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1983-0705_POWA - ROOTER_Agreement• • "CITY COPY" A G R E E M E N T CITY OF SAN JUAN CAPISTRANO THIS AGREEMENT, made and entered into this Sth day of July , 1983, by and between the City of San Juan Capistrano, a Municipal Corporation, hereinafter referred to as "CITY" and hereinafter referred to as "CONTRACTOR". W I T N E S S E T H: WHEREAS, CITY requires maintenance and emergency services for its sewerlines; and WHEREAS, CONTRACTOR is capable of providing such services. NOW, THEREFORE, in consideration of the promises hereinafter contained, CITY and CONTRACTOR agree as follows: I. CONTRACTOR'S PERFORMANCE A. CONTRACTOR shall, upon direction of the Department of Public Works/or other designated personnel, furnish all tools, equipment, apparatus, facilities, labor and materials necessary to clean CITY's sewerlines. All such work and services shall be performed by CONTRACTOR, as an independent contractor, in a good and workmanlike manner and shall at all times be subject to the inspection and approval of the Department of Public Works. B. Except as otherwise directed by the CITY, CONTRACTOR shall utilize the hydraulic and/or vacuum method of cleaning, using all necessary tools, and shall remove and dispose of all debris at such place as may be designated by the Director of Public Works. C. CONTRACTOR shall provide a twenty-four hour emergency service capable of procedures of maintenance necessary to keep the sewerlines in operation. D. CONTRACTOR shall provide a daily report in triplicate for approval by the Department of Public Works. The original to be maintained by the Department of Public Works, the approved duplicate to be included with the CONTRACTOR's billing at the end of the month. 0 0 E. CONTRACTOR shall include in each daily report the conditions encountered, the nature and extent of all emergency services performed and recommendation for improvement. F. CONTRACTOR shall in all its operations, take all necessary precautions that are called for under the circumstances of each cleaning operation and so as not to obstruct unnecessarily, hinder or endanger the surface use of any streets. CONTRACTOR shall keep and hold CITY free and harmless from any and all liability which may arise from the conduct of its operation and shall keep and maintain the following minimum insurance coverage showing the CITY as an additional insured: 1) Public Liability and Property Damage, including all vehicles used in the performance of this agreement, in the amount of $500,000.00 for injuries, including accidental death, for any one person, $500,000.00 for any one accident and $500,000.00 for property damage. Statutory coverage B, $500,000.00 - Aggregate $1,000,000.00. 2) Workmen's Compensation coverage for all of its employees. All of the aforesaid insurance shall be written on companies approved by the CITY and shall be cancellable only upon ten (10) days written notice to the CITY. If the CONTRACTOR fails to maintain such insurance, the CITY may obtain such insurance and deduct and retain the amount of the premiums for such insurance from any sums due under this agreement. If the CONTRACTOR should neglect to prosecute the work properly or fail to perform any provisions of the agreement, the CITY, after three (3) days written notice to the CONTRACTOR, may, without prejudice to any other remedy it may have, make good such deficiencies, and may deduct the cost thereof from the payment then or thereafter due the CONTRACTOR. -2- t • II. CITY'S PAYMENT CITY shall pay the CONTRACTOR and the CONTRACTOR agrees to accept in full satisfaction, therefore, the unit price of $.0849 ( ) per lineal foot for sewer cleaning. Emergency services will be performed per hour, first two hours $ 160 charge and per hour, for each hour after $ 60 Excavation, materials, time and labor will be identified as an additional charge dependent on scope of repair necessary and at CITY's approval before proceeding, in the event of an emergency. THIS AGREEMENT may be renewed for an additional one (1) year period upon such terms and conditions as may be mutually agreeable to the parties. In the case of any renewal, each and every term and conditions of this agreement shall apply to the performance of the work specified herein during the effective period of such renewal. In the event of escalating costs being experienced by the CONTRACTOR, these costs will not change the provisions of costs as stated in Paragraph II, Line 3 on Page 3 without negotiation and written approval by the City of San Juan Capistrano. III. TERMINATION Either party may terminate this agreement without prejudice or penalty by serving written notice of intent, thirty (30) days in advance, on the other party at the following addresses: CITY OF: San Juan Capistrano Steeet: 32400 Paseo Adelanto City: San Juan Capistrano State: California 92675 Company: Powa-Rooter Sewer 4 Drain Service, Inc. Street: P. 0. Box 1770 City: Santa Ana, State: California 92702 -3- 0 It is hereby understood that this agreement shall terminate on the 30th day of June, 1984. IN WITNESS WHEREOF, the City Council of the City of San Juan Capistrano caused this agreement to be subscribed by its Mayor and City Clerk and said CONTRACTOR has executed or caused this agreement to be executed by his duly authorized officer. CITY OF SAN JUAN CAPISTRANO By Z� z(' L � ANTHONY /BLAND, MAYOR ATTEST: �' ' MARY ANN ANOVER, CITY CLERK POWA-ROOTER SEWER $ DRAIN SERVICc, INC. 0 By, APPROVED AS TO FORM: , O-A� n�. ES S. OKAZAKI, CI ATTORNEY U BIDS, CONTRACTS, AGREEMENTS 0 SEWERLINE MAINTENANCE (38) Written Communications: (80) Report dated July 5, 1983, from the Director of Public Works, forwarding results of the bid opening held on June 27th for the maintenance of City sewerlines. Award of Contract: It was moved by Councilman Schwartze, seconded by Councilman Friess and unanimously carried to determine the bids to be complete and to award the contract for City sewerline maintenance to the low responsible bidder, Powa-Rooter, of Santa Ana, in the amount of $0.0849 per square foot. The Mayor and City Clerk were authorized to execute the document on behalf of the City. AGENDA ITEM July 5, 1983 TO: Stephen B. Julian, City Manager FROM: W. D. Murphy, Director of Public Works SUBJECT: Award of Contract - Sanitary Sewerline Maintenance RTTTTATTON As per City Council direction, bids for the maintenance of City sewerlines were advertised for and received. The June 27th opening was held at 2:00 p.m. with the following results: Powa-Rooter $.0849 per sq. ft. Pacific Sewer Maintenance .089 " Rodding & Cleaning Services .12 " All bids were reviewed and determined as complete. Powa-Rooter, the low bidder, has done work for the City before and it has been in a satisfactory manner. BOARD/COMMISSION REVIEW RECOMMENDATION Not applicable. FINANCIAL CONSIDERATIONS The costs for providing this contractual service has been allocated in the 1983-84 budget. It is aproximately $10,000 and will be assessed the Maintenance Specialized Services Public Works account. ALTERNATE ACTIONS 1. Determine the bids as complete and award the City's sewerline maintenance contract to Powa-Rooter. 2. Do not award the sewerline maintenance contract. 3. Refer to staff for further information. RECOMMENDATION By motion, determine the bids to be complete and award the contract for City sewerline maintenance to the low responsible bidder, Powa-Rooter in the amount of $.0849 per sq. ft. Authorize the Mayor and City Clerk to execute the document. This service is authorized in the Specialized Services Acct. #01-4440-213. Respectfully submitted, W. D. Murphy rR CITY COUNCIL AGENOA / WDM:CSF/rem 0 P.M. (PROJECT TITLE) BIDDER AMBID UNT BONE ,V IT -Z ArS F 7 Lf? D � /,tJ � �� .viN r' cf�e-dig-� • / Z �/u� Ld'd cc: City Clerk's Staff (3) Public Works (3) 1 n u PROPOSAL SCHEDULE F- 1 L-A FOR SANITARY SEWERLINE MAINTENANCE ITEM 1. Sewerline Cleaning Per Lineal Foot 2. Emergency Sewerline Cleaning Unit Price Per Hour First Two Hours Per Hour For Each Hour After .0849 $160.00 $60.00 Per Sanitary Sewerline Maintenance Specifications, dated June, 1983 attached hereto. The undersigned, as bidder, declares that he has carefully examined the Agreement, Proposal Schedule, Notice Inviting Bids, and hereby proposes and agrees, if the proposal is accepted, to provide all necessary labor, machinery, tools, equipment and all other utility and transportation services required to perform the sewerline maintenance services as expressed in the Agreement accompanying this proposal. 