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HomeMy WebLinkAboutW. Koo & Associates 3AGREEMENT TERMINATION00 n'> Please complete this form when the attached agreement is no longer effects ; zs^:{.s{ Return form to the Sr. Deputy Clerk of the Council (M-30) W�-294 647-52 8 if you have any questions. The agreement with *V/ l<Oa was completed on 177 / / / nand final payment has been made. Department: y We —%tq p s q, n- Signature: , `�L-�A CA Date: / per , City of Santa Ana Revised 8-7-03 Clerk of the Council A-2005-012 INSURANCE ON FILE WORK MAY PROCEED UNTIL NSURANCE EXPIRES 9 -,30 -05 CONSULTANT AGREEMENT CLE6rl OF COUNCIL DATE: .Z-'] - 0 6 C; P�Ia iµ•�Y� THIS AGREEMENT made and entered into this I g day of January, 2005 by and between W. Koo & Associates, Inc., a Division of PBS&J, a Florida corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of engineering to provide structural Plans, Specifications and Estimates for three City bridges and a cantilever bike trail structure. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform engineering design services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in the Cost Proposal, attached hereto as Exhibit B, and more fully detailed in Consultant's Proposal dated December 27, 2004, on file in the Santa Ana Public Works Agency. The total sum to be expended under this Agreement shall not exceed $303,160.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. WORK PRODUCT Consultant shall deliver to City all work product resulting from the services provided. Said work product shall be submitted in a hard copy and produced in a form compatible with City's computer system, as agreed between the Project Manager and Consultant. In regard to any copyrightable material, produced as a deliverable under this Agreement, including but not limited to books, reports, plans, photographs and drawings, which are produced as part or result of this project, the Consultant understands and shall ensure that all of Consultant's affected officers, employees, agents, subconsultants, and volunteer workers also understand that (a) other such material may not be copyrighted without prior review from the City: (b) the authors of all such material, whether copyrighted or not, award to the City, and to its officers, agents and employees acting within the scope of their official duties, as a condition of payment to the Consultant, a royalty -free, nonexclusive, irrevocable license throughout the world for governmental purposes to disclose, publish, translate, reproduce, and use such materials. 4. TERM This Agreement shall commence on the date first written above and terminate on December 31, 2005 unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Public Works and the City Attorney. 5. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit C upon execution of this Agreement and shall be approved in form by the City Attorney. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. c. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 7. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, employees and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, to the extent caused by the operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including reasonable fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 8. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information' shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 9. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 10. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: and Executive Director of Public Works City of Santa Ana 20 Civic Center Plaza (M-21) Santa Ana, California 92702 telefacsimile (714) 647-5622 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Consultant: W. Koo & Associates, a Division of PBS&J 600 The City Parkway West, Suite 310 Orange, California 92868 Telefacsimile (714) 456-0295 Attn: Wei Koo, S. E. A party may change its address by giving notice in writing to the other party. Thereafter, any notice, tender, demand, delivery, or other communication shall be addressed and transmitted to the new address. If sent by mail, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 11. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 12. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 13. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. Consultant shall not be liable in any way for the unapproved use, re -use or modification of the deliverables or other documents without Consultant's express written authorization. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 14. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 16. COMPLIANCE WITH GOVERNMENTAL REQUIREMENTS Consultant shall carry out all services pursuant to this Agreement in substantial conformity with all applicable laws, ordinances, statutes, codes, rules, regulations, orders, and decrees of the United States, the State of California, the County of Orange, the City, and of any other political subdivision, agency, or instrumentality exercising jurisdiction over the City, including all applicable federal, state, and local occupation, safety and health laws, rules, regulations and standards, applicable state and labor standards, prevailing wage requirements, the City zoning and development standards, City permits and approvals, building, plumbing, mechanical and electrical codes, as they map apply, and all other provisions of the City and its Municipal Code (as they may apply), and all applicable disabled and handicapped access requirements, including, without the limitation, the Americans With Disability Act, 42 U.S.C. § 12101 et seq., Government Code § 4450 et seq., and the Unruh Civil Rights Act, Civil Code § 51 et seq. 17. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. H IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA PATRICIA E. HEALY DAVID N. REAM Clerk of the Council City Manager APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By:/( Laura Sheedy Assistant City Attorney CONSULTANT WEI KOO President Tax ID # 33-0082411ii A Division of • A employee -owned company December 27, 2004 Ms. Souri Amirani, P.E. City of Santa Ana — Public Works Agency Office of the Executive Director 20 Civic Center Plaza, 4m Floor Santa Ana, CA 92701 Re: Bridge Rehabilitation and Bike Trail Structure Design Consultant Services Fee Proposal Dear Ms. Amirani, W. Koo & Associates, Inc. (WKA), a division of PBS&J, is pleased to submit this fee proposal to the City of Santa Ana for Bridge Rehabilitation and Bike Trail Structure Design Consultant Services. Pursuant to our meeting on December 14`s the fee proposal has been revised to reflect the updated scope. Presented below is a summary of the work items that have been deleted from the previous fee proposal: • Geotechnical report for Flower Street over Santiago Creek • Geotechnical Field Investigation & Laboratory Testing (May need to be added back if the existing LOTB is inadequate) • Utility Coordination (To be completed by City) • Topographic surveys and surveys for centerline tie at all four locations. • Roadway survey on McFadden • Alternatives Analysis of the Bike Trail structure type (The preferred design is the cantilever structure) • Hydraulic Analysis of the Santa Ana -Della Channel • CEQA & NEPA documents for Flower Street Bridge Rehabilitation The full text of the revised scope and fee are attached. We are confident that the enclosed fee proposal reflects our clear understanding of the project issues and a solid approach to performing the necessary services. If you have any questions, please don't hesitate to call me at (714) 456- 0280. Respectfully Submitted, W. KOO & ASSOCIATES, INC. Dan Weddell, P.E. Project Manager EXHIBIT A Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 SANTA ANA BRIDGE REHABILITATION AND BIKE TRAIL STRUCTURE DESIGN SERVICES SCOPE OF WORK I WORK PLAN TASK 1.0 - PRELIMINARY ENGINEERING 1.1 PROJECT KICKOFF MEETING / FIELD REVIEW / RECORD SEARCH WKA Team will attend a "kickoff meeting" with the City to go over the project approach as well as design criteria, requirements, intents, scope, approach and procedures. We will also conduct a field review; obtain any as -built plans of the existing Structures. We will identify and perform the field surveys. Research records and obtain information from City of Santa Ana and the Orange County Flood Control District, and any other documents that may be available from the County and the US Army Corps of Engineers. DELIVERABLE: As -BUILT & DESIGN DATA 1.2 FIELD SURVEY The following survey tasks will be performed to provide the base maps for the roadway and structure layouts. • Perform survey research at the City of Santa Ana and the County of Orange for horizontal and vertical control, centerline ties, monumentation maps, right-of-way maps, record maps, right-of-way information, and any other pertinent information. • Compute the existing right of way for each project area utilizing the existing Tract Maps, Parcel Maps, and Assessor Maps. Perform design topographic surveys between the bridge abutments and the existing street sidewalk on McFadden Avenue and Fifth Street, and from R/W to R/W on the Flower Bike Structure, including obtaining RR bridge soffit grades. Perform cross -sections every 20 feet on Fifth Street and Flower Street Bridges. Deliver a MicroStation DGN file in Imperial units of the survey results per City of Santa Ana Standards and a TXT file of all the survey points with point number, X, Y, Z and descriptor. City of Santa Ana - Bridge • On one field visit, determine horizontal and vertical control positions upon up to 10 utility pothole locations for the Flower Street Bike project, utilizing project horizontal and vertical control. DELIVERABLE: BRIDGE SITE SURVEY DATA Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 1.3 PRELIMINARY RIGHT-OF-WAY RESEARCH AND UTILITY COORDINATION We will collect the right-of-way information from City, Caltrans and County to identify the property owners, easements, and/or airspace rights. This data will be added to the base map. For each bridge, we will define the needed right-of-way (partial or complete fee take, temporary and/or permanent easements, and airspace rights), current type of ownership, and whether relocation, relinquishments, abandonments, on -site construction, etc. will be required. We will determine who will transfer the right-of-way, the state or the local agency. This information will be summarized along with the estimated costs on Caltrans Right -of -Way Data Sheet for each structure. It is assumed that the City will complete all necessary utility coordination DELIVERABLE: ROW DATA SHEET 1.4 ROADWAY All bridge improvement plans will be based on an assumed centerline and stationing on the streets. Consultant will perform roadway design services to complete the curb and sidewalk improvements behind the bridge abutments to provide ADA conformance connections to existing sidewalks. 