HomeMy WebLinkAboutAll American Asphalt, Inc. - 2009-12-21- RECEIVED BY (Name) JI (Date) TO Shan'iFreidenrich City Treasurer FROM �4 %� L 16"ki ?� f DATE - 490/0 f SUBJECT Bond Acceptance I have received the bonds for Faithful Performance Bond No Labor and Material Bond No Monument Bond No Maintenance Bond No Guarantee and Warranty Bond No Re Tract No r CC No MSC No CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk s Office after signing/dating �(`,rI, J F)�J ; 4-4 L / (Company Name) :7-6100 ! 30 0 Approved ltl�Cl Agenda Item Nof (Council Approval Date) ��� �� City Clerk Vault No is #27 g /followup/bondietter doc •� City of Huntington Beach OU INTER -DEPARTMENT COMMMUNICATION HUNTINGTON BEACH TO THOSE LISTED HEREON FROM Eric R Charlonne Construction Manager DATE September SUBJECT Retention Release Payment Company Name All American Asphalt Address PO Box 2229 City, State and Zip Code Corona CA 92878-2229 Phone Number (951) 736-7600 Business License Number A016726 Local Address Same as above Notice of Completion Date 6/28/10 Contract Purpose Release of remaining retention funds to the above contractor withheld for the Arterial Highway Rehabilitation project CC-1359 The conformed copy of the Notice of Completion for the above contract has been filed The thirty-five (35) day waiting period has elapsed or will elapse before payment is made Processing of the retention payment is recommended so long as no stop notices or outstanding invoices are on file with the City I certify that no stop notices are on file o� subject pt this time Date 4Tra s opkins Public' I certify that there are no outstanding invoices okfile ,C& 3 -1 Date S City Treasurer f/ Rating I certify that no stop notices are on file on the subject contract, and that a guaranty bond has been1;[J iththis officeo --- J,�, "2 � Da a Jo nn Cler Retention Release memo U 7/7/2010 11 33 00 AM PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO WHEN RECORDED MAIL TO CITY OF HUNTINGTON BEACH Attn Robert A Martinez P O Box 190 — 2000 Main Street Huntington Beach CA 92648 Recorded in Official Records, Orange County Tom IIII IIIII III IClerk IIIII IIIII Recorder IIIII IIIII IIII IIII N NO FEE 201000030294710 50 am 06/28/10 47 412 N12 1 000000000000000000000000 TITLE OF DOCUMENT NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach owner in fee 2000 Main Street Huntington Beach CA 92648 that the contract heretofore awarded to All American Asphalt who was the company thereon for doing the following \\\ work to wit SLATER AVENUE REHABILITATION FROM GRAHAM TO GOLDEN WEST, CC# 1359 That said work was completed June 18 2010 by said company according to plans and specifications and to the satisfaction of the City Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on June 18 2010 per City Council Resolution No 2003 70 adopted October 6 2003 That upon said contract Fidelity and Deposit Company of Maryland was surety for the bond given by the said company as required by law This document is solely for the official business of the City of Huntington Beach as contemplated under Government Code Section 6103 and should be recorded free of charge Dated at Huntington Beach California this June 21 2010 k2Dire for of P Iic Works or City Engineer cof Hu ington Beach California STATE OF CALIFORNIA) v County of Orange ) ss City of Huntington Beach ) I the undersigned say I am an Agent of the City of Huntington Beach owner in fee in the foregoing NOTICE OF COMPLETION I have read said NOTICE OF COMPLETION and know the contents thereof the same is true of my knowledge I declare under penalty of perjury that the foregoing is true and correct and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County Dated at Huntington Beach California this June 21 2010 /� 1 'rof PubliVWbrks or City Engineer Hunting n Beach California THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) -0- 059 TITLE PAGE (R7/95) Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To City of Huntington Beach Department of Public Works 2000 Main Street/P O Box 190 Huntington Beach, CA 92648 Re Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract c C — 1 3 5q Project S10,4er h 2 YZ VA_P_ 4► 1ajo I I Iof Q inn Gra h aM t,)ns + 9rD e eru At ck fn�ff_A1 S L- 51 11 UL,9 The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed this day of , 2M 'at C 0 YD I(O` , California At1 Amkvca- A5phal+- (Type Contractor Name) 1' 4 N [Type Name] J "-- r Title [Type Tittle] 1 R n �3 later+ �rGtc�+ ` A C�RNEX v I Pry��/ -.