HomeMy WebLinkAboutCC RESO 16,260RESOLUTION NO. 16,260
RESOLUTION OF THE CITY COUNCIL OF THE CITY
OF NATIONAL CITY DECLARING
ABC CONSTRUCTION CO., INC.
THE LOWEST RESPONSIBLE BIDDER AND AUTHORIZING
THE MAYOR TO EXECUTE AN AGREEMENT
WITH ABC CONSTRUCTION CO., INC.
WHEREAS, the City Clerk of the City of National City
did, on May 24, 1990, publicly open, and examine and declare
all sealed proposals or bids for improvements of the Ridgeway
Drive Cul-de-sac (Engineering Specs. No. 1031).
NOW, THEREFORE, IT IS HEREBY RESOLVED that the City
Council of the City of National City hereby rejects all of
said bids except that herein mentioned, and hereby awards the
contract for improvements of the Ridgeway Drive Cul-de-sac to
the lowest responsible bidder, to wit:
ABC CONSTRUCTION CO., INC.
BE IT FURTHER RESOLVED by the City Council of the
City of National City, California, that the Mayor is hereby
authorized to execute on behalf of the City, a contract
between ABC Construction Co., Inc. and the City of National
City to provide improvements of the Ridgeway Drive Cul-de-sac.
PASSED and ADOPTED this 5th day of June, 1990.
! ` v`t�-
George H. a ersers, Mayor
ATTEST:
Lor Anne Peoples, Cit
APPROVED AS TO FORM:
UJ
d'c
George H. Eiser, III
City Attorney
Clerk y
/MPROVEtEA'T OF R/DGEWAY DR.
SPEC.* /03/ N
LOCATION MAP
w.T 5/30/90
CCt[.T
SPECIFICATION NO. 103]
REC
2 1990
THIS AGREEMENT, made this, the 5th day of June 119 90 ,by and
between City of National City hereinafter called IOWNER", acting herein
through its Mayor, and (1) ABC CONSTRUCTION COMPANY, INC.
an individual doing business as (an individual) (a partnership) (a
corporation) of the City of San Diego County of San Diego and State
of California hereinafter called "CONTRACTOR".
WTINESSETH• That for and in consideration of the payments and agreements
hereinafter mentioned, to be made and performed by the OWNER, the
CONTRACTOR hereby agrees with the OWNER to commence and complete the
construction described as follows:
IMPROVEMENT OF RIDGEWAY DRIVE
hereinafter called the project, for the sum of ONE HUNDRED AND NINE THOUSAND
THREE HUNDRED AND FIFTY EIGHT Dollars
($ 109.358.00 ) and all extra work in connection therewith, under
the terms as stated in the General and Special Provisions of the Contract;
and at his (its or their) own prover cost and expense to furnish all the
materials, supplies, machinery, equipment, tools, superintendents, labor,
insurance, sales tax, and other accessories and services necessary to
complete the said project in accordance with the conditions and prices
stated in the Bidder's Proposal, the General Provisions and Special
Provisions of the Contract, the Plans, which include all maps, plats,
blueprints, and other drawings, and printed or written explanatory matter
thereof, the specifications and contract documents therefore, all which are
made a part hereof and collectively evidence and constitute the Cyr►tract.
The CONMUCTOR hereby agrees to commence work under this contract on or
before a date to be specified in a written "NOTICE TO PRE" of the OWNER
and to fully complete the project within 45 working days thereafter. The
CONTRACTOR further agrees to pay, as liquidated damages, the suss of
$ 250.00 for each consecutive calendar day that he is in excess of the time
specified for completion.
The Cat agrees to pay the CONTRACTOR in current funds for the performance
of the contract, subject to additions and deductions, as provided in the
General Provisions of the Contract, and to make payments on account
thereof.
(1) Correct name of Contractor
CONTRACT
Revised 6/7/90
-11-
IN WITNESS WHEREOF, the parties to these presents have executed this
contract in two (2) counterparts, each of which shall be deemed an
original, in the year and day first above mentioned.
Licensed in accordance with
an Act providing for the
registration of Contractors.
LICENSE N0. 254763
LICENSE TYPE A,B,C12
CITY LICENSE obtaining
FEDERAL I.D. N0. 95-2549063
CITY OF NATIONAL CITY
By:_Mayor
ABC CONSTRUCTION COMPANY, INC.