1.5 HYDRAULIC ANALYSIS, HYDROLOGY AND STORM DRAIN DESIGN No Hydraulic analysis of the Santa Ana -Delhi Channel will be conducted. It is assumed the existing high water elevation will be provided by OCFCD. A Storm Water Data Report will be prepared. The Project Planning Design Guide (PPDG) was revised in September 2002 to incorporate storm water quality control at the planning and design stage. The new standards require the preparation of a Storm Water Data Report (SWDR) describing the drainage, potential water quality issues, and proposed construction and permanent Best Management Practices (BMP's). This report is accompanied by checklists including all water quality items to be addressed, a cost estimate for the storm water quality efforts and construction costs, and constitutes "Appendix E" of the PPDG. This report will describe the drainage and water quality conditions of the project area, evaluate potential issues and propose best management practices (BMP's) to mitigate existing and future conditions, as well as construction related water quality prevention requirements. Also part of the NPDES requirements, the NPDES Information Submittal form will be prepared. DELIVERABLE: STORM WATER DATA REPORT 1.6 RAILROAD COORDINATION The Flower Street Bike Trail Structure may encroach on UPRR ROW as well as require the modification of the existing Railroad Crossing Guard Gates. WKA assumes the City will obtain all the necessary permits and access permissions from the UPRR and PUC as part of the bikeway design, as well as the design for all required RR crossing gates. The WKA team will provide the necessary information to the City for UPRR coordination. For each of the four structures, the existing drainage conditions will be reviewed Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 and potential impacts to the existing drainage facilities assessed for each proposed improvement alternatives. 1.7 GEOTECHNICAL STUDY Foundation reports for Fifth Street and McFadden Avenue Bridges have been previously completed during the seismic retrofit strategy of these bridges. For the Flower Street Bridge rehabilitation, it is assumed that the proposed improvements will have insignificant load increase on existing bridge foundations (less than 3%). Thus no foundation work is anticipated, and the foundation report will not be required. During the December 14t' meeting at the City, it is determined that alternative 3 of our proposal (cantilevered slab brigge) for the proposed Flower Street Bike Path improvements over Santa Ana -Delhi Channel is the preferred option because it has minimal effect on the Delhi Channel. This alternative will require a new row of pile foundations along the channel banks. Due to the new foundations, the Flower Street Bike Path requires a Foundation Report. A preliminary foundation report will be performed in general compliance with the Caltrans Guidelines for Foundation Investigations and Reports (Version 1.2, June 2002). including an evaluation of seismicity and ARS curves, liquefaction potential, and slope stability. This report will also recommend alternative foundation types and preliminary capacities for the new foundations. TASK 1. 7.1 - SUBSURFACE INVESTIGATION It is assumed that WKA will use the existing subsurface information for a recently constructed bike lane structure downstream from the proposed bike path structure. The information will be the basis for the design of new CIDH foundations on the bike path cantilever slab. This is the direction by the City during the December 14t"'s meeting. During the course of design, if additional explorations are deemed necessary, subsurface exploration and investigation will be performed on the basis of "Extra Services". TASK 1. 7.2 - LABORATORY TESTING This item of work was deleted per the December 141" meeting for the same reasoning presented in the Subsurface Investigation task above. Similarly, during the course of design, if additional explorations are deemed necessary, Laboratory Testing will be performed on the basis of "Extra Services". TASK 1. 7.3 - ENGINEERING ANALYSES Review of the existing Bike Structure LOTB and foundation report will form the basis of our engineering analyses. We will provide preliminary engineering conclusions and recommendations regarding: • Site conditions. • Geologic and seismic hazards. • Foundation design criteria. • Stability of existing slopes. • Lateral earth pressures and resistance to lateral loads. Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 • Soil corrosion potential TASK 1.7.4 - GEOLOGICISEISMIC INVESTIGATION A Certified Engineering Geologist (CEG) will lead the geologic/seismic investigation and will: • Review available published geologic/seismic reports pertinent to the project site. • Visit the site to identify geologic/seismic issues of concern. • Provide a discussion of relevant geologic/seismic issues. Results of recent investigations by Southern California Earthquake Center scientists and their consultants will be reviewed in our evaluation and incorporated into the development of site ground motion. TASK 1.7. 5 —FINAL FOUNDATION REPORTS The Final Foundation Report will be developed based on the existing LOTB and Engineering analysis described above. The final foundation report will include discussion of the soil conditions at the site, existing boring logs, soil classifications, groundwater level, and unusual conditions. We will also recommend an AIRS curve and seismic parameters using Caltrans California Seismic Hazard Map and ATC-32. All reports will be issued as draft for review and comments. Final reports will be issued after incorporating the review comments. DELIVERABLE: FINAL FOUNDATION REPORT (t STRUCTURE) 1.8. CONCEPT ALTERNATIVE STUDY For the bike path structure along the Santa Ana -Delhi Channel it is our understanding that the cantilever bike structure is the chosen structure type. DELIVERABLES: (Deleted) 1.9 BRIDGE GENERAL PLANS / STRUCTURE TYPE SELECTION The WKA Team will prepare the bridge general plans to reflect all the English, utility, foundation and bridge design changes. The general plan will follow Caltrans OSFP I&P Guide Section 4-2 "Structure Type Selection'. Bridge General Plans. The proposed bike path structure will span over or be constructed in the Santa Ana -Delhi Creek, which is a lined channel owned and maintained by Orange County Flood Control District. Channel hydrology and hydraulic will not be completed as it is anticipated that the structure will be above the existing high water elevation plus the minimum freeboard required The bridge type for McFadden Avenue and Fifth Street will include the study of widening by removing the existing overhang and constructing a new wider overhang to carry the girder. The existing outside girder will be checked with the increased weight of the new barrier. If necessary the girder will be strengthened to carry the additional load. For Flower Street Barrier Replacement, two alternatives will be studied. The barrier rehabilitation and replacement requires the outside sidewalk girder to be replaced and/or strengthened to carry the additional barrier weight as well as vehicular wheel loads and barrier crash loads. The first alternative will investigate strengthen the existing edge Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 girder and replacing the sidewalk girder with cast -in -place concrete. The second alternative will investigate using precast girders. This may be advantageous in that it may reduce the impact on the channel during construction Bridge Type Selection Report will be prepared that contains the material as required under I&P Guide 4-2. We will also prepare General Plan Estimates for all the structure alternatives that have been studied during the Type Selection process, and will confirm the proposed foundation design for the bike path following foundation recommendations contained in the Final Foundation Report. DELIVERABLES: BRIDGE GENERAL PLANS (4) BRIDGE TYPE SELECTION REPORT (4) GP ESTIMATES (4) 1.9.1 HBRR COMPLIANCE The Bridge Type Selection designs will be designed to meet the HBRR requirements that will remove the three bridges from the EBL and strive to follow the HBRR approved scope. The City will be notified if any HBRR scope change is required to be processed due to new design considerations. WKA will process through Caltrans the change in scope forms 6A and 6D of the Local Assistance Program Guidelines as well as coordinate with Caltrans District Local Assistance on their approval. DELIVERABLES: HBRR SCOPE CHANGE APPLICATION (IF REQUIRED) TASK 2.O - ENVIRONMENTAL APPROVAL It is assumed that the City has obtained approval of the CEQA and NEPA documents for the Flower Street Bridge Rehabilitation. To begin the environmental process for the other three structures, a Preliminary Environmental Study is required for each project. A signed PES is assumed to be completed by the City prior to the start of this project. TASK 2.1 : INITIAL SITE ASSESSMENT Fifth Street and McFadden Avenue Bridges both are part of a recent seismic retrofit project and thus are assumed to have a current ISA checklist. For Flower Street Bike Trail Structure, pursuant to Caltrans requirements, RBF will prepare an Initial Site Assessment (ISA) consisting of a regulatory database search, site walkover and completion of the standard Caltrans ISA Checklist. TASK 2.2: MINIMAL NATURAL ENVIRONMENT STUDY A literature review will be conducted to determine which species have been identified as special status by state, federal, and local resources agencies and organizations, and have a potential to occur within the project site or immediate vicinity. Sources to be reviewed include: (1) special status species lists from the California Department of Fish and Game (CDFG), U.S. Fish and Wildlife Service (USFWS), and California Native Plant Society (CNPS); (2) database searches of the California Natural Diversity Database (CNDDB) and the Electronic Inventory of the CNPS; (3) the most recent Federal Register listing package and critical habitat determination for each federally -listed Endangered or Threatened species potentially occurring within the project site; (4) the Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 CDFG Annual Report on the status of California's listed Threatened and Endangered plants and animals; and (5) other biological studies conducted in the vicinity of the project site. Vegetation types will be mapped to identify and describe the extent and distribution of various vegetation types on the project site, including any special status vegetation types. A description of the existing quality and species composition of the vegetation types on the project site will be compiled based upon observations and field notes taken during the survey and will be included with the documentation for the project site. A general walk -over survey will be conducted to document existing wildlife use on the project site, including an assessment of the potential for special status plant and wildlife species that may be present. This survey will be conducted simultaneously with vegetation mapping. Three (3) Minimal Impact Natural Environment Studies, consistent with the current guidelines, will be developed based on the results of various biological surveys, analysis, and data compilation described above. Each report will describe: (1) the methodology used to conduct the biological surveys; (2) a detailed description of the existing vegetation types and associated wildlife resources on the project site; (3) potential impacts from project development; and (4) recommended mitigation measures to reduce identified impacts to less than significant levels. TASK 2.3A: SECTION 106 COMPLIANCE (HBRR BRIDGES) Consultant will secure a cultural resources records search from the South Central Coastal Information Center (SCCIC) at California State University, Fullerton. The records search will provide data on known cultural resources and on previous studies within one mile of each project. Data sources consulted at the SCCIC will include archaeological and structural resource records, historic maps, and the Historic Resource Inventory (HRI) maintained by the California