1 S ATUR OF BIDDER 308584 LICENSE NUMBER Powa-Rooter Sewer & Drain Service, Incorporated P.O. Box 1770 Santa Ana, CA 92702 714-839-3900 0 0 SANITARY SEWERLINE MAINTENANCE SPECIFICATIONS JUNE, 1983 SCOPE OF WORK The work covered by these specifications consists of furnishing all materials, labor, supervision, equipment and performing all work necessary for the cleaning of the City's sewer mains. 1. Clean the sanitary sewer system of the City as designated by and to the satisfaction of the Superintendent of Maintenance. 2. Perform 24 hour emergency service, 365 days a year with reference to said system. 3. Upon request of the City, clean known trouble spots as often as necessary. 4. Upon request of the City, furnish the labor and equipment for raising and lowering manholes to grade, or any other minor construction pertinent to good sewer maintenance and operation. 5. In performing the work identified in Paragraph 1, Contractor shall ball the system unless otherwise directed by the Maintenance Superintendent. On all cleaning operations where the flow is not sufficient to clean, the City will furnish the necessary water. 6. To use the hydraulic method of sewer cleaning using a restrained ball or cone to remove sand, eggshells, and other debris at each manhole; and to remove and dump said material at a location approved by the City. 7. To prepare and submit to the City a complete monthly report of its entire cleaning operations within the City for the preceding month, and to make any recommendations it may deem advisable for improvements in the City sewer system after cleaning operations have been completed. 8. To maintain an adequate crew of experienced employees to perform the service required. 9. To maintain all sewer maintenance cleaning equipment and safety equipment as may be necessary to perform the work. 10. To at all times carry and keep in force general liablity insurance and automobile liability in the amount of $4,000,000 naming the City as additional insured. 11. To at all times carry and keep in force Workmen's Compensation Insurance as may be required by law. 12. The City has 58.6 miles of public sewerlines within its system. While cleaning of the entire system is not anticipated, portions of major sections, as well as spot maintenance will be required. PROOF OF PUBRATION (2015.5 C.C.P.) STATE OF CALIFORNIA, County of Orange City of San Clemente I am a citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the above -entitled matter. I am the principal clerk of the printer of the San Clemente Sun -Post a newspaper of general circulation printed and published ..... daily ............. .................................... in the City of San Clemente County of Orange, and which newspaper has been adjudged a newspaper of general circulation by the Superior Court of the County of Orange, State of California under the date of March 11, left Case Number A9140; that the notice, of which the annexed is a printed copy (set in type not smaller than nonpareil), has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, to -wit: Jurle... 1.5.1...Alld.. 22 all in the year 19A.3 I certify (or declare) under penalty of perjury that the foregoing is true and correct. Dated at San Clemente, California, this 22nd June of ..... e------.. • ....... 19_53..... Signature SAN CLEMENTE PUBLISHING CORP. 1542 North El Camino Real - P.O. Box 367 San Clemente, Calif. 92672 - Phone 714-492-5121 This spad for the County Clerk's Filing Stamp RECEIVED Jura 17 a os PM '03 CiT' 'h DEPi,�7M-N{ CITY OF 'IJ JUAN CANST'RANO Proof of Publication of Notice inviting Bids ....................................................................._....._......... 0 0 NOTICE OF TRANSMITTAL - LEGAL PUBLICATIONS TO: DAILY SUN -POST Donna Harrison, Legal FOR PUBLICATION ON: WEDNESDAY, JUNE 15, 1983 and WEDNESDAY, JUNE 22, 1983 DOCUMENT(S) TO BE PUBLISHED: NOTICE INVITING BIDS - SANITARY SEWERLINE MAINTENANCE PROOF OF PUBLICATION: Please send to: City Clerk's Department City Hall 32400 Paseo Adelanto San Juan Capistrano, CA 92675 AUTHORIZED BY• DATE: June 10, 1983 Date of Bid Opening Date(s) notice published Date affidavit received Date notice posted in designated posting places (3) Date notice(s) posted on property Date of mailing notices to property owners - 6/27/83 - 6/15/83 & 6/22/83 - 6/15/83 �G�io�83✓� - n/a - n/a NOTICE INVITING BIDS SANITARY SEWERLINE MAINTENANCE Notice is hereby given that the City of San Juan Capistrano will receive sealed proposals or bids for sanitary sewerline maintenance until 2:00 P.M. on the 27th day of June, 1983. Copies of Specifications may be obtained at the Office of the City Clerk of San Juan Capistrano, 32400 Paseo Adelanto, San Juan Capistrano, California. Dated: June 10, 1983 CITY C K CITY O SAN JUAN CAPISTRANO ORANGE COUNTY, CALIFORNIA NOTICE INVITING BIDS FOR SANITARY SEWERLINE MAINTENANCE CITY OF SAN JUAN CAPISTRANO, CALIFORNIA 1. Sealed proposals will be received at the office of the City Clerk of San Juan Capistrano, California, until 2:00 p.m. Monday, June 27 1983. Two o'clock is the scheduled time of bid opening. The award of bid will be made after Council determination on Tuesday, Julv 5 1983. 2. The Bid Proposal and Agreement to perform work may be secured at the office of the City Clerk at City Hall, 32400 Paseo Adelanto, San Juan Capistrano. 3. All proposals filed shall be in the form furnished by the City, sealed and plainly marked "Bid Proposal". 4. The City Council reserves the right to reject any and all bids. 5. Each bidder shall state the California Contractor's License Number of such bidder, so bidding, as no bid will be accepted from a contractor who has not been licensed in accordance with the provisions of the laws of the State of California relating to the licensing of contractors. 6. BIDDERS ARE HEREBY NOTIFIED THAT, pursuant to the Labor Code of the State of California, copies of the prevailing rate of per diem wages, as determined by the Director of the State Department of Industrial Realtions, are on file in the office of the City Clerk and shall be made available to any interested party on request. 7. This notice is hereby given and published by order of the City Council of the City of San Juan Capistrano, and is dated this 10th day of June 1983. MARY ANN OVER, CITY CLERK CITY O/SAN JUAN CAPISTRANO ORANGE COUNTY, CALIFORNIA 'R»441 61 • 2. APPROVAL OF SPECIFICATIONS AND CALL FOR BIDS - SEWERLINE MAINTENANCE J48) Written Communications: (80) Report dated June 9, 1983, from the Director of Public Works, forwarding specifications for maintenance and emergency servicing of City sewerlines; the existing contract expires June 30, 1983. The item has been budgeted in the 1983-84 Public Works Maintenance Specialized Services Account at $10,000. Approval of Specifications/Call for Bids: It was moved by Councilman Schwartze, seconded by Councilman Hausdorfer and unanimously carried to approve the specifications and to authorize a call for bids for City sewerline maintenance. IN 0 0 AGENDA ITEM June 9, 1983 TO: Stephen B. Julian, City Manager FROM: W. D. Murphy, Director of Public Works SUBJECT: Approval of Specifications and Authorization to Call For Bids - Sewerline Maintenance gTTTIATTON The maintenance and emergency servicing of City sewerlines is a vital program. As the City does not have the equipment or expertise required to provide this work, the contracting for these services has been necessitated. At this time the existing contract will expire on June 30, 1983, and authorization to solicit for the coming year's services is now requested. There are approximately 58.6 miles of public sewerlines within the City's system. While cleaning the entire system is not anticipated, portions of major sections as well as spot emergency maintenance will be required. FINANCIAL CONSIDERATIONS Since the entire system is not and does not require annual cleaning, a City-wide program has been established which over the year has required approximately $10,000 a year. This expense could be some- what more, depending upon emergency call -out incidences. The budget for 1983-84 anticipates this expenditure in the Public Works Maintenance Specialized Services Account. ALTERNATE ACTIONS 1. Approve the specifications for City sewerline maintenance. 