By:
Con
WAYNE CZUBERNAT, President
Official Title
3120 National Ave.
San Diego, CA 92113
Business Address
CCRPCRATE ICA E
,' STATE OF California )
COUNTY.OF • San Diego
On this Twenty-first
came MARY CZUBERNAT
SS:
).
day of
Juno
1990,;before me personally
to me known,, who, being by
,me duly sworn, did depose and say that he resides in San Diego, CA
thatshe is the Secretary of
the ABC Construction Co., Inc;
•
the corporation which executed the foregoing instrument; thatshe knows the seal of
the•said corporation; that,the sealaffixed, to the said instrument is.such corporate
seal; that it was so affixed by order of the Board of Directors of the said
corporation, and thatshe signed his name to the said instrument by like order.
OFFICIAL SEAL •
•KENNETH CZUBERNAT
Notary Public -California
PRINCIPAL COUNTY 'IN .*q•SAN DIECO COUNTY
My Comm. Ex;.. May 28. 1991
came WAYNE CZUBERNAT
J LLL1C
177V,;osrore me personally
to me known...who, being by
,me duly sworn, did depose and say that he resides in San Diego, CA . -
that he is the PrnaiAant of the ABC Construction Co., Inc..
•
the corporation which executed the foregoing instrument; that he knows the seal of
"--"the said corporation; that,the seal.affixed.co.the said instrument is such corporate
-seal; that it was so affixed by order -of the Board of Directors of the said
corporation, and that he signed his name to the said instrument by like order.
OFFICIAL SEAL .
KENNETH CZUBERNAT
• Notary Publk-Calitomia
PRINCIPAL COUNTY fN
SAN DIEGO COUNTY
Iy Comm. Exp. May 28. 1991
BOND NO. 20902090
CCNTRACTBG[_- CIYCFNATIONALCITY
PAYMENT BCK) - P[ELSC IERK,S
MOW ALL NEN BY THESE PRESENTS: That we ABC CONSTRUCTION CO., INC. of
,CAN niFc;O. CALIFORNIA
as Principal, and
SEABOARD sURETY COMPANY , a Surety
authorized to transact surety business in the State of California, as
Surety, are held and firmly bound unto the City of National City, as
Obligee, in the sum of FIFTY FOUR THOUSAND SIX HUNDRED AND SEVENTY
-NINE Dollars
($ 54.679.00 ), for the payment whereof, well and truly to be made,
said Principal and Surety bind themselves, their heirs,
administrators, successors and assigns, jointly and severally, firmly
by these presents.
WHEREAS, the condition of the foregoing obligation is such that
the above bounden Principal has entered into a contract, dated
June 5 , 1990 , with the Obligee to do and perform the following
work, to wit:
IMPROVEMENT OF RIDGEWAY DRIVE
Specs No. 1031
NOW, RARE, if the above -bounden Principal or his
subcontractors fail to pay any of the persons named in Section 3181 of
the Civil Code of the State of California, or amounts due under the
Unemployment Insurance Code with respect to work or lah-r performed
under the contract, or for any amounts required to be deducted,
withheld, and paid over to the Employment Development Department from
the wages of employees of the contractor and his subcontractors
pursuant to Section 13020 of the Unemployment Insurance Cbde of the
State of California, with respect to such work and 3ah+r, the Surety
will pay for the same, in an amount not exceeding the sum specified in
this band, and also, in case suit is brought upon this bond, a
reasonable attorney's fee, to be fixed by the Court.
This bond shall insure to the benefit of any and all persons,
ocxapanies or corporations entitled to file claims under Section 3181
of the Civil Code of the State of California, so as to give a right of
action to them or their assigns in any suit brought upon this bond.
SIGNED, SEALED and DATED this
1990
18TH day of JUNE
ABC CONSTRUCTION CO., INC.
