same is true of my knowledge.
I declare under penalty of perjury that the foregoing is true and correct,and that said NOTICE OF COMPLETION was duly and
• regularly ordered to be recorded in the Office of the County Recorder of Orange aunty.
This document is solely the official business of 3//-ji7
the City of Huntington Beach,as contemplated
under Government code section 27383 and •r of Pub 'orks or City Engineer Datb
should be recorded free of charge. City of Huntington Beach,California
THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION
(Additional recording fee applies)
•
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