Office of Historic Preservation (OHP) for Orange County, listing all National Register of Historic Places (NRHP), California Register of Historic Resources (CRHR), State Historical Landmarks (SHL), and California Points of Historical Interest (PHI). Consultant will review the Orange County Historical Commission's (OCHC) Inventory of Historical Sites. Consultant will conduct a short site visit at each project location. The location will briefly be examined for prehistoric (Native American) and historic (non -Native American) archaeological evidence as well as historic built -environment resources (e.g., bridges and other structures). Consultant will prepare a letter report for each of the two bridge rehabilitation locations summarizing the results of the records search and site visit for each location. The reports will describe the potential of the project to adversely affect any potentially significant cultural resources. Consultant assumes that these three projects will be classified by Caltrans as screened undertakings under the recent Programmatic Agreement (PA). TASK 2.3B: SECTION 106 COMPLIANCE BIKE TRAIL) In addition to the works described in the previous section for Section 106 Compliance for HE RR Fifth, McFadden and Flower Street, consultant will prepare Caltrans-specific Section 106 documents appropriate under the PA for the proposed Flower Street Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 Bikepath structure along the Delhi Channel. Consultant assumes that this documentation will consist of a short -form Historic Property Survey Report (HPSR) and short -form Archaeological Survey Report (ASR), including an Area of Potential Effects (APE) Map. The HPSR/ASR report package will contain the SCCIC records search, evidence of Native American and local historical consultations, and appropriate exhibits. TASK 2.4: WATER QUALITY STUDY The WKA Team will prepare a Water Quality Study for Fifth Street, McFadden Ave rehabilitation projects as well as the Flower Street Bike Structure project. The study will: (1) identify the sources of sediment and other pollutants affect the quality of storm water discharges and (2) to describe practices to reduce sediment and other pollutants in stormwater discharges generated from the construction site. Standard control measures will be recommended. The Water Quality Study will provide a preliminary broad overview of available methods to reduce sediment, pollutants, and other construction related debris from impacting stormwater quality. TASK2.5: NEPA COMPLIANCE On behalf of the project applicant (City), the Consultant will forward environmental and preliminary engineering documentation which demonstrates that significant environmental effects will not result with project implementation. This submittal will be accompanied by a draft PCE with formal request for approval. A separate submittal will be required for each project. RBF will respond to one (1) comprehensive set of comments on the Draft documents. The revised Draft Reports will incorporate all comments received on the Draft documents. RBF will provide three (3) copies of each Final Technical Report (separately bound) to the City of Santa Ana. TASK2.6: CEQA COMPLIANCE RBF will prepared three separate Categorical Exemptions (CEs) pursuant to CEQA for processing by the City. TASK 3.O - REGULATORY PROCESSING The following will be prepared for the three HBRR rehabilitation structures. TASK 3.1: SITE VISIT To DETERMINE CORPS JURISDICTION RBF will determine acreage considered by the Army Corps of Engineers (ACOE) and the California Department of Fish and Game (CDFG) to be jurisdictional non -wetland waters of the United States.@ Since these areas of the Santa Ana River are concrete lined, it is assumed that no Wetlands will be identified. RBF will conduct a site investigation with respect to hydrology, hydrophytic vegetation (if applicable), and hydric soils (if applicable). RBF will prepare a determination of the ordinary high water mark (OHWM) within the existing drainage channel. Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 TASK 3.2: PRE -APPLICATION FIELD MEETING If desired by the ACOE, RWQCB and/or CDFG, RBF will conduct a pre -application meeting to discuss proposed project with the agencies staff. It is assumed that only one field meeting will be conducted and that all three (3) bridges will be visited the same day. This meeting will facilitate the processing of the permits by allowing the resource agencies to comment on the proposed project prior to submitting the applications. TASK 3.3: ARMY CORPS OF ENGINEERS 404 PERMIT APPLICATION Prepare submittal package for an Army Corps of Engineers 404 Permit to satisfy the requirements of Section 404 of the Clean Water Act. It is assumed that, based upon conceptual project plans, the proposed activities can be permitted under Nationwide Permit No. 14, Linear Transportation Projects. The submittal package will include: (a) 404 permit application, (b) vicinity map, (c) project description, (d) jurisdictional delineation map, and (e) site photos. It is anticipated that it will take two (2) to four (4) months to process this application. This time frame is dependent on issuance of a water quality certification by the Regional Water Quality Control Board. TASK 3.4: CA DEPARTMENT OF FISH AND GAME 1 600 PERMIT APPLICATION RBF will prepare an application submittal package for the CDFG 1602 Streambed Alternation Agreement. The submittal package will include: (a) Form FG 2023, (b) vicinity map, (c) project description, (d) jurisdictional delineation map, and (a) site photos. This task does not include the permit filing fee, which can range up to $1,390.50 depending on the construction cost of the proposed project. TASK 3.5: REGIONAL WATER QUALITY CONTROL BOARD SECTION 401 WATER QUALITY CERTIFICATION RBF will prepare a submittal to secure a 401 Water Quality Certification from the State pursuant to Section 401 of the Clean Water Act. This certification is necessary prior to the ACOE concurring with discharges of fill material under their permit process. This task does not include the permit filing fee, typically $500 per bridge. TASK 3.6: RESOURCE AGENCY PERMIT PROCESSING Provide regulatory services for the processing of the permits to the Army Corps of Engineers, the California Department of Fish and Game, and the Regional Water Quality Control Board. The processing shall include required correspondence or telephone calls between the reviewing staff related to the permit or points of clarification. TASK 4 - 60% PS&E UNCHECKED DETAILS The 60% design will not commence until WKA is given the notice to proceed. This notification is predicated on the City obtaining approval from the Caltrans District Local Assistance that the environmental documents have been approved per Caltrans Local Assistance Procedure Manual. The bridge design will have prepared in accordance with the codes and standards of Caltrans. The following list summarizes the key design Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 components of the structural improvements for the proposed bridge widening and reconstruction. 1. All plans will be prepared in English units. 2. Seismic analysis will follow the procedures as outlined in Caltrans SDC and chapter 20 of the Caltrans Memo to Designers. Effect of the combined structures will be analyzed, and additional retrofit requirement in addition to the bridge widening will be evaluated. 3. Structural aesthetics design will be included for the design of the structure barrier rails on Flower Street. Bridge aesthetics will follow the treatment on the existing structure. 4. Bridge structures will be designed following the latest Caltrans Seismic Design Criteria (SDC). 5. Because the bridge widening would involve a partial removal of the existing bridge overhang, the widening will be designed with the properly coordinated construction sequence and staging plans. Construction joints will be placed and specified on the plans to indicate location of splices. 6. Utility list will be updated at the bridge. New utility openings will be provided to accommodate new or realigned utilities. Utility relocation will be referenced in the bridge plans. 7. Bridge railings will be designed in accordance to the FHWA memorandum on Bridge Rail Analysis shown in exhibit 6-F of the Local Assistance Program Guidelines. The Unchecked Details plans and specifications will be submitted to the City of Santa Ana and Caltrans. It has been our experience that Caltrans will review the unchecked details plans (65% plans), but the railroad companies, US Corps of Engineers, County of Orange Flood Control District and Orange County Harbor Beaches and Parks, will not review them until the plans are near complete. The 65% plans will thus not be submitted to these agencies. DELIVERABLES: PRELIMINARY ESTIMATES DRAFT STRUCTURE SPECIAL PROVISIONS 65% UNCHECKED DETAIL PLANS. TASK 5 - 90% PS&E CHECKED DETAILS The WKA Team will follow the Caltrans practice and the plans will be checked independently by a registered engineer. The intent is to swap between the designers and checkers in order to maintain objectivity of the independent checking process. Differences in the calculations will be reconciled first before the Initial Plans will be submitted to Caltrans for review and approval. WKA will prepare a final quantity takeoff based on the standard Item List developed in accordance with the Caltrans Standard Specification and SSP. Designer quantity take- offs will be compared with the independent quantity takeoffs following the completion of unchecked Details Plans. We will also prepare a complete set of independent quantity check calculations of all structural components. The quantities will be compared with the designers quantity takeoffs, and all structure bid items will be checked in accordance with Caltrans Bridge Design Aids Section 11 "Estimating". Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 Suggested Work Days schedules will be prepared for the individual structures, as well as for the group of structures to be advertised and constructed in single phase. The Standard Specifications for Public Works, "Greenbook", will be the basis of the project specification and supplemented by sections of the Caltrans Standard Specification for the bridge work. We will develop a project specification based on the Greenbook and Caltrans Standard Special Provisions (SSP) in English format. The WKA Team will submit the Initial Structure Plans to the City of Santa Ana, Caltrans, County of Orange Flood Control District, and UPRR, and County of Orange Harbor Beaches & Parks where applicable, for review and approval. This stage of the submittal will include the following: • Bridge Plans • Standard Special Provisions • Quantity and Initial Engineers estimates DELIVERABLES: 90% PLANS, SPECIAL PROVISIONS AND ESTIMATES DESIGN CALCULATIONS CHECK CALCULATIONS CHECK DETAIL COMMENTS AND RESOLUTIONS TASK 6 - 100% PS&E The WKA Team will collect all the comments on the initial PS&E from the City and from Caltrans, and other reviewing agencies that issue permits for construction of the bridge and the relocation of utilities. We will respond the comments with written resolution letters that describes the method of dispositions of all comments. Revisions to the initial PS&E submittals will be made after the proposed dispositions are approved by the reviewers. The PS&E packages will be re -submitted to Caltrans for final review and approval. DELIVERABLES: gb% PLANS, SPECIAL PROVISIONS AND ESTIMATES REPONSES TO REVIEW COMMENTS TASK 7 - FINAL PS&E SUBMITTAL The final approval submittal will implement the design corrections as noted in the agency's review and our response comments. We will also produce our final Engineers Estimates as part of the final PS&E Submittal. We will also prepare the final RE pending files in accordance with Caltrans OSFP I&P Guides. All structure plans will be submitted to Caltrans both in hardcopy format, and electronic format. All plans will be prepared in DGN formats following Caltrans structure CAD preparation guidelines. RE pending files will be prepared in accordance with Caltrans MTD requirement, including the quantity summary sheets, , final approved foundation report, , and construction notes to RE. DELIVERABLES: FINAL 100% PS&E SUBMITTAL RE PENDING FILES TASKS - POST DESIGN SERVICES Santa Ana Bridge Rehabilitation and Bike Trail Structure 12/27/2004 The WKA Team will conduct post design services (PDS) during the construction of the structures. The post design services include the following activities: 1. Attend pre -construction meeting 2. Respond to Request for Information (RFI) generated by the Construction Manager 3. Review shop drawings as required by the engineer -of -record per Caltrans Standard Specification. 