•
(Name o� i 1�
By:
Title WAYN CZUB AT, President
(Seal)
SEABOARD SURETY COMPANY
Surety
act)
OLD D. HALL •
(Atte tary Acknowledgment
for At • -y-in Fact)
Address to which notices to
should be sent:
19700 FAIRCHILD uxivt #iiu
-13-1RViNE, CA 91/1S
City Attorney
• BOND NO. 20902090
CONIRAC,T BOND - CITY CF NATIONAL CITY
PAYMENT HID - PUBLIC __ -
MOW ALL MEN BY THESE PRESENTS: That weABC CONSTRUCTION CO.. INC. of
SAN DIEGO. CALIFORNIA as Principal, and
$F.AROART) SURETY COMPANY , a Surety
authorized to transact surety business in the State of California, as
Surety, are held and firmly bound unto the City of National City, as
Obligee, in the sum of FIFTY FOUR THOUSAND SIX HUNDRED AND SEVENTY
NINE Dollars
($ 54.679.00 ), for the payment whereof, well and truly to be made,
said Principal and Surety bind themselves, their heirs,
administrators, successors and assigns, jointly and severally, firmly
by these presents.
WHEREAS, the condition of the foregoing obligation is such that
the above bounden Principal has entered into a contract, dated
June 5 , 1990 , with the Obligee to do and perform the following
work, to wit:
IMPROVEMENT OF RIDGEWAY DRIVE
Specs No. 1031
• STATE OF -California )
ss:
-COUNTY OF San Diego
On this Twenty-first day of J
41
.came WAY czTTRF.RNAT to me known, who,. being by
`-le duly sworn, did depose and say that he resides in San Diego, CA
that .he is the President of the ABC Construction Co.;Inc;•
the'corporation.which executed the foregoing instrument; that he knows the seal of
the said corporation; that the seal affixed to the said instrument is such corporate
seal;. that•it-was so affixed by order.of the Board of Directors of the said
. .corporation, and that he signed his name to the said instrument by like order.
•
OFFICIAL SEAL
KENNETH CZUBERNAT
Notary Public-Califomia
PRINCIPAL COUNTY IN
SAN DIEGO COUNTY
My Comm E MC.),28. 1991
179U
STATE OF CALIFORNIA
CITY AND COUNTY OF SAN DIEGO ) ss.:
June 1990, before me personally
0n this 18TH day of JUNE 1990 , before me, the undersigned Notary Public
in and for the State, personally appeared JEROLD D. HALL
me (or proved to me on the basis of satisfactory evidence), to be the person whoperson executedotheto
written instrument as Attorney -in -Fact on behalf of the corporation therein named and
acknowledged to me that the corporation executed it.
#n` .iven under my hand and Notarial Seal this 18TH
d
My commission expires
OFFICIAL SEAL
LAMES F. TEGHTMEYER
NOTARY PUBLIC . CALIFORNIA
PRINCIPAL OFFICE IN
SAN DIEGO COUNTY
My Commisson E.o May 11 I997
day of
-e
JUNE A.D., 1990
Nota irubl
_ -
- -
• CeHied Copy SEABOARD SURETY COMP
410. -2-1. 0 371 DFFICES, BEDMINSTER, NEW JERSEY_ -j,=_
- - "=.-----1-1:00wER OF ATTORNEY
• ---ACNOW ALL MEN BY THESE PRESENTS: That SEABOARD SURETY COMPANY, a corporation of the _State of New York, has
• 4riade, constituted and appointed and by these presents does make, constitute and appoint 43'ero1d
- -San Diego, California
its true and lawful Attorney -in -Fact, to make, execute and deliver on its behalf insurance policies, surety bonds, undertakings and
other instruments of similar nature as follows: without Limitations
Such insurance policies, surety bonds, undertakings and instruments for said purposes, when duly executed by the aforesaid
Attorney -in -Fact, shall be binding upon the said Company as fully and to the same extent as if signed by the duly authorized
- officers of the Company and sealed with its corporate seal; and all the acts of said Attorney -in -Fact, pursuant to the authority
hereby given, are hereby ratified and confirmed. . := 7-• . -
This appointment is made pursuant to the following By -Laws which were duly adopted by the Board of Directors of the said
Company on December 8th, 1927, with Amendments to and including January 15, 1982 and are still in full force and effect:
ARTICLE VII, SECTION 1:
"Policies, bonds, recognizance., stipulations, consents of surety, underwriting undertakings and instruments relating thereto.
insurance policies, bonds, recognizances, stipulations, consents of surety and underwriting undertakings °Me Company, and releases, agreements and other
writings relating in any way thereto or to any claim or loss thereunder, shall be signed in the name and on behalf of the Company
(a) by the Chairman of the Board, the President, a Vice -President or a Resident Vice -President and by the Secretary an Assistant Secretary, a Resident
Secretary or a Resident Assistant Secretary; or (b) by an Attorney -in -Fact for the Company appointed and authorized by the Chairman of the Board, the
President or a Vice -President to make such signature: or (c) by such other officers or representatives as the Board may from time to time determine.