-- 1LJ 3 2rb oto 245911 1 Certification of Compliance with Prevailing Wage Laws To City of Huntington Beach Department of Public Works 2000 Main Street/P O Box 190 Huntington Beach, CA 92648 Re Certification of Compliance with Prevailing Wage Laws Contract C C" (3 559 Prof ect I a4dw, A ve o l/l_ 1 t t wb lAI, Pro ec+ Aid The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the immum wage and bona fide fringe benefit requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed this 64K day of u 1 , 20A 0 , at W l� 11 , California All Awtc r i c cw A�� 4 (Type Contractor Name) By Name [Type Name] Title [Type Title] A` O �[cGItA CITY ATTORNEY Uri ���5► -TZS o3 a'b �v 2475421 CONTRACTOR'S CER'TIFICA'TE I Shirley R Suence , state and certify that (Name of Declarant) All American Asphalt is the general contractor to the City of Huntington Beach ("City") on Contract No #1359 (the "Contract") for the construction of the public work of improvement entitled CC-1359, SLATER AV ENUE & REHABILITATION FROM GRAHAM TO GOLDENWEST ST (the Project") 2 All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract) 3 Except for the claims listed below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims, if none, write "NONE") 4 Attached hereto are the lien waivers required by the Contract Documents, which hen waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project 5 Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims, if none, write "NONE") NONE I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct Executed7t Corona, CA APPROVED AS TO FORM on this 19th day of July , 201o_ (Sign9fue of Decl ant) Credit Manag By Zo 0C4 Name [Type Name] Title [Type Title] 2459141 tr Company Profile Page 1 of 2 MARYLAND 1400 AMERICAN LANE, 19TH FLOOR 'TOWER 1 SCHUAMBURG, IL 60196-1056 800-382-2150 Agent for Service of Process KAREN HARRIS, C/O CORPORATION SERVICE COMPANY 2730 GATEWAY OAKS DRIVE, SUITE 100 SACRAMENTO, CA 95833 Unable to Locate the Agent for Service of Process? Deference Information NAIC # NAIC Group # California Company ID # Date authorized in California License Status Company Type State of Domicile 39306 0212 2479-4 January 01, 1982 UNLIMITED -NORMAL Property & Casualty MARYLAND Lines of Insurance Authorized to Transact The company is authorized to transact business within these lines of insurance For an explanation of any of these terms, please refer to the glossary AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY CREDIT FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER http //interactive web insurance ca gov/webuser/idb_co_prof utl get_co_prof?p_EID=6217 7/20/2010 Company Profile Page 2 of 2 SURETY TEAM AND VEHICLE WORKERS' COMPENSATION Company Complaint Information Company Enforcement Action Documents Company performance & Comparison Data Composite Complaint Studies Want More`' Help Me Find a Company Representative zn My Area Financial Rating Organizations Last Revised June 26 2009 05 53 PM Copyright © California Department of Insurance http //interactive web insurance ca gov/webuser/idb_co—prof utl get_coDrof?p_EID=6217 7/20/2010 RECEIVED BY (Name) (Date) TO ShaFreidenrich City Treasurer FROM p DATE 0 l� SUBJECT Bond Acceptance have received the bonds for Faithful Performance Bond No Labor and Material Bond No Monument Bond No Maintenance Bond No Guarantee and Warranty Bond No Re Tract No CC No 1113,5�y/ MSC No (Company Name) �76 1501300 CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk s Office after signing/dating Approved Agenda Item No —41/ I- (Cou cd Approval D e) City Clerk Vault No --77 --�'Aa7T #27 g /followup/bondletter doc Bond No 761301300 Maintenance Bond Executed in Two (2) Parts KNOW ALL MEN BY THESE PRESENTS that we All American Asphalt hereinafter called Principal as Principal and Fidelity and Deposit Company of Maryland a corporation of the State of Maryland hereinafter called Surety as Surety are held and firmly bound unto City of Huntington Beach CA hereinafter called Obligee in the sum of One Million Ninety Three Thousand One Hundred Nineteen & 63/100ths ($1 093 119 63) DOLLARS lawful money of the United States of America, to be paid to the said Ob ligee or its successors or assigns to the payment of which sum well and truly to be made we do bind ourselves our heirs executors administrators successors and assigns jointly and severally firmly by these presents SIGNED sealed and dated this 14th day of 2010 WHEREAS the Principal entered into a contract with the said Obligee dated