4. Produce As -Built plans WKA will provide other PDS at the request of the City or the Construction Manager. The services will be provided on an hour and material basis as agreed by the City of Santa Ana. Exclusions The following items are no included as part of this scope and fee: 1. Utility coordination 2. RR Coordination 3. Geotechnical report for Flower Street over Santiago Creek 4. Geotechnical Field Investigation & Laboratory Testing at all four locations. 5. Topographic surveys and surveys for centerline tie at all four locations. 6. Roadway survey on McFadden 7. The Bike Trail structure is assumed to be the cantilever slab alternative, thus hydraulic analysis of the Santa Ana -Delhi Channel is not required. 8. CEQA & NEPA documents for Flower Street Bridge Rehabilitation Page 1 W. KOO AND ASSOCIATES PROFESSIONAL FEE PROPOSAL FOR R4? kEeTi;i Bridge Rehabilitation and Bike Trail Structure Serv,CONTRACT NO 0 McFadden, Fifth, Flower Rehab & Flower Bike Trail Structure CE fN3 ;:;:;;:;:;I City of Santa Ana1111/f1R>;> City of Santa Ana Prep. by: D. Weddell Date: 10/25/2004 RFP No Date: Provide Environmental and PS&E services for the rehabilitation of McFadden Ave over the Sana Ana River, Fifth Street over theSanta Ana River, and Flower Street over the Santiago Creek, as well as design services for the Flower Street Bike Strucutre over the Santa Ana -Delhi Channel. ___._. .......................... Na�t3... ...itd..AA..... »:>:>::»::>:z:;»:>i;i:»:: y 5 L 0 U d N m J g m m No. Classification (n U 1 Project Manager 70 149.00 10,430 2 Senior Engineer 139 130.00 : 18,070 3 Project Engineer 435 93.00 40,455 4 Assistant Engineer 291 7&00 22,698 5 CAD 674 82.00 55,268 1) Salary Cost 1,609 01 Reproductions 891 02 Xerox 330 03 Computer 115 04 Travel/Transportation 183 05 SubConsultants 128,876 06 Special Deliveries 700 FEE BREAKDOWN 146,921 DESIGN SERVICES $ 261,841 CONSTRUCITON SERVICES $ 15,96f (a) Other direct cost breakdowns are shown on Page 4. Page 2 W. KOO AND ASSOCIATES MANHOUR ESTIMATES BY CATEGORY .] qF.:w. :x m.iXw Bridge Rehabilitation and Bike Trail Structure Services CONTRACT NO. McFadden, Fifth, Flower Rehab & Flower Bike Trall Structure City of Santa Ana City of Santa Ana w LL 0 m 0 O W N m = Q. m m c W w < f C Q. W C J J m 9 0 x O F O F O a to tl � U 70 139 435 291 674 1,609 146,921 Task TASK DESCRIPTION No. 2 - 2 - - 4 484 1.1. Project Kickoff Meeting 1.2�� Field Survey - - 4 - - 4 372 1.3'1I Preliminary ROW & Utility Coord 1 4 6 - - 11 1,227 1.4I Roadway - - 2 - - 2 186 1.5,Hydraulics 1 - 2 - - 3 335 1.61 Railroad Coordination - - 2 - - 2 186 I 1.7i Geotechincal Study 1 - 8 - - 9 893 1.& Concept Alternative Study - - - - - - 0 1.9 Bridge T Selecalion 6 15 28 30 72 151 13.692 :5;:7ab'bi:SubT:Otlt! 11 1 19 54 1 30 72 186 17,375 2.11 ISA - - 2 - - 2 186 2.2i MNES - - 1 - - 1 93 2.3 Section 106 - - 3 - - 3 279 2.4 Water Quality Study - - 2 - - 2 186 2.4 NEPA Compliance 2 - 6 - - 8 856 2.5CEQA Compliance 2 6 8 856 :;:;G.atid�Subfdfat, 4 20 24 2.456 3.1 Site Visit - - 4 - - 4 372 3.2 is Meeting - - 4 - - 4 372 3.3 Any Corps 404 Permit - - 1 - - 1 93 3.4 Fish & Game Permit - - 1 - - 1 93 3.5I Water Quality Certification- - 1 - - 1 93 3.6 Resource Aaencv Pemnittino 1 2 3 335 :: i:Cahoi:SidtYotat 1 13 14 1,358 4.1' Bridge Plans 19 53 115 101 281 569 51,336 4.2; Preliminary Estimates 2 - - 36 - 38 3.106 4.3• Draft Structure SSP 1 10 36 47 4.797 :;;;Gabtia:3liilitdlAF 22 63 151 137 281 654 59,239 Bridge Plans 10 27 40 47 150 274 24,686 5.11 5.2 Preliminary Estimates 1 - - 24 38 63 5.137 5.3 Draft Structure SSP 1 6 16 23 . 2,417 12 33 56 71 188 360: 32,240 6.1 Bridge Plans 5 9 27 16 55 112 10,184 6.2 Preliminary Estimates - - - 16 - 16 1,248 6.3 Draft Structure SSP 1 5 8 14 1,543 ljfftp 66 14 35 32 55 142 12,975 VA 2 1 OWN 2-Vial Bridge Plans 4 1 6 3 18 32 2,994 7.1 7.2 Preliminary Estimates 1 - - 8 - 9 773 7.3 Draft Structure SSP 1 5 8 14 1,543 ::;:rlaAei'sti/Dl6taf 6 6 14 11 18 55 5,310 . • r Construction Meetings 2 - 8 - - 10 1,042 8.1 8.2 Respond to RFI 2 - 16 10 - 28 2,566 8.3 Review Shop Drawings 2 - 32 - - 34 3,274 8.4� Prepare As -Built Plans 2 4 36 60 102 9086 >::Fahiii:Slibtbial 8 4 92 10 60 174 1 15.968 W. KOO AND ASSOCIATES PAGE 3 MANHOUR BY SHEET LIST Bridge Rehabilitation and Bike Trail Structure Services • McFadden, Fifth, Flower Rehab & Flower Bike Trail Structure .............................. d rn � c W c t m o W W m 6 a v t 0 O a` n a` ¢ U ~ 62 1351 343 2801 614 14U- Sht List of Plans !BRIDGE REHABILITATIONS 1 Title Sheet 2 2 6 0 3 13 Fifth Street 2 Bridge General Plan 2 10 20 18 33 83 3 Abutment Details/ Wing Wall Details 2 8 20 16- 34 80 4 Girder Widening Plan & Deck Details 6 8 20 18 34 86 5 Barrier Details 6 8 21 18 34 87 6 Bridge Removal and Staged Construction Plan 2 6 16 7 35 66 McFadden Avenue 7 Bridge General Plan 2 5 15 15 30 67 8 Abutment Details/ Wing Wall Details 2 4 15 8 28 57 9 Girder Widening Plan & Deck Details 4 4. 15 9 281 60 10 Barrier Details 4 41 15 9 28 60 11 Bridge Removal and Staged Construction Plan 2 3 8 5 24 42 Flower Street 12 Bridge General Plan 2 10 20 18 36 86 13 Abutment 1 & 4 Details 4 6 20� 16 30 76 14 Girder Widening Plan & Deck Details 4 6 22 18 30 80 15 Barrier Details 6 10 20 20 36 92 16 Bridge Removal and Staged Construction Plan 2 6 161 7 32 63 1 Loq of Test Bonn s 1 01 01 01 0 0 0 521 100 269', 202! 475 1098 !BIKE STRUCTURE 17 Bridge General Plan 2 10 22 18 27 79 Foundation Plan 0 0 0 0 0 0 18 Abutment Layout 31 7 18 22 34 84 Abutment Details/Wing Wall Details 01 0 0 0 0 0 19 Bent Layout 21 8 18 18 38 84 20 Deck & Bent Details 21 8 16 20 38 84 21 Log of Test Borings 11 2 0 0 2 5 StFp . . i ii ii is ltl[;i 104 351 741 781 1391 1 336 W. KOO AND ASSOCIATES Page 4 OTHER DIRECT COSTS FROl E:i? 3:1 ::::: Bridge Rehabilitation and Bike Trail Structure Service CONTRACT NO. McFadden, Fifth, Flower Rehab & Flower Bike Trail St 0 GI. f.E NT>:.:....>::: ;:::.:City of Santa Ana ITEMS BASIS UNIT AMNT. COST TOTAL Number of drawings 21 EA Size of Drawings 5.5 SF _ No. of Sets Bluelines (24x36)= 20 SF 2310 0.13 300 Sepia Transp= 0 SF 0 0.25 0 Mylars= 0 SF 0 4.50 0 Vellums= 1 SF 115.5 1.20 139 Xerox 11_X�= _ 40 _SHT 840 0.30 252 TOTAL (1) 691 )`G4P tJGlt31NDiNG::::........ Calculations 2000 Sht 2000 0.08 160 Reports 400 Sht 400 0.08 32 Color copy (letter size) 0 Shts 0 1.75 0 Xerox (letter size)= 0 Shts 0 0.09 0 Xerox (11X17)= 10 Shts 210 0.35 74 Specifications _ 800 Sht _ 800 0.08 _- _ 64 TOTAL (2) 330 (3)Pi2ESENTATION AA14T£12tAL COLOR PLOTS 3 EA 3 20.00 60 Mounted Boards 1 EA 1.00 55.00 55 TOTAL (3) 115 fil\YEFJTRANSP RTJ? T...... Flight- 0 EA 0 250 0 Rental Car 0 Days 0 65.00 0 Htl/PerDiem 0 Days 0 75.00 0 Person. Car 497 Miles 497 0.37 183 TOTAL (4) 183 (3):5E18C<]}¢St3LFAi�FFS;:: <:> Metropointe Engineers 35598 LS 35598 Coast Survey 36678 LS 36678 RBF 46800 LS 46800 Diaz Yourman 9800 LS 9800 TOTAL (5) 128876 -- - - ... {fi� 5i?ECFALDEF.kYERIffS;; US Mail 0 EA 1.00 0.45 0 FedEx(or Eq) 20 EA 1.00 25 500 Special Del. 5 EA 1.00 40 200 TOTAL (6) 700 EXHIBIT C ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # Issued to this endorsement form as a part of Named Insured Countersigned by Authorized Representative 1125 DATE (MM ACDRD. CERTIFICATE OF LIABILITY INSURANCE 0'120DONYYII l/252004 Collinsworth, Alter, Fowler, Dowling & French Group Inc. P. 0. Box 9315 Miami Lakes, FL 33014-9315 INSURED W. Koo & Associates, a division of PBS&3 2001 NW 107 Avenue Miami, FL 33172-2507 rromcencc ONLY AND CONFERS NO RIGHTS UPON HOLDER. THIS CERTIFICATE DOES NOT INSURERS AFFORDING COVERAGE 111,JFERA Sentry Insurance a Mutual Com_ In] FEFE CtP.dfact Tno,ranra ('mm.a.v A H JPFF F, N_JREF E NAIC # Iy A+ XV 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'L POLICY EFFECTIVE POLICY EXPIRATION T R TYPE OF INSURANCE POLICY NUMBER DATE MMIDD LIMITS GENERAL LIABILITY 90-15807-03 09/30/2004 09/30/2005 EACH POP JRRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TOREC`ED $ 1,000,00 CL AIMS MADE X OCCUR MEDEXP(AlryoRFerson) $ 25,000 PERSONAL&ADVINJURY $ 1,000,000 A X Contractual Liab GENERAL AGGREGATE $ 2,000,00 GEN'L AGSREGATE LIMIT APPLIES PER PRODUCTS-COMCOPAGG $ 2, DD0,00 _—. PRt1 POLCY X dECT X I LCC AUTOMOBILE LIABILITY 90-15807-04 09/30/2004 09/30/2005 COMBINED SINGLE LIMIT X ANYAUTO 90-15807-05 (Ea act dent) $ 1,000,00 X ALL ONMED AUTOS EODILY wdLRY $ SCHEDULED AUTOS APPROVED YYll AS TO FORM .Parpers.n, A X HIRED AUTOS EGDILYINA $ X NDILLDWNED AUTOS (PeraP:itlenl) dA'L X Contractual Liab �J/ LBu PkGPEAGE (PeraaitleniJent) p $ SlS eed GARAGE LIABILITY - SS18La it CAY Attori LeyAUTO ONLY EA ACCIDENT $ ANYAUDL OTHEEAACC THAN $ $ AUTO ON AUTO ONLY AGO EXCESSIUMBRELLALIABILIIY AUCS08762100 09/30/2064 09/30/2005 EACH OCCURRENCE $ 25,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 25,600,00 B $ DEDUCTIBLE $ X RETENTION S 10,00 $ WORKERS COMPENSATION AND 90-15807-01 09/30/2004 09/30/2005 X WR STAUL' DER A EMPLOYERIETOR LIABILITY ANY PROPRIET9R'PARTNERIE%<ECLTIVE 90-15807-02 EL EACH ACCIDENT $ 1,000,06 ELDISEASE-EAEMPLOYEE $ 1,000,00 OPFCERMEMBER EX.CLUDED9 Tq tlesanbeuMer 5�ECIAL PROVISIONS Lelore NO EL DISEASE-POLICYLIMIT $ 1,000,00 OTHE Prrooessional/ P42304 09/30/2004 09/30/2005 $1,000,000 Limits C Pollution Liability Ea Claim and Annual Aggregate CLAIMS -MADE FORM 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS e: ASOS50.05 Santa Ana Bridge. Santa Ana, City of Public Works Agency and City of Orange are named additional insured on the General liability, excluding professional services. Insurance evidenced by this certificate shall be primary and non-contributory to that of the named additional insured; said coverage contains severability of interest provision. Issuing companies will provide 30 days written notice of cancellation. Santa Ana, City of Public Works Agency Attn: Taig Higgins 20 Civic Center Plaza Santa Ana, CA 92707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 7FX)MX%XAA1L 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KMNDtAU(7t71fJ )ikC xDEN%dk1574xxx*YA)OKII(MX'Df[ M)GX94MXXXXX AUTHORIZED REPS Meade Coll ACORD 25 (2001/0S) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. APPROVED AS TO FORM k3 `Laura Stitt Sheedy Assistant City Attorney AI UKU Zo tZUUINtl) ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company Sentry Insurance a Mutual Company This endorsement modifies such