COMPLETED BOARD ORDER AND CON�\�Before the Board of Supervisors in and for the
County of Monterey, State of California
Construction No. 2011-007; Agreement No. A-11995
a. Award a contract to Telfer Oil Company, the lowest
responsible base bidder, for the Procurement Delivery
and Application) of Asphalt Emulsion for the Seal Coat
2010 Project, Contract No. 11-551120; in the total
amount of $702,596.66;
b. Approve the Performance and Payment Bonds executed
and provided by Telfer Oil Company;
c. Authorize a contingency not to exceed 10% of the
Contract amount) to provide funding for approved
contract change orders; and
d. Authorize the Director of Public Works to execute the
contract and subject to the terms of the Public Contract
Code, approve change orders to the contract that do not
exceed 10% of the original contract amount and do not
significantly change the scope of work
Upon motion of Supervisor Potter, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby;
a. Awarded a contract to Telfer Oil Company, the lowest responsible base
bidder, for the Procurement Delivery and Application) of Asphalt Emulsion
for the Seal Coat 2010 Project, Contract No. 11-551120; in the total amount of
$702,596.66;
b. Approved the Performance and Payment Bonds executed and provided by
Telfer Oil Company;
c. Authorized a contingency not to exceed 10% of the Contract amount) to
provide funding for approved contract change orders; and
d. Authorized the Director of Public Works to execute the contract and subject to
the terms of the Public Contract Code, approve change orders to the contract
that do not exceed 10% of the original contract amount and do not
significantly change the scope of work.
PASSED AND ADOPTED on this 24th day of May, 2011, by the following vote, to wit:
AYES: Supervisors Armenta, Calcagno, Salinas, Parker, and Potter
NOES: None
ABSENT: None
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby
certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered
in the minutes thereof of Minute Book 75 for the meeting on May 24, 2011.
Dated: May 26, 2011 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
50
Deputy
BIB]
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COMPLETED BOARD ORDER AND CON�\�CONTRACT FOR PUBLIC WORK
COUNTY OF MONTEREY
STATE OF CALIFORNIA
CONTRACT NO. 11-551120
THIS AGREEMENT, made in triplicate by and between the COUNTY OF MONTEREY, a
political subdivision of the State of California, hereinafter called the County," and
Telfer Oil Company hereinafter called the Contractor,"
WITNESSETH:
1) THE WORK
The Contractor shall do all the work and furnish all the materials, except such as are
mentioned in any of the contract documents to be furnished by the County, necessary to construct and
complete in a good, workmanlike and substantial manner and to the satisfaction of the County, the
following public work:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010
CONTRACT NO. 11-551120
in accordance with this agreement and with all of the following additional contract documents which
are incorporated into and made a part of this agreement:
a) The Standard Specifications, dated May 2006, and the Standard Plans, dated May 2006
including issued amendments through November 30, 2010, of the State of California,
Department of Transportation.
The Special Provisions for the work.
The Notice to Bidders calling for bids.
The Payment and Performance bonds required.
Certificate of Insurance.
Rate List
The accepted bid/proposal including the following:
1) List of Subcontractors
2) Equal Employment Opportunity Certification
3) Public Contract Code
Section 10285.1 Statement
Section 10162 Questionnaire
Section 10232 Statement
4) Non-Collusion Affidavit
BIB]
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IN-U012
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AMOUNT-U012
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$702,596.66;-U012
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COMPLETED BOARD ORDER AND CON�\�F 5) Debarment and Suspension Certification
6) Statement Concerning Employment of Undocumented Aliens
7) Contractor's Certificate as to Worker's Compensation
8) Contractor's Certification of Good-Faith Effort to Hire Monterey Bay
Area Residents
9) List of Satisfied Public Agencies
10) Bidder's Bond
All contract documents are intended to cooperate, so that any work called for in one and not
mentioned in another is to be executed the same as if mentioned in all. However, should there be any
conflict between the terms of this instrument and the Contractor's bid or proposal, then this instrument
shall control.
2. WORKERS' COMPENSATION
In accordance with the provisions of Section 3700 of the Labor Code, the Contractor and
every Subcontractor will be required to secure the payment of compensation to his employees.
3. CONTRACT PRICE
The County shall pay the Contractor the following prices for the performance of this
contract:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO. 11-551120
ITEM ITEM ITEM UNITS ESTIMATED UNIT PRICE ITEM TOTAL
NO. CODE QUANTITY INCLUDING 8.25% INCLUDING 8.25%
TAX TAX
In Figures) In Figures)
PASS or Equivalent for
1 the San Miguel Road TONS 115 5777.00 589,355.00
Maintenance District
PASS or Equivalent for
2 the Monterey Road TONS 179 8777.00 S 139,083.00
Maintenance District
PMCRS2h for the I I
3 374492 Greenfield Road TONS 239 S650.00 5155,350.00
Maintenance District
PMCRS2h for the San
4 374492 Ardo Road TONS 287 S650 5186,550.00
Maintenance District
FastSet for the San
5 Miguel Road TONS 25 S500.00 512,500.00
Maintenance District
BIB]
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COMPLETED BOARD ORDER AND CON�\� FastSet for the
6 Monterey Road TONS 62 $500.00 $31,000.00
Maintenance District
Accessorial Charges on HRS 210 $195.00 $40,950.00
7 Spreading
8 Accessorial Charges on HRS 44 $110.00 $4,840.00
Unloading
9 Other Accessorial LS 1 $42,968.66 $42,968.66
Charges
TOTAL COST $702,596.66
BIB]
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COMPLETED BOARD ORDER AND CON�\�IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the dates
appearing opposite their respective signatures.
CONTRACTOR:
M,-k i~' 1-1 7-0/1
COUNTY OF MONTEREY:
By:
Name: Yazdan T. Emrani, P.E.
Title: Director of Public Works
Date:
By:
Name:
Title:
Date:
Name of Company)
7e.1-F-er a l Gym D'-
APPROVE AS TO FORM
Cynthia L. Hasson
Deputy County Counsel
S O //
PR l A TO INDEMNITY /
P1`" 1''11, TbUAGE
r T,' O 10OtN TER-,;
30
By: Aar Z k,= Tr') I~, DE 44 I!
Name! S tii c el3 U l,
Date:Dat~' //-Y
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COMPLETED BOARD ORDER AND CON�\�COUNTY OF MONTEREY
PAYMENT BOND
Civil Code Section 3249)
Bond Number: 929419948
Premium: Included in the
Performance Bond
WHEREAS, the County of Monterey has awarded to Principal, as Contractor, a contract for
the following project:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO. 11-551120
AND WHEREAS, Principal, as Contractor, is required to furnish a bond in connection with
said contract, to secure the payment of claims of laborers, mechanics, materialmen, and other persons
furnishing labor and materials on the project, as provided by law.
NOW, THEREFORE, we Telfer Oil Company as Principal,
and Western Surety Company
as Surety, are held and firmly bound
unto the County of Monterey, a political subdivision of the State of California hereinafter called
County"), and to the persons named in California Civil Code Section 3181 in the penal sum of
beb7e50 RolrladsTwo__housand Five Hundred Ninety Six and for the payment of which
sum in lawful money of the United States, well and truly to be made, we bind ourselves, our heirs,
executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT:
If the Principal, or any of Principal's heirs, executors, administrators, successors, assigns, or
Subcontractors, 1) fails to pay in full all of the persons named in Civil Code Section 3181 with respect
to any labor or materials furnished by said persons on the project described above, or 2) fails to pay in
full all amounts due under the California Unemployment Insurance Code with respect to work or labor
performed on the project described above, or 3) fails to pay for any amounts required to be deducted,
withheld,.and paid over to the Employment Development Department from the wages of employees of
the Principal and Subcontractors pursuant to Unemployment Insurance Code Section 13020 with
respect to such work and labor, then the Surety shall pay for the same.
Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to
the terms of the contract on The call for bids, or to the work to be performed thereunder, or the
specifications accompanying the same, shall in any way affect its obligation under this bond, and it
does hereby waive notice of any such change, extension of time, alteration or addition to the terms of
said contract or the call for bids, or to the work, or to the specifications.
BIB]
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THE-U012
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AMOUNT-U012
OF-U012
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COMPLETED BOARD ORDER AND CON�\�If suit is brought upon this bond by the County and judgment is recovered, the Surety shall
pay all litigation expenses incurred by the County in such suit, including court costs, expert
witness fees and investigation expenses.
This bond inures to the benefit of any of the persons named in Civil Code Section 3181, and
such persons or their assigns shall have a right of action in any suit brought upon this bond, subject to
any limitations set forth in Civil Code Sections 3247 at seq. Civil Code, Division 3, Part 4, Title 15,
Chapter 7: Payment Bond for Public Works).
IN WITNESS WHERE OF the above-bounden parties have executed this instrument under
their several seals this 4th day of May 20 11 the name and corporate seal of each
corporate party being hereto affixed and these presents duly signed by its undersigned representative,
pursuant to authority of its governing body.
Corporate Seal) Telfer oil Company
Principal
By
Corporate Seal)
Name and Title Uvl__~) 7 t P t-(.e t/
Nt'to i iv"1 6eAev J
Western,Sprety Company
Surety
Name and Title Christopher J. Angelo, Attorney-in-Fact
By
Attach notary acknowledgment for all signatures and attorney-in-fact certificate for signature by
surety's representative.)
BIB]
40721-U01
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COMPLETED BOARD ORDER AND CON�\�CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
On c~2DI) before me, I/Gr!1 le! V l W'~'11~u/ fib(;
/ Date Here Insert Name and TIM of the Officer
U(J4 is e1
who proved to me on the basis of satisfactory
evidence to be the personSra'' whose name(s) is/a4e-
subscribed to the within instrument and acknowledged
to me that he/&4e/4 ey executed the same in
his/harftheir authorized capacity(ies), and that by
his/letheir signaturek< on the instrument the
person( or the entity upon behalf of which the
person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hang'alid,,official sea
Signature:
Place Notary Seal and/or Stamp Above
OPTIONAL
Though the information below is not required by lain, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
Corporate Officer Title(s):
Individual
RIGHTTHUNIHPRINT
OF SIGNER
Partner D Limited General hoof thumb here
Attorney in Fact
Trustee
C Guardian or Conser for
gner's Name:
D Corporate Officer Title(s):
D Individual
Partner C' Limited Ci General
Attorney in Fact
fl Trustee
Guardian or Conservator
D Other:
HRIGHrTHUMBPRINT
OFBIGNER
Signer Is Representing:
t%Y<cK:<.^~ sx=<csc_cr~c~^~-<n=.c;~-c^w~-cr~cs~.u~ru:~'cn.=u~.c:~c;~.%c,~:c^~css=~su,~-cx=c~u:~c~.c^~~crc_~,^v~ Al
/12006 National Notary Association 9350 De Solo Ave., P.O. Box 2402 Cnalswodir, CA 91313-2402 wwvw.NalionalNolary.org Item 115907 Reorder: Call Toll-Free 1-600-676.6627
BIB]
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COMPLETED BOARD ORDER AND CON�\ �CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Sacramento
On May 4, 2011 before me, Anitra L. Dumlao Notary Public------
Here insert name and title of the officer)
personally appeared Christopher J. Angelo------
who proved to me or, the basis of satisfactory evidenpe to be the person s)hose name($r(T~'lare subscribed to
the within instrument and acknowledged to me thaf':he/she/they executed the same in 1s'/her/their authorized
capacityy~ies~,'and that by( /her,/their signature(s)-on the instrument the person 7, 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
DESCRIP
TION
OF
ATTACI D
DOCUIvIENT
Title
or
descn
ption of attached
document)
Title or description of attached document continued)
Number of Pages Document Date
Additional information)
CAPACITY CL.AR LEJ BY THE SIGNER
Individual s)
Corporate Officer
Title i
Partner(s)
Attorney-in-Fact
Trustee(s)
Other
property completed and attached to that document. The onto exception is if a
document is to be recorded outside of California. In such instances, any alternative
aclmowiedgment verbiage as may be printed on such a document so long as the
verbiage doe., not require the notary to do something that is illegal for a notary in
California i.e. certifying the authorized capacity of the signer). Please check the
document carefully for proper notarial wording and attach this form if required.
ADDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acimowledgment completed in California must contain verbiage exact!' as
appear., above in the notary section or a separate acimowieagmen: form must be
State and Count.' information must be the State and County where the document
sitmer(s) personally appeared before the notary public for acknowiedement.
Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
The notary public must print his or her name as it appear, within his or her
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.
Indicate the correct singular or plural forms by crossing off incorrect forms i.e.
heishe/tlie~-- is tare or circling the correct forms. Failure to correctly indicate this
information may lead to resection of document recording.
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
sufficient area permits. otherwise complete a different acknowledgment form.
Si:maturc of the notary public must match the signature on the with the office of
the count'.' clerk.
Additional information is not required but could bell) to ensure this
Notary Seal)
acknowiedgnrent is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
indicate the capacity claimed b' the signer If the claimed capacity is a
corporate officer, indicate die title i.e. CEU. CFO. Seeretart).
Securely attach this document to the signed document
2008 Version CAPA v 12_. 10.07 300-87 3.9865 www.NotarvClasses.com
BIB]
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THE-U012
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COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
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IN-U012
THE-U012
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AMOUNT-U012
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$702,596.66;-U012
B. APPROVE-U012
THE-U012
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COMPLETED BOARD ORDER AND CON�\
�Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Randall L Jorgensen, Joseph E Weber, Christopher J Angelo, Paul F Bystrowski, Carol Dunn,
John E Murphy, Sandi Pullen, Individually
of Sacramento, CA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf
bonds, undertakings and other obligatory instruments of similar nature
In Unlimited Amounts
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be heretoaffixed on this 3rd day of November, 2006.
WESTERN SURETY COMPANY
State of South Dakota
County of Minnehaha
f
ss
Paul Bruflat, Senior Vice President
On this 3rd day of November, 2006, before me personally came Paul T._Bruflat, to me known, who, being by-me duly sworn, did depose and say: that
he resides in-the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and
which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was
so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires +
J D. KRELL r
November 30, 2012 SEAL NOTARY PUBLIC s~L j
r JSOUTH DAKOTA
CERTIFICATE
D. Krell, Noiary Public
I, L. Nelson, Assistant Secretary of WESTER',,' SURE"; Y COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this 4th tray of May
2011.
WESTERN SURETY COMPANY
T Ne.icnn Accicrnnr SrrrPraN
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COMPLETED BOARD ORDER AND CON�\
�Authorizing By-Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders
of the Company'
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations.of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
BIB]
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COMPLETED BOARD ORDER AND CON�\
�Bond Number: 929519948
Premium: $4,816.00
COUNTY OF MONTEREY
PERFORMANCE BOND
WHEREAS, the County of Monterey has awarded to Principal, Telfer Oil Company
Contractor, a contract for the following project:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO. 11-551120
WHEREAS, Principal, as Contractor, is required to furnish a bond in connection with said
contract, to secure the faithful perfonnance of said contract.
NOW, THEREFORE, we Telfer Oil Company as Principal, and
Western Surety Company
as Surety, are held and firmly bound
unto the County of Monterey, a political subdivision of the State of California hereinafter called
County"), in the penal sum of NineetyHSndrandTvr~/T00ud lars---Hundred for the payment of
which sum in lawful money of the United States, well and truly to be made, we bind ourselves, our
heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents,
THE CONDITION OF THIS OBLIGATION IS SUCH THAT:
If the Principal, as Contractor, or Principal's heirs, executors, administrators, successors, or assigns,
1) shall in all things stand to and abide by and well and truly keep and perform the covenants,
conditions, and agreements in said contract and any alteration thereof made as therein provided, on
Principal's part to be kept and performed,. at the time and in the manner therein specified and in all
respects according to their true intent and meaning, and 2) shall defend, indemnify and save harmless
the County, the members of its board of supervisors, and its officers, agents and employees as therein
stipulated, then this obligation shall become null and void; otherwise, it shall be and remain in full
force and virtue.
Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the
terms of the contract on the call for bids, or to the work to be performed thereunder, or the
specifications accompanying the same, shall in any way affect its obligation under this bond, and it
does hereby waive notice of any such change, extension of time, alteration or addition to the terms of
said contract or the call for bids, or to the work, or to the specifications,
Whenever the Principal, as Contractor, is in default, and is declared in default, under the contract
by the County of Monterey, the County of Monterey having performed its obligation under the
contract, Surety may promptly remedy the default, or shall promptly:
1) Complete the contract in accordance with its terms or conditions, or
2) Obtain a bid or bids for submission to County of Monterey for completing the contract
in accordance with its terms or conditions, and upon determination by County of
Monterey and Surety of the lowest responsible and responsive bidder, arrange for a
contract between such bidder and County of Monterey, and make available as work
progresses even though there should be a default or a succession of defaults under the
contract or contracts of completion arranged under this paragraph) sufficient funds to
pay the cost of completion less the balance of contract price,
as
BIB]
40721-U01
COMPLETED-U02
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LI21329-U03
FO96183-U03
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FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO103453-U03
C15-U03
COMPLETED-U03
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ORDER-U03
6/27/2011-U04
MARCELLAC-U04
16548-U05
3-U06
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AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
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COMPANY,-U07
THE-U07
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THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
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NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND CON�\
�If suit is brought upon this bond by the County and judgment is recovered, the Surety shall pay
all litigation expenses incurred by the County in such suit, including court costs, expert witness fees
and investigation expenses.
IN WITNESS WHEREOF, the above-bounden parties have executed this instrument under their
several seals this 4th day of May 20 11 the name and corporate seal of
each corporate party being hereto affixed and these presents duly signed by its undersigned
representative, pursuant to authority of its governing body.
Corporate Seal) Telfer Oil Company
Principal
Corporate Seal)
By
Name and Tide UVf C k /
MG UALA;1Aa 6ejAe%
Western S e Company
By
ety
Name and Title Christopher J. Angelo, Attorney-in-Fact
Attach notary acknowledgment for all signatures and attorney-in-fact certificate for signature by
surety's representative.)
BIB]
40721-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
CONTRACT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
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AS99817-U03
AS99824-U03
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DO103453-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/27/2011-U04
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16548-U05
3-U06
A.-U07
AWARD-U07
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TO-U07
TELFER-U07
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COMPANY,-U07
THE-U07
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300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
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OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
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TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
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BONDS-U012
EXECUTED-U012
PROVIDED-U012
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TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
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A-U012
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NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
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CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND CON�\�CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
M.
State of California
personally appeared
On UVIa l before me, Gt. x J e) I T 1'(/</,
Dale Here Insert Name and Title of the Officer
County of
/P L-Fec
Name(s) of Signer(s)
who proved to me on the basis of satisfactory
evidence to be the person~,sj whose namep4 is/ape-
subscribed to the. within instrument and acknowledged
to me that he/she/they executed the same in
his/her/their authorized capacity(�iesj' and that by
his/hefA-~r& signatures on the instrument the
person or the entity upon behalf of which the
perso 4 acted, executed the instrument.
DANIEL 1. FRIIINIEL
Commission * 1590291
Notary Public CNNorrAs
Contra costa County
Place Notary Seal and/or Stamp Above
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
Signature:
OPTIONAL
s
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
tl
Signer's Name:
7-1 Corporate Officer Title(s):
Individual
C Partner D Limited E Genergl'
Attorney in Fact
Z'
Trustee
Guardian or Conservator
Other:
Signer's Representing:
RIGHTTHUMBPRINT;
UFSIGNER
Signer's Name:
CI Corporate Officer Title(s):
71 Individual
i Partner Limited L! General
E Attorney in Fact
L Trustee
ri Guardian or Conservator
Other:
Signer Is Representing:
01-04MIMIRMIM M101;
I
RIGHTTHUMBPRINT I
VFSIGNER
C,~,~,~.CS~iv~,,tic=.~;~c=Nv=%Cx'Cs~,~.C^csC'�c.<S~%fi~c:,~,~c!Cti!Ci~>.CS~ix-C."~.C^~%Cl"~%C^~i�'~!6~iJ^c=%Ci~c_'~C-~c"'Ci'~-;U"~i<^~'.<itiiV^uU~c V~'~^~:.~s~i�ti:4'C/SC~re%Ci~%L!'~%<~"~-.t%~ V^c::CS~v
02008 National Notary Association 9350 De Solo Ave., P.O. box 2402 Chatsworth. CA 61313-2402 wwv:.Nationalbolary.org Item 115607 Roomer: Call Toli-Free i-600.670-6827
BIB]
40721-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
CONTRACT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO103453-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/27/2011-U04
MARCELLAC-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
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AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND CON�\�CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Sacramento
On May 4, 2011 before me, Anitra L. Dumlao Notary Public------
Here insert name and title of the officer)
personally appeared Christopher J. Angelo------
who proved to me on the basis of satisfactory evidence to be the persons) whose names /is/are subscribed to
the within instrument and acknowledged to me thaf`he/she/they executed the same in lugs'/tiler/their authorized
capacityy iies)and that by lis/her/their signature~s)"on the instrument the person(s7, or the entity upon behalf of
which the persoi Reacted, 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.
4
DESCRIPTION OF THE ATTACI D DOCUMENT
Title or description of attached document)
Title or description of attached document continued) Number of Pages Document Date
Additional information)
CAPACITY CZAR ED BY THE SIGNER
Individual s)
J Corporate Officer
Title
0 Partner(s)
0 Attorney-in-Fact
0 Trustee(s)
0 Other
IMTTNESS(inyJiand and official seal.
/
Signature of Notary Public
Notary Seal)
t
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 signet(s) personally appeared which
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
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.
Indicate the correct singular or plural forms by crossing off incorrect forms i.e.
hetshe/tlte. is lace or circling the correct forms. Failure to correcth' indicate this
information may lead to reejecnon of document recording.
The notar.' seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-scat if a
sufficient area permits, otherwise complete a different acknowledgment form.
Signature of the notar public must match the signature or hie with the office of
the count,! clerk.
Additional information is not required but could help to ensure this
acknowiedement is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed in the signer. If the claimed capacir it. a
corporate officer, indicate the title i.e. CEO, CFO. Secretarnt.
Secureiv atuich this document to fire si<med document
2008 Version CAPA vl_.10.07 30(1-37:-9861 www.Nomr,Classes.com
BIB]
40721-U01
COMPLETED-U02
BOARD-U02
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CONTRACT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO103453-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/27/2011-U04
MARCELLAC-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
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PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
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PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
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DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
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COMPLETED BOARD ORDER AND CON�\�Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know AMI Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls,, and State of South Dakota, and that it does by virtue of the signature and seal herein affixedhereby
make, constitute and appoint
Randall L Jorgensen, Joseph H Weber, Christopher J Angelo, Paul F Bystrowski, Carol Dunn,
John E Murphy, Sandi Pullen, Individually
of Sacramento, CA, its true and.lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf
bonds, undertakings and other obligatory instruments of similar nature
In Unlimited Amounts
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized office, of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 3rd day of November, 2006.
WESTERN SURETY COMPANY
Paul Bruflat, Senior Vice President
State of South Dakota
County ofMinnehaha
ss
On this 3rd day of November, 2006, before me personally came Paul TBruflat, to me known, who, being by.me.duly sworn, did depose and say: that
he resides in the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and
which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was
so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires
November 30. 2012
+
D. KRELL
f SAL NOTARY PUBLIC SEAL f
lSOUTH DAKOTA'r
+
CERTIFICATE
D. Krell, Noiarv Public
1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify, that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof 1 have hereunto subscribed
my name and affixed the seal of the said corporation this 4th day of May,
Jr_~
E Air Tc
2011.