December 21 2009 for CC 1359 Slater Avenue Rehabultation from Graham to Goldenwest Street and WHEREAS the Obligee requires that these presents be executed on or before the final completion and acceptance of said contract and WHEREAS said contract was completed and accepted on the 18th day of June 2010 NOW THEREFORE THE CONDITION OF THIS OBLIGATION IS SUCH that if the Principal shall remedy without cost to the Obligee any defects which may develop during a period of One (1) Year from the date of completion and acceptance of the work performed under the contract caused by defective or inferior materials or workmanship then this obligation shall be void otherwise it shall be and remain in full force and effect 4"J�- -E/ , w14�- Barbara J Bender Notary Public All Amer sphalt Fidelity and Deposit Company of Maryland By ma� e Rebecca Haas Bates Attornev in Fact CON80010ZZ0601 f AP VED S TO F JE FE McGRATH 14ROM .11 g t l o CALIFORNIA ALL-PURPOSE AC' fi) P. f' MT ii State of California County of Riverside On July 19, 2010 before me Carmen Marie Ochoa, Notary Public Hate Here Insert name and Title of the officer personally appeared Robert Bradley NameFs) of Signers) who proved to me on the basis of satisfactory evidence to be the personW whose name(s) is/44;a subscribed to the within instrument and acknowledged to me that heisheAhey executed the same in hiss authorized capacity(wo and that by his signature(G) on the instrument the person(s) or the entity upon behalf CARMEN MARIE OCHOA of which the person€e acted executed the instrument Commission # 1812634 Z -e� Notary Public California I certify under PENALTY OF PERJURY under the laws of the State of 2 Riverside County California that the forgoing paragraph is true and correct My Comm Expires Sep 8 2012 WITNESS m hand and official seal l V Signature Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document a I (I "T,0,_j() a 1/Ap� Document Date v Number of Pages Signer(s) Other Than Named Above Capacity( Claimed by SignerO Signer's Name Robert Bradley ❑Individual X Corporate Officer — Title(%) Vice President ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Other Signer is Representing All American Asohalt J Signer's Name ❑ Individual ❑ Corporate Officer — Title(s) _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Other , Signer is Representing 9" �s :c3.,r?.': State of California County of Orange On 7-14 10 before me Barbara J Bender Notary Public Date Here insert Name personally appeared Rebecca Haas Bates who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islere subscribed to the within instrument and acknowledged to me that -he/she/" executed the same in itra(her/thetr authorized capacity(les) and that by h*AerA4w signature(4 on the Instrument the person(*} or the entity upon behalf of which the person(s} acted executed the Instrument B Commission J BENDER 1 certifyunder PENALTY OF PERJURY under the laws Commission # 1801899 Notary Public California > of the State of California that the foregoing paragraph is Z `�O Orange County true and correc My Comm Expires Jul 13 2012 WITNESS d and Iclal eal Signature — AX Piace Notary Seal Abo a Signature of ry Pubttc OPTIONAL AL Though the information below is not required by law it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document Maintenance Bond No 761301300 Document Date 7 14 10 Signer(s) Other Than Named Above All American Asphalt Capacity(les) Claimed by Signer(s) Signers Name Rebecca Haas Bates ❑ Individual Corporate Officer — Title(s) Partner — D Limited _j General 1] Attorney in Fact + Trustee Top of th rmb here Guardian or Conservator Other Signer Is Representing _ Fidelity and Deposit Company of Maryland _ Number of Pages One (1) Signers Name Individual Corporate Officer — Tltle(s) Partner — J Limited C General Attorney in Fact + Trustee Top of thJmb here C Guardian or Conservator Other Signer Is Representing 02007 Natonal Notary Assoaabon 9350 De Soto A e PO Bo 2402 Ch L-&orth CA 91313-2402 w Natona4Nota yo 9 1i m #5907 Reorder CaflToll Free 1-8W876 6827 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland by WILLIAM J MILLS Vice President and GREGORY E MURRAY Assistant Secretary in pursuance of authority granted by Article VI Section 2 of the By Laws of said y which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the d ereby nominate constitute and appoint William SYRKIN, Rebecca HAAS-BATES an f Irvine, California, EACH its true and lawful agent and Attorney -in Fact to mak e u ► " behalf as surety and as its act and deed any and all bonds and undert o ecu or undertakings in pursuance of these presents shall be as binding upon 1 d 1 ents and purposes as if they had been duly executed and acknowled y ele ompany at its office in Baltimore Md in their own proper persons er rn e on behalf of William SYRKIN Rebecca HAAS BATES Sergio D BECHAR and ed April 8 2008 The said Assistant F s e eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI Section 2 of the By s said Company and is now in force IN WITNESS WHEREOF the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND this 25th day of September AD 2009 ATTEST PTV DUO, _ o t State of Maryland ss City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND J Gregory E Murray Assistant Secretary William J Mills Vice President On this 25th day of September A D 2009 before the subscriber a Notary Public of the State of Maryland duly commissioned and qualified came WILLIAM J MILLS Vice President and GREGORY E MURRAY Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND to me personally known to be the individuals and officers described in and who executed the preceding instrument and they each acknowledged the execution of the same and being by me duly sworn severally and each for himself deposeth and saith that they are the said officers of the Company aforesaid and that the seal affixed to the preceding instrument is the Corporate Seal of said Company and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation IN TESTIMONY WHEREOF I have hereunto set my hand and affixed my Official Seal the day and year first above written 'k0%1l I it III, C � Maria D Adamski Notary Public My Commission Expires July 8 2011 POA F 012 0033 RECEIVED BY:/) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating 10 (Date) H CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION B TO: Shari Freidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for (company Name) Performance Bond No. /x--, 1,30 / 3 /21) Labor and Material Bond No. /9 Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. 44t,, Ir Re: Tract No. CC No. MSC No. L Approved J&�b, /0 Agenda Item No. (Council Approval Datq) City Clerk Vault No. 4A A #27 g1followup/bondletter.doc FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND FOR TABLE OF CONTENTS Page No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 3 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 4 7. NOTICE TO PROCEED 5 8. BONDS 5 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 6 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 9 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 10 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 10 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT & TERMINATION 14 24. TERMINATION FOR CONVENIENCE 14 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 15 27. CITY EMPLOYEES AND OFFICIALS 15 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 15 29. NOTICES 16 30. SECTION HEADINGS 16 31. IMMIGRATION 16 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 34. INTERPRETATION OF THIS AGREEMENT 35. GOVERNING LAW 36. DUPLICATE ORIGINAL 37. CONSENT 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 39. CALIFORNIA PREVAILING WAGE LAW 40. CALIFORNIA EIGHT -HOUR LAW 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 42. EMPLOYMENT OF APPRENTICES 43. PAYROLL RECORDS 44. FEDERAL PARTICIPATION 45. ADDITIONAL FEDERAL REQUIREMENTS 46. DAVIS-BACON ACT 47. DISCRIMINATION, MINORITIES, ALIENS 48. EQUAL EMPLOYMENT OPPORTUNITY 49. COPELAND "ANTI -KICKBACK" ACT 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 52. ENERGY CONSERVATION 53. HOUSING AND URBAN DEVELOPMENT 54. SIGNATORIES 55. ENTIRETY 17 17 18 18 18 18 19 19 20 20 20 21 21 22 22 23 23 24 25 25 25 25 25 ii FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND G C �6L1,E�2 / G�—jci S�hwl-T FOR 72) THIS AGREEMENT ("Agreement") made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and l E/G�C�� ��S/�/�/,�L7�, a [type of entity and State] hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as cSG �i c2 67 UC. /�Eif,9 �/ 4 / Trt i/ ©.J 1524,m (a/LA hl Arhn sT ^ TU D d C-,J 4JC�JS % in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not g/agree/ surfnet/federal const 12-07 Page 1 of 27 limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK, PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; g/agree/ surfnet/federal const 12-07 Page 2 of 27 r D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference), and the Federal Requirements from FHWA 1273 and additional requirements (which is attached hereto as Exhibit "B"); F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. g/agree/ surfnet/federal const 12-07 Page 3 of 27 Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed C E c , sW vRJE �u.