insurance as is afforded by the provisions of Policy # 90-15807-03 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses perforated by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 1/25/2005 this endorsement form as a part of Policy # 90-15807-03 Issued to City of Santa Ana Named Insured Countersigned by '1,9 SYleade coffins -worth Authorized Representative APPROVED AS TO FORivt ��Sh edy Assistant City Auornev CORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD YYYY) 'PRODUCER (305)822-7800 FAX (305)827-0585 Collinsworth, Alter, Fowler, Dowling & French Group Inc. P. 0. Box 9315 1Q/I8/2QQS THIS CERTIFICATE IS 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. INSURERS AFFORDING COVERAGE INSURERA: Sentry Insurance a Mutual Co mpan NAIC # A+ XV Miami Lakes, FL 33014-9315 INSURED W. Koo & Associates, a division of PBS&3 2001 NW 107 Avenue Miami, FL 33172-2507" INSURERS: Steadfast Insurance Company A XV INSURERc: Lloyds of London A XV INSURER D' I I " D Y INSURER E: CtlVFRAC.PS 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 ISSUEDNS OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND C POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ONDITIOOF SUCH INSRFGAR�AGELIABILIW TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION Antractual AL LIABILITY MMERCIAL GENERAL LIABILITY CLAIMS MADE L I OCCUR LTab 90-15807-03 09/30/2005 09/30/20DAIE 06 LIMITS EACH OCCURRENCE $ 1,000,00( DAMAGE TO RENTED $ 1,000,00( $ 2S,000 MED EXP(Any one person) PERSONAL&ADV INJURY $ 11Q00100 GENERAL AGGREGATE $ 2,000,00( GGREGATE LIMIT APPLIES PER: LICY X PRO- JECT X LOC PRODUCTS- COMPIOP AGG $ 2,000,00( BILE LIABILITY ANY AUTO OWNED AUTOS 90-15807-04 90-1S807-OS 09/30/2005 09/30/2006 COMBINED SINGLE LIMIT (Ea accident) $ 11000,00 BODILY INJURY (Per person) $ AHEDULED AUTOS ED AUTOS BODILY INJURY (Per accident) $ N-OWNED AUTOS ntractual Liab PROPERTY DAMAGE (Per accident) $ LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE AUCS08762101 Q9/30/2005 09/30/2006 EACH OCCURRENCE $ 2S,000,000 AGGREGATE $ 2S,000,000 DEDUCTIBLE X RETENTION $ a WORKERS COMPON AND 9O-ISSO7-Ol EMPLOYERS' LIABILITY 09/30/2005 09/30/2006 A ANY PROPRIETOR/ R/EXECUTIVE 90-IS807-02 OFFICER/MEMBER E%CLUDED7 EXCLUDED? X WC STATU- OTH- E.L. EACH ACCIDENT g 1,000,00 If yes, describe under SPEOTHCIAL PROVISIONS below NO roVessional/ LDUSA0500811 09/30/2005 09/30/2006 C ollution Liability CLAIMS -MADE FORM DESCRIPTION OF OPERATIONS (LOCATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS e: 1st Sth Street & McFaden Avenue Bridge. E.L. DISEASE - EA EMPLOYE $ 1,000,000 ELDISEASEE-POLICY LIMIT $ 1,000,00 $1,000,000 Limits Ea Claim and Annual Aggregate 11/11/1961 Retrodate Santa Ana, City of Public Works Agency and City of Orange are named additional insured on the General liability, excluding professional services. Insurance evidenced by this certificate shall be primary and non-contributory to that of the named additional insured; said coverage contains severability of interest provision. Issuing companies will provide 30 days written notice of cancellation. Santa Ana, City of Public Works Agency Attn: Mindy Ly 20 Civic Center Plaza Santa Ana, CA 92707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X MAIL Y 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, � , KXii�6KI[SFXd(30fn1tX44kKNd(ifdd6lGXC[7fi(iOCI€l4)06Md(diA570fd06XYAl5XM)(XX ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 2�3 ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company. Sentry Insurance a Mutual Company This endorsement modifies such insurance as is afforded by the provisions of policy # 90-15807-03 relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 1/25/2005 this endorsement form as a part of Policy # 90-15807-03 Issued to City of Santa Ana Named Insured Countersigned by W. `Meade (bQjmsworth Authorized Representative AC -RQN CERTIFICATE OF LIABILITY INSURANCE PRODUCER (305)822-7800 FAX (305)827-0585 THIS CERTIFICATE IS ISSUED AS A MATTER O Collinsworth, Alter, Fowler, Dowling ONLY AND CONFERS NO RIGHTS UPON THE & French Group Inc I HOLDER. THIS CERTIFICATE DOES NOT AMEN P. 0. Box 9315 Miami Lakes, FL 33014-9315 INSURED W, Koo & Associates, a division of PBS&J 2001 NW 107 Avenue Miami, FL 33172-2507 INSURERS AFFORDING COVERAGE INSURERA: L INSURER B. INSURER C. INSURER D. INSURER E DATE (MM/DDIYYYY) 10/03/2006 INFORMATION OR NAIC # 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR OD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMVDDffY1 POLICY EXPIRATION DATE Wili LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 7 COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑OCCUR DAMAGE TO RENTED $ $ MED EXP (Any one person) PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMPIOP AGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED' E. L. EACH ACCIDENT $ If yes, describe under SPECIAL PROVISIONS below Procssional/ LDUSA0600811 09/30/2006 09/30/2007 A Pollution Liability CLAIMS -MADE FORM DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL FROM e. Job # 55-002 City of Santa Ana -Bridge Seismic Retrofit Design E.L. DISEASE - EA EMPLOYEE $ E. L. DISEASE - POLICY LIMIT $ $1,000,000 Limits Ea Claim and Annual Aggregate 11/11/1961 Retrodate Santa Ana, City of Public Works Agency City Orange 20 Civic Center Plaza Santa Ana, CA 92707 Armen — ,..,....,,..., SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE -� Meade Collinsworth/FVM ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. CITY S R — ENG 3RD FL. Fax:714-647-5635 Feb 26 2007 8:48 P.01 7 v.cr..... THE POLICIES OF INSURANCE L98TE0 BELOW HAVE BEEN I68UB0 YO VHO INSURED NAMED ABOVE FOR THE POLICY POWD INDICATED. NOTWITHETANUINO ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RfiRP6CT TO WHICH THIS CERTIROATE MAY 80 158UED OR POTAO6RHE LNGATE RANCELIMITSFFWONHAVE BEEN OM POLICIESDESCRIM HEREINB SUBJECT TO ALLTHE TERMS. EXCLU016N0 AND CONMYlONB OF SUCH LICIES BY PAID OUIMB TYP OP91mmmu MV NMMe/P T / T B pMFMLLIAEIMTY I ODNMIIN:WLOENIjRjAL,,NOMTY lAA1Me MACE u OCCUR C==0c%u#1 LiahilSty OW 917943e•00 ° 09/3D/09 00/30/07 EACH pCCUWA--I, 1, OD0, 000 FIRE O/MAOE a" 1;0DO,000 MEBFIP "nnwcl 131.040 I PPRSOxALLADVINIURY 19 L10001 000 OWIRALAGGREGATE 63,000,000 DENL A00 7SUMr APPUEO PPR 9D Y 9 P S LOC DWTB•COMwOPAO 11,969,219 C C AVTONrJeRl I I I I MylMry ANY AVTO AIL ONNPDA" BCfIEDULEO MT09 HMO AUT06 HONCM60 AlTO0 Contractual L19ESlity SRP E1794 S7.00 OAP 9139486.00 - 09l70 /09 OS/90/00 09l30/07 09/30/07 X.M.DIOBP MhAT IIEEaa 0 D, OPO.p00 no RLY 94NRY IPr OM9R11 B BOO :LYI - lPW /� I y PROPERTY O"AOd IWrAaU9.N0 ,E 1415LIABEIN MY AUTO - - AVTO ONLY.BAACCIDOW s MaRlHAN MA" AM ONLY: ADc 1 R UWN LIAe1LTTY 7: OCCUR p CLAMS MA09 DEDUCTINLM RETENTION D ROC 909793107 99/DO/9d 01/19/07 9AOn5CWRNNu 019.000.000 AGMOATS : 0 am. DOD r 000 e 0 wDERERSOOMINEAT15x AM 9MPLVMNWWAPH Y 9C 10.004I9-00 09l70/06 09/30/07 I EL FAON ACMW 1i,000, 000 ELOESAEL9AEMPLiOtY i 0 EL. DIEEME-ravdr lEr 1.0o0D00 MIR 1 LxECRvnox ar oPellAnoxnocA71okw9nN;LttlIR%04�Y9+Pns A0000eY exo0Ra9Rw7nPecuLP9nvrlox9 Ou A00550,05 Santa "a Esid9a. Additional UNWO417 city Of kPIIP Aua, PVAlia Works ABaRty. and City Of OXWQM COWRY, Nad 1BaSBad Yi1C 1MdaP. B. Boa 1 AAaaaiataa, Inc., A &VieiOB o1 PDOaJ. eu attach" tar additional nOidS y Oc Ran" Ana IIG Nnik9 Rpaacy Dr Handy Ly Civic Samar PLEAS -La Ana. CA 99701 R1'MEAeiin4 9000909 .4t`n':3�JVLY �9:i Fo M'sisLanz qly 9HOIID MY OFTHE MOY! D99Dg90 POUfiReai CYI99LL90 EV 9P! TN9 91VIMT194 OATS TNERRW, IRt NNINe IN9BRER WILL �� �� OA11 MIen9a NOncr TO THE 0ERTIPICAT9 MOLDER NAMED M TNS LOT.■ NKM9EiMMMIWA I CITY S R - ENG 3R➢ FL. Fax:714-647-5635 Feb 26 2007 8:48 P.02 IMPORTANT It the ceWcets holder In an ADDITIONAL INSURED, the Poecy(tes) must be endorsed. A statement on thls gK(ioete does not confer rights to the oerUllcats holder In Ileu of such endorsemsnt(s), if SUBROGATION 13 WANEP, subject to the terms and conditions of the policy, cortaln pollolee may require an endorsement. A statement on thls cedflcats dooe not confer rights to the conlacate holder In Ilau of such endorsement(s). DISCLAIMER The CrOgeta of Ineuranoe on the reverse aide or this form does not constitute a oornmot between the tsaulng Insurer(s), authorized representatNe or gmduoar, and this certificate holder, nor does It offlrmepvely or negatively amend, extend or after the cdrerege afforded by the policies listed Thorson. ,.._ntnat Citw' Atior"J�A CITY S R - ENG 3RD FL. Fax:714-647-5635 Feb 26 2007 8:48 P.03 SUPPLEMENT TO CERTIFICATE OF INSURANCE I DATE I of/ae/F+ Feet. lueleley. Rob" a lateiran, Ina. Additiemal Inoueed as the General Liability A Auto Liability On a FriearY a ran-COatribulDry beetle, tatludinH noeplated operation -Where XOVLred by Coutsedt• (RU 0=71. dmeral LisbiltiY ApfraRata limdt ippliae yes Frele0t. slAnret AdditW"l Iwured Leae0s/Rase PAyea cif the Ante Liability. waives of FubaeFatien an the emw Liability, Aura LSabL2Lty, end WetRere Cempsautiee +where Repuired by Cm=a0t•. Cebrella 1011oee fern to the Additional Ineurede an the deuarel LLRbtlity. :.d¢Id Stilt sh.auy A:,sg1sm--iL City Auv,.uy CITY S R — ENG 3RD FL. Fax-714-647-5635 Feb 26 2007 8:49 • e, Additional Insured — Automatic - Owners, Lessees Or Contractors - Broad Form Named Insured: Post, Buckley, Schuh & Jernigan, Inc. dlbla PB8&J Named Insured Includes: VV. Koo & Aaeocltkea Ina, a dmelon of PBS&J 0 ZURICH Policy No, £71'. 04ta ar F.I. aqi. Data of Pd. TWIDItIlf Pad Producer Add -I- Pre n Rmin Prom GLO9139458-00 09130/06 09130/07 1 09/30/06 s $ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A, WHO IS AN INSURED (Section H) is amended to include as an insured any person or organization whom you are required m add as an additional insured on this policy wular a wriltcn contract or written ogroometlt, B. The insurance provided to additional imureds appli@5 only to "bodily injury", "property damago" or "paraonal and advertis- ing iroury° covered tmdor Section 1, Coverage A; BODILY INJURY AND PROPERTY DAMAGE L11,01LITY and Coverage B, PERSONAL AND ADVERTISING INJURY LIABILITY, but only it 1. The "bodily Injury" or "property damage" results from your negligence; and 2. The "bodily Injury", 'property damage" or "personal and advertising ir4ury" results directly from; a. Your ongoing operations; or b. "Your work" completed as Included In the "products -completed operations hazard", performed for the additional insured, which is the subject of Ship written contract or written agreement. C. However, regardless of the provisions of paragraphs A. turd B, above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided ro you in thii policy; or b. That is any broader coverage than you arc required to provide to the additional instved person or organisation in the vklttan contract or written agreement; and 2. We will not provide Limits of insurance to any additional insured person or organization that exceed the lower of, a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide In" written ccutract or written agreement. D. The insurance provided to the additional insured person or organisation does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" that results solely from negligence of the Bddi- tionalinsured; or 2. "Bodily injury", `property damage" or "personal and adveRising injury" &rising out of the rendering or fbilure to seder any prefkesipp�j,apchsUcm9l,.eoglnperingao{Purveying services including: S x aturu S1.G41175-ACN(DMS) trfelirtitii Mauaq nI insurance SerAeae OMra, trio, with Its permission. Page I of 2 �FP�tseY CITY S R - ENG 3RD FL. Fax:714-647-5635 Feb 26 2007 8:49 P.05 a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and spooificatioas; and b. Supervisory, inspection, architeotural or engineering sctivitica. E. The additional insured trout see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a tlaim: 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "soh" Will promptly be brought against any policy Issued by ea - other insurer under which the addition: insured also has rights as an insured or additional Insured. F. The tosurance provided by this endorsement is primary insurance and we will not seek contribution from any other in- surance availoblo to any additional insured person or organization aalees the other instance is provided by a contractor other Then you for the same operations and job location. Then we will share with that other insurance by the method do - scribed In paragraph 4.c. of SECTION IV . COMMERCIAL GENERAL LIABILITY CONDITIONS. Any provisions in this Coverage Pert not changed by rho rdrme and conditions of this endorsemeent continue to only as writ- ten. Name of Person or Orgsairattaat Santa Ana, City of Public Works Agency and City of Orange 20 Civic Center Plaza Santa Ann, CA 92M Ite: A50550.05 Santa Ana Bridge U-Gf.1175-A CW (9103) PM 2 or2 G a Ii: y rP t Y AF To j �J3�1bS A'"ua'`+�•i! 17AY Ai1Qln;.'y 61 12 . CERTIFICATE OF L ILIT 12/OAT11/07 FYI PRODUCER 1-066-220-8625 Holmes Murphy and Anaociates - Omaha THIS CERTIFICATE W ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2637 South 158th PISS& Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Omaha, R$ 69130 €N Post, Buckley, Schuh 6c Jernigan, Inc. €NSURERA Xlaricil Ameri'LfL' Ts'S ranca COa �Ry/` 16535 €NSURERa Zurich AmeriOan Inauraasca Company / #16535 __ _ _..