The seal of the Company shall if appropriate be affixed thereto by any such officer. Attorney -in -Fact or representative."
IN WITNESS WHEREOF, SEABOARD SURETY COMPANY has aused these presents to be signed by one of its Vice -
Presidents, and its corporate seal to be hereunto affixed and duly attested by one of its Assistant Secretaries, this _._24.th...
day of . _ _ - - - - -
1,1111E7 y
$ e
•v - - SEABOARD SURETY COMPANY, ° Attest - - -- -- — — -
- Assistant etary ±._-. - -_- 13-Y- 'Lk- - - - _ - Alice- esident
s‘,......
= -
STATE OF NEW JERSEY = _
COUNTY OF SOMERSET
On this . - = 40 :13siefore meciersonally appeared
-.14241itchhie-1--- -113:3'41a. f..-4 Vice -President of SEABOARD SURETY COMPANY,
, • with whom I am personally acquainted, who, being by me duly sworn, said that he resides in the State of --Ne-w---Jer-sey.:
that he is a Vice -President of SEABOARD SURETY COMPANY, the corporation described in and which executed the foregoing
instrument:that he knows the corporate seal of the said Company;lhat the seal affixed to said instrument is SUCtl corporate seal;
that it was so affixed by order of the Board ofDirectors of said Company; and that he signed his name thereto as Vice -President of
parry by like authority. 4„.
-FEUCE 14.4,'CTACANO - -
NOTARY PUBLIC OF NEW -105gY
My Commission Exp. Juni 4/1e91
CERTIFICATE
of Attorney
herebytertofvitlich. Notaryth foregopubinglicis
- -COMPANY efnazuted the said of
undersigned Assustant
ary 01
thatthe
and currectcopy, force entirized beytie;le Board of Directors 10 poInt an On the further_7: "7ct 447. Sectionrovided in Articte VH, of theoiyAliVisdr °ofi
Attomey
This 01 the toliowing resolution Ot the Executiiie Directors 01 wassEAtl'ne *oc larmifier suREtesTynSEABOARD SURE1'Y ANY. dayerfDaiiAleNa`lteiciti;a=alliet-ing---7-dttliSirielerdititrIeltad°;:itYznr,go, aflApany zirwz si an slant Secretary on any
Cefti7iCariOilLoIVEL(2)corrretatrietofttsizeCo°14111fintof aneidnstrfacslinliervent lgexecuted by the-P or sell:ice-President Ptiritiant to Article Vist.Seeng undetion LaktingthesSory-Leothewsr
IIPP°1 g and authorizing
-Sifted it Such 298i and sisal aignature had been manually -affixed and made. hereby
an attorney -in -loci 10 sign inMe name - wad _on behalf Company surety bonds.
instruments described in said Article Vtl, Section karth like iS
.41,11horized and approved..7
* _
IN
WITNESS 1 have hereunto set my hand and affixed ttte corporate seal of fh:Companylio these presents this
- -
4927
Secretary;
VIM -7,84)
„ var,ifinatinn_of thP_auttentiritmzflbis_eci.wer,cif..Altritnnst wrx, mom
BOND NO. 20902090
CCNTRACT BOND - CITY OF NATIONAL CITY
FAIMBF L IS - PUBLIC VMS
KNOW ALL NEN BY THESE PRE: 'ZiAT ABC CONSTRUCTION CO., INC.
of SAN DIEGO, CALIFORNIA
as Principal, and SEABOARD SURETY
COMPANY , a surety authorized to transact
surety business in the State of California, as Surety, are held and firmly
bound unto CITY OF NATIONAL CITY, CALIFORNIA, in the sum of ONE HUNDRED AND
NTNE THOUSAND AND THREE HUNDRED FIFTY EIGHT Dols
($ 109.358.00 ), for the payment whereof, well and truly to be made,
said Principal and Surety bind themselves, their heirs, administrators,
successors and assigns, jointly and severally, firmly by these presents.