2. Do not approve the specifications. 3. Request additional information from staff. RECOMMENDATION By motion, approve the specifications for City sewerline maintenance and authorize the call for bids. Respectfully submitted, (1)1�31 6 -PA W. D. Murphy WDM/rem FOR CITY COUNCIL AGENDA Attach. •••• 10 a ______ C..",?� � JNbNl�N6,.,,.. ` _ .��v n �. ��/ �Z� 11` IaaaRgazzazezzvvv.assazzaaaaaaaazsazaazs:assaueaaaazzazaavazazazzaazazazzaazaeaaazzsaazazzazeaazaazzaaa ±z±vezr_zaal IA C O R D C E R T I F I C A T E O F I N S U R A N C EDate 04/15/88, I ._ IPRODUCER Oper. ID MM IThla certificate Is Issued as a matter of information only and confers no 1 McFann I Associates, Inc. [rights upon the certificate holder.This certificate does not anend,extend 1 [ 501 North Golden Circle 1200 Jor alter the coverage afforded by the policies below. I Santa Ana CA 92705- -------------------------------------------------- IC 2705-__________________________________________________IC 0 M P A N I E S A F F 0 R D I N 0 C 0 V E R A G E -------- C --------------- I (INSURED I _ 1 I ICOMPANY LETTER A: INDUSTRIAL INDEMNITY POYMROOTER SEWER i DRAIN SER. ICOMPANY LETTER B: ri J s C� 11564 TRASK AVE ICOMPANY LE77ER C:-.'�,;�� OD ra J WRDEN GROVE CA 92643 ICOMPANY LETTER D: m v rn I I ICOMPANY LETTER E z IC0 V E R A 0 E 5--------------------------------------------------------------------------------------r . ____----- ------------ I I This is to certify that policies of Insurance listed below have been Issued to the insured named above for the poIM period I I indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this J 1 certificate say be Issued or may pertain,the insurance afforded by the policies described herein is subject to all the terms, J [ exclusions,and conditions of such policies. 1 I--•----------•------------------------------------------------------------------------------------------------------------------- I ICO LYR ITYPE OF INSURANCE IPOLICY NUMBER JEFF DATE IEKP DATE TALL LIMITS IN THOUSANDS 1 I_________________________________________________________________________________________________________________________________ I I IGENERAL LIABILITY I I I IGENERAL AGGREGATE 1000 J I A I(KICOMMERCIAL GENERAL LIABILITY I FORTHCOMING 1 04/07/88 1 04/07/89 JPRODUCTS-COMP/UFS AGGREGATE 1000 J I A I(K][ ]CLAIMS MADE [N]OCCURRENCE I I / / I / / IPERSONALSADVERTISING INJURY 1000 1 it ]OWNER'S 9 CONTR. PROTECTIVE I [ / / I / / JEACH OCCURRENCE 1000 J I1 ] I I / / I / / (FIRE DAMAGE(ANY ONE FIRE) 50 J It ) I I / / I / / INED ENPENSE(ANY ONE PERSON) 5 1 I------------- •------------------------------------------------------------------------------------------------------------------- I JAUTOMOBILE LIABILITY I I I I I I A I(N7ANY AUTO J FORTHCOMING 1 04/07/88 1 04/07/89 I I It ]ALL OWNED AUTOS I 1 / / 1 / / [CSL 1000 I I It ]SCHEDULED AUTOS I I / / I / / IBODILY INJURY(PER PERSON) J I A I(%]HIRED AUTOS I I / / J / / ISO)ILY INJURY(PER ACCIDENT) J I A 1(K)NON-OUNED AUTOS 1 I / / I / / IPROPERTY DAMAGE .. I I It )GARAGE LIABILITY •---------------------------•---------------------------•------------------------------------------------------------------------ I JEKCESS LIABILITY J I I I I I It ]UMBRELLA FORM I I / / I / / JEACH OCCURRENCE J I I( ]OTHER THAN UMBRELLA FORM J I / / I / / JAGGREGATE I _________________________________________________________________________________________________________________________________I I I I I ISTATU70RY I 1 IWORKER'S COMPENSATION I J I I (EACH ACCIDENT) I J I AND J 1 // 1 // J (DISEASE -POLICY LIMIT) I 1 JEMPLOVER'S LIABILITY I I / / I / / I (DISEASE -EACH EMPLOYEE) I I-----------------------------------------------••--------------------•----------------------------------------------------------I I JOINER I I I I I IDESCRIPTION Of OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS ----------------------------------------------------------1 J CERTIFICATE HOLDER - ADDITIONAL NAMED INSURED AS RESPECTS JOB#W62474.86-09099 J I I J I SLERi1F1t:11iE HOLDER -------------------- CANCELLATION _.______________________________________________________________.___.__________J 1 CITY OF SAN JUSN CAPISTRANO J Should any of the above described policies be cancelled before the expiration date thereof) J BLo0 t SAF. DEPT J the issuing company will endeavor to mall 30 days written notice to the certificate holder) J 32400 PASEO ADELANTO J maned to the left,but failure to mail such notice shalt impose no obligation or liability I EAPMTRANO CA 92675 of any Wpon the company, its agents or representaNks. AUTHORIZED REPRESENTATIVE ' / 25•S(11/BS)azaezvaavaaxaazvvaaesavezaseazaazaaaax:azezaxxae:aaxzaa:azxzax:axzvsazaaxaaavaaaxaaxv:xxsaxxeazvax:exx:axxxx:zl 7 -77 - STATE P.O. SOX 807, SAN FRANCISCO, CALIFORNIA 94101-0807 COMPENSATION INOUR ANCIS FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE MARCH 15, 1908 POLICYNUMSER: 0614773 - 88 CERTIFICATE EXPIRES: 3-1—H9 CITY OF SAN JUAN CAPISTRANO BUILDING & SAFETY DEPARTMENT 32400 PASEO ADELANTO SAN JUAN CAPISTRANO JOB: ALL OPERATIONS CALIFORNIA 92675 L This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named Below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will alto give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance 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. VO4 X. PRESIDENT Y EMPLOYER r L POWA—ROOTER SEWER & DRAIN SERVICE 11564 TRASK AVENUE GARDEN GROVE CALIFORNIA 92643 aclF 10262 (REV, to-asl COPY FOR INSURED'S FILE OLD 462A PRODUCER PAUL NUENCH COMPANY P.O. BOX 799 ORANGE, CA 92667 (714) 633-4551 04-29-87 THIS CERTIFICATE IS ISSUED AS A MATTER OF BW RMATION IINLY AND CO`IFERIS NO RIGHTS UPON' TE CERTFTCATI HOLDER. THIS ( ERTNRCAT E DOES NOT A ITEND, EXTEND OR ALTEI I THE COVERAO : AFFORDED BY THE POLICIES BELOW. COI APANIES AFFORDING COVERAGE ETEa Y A COMMERICIAL UNION COMPANY INSURED LETERCO S POWA-ROOTER LEI TERNV C P.O. BOX 1770 CO MPANV SANTA ANA, CA 92702 LETTER D s� CONPANV LETTER E N� THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TI E INSURED NAN ED ABOVE NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY O)NTRACT OR OTHE R DOCUMENT W TN RESPECrTo BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIO ES DESCRIBED HE TERN IS SUBJECT TO ALL THE TEI TIONS OF SUCH POLICIES. s CO TYPE OF INSURANCEPOIK:Y NUMBER FDL CY EFFECTIVE Pal Y EXPIRATION L ABILITY LIMITS IN THOUSANDS LTR DAT: AMMWYI DAT INNND;YYI 0 H AG A9EGATE 0CCJjRRENCE GENERAL LIABILITY �U;N $ $ X COMPREHENSIVE FORM PREMISESUPERATIONS PFO'ERTY $ $ UNDERGROUND EXPLOSION L COLLAPSE HAZARD CAL 56072 4-7-87 4-7-88 DAWOE - PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL COME NED $ $ 1,00o 1 .000 INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ 1 , OOO BBDLYkm AUTOMOBILE LIABILITY $ X ANY AUTO ps m NOM ALL OWNED AUTOS (PRN. PASS.) BOaY ALL OWNED AUTOS (TV.P� law $ � IDEBR CAL 56072 4-7-57 4-7-88 X HIRED AUTOS PROPI'Rry DAMA 3E $ X NON-GWNED AUTOS GARAGE LIABILITY & a PD COMBINED $ 1,000 EXCESS LIABILITY UMBRELLA FORM Ell A TO CCOMBBINEO ,$ $ OTHER THAN UMBRELLA FORM STA nnoRY WORKERS' COMPENSATION ,$ (EACH ACCIDENT) AND (DISEASE -POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE -EACH EMPLOYEE) Y� OTHER UtJUHIP I IUN OF UFtH IMNA'/LUURIIUNS/VtHIULEA'/S1'EGIAI IEMS JOB: ALL OPERATIONS 1p k k SHOULD ANY OF THI- ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EX- PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO CITY OF SAN JUAN CAPISTRANO MAIL 10 DAYS IBRTTTEN NOTICE, TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTE uSFT, BUT FAILURE TDMAILSUCHNOITCESMALL BBPOSENOOBLIGATION ORLUEIUTY OF ANY KIND UPON THE COMPANY, ITS AGENT'S OR REPRESENTATIVES. SAN JUAN CAPISTRANO, CA 92675 AInT40RIJFn RFPRFRI;NTATWP NAME AND ADDRESS OF AGENCY cogaereial Union CATE 4-14-87 as POLICY NUMBER POLICY TYPE iC Pending C.. 7 - INCEPTION DATE OF POLICY EXPIRATION DATE CODE I, ,. .., SUB CODE: .e . 