WESTERN SURETY COMPANY
17 P
L. Nelson, Assistant Secretary
BIB]
40721-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
CONTRACT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO103453-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/27/2011-U04
MARCELLAC-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
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OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND CON�\�Authorizing By-Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
BIB]
40721-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
CONTRACT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO103453-U03
C15-U03
COMPLETED-U03
BOARD-U03
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6/27/2011-U04
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COMPLETED BOARD ORDER AND CON�\�41CR17
CDATE ERTIFICATE OF LIABILITY INSURANCE 05/05M/DD/YYYY)
OS/05/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER LIC #0660864 1-925-671-5110 CONTACT
NAME: Liz Boehmer
Argo Insurance Group, Inc. PHONE FAX
A/C No Exl� 925-852-0401 A/C, No 925-852-0451
2300 Contra Costa Blvd E-MAIL
ADDRESS: LizbtEargoinsurance.com
Suite 375 PRODUCER
Pleasant H ill
CA 94523 CUSTOMER ID #�
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
INSURER A: LIBERTY NUT FIRE INS CO
23035
Telfer Oil Company
INSURER B: GREAT AMER INS CO
16691
PO Box 709 INSURER C
Martinez,
CA 94553 INSURER D
INSURER E
INSURER F
COVERAGES
CERTIFICATE NUMBER: 21073176
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
POLICY NUMBER MM/ODIYYYY MM/DDIYYYY LIMITS
A GENERAL LIABILITY X X TB2661036901031 02/01/1 02/01/12 EACH OCCURRENCE S 1,000,000
X
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Ea occurrence) S 100, 000
CLAIMS-MADE OCCUR
MED EXP Any one person) S 51 000
000
PERSONAL& ADVINJURY 9 1,000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT AP LIES PER: PRODUCTS COMP/OP AGG S 2,000,000
M PRO
POLICY
I LOC $
A AUT OMOBILE LIABILITY X X AS7661036901051 02/01/11 02/01/12 COMBINED SINGLE LIMIT
S 2, 000, 000
Ea accident)
ANY AUTO
BODILY INJURY Per person) S
ALL OWNED AUTOS
BODILY INJURY Per accident) 5
SCHEDULED AUTOS
PROPERTY DAMAGE
HIRED AUTOS Per accident)
NON-OWNED AUTOS
B Y UMBRELLALIAB OCCUR TUU033259302 02/01/11 02/01/121 EACH OCCURRENCE 5 1, 000, 000
EXCESS LIAB CLAIMS-MADE 000
AGGREGATE s 1
ODD
DEDUCTIBLE
RETENTION S 10,000
S
A WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY I X 1 WC2661036901111
1
02/0/1
I WC
IOTH-
02/01/12 I
Y / N LIMIT
1 TORY LIMITS R
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N/A
E.L. EACH ACCIDENT 1, ODD, 000
Mandatory in NH)
E
L
DISEASE EA EMPLOYEES 1
000
000
Il yes
describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT 1, 0 0 0, 0 0 0
S
DESC RIPTION OF OPERATIONS LOCATIONS /VEHICL ES Attach A CORD 101
Additional Remarks Schedule
If more s
ce i i
d
pa
s requ
re
County of Monterey, their officers, agents, and employees are Additional Insureds per the language provided in the
attached LN2001 0605 & CA2048 0299.
A.M. Best rating: A++XV RE Project: Procurement Delivery and Application) of Asphalt Emulsion For the Seal Coat
2010 Project Contract 4111-551120
Primary wording applies per the language provided in the attached CG0001 1207.
Waiver of Subrogation applies to General Liability, Auto & Workers Comp per the attached CG2404, AX1210 & WC040306.
***30 d
ay notice of cancellation except 10 days for non-payment of premium.***
CERTIFICATE HOLDER CANCELLATION
Contract 4)11-551120
Monterey County
Department of Public Works
166 West Alisal Street, 2nd Floor
Salinas, CA 93901
LMazza.
ACORD 25 2009/09)
21073176
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
C) 1988-2009 ACORD CORPORATION
All
rights reserved.
The ACORD name and logo are registered marks of ACORD
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COMPLETED BOARD ORDER AND CON�\�I
01,621 110001 61 000033
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
BLANKET ADDITIONAL INSURED
This endotstrnent modifies insurance provided under the following.
COMMERCL\L GENERAL LLABILIT's' COVERAGE FORM
SECTION IT WHO IS AN INSURED is amended to include as an insured any person or organization for whom you have
agreed in writing to provide liability tnsurancc. But:
The insurance provided by this amendmenr.
2 Applies only to coverage and msntmum brruts of insurance required by the worsen agreement, but in no event exceeds either
the scope of coverage or the limits of insurance provided by this policy; and
3 Does not apply to any person or organization for whom you have procured separate liability tnturanec while such insurance is
to effect, regardless of whether the scope of coverage or limits of insurance of this policy exceed those. of such other insurance.
or whether such other insuraner is valid and collectible.
The following provisions also apply:
1 Where the applicable written agreement requires the insured to provide liability insurance on a primary, excess, contingent, or
any other basis, this policy will apply solely on the basis required by such written agreement and Item 4. Other insurance of
SECTION IV of this policy will not apply.
2 Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of I tan
4 Other Insurance of SECTJON TV of this policy will' govern.
3 This endorsement shall not apply to any person or orgaruzanon for any bodily injury' or property damage" if any oche:
additional insured endorsement on this policy applies to that person or organization with regard to the bodily injury" or
property damage".
4. If any other additional insured endorsement applies to any person or organization and you arc obligated under n written
agreement to provide liability insurance on a primary, excess, contingent, or any other basis for that additional insured, this
policy will apply solely on the basis required by such written agreement and Item 4. Other Insurance of SECTION' IV of this
policy will not apply, regardless of whether the person or otgaruzation has available other valid and collectible insurance If
the applicable written agreement does not specify on what basis the liability insurance will apply, the provisiors of Item 4
Other Insurance of SECTION IV of this policy will govern
thisendorsancntisc>en,trdbythe LIBERTI' MUTUAL FIRE INSURANCE COMPANY
1 Applies only to bodily injury" or property damage" arising out of a) your work" or b) premises or other property owned
by or rented to you;
I'nmiurn S
i;fiea;cr loam 2/ 1 x 201 1 F.apuauon Date r 1 2
I'a: attachment to Potty ND TE2-b61-C3690 I n
Audit ban,
hived T.
Telfer Oil Company, A Partnership
of Telfer Tank Lines, Inc., &
Telfer Enterprises, Inc. and as
per Endorsement #'1
PRESI0El\
lountcregncd by
issued
Sale; Oilier and No
End Serial t4c
LN 20 DI 06 05
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COMPLETED BOARD ORDER AND CON�\�Aml Avallahk Image 056201000J6100D001i
Named Insured Schedule
Asphalt Service Company, Inc.
Mulberry Land Co., LLC
Continental Western Transportation Co., Inc.
Telfer Highway Technologies, LLC
Telfer Oil Company 401K & Profit Sharing Plan
Continental Western 401K & Profit Sharing Plan
DBA's:
Western Oil & Spreading
Windsor Fuel Company
Telfer Geosynthetics
Telfer Geosynthetics DBA California Paving Fabrics
For AUacluncnt to
Policy: TB2-661-036901-031 Pagc 1A Eod. I
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NO.-U012
11-551120;-U012
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THE-U012
TOTAL-U012
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$702,596.66;-U012
B. APPROVE-U012
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BY-U012
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COMPLETED BOARD ORDER AND CON�\�i
0S6201 0001 61 00004 9
WABVFR OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization: Any person or organization with whom you have agreed in writing to waive
any right of recovery prior to a loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV Conditions:
We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
your work" done under a contract with that person
or organization and included in the products-
completed operations hazard". This waiver applies
only to the per-son or organization shown in the
Schedule above
l'tus endorsement c, cutcd U� tht LIBERTY MUTUAL P1 E INSUKANCE COMPANY
Ytemtum E
l.Sritcdre Datc /1/ 2011 Ezpimnon Datc 11 1 201 2
1-'Di attachmtnt to flaky No. TB1-66,-036901-031
Aud,t 624%5
Isaved is
s1:CFZT 11Y
Countersigned by
Issued Saks Ofbc< and No
PruslDerr
Awti oriztd kcr roen, tivt
End. 5o Nu
CG 24 04 0f, 09 C,1 Insurance Services Office. Inc., 2008 Page 1 of 1
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THE-U012
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COMPLETED BOARD ORDER AND CON�\�116N20e71)e2595e(It)a6 w
3) The nature and location of any injury or
damage arising out of the occurrence" or
offense.
b, if a claim is made or suit" Is brought against
any insured, you must:
1) Immediately record the specifics of the
claim or suit" and the dale received; and
2) Notify Us as soon as practicable.
You must see to 11 that we receive written no-
tice of the claim or sult" as soon as practica-
ble.
c. You and any other Involved Insured must:
1) Immediately send us copies of any de-
mands, notices, summonses or legal pa-
pers received in connection with the claim
or suit";
2) Authorize us to obtain records and other
information;
3) Cooperate with us in the investigation or
settlement or the claim or defense against
the suit'; and
4) Assist us, upon our request, in the en-
lorcemenl of any right against any person
or organization which may be liable to the
insured because of injury or damage to
which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.
3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a suit" asking for damages from an Insured: or
b. To sue us on this Coverage Part unless all of
Its terms have been fully complied with.
A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the ap-
plicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the claim.
ant's legal representative.
4, Other Insurance
II other valid and collectible insurance is available
to the insured for a loss we cover under Cover-
ages A or S of this Coverage Part, our obligations
are Am Ited as follows:
a. Primary Insurance
This Insurance is primary except when Para-
graph b. below applies. If this insurance is pri-
mary, our obligations are not affected unless
any of the other Insurance is also primary,
Then, we will share with all that other insur-
ance by the method described In Paragraph c.
below.
b. Excess Insurance
1) This insurance is excess over:
a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
I) That is Fire, Extended Coverage,
Builders Risk, installation Risk,, or
similar coverage for your work,";
it) That is Fire insurance for premises
rented to you or temporarily occu-
pied by you with permission of the
owner
lip That is Insurance purchased by you
to cover your liability as a tenant for
properly damage" to premises
rented to you or temporarily occu-
pied by you with permission of the
owner; or
iv) It the loss arises out of the mainte-
nance or use of aircraft, autos' or
watercraft to the extent not subject to
Exclusion g. of Section I Coverage
A Bodily Injury And Property Dam-
age Liability.
b) Any other primary insurance available to
you covering liability for damages aris-
Ing out of the premises or operations, or
the products and completed operations,
for which you have been added as an
additional insured by attachment of an
endorsement.
2) When this Insurance is excess, we will have
no duty under Coverages A or 13 to defend
the Insured against any suit' if any other
insurer has a duly to defend the insured
against that suit". It no other insurer de-
lends, we will undertake to do so, but we
will be entitled to the insured's rights
against all those other insurers
CG 00 01 12 07 10) ISO Properties, Inc., 2006 Page 11 of 16
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LI21329-U03
FO96183-U03
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OF-U012
ASPHALT-U012
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THE-U012
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COAT-U012
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CONTRACT-U012
NO.-U012
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COMPLETED BOARD ORDER AND CON�\�THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
WAIVER OF TRANSFER, OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
Business Auto Coverage Form
Garage Coverage Form
Truckers Coverage Form
Motor Carrier Coverage Form
SCHEDULE
Premium: TNCL
Name of Person or Organization:
Any person or organization for whom you perform work under a written contract if the contract requires
you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage
occurring.
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US condition is amended by the
addition of the following:
We waive any right of recovery we may have against the person or organization shown in the Schedule
above because of payments we make for injury or damage arising out of your operations of a covered auto
done under contract with that person or organization. This waiver applies only to the person or organization
shown in the Schedule above.
Policy No: A57-661-036901-051
Effective Date: 2/1 /2011
Expiration Date: 2/1/2012
Sales Office: 0393
Issue', By. Libe_-:y Insurance c
Lridt see ai Inc
AY 12 10 02 05 B Page 1 of 1
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NO.-U012
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B. APPROVE-U012
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WORK.-U012
COMPLETED BOARD ORDER AND CON�\�THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fied by this endorsement.
This endorsement identifies person(s) or organization(s) who are insureds" under the Who Is An Insured Provi-
sion of the Coverage Form This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name of Person(s) or Organization(s):
Any person or organization whom you have agreed in writing to add as an additional insured, but only to
coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either
the scope of coverage or the limits of insurance provided in this policy.
if no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to the endorsement.)