The condition of the foregoing obligation is such that, whereas the
above -bounden Principal has entered into a contract, dated June 5
19 90 , with the CITY OF NATIONAL CITY, CALIFORNIA, to do and perform the
following work, to wit:
IMPROVEMENT OF RIDGEWAY DRIVE
Specs No. 1031
NOW, THEREFORE, if the above -bounden Principal shall faithfully
,perform all of the provisions of said contract, then this obligation shall
be void; otherwise to remain in full force and effect.
SIGH and SEAL this 18TH day of JUNE ,
19 90 .
APPROVED AS TO FORM:
By:
ABC CONSTRUCTION CO., INC.
(Name of Principal)
By: Afar/ qt44144.
Title WAYNE CZUBERNAT, President
(Seal)
SEABOARD SURETY COMPANY
(Surety)
By:
Attorney -in -Fact
JEROLD D. HALL
(Atta.; •tart' Acknowledgment for
At - -in-Fact)
Address to which notice to Surety
should be sent:
19700 FAIRCHILD DRIVE #130
IRVINE, CALIFORNIA 92715
Revised
-14-
6/5/90
BOND NO. 20902090
CNTRAC.TBID- CLTYOFIATIOALCIY
FATEFUL PS 4 Z E - PCB;.IC MORES
KNOW AIL MEN BY THESE PRESENTS: THAT ABC CONSTRUCTION CO., INC.
of SAN DIEGO. CALIFORNIA
as Principal, and SEABOARD SURETY
COMPANY , a surety authorized to transact
surety business in the State of California, as Surety, are held z f
bound unto CITY OF NATIONAL CITY, CALIFORNIA, in the sum of
E HUNDRED AN"
pINE THOUSAND AND THREE HUNDRED FIFTY EIGHT _
($ 109.358.00 ), for the payment whereof, wm"
said Principal and Surety bird theme
successors and assigns, in''`•
Calif o r ia
^ATE OF
CODIIT1 'OF • in
'On this g R bsAt he =
�e sworn; id dePoge an rum
mt auly
San Die'o
-first
des
d say t esi of the ht yows thh co 4 = to
ant; that ant is suc
8 e re$oing instrument;
fixed to d instrument
OTe the raiser.
that tie is the rporation whirl' that°that,the seal. afof the board d instof rument y like or.
the CO at corporation;
and ioa, affixed by ors name to the said al of
his
e'8a�t it wastiC ht• sl8ned gEAt
corporation,
o Porati°a, an02.4OF�eeT
....oaERNAT, President
Tweet
WAYNE
STATE OF CALIFORNIA
CZ
) ss.:
CITY AND COUNTY OF SAN DIEGO
es; ma personally
i990, .before
who ► being by
day to me knows,.
San Die °
ADC Construction Co.
at
NOTARY
LIC
TAC'• .
SEABOARD SURETY COMPANY
(Surety)
By:
1 Li-rS
(Seal)
0n this 18TH day of JUNE 19_10, before me, the undersigned Notary Public
in and for the State, personally appeared .iFRnt.fl n_ PAT.t. a person known to
me (or proved to me on the basis of satisfactory evidence), to be the person who executed the
written instrument as Attorney -in -Fact on behalf of the corporation therein named and
acknowledged to me that the corporation executed it.