�/A2 F_,U T�.c� Dollars ($ �� a o 0/6. 7), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within G !' - (%S ) cwmeeutive lCjAl y5 from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/ swfnet/federal const 12-07 Page 4 of 27 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/ surfnet/federal const 12-07 Page 5 of 27 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/ surfnet/federal const 12-07 Page 6 of 27 secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of Dollars per day for each and every working day's delay in completing the work in excess of the number of working/calendar days set forth herein, which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. g/agree/ surfnet/federal const 12-07 Page 7 of 27 CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DIFFERING SITE CONDITIONS A. Notice: CONTRACTOR shall promptly, and before such conditions are disturbed, notify DPW in writing of- (1) Subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents; or g/agree/ sw fnet/federal const 12-07 Page 8 of 27 (2) Unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the character to be performed under this Agreement. DPW shall promptly investigate the conditions and if it finds that such conditions do materially so differ and cause an increase or decrease in the time required for performance of any part of the work under this Agreement, whether or not changed as a result of such conditions, an equitable adjustment shall be made and the agreement modified in writing accordingly. B. Time Extension: No claim of CONTRACTOR under this Section shall be allowed unless CONTRACTOR has given the notice required hereunder provided, however, the time prescribed therefor may be extended by CITY. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an g/agree/ surfnet/federal const 12-07 Page 9 of 27 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, ten percent (10%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the Agreement price shall not be considered as a acceptance of any part of the work. g/agree/ surfnet/federal const 12-07 Page 10 of 27 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by g/agree/ surfnet/federal const 12-07 Page 11 of 27 CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, g/agree/ sur£net/£ederal const 12-07 Page 12 of 27 a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above -mentioned insurance contain a self -insured retention without the prior written consent of CITY; however an insurance "deductible" of $5,000.00 or less is permitted. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. g/agree/ surfnet/federal const 12-07 Page 13 of 27 CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 23. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default g/agree/ surfnet/federal const 12-07 Page 14 of 27 by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. g/agree/ surfnet/federal const 12-07 Page 15 of 27 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES• RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: g/agree/ surfnet/feaeral const 12-07 Page 16 of 27 TO CITY: City of Huntington Beach ATTN:,Ojewi�6 2000 Main Street Huntington Beach, CA 92648 30. SECTION HEADINGS TO CONTRACTOR: Jo �7 GO,eowx , G`I Z�'7�-Zzz5 The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. g/agree/ surfnet/federal const 12-07 Page 17 of 27 33. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 34. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 35. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. g/agree/ surfnet/federal const 12-07 Page 18 of 27 36. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 37. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 39. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of g/agree/ surfnet/federal const 12-07 Page 19 of 27 Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 40. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty- five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is g/agree/ surfnet/federal const 12-07 Page 20 of 27 required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 42. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 43. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 44. FEDERAL PARTICIPATION The PROJECT pursuant to which the work covered by this Agreement is being executed is being assisted by the United States of America. Several Agreement provisions embodied herein are included in this Agreement in accordance with the provisions applicable to such federal assistance. As federal funds are financing all or part of this work, all of the statutes, g/agree/ sur£net/federal const 12-07 Page 21 of 27 rules and regulations promulgated by the Federal Government and applicable to the work will apply, and CONTRACTOR agrees to comply therewith. Attached is FHWA Form 1273, known as Exhibit "1B", which describes required contract provisions for federal -aid construction contracts. Additionally, the CONTRACTOR shall insert in each subcontract all of the stipulations contained in the Required Contract Provisions of Form 1273, and further require their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. Certain sections of Form 1273 may not be applicable depending upon the project and will be crossed out. 45. ADDITIONAL FEDERAL REQUIREMENTS CONTRACTOR agrees to abide by the additional requirements necessary for federal- aid (see pgs. 12-14 of Exhibit ">B"). The CONTRACTOR agrees to buy only steel and iron made in the United States for all federal -aid construction projects ("Buy America"). The CONTRACTOR also agrees to be subject to the legislative and regulatory Disadvantaged Business Enterprise (DBE) requirements (42 USC Section 2000d, et seq.). If the CONTRACT does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non -collusion certification. Select projects may also require "Federal Trainee" or "On -the -Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined g/agree/ surfnet/federal const 12-07 Page 22 of 27 by the Secretary of Labor in accordance with the Davis -Bacon Act (40 USC Section 176a, et seq.) for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 46. DISCRIMINATION, MINORITIES, ALIENS The CONTRACTOR or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The CONTRACTOR shall carry out applicable requirements of 49 CFR, Part 26 in the award and administration of DOT -assisted contracts. Failure by the CONTRACTOR to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as recipient deems appropriate. 47. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled "Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit "B") CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. g/agree/ surfnet/federal const 12-07 Page 23 of 27 Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 (38. USC Section 219 et seq.) prohibits job discrimination and requires affirmative action to comply and advance in employment (1) qualified Vietnam veterans during the first four (4) years after their discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 48. COPELAND "ANTI -KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations, which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 49. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327 et seq.) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight (8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in g/agree/ surfnet/federal const 12-07 Page 24 of 27 excess of eight (8) hours in any calendar day or forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 50. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 114 of the Clean Air Act and section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every g/agree/ surfnet/federal const 12-07 Page 25 of 27 nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. 51. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 USC Section 6201, et seq.). 52. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 53. SIGNATORIES 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 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. 54. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, g/agree/ surfnet/federal const 12-07 Page 26 of 27 have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on Z) L' � /, 20 421 . CONTRACTOR CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California PA O-K 2229 Cvmltg, 64 ?X ' Mayor IF By: laz ty Clerk ?411110 .