__......__._.....___ d/b/a PBSaT 2001 BW 107th Avenue Miami, FL 53172-2507 INSUREND:_.. INSURER E• .... 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCER BY PAID CLAIMS. —� INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTlYE POLICY EXPIRATION LIMITS A GENERAL LIABILITY GLO 9139458-01 09/30/07 09/30/08 EACH OCCURRENCE $1,000,000 X COMMERCIAL. GENERALLIABIUTY X �UGCUR FIR EDAMAGE(Anyunafiro�..$l,_000,OOO CLAIMS MADE MkU EXP�Myonn Eurson)_ 5_35, 000 X Contractual Liability PERSONAL B ADV INJURY _......__... ........... _ S1,000,000 ........ _......_..._..._.,.. .. __7 ,._T�._____.._._......... ._.___.._ GENERAL AOORFG_ATE S2 0-00,000 GEN'L hGGREGATE UMH APPLIES PER:, PRODUCTS-CGMPX)PAGO 52, 000,000 POLICY X PRO- JFCT X" LOC B AUTOMOBILE LIABILITY BAP 9139457-01 09/30/07 09/30/08 .._x." .. ANY AUTO COMBINED EBE SINGLE LIMIT S2,000,000 ALL OWNED AUTCtS -" BODILY INJURY 3 SCHEDULED AUTO$ (Pet Parson) X HIREDAUTOS X BODILY INJURY S NON -OWNED AUTOS (PoI awdonl) X Contractual Liability __......__ PROPc_€LTY DAMAGE $ {Pat atx,adaxt#) GARAGE LIABILITY AUTO GiiLY-ER AGCIOENT S 144Y AUTO ^ k oxi� ra n AN ....._...._._........._......__...__._._..... AUTO ONLY: C EKLCS5LIAUWIY AUC 508762103 09/30/07 09/30/06 FACLI( URRENCE S 25, 000, DOD 7 AC#OREGATE g25,000,000 X OCCUR ..._!CLAWS MADE DEDUCT#BR.E.— RETENTI.ON $ 0 A W09NERSGOMPEN3ATTONANO WC 9139459-01 09/30/07 09/30/08 X WCSTAT I OT#€ I . EMPLOYERS` LIABILITY E1.tAMI AOVJDENT 51, 000,000 FA..DISEASE. -."-.AEMNOYEIt S1,000,000 . •ce F.L.€}ISEASE-POUCYL€MIT �1,000,000 OTHER n 3 s s DESCRIPTION OF OP ERATIONStLOCATIONSNERtCLESIEXCLUSIONS ADOEO BY ENDORSfMENTISPECLAL PROMSION5 Rwf A50550.05 9 A2005-012; Santa Ana Hrid a Rehabilitation Heass Snsrare Includes: T4". o 4, Aaaooiatas, TnO., a v a On of PSiSAJ. The City of 8auts Ana, PDblio Works Agency, and the City 6f Orange County on the Oanara Liabil—Tt—y—wnh respect to the Operations Of the insured on the above project. Gees attached for addition#sl wording, _- •. •... •......... ..........ee..w.. wsauncv ramuvnvs �.ce acn: bnParYitt:„i.F..N1 I Rial SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Of Santa Aaa DATE THEREOF, THE ISSUING INSURER WILL MAR. 90 DAYS WRITTEN Public works Agency NOT)CE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, X Attn, Mindy Ly ,K 2D Civic Center Plaza CiDtxxxx XY.XXXXXXX=XXX Banta .Ana, CA 92702 F: A°JTHORIiEDREPRESENTATNE _ �w '=1 USA t'J'4'•L'" I ACORD 25-S (7/97) rflatoaicx '� 5 N21=4:1V 7w"r (DACORD CORPORATION 1988 i.S..s.�..ta A. ks..v..,wv it the carifficater holder is an ADDITIONAL INSURED, the Oicy(ies) trust be arrdrjrsedstaterrient on fts certificate does not confer rights, to the certificate holder in lieu of such endorsement(s). 1 SUBROGATION 13 WAVVED, subject to the terms and cmiditions of the policy, certain Policies may require an endomament A statement on this certificate does not confer ngntB to the certiticate holder in lieu of such eMorsornent(s). R'10 GeMfiGate Of insurance On Via reverse :ewe of this form does not or€ns. Irate a contract between the issuing insurer(s), authorized repmentative or producer, and the cortificate holder, nor does it affirmatively or negatively amend, extend or sitar the coverage afforded by the pokies listed therson. I SUPPLEMENT TO CERTIFICATE OF INSURANCE ��'0 ' lz/11/a7 NAM= Vr MDUKC:U. Post, Buckley. Sahut, i Jernigan, Inc. d/b/a PBSiJ' Additional .Insured on the General Liability a Auto Liability on a Primary a Non -Contributory basis, including completed operations 'Where Raquirsd by Contract" (GL ONLY}. General Liability Aggregate limit applies per Project Blanket Additional insured Lessor/Loss Payee on the Auto Liability. waiver of Subrogation on the General Liability Auto Liability, and workers Compandation 'Where Required by Contract". Umbrella follows form to the Additional Xnaureds on the General Liability. ANWA Additional Insured -- Automatic - Owners, Lessees Or ZURICH Contractors - Broad Form Named Insured. Post, Buckley, Schuh & Jernigan, Inc. d/b/a PBS&J Named Insured includes: W. Koo & Associates lnc., a division of PBSJ Pohoy No, Eff. Wo of Pol. Exp. Date of Pot. Eff. Data of Eta& Praduccr Addl Pttxn ketum Priam. GL0913945"I 09/30/07 09/30/081 09/30/09 THIS ENDORSEMENT ENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. "dais endorsement modifies insurance provided sunder the - Commercial General Liability Coverage fart A. WHO IS AN INSURED (Section II) is a rnendcd to include as an insured any person or organization whom you are required to add as are additional insured on dais policy under a written contract or written agreement. B, The insurance provided to additional insureds applies only to "bodily injury" "property dwuage" tar "personal and advertis- ing injury" covered under Section I, Coverage A, BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage B, PERSONAL AND ADVERTISING INJURY LIABILITY, but only if-, 1. The "bodily injury - or "property damage" results fror€a your negligence. and 2.. The "bodily injury', "property damage" or "personal and advertising injury" results directly from: a. Your ongoing, operations, or b, ""Your work" completed as included in the "products -completed operations hazard", performed f,r the additional insured, which is the subject ofthe written contract or written agreement. C. However, regardless of the provisions of paragraphs A, and B. above. L We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or L That is any broader coverage than you are required to provide to the additional insured person ororganization in the -written contract or written agreement; and 2. We will riot provide Limits of Insurance to any additional insured person or organization that exceed the loever of: a. T'he Limits of Insurance provided to you in this policy; or b. °l'hc Limits of Insurance you are required to provide in the written contractor written agreement, I. The insuraancc provided tra the additional insured person or organization does not apply to: "Bodily injury', "property damage" or "personal and advertising injury" that results solely from negligence of the addi- tional insured; or 2. "Bodily injury""property damage" or "personal and advertising injury" arising out of lire rendering or failure to render any professional architectural, engineering or surveying services including: Irsdudes cmdyrightp.d rnhtzrlal of hjrancu erok s office, trxc wltfr us pnr",, i of 2 ax parznt a rn , or lei] ng to pmjAru of appro,,c rnaapa, shop itrawm%s, op,riaaatrk repott,, surveys, field -mdus, ctvmp orders or drawings and gpecificatiom; an b, sa,;;t,?':.t � .&' r�, inspection, architectr.€ al € f eritg%3ba4°oriaag uctjvEiie s. E, fic Adul.ax,ndi insured tt,USt fee to 4 that: .% w't i1o"i aed ag soon as praotfLable Lf an ' c?r Ca5cme that may rerix ilt a'n a clai= 2. We reed€ u written rimice of it Cit,tan or'°auW' as sm48 aaaa practicable; and 3 - raqx t for ifc;f tin.:r;; a,vj indemnity of he Oairn or "suit" wdji prarl-Oy be, rsrtru itt apin,st -:i x pobcy is,,wP41 fir.} an- ?i4er Si surcr Under which the additional rrttwred ah-;o hu rights ai an %°.a. tired or uu&id dal insui'€.`•::1.. tg i sic ia.aaraaav=:; pr,,gici l by tiiia is primary' martrtin :ratan we girl not x C' artribtrtimi tip m an other in- r r : a�,jh able to an; t lalidonal insure enwra or or anizati<'m ra,a.laits the 'other n aruncc is pruiided by a contractor- , • Jam you or the i arr p Ggeratious a=rca,i atr t€ ration. Then sharc with t;rrr't € ther insurAri e by to me -hod dew sr,a:cd m pira graph 4,a. as'':iECTIO IV - COMMER :lM. GENERALLUBIL t` ' t ONDI° ttl. iS .aay pravisiOv, it, this Coverage Part m4 c.hang od by the t arrra `e d condritioim of tiria atziliaraa-uncrai a;rantinue to app;, as writ - Want' of Pecwn vi, {: r an «at#,area 8.a 0 - Afm,. C: t:y Of €era elta ori-, Agc acy and Oky of Oran 20 Civic centaar Plaza :S,:raa Ana, CA 942702 Re. ASgl t` O s a A2005- i2; Santa Aga t°idge l,abliltathm DATE (MWDD/YYYy) 12/11/2007 (aOS)822-7900 FAX (305)927-0585 !Collinsworth, Alter, Fowler, Dowling French Group Inc. Box 9315 Miami Lakes, FL 33014-931S jamuw ", # 0 I N S U R ERS AFFORDING COVERAGE a division of PBUJ A, 2001 NW 107 Avenue Miami, FL 33172-2SO7A - c200,�5 NIS UR ER A- Lloyds of London A XV THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM 08 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR WR DD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE tMM,DM`YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TO RENTED $ MED EXP (Any one person) PERSONAL & ADV INJURY $ GENERAL AGGREGATE GENT, AGGREGATE LIMIT APPLIES PEAv POLICY LOC: JECT PRODLICTS-C�P� �AW. AUTOMOBILE LIABILITY ANY AUTO COMBINED SNGLE LIMIT (Ea amwere) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (P% Pwaon) HIRED AUTOS NON -OWNED ALTOS BODILY INJURY (Per aoddonl) $ PROPERTY DANAAOE Wer A_*Iew) LIABILITY AUTO ONLY - EA ACCIDENT $ AUTO 17, OTHER THAN EA ACC AUTO ONLY: AGG EXCESSWORELLA LIABKJTY OCCUR CLAIMS MADE EACH OCCURRENCE $ A(GREGATE OEDUCTISLE RETENTION WORKERS COMPENSATION AND WC STATU- IT711- EMPLOYERS'LADJUTY El. EACH A=MENT ANY PROPRIETORIPARTNER'EXECUTIVE OFHCEK,WFM8ER EXCLUDED? "m do=�4v wyw cc S ECIAL PROVI&ONS b*I" E.L. DISEASE . EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ ProTessional/ LDUSA0700811 09/30/2007 09/30/2009 $1,000,000 Limits A Pollution Liability Ea Claim and Annual Aggregate I i I CLAIMS -MADE FORMI 11/11/1961 Retrodate WrT"" OF OPERATIONS I LOCAT"M I V"ICLES i EXCLUSIOKS ADDED BY ENDORSEMENT I SPECIAL PROVelaws A50550-OS Santa Ana Bridge. ssuing company will provide 30 days written notice of qqcellation; 10 days for non-payment. As TO F0 Santa Ana, City of Public works Agency Attn: Mindy Ly 20 Civic Center P1 ut Santa Ana, CA 927W ACORD 25 (2001/08) SHbOLD ANY Of THIRABOVE OMM090 POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL Kf)X*Xft MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, AUTHORUND