4-7-87 4-7-88_ NAME AND MAILING ADDRESS OF INSURED - EFFECTIVE DATE OF CHANGE TIME Powa - Rooter P.O. BOX 1770 This is an acknowledgement of your request. Upon approval, the com- pany's records will be adjusted accordingly and if a premium adjust - Santa Ana, CA 92702 ment is required, it will be done at premium audit or by endorsement. TYPE OF CHANGE: ADD, CHANGE OR DELETE TYPE Or CHANGE vee N YEAR I MAKE, MODEL, BODY TYPE VIN/SERIAL NUMBER GARAGE LOCATION CITY. STATE, ZIP CODE SYM./AG COST NEW USE RADIUS GVW/GCW CLASS SIC TERR. FACTOR LIABILITY 'T PIP MEDICAL PAYMENT UNINSURED MOTORIST COMPREH. OACV DIE $ SPECIFIED PERILS COLLISION TOWING $ 4MAKE,MODEL, $ DEDUCT $ $ C1F �.TW DEDUCT DEDU ❑FST LM1.S. P. $ $ $ TYPE Or CHANGE VEH x YEAR BODY TYPE VINISERIAL NUMBER GARAGE LOCATIONCITV, STATE, ZIP CODEYM./AGE COST NEW USE RADIUS GVW/GCW CLASS SIC TERR. FACTOR LIABILITY PIP I ADD'T PIP MEDICAL PAYMENT I UNINSURED MOTORIST COMPREH.[:]ACy SPECIFIED PERILS COLLISION TOWING $ $ $ • • i I I• $ $ $ DEDUCT STATED DEDUCT DEDUCT F CIFT $AMT. OF&T OL.S.P. $ $ $ TYPE OE CHANGE lOC x LOCATION ADDRESS DESCRIPTION OF OPERATIONSIOCCUPANCY TYPE OF CHANGE # SUBJECT OF INSURANCE AMOUNT DEDUCT. COINS. ACV/RC PERILS, FORMS AND CONDITIONS TO APPLY $ $ CONSTRUCTION TYPE MOT CLASS , r. • N STORIES BASEMENT YEAR BUILT TOTAL AREA OTHER OCCUPANCIES C] NAMED INSURED C] MAILING ADDRESS 0 DEDUCTIBLE 0 DRIVER INFORMATION 0 ADDITIONAL INTEREST Please add as additional insured with.respects to Sam Jaen Cepistrmo x 32400 Paseo 6delaste San Juan Capistrano, CA 92675 ❑ ATTACHMENT I (52a& SIGNATURE OF AUTHORIZED REPRESENTATIVE 0 April 10, 1987 Powa Rooter P.O. Box 1770 Santa Ana, CA 92702 'u mlol:, r<no InOmYm 1961 1776 MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIESS GARY L. HAUSDORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN Re: Renewal of Certificate of Insurance (City Sewerline Maintenance Agreement) Gentlemen: The attached Certificate of Insurance, regarding the above referenced project has expired on April 7, 1987. In accordance with your contract, the insurance certificate, needs to be renewed. Please forward an updated Certificate to the City in 15 days or by April 25, 1987. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, Mary Ann Hanover, GMC City Clerk MAH(dms Attachment cc: Director of Public Works 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO. CAL"ORNIA 92675 0 (714) 493-1171 PAUL MUENCH INSURANCE P.O. BOX 799 ORANGE, CA 92667 (714) 633-4551 INSURED Powa Rooter P.O. Box 1770 Santa Ana, CA 92702 THIS IS TO CERTIFY THAT POLICIES OF TNSURA NOTWITHSTANDING ANY REOUSIEMEN, TERM BE ISSUED OR MAY PERTAIN, THE INSL RANCE TIONS OF SUCH POLICIES. TYPE OF INSURANCE GENERAL LIABILITY COMPREHENSIVE FORM PREMIS€SIOPERATIONS UNDERGROUND EXPLOSION 8 COLLAPSE HAZARD THIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON' HE CERTIFICATV HOLDER. THIS CERTIFICAT"E DOES NOT AMEND, ?XTEND OR ALTO! THE COVERAGE AFFORDED BY THE POLICES BELOW. COMPANIES A,9FORDING COVERAGE CCAPANY A LE' TER CC APANY LEITER s CO' APANY LE TER C COVPANY p LE TER COAPANY E LEITER NCE LISTED BELOW HAVE SEEN ISSUEOTOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. OR CONDITION OF ANY C:MITRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY AFFORDED BY THE POLICIES DESCRIBED HEFIEBI IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDO POLICY ERE('.TIVE POLICY EXRRATION UABIUTY LIMITS IN THOUSANDS POLICY NUMBER DATE (M D(VYY) DATE IMMIONYYI =T U:: AC AGGREOA1f ",,.?x,?; ,I` OCCURRENCE BODILY INJURY 1 $ $ PRODUCTS/COMPLETED OPERATIONS 01 -PP -0380031 CONTRACTUAL INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE v I PERSONALINJURY AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS (PRN. PASS.) ALL OWNED AUTOS (OTHER PHNVRPTHAN) SS X HIRED AUTOS X NON -OWNED AUTOS OL -BA -066424-1 GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY ITEMS JOB: All Operations City of San Juan Capiscrano 32400 Paseo Adelante San Juan Capistrano, CA 92675 4-7-86 1 4-7-87 $ 1,000,$ 1,000, PERSONAL INJURY $ 1 000, mDLYKm IRR AM* Is ACCIDENT) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- PIIIATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY IRR ACCIUEIIC $ oRA°MPAcery $ 4-7-86 4-7-87 BI S PD COMBINED $1 00( BI & PID COMBINED ¢. $ STATUTORY DI: 0�n- W 'ao�cA m .~lA -I ti rn n V tz�� ro r � ACCIDENT) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- PIIIATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OT• • • C ATE NAME AND ADDRESS OF AGENCY COM 'ANY Awrlsiss 11M POLO ;Y NYMBE 9 POL CY TYPE Ori, CA. W11,67 INCEPTION DA- E OF POL CV EXPIRATION DOTE CODE: SUB CODE: 476" 4-7-47 NAME AND MAILING ADDRESS OF VSURED .. EFFE C5TIVE DA' -E OF CHANGE TIME s -n -in 32181 es Z0�'at� _ is an acknowledgement o f our request. Upon a 1 y 1 p approval, the P.O. am : . jum- - pary's recoris will be adjusted accordingly and If a premium adjust Sam" AM* ft meat is required, it will be done at premium audit or by endorsement. TYPE OF CHANGE: ADD, CHANGE OF DELETE TYPE GE CHANGE I V(H. x I YEAR MAKE, MODEL, BODY TYPE VIN/SEIALNUMBER GARAGE LOCATION -CITY, STATE, ZIF CODE SVNL/AG COSTNEW USI' �R -LASS SIC TERR. (ACTOR LIABILITY PIP ADD'T PIP MEDICAL PAYMENT UNINISURED MOTORISTACV LRAL11USGVV4A3CW SPECIFIED PERILS COLLISION TOWING An❑F [r'B-�,TWE: DEDU$ $ $ $ $ ❑F&T L,}-S.P. $ $ $ TYPE OF CHANGE VD x I YEAR MAKE, MODEL, BODY TYPE VIN/SERIAL NUMBER GARAGE LOCATION -CITY, STATE, ZIP CODE SYM. /AGE COST NEW USE RADIUS GVW/GCW CLASS SIC TERR. FACTOR LIABILITY P ADD'TPIP MEDICALPAYMENT JUNINSURED MOTORIST COMPREH. ❑ALy SPECIFIED PERILS COLLISION TOWING DEDUCT ❑STATED DEDUCT DEDUCT F E1F.TVV. $ $ $ $ $ $ $AMT. OFBT ❑L.S.P $ $ $ • ' I • TYPE DF CHANGE I LOC IN I LOCATION ADDRESS DESCRIPTION OF OPERATIONS/OCCUPANCY TYPE DE CHANGE # I SUBJECT OF INSURANCE AMOUNT DEDUCT. COINS. ACV/RC PERILS, FORMS AND CONDITIONS TO APPLY $ $ $ YEAR BUILT TOTAL AREA OTHER OCCUPANCIES CONSTRUCTION TYPE MOT. CLASS x STORIES #BASEMENT §11111 • ❑ NAMED INSURED ❑ MAILING ADDRESS ❑ DEDUCTIBLE Plea" aid ism Adiitlemal 2aweN3 CILy $ irla i�r•t -. 3" ftow- ,Aft"mft SN ism M . ❑ DRIVER INFORMATION ❑ ADDITIONAL INTEREST ❑ ATTACHMENT .�EPRFi .'' SIGMA F AUTHORIZED ESENTATIVE 0 March 3, 1987 JMa„ �'%" iiAfIA,OAAgI unuu+u '1961 1776 Powa-Rooter P.O. Box 1770 Santa Ana, California 92702 Re: Renewal of Certificate of Insurance Gentlemen: MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIESS GARY L. HAUSDORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN The Certificate of Insurance, regarding the City Sewerline Maintenance is due to expire on April 7, 1987. In accordance with your contract, the insurance certificate needs to be renewed. Please forward an updated Certificate to the City before the above expiration date. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, ai v Mary Ann Hanover, CMC City Clerk MAH/dms 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493-1171 I m+on vertu nHw+elo �'i 1961 1776 March 16, 1987 Powa Rooter P.O. Box 1770 Santa Ana, CA 92702 Re: Certificate of Insurance Gentlemen: MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIERS GARY L. HAUSDORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN Thank you for the Certificate of Insurance, which was received by the City on March 12, 1987. In accordance with your contract, please be advised of the following: (1) It is necessary for the City to be named as an Additional Insured. Please forward the corrected Certificate by March 30, 1987. If you have any questions, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, Mary Ann Hanover, CMC City Clerk MAH(dms 32400 PASEO ADELANTO. SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493-1171 Complete only when this endorsement is not prepared e policy or when the effective datattee.difffers,from mtthe policy. �/��r, p� Pof No.. 01—PP-0380031 Efl.'. __. 01 2" Insured POWA PDOM 41 ADDITIONAL INSURED (Owners or Lessees) This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following: COMPREHENSIVE GENERAL LIABILITY INSURANCE MANUFACTURERS' AND CONTRACTORS' LIABILITY INSURANCE i r GL 20 10 It is agreed that: 1. The "Persons Insured" provision is amended to include as an insured the person or organization named below but only with respect to liability arising out of operations performed for such insured by or on behalf of the named insured. 2. The applicable limit of the company's liability for the insurance afforded under the Contractual Liability Insurance Coverage Part forming a part of this policy shall be reduced by any amount paid as damages under this endorsement in behalf of the person or organization named below. Name of Person or Organization (Additional Insured) ;- > CITY OF SAA JUAN CAPISTRIM y 32400 PAszO ADzi',Ilm _ SAA JUAN CAPT3'aUll cA. 92675 All other terms of this policy remain unchanged. �'WYYL3� R ��wuuawcs�.s Countersigned by 9-702 CL, ML (7-73) American States Insurance Company American Economy Insurance Company INDIANAPOLIS, INDIANA AUTHORIZED AGENT PAS XWWM CO. ORUIZo CA. President Secretary PR, IDUCER PAUL MUENCH INSURANCE P.O. BOX 799 ORANGE, CA 92667 (714) 633.4551 INS IRED POWA-ROOTER P.O.BOX 1770 Santa Ana , CA 92702 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFCRMATIONDNLY AND CONFERS NO RIGHTS UPON HE CERTIFICATE HOLDER. THIS CERTWICA' E DOES NOT AMEND, EMEND OR ALTEI THE COVERAG!'. AFFORDED BY FIE POLWIES BELOW. CORIPANIES AFFORDING COVERAGE CC TER LE TER A AMERICAN STATES INSURANCE /7 G CC' MPANY B LE 7ER oTED j NGMF ANTI Ann PPQS hF Ar.GNCV r.nUPANV C 617E 10-24-86 4fim 4ARAM POLICY NUMBER POL CY TYPE 01 -PP -0380031 7 INCEPTION DATE OF POLICY EXPIRATIO D,=,TE - CODE: SUB CODE: 4-07-86 (i-07-8 ?_ NAME AND MAILING ADDRESS OF INSURED EFFECTIVE DATE OF CHANGE TIME POA ROOTM P.O.Box 1770 This is an acknowledgement of your request. Upon approval, the Com - Santa Ani, CA 92702 pany's records will be adjusted accordingly and if a premium adjust- ment is required, it will be done at premium audit or by endorsement. TYPE OF CHANGE: ADD, CHANGE OF DELETE TYPE of CHAHOE VLH x I YEAR MAKE, MODEL, BODY TYPE VIN/SERIAL NUMBER GARAGE LOCATION CITY, STATE, ZIP CODE SYM./AG COST NEW USE RADIUS GVWIGCW CUSS $IC TERR. FACTOR is I LIABILITY PIP ADD'T PIP MEDICAL PAYMENT UNINSURED MOTORIST COMPREH. E]ACV SPECIFIED PERILS COLLISION TOWING DEDUC ❑STATE r)FTW E DE DU T LC)LS.P. $ $ $ $ $ $ $ &T $ $ L[J $ MAKE, MODEL, BODY TYPE VIN/SERIAL NUMBER IYPE OE CHANGE VEH x I YEAR GARAGE LOCATION CITY, STATE, ZIP CODE YM./AGE COST NEW USE RADIUS SS SIC TERR. FACTOR LIABILITY PIP ADD'T PIP MEDICAL PAYMENT UNINSURED MOTORIST CDMPREH.COLLISION TOWING LOA DEDUCT DEDUCT $$$$L.S.P $ $ $ rwE OF cnnrvcE Loc x LOCATION ADDRESS DESCRIPTION OF OPERATIONSIOCCUPANCY TYPE OF CHANCE g SUBJECT OF INSURANCE AMOUNT DEDUCT. COINS, ACVIRC PERILS, FORMS AND CONDITIONS TO APPLY $ $ $ CONSTRUCTION TYPE PRAT CLASS x STORIES t EASEMENT YEAR BUILT TOTAL AREA OTHER OCCUPANCIES NAMED INSURED [:] MAILING ADDRESS [:] DEDUCTIBLE [:] DRIVER INFORMATION a ADDITIONAL INTEREST Please add the following as additbual insureds: City of San Jean Capistrano 32400 Paseo Adelaeto San Jean Capistrano, CA 92675 ❑ ATTACHMENT A10= -� 15 Brookhollow..Drive -' Santa Anus CA 9270 ;n C! tl G A OF AUTH RI EDZ REPRE:>ENTAYVE 0 October 14, 1986 I,�%oo•ow+no 111l.II D 1961 1776 Powa-Rooter Sewer and Drain Service P.O. Box 1770 Santa Ana, California 92702 Re: Certificate of Insurance Gentlemen: MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIESS GARY L. HAUSOORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN Thank you for the Certificate of Insurance, which was received by the City on October 7, 1986. In accordance with your contract, please be advised of the following: (1) It is necessary for the City to be named as an Additional Insured. (2) A policy number is required. Please forward the corrected Certificate by October 30, 1986. If you have any question, please contact Dawn Schanderl, Records Coordinator, at (714) 493-1171 extension 244. Thank you for your cooperation. Very truly yours, MARY ANN ANOVER, CMC City Clerk MAH/ds 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 0 (714) 493-1171 0 October 2, 1986 Powa-Rooter P. O. Boa 1770 Santa Ana, California 92702 Javan L'— �m.r•Imo mlm�,ro 1961 1776 Re: City Sewerline Maintenance Contract Extension Gentlemen: MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIESS GARY L. HAUSOORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN Enclosed for your records is a fully executed copy of the Extension .Agreement between the City of San Juan Capistrano and Powa-Rooter for sewerline maintenance. Thank you for your cooperation. If you have any questions, please do not hesitate to call. Very truly yours, I 2-742-e� MARY ANN HANCy ER, CMC City Clerk MAH/mac Enclosure cc: Director of Public Works 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493-1171 0 September 25, 1986 MEMBERS OF THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE F. BUCHHEIM KENNETH E. FRIESS GARY L. HAUSDORFER PHILLIP R. SCHWARTZE CITY MANAGER STEPHEN B JULIAN Powa-Rooter P. O. Box 1770 Santa Ana, California 92702 Re: City Sewerline Maintenance Contract Extension Gentlemen: The City Council of the City of San Juan Capistrano at its regular meeting held July 1, 1986, extended the City's contract with your firm for sewerline maintenance in the amount of $.09 per lineal foot for one additional year, through June 30, 1987. Enclosed are two copies of the Extension Agreement. Please execute both copies of the Agreement and return them to this office. After the document has been executed by the City, an executed copy of the Agreement will be forwarded to you for your records. Thank you for your cooperation. Very truly yours, MARY .ANN ANOVER, CN1C City Clerk MAH/mac Enclosure 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 0 (714) 493-1171 0 July 3, 1986 Powa-Rooter P. O. Box 1770 Santa Ana, California 92702 Re: City Sewerline Maintenance Contract Extension Gentlemen: MEMOIRS OP THE CITY COUNCIL ANTHONY L. BLAND LAWRENCE P. BUCHHEIM KENNETH E. PRIEBS GARY L. HAUSOORPER PHILLIP R. SCHWARTZK CITY MANAGER STEPHEN S. JULIAN The City Council of the City of San Juan Capistrano at its regular meeting held July 1, 1986, extended the City's contract with your firm for sewerline maintenance in the amount of $.09 per lineal foot for one additional year, through June 30, 1987. Thank you for your cooperation. If you have any questions, please do not hesitate to call. Very truly yours, MARY ANN HANOVER, CMC City Clerk MAH/mac cc: Director of Public Works 32400 PASEO ADELANTO, SAN JUAN CAPISTRANO, CALIFORNIA 92675 • (714) 493-1171 U MEMORANDUM TO: John Shaw, City Attorney FROM: W. D. Murphy, Director of Public Works SUBJECT: City Sewerline Maintenance Contract June 6, 1986 The 1985-86 City Sewerline Maintenance Contract with Powa-Rooter Sewer and Drain Service, Inc., which provides for the cleaning and routing of specific City sewerlines, will expire on June 30, 1986. We intend to extend the