-, ��� /L I G,✓' 1, / � l./ print nam ITS: (circle one) Cha an/Presiden ice AND By M L � print n ITS: (circle one) ecretary hief Financial Officer/A .. Secretary - Treasurer INITIATED AND APPROVED: APPROVED AS TO FORM: City Attorney g/agree/ surfnet/federal const 12-07 Page 27 of 27 State of California County of Riverside On January 19, 2010 before me, Carmen Marie Ochoa, NotM Public Date Here Insert name and Title of the Officer personally appeared Robert Bradley and Mark Luer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that /they executed the same in his/her/their authorized capacity(ies), and that by /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. CARMEN MAOCHOA ' Commission # 1812634 Ir I certify under PENALTY OF PERJURY under the laws of the State of ' Notary Public - California a Riverside County f California that the forgoing paragraph is true and correct. My COMM Expires Sep 8, 2412 WITNESS my hand and official seal. , Signature 0 a"Mai � C a� Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Docume((int`^ Title or Type of Document brSAT, c Document Date: Q D 1 � umber of Pages: 9 Signer(s) Other Than Named Above: �� )i V t q- Capacity(ies) Claimed by Signer(s) Signer's Name: Robert Bradley Signer's Name: Mark Luer ❑ Individual ❑ Individual X Corporate Officer — Title(s): Vice President X Corporate Officer — Titie(s): Secretary ❑ Partner— ❑ Limited ❑ General �_ ❑ Partner— ❑ Limited ❑ General : PRINT ❑ Attorney in Fact ❑ Attorney in Fact f thumb here❑ Trustee Top of thumb here ❑ Trustee lop ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROM: 11 �,Yl 4S �Ro��Cr: CC - 3 S i , Sla 46K (Contractor Flame) V U'C S� h % l M11 iW CaS�' �-I'h S�- �, (k him -fi (Street Address) � COrarla M 1� 11S/ (City, State and Zip) TO: CITY OF !-llUNTINGTON BEACH Attached hereto is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement CG 2010 1185, which Certificate complies with the insurance requirements of the Contract by and between the City of Huntington Beach (City') and the above -named Contractor ("Contractor') for the above -described project ("Project'). I declare under penalty of perjury under the laws of the State of California CA the above statement is true and correct. Signed on _Ja U0 20 6 at CorDna C � (Date) (City, State) of Individual Who is Contractor hereby warrants and agrees to maintain Products and Completed Operations Insurance in compliance with the insurance requirements of the Contract for the Project. Said insurance shall be maintained through and until the expiration of all Warranties provided by Contractor. Said insurance shall contain Additional Insured Endorsement CG 2010 1185, naming City as an additional insured. Contractor shall supply to City, on at least an annual basis, a Certificate of Insurance and the aforementioned Endorsement evidencing continued coverage which meets the Contract requirements. Signed on Dail 20/0 at &/Z)17 , (Da ) (City, State) CONTRACTOR: Name: tq/ (/ �C °i✓ 6 By, 277621.2 E�- A SECTION C PROPOSAL, for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days,, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find bi n the amount of $ 10 �° �° which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bi a able to the AGENCY. (Please insert the words " ", 'Vc'ertified� ef ', or ' idder's Bond" as the case maybe). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received B' der's Sit ture 0 1 0 C-2 SECTION C PROJECT DID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STPL-5181 (166) BASE BID: TOTAL AMOUNT BASE BID IN FIGURES: $ �,�� c,1ko ob TOTAL AMOUNT BASE BID IN WORDS: C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1359 Item ..... ............................................................................................ : Est�matecl :::::::::::::::: .............. 3tetii:�vitii taint: rcce::::::::::::::::::::::::::::::::::;::::::::::::::::::::::::::::::::::: ......................................................................................................... ................. Ext6iide:d::'.: .................. a, ... ......::::::::::::::::.w...........w.... ritteri i� ...ord..................................:::::::::::::::....:::::::::: s.................................. . IJi►it :Pr ee::::::::Airioui�it::: : 1 1 Mobilization LS @ Oct'rnhvsc"vCA -(' Dollars $ $ Cents Per LS 2 1 Traffic Control Plan LS Dollars $ $ Cents Per LS 3 1 Furnish Project Traffic Control LS ,-h,,""z',, A Dollars $ 21,(�on $ 21�000 Cents Per LS 4 96430 Cold Milling & Header Cutting incl. disposal of material SF @ — Dollars $ ,a $ Y, Loy, Cents Per SF 5 195300 Surface Grind (0.17) including dipposal of material SF @ — Dollars $ °ILG - $ 2ti� Cents Per SF 6 1325 Unclassified Excavation CY Dollars $ Cents Per CY 7 5040 Construct Asphalt Concrete (0-0.17', 0.17', 0.42' & 0.50') Ton @ `