Given under my hand and Notarial Seal this
commission expires
OFFICUL SEAL
18TH day of
JAMES F. TEGHTMEYER
NOTARY PUBLIC • CALIFORNIA
PRINCIPAL OFFICE IN
SAN DIEGO COUNTY
My Comm,ss,ori Eap May I I 1992
1TTNF
A.D., 19 an
Revised
-14-
6/5/90
-
BOARD SURETY COMP
- ,DMINlSTRATIVE OFFICES, BEDMINSTER,44EW RS
SOWER OF -ATTORNEY
KNOW ALtMEN BY THESE PRESENTS: That SEABOARD SURETY COMPANY, a t orporatian oftheState of New York,has
;made, constituted and appointed and by these presents does make, constitute and appoint Jerolt3 iai l
of -fan lyaego, California
its true and lawful Attorney -in -Fact, to make, execute and deliver on its behalf insurance policies, surety bonds, undertakings and
-other instruments of similar nature as follows: Without Limitations
Such insurance policies, surety bonds, undertakings and instruments for said purposes, when duly executed by the aforesaid
Attorney -in -Fact, shall be binding upon the said Company as fully and to the same extent as if signed by the duly authorized
officers of the Company and sealed with its corporate seal; and all the acts of said Attorney -in -Fact, pursuant to the authority
hereby given, are hereby ratified and confirmed. _
This appointment is made pursuant to the following By -Laws which were duly adopted by the Board of Directors of the said
Company on December 8th, 1927, with Amendments to and including January 15, 1982 and are still in full force and effect:
ARTICLE VII, SECTION 1:
'Policies, bonds, recognizances, sUPWafions, mats of surely, underwriting undertakings and instruments relating thereto.
Insurance policies, bonds, recognizances, stipulations, consents of surety and underwriting undertakings of the Company, and releases, agreements and other
- writings relating in any way thereto or to any claim or loss thereunder, shall be signed in the name and on behalf of the Company
(a) by the Chairman of the Board, the President, a Vice -President ora Resident Vice -President and by the Secretary,an Assistant Secretary, a Resident
Secretary or a Resident Assistant Secretary; or (b) by an Attorney -in -Fact for the Company appointed and authorized by the Chairman of the Board, the
-President or a Vice -President to make such signature; at (c) by such other officers or representatives as the Board may from time to lime determine.
The seal of the Company shall if appropriate be affixed thereto by any such officer, Attomey-in-Factor representative." -
_.,- (N WITNESS WHEREOF, SEABOARD SURETY COMPANY has caused these presents to be signed by one of its Vice-
?residents, and its corporate seal to be hereunto affixed and duly attested by one of its Assistant Secretaries, this _..29.ti1...
day of At? t...___ :.;_,19 $.
e Attest:
;_
--(Seal
SIAI t OF NEW JERSEY
COUNTY OF SOMERSET
Con this ..day of 8._= eiore me personally appeared
Michael j3. Keegan °�_.�_ . ,___._ __.__ Vice -President of SEABOARDSURE fY COMPANY,
with whom I am personally acquainted, who, being by me duly sworn, said that he resides in the State of ;
that he is a Vice -President of SEABOARD SURETY COMPANY, the corporation described in and which executed the foregoing
instrument; that he knows the corporate seal of the said Company; that the seal affixed to said instrument is such corporate seal;
-#hat it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto as Vice -President of
pany by like authority. ft E II . tATAIAN0
-= NOTARY 1'UBUC Df- NEW fbRs Y
sty Commission E.xp. Jtlni 4;1191
CERTIFICATE
undersigned Assistant Secretary of SEABOARD SURETYCOMPANYtio hereby certify Ibatthe original Power of Attomey of which the foregoing is
and correct copy, is intuit force and efa on the date alibis CertifiateardIdolurthercertifythattheViice PresidentwhooxeaHedthesaidPowerof
Attorney was one of the Officers authorized by y the Board of Director* to appoint an Attorney t-fact as -Provided ht-Attietert Section 1. of the By -Laws of
E EABOARDSURETt COMPANY.
phis Certificate maybe signed and sealed by facsimii findeia d by authority id the foffewing resolution of the Exetumve Committee of the Board of
Directors of SEABOARD SURETYCOMPANY at a meeting duly bad and held on the 25th day of fdarch 1970. -
'RESOLVED: -(2) That the lite of a printed facsimile of the corporate seal of the Company and el the ire of en Assistant Secretary on any
certification of the correctness of a copyof an instrument executed by the President or a Vice -President pursuant to Article VII, Section 1. of the 8y-laws
-appointing and authorizing an attorney -in -fact to sign in the nerve and an behalf of the Company surety bonds, 'underwriting undertakings or other
instruments described in said Article lilt, Sections with like effecter flsuch seal and such suture had bon3ranusHyaffixed and made, hereby is
=urttmriaed and approved.