contract for one more year since Powa-Rooter has provided good service and the rates remain unchanged. Please review the contract and respond with suggestions, if you find any problems with the contract extension. Attached is a copy of the contract and a copy of the letter from Powa-Rooter requesting t�he� renewal of the contract and stating that the rates will remain unchanged. WDM: LD B/kd Attachments Y' (714) 839-3900 ORANGEPOWA—ROOTER SEWER AND DRAIN SERVICE, INC. P. O. Box 1770 COUNTY Santa Ana, California 92701 May 15, 1986 Mr. John Jones Superintendent. City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Dear Mr. Jones: In keeping with the provisions of the contract existing between the City of San Juan Capistrano and Powa-Rooter Sewer and Drain Service, Inc., this letter of renewal is proposed for necessary approval. The provisions and specifications remain unchanged for your continuing cost of .09c, per lineal foot for sanitary sewerline cleaning for the period of June 30, 1986 through June 30, 1987. Insurance certificates for this period will be sent to the City as required. We look forward to your approval after June 30, 1986. Yours truly, Leroy Thomas President LT/pat r -i MAUL MUENCH COMPANY Company Numbers If this endorsement is issued concurrently win the policy. the Attaching Clause need not be completed. Endt. No. I = Reliance Insurance Company Issued by Co No. Effective Data Insured Addmmnal Premmm 2 = Planet Insurance Company 6 =_ United Pacific Insurance Company 1 4-7-84 POWA-ROOTER ANDRAIN SERVIC s Premium Attached to and forming partof Policy N. oAu Cot igned by I Repr en Return Premium BY AUDIT ® toa'udit CI 311 08 69 $ All terms and conditions of the policy remain unchanged exceptAl"Inuenceif by this endarseme nearned Prem. Pactnr, 0 ADDITIONAL INSURED ENDORSEMENT (Operations Let or Sublet to Designated Contractor) Such insurance as is afforded by this endorsement applies only with respect to: SCHEDULE 1. Named Insured CITY OF SAN JUAN CAPISTRANO BUILDING DEP. 2. Address of Named Insured 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 3. Description of Covered Operations 4. Designated Contractor POWA-ROOTER AND DRAIN SERVICE, INC. 5. Contractor's Address P.O. BOX 1770 SANTA ANA, CA 92702 u R�EIVED�� MAY 91984 Ills - CITY OF SAN JUAII CAPISTItoll , / CALWOM The insurance afforded is only with respect to such and so many of the following coverages as are indicated by insertion of the limit of the Company's liability opposite the coverage. The limit of the Company's liability for each such coverage shall be as stated herein, subject to the terms of this endorsement having reference thereto. COVERAGES LIMITS OF LIABILITY MULTIPLE LIMIT PLAN: EACH OCCURRENCE AGGREGATE Bodily Injury Liability $ SINGLE LIMIT PLAN: Bodily Injury Liability and ProcertvDamaaeLiability is 11000,000, It 1,000,000• Classification of Operations Code No Premium Base Cost Rates per $100 of Cost Estimated Premium BI PD BI PD OPERATIONS N.O.C. 17982 BY AUDIT ,019 .008 BY AUDIT Total Estimated Premium $ By AUDIT Check here if the following provision is applicable: The person or organization designated as the Contractor has undertaken to pay the premium for this endorsement and shall be entito receive any return premiums which may become payable under the terms of this endorsement. 901— (See Reverse Side for other Provisions Applying to this Endorsement) cin4-13-84 L-3422 1/79 rpoued Ao4od 841 Buunp pue;Oala4 alep 8A1j00;;a 841 J811e JO uo Bu!uadde4 saOuaJJn000 of Aluo sa4dde Iu9WOSJOPua s!41 a011d3d 1NSIMSMOON3 'Al B4)p 'aap Jo pled .'epsue!wwem !ssoo-jo smnugq'swuolle'See) 0e, NoUl 'Joioejwooagg5 JO %OeJluoo'Jaumo 041 Aq w pe4sln; Ja4la4m' SP04ees 4JMS jo ugjoboxa ayi w asn 7o; palam!lap JO Peso'pa4sluin; wawdwba pue sleualew 'Jogel Ile ;o iscia a41 6wpnlow 'wafwd 3413ads 40128 411M u0110auuoa w lalgns m ial IIJOM Ile ;O SJOAeJlum luepuedepu! 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THIS CERTIFICA"E DOES NOTA LEND, EXTEND OR ALTEri THE COVLRAGI? AFFORDED BY THE POUAES BELOW. pua�amM COWANIES AFFORDING COVERAGE yQ ,433 E!!lANti%C`L82887 t V" 832.4451 -,_ COMPANY A .. LE -TER I TA DIST , G_MPANY LETTER B p INSURED .CCMPANY w C DRM =V=j, Y.O. 13aZ 1770 LETTER c:v—w - x_�r�E-- COMPANY I2 SANTA Aft, Cd. 92702 LEITER CuMPANY -,n-AST - LE=TIER F` ,X'= � • pp BEEN ISSUEDTO T'HE INSURED NAMED ABOVE FOR THE POLIO Y PEINDICATED THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE: NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY WITH CONTRACT OR OTHER DOCUMENT RESPECT TO WHICH THIS C ICAIE MP BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. CO TYPE OF INSURANCE POLICY NUMBER DAATEIMMDDT� RATION DATEY(MMNDM) LIABILITY LIMITS IN THOUSANDS EACH - OC_CURRENCE"'3GREGATE GENERAL LIABILITY A COMPREHENSIVE FORM � Il6 •C sol: - 4-7-85 �'� � IWJRv $ $ PROPERTY PREMISES/OPERATIONS UNDERGROUND DAMAGE $ $ EXPLOSION 8 COLLAPSE HAZARD' _ PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL " CC MB NED $ $ INDEPENDENT CONTRACTORS 1.009 1 •Doo _ BROAD FORM PROPERTY DAMAGE PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY Ly _ ANY ANY AUTO (PEPPERON) $ i M' A ALL OWNED AUTOS (PRIV.PASS.) DC 66!l-8546 4-7-85 4-7-66 1'. EDD�L, ALL OWNED AUTOS (OTHER THAN (OTHER PASS. iff�w Ery /-DEQ $ HIRED AUTOS ' PROPERTY NON-OWNED AUTOS DAMAGE $ GARAGE LIABILITY. BI d PD COMBINED $ EXCESS LIABILITY UMBRELLA FORM ID COMBINED 1 $ $ OTHER THAN UMBRELLA FORM sTAru7aRv `. WORKERS' COMPENSATION $ (EACH ACCIDENT) AND (DISEASE-POLICY LIMIT) EMPLOYERS' LIABILITY 1C~ ,: $ (DISEASE-EACH EMPLOYEE) OTHER \` DESCRIPTION OF OPERATIONS/LOCATIONS/VEHI ES/SPECIAL ITEMS !HE CBttUMU == IS Hit® AS AMETTI01" AU MUM= I .vm=rw DVA2 MT SHOU;ANYOFE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EX- cm 08 so JOdH CdPISTRillfl PIRATTHEREOF, THE ISSUING COMPANY WILLrd�� *�MAILWRITTEN NOTICE TO THE ERTIFICATE HOLDER NAMED TO THE LEFT,Siff JIl4M CilISlSMo Cd. 92675 AUTHORN7A71VE 1� It 3Y400 P"BO?ADfitt SAN JUJI146CAMSTRA*Q, CA4 June 6, 1985 Powa-Rooter, Inc. P. O. Box 1770 Santa Ana, California 92702 0 92673 Re: City Sewerline Maintenance Contract Extension Gentlemen: The City Council of the City of San Juan Capistrano at its regular meeting held June 4, 1985, approved the Contract with your company extending sewerline'maintenance to June 30, 1986, at 9C per lineal foot. An executed copy of the contract is enclosed for your information. Thank you for your cooperation. If you have any questions, please do not hesitate to call. Very truly yours, MARY ANN ANOVER, CMC City Clerk MAH/mac Enclosure cc: Director of Public Works �. .- IN . .. NAME AND AODRESS OF AGENCY PAUL MUNCH COMPANY k Fo P�1 ES AFFORDING COVERAGES P.O. BOX 799 ORANGE, CA 93667 �t COMPANY 'J f ITEC RACIFIC/RELIANCE (714) 6334661 COMPANY B NAME AND ADDRESS OF INSURED S k�, �y Np$E A POW A-ROOTER & DRAIN SERVICE, INC _ P.O. BOX 1770 � � ' Santa Ana ,CA 92702 COMPANY LETTER COMPANY LETTER E For policy term indicated This is to certify that potties of insurance listed below have been issued to the insured named above and are in force at thistime. Notwithstanding any requirement, termor 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 of Liability In T ousin 5 COMPANY LETTER TYPE OF INSURANCE POLICY NUMBER POLICY EXPIRATION DATE EACH AGGREGATE OCCURRENCE GENERAL LIABILITY BODILY INJURY $ $ ® COMPREHENSIVE FORM C1 311 0869 4-7-85 El PREMISES—OPERATIONS PROPERTY DAMAGE $ $ A EXPLOSION AND COLLAPSE HAZARD O UNDERGROUND HAZARD ® PRODUCTS/COMPLETED OPERATIONS HAZARD ® CONTRACTUAL INSURANCE BODILY INJURY AND ® BROAD FORM PROPERTY PROPERTY DAMAGE COMBINED $ s DAMAGE ® 1,000, 1,000, INDEPENDENT CONTRACTORS PERSONAL INJURY $1r000, © PERSONAL INJURY AUTOMOBILE LIABILITY BODILY INJURY $ (EACHPERSON) A ® COMPREHENSIVE FORM BODILY INJURY $ OWNED Cl 311 0869 4-7-85 (EACH ACCIDENT) PROPERTY DAMAGE ® HIRED § BODILY INJURY AND BODILY DAMAGE NON-OWNED COMBINED EXCESS LIABILITY UMBRELLA FORM BODILY INJURY