Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
CJ Concrete Construction
|
| Vendor Number (3____ for AP and 00___ for AR) |
0
|
| Vendor Contact Name |
John Samo
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Concrete Repair Program - Phase XI, CIP 2201
|
| Contract / Amendment Amount |
$227,032.50
|
| Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
| Supplemental Insurance (for Risk team only) |
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|
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
CJ CA Auth Form (Signed).pdf
|
| Upload Agreement or Amendment |
CJ CA (Dir Signed).pdf
|
| Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
CJ Ins.pdf
|
| Describe changes to Insurance Requirements, if any (if no insurance is required, type "None required") |
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|
| Describe changes to Contract Template, if any (If none, type "None required") |
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|
| Upload other supporting documents here, if necessary (e.g. staff reports, etc.) |
Award of CIP 2201 Concrete Repair Program Phase XI CDBG -Final.docx, CJ Business Tax Application Received.pdf, Attachment B - Reso CIP 2201 -Final.pdf, Public Works Contracts Checklist.docx, West Hollywood Bid Bond.pdf, West Hollywood Bid Proposal.pdf, CJ No Debarment.pdf, CJ DIR.pdf, CJ License.pdf, Addendum No. 1.pdf, 38_CIP 2201 Bid Specification.pdf
|
Supplemental Risk Information
Upload Additional Insurance Files Here
General Liability Details
| Policy Effective Date |
11/12/2021
|
| Policy Expiration Date |
11/12/2022
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
PNC, AI
|
| Waived |
Waiver of Subro is missing
|
Automobile Policy Details
| Effective Date |
11/12/2021
|
| Expiration Date |
11/12/2022
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
05/08/2021
|
| Expiration Date |
05/08/2022
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
WOS
|
| Waived |
Actual WOS endorsement is missing
|