N WITNESS WHEREOF; t Have hereunto t myf hand and- r e atecorporate al of „ C any to fuse presents this
ITEMS CY ACCIFICATICE LIST
the Contractor shall provide the names, addresses and telephone numbers of
three different responsible persons who can be contacted In an emergency
situation who will have the authority to act in the Contractor's absence.
NAME
1. Robert Czubernat
..'NI .
6722 Sunnybrae
San Diego, CA 92119
ACNE
During After
Working Hours *irking Hours
239-3428 697-7467
2. David A. Inman 11119 Scripss Ranch Blvd. 239-3428 536-9850
San Diego, CA 92131
3 Wayne Czubernat 9171 Circulo Margen
Spring Valley. CA 92077
iTH:MERCY I C TI ICNTICN LIST
239-3428 470-6076
-15-
Form -9
�a40etoeer 1983)
;partirentof brie Treasury
interest Revenue Somme
Payer's Request for Taxpayer
Identification Number
i
1
lit
Name as shown on account (d joint account. also gwe joint owner's name)
ABC CONSTRUCTION COMPANY, INC.
Address
3120 National Ave.
Crty. State, and 2IP code
San Diego, CA 92113
List account number(s) here (See Instructions) ►..»»»
PART I. -Taxpayer Identification Number
Enter the taxpayer identification number in the
appropriate box. For most individual taxpayers,
this is the social security number.
Note: If the account is in more than one name.
see the chart on page 2 for guidelines on which
number to give the payer.
Social seamy number
OR
Employer identification number
95; 2549063
PART II. —Backup Withholding On
Accounts Opened After
12/31/83
Check the box if you
are NOT subject to
backup withholding
under the provisions of
section 3406(aX1XC)
of the internal Revenue
Code ►
(See Highlight below.)
Certification. —Under the penalties of perjury, 1 certify that the information provided on this form is true. correct, and complete.
Signature ►
w
Instructions (Section references are to the Internal Revenue Code.)
-`righlight for Interest or Dividend Accounts Opened After
1/31/83—Backup Withholding
You may be notified that you are subject to backup withholding under
section 3406(a)(1XC) because you have underreported interest or
dividends or you were required to but failed to file a return which would
have included a reportable interest or dividend payment. If you have NOT
been so notified. check the box in PART II. Note: Backup withholding may
apply to existing accounts as well as accounts opened after December 31,
1983.
Caution: There are other situations where you may be subject to backup
withholding. Please read the instructions below carefully.
Purpose of Form
Use this form to report the taxpayer identification number (UN) of the
record owner of the account to the payer (or broker).
Beginning January 1.1984. payers must generally withhold 20% of
• taxable interest, dividend. and certain other payments it you fad to furnish
payers with the correct taxpayer identification number (this is referred to as
backup withholding). For most individual taxpayers. thetaxpayer
identification number is the social security number.
• To prevent backup withholding on these payments, be sure to notify
payers of the correct taxpayer identification number and. for accounts you
open after December 31.1983, properly certify that you are not subject to
backup withholding under section 3406(aX1XC).
You may use this form to certify that the taxpayer identification number
you are giving the payer is correct and, for accounts opened after.
December 31.1983. that you are not subject to backup withholding..
If the payer provides a different form than Form W9 to request the
taxpayer identification number, please used.
Backup Withholding
You are subject to backup withholding if:
(1) You fail to furnish your taxpayer identification number to the payer, OR
(2) The Internal Revenue Service notifies the payer that you furnished an
incorrect taxpayer identification number. OR
(3) You are notified that you are subject to backup w:9iholding (under
�r xection 3406(aX1XC)), OR
a) For an interest or dividend account opened after December 31,
483. you fad to certify to the payer that you are not subject to backup
withholding under (3) above, or fail to certify your taxpayer identification
number.
For payments other than interest or dividends. you are subject to backup
withholding only if (1) or (2) above appbies.
(See the section on the back titled "Payees Exempt from Backup
Wenholoing.'•)
(Give this form to the payer, not to the Internal Revenue Se
•Date ► June 21, 1990
Payments of Interest, Dividends, and Patronage
Dividends
Accounts Opened Before January 1,1984
To certify that the taxpayer identification number is correct for accounts
opened before January 1.1984, fill out your name and address, enter your
account numbers) (if applicable), complete Part I, sign and date the form
and retum it to the payer.