AND PROPERTY DAMAGE $ $ OTHER THAN UMBRELLA COMBINED FORM WORKERS' COMPENSATION STATUTORY and EMPLOYERS' LIABILITY § (EOGM ACCIDENT) OTHER DESCRIPTION OF OPERATIONSA DCATIONSNEHICLES Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail In days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: August 6, 1984 ]c DATE ISSUED: City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 %UXHORIZED REPRESENTATIVE ACORD 25 (1-79) a Am T'.ITT8.Nru Cn. C,rnpany Numbers If this endorsement is issued concurrently with the policy, the Attaching Clause need not be completed. Endt No 2 SEC II I = 891jance Insurance Company Issued by Co. No. Effective Date Insured INC.L1Y V . dditional Premium 2 = Planet Insurance Company 6 -- United Pacific Insurance Company L7962 7-11-84 POWA-ROOTER & DRAIN SERVICE $ Premium Attached to and forming part of Policy No. Cjo'ntersigned b Aut onzed Represent alive) Return Premium suaudi t o audi C13110869 • /� �' • $ All terms and conditions of the policy remain unchanged except as amended by this endorsement. unearned Premium Factor, ADDITIONAL INSURED ENDORSEMENT (Operations Let or Sublet to Designated Contractor) Such insurance as is afforded by this endorsement applies only with respect to: SCHEDULE 1. Named Insured CITY OF SAN JUAN CAPISTRANO 2. Address of Named Insured 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 3. Description of Covered Operations 4. Designated Contractor POWA-ROOTER & DRAIN SERVICE, INC 5. Contractor's Address P.O* BOX 1770 SANTA ANA, CA 92702 The insurance afforded is only with respect to such and so many of the following coverages as are indicated by insertion of the limit of the Company's liability opposite the coverage. The limit of the Company's liability for each such coverage shall be as stated herein, subject to the terms of this endorsement having reference thereto. COVERAGES LIMITS OF LIABILITY MULTIPLE LIMIT PLAN: EACH OCCURRENCE AGGREGATE Bodily Injury Liability $ SINGLE LIMIT PLAN: Bodily Injury Liability and Property Darnall Liability $ •I nnn nnn $ 1 nnn nnn Classification of Operations Code No. Premium Base Cost Rates per $100 of Cost Estimated Premium BI PD BI PD OPERATIONS N.O.C. L7962 BY AUDIT 0019 0008 BY A JDIT Total Estimated Premium $ 0.1 AUV.LT Check here if the following provision is applicable: The person or organization designated as the Contractor has undertaken to pay the premium for this endorsement and shall be entitled to receive any return premiums which may become payable under the terms of this endorsement. 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Lions Blew Aew pue'lualnpneil 10 aslel 'ssalpunol6 ale ling a4t to suo14e681le 341;o Aue;! time a6ewep AiAadwd An Aniul Allpog Lions 10 lun000e uo sa6ewep 6ul>laas palnsul a4i isme6e tins Aug, pua;ap of Amp pue tul6!A eqj ane4 ❑eits Auetlwoo agl pue'suoijwado Lions ;o uo!s!AAadns Ielaua6 vg 4l!m uo!loauuoa ui pamsul paweN 041 to suo!sslwo An stop (Z) AD u!a1a41 paleu6lsap uofie3ol eqj ie alnpa4os aql u! paieu6lsap Aoweiwoo a4i l0 11e4eq LAD Ao'Aq pamsu! P31AUBN 041 Aol pawlo;Aad suaimado (I) ;o mo 6u!s!Ae pue aawgiinooO ue Aq pasneo'saildde luawaslopua s!gj go!gM of a6ewep AAadOAd'9 a6elanoo AD Aniul Agpoa'V 06elanoo ;o asneo0q sa6ewep se Aed o1 pale64go Ade6at awooaq 6e4s pamsul a4i gai4M scans !le palnsul a4i 10 Hegaq uo And him Auetlwoo aqj_ AllllgVll 3OVWV0 A1H3d01:Id — 11 3OVH3A03 AlI11HV11 AHflf NI A11O011 — V 3VV83A00 '1 •r r• r r • r r r Mlle�/a'�/ o r r r -r r •r r r NAME AND ADDRESS OF AGENCY PAUL WINCH COMPANY C ,CANIES AFFORDING COVERAGES P.O. BOX 799 COMP �� United Pacific ORANGE, CA 92667 LE (714) 6334561 `OMPA Y B NAME AND ADDRESS OF INSURED Powe -Rooter &Drain Service, Inc. cl � , }'SA P. Or BOX 1770 "h� COMPANY D Santa Ana, CA 9272 LETTER COMPANY E LETTER This Is to certify that pollc,es of Insurance listed below here been issued to the insured named nboveand are in force at this time. Notwithstanding any rer♦uirement, term or condition of any contract or Osla document with respect to which this certificate may be issued or may pertain, the insurance afEl forded by the policies described herein is subject to all the terms, exdusbns and conditions of such policies. Limits Of Liablli in E COMPANY LETTER TYPE OF INSURANCE POLICY NUMBER POLICY EXPIRATION DATE EACH OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY INJURY E E ' A INFORM C1 311 0869 4/7/85 tt(COMPRENENSIVE (4} PREMISES -OPERATIONS PROPERTY DAMAGE E E E%PLOSION AND COLIr LAPSE ' HAZARD ❑ UNDERGROUND HAZARD PAODUCTSJCOMPLETED (� OPERATIONS HAZARD CONTRACTUAL INSURANCE BODILY INJURY AND PROPERTY DAMAGE f 10000 E 1, 00o BROAD FORM PROPERTY COMBINED E tEi�3 (� DAMAGE L,XL INDEPENDENT CONTRACTORS PERSONAL INJURY E 1,000, rL�O PERSONAL INJURY AUTOMOBILE LIABILITY aooav lNJuav $ A ®COMPREHENSIVE C1 311 0869 4/7185 (EACH PERSON) FORM BODILY INJURY ® OWNED (EACH ACCIDENT) PROPERTY DAMAGE HIRED E BODILY INJURY AND NON-0WNED E 1 OOO PROPERTY DAMAGE � COMBINED EXCESS LIABILITY UMBRELLA FORM BODILY INJURY AND b E PROPERTY DAMAGE ' ❑ OTHERTHAN UMBRELLA COMBINED FORM WORKERS' COMPENSATION sTATuroav and EMPLOYERS' LIABILITY E (LCew:gl�EMl OTHER DESCfaFT OF 'OPERAYgNS/LOCATION$NEHICLES D Q Cancellation: Should any of the above des4 ibed policies be cancelled before the expiration date thereof, the issuing com- 1_ pany will endeavor to mail days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: DATE ISSUED. City of San Juan Capistrano 324.00 Paseo Adelanto San Jean Capistrano, CA 92675 AUTHORIZED REP NTATIVE ACORD 25 (1-79) 1 • C)16 (Ed r 13) This endorsement forms a part of the policy to which attached, effective on the inception date of the policy unless otherwise slated herein (The following information Is required only when this endorsement is issued subsequent to preparation of policy.) Endorsement effective July 11, 1984 Policy No. C1 311 0869 Endorseme Named Insured Powa-Rooter & Drain Service, Inc. Additional Premium $ t.b.d. Countersigned (Authorized Represen rve) This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following COMPREHENSIVE GENERAL LIABILITY INSURANCE MANUFACTURERS AND CONTRACTORS LIABILITY INSURANCE ADDITIONAL INSURED (Owners or Contractors) Mame of Person or Organization (Additional Inured) City of San Juan Capistrano Premum Bases Bodily Injury Liability Property Damage Liability cost cost Schedule Location of Covered Operations Rates $100 of cost $100 of cost Total Advance Premium Advance Premium g t.b.d. s t.b.d. It is agreed (lot 1. The "Persons Insured" provision is amended to include as an insured the person or organization named above (hereinafter called "additional insured"), but only with respect to liability arising out of (1) operations performed for the additional insured by the named insured at the location designated above or (2) acts or omissions of the additional insured in connection with his general supervision of such operations. 2. None of the exclusions of the policy, except exclusions (a), (c), (f), (g), (i), (j) and (m), apply to this insurance. 3. Additional Exclusions This in;urance does not apply: (a) to bodily injury or property damage occurring after (1) all work on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured at the site of the covered operations has been completed or (2) that portion of the named insured's work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project: (b) to bodily injury or property damage arising out of any act or omission of the additional insured or any of his employees, other than general super. vision of work performed for the additional insured by the named insured; (c) to property damage to (1) property owned or occupied by or rented to the additional insured, (2) property used by the additional insured, (3) property in the care, custody or control of the additional insured or as to which the additional insured is for any purpose exercising physical control, or (1) work performed for the additional insured by the named insured. Additional Definition When used in reference to this insurance, "work" includes materials, parts and equipment furnished in connection therewith. PMC/ss G116 (Ed. 1-73) -- STATE P.IbX 807, SAN FRANCISCO, CALIFORNIA 01 COMPENSATION 11`4 SURA N C E FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE February ??, 1494 POLICY NUMBER: CERTIFICATE EXPIRES: r— City of San Juan Capistrano Ruildina a, S,afPty Department . Z1400 Paseo Adelanto Sar, Juan Capistrano, California o?675 614773—P4 1/1/q5 L This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance 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. _� RESIOENT EMPLOYER r Powa-Rooter Sewer & Drain Service ALL OPEPATTO*IS 10?2-R Trask Carden (:rove, California o?647 • L SCIF 10262 (REV. 11-83) OLD 262A • /'.