Each person or organization shown in the Schedule is an insured" for Liability Coverage, but only to the extent
that person or organization qualifies as an insured" under the Who Is An Insured Provision contained
in Section II of the Coverage Form.
Policy No: AS7-661-036901-051
Effective Date. 2/01 /2011
Expiration Date. 2/01/2012
Sales Office: 0395
Issued By Liberty Insurance Corp.
Pridt Scricl I'o:
CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of I
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THE-U012
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PAYMENT-U012
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WORK.-U012
COMPLETED BOARD ORDER AND CON�\�WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
This endorsement changes the policy to which it is attached effective on inception date of the policy unless
a different date is indicated below.
The following attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective 12:01 AM 02/01/11 forms a part of Policy No. WC2 6 610 3 6 9 01111
Issued to: Telfer Oil Company
By: LIBERTY NUT FIRE INS CO
Premium: INCL
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will
not enforce our right against the person or organization named in the Schedule. This agreement applies
only to the extent that you perform work under a written contract that requires you to obtain this agreement
from us).
You must maintain payroll records accurately segregating the remuneration of your employees while
engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 5% of the California workers' compensation
premium otherwise due on such remuneration.
Schedule
Person or Organization
County of Monterey, their officers, agents and employees
Job Description
RE Project: Procurement Delivery and Application) of Asphalt Emulsion For the sea!- coat 2010
Project Contract #11-551120
WC 04 03 06
Ed. 4-84)
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COMPLETED BOARD ORDER AND CON�\�i
MONTEREY
Legend
SEAL COAT 2010 ROADS
GONZALES
LOCATION MAP AND ROAD LIST
PROCUREMENT DELIVERY AND APPLICATION) OF ASPHALT EMULSION FOR THE SEAL
COAT 2010 PROJECT
CONTRACT NO. 11 551120)
ROAD NAME LWTS
DAVIS ROAD RESERVATION ROAD TO BLANCO ROAD
COOPER ROAD BLANCO ROAD TO NASHUA ROAD
RESERVAT1ON ROAD HWY 68 TO BLANCO ROAD
WILD HORSE CANYON ROAD CATTLEMEN ROAD TO END
OASIS ROAD SAN LUCAS ROAD TO LOCKWOOD-SAN LUCAS ROAD
SAN LUCAS ROAD JOLON ROAD TO OASIS ROAD
PANCHORICO ROAD SC 2009 LIMITS TO END
PARIS VALLEY ROAD INTERSECTION LOCKWOOD SAN LUCAS TO END
LOCKWOOD SAN LUCAS ROAD HWY 101 RAMP TO 2 MILES SOUTHEAST
MONTEREY COUNTY ROADS
STOCKPILE LOCATION
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11-551120;-U012
IN-U012
THE-U012
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SIGNED BOARD REPORT"�|Eb��MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: May 24,2011 Consent AGENDA NO.:
SUBJECT: a. Award a contract to Telfer Oil Company, the lowest responsible base
bidder, for the Procurement Delivery and Application) of Asphalt Emulsion
for the Seal Coat 2010 Project, Contract No. 11-551120; in the total amount
of $702,596.66;
b. Approve the Performance and Payment Bonds executed and provided by
Telfer Oil Company;
c. Authorize a contingency not to exceed 10% of the Contract amount) to
provide funding for approved contract change orders; and
d. Authorize the Director of Public Works to execute the contract and subject
to the terms of the Public Contract Code, approve change orders to the
contract that do not exceed 10% of the original contract amount and do not
significantly change the scope of work.
DEPARTMENT: RMA Public Works
RECOMMENDATIONS:
It is recommended that the Board of Supervisors:
a. Award a contract to Telfer Oil Company, the lowest responsible base bidder, for the
Procurement Delivery and Application) of Asphalt Emulsion for the Seal Coat 2010
Project, Contract No. 11-551120; in the total amount of $702,596.66;
b. Approve the Performance and Payment Bonds executed and provided by Telfer Oil
Company;
c. Authorize a contingency not to exceed 10% of the Contract amount) to provide funding for
approved contract change orders; and
d. Authorize the Director of Public Works to execute the contract and subject to the terms of
the Public Contract Code, approve change orders to the contract that do not exceed 10% of
the original contract amount and do not significantly change the scope of work.
SUMMARY/DISCUSSION:
The Board approved the Plans and Special Provisions for the Procurement Delivery and
Application) of Asphalt Emulsion for the Seal Coat 2010 Project, Contract No. 11-551120, on
April 12, 2011. The project was subsequently advertised and bids were solicited. An addendum
was issued to remove seventy one 71) tons of PMCRS2h in the Greenfield maintenance district.
The revised Engineer's Estimate for the project is $676,621. The bids were opened on
May 2, 2011, and the lowest responsible base bidder was Telfer Oil Company in the amount of
$702,596.66. The lowest bid is approximately 4% greater than the revised Engineer's Estimate.
This contract consists of the procurement and application of PASS or equal and FastSet or equal
for scrub seal and fog seal operations on selected roads in the San Miguel and Monterey
maintenance districts, and PMCRS2h asphalt emulsion for chip seal operations on selected roads
in the Greenfield and San Ardo maintenance districts.
BIB]
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SIGNED BOARD REPORT"�|Eb��Award Telfer Oil Company contract for the Procurement Delivery and Application) of Asphalt
Emulsion for the Seal Coat 2010 Project
May 24, 2011
Page 2
Accessorial charges associated with procuring emulsion for pavement-surfacing projects scrub
seal, chip seal and fog seal) are included in the contract. The contract is a component of the Seal
Coat 2010 Project. The Department of Public Works' maintenance forces shall be responsible
for all other project incidentals including but not limited to the control of traffic and the
spreading of screenings over the applied emulsion. Approximately 43.5 miles of roads with an
equivalent square yardage of 558,300 are planned for treatment.
Telfer Oil Company is unable to promise to make a good-faith effort to comply with the good-
faith local hiring provisions set forth in Monterey County Code Section 5.08.120. The
Contractor is contractually obligated to provide two drivers and two spreader trucks to spread the
emulsion for the project; the majority of the workers are County maintenance forces. Oil
spreading requires highly specialized skills to meet quality and efficiency standards of the
Special Provisions. The majority of Contractors for chip seal projects use their own experienced
drivers to operate their specialized spreader trucks to avoid loss while maintaining quality. Two
additional bids were received by the Department of Public Works: one from Western Emulsions,
Inc. in the amount of $714,193.54, and another from VSS Emultech in the amount of
$716,435.81. Only VSS Emultech agreed to make the good-faith effort to comply with Code
Section 5.08.120, which they did by placing a help wanted ad in a local paper. As it is or likely
that such specialized personnel are not locally available, placing an ad in the paper does not
guarantee that the drivers ultimately used by the selected contractor for this project will be hired
locally. The Department of Public Works recommends acceptance of Telfer Oil Company's bid
as the lowest responsive bidder as it is the best interests of the County to do so.
OTHER AGENCY INVOLVEMENT:
County Counsel and Contracts/Purchasing attended the bid opening and reviewed the low bid for
conformance with applicable regulations. County Counsel and Risk Management approved the
Contract and Bonds as to form, and insurance provisions, respectively.
FINANCING:
There is no financial impact to the General Fund. Sufficient appropriations are included in the
FY 2010-11 Road Fund budget Fund 002, Unit 8195) for this project. The estimated total cost
for this contract is $702,596.66, with a contingency of 10% of the base bid in the amount of
$70,259, for a total contract of $772,855.
Prepared by: Approved by:
Arturo A. Adlawan,1831) 755-4823 Yazdan T. Emrani, M.S., P.E.
Civil Engineer Director of Public Works
Dated: May 16, 2011
Attachments: Board Order; Project Budget; Bid Summary; Contract; Bonds on file with the
Clerk of the Board); Location Map
BIB]
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EXECUTED AGREEMENT"�|Eb�"�1*
CONTRACT FOR PUBLIC WORK
COUNTY OF MONTEREY
STATE OF CALIFORNIA
CONTRACT NO. 11-5 51120
THIS AGREEMENT, made in triplicate by and between the COUNTY OF MONTEREY, a
political subdivision of the State of California, hereinafter called the County," and
Telfer Oil Company hereinafter called the Contractor,"
WITNESSETH:
1) THE WORK
The Contractor shall do all the work and furnish all the materials, except such as are
mentioned in any of the contract documents to be furnished by the County, necessary to construct and
complete in a good, workmanlike and substantial manner and to the satisfaction of the County, the
following public work:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010
CONTRACT NO. 11-551120
in accordance with this agreement and with all of the following additional contract documents which
are incorporated into and made a part of this agreement:
a) The Standard Specifications, dated May 2006, and the Standard Plans, dated May 2006
including issued amendments through November 30, 2010, of the State of California,
Department of Transportation.
b) The Special Provisions for the work.
c) The Notice to Bidders calling for bids.
d) The Payment and Performance bonds required.
e) Certificate of Insurance.
f) Rate List
g) The accepted bid/proposal including the following:
1) List of Subcontractors
2) Equal Employment Opportunity Certification
3) Public Contract Code
Section 10285.1 Statement
Section 10162 Questionnaire
Section 10232 Statement
4) Non-Collusion Affidavit
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
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FO96183-U03
FO96184-U03
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MG99791-U03
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AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
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2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
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THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
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SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
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DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�5) Debarment and Suspension Certification
6) Statement Concerning Employment of Undocumented Aliens
7) Contractor's Certificate as to Worker's Compensation
8) Contractor's Certification of Good-Faith Effort to Hire Monterey Bay
Area Residents
9) List of Satisfied Public Agencies
10) Bidder's Bond
All contract documents are intended to cooperate, so that any work called for in one and not
mentioned in another is to be executed the same as if mentioned in all. However, should there be any
conflict between the terms of this instrument and the Contractor's bid or proposal, then this instrument
shall control.
2. WORKERS' COMPENSATION
In accordance with the provisions of Section 3700 of the Labor Code, the Contractor and
every Subcontractor will be required to secure the payment of compensation to his employees.
3. CONTRACT PRICE
The County shall pay the Contractor the following prices for the performance of this
contract:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO. 11-5 51120
ITEM ITEM ITEM UNITS ESTIMATED UNIT PRICE ITEM TOTAL
NO. CODE QUANTITY INCLUDING 8.25% INCLUDING 8.25%
TAX TAX
In Figures) In Figures)
PASS or Equivalent for
1 the San Miguel Road TONS 115 $777.00 $89,355.00
Maintenance District
PASS or Equivalent for
2 the Monterey Road TONS 179 $777.00 $139,083.00
Maintenance District
PMCRS2h for the
3 374492 Greenfield Road TONS 239 $650.00 $155,350.00
Maintenance District
PMCRS2h for the San
4 374492 Ardo Road TONS 287 $650 $186,550.00
Maintenance District
FastSet for the San
5 Miguel Road TONS 25 $500.00 $12,500.00
Maintenance District
BIB]
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DO109664-U03
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2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
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A-U07
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TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
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DELIVERY-U07
300-PUBLIC-U08
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PENA-U09
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PENAR-U10
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OF-U012
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EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
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TELFER-U012
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COMPANY;-U012
C.-U012
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EXCEED-U012
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OF-U012
THE-U012
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AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
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TO-U012
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EXECUTED AGREEMENT"�|Eb�"� FastSet for the
6 Monterey Road TONS 62 $500.00 $31,000.00
Maintenance District
Accessorial Charges on HRS 210 $195.00 $40,950.00
7 Spreading
8 Accessorial Charges on HRS 44 $110.00 $4,840.00
Unloading
9 Other Accessorial LS 1 $42,968.66 $42,968.66
Charges
TOTAL COST $702,596.66
BIB]
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2/13/2012-U04
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16548-U05
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11-551120;-U012
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OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
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EXECUTED AGREEMENT"�|Eb�"�i
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the dates
appearing opposite their respective signatures.
CONTRACTOR:
COUNTY OF MONTEREY:
By:
Name: Yazdan T. Emrani, P.E.