Accounts Opened After December 31,1983
To certify that the taxpayer identification number is correct and that you are
not subject to backup withholding under section 3406(aX1XC) for accounts
opened after December 31.1983, fill out your name and address, enter
your account number(s) (if applicable), complete Parts 1 and II, sign and
date the form and return it to the payer.
tf you are subject to backup withholding and are merely providing your
correct taxpayer identification number to the payer, fill out your name.
address, enter your account number(s) (if applicable), and complete Part I.
Other Payments
If you are merely providing your correct taxpayer identification number to
the payer for payments other than interest. dividends, and patronage
dividends, you need not sign this form. Fill out your name and address,
enter your account number(s) (if applicable), complete Part 1 and return
the form to the payer.
Account Numbers
tf you have more than one account with the same payer (for example, a
savings account and a certificate of deposit at the same bank), the payer
may request a separate Form W9 for each account depending on how the
payers records are kept.
What Number to Give the Payer
Give the payer the social security number or employer identification
number of the record owner of the account. B the account belongs to you
as an individual, give your social security number. If the account is in more
than one name or is not m the name of the actual owner, see the chart on
page 2 for guidelines on which number to report.
Obtaining a Number
If you don't have a taxpayer identification number or you don't know your
number, obtain Form SS•5. Application for a Social Security Number Card,
or Form SS•0, Application for Employer Identification Number. at the local
office of the Social Security Administration or the Internal Revenue Service
and apply for a number. Write 'applied for' in Part 1 in place of your
number. When you get a number, submit a new Form W9 to the payer.
rvice)
Form W9 (14d3)
CERTIFICATE OF INSURANCE
PRODUCER
JBERT F. DRIVER CO., INC.
1620 5TH AVENUE
SAN DIEGO, CA. 92101
AGENT: STEVEN MESSER
CODE SUB -CODE
RISURED
ABC CONSTRUCTION CO., INC.
3120 National Ave
San Diego CA 92113-2544
ISSUE DATE (MM/DDNY)
6-19-90
THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
A
E
COMPANIES AFFORDING COVERAGE
GOLDEN EAGLE INSURANCE
COVERAGES
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.
CO
TYPE OF INSURANCE
LTR
A GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.
OWNERS 8 CONTRACTORS PROT.
IUTOMOBILE LIABILITY
ANY AUTO
X ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
GARAGE LIABILITY
A EXCESS LIABILITY
A
X OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
POLICY NUMBER
POLICY EFFECTIVE POUCY EXPIRATION
DATE IMWDDNY) DATE (MMNDDNY)
CCP117195 7/01/90 7/01/91
CCP117195
EXC117196
PWC108658
7/01/90 7/01/91
7/01/90 7/01/91
7/01/90 7/01/91
Additional Insured as per attached endorsement CG 20 09.
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/ iESTR ICTIONS/SPECIAL ITEMS
JOB: Improvement of Ridgeway Drive, Spec. #1031.
ALL LRAITS IN THOUSANDS
GENERAL AGGREGATE
PRODUCTS-COMP/OPS AGGREGATE
PERSONAL & ADVERTISING INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
MEDICAL EXPENSE (Any one person)
COMBINED
SINGLE
LIMIT
$
BODILY
INJURY g
(Per person)
BODILY
INJURY $
(Per accident)
PROPERTY
DAMAGE g
1000
$ 2000
$ 1000
$ 1000
$ 1000
$ 50
$ 5
EACH AGGREGATE
OCCURRENCE
$1000 $ 1000
STATUTORY
$ 100
$ 100
$ 500
(EACH ACCIDENT)
(DISEASE -POLICY LIMIT)
(DISEASE -EACH EMPLOYEE)
CERTIFICATE HOLDER
City of National City
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL g SAT(x XIX MAIL
ifl DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
1243 National City Blvd. LEFT,I@ xRNWROTIMPl AORAtf IRN NNiPnNIRR 3chAOO9CXoRvNxe
National City, CA 92050-4397ldNWARIIVFxst+xiRMW43nNxWNft xxx aTWWWWRRNxxm€Y:
AUTHORIZED REPRESENTATIVE
Steven P. Messer/rsc