�' AUW' jam^,... :7"_: � R SAIFi5T*C4J4FOW41A 11�141A 92675 eHON49.]}117;V t ,✓`ham"' July 6, 1984 Powa-Rooter P. 0. Box 1770 Santa Ana, California 92702 Re: Award of Contract - Sewerline Maintenance Gentlemen: At their meeting of July 3, 1984, the City Council awarded the contract for Sewerline Maintenance to your company at 9C per lineal foot. Enclosed are two copies of the contract. Please sign and'date both contracts and return the "City" copy to this office along with all required bonds and insurance. The contract documents are to be executed by your company within 15 days of this notice. Please note the information on page two of the Contract which cites the City's requirements for bond and insurance amounts. Also note that the City is to be named as an additional insured. These requirements must be met as stated before the contract is effective. If I can be of any help to you, please do not hesitate to call. Thank you for your cooperation. Very truly yours, MARY ANN �fNOVER, CMC City Clerk MAH/mac Enclosures cc: Director of Public Works Director of Administrative Services Io N qO Ol N Fa 4 -N U O ¢4 O cd 4� O 94 N -P �l b N h •'i a 0 Cd Y N U �Ncd wHw O U O y - �O '-d- N 0 0 U U MU] N U i'. N �i N H co F4 d3(DODOo Pa MION PLANS AND SPECIFICATIONS n PROJECT TITLE S C -JS \ IT Qh a PROJECT ENGINEER N� a T� PRE BID DATE/TIME BID OPENING DATE/ TIME �� t �p �� $`� c�.00� D•M, ENGINEER'S ESTIMATE — PURCHASE COST MAIL COST NAME DDRESS PHONE NO. E AND ADDRESS OF AGENCY PAUL MUENCH COMPANY P.O. BOX 799 ORANGE, CA 92667 (714) 633.4551 NAME AND 1DDRESS OF INSURED Rr0E Powa-Rooter & Drain Service, Inc. Al P.O. Box 1770 N Santa Ana- CA 92702 C APII or ether document with respect to which this certificate may be COMPANY LETTERTY TOF INSURANCE , I 0110 NUMBER [� GENERAL LIABILITY 1 vel^force at or may perti COMFREHENSIVE FORM PREM SES—OPERATIONS o(. :Y EXPLOSION AND COLLAPSE cIRAhN ')ATE I HA.ARD A UNDE?GROUND HAZARD C1 311 08 69 PRODJCTS/COMPLETED OPI RATIONS HAZARD CONT tACTUAL INSURANCE [� BROA') FORM PROPERTY DAMAGE Ir�� INDEFENDENT CONTRACTORS LR PERSONAL INJURY AUTOMOBILE LIABILITY jj � [A COMIREHENSIVE FORM A IAOWNID C1 311 08 69 IA HIREr 51 NON OWNED ❑ UMBRELLA FORM ❑ OTHER THAN UMBRELLA FORM and EMPLOYERS' LIABILITY OTHER COMPIAIES AFFORDING COVERAGES A_ United Pacific erpMp- - -- IAR" C COMPAN) C L ETT EH [� med above ar 1 vel^force at or may perti ),'he insurance o(. :Y = cIRAhN ')ATE 4/7/85 4/7/85 AGGREGATE BODILY INJURY I $ I $ PROPERTY DAMAGE I $ I $ BODILY INJURY AND PROPERTY DAMAGE $ 1,000, $ 1,000, COMBINED PERSONAL INJURY $ 1,000, BODILY INJURY k$Si (EACH PERSON) BODILY INJURY (EACH ACCIDENT) PROPERTY DAMAGERpDILY INIURY AND000PROPERTY DAMAGE , BODILY INJURY AND PROPERTY DAMAGE $ $ COMBINED STATUTORY f DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ti/y'YY Y�c.,wA2a u 5-LJIaII �'i A^�La(�(' New c 71,- f .t n 6e p✓h r�� . Cancellation: Should any of the above descriVd policies be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail _ days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: City of San Juan Capsitrano Building Dept. 32400 Paseo Adelanto San Juan Capistrano, CA 92675 25 (1-791 DATE 3/20/84 ACCIDENT) o ,I , �'�„ r� 1� I 'ii (Ilii i .•, , •. NAME AND 1DDRESS OF AGENCY Pain Mepuuench Company I 041P Ii AFFORDING COVERAGES IFJY^. Box 799 ( )h 'eN Oranp,ICA 92667-0799 r'; 1 _United Pacific Ins. Co. (714) 6334551 )N ,IN NAME AND DDRESS OF INSURED C T! / N` Powa-Rooter & Drain Service, Inc. ` T''--'—— P.O. Box 1770 C W!1 'N' Santa Ana, CA 92702 ` r ='— C +MI IN) L Tl' II ., This is to curtity that policies of insurance listed below have been issued to Yi IreI 1� it„:i b1r-a d.+ )me at this time. Notwithstanding any res of any conrract or other document with respect to which this certificate I ugb• i; if I c Try ; x:rt, !'. : r ;urance afforded by the policies describes terms, exclusions a'+d conditions of such polices.COMPAN Lim is of Lfabilit it LETTERY TY rE OF INSURANCE POLICY NUN 3. 1? j DATE GENERAL LIABILITY try, COMPREHENSIVE FORM LJ(I PREM 3ES—OPERATIONS A [] E%PL(SION AND COLLAPSE HAZARD LJ UNDERGROUND HAZARD CXI PRODI)CTS/COMPLETED OFF RATIONS HAZARD 19 CONT+'ACTUAL INSURANCE IN BROAI - FORM PROPERTY DAMAGE D��x INOEP':NDENT CONTRACTOL LJ PERSONAL INJURY I �A7UTOMOBILE LIABILITY A LJ COMPREHENSIVE FORM O OWNED ❑x HIREC L J NON{ WINED UMBRL LLA FORM L�l OTHEI+THAN UMBRELLA FORM and EMPLOYERS' LI OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES C1 311 08 69 C1 311 08 69 4/7/24 4/7/84 BODILY INJURY E PROPERTY DAMAGE E to AGGREGATE E BODILY INJURY AND1 PROPERTY DAMAGE E 1,000, E 1,000 COMBINED PERSONAL INJURY BODILY INJURY E (EACH PERSON) BODILY INJURY E (EACH ACCIDENT) PROPERTY DAMAGE E BODILY INJURY AND PROPERTY DAMAGE E 1,000, COMBINED 9001LY INJURY AND PROPERTY DAMAGE E COMBINED STATUTORY E E 1,000 E Cancellation: Should any of the above desirfbed policies be -:Jncelled bel)i E the expiration date thereof, the issuing com- pany will endeavor to mail _ dJys wt A( n notice t) tF : I Blow named certificate holder. but failure to mail such notice shall impose no obli€ ation er I ability of E ny I;ir I upon the company. NAME AND ADDRESS OF CERTIf ICATE HOLDER 7� 5/83 Dn E IssuEn City of San Juan Capistrano Building Dept. 32400 Paseo Adelanto San Juan Capistrano; CA 92675 AUTHORIZED REPRESENTATIVE pc 25 STATE • a COMPENSATION P.O. BOX 807, SAN FRANCISCO, CALIFORNIA 94101 I N S UR A N C E FUND July 8, 1983 CERTIFICATE OF WORKER'S COMPENSATION, INSURANCE POLICY NUMBER: 614773-83 CERT(FICATE EXPIRES: 3/l/84 City of San Juan Capistrano Building & Safety Department 32400 Paseo Adelanto San Juan Capistrano, California 92675 This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of Insurance 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. EMPLOYER Powa-Rooter Sewer & Drain Service 10282-B Trask Garden Grove, California 92643 X %-/,5--6-3 0T— SCIF FORM 262A (REV. 1280) PRESIDENT ALL OPERATIONS 0 0 3Z400 PASEO ADELANTO SAN JUAN;CAPISTRANO, CALIFORNIA 92675 PHON @ 493:1 1 71 ✓Y',L July 6, 1983 Powa-Rooter Sewer & Drain Service, Inc. P. O. Box 1770 Santa Ana, California 92702 Re: Sanitary Sewerline Maintenance Gentlemen: At their meeting of July 5, 1983, the City Council took action to award the contract for sanitary sewerline maintenance in San Juan Capistrano to your company in the amount of $0.0849 per lineal foot. Enclosed are two copies of the contract executed by the City. Please sign both copies and return the "City Copy" to my office along with the required insurance and Workmen's Compensation coverage. Thank you for your cooperation. Very truly yours, MARY ANN HANOVER, CMC City Clerk MAH/cj Enclosures cc: Director of Public Works 0 0 C" _ a CL o tl ra>� W C nl � x 1 0 N �q 9 m FA 4� q � U Pio Cd C) Uq (d N � p a, cd a°r U m m ocd� JP 14- ri N aS U to U] Aa N Q � � U 2 U � q a� M > ��{{i ��.. C N J m N O r .. O Z v N Q jr a a) a.. d,a opo Hd �Wam w °x'•14 0 W o aNN� o NH ul PROJECT TITLE PROJECT ENGINE PLANS AND SPECIFICATIONS i a PRE BID DATE �'- BID OPENING DATE ENGINEER'S ESTIMATE PURCHASE COST "- MAIL COST I :� ��._. i s L •:�'�� _�'�► 8101 _ mom /mo � A �� Milll►� 117► �1 � - \ . �