Title: Director of Public W rks
Date:
By:
Name:
APPROVE AS TO FORM
Cynthia L. Hasson
Title: Deputy County Counsel
Date:
ts to_ t,
IND
/
UAGE EMNITY
R IS fC %, b
COUNTY 01= MONTEREY
By: APPROVED AS TOINDEMNITY!
NamdNSliE J F C GUAGE
Title: By: Risk
Date:Date:
BIB]
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OF-U012
$702,596.66;-U012
B. APPROVE-U012
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EXECUTED AGREEMENT"�|Eb�"�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: May 24,2011 Consent AGENDA NO.:
SUBJECT: a. Award a contract to Telfer Oil Company, the lowest responsible base
bidder, for the Procurement Delivery and Application) of Asphalt Emulsion
for the Seal Coat 2010 Project, Contract No. 11-551120; in the total amount
of $702,596.66;
b. Approve the Performance and Payment Bonds executed and provided by
Telfer Oil Company;
c. Authorize a contingency not to exceed 10% of the Contract amount) to
provide funding for approved contract change orders; and
d. Authorize the Director of Public Works to execute the contract and subject
to the terms of the Public Contract Code, approve change orders to the
contract that do not exceed 10% of the original contract amount and do not
significantly change the scope of work.
I DEPARTMENT: RMA Public Works
RECOMMENDATIONS:
It is recommended that the Board of Supervisors:
a. Award a contract to Telfer Oil Company, the lowest responsible base bidder, for the
Procurement Delivery and Application) of Asphalt Emulsion for the Seal Coat 2010
Project, Contract No. 11-551120; in the total amount of $702,596.66;
b. Approve the Performance and Payment Bonds executed and provided by Telfer Oil
Company;
c. Authorize a contingency not to exceed 10% of the Contract amount) to provide funding for
approved contract change orders; and
d. Authorize the Director of Public Works to execute the contract and subject to the terms of
the Public Contract Code, approve change orders to the contract that do not exceed 10% of
the original contract amount and do not significantly change the scope of work.
SUMMARY/DISCUSSION:
The Board approved the Plans and Special Provisions for the Procurement Delivery and
Application) of Asphalt Emulsion for the Seal Coat 2010 Project, Contract No. 11-551120, on
April 12, 2011. The project was subsequently advertised and bids were solicited. An addendum
was issued to remove seventy one 71) tons of PMCRS2h in the Greenfield maintenance district.
The revised Engineer's Estimate for the project is $676,621. The bids were opened on
May 2, 2011, and the lowest responsible base bidder was Telfer Oil Company in the amount of
$702,596.66. The lowest bid is approximately 4% greater than the revised Engineer's Estimate.
This contract consists of the procurement and application of PASS or equal and FastSet or equal
for scrub seal and fog seal operations on selected roads in the San Miguel and Monterey
maintenance districts, and PMCRS2h asphalt emulsion for chip seal operations on selected roads
in the Greenfield and San Ardo maintenance districts.
BIB]
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$702,596.66;-U012
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EXECUTED AGREEMENT"�|Eb�"�Award Telfer Oil Company contract for the Procurement Delivery and Application) of Asphalt
Emulsion for the Seal Coat 2010 Project
May 24, 2011
Page 2
Accessorial charges associated with procuring emulsion for pavement-surfacing projects scrub
seal, chip seal and fog seal) are included in the contract. The contract is a component of the Seal
Coat 2010 Project. The Department of Public Works' maintenance forces shall be responsible
for all other project incidentals including but not limited to the control of traffic and the
spreading of screenings over the applied emulsion. Approximately 43.5 miles of roads with an
equivalent square yardage of 558,300 are planned for treatment.
Telfer Oil Company is unable to promise to make a good-faith effort to comply with the good-
faith local hiring provisions set forth in Monterey County Code Section 5.08.120. The
Contractor is contractually obligated to provide two drivers and two spreader trucks to spread the
emulsion for the project; the majority of the workers are County maintenance forces. Oil
spreading requires highly specialized skills to meet quality and efficiency standards of the
Special Provisions. The majority of Contractors for chip seal projects use their own experienced
drivers to operate their specialized spreader trucks to avoid loss while maintaining quality. Two
additional bids were received by the Department of Public Works: one from Western Emulsions,
Inc. in the amount of $714,193.54, and another from VSS Emultech in the amount of
$716,435.81. Only VSS Emultech agreed to make the good-faith effort to comply with Code
Section 5.08.120, which they did by placing a help wanted ad in a local paper. As it is or likely
that such specialized personnel are not locally available, placing an ad in the paper does not
guarantee that the drivers ultimately used by the selected contractor for this project will be hired
locally. The Department of Public Works recommends acceptance of Telfer Oil Company's bid
as the lowest responsive bidder as it is the best interests of the County to do so.
OTHER AGENCY INVOLVEMENT:
County Counsel and Contracts/Purchasing attended the bid opening and reviewed the low bid for
conformance with applicable regulations. County Counsel and Risk Management approved the
Contract and Bonds as to form, and insurance provisions, respectively.
FINANCING:
There is no financial impact to the General Fund. Sufficient appropriations are included in the
FY 2010-11 Road Fund budget Fund 002, Unit 8195) for this project. The estimated total cost
for this contract is $702,596.66, with a contingency of 10% of the base bid in the amount of
$70,259, for a total contract of $772,855.
Prepared by: Approved by:
Arturo A. Adlawan, P 831) 755-4823 Yazdan T. Emrani, M.S., P.E.
Civil Engineer
Dated: May 16, 2011 Director of Public Works
Attachments: Board Order; Project Budget; Bid Summary; Contract; Bonds on file with the
Clerk of the Board); Location Map
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EXECUTED AGREEMENT"�|Eb�"�Before the Board of Supervisors in and for the
County of Monterey, State of California
a. Award a contract to Telfer Oil Company, the
lowest responsible base bidder, for the
Procurement Delivery and Application) of
Asphalt Emulsion for the Seal Coat 2010
Project, Contract No. 11-551120; in the total
amount of $702,596.66;
b. Approve the Performance and Payment
Bonds executed and provided by Telfer Oil
Company;
c. Authorize a contingency not to exceed 10%
of the Contract amount) to provide funding
for approved contract change orders; and
d. Authorize the Director of Public Works to
execute the contract and subject to the terms
of the Public Contract Code, approve change
orders to the contract that do not exceed 10%
of the original contract amount and do not
significantly change the scope of work.........
Upon motion of Supervisor seconded by Supervisor
and carried by those members present, the Board hereby:
a. Awarded a contract to Telfer Oil Company, the lowest responsible base bidder, for the
Procurement Delivery and Application) of Asphalt Emulsion for the Seal Coat 2010
Project, Contract No. 11-551120; in the total amount of $702,596.66;
b. Approved the Performance and Payment Bonds executed and provided by Telfer Oil
Company;
c. Authorized a contingency not to exceed 10% of the Contract amount) to provide funding
for approved contract change orders; and
d. Authorized the Director of Public Works to execute the contract and subject to the terms of
the Public Contract Code, approve change orders to the contract that do not exceed 10% of
the original contract amount and do not significantly change the scope of work.
PASSED AND ADOPTED on this 24th day of May, 2011, by the following vote, to-wit:
AYES:
NOES:
ABSENT:
1, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby
certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in
the minutes thereof of Minute Book for the meeting on
Dated: Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
Deputy
BIB]
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EXECUTED AGREEMENT"�|Eb�"�MONTEREY COUNTY DEPARTMENT OF PUBLIC WORKS
PROCUREMENT DELIVERY & APPLICATION) OF ASPHALT EMULSION
FOR THE SEAL COAT 2010 PROJECT
CONTRACT NO. 11-551120
CONTRACT BUDGET
Base Bid $702,596
10% Contingency $70,259
TOTAL ESTIMATED CONTRACT COST: $772,855
REVENUE
Road Fund Fund 002, Unit 8195) $772,855
TOTAL: $772,855
BIB]
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EXECUTED AGREEMENT"�|Eb� "�BID SUMMARY SHEET:
BOARD OF SUPERVISORS, COUNTY OF MONTEREY
Project: Seal Coat 210 Project No. 1 1-~"1 120
Department: Public Works
Authority: Ordinance No. 1862 as amended jOrdinance No. 2628
Bidders: Estimated Cost:
Base Bid Amount
Western Emulsions inc.
3 Monarch Bay Plaza, Ste 210
Dana Point CA 92629 $ c~ fj $
Telfer Oil Co.
P.O. Box 709
Martinez, CA 94553 S r r~ $
VSS Emultech
PO Box 981150
West Sacramento, CA 95798 S
$ $
$ $
$ S
Ccrtilication: I certify that bids listed above were opened, examined, and declared by me on May 2, 2011 at 3:00 P.M., in the Clerk to the Board's
Closed Session Room, 1st Pl Government Center, Salinas. CA
Lew C. Bauman, Purchasing A
By
Deputy Purchasing Age"it=
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EXECUTED AGREEMENT"�|Eb�
"�CONTRACT FOR PUBLIC WORK
COUNTY OF MONTEREY
STATE OF CALIFORNIA
CONTRACT NO. 11-551120
THIS AGREEMENT, made in triplicate by and between the COUNTY OF MONTEREY, a
political subdivision of the State of California, hereinafter called the County," and
Telfer Oil Company hereinafter called the Contractor,"
WITNESSETH:
1) THE WORK
The Contractor shall do all the work and furnish all the materials, except such as are
mentioned in any of the contract documents to be furnished by the County, necessary to construct and
complete in a good, workmanlike and substantial manner and to the satisfaction of the County, the
following public work:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010
CONTRACT NO. 11-551120
in accordance with this agreement and with all of the following additional contract documents which
are incorporated into and made a part of this agreement:
a) The Standard Specifications, dated May 2006, and the Standard Plans, dated May 2006
including issued amendments through November 30, 2010, of the State of California,
Department of Transportation.
b)
c)
The Special Provisions for the work.
The Notice to Bidders calling for bids.
The Payment and Performance bonds required.
Certificate of Insurance.
Rate List
The accepted bid/proposal including the following:
1) List of Subcontractors
2) Equal Employment Opportunity Certification
3) Public Contract Code
Section 10285.1 Statement
Section 10 162 Questionnaire
Section 10232 Statement
4) Non-Collusion Affidavit
BIB]
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EXECUTED AGREEMENT"�|Eb�
"�5) Debarment and Suspension Certification
6) Statement Concerning Employment of Undocumented Aliens
7) Contractor's Certificate as to Worker's Compensation
8) Contractor's Certification of Good-Faith Effort to Hire Monterey Bay
Area Residents
9) List of Satisfied Public Agencies
10) Bidder's Bond
All contract documents are intended to cooperate, so that any work called for in one and not
mentioned in another is to be executed the same as if mentioned in all. However, should there be any
conflict between the terms of this instrument and the Contractor's bid or proposal, then this instrument
shall control.
2. WORKERS' COMPENSATION
In accordance with the provisions of Section 3700 of the Labor Code, the Contractor and
every Subcontractor will be required to secure the payment of compensation to his employees.
3. CONTRACT PRICE
The County shall pay the Contractor the following prices for the performance of this
contract:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO. 11-551120
ITEM ITEM ITEM UNITS ESTIMATED UNIT PRICE ITEM TOTAL
NO. CODE QUANTITY INCLUDING 8.25% INCLUDING 8.25%
TAX TAX
In Figures) In Figures)
PASS or Equivalent for
1 the San Miguel Road TONS 115 $777.00 $89,355.00
Maintenance District
PASS or Equivalent for
2 the Monterey Road TONS 179 $777.00 $139,083.00
Maintenance District
PMCRS2h for the
3 374492 Greenfield Road TONS 239 $650.00 $155,350.00
Maintenance District
PMCRS2h for the San
4 374492 Ardo Road TONS 287 $650 $186,550.00
Maintenance District
FastSet for the San
5 Miguel Road TONS 25 $500.00 $12,500.00
Maintenance District
BIB]
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COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�
"� FastSet for the
6 Monterey Road TONS 62 $500.00 $31,000.00
Maintenance District
Accessorial Charges on IIRS 210 $195.00 $40,950.00
7 Spreading
8 Accessorial Charges on HRS 44 $110.00 $4,840.00
Unloading
9 Other Accessorial LS 1 $42,968.66 $42,968.66
Charges
TOTAL COST $702,596.66
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�
"�IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the dates
appearing opposite their respective signatures.