REPRESENTA'"VE Meade Coll insworthLANNA CACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the olicy(ies) roust be endorsed. A statement ,n this certificate doses not counter rights to the certificate holder in lieu of such endorsernent(s). If SUBROGATION IS AI )ED, sub)eet to till:` Urns and conditions of the policy, certain policies may nxiiArex an ando se;rnent. A statement on this vertiticate does not writer rights to the c ortificate holder i lieu of such endorsarnent(s). DISCLAIMER i he iUartlfiff-ate of Insurance on the; reverse side of this form does not constitute a contract between the €ssw g insurer s), authorized ropr�senllfive ur producer, and the certificate hok.for, nor does it affirmatively or negatively ez mend, extend or ater the coverage afforded by the policies €fisted the; san ACORD 25 (2001/08) -1 1 9/16 ACOR ., CERTIFICATE OF LIABILITY INSURANCE M/DD/YY) 09/16/OB PRODUCER 1-866-220-4625 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Holmes Murphy and Associates - Omaha ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2637 South 158th Plaza ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Omaha, NE 68130 INSURERS AFFORDING COVERAGE INSURED csiZ6 INSURER A: Zurich American Insurance Com an /#16535 Post, Buckley, Schuh & Jernigan, Inc. d/b/a PBS&J INSURER B: Zurich American Insurance Company / #16535 2001 NW 107th Avenue INSURER C: steadfast Insurance Company/#26387 Miami, FL 33172-2507 INSURERD: INSURER E: 'OVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY GLO 9139458-02 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 rA X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 25,000 CLAIMS MADE a OCCUR PERSONAL &ADV INJURY $1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO-JECT X LOC B AUTOMOBILE X LIABILITY ANY AUTO BAP 9139457-02 09/30/08 09/30/09 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X X HIRED AUTOS" NON -OWNED AUTOS Contractual Liability1-62 X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG C EXCESS LIABILITY AUC 508762104 09/30/08 09/30/09 EACH OCCURRENCE $25,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 25, 000, 000 $ $ DEDUCTIBLE $ RETENTION $ 0 A WORKERS COMPENSATION AND WC 9139459-02 09/30/08 09/30/09 X I WC STATU- OTI- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI $ 1, 000,000 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 OTHER 3 3 S DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: A50550.05 & A2005-012; Santa Ana Bridge Rehabilitation. Named Insured Includes: W. Roo & Associates, Inc., a division of PBS&J. The City of Santa Ana, Public Works Agency, and the Ci of Orange Coun y on �er$iiiability with respect to the operations of the insured on the above project. I, M I 1 C nvLVCrt I I ADDITIONAL INSURED; INSURER LETTER: l.A149.t LLA 1 IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Santa Ana, City of DATE THEREOF, THE ISSUING INSURER WILL ffJMX9WY4 MAIL 90 DAYS WRITTEN Public Works Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 9[0[]EXIiXgEQCXEiAYKX Attn: Mindy Ly 20 Civic Center Plaza X g jigxxxXXXXXXXXXXXXxxxxxxxxx%xxxxxxXXXXXXXXXXXXXXXX Santa Ana, CA 92702 USA AUTHORIZED REPRESENTATIVE C�-!f P0,UKU ZO-b (11Uf) ganderson 9771538 Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600 Q ACORD CORPORATION 1988 7 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AGUKUL5-5 (1191) DATE SUPPLEMENT TO CERTIFICATE OF INSURANCE 09/16/08 NAME OF INSURED: Post, Buckley, Schuh & Jernigan, Inc. d/b/a PBS&J Additional Insured on the General Liability & Auto Liability on a Primary & Non -Contributory basis, including completed operations "Where Required by Contract" (GL ONLY). General Liabiltiy Aggregate limit applies per Project Blanket Additional Insured Lessor/Loss Payee on the Auto Liability. Waiver of Subrogation on the General Liability Auto Liability, and Workers Compensation "Where Required by Contract". Umbrella follows form to the Additional Insureds on the General Liability. NOTICE OF CANCELLATION WORDING: SHOULD ANY OF THE DESCRIBED POLICIES ON THE CERTIFICATE BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL 30, 60 OR 90 DAYS WRITTEN NOTICE "WHERE REQUIRED BY CONTRACT" EXCEPT 10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM TO THE CERTIFICATE HOLDER NAMED ON THE ATTACHED CERTIFICATE. Additional Insured — Automatic - Owners, Lessees Or Contractors - Broad Form Named Insured: Post, Buckley, Schuh & Jernigan, Inc. d/b/a/ PBS&J 0 ZURICH Policy No. Eff. Date of Pol. Exp. Date of Poll. Eff. Date of End. Producer AddT Prern Return P.. GL09139458-02 1 09/30/08 09/30/09 09/30/08 $ $ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. B. The insurance provided to additional insureds applies only to "bodily injury', "property damage" or "personal and advertis- ing injury' covered under Section I, Coverage A, BODILY INJURY AND PROPERTY DAMAGE LIABILITY and Coverage B, PERSONAL AND ADVERTISING INJURY LIABILITY, but only if: 1. The "bodily injury" or "property damage" results from your negligence; and 2. The "bodily injury', "property damage" or "personal and advertising injury' results directly from: a. Your ongoing operations; or b. "Your work" completed as included in the "products -completed operations hazard", performed for the additional insured, which is the subject of the written contract or written agreement. C. However, regardless of the provisions of paragraphs A. and B. above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or "personal and advertising injury' that results solely from negligence of the addi- tional insured, or 2. "Bodily injury', "property damage" or "personal and advertising injury' arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and U-GL-I I75-A CW (9/03) Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page I of 2 Form -9 Request for Taxpayer Give form to the (Rev. November2005) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal revenue service c` Name (as shown on your income tax return) POST, BUCKLEY, SCHUH & JERNIGAN, INC., D/B/A PBS&J C- Business name, if different from above c 0 e uO Individuall ❑ Other.................Exempt Check appropriate box: ❑ sob proprietor ® Corporation ❑ Partnership from backup ❑ withholding tAddress (number, street, and apt. or suite no.) Requester's name and address (optional) ac 0 2001 N. W.107 AVENUE City, state, and ZIP code !E MIAMI, FLORIDA 33172-2507 H List account num ber(s) here (optional) co K;EM Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security Ium backup withholding. For Individuals, this is your social security number (SSN). However, for a resident II alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIM. If you do not have a number, see How to get a TIN on page 3. or Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. person (rrJuding a U.S. resident alien). Certification Instructions. You must cross out item 2 above if you have been noted by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement ORA), and generally, payments other th interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (See the instructions on p#ge 4.) Sign signature of Here I U.S. Demon ► Purpose Of Form c u a r a' m- G r u b e 1, S e n A person who is required to file an information return with the IRS, must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. U.S. person. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. In 3 above, if applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. For federal tax purposes, you are considered a person if you are: •The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W-9 (Rev. 11-2005) Date► April 9, 2008 o re W d 9 $i>rizen or resident of the United States, e A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, or • Any estate (other than a foreign estate) or trust. See Regulations sections 301.7701-6(a) and 7(a) for additional information. Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: Form W-9 (Rev. 11-2005) Page 2 • The U.S. grantor or other owner of a grantor trust and not the trust, and • The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the recipient has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present In the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8. What Is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments (after December 31, 2002). This is called "backup withholding." Payments that may be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part 11 instructions on page 4 for details), 3. The IRS tells the requester that you furnished an Incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W-9. Also see Special rules regarding partnerships on page 1. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered In Part I of the form. Sole proprietor. Enter your individual name as shown on your income tax return on the "Name" line. You may enter your business, trade, or "doing business as (DBA)" name on the "Business name" line. Limited liability company (LLC). If you are a single -member LLC (including a foreign LLC with a domestic owner) that is disregarded as an entity separate from its owner under Treasury regulations section 301.7701-3, enter the owner's name on the "Name" line. Enter the LLC's name on the "Business name" line. Check the appropriate box for your filing status (sole proprietor, corporation, etc.), then check the box for "Other" and enter "LLC" in the space provided. Other entities. Enter your business name as shown on required federal tax documents on the "Name" line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the "Business name" line. Note. You are requested to check the appropriate box for your status (individual/sole proprietor, corporation, etc.). Exempt From Backup Withholding If you are exempt, enter your name as described above and check the appropriate box for your status, then check the "Exempt from backup withholding" box in the line following the business name, sign and date the form. Form W-9 (Rev. 11-2005) page 3 Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as Interest and dividends. Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding. Exempt payees. Backup withholding is not required on any payments made to the following payees: 1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2), 2. The United States or any of its agencies or instrumentalities, 3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities, 4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or 5. An international organization or any of its agencies or instrumentalities. Other payees that may be exempt from backup withholding include: A corporation, A foreign central bank of issue, 8. A dealer in securities or commodities required to register In the United States, the District of Columbia, or a possession of the United States, 9. A futures commission merchant registered with the Commodity Futures Trading Commission, 10. A real estate investment trust, 11. An entity registered at all times during the tax year under the Investment Company Act of 1940, 12. A common trust fund operated by a bank under section 584(a), 13. A financial institution, 14. A middleman known in the investment community as a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section 4947. The chart below shows types of payments that may be exempt from backup withholding. The chart applies to the exempt recipients listed above, 1 through 15. IF the payment is for ... THEN the payment Is exempt for... Interest and dividend payments All exempt recipients except for 9 Broker transactions Exempt recipients 1 through 13. Also, a person registered under the Investment Advisers Act of 1940 who regularly acts as a broker Barter exchange transactions Exempt recipients 1 through 5 and patronage dividends Payments over $600 required Generally, exempt recipients to be reported and direct 1 through 7' sales over $5,000 ' 'See Forth 1099-MISC. Miscellaneous Income, and its instructions. z However, the following payments made to a corporation (Including gross proceeds paid to an attorney under section 6045(f), even if the attorney Is a corporation) and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees: and payments for services paid by a federal executive agency. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If yyou are a resident alien and you do not have and are not all ible to get an SSN, (Iour TIN is your IRS individual taxpayer identification number TIN). Enter it in the social security number box. if you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single -owner LLC that is disregarded as an entity separate from its owner (see Limited liability company (LLC) on page 2), enter your SSN (or EIN, if you have one). If the LLC is a corporation, partnership, etc., enter the entity's EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.socialsecurity.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer ID Numbers under Related Topics. You can get Forms W-7 and SS-4 from the IRS by visiting www.irs.gov or by calling 1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Writing "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8. Form W-9 (Rev. 11-2005) Page 4 Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items and 5 below indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). Exempt recipients, see Exempt From Backup Withholding on page 2. Signature requirements. Complete the certification as indicated in 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage Interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. Privacy Act Notice What Name and Number To Give the Requester For this type of account Give name and SSN of. 1. Individual The individual 2. Two or more individuals (joint The actual owner of the account account) or, if combined funds, the first individual on the account ' 3. Custodian account of a minor The minor 2 (Uniform Gift to Minors Act) 4. a. The usual revocable The grantor -trustee ' savings trust (grantor is also trustee) b. So-called trust account The actual owner' that is not a legal or valid trust under state law 5. Sole proprietorship or The owner' single -owner LLC For this type of account Give name and EIN of. 6. Sole proprietorship or The owner' single -owner LLC 7. A valid trust, estate, or Legal entity 4 pension trust 8. Corporate or LLC electing The corporation corporate status on Form 8832 9. Association, club, religious, The organization charitable, educational, or other tax-exempt organizaton 10. Partnership or multi -member The partnership LLC 11. A broker or registered The broker or nominee nominee 12. Account with the Department The public entity of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished. z circle the minor's name and furnish the minor's SSN. You must show your individual name and you may also enter your business or 'DBA" name on the second name line. You may use either your SSN or EIN (If you have one). If you are a sole proprietor, IRS encourages you to use your SSN. List first and circle the name of the legal trust, estate, or pension trust. (Do not fumish the TIN of the personal representative or trustee unless the legal entity itself is not designated In the account tile.) Also see Special rules regarding partnerships on page i. Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S. possessions to cant' out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply. oraorate Creations® Registered Agent • Director • Incorporation Services 941 Fourth Street Miami Beach FL 33139 ADDRESS SERVICE REQUESTED Deborah Shimel Post, Buckley, Schuh & Jernigan, Inc. (PBS&J) 2001 N.W. 107 Avenue MIAMI FL 33172-2507 Dear Deborah, Independently owned and operated by Corporate Creations International Inc. Tel (305) 672-0686 Fax (305) 672-9110 June 7, 2005 Re: W. KOO & ASSOCIATES / A DIVISION OF PBS&J Enclosed please find the Fictitious Business Name Statement filed with the state of California for the above mentioned company. Per your request, I have also enclosed a copy of the publication for the fictitious name with the Orange County News. The dates of publication are 6/8, 6/15, 6/22, 6/29, 2005. Should you need any further assistance, please do not hesitate to contact me. Thank you. tSincerely, %. Norman l asquier Project Manager www.CorporateCreations.com norman.pasquier@corpereations.com TOM DALY ORANGE COUNTY CLERK -RECORDER 12 CIVIC CENTER PLAZA, ROOM 106 POST OFFICE BOX 238 SANTA ANA, CA 92702-023B LA Recorded in Officiai ,records, Orange County Tom Daly, Clerk -Recorder II IIII 1111111111111 IN 111111111111111111111123.00 20056031442 02:07pm 06103/05 78 39 F01 23.00 0.00 0.00 0.00 0.00 0.00 FICTITIOUS BUSINESS NAME STATEMENT FILM, INSTRUCTION$ To ensue a prompt and accurate record of your fling, type or print in black ink ordy. 00 NOT MOREMTE. W. Koo d Asawlefss / A Division of POW Now arms n" 13 & M Mm r4 faepbtm t (" CoMwalion, enter mpews0m name) 66elnees Phone No. l 714 1 45B-02!)0 A;eJoDq AdMfreee NR3T uwnr a .O. Mbs P.lI6 8.) Csy ams, zip co* 2001 NW 107AvenW fYNarrli FL 33172 Ft# nsrne of P160WO '+t (it {,orper 000, mtW 00'Wed" nW"*) nsf�eel► sir : I- am Res./Corp. A0*W (Do Wt' um a P.O. Bak of P.bf.IL) piy State ZIP hods /OM Fine heels of RoOid" (it CarPo SO^ enter 004wfstien rx"e) tiIneorflt Ie"o wn coo ft*JCAW Addrew (00 MT W" s PA SW or P.fk&) City► issue ;vp (CWCK ONE ONLY) Tfse *A"" b aa+Aiited bye to! an.ndhledar" (Q) • � ps trlyr► (C+) • MnNiad PMM+sF+hIP wrp nW6d 4400 ietien other then a PlWtn "h'P (iy a esrporador► tttj , btaMnesa tte+Fle (p) cogrererers 4. (0) an W* +C?) hlri bww ww wft (0) vwftto (0) t irlrited Ca �f ) Have you started dolny bUsk"" yen Mt#MYWIr. YfMIz ffL7TtfSMNlI MANM irC AT!lwgrfi lMfE 7EMIIM MpM t1iM MtE R us fM w w wMfffr m awm MtMB•MIESfI m— A Mid f)C13:f" YWL-:; Imert to daft you @am* � MMfFi1A 1 M�M:i! f�M@ff�'AMTifAlM. ii�IRMwMF iiNM O, 07 f'�r'�til6MflffTOilFiiifl`ItlflE{ilEfI11'1NM�1�E�M1�ifldifM MAMfEEI't#OfIN M►�MMIfNlM fli<i~ifetflef tNMl�Elf1'ffrMdfi�w Ne �. ftlf f tJNlf 1M�TfMff 1M11 i8' �1.. MfJlf@i�MMfd11M if ft Obt m Is NOT a wrpomdon, alpn below: M b s eeifNFrstlo , en oftlw ewe ffr 101pottlert OM below. fI. (Ses ft*nxWw on the Foverse side d this form.) It tMipitlbsllt it s MNtW fitlft el7dfl ". a M~ or ss raMpit SIprW■ Y �• « eta tyw Iseeen av esf MW - w 1%060al10001arAONWNW I d*dW ea aN rNolelMo. b o" /MraaurM b U w aad m mec iA wM saw•. rernrt iarawneMwl+dMer� ►y ar qIe Melees M M (A f/jtreMt MAw daataeN M fee Ydorerlbw aAIIM w ar the kfl0ra to M M 4410040 (7NIi tH TIi! 1tN1E PgS4 S RUNS FEE W&W FOR ONE WSINESS NAML J 17.00 FOR EACH ADDITIONAL BUSINESS NAME. L46 f7.00 R011 EACN AOOFTIDNAL � F1RbTTYF�� .. . " " r"�, � PROVIDE A KV-AW116 EO. STAMPED, RM00AIE006- '+ i� 1 M f0aafbtMbwaw.ewL 0117r01) 0d: "$k ej Cx1F; JUN-6-2005 19:10 FROM:PCTS NC -)LK 562-462-1890 ' T13056729110 P.3/3 FILE NO.20056031442 ACTMOUS BUSINESS NAME STATEMENT THE FOLLUMNG PERSON(S) IS (ARE) DOING BUSINESS AS. W. KOO & ASSOCIATES / A DIVISION OF PBS83, 600 CITY PARKWAY WEST SURE 310 ORANGE CA 92888. The U narne POST.BeUCKLEY�5CF0.JH & JERNIGAN, INC OWU) 2001 NW 107 AVENUE MIAMI FL 3317Z This Busn05s is befog conducted b W.; A CORPORATION. The regissant armlenced to transact business under the 6ciii1ious business narnablames Usmd above on: 7/1104. 1 dedare that al the information in this staternent Is true and caned. (A mpstrard who dadares true, Wonm1on which he knows to be INC a crime). This statemard was filed with Cie County Cleik of ORANGE Courity on &3/O5 indicated by fie stamp above. NCJTICE-THS FICTITIOUS NAME STATEMENT EXPIRES FIVE YEARS FROM THE 1147E IT WAS FILED IN THE OFFICE OF THE COUNTY CLERK A NEW FICTITIOUS BUSINESS NAME STATEMENT MUST BE FLED PRIOR TO THAT DATE The fling of bs ste ntent does not of Itm# auOu ize the use in Cgs state of a ficHous business name sWermerit in vidatIon of the ripllts of ar>dher under federal, state, or cornmmn taw (See Section 14411 et seq„ Business and Professions Code), LA108348 ORANGE COUNTY NEWS 618,1 S,2 M, 2006 2120891 or SECRETARY OF STATE CERTIFICATE OF QUALIFICATION I, BILL JONES, Secretary of State of the State of California, hereby certify: That on the 21st day of September, 1998, POST, BUCKLEY, SCHUH & JERNIGAN, INC. WHICH WILL DO BUSINESS IN CALIFORNIA AS PBS&J, a corporation organized and existing under the laws of Florida, complied with the requirements of California law in effect on that date for the purpose of qualifying to transact intrastate business in the State of California, and that as of said date said corporation became and now is fully qualified and authorized to transact intrastate business in the State of California, subject however, to: (a) any licensing requirements otherwise imposed by the laws of this State, and (b) that subject corporation shall transact all intrastate business within this State under the above fictitious name elected by it. IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this day of September 23, 1998. 97 _L•Oa • r. A 2120891 vti,• t- K4. SECRETARY OF STATE I, BILL JONES, Secretary of State of the State of California, hereby certify: That the attached transcript has been compared with the record on file in this office, of which it purports to be a copy, and that it is full, true and correct. IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this Secretary of State i P. 2120897 STATEMENT AND DESIGNATION BY FOREIGN CORPORATION Post, Buckley, Schuh S Jerni E?tD0 2SED - F ILLD W THE OFFICE OF THE SECRETARY OF STATE OF T1;E S i ATE Cr CALIFORNIA SEP 21 1998 ALL JONES. SECRETARY of STATE Inc. which will do business in California as name of corporation) ration) a corporation organized and existing under the laws of Florida (State or Place of Incorpo, makes the following statements and designation: ration) 1. The address of its principal executive office is 2001 N.W. 107 Avenue, Miami, FL 33172-2507 2. The address of its principal office in the State of California is 18022 Cowan, Suite 100A, First Floor, Irvine, CA 92614 DESIGNATION OF AGENT FOR SERVICE OF PROCESS IN THE STATE OF CALIFORNIA (Complete Either Item 3. (Use this paragraph if the process agent is a natural 3 or Item 4) person.) a natural person residing in the State of California, whose complete address is to this corporation may be served within the State of Ca iforna a n the manner Provided by lagent un whom aw Irected 4. (Use this paragraph if the process agent is a corporation.) __ CT Corporation System , a corporation organized and existing under the laws of _ n1a"Are , is designated as agent upon whom process directed to this corporation may be served within the State of California, in the manner provided by law. NOTE: Corporate agents must have complied with Section 1505, California Corporations Code, prior to 5. It irrevocably consents to service of process directed to it upon the agent designated above, and to service of process on the Secretary of State of the State of California if the agent so designated or the agent's successor is no longer authorized to act or cannot be found at the address given. (Signature of Corporate Icer) Wi 71 i am w_ Randol nh (Typed Name nd hai raA of _ the Board T 'DO NOT USE A POST OFFICE BOX ADDRESS a rtle of Officer Signing) c� r, '