CONTRACTOR:
7,e-1-f-er all w4 p4L4
COUNTY OF MONTEREY:
By:
Name: Yazdan T. Emrani, P.E.
Title: Director of Public Works
Date:
By:
Name:
Title:
Date:
APPROVE AS TO FORM
j& Yi- VDT
Cynthia L. Hasson
Deputy County Counsel
PR YE A 10 INDEMNITY /
lily UAGE
CEO N TY OF M0NTMR h'
By: Name' ivS4iiW6 lfc tid\SUAC
Title:. Risk
Date:Date
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�COUNTY OF MONTEREY
PAYMENT BOND
Civil Code Section 3249)
Bond Number: 929419948
Premium: Included in the
Performance Bond
WHEREAS, the County of Monterey has awarded to Principal, as Contractor, a contract for
the following project:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO.11-551120
AND V,HIEREAS, Principal, as Contractor, is required to furnish a bond in connection with
said contract, to secure the payment of claims of laborers, mechanics, materialmen, and other persons
furnishing labor and materials on the project, as provided by law.
NOW, THEREFORE, we Telfer Oil Company as Principal,
and Western Surety Company
as Surety, are held and firmly bound
unto the County of Monterey, a political subdivision of the State of California hereinafter called
Count)"), and to the persons named in California Civil Code Section 3181 in the penal sum of
nJrieds--- Two-- housand Five Hundred Ninety Six and
o ar for the payment of which
sum in lawful money of the United States, well and truly to be made, we bind ourselves, our heirs,
executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH THAT:
If the Principal, or any of Principal`s heirs, executors, administrators, successors, assigns, or
Subcontractors, 1) fails to pay in full all of the persons named in Civil Code Section 3181 with respect
to any labor or materials furnished by said persons on the project described above, or 2) fails to pay in
full all amounts due under the California Unemployment Insurance Code with respect to work or labor
performed on the project described above, or 3) fails to pay for any amounts required to be deducted,
withheld, and paid over to the Employment Development Department from the wages of employees of
the Principal and Subcontractors pursuant to Unemployment Insurance Code Section 13020 with
respect to such work and labor, then the Surety shall pay for the same.
Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to
the terms of the contract on the call for bids, or to the work to be performed thereunder, or the
specifications accompanying the same, shall in any way affect its obligation under this bond, and it
does hereby waive notice of any such change, extension of time, alteration or addition to the terms of
said contract or the call for bids, or to the work, or to the specifications.
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�If suit is brought upon this bond by the County and judgment is recovered, the Surety shall
pay all litigation expenses incurred by the County in such suit, including court costs, expert
witness fees and investigation expenses.
This bond inures to the benefit of any of the persons named in Civil Code Section 3181, and
such persons or their assigns shall have a right of action in any suit brought upon this bond, subject to
any limitations set forth in Civil Code Sections 3247 of seq. Civil Code, Division 3, Part 4, Title 15,
Chapter 7: Payment Bond for Public Works),
IN WITNESS WHERE OF the above-bounden parties have executed this instrument under
their several seals this 4th day of May 2011 the name and corporate seal of each
corporate party being hereto affixed and these presents duly signed by its undersigned representative,
pursuant to authority of its governing body.
Corporate Seal)
Corporate Seal)
Telfer 011 Company
Name and Title
Principal
By
I TP 4'e /
6BN PtIA d wf
re,Zy Company
N4--tIAA~ I'
Name and Title Christopher J. Angelo; Attorney-in-Fact
By
Surety
Attach notary acknowledgment for all signatures and attorney-in-fact certificate for signature by
surety's representative.)
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
5~'.C/.f~`C~SX~.l7.C~4f~.C~~:Wis.~X+.ln~+nn~wi~t+.t~ti n,~w.~, n.~tinn:
On before me, I/Gt 11 I~~ ti f) l 7 b(1L
n more Insert Name and Till. of Iho Officer
State of California
County of & yl
personally appeared
Name(s) of Signer( a)
who proved to me on the basis of satisfactory
evidence to be the personss'j' whose name(g) is/a-
subscribed to the within instrument and acknowledged
to me that he/she#hey executed the same in
his/Herteir authorized capacity(ies), and that by
his/I-teeLtf tr signature on the instrument the
person( or the enti y upon behalf of which the
person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand~indofficial seal.
Signature:
Signature of Notary Public
Place Notary Seal andlor Stamp Above
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Document Date: Number f-Pges:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: igner's Name:
D Corporate Officer Title(s): D Corporate Officer Title(s):
a iiGFTfTHUMBPHIM�P
D Individual Dl Individual
D Partner D Limited CI General jp ot thumb here D Partner Limited D General
D Attorney in Fact D Attorney in Fact
D Trustee C Trustee
C: Guardian or Conser for Guardian or Conservator
Other: i Other:
Signer Is Representing: Signer Is Representing.
L----]
MR SIGNER
l!Nt~L,~.C,~'~/SY~'-�~S~fv G'~/J~K=!,C,~CK~J~GS~,.C,~~JK'~i~%CS~~.C+K%f:7~ n~~J~~~~~=lV %Cl~'C�~~JK~V~�~~V~J~~V~!CK~v J~=~v~~.v~!C,~YV~~VY%C+~�C)~S~ti~%G~i~Yii:
2000 National Notari Associations 0350 De bolu Avc-., P.O. ho,: 2402 Chatsworth, Ci�. 91313.2402 wi r.NalionalNotary.org tiers 115907 Reorder. Coll Toll-Fran 1-000.076.6027
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�CALIFORNL4 ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Sacramento
On May 4, 2011 before me, Anitra L. Dum.lao Notary Public------
Here insert name and title of the officer)
personally appeared Christopher J. Angelo------
who proved to me on the basis of satisfactory evidence to be the person/sThose name( rlsYlare subscribed to
the within instrument and acknowledged to me tha~he/she/they e\ecuted the same m:s)/her/their authorized
capacity i and that by(/her/their signature,(s~'on the instrument the personFs7 or the entity upon behalf of
which the person) acted; executed the instrument.
I certify under PENALTY OF PERT[ Y under the laws of the State of California that the foregoing paragraph
is true and correct.
Notary Seal)
ADDITION AL OPTIONAL INFORM TION
DESCRLnTION OF THE ATTACHED DOCUIvIENT
Title or description of attached document)
Title or description of attached document continued)
Number of Pages Document Date
Additional information)
CAPACITY CLABYED BY THE SIGNER
Individual s)
Corporate Officer
Titles
E Partner(s)
D Attorney-in-Fact
Trustee, s)
r Other
INSTRUCTIONS FOR CDIv[PLETING THIS FORM
1ny acknowledgment completed in California must contain verbiage exactly as
appears above in the notane section or a separate aciotowiedgment form must be
properly completed and attached to that document. The oniv exception is it a
document is to be recorded outside of California. In such instances, ant' a/tentative
acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
California i.e. certfving the authorized capacity of the signer). Please check the
document carefully for proper notarial wording and attach this form if required.
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
must also be the same date the acknowledgment is completed.
The notary public must print his or her name as it appear, within In, or her
commission followed by a comma and then your title notar' public).
Pratt the name(s) of document signer(s) who personally appear at the time of
notarization.
Indicate the correct singular or plural forms by crossing- off incorrect forms i.c.
iteishe/t4e�- is rare or circling the correct forms. Failure to correctly indicate this
information may lead to rcicction of document recording.
The notary seal impression must be clear and photographically reproducible.
Impression most not cover text or lines. If seal impression smudgcs, re-seal if it
sufficient area permits, otherwise complete it different acknowledgment form.
Signature of the notary public must match the signature ou file with the office, of
the count'.' clerk.
Additional information is not required but could help to ensure thn
ac(mowiedgment is not misused or attached to it different document.
Indicate title or type of attached document, number of pages and date.
indicate the capacity claimed by the signer If the claimed capacity is it
corporate office:, indicate the titl i.e. CEO, CFO. Secretary).
Securely attach this document to the signed document
91ttw V-6- CA P,\ v I' 10 0? 8,00-2 7 +-065 www.Notar,Classes.com
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
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AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
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THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
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OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its,principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and sea] herein affixed hereby
make, constitute and appoint
Randall L Jorgensen, Joseph H Weber, Christopher J Angelo, Paul F Bystrowski, Carol Dunn,
John E Murphy, Sandi Pullen, Individually
of Sacramento, CA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf
bonds, undertakings and other obligatory instruments of similar nature
In Unlimited Amounts
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed or, the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 3rd day of November, 2006.
WESTERN SURETY COMPANY
Paul Bruflat, Senior Vice President
State of South Dakota
County of Minnehaha
5
ss
On this 3rd day of November, 2006, before me personally came Paul T.-Bruflat, to me known, who, being bv.rne duly sworn, did depose and say: that
he resides in' the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described jr and
which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was
so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires
November 30, 2012
+
D. KRELL
X(SEAL) NOTARY PUBLtrt SEALJJ
SDUTH DAKOTA
J
j'~s~r'+~r r her s`...~rti r~rtitititiM ti.sh +
CERTIFICATE
D. Krell, Noiarv Public
I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By-Law of the corporation printed on the reverse hereof is still in force.
my name and affixed the seal of the said corporation this 4t rt day of May 2011
In testimony whereof I have hereunto subscribed
WESTERN SURETY COMPANY"
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�Authorizing By-Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obiigations.of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�Bond Number: 929519948
Premium: $4,816.00
COUNTY OF MONTEREY
PERFORMANCE BOND
WHEREAS, the County of Monterey has awarded to Principal, Telfer oil Company as
Contractor, a contract for the following project:
PROCUREMENT DELIVERY and APPLICATION) of ASPHALT EMULSION for the
SEAL COAT 2010 PROJECT
CONTRACT NO. 11-551120
WHEREAS, Principal, as Contractor, is required to furnish a bond in connection with said
contract, to secure the faithful performance of said contract.
NOW, THEREFORE, we Telfer Oil Company as Principal, and
Western Surety Company
as Surety, are held and firmly bound
unto the County of Monterey, a political subdivision of the State of California hereinafter called
County"), in the penal sum of Ninety HSidrandT 6/ 1 T 00udal ld arsve_Hundred for the payment of
which sum in lawful money of the United States, well and truly to be made, we bind ourselves, our
heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents,
THE CONDITION OF THIS OBLIGATION IS SUCH THAT:
If the Principal, as Contractor, or Principal's heirs, executors, administrators, successors, or assigns,
1) shall in all things stand to and abide by and well and truly keep and perform the covenants,
conditions, and agreements in said contract and any alteration thereof made as therein provided, on
Principal's part to be kept and performed,. at the time and in the manner therein specified and in all
respects according to their true intent and meaning, and 2) shall defend, indemnify and save harmless
the County, the members of its board of supervisors, and its officers, agents and employees as therein
stipulated, then this obligation shall become null and void; otherwise, it shall be and remain in full
force and virtue,
Surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the
terms of the contract on the call for bids, or to the work to be performed thereunder, or the
specifications accompanying the same, shall in any way affect its obligation under this bond, and it
does hereby waive notice of arty such change, extension of time, alteration or addition to the terms of
said contract or the call for bids, or to the work, or to the specifications,
Whenever the Principal, as Contractor, is in default, and is declared in default, under the contract
by the County of Monterey, the County of Monterey having performed its obligation under the
contract, Surety may promptly remedy the default, or shall promptly:
1) Complete the contract in accordance with its terms or conditions, or
2) Obtain a bit] or bids for submission to County of Monterey for completing the contract
in accordance with its terms or conditions, and upon determination by County of
Monterey and Surety of the lowest responsible and responsive bidder, arrange for a
contract between such bidder and County of Monterey, and make available as wort:
progresses even though there should be a default or a succession of defaults under the
contract or contracts of completion arranged under this paragraph) sufficient funds to
pay the cost of completion less the balance of contract price.
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�If suit is brought upon this bond by the County and judgment is recovered, the Surety shall pay
all litigation expenses incurred by the County in such suit, including court costs, expert witness fees
and investigation expenses,
IN WITNESS WHEREOF, the above-bounden parties have executed this instrument under their
several seals this 4th day of May 20_1 1 the name and corporate seal of
each corporate party being hereto affixed and these presents duly signed by its undersigned
representative, pursuant to authority of its governing body,
Corporate Seal)
Corporate Seal)
Telfer Oil Company
Principal
By
Name and Title,nUV~~C~tkCt /I
YF' 1U I~tr~a~~~1~ Ne/u 1 u~
l
Surety
Comp y
an
Nameand Title Christopher J. Angelo, Attorney-in-Fact
Attach notary acknowledgment for all signatures and attorney-in-fact certificate for signature by
surety's representative,)
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb�"�CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
On 1~'la 1 D~~ before me, / IA) g) J T 4 1//< / ll/~ G,1 G
Dale Here Insert Name and Title el the Officer
personally appeared 4
Name(s) of Signer(s)
State of California
County of 04,r;~'k
DANIEL I. FNMINIEL
CommissIon S 1190291
Notary'Pubtic CNNonWa
Contra Costa County
who proved to me on the basis of satisfactory
evidence to be the persons)' whose namee is/are-
subscribed to the within instrument and acknowledged
to me that he/she/they executed the same in
his/her/their authorized capacityfiesj' and that by
his/l4erfthrefr signature on the instrument the
person(,~'j, or the entity upon behalf of which the
perso e 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.
Signature:
Place Notary Seal and/or Stamp Above
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
O Corporate Officer Title(s):
Individual
D Partner E] Limited D General/
Attorney in Fact
Trustee
Li Guardian or Conservator
D Other:
Signer's Name:
D Corporate Officer- Title(s):
J Individual
D Partner Limited General
L: Attorney in Fact
Trustee
D Guardian or Conservator
Other:
IGHTTHUMBPRINT
OFIIGNER
SJ
7/0'~<�,'~.CSC.SWn~U'<-N"Uut"c?,~.~uSC./�u~v,;p~,ESC%C)cat %.~?'
0 2000 National Notary Association 9350 De Solo Ave., P.O. box 2402 Cnaiswodi 1, CA 91 31 3-24 02 www.Nationaii Olcrv.org llem 115907 Reoroor. Cal; Teli-Fiee 1-900.076.6027
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
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EXECUTED AGREEMENT"�|Eb�"�CALIFORNIA ALL-PURPOSE
CERTIFICATE OF AC NOWLEDG NT
State of California
County of Sacramento
On May 4, 2011 before me, Anitra L. Dumlao Votary Public------
Here insert name and title of the officer)
personally appeared Christopher J. Angelo------
who proved to me on the basis of satisfactory evident to be the person(s)whose name;. j7is/are subscribed to
the within instrument and acknowledged to me thafld/she/they executed the same in lugs'/1 er/their authorized
capacit~and that bye%her/their signature(s) on the instrument the persorl or the entity upon behalf of
which the person s*)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.
K tVITNESSIy nd and official seal.
Notary Seal)
Signature of Notary Public
W
C~wM11~ F iMMOE
tMf~111~ cum
oeWc. y"ra,oa t, lots
ADDITIONAL OPTIONAL INFORMATION
INSTRUCTIONS FOR COIvIPLETING THIS FORM
dny acknowledgment completed in California must contain verbiage exactly as
DESCRIPTION OF THE ATTAC.ITSD DOCUMENT appears above in the notary section or a separate acknowledgment jorm must be
properly completed and attached to that document, The only exception is if a
document is to be recorded outside of California. In such instances, any alternative
acknowledgment verbiage as may be printed on such a document so long as the
Title or description of attached document) verbiage does not require the notary to do something that is illegal for a notary in
California i.e. certifying the authorized capacity' of the signer), Please check the
document carefullyjot' proaer notarial wording and attach this form if required.
Title or description of attached document continued)
Number of Pages Document Date
Additional information)
CAPACITY C';_-;%E EL) BY THE SIGNER
D Individual s)
D Corporate Office;
I nine)
D Partner(s)
D Attorney-in-Fact
U Trustee(s
Other
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
must also be the same date the acknowledgment is completed.
The notary public must print his or her name as it appear; within his or her
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.
R Indicate the correct singular or plural forms by crossing. off incorrect forms i.e.
heishe/they- is tare or circling the correct forms. Faiiure to correctly indicate this
information may lead to rejection of document recording.
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
sufficient area permits, otherwise complete a different aclcnowlcdement form.
Siinnature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure du
acknowledgment is not misused or attached to a eliffcrent document.
Indicate title or type of attached document, number of page:; and date.
Indicate the capacity claimed he this signer. I the claimed capacity is a
corporate officer, indicate the title i.e. CEO, CFO. Secretary).
Securely attach flue document to the sinned document
r e o., n n Q11( vim not.; I----
BIB]
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EXECUTED-U02
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EXECUTED AGREEMENT"�|Eb�"�Western Suety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux FaUs,,.and State of South Dakota, and. that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Randall L Jorgensen, Joseph B Weber, Christopher J Angelo, Paul F Bystrowski, Carol Dunn,
John E Murphy, Sandi Pullen, individually
of Sacramento, CA, its true and.lawful Attorney(s)-in-Fact with full power and.authority hereby conferred to sign, seal and execute for and on its behalf
bonds, undertakings and other obligatory instruments of similar nature
In Unlimited Amounts
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the revere hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 3rd day of November, 2006.
WESTERN SURETY COMPANY
State of South Dakota
County of Minnehaha
On this 3rd day of November, 2006, before me personally came Paul T._Bruflat, to me known, who, being by.me.duly sworn, did depose and say: that
he resides in' the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and
which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was
so affixed pursuant to authority given by the Board of Director, of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires
November 30, 2012
i
D. KRELL j
i SS AL1 NOTARY PUBLIC SEAL
JJSOUTH DAKOTAi
+~r�r'+'+h`rM s r4~r titi.sMti ti~s~+hti`i +
CERTIFICATE
D. Krell, Not`arv Public
I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Pow- of Attorney hereinabove set forth is still in
force, and further certify that the By-Law of the corporation printed on the reverse hereof is still in force.
my name and affixed the seal of the said corporation this 4th day of May 2011.
In testimony whereof 1 have hereunto subscribed
WESTERN SURETY COMPANY
L. Nelson. Assistant
Secretary
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EXECUTED AGREEMENT"�|Eb�"�Authorizing By-Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders
cf the Company.
Section 7. All bonds, policies. undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations.of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
BIB]
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ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
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EXECUTED AGREEMENT"�|Eb�"�DATE MM/ODNYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/05/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER LTC #0660864 1-925-671-5110
Argo Insurance Group, Inc.
2300 Contra Costa Blvd
Suite 375
Pleasant Hill, CA 94523
INSURED
Telfer Oil Company
PD Box 709
Martinez, CA 94553
COVERAGES
CERTIFICATE NUMBER: 21073176
CONTACT Liz Boehmer
NAME:
PHONE
AIC No Exi) 925-852-0401
E-MAIL
ADDRESS: Lizb@argoineurance.corn
PRODUCER
CUSTOMER ID #:
INSURER(S) AFFORDING COVERAGE
INSURER A LIBERTY NUT FIRE INS CO
INSURER B: GREAT AMER INS CO
INSURER C
INSURER D
INSURER E
INSURER F
REVISION NUMBER:
NAIC #
23035
16691
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP
POLICY NUMBER MMIDD/YYYY MM/DD/YYYY
LIMITS
A GENERAL LIABILITY X I TB2661036901031 02/01/1 02/01/12 EACH OCCURRENCE S 1,000,000
I
X
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Eeoccurrence) 100,000
CLAIMS-MADE I JOCCUR MED EXP Any one person) S 5 000
PERSONAL&AOVINJURY S 1, DO, 000
GENERAL AGGREGATE is 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG S 2,000,00D
POLICY hPRO- I I LOC S
A AUT OMOBILE LIABILITY X A57661036901051 02/01/1 1 02/01/12 COMBINED SINGLE LIMIT 2,000,000
Es accident)
X ANY AUTO
BODILY INJURY Per person) $
ALL OWNED AUTOS
BODILY INJURY Per accident) S
SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS S
Per accident)
NON-OWNED AUTOS S
S
B UMBRELLALIAB OCCUR TUU033259302 02/01/11 02/01/121 EACH OCCURRENCE S 1,000,000
EXCESS LIAR CLAIMS-MADE AGGREGATE 1, 000, 000
DEDUCTIBLE
RETENTION c 10, 000
A WORKERS COMPENSATION WC2661036901111 02/01/1 02/01/12 U
WCYT
0TH-
AND EMPLOYERS' LIABILITY I
S
YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
N
N/A E.L. EACH ACCIDENT 5 1 000 00 0
OFFICERJMEMBER EXCLUDED?
Mandatory in NH) E.L. DISEASE EA EMPLOYEE S 1, 000, 000
II yes, describe under
DESCRIPTION OF OPERATIONS bolos, E.L. DISEASE POLICY LIMIT S 1, U00, 000
DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES Attach ACORD 101, Additional Remarks Schedule, If more space is required)
County of Monterey, their officers, agents, and employees are Additional Insureds per the language provided in the
attached LN2001 0605 & CA2048 0299.
A.M. Best rating: A++YtV RE Project: Procurement Delivery and Application) of Asphalt Emulsion For the Seal Coat
2010 Project Contract 1111-551120
Primary wording applies per the language provided in the attached CG0001. 1207.
Waiver of Subrogation applies to General Liability, Auto & Workers Comp per the attached CG2404, AX1210 & W0040306.
***30 day notice of cancellation except 10 days for non-payment of premium.***
CERTIFICATE HOLDER CANCELLATION
Contract 411-551120
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Monterey County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Department of Public Works ACCORDANCE WITH THE POLICY PROVISIONS.
160 West Alisal Street
2nd Floor
AUTHORIZED REPRESENTATIVE
Salinas, CA 93901
USA
LC No): 925-85.2-0451
LMazza 011986-2009 ACORD CORPORATION. All rights reserved.
ACDRD 25 2009/09) The ACDRD name and logo are registered marks of ACDRD
21073176
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EXECUTED AGREEMENT"�|Eb�"�I15 6 2 01 0 0111 6 1 1)00033
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,
J,A.NKET ADDITIONAL INSURED
This endorsement modifies insurance provided under the following.
CO\f\fERCIAL GENERAL LIABILITY COVERAGE FOR1
SECTION 11 WHO IS AN INSUREt) is amended to uteludc as an insured any person or organization for whom you havt
agreed in writing to provide liability insurance. But:
The insurance provided by this amendment.
1 Applies only to bodily injury" or property damage" arising out of a) your work" or b) premises or other property owned
by or rented to you;
2 Applies only to coverage and nununtun brats of insurance required by the wnttCn agreement, but in no event exceeds either
the scope of coverage or the lusts of insurance provided by this policy, and
3 Does not apply to any person or organization for whom you have procured separate liability insurance while. such insurance is
to effect, regardless of whether the scope of coverage or limits of insurance of this policy exceed those. of such other insurance
or whether such other insurance is valid and collectible.
The followutg provisions also apply:
1 Where the.applicsble written agreement requires the insured to provide liability insurance on a primary, excess, contingent, or
any other basis,.tlus policy will apply solely on the basis required by such xTitttri agreement and item 4. Other insurance of
SECTION IV of this policy will not apply.
2 Where the applicable written agreernenr does not specify on what basis the liability Insurance will apply, the provisions of 1 ttxn
4 Other Insurance of SECTION TV of this policy will govern.
3 This endorsement shall not apply to any person or orgaruzauon for any bodily injury' or props rry damage" if any other
additional insured endorsement on this policy applies to that person or organization with regard to the bodily uyury" or
1, propcrny damage".
4. If any other additional insured endorsement applies to any person or orga_n+zaaon and you arc obligated under e written
agreement to provide liability insurance on primary, excess, conangcnt, or any other basis for that additional insured, this
policy will apply solely on the basis required by such written agreement and Item 4. Other Insurance of SECTION ITV of this
policy will not apply, regardless of whether the person or organization has available other valid and collectible instuance if
the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Item A
Other Insurance of SECTION rV of thin policy will govern
t'nth endorsement lac>cruicdby the LIBERTY MUTUAL FIRE INSURANCE COMPANY
Prvtnium S
Effective Drtt 1. /201 Expuarion Dote 2/ 1-/ 01 7
I on arncivnrni to Pobry Ne TB~?-661 035901. 031
Audit bull
hrucd To Telfer Oil Company, A Partnership
of Telfer Tank Lines, Inc., &
Teller Enterprises, Inc. and as
per Endorsement 111.
cream ns
PRESIDE
Countervgncd by
bared auk; Of lien and We,
LN 2h 0106 05
Aualullird ktprcwluorc
End bcrisl Nc
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
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SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb� "�flasl lvallahk Image 06201 Q0DJ 6J 0000011
Named Insured Schedule
Asphalt Service Company, Inc.
Mulberry Land Co., LLC
Continental Western Transportation Co., Inc.
Telfer Highway Technologies, LLC
Telfer Oil Company 401K & Profit Sharing Plan
Continental Western 401h & Profit Sharing Plan
DBA's:
Western Oil & Spreading
Windsor Fuel Company
Telfer Geosynthetics
Telfer Geosynthetics DBA California Paving Fabrics
For Attaclvncnt to
Pohcy: TB2-661-036901-031 Pugs to End. i
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb� "�I
056201000161000049
WAEVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL. GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization: Any person or organization with whom you have agreed in writing to waive
any right of recovery prior to a loss.
Information required to complete this Schedule, if not shown above, will be shown In the Declarations
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV Conditions:
We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
your work" done under a contract with that person
or organization and included in the products-
completed operations hazard". This waiver applies
only to the person or organization shown in the
Schedule above.
J'tus cndor+crrani csccutcd Ir� the LIBERTY 1AU'1'UAI, FIRE INSURANCE CUMPAKY
1'rerruum I
Jfiecdrt rate 2 / 1 / 2011 Expiration Dutc 2 1~ 2 C) 1 L
Eoi aoachmtnt to Puhcy I' TE 2-661-03690 1-0 3 1
Audi Basis
Issued'It
Counien,igncd by
Is.ued Sales Office *ilia No
2
SECJtC'ihity
P P.ISIUEi: i
hwtiwnrrd ikoreunnuvc
Enc. Scnul No.
CG 24 04 05 OP * Insurance Services Office. Inc� 2008 Page f of 1
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb� "�116112 t i n 911 e2555 o f I I l H 6
3) The nature and location of any injury or
damage arising out of the occurrence" or
offense,
b, it to claim is made or suit" Is brought against
any insured, you must:
1) Immediately record the specifies of the
claim or Bull" and the date received; and
2) Notify us as Soon as practicable.
You must see to It that we receive written no-
tice of the claim or Bull- as soon as practica-
hle,
c. You and any other Involved insured must:
1) Immediately send us copies of any de-
mands, notices, summonses or logo! pa-
pers received In connection with the claim
or suit";
2) Authorize us to obtain records and other
3)
information;
Cooperate with us in the investigation or
settlement of the claim or defense against
the stilt'; and
4) Assist us, upon our request, in the en-
orcemenl of any right against any person
or organization which may be liable to the
insured because of injury or damage to
which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.
3. Legal Action Against Us
No person o; organization has a nght under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a suit" asking for damages from an Insured; or
b. To sue us on this Coverage Part unless all of
Its terms have been fully complied with.
A person or organization may sue us to recover on
an spread settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Pan or that are in excess of the ap-
plicable limit of insurance. An agreed settlement
moans a settlement and release of liability signed
by us, the insured and the claimant or the claim.
ant's legal representative.
4,
Other Insurance
If other valid and cotlecllblo insurance is available
to the insured for a loss we cover under Cover-
ages A or 17 of this'Coverage Part, our obligations
are limiter) as follows:
a. Primary Insurance
This Insurance Is primary except when Para-
graph b. botow applies. If this Insurance is pri-
mary, our obligations are not affected unless
any of the other Insurance is also primary.
Then, we will share wiih all that other insur-
ance by the method described In Paragraph c.
below.
b. Excess Insurance
1) This insurance is excess over;
a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
i) Thai is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for your wort,";
it) Thai is Fire insurance for premises
rented In you or temporarily occu-
pied by you with permission of the
owner;
111) That is Insurance purchased by you
to cover your liability as a tenant for
property damage" to premises
rented to you or temporarily occu-
pied by you with permission of the
owner; or
iv) If the loss arises out of the mainte-
nance or use of aircraft, autos' or
watercraft to the extent not subject to
Exclusion g. of Section I Coverage
A Bodily Injury And Property Dam-
age Liability.
b) Any other primary insurance available to
you covering liability for damages erie-
Ing out of the, premises or operations, or
the products and completed operations,
for which you have bean added as an
additional insured by attachment of an
endorsement.
2) When this insurance is excess, we will have
no duty under Coverages A or 13 to defend
the Insured against any suit' if any other
insurer has a duly to defend the insured
against that sull". II no other insurer de-
lends, we will undenaKe to do so, but we
will be entitled to the insured's rights
against all hose other insurers.
CG 00 01 12 07 ter ISO Properties, Inc., 2000 Pago 11 of 16
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb� "�THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY
MOVER OF TRANSFER, OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
Business Auto Coverage Form
Garage Coverage Form
Truckers Coverage Form
Motor Carrier Coverage Form
Premium: INCL
SCHEDULE
Name of Person or Organization:
Any person or organization for whom you perform work under a written contract if the contract requires
you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage
occurring.
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US condition is amended by the
addition of the following:
We waive any right of recovery we may have against the person or organization shown in the Schedule
above because of payments we make for injury or damage arising out of your operations of a covered auto
done under contract with that person or organization. This waiver applies only to the person or organization
shown in the Schedule above.
Policy No: AS7-661-036901-051
Effective Date: 2/1!2011
Expiration Date: 2/1/20'2
Sales Office: 0395
Issued By. Li oe_"_y nsurance Corr,
Endt SeC'~. e Nc
AY 1'100205B Page Iof1
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
CHANGE-U012
ORDERS-U012
TO-U012
THE-U012
CONTRACT-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Eb� "�THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIIGNATED ENSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by,this endorsement, the provisions of the Coverage Form apply unless modi-
fied by this endorsement.
This endorsement identifies person(s) or organization(s) who are insureds" under the Who Is An Insured Provi-
sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name of Person(s) or Organization(s):
Any person or organization whom you have agreed in writing to add as an additional insured, but only to
coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either
the scope of coverage or the limits of insurance provided in this policy.
If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to the endorsement.)
Each person or organization shown in the Schedule is an insured" for Liability Coverage, but only to the extent
that person or organization qualifies as an insured" under the Who Is An Insured Provision contained
in Section II of the Coverage Form.
Policy No: AS7-661-03690]-051
Effective Date. 2/01/2011
Expiration Date: 2/01/2012
Sales Office: 0395
Issued By L berry 7risu2-ar,ce Corp.
Erjdt Sofa Igo:
CA 20 415 02 99 Copyright, Insurance Services Office, Iric., 1998 Page 1 of I
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
A.-U07
AWARD-U07
A-U07
CONTRACT-U07
TO-U07
TELFER-U07
OIL-U07
COMPANY,-U07
THE-U07
LOWEST-U07
RESPONSIBLE-U07
BASE-U07
BIDDER,-U07
THE-U07
PROCUREMENT-U07
DELIVERY-U07
300-PUBLIC-U08
WORKS-U08
PENA-U09
RUBY-U09
PENAR-U10
5/16/2011-U011
APPLICATION)-U012
OF-U012
ASPHALT-U012
EMULSION-U012
THE-U012
SEAL-U012
COAT-U012
2010-U012
PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
PERFORMANCE-U012
PAYMENT-U012
BONDS-U012
EXECUTED-U012
PROVIDED-U012
BY-U012
TELFER-U012
OIL-U012
COMPANY;-U012
C.-U012
AUTHORIZE-U012
A-U012
CONTINGENCY-U012
NOT-U012
TO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
CONTRACT-U012
AMOUNT)-U012
TO-U012
PROVIDE-U012
FUNDING-U012
APPROVED-U012
CONTRACT-U012
CHANGE-U012
ORDERS;-U012
D.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
PUBLIC-U012
WORKS-U012
TO-U012
EXECUTE-U012
THE-U012
CONTRACT-U012
SUBJECT-U012
TO-U012
THE-U012
TERMS-U012
OF-U012
THE-U012
PUBLIC-U012
CONTRACT-U012
CODE,-U012
APPROVE-U012
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EXECUTED AGREEMENT"�|Eb�!"�WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA
This endorsement changes the policy to which it is attached effective on inception date of the policy unless
a different date is indicated below.
The following attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective 12:01 AM 02/01/11 forms a part of Policy No. W02661036901111
Issued to: Telfer oil Company
By: LIBERTY MUT FIRE INS CO
Premium: INCL
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will
not enforce our right against the person or organization named in the Schedule. This agreement applies
only to the extent that you perform work under a written contract that requires you to obtain this agreement
from us).
You must maintain payroll records accurately segregating the remuneration of your employees while
engaged in the work described in the Schedule.
The additional premium for this endorsement shall he 5% of the California workers' compensation
premium otherwise due on such remuneration.
Schedule
Person or Organization
County of Monterey, their officers, agents and employees
Job Description
RE Project: Procurement Delivery and Application) of Asphalt Emulsion For the Sea Coat 2010
Project Contract #11-551120
WC 04 03 06
Ed. 4-84)
BIB]
40953-U01
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LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99824-U03
AI102149-U03
DO109664-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16548-U05
3-U06
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CONTRACT-U07
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300-PUBLIC-U08
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RUBY-U09
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5/16/2011-U011
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OF-U012
ASPHALT-U012
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THE-U012
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COAT-U012
2010-U012
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CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
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AMOUNT-U012
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$702,596.66;-U012
B. APPROVE-U012
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BONDS-U012
EXECUTED-U012
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EXECUTED AGREEMENT"�|Eb�""�s
Legend
SEAL COAT 2010 ROADS
MONTEREY COUNTY ROADS
STOCKPILE LOCATION
LOCATION MAP AND ROAD LIST
PROCUREMENT DELIVERY AND APPLICATION) OF ASPHALT EMULSION FOR THE SEAL
COAT 2010 PROJECT
CONTRACT NO. 11 551120)
ROAD NAME LIMITS
DAVIS ROAD RESERVATION ROAD TO BLANCO ROAD
COOPER ROAD BLANCO ROAD TO NASHUA ROAD
RESERVATION ROAD HWY 68 TO BLANCO ROAD
WILD HORSE CANYON ROAD CATTLEMEN ROAD TO END
OASIS ROAD SAN LUCAS ROAD TO LOCKWOOD-SAN LUCAS ROAD
SAN LUCAS ROAD JOLON ROAD TO OASIS ROAD
PANCHORICO ROAD SC 2009 LIMITS TO END
PARIS VALLEY ROAD INTERSECTION LOCKWOOD SAN LUCAS TO END
LOCKWOOD SAN LUCAS ROAD HWY 101 RAMP TO 2 MILES SOUTHEAST
BIB]
40953-U01
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LI21329-U03
FO96183-U03
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FO99716-U03
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2/13/2012-U04
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A.-U07
AWARD-U07
A-U07
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SEAL-U012
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PROJECT,-U012
CONTRACT-U012
NO.-U012
11-551120;-U012
IN-U012
THE-U012
TOTAL-U012
AMOUNT-U012
OF-U012
$702,596.66;-U012
B. APPROVE-U012
THE-U012
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PAYMENT-U012
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EXECUTED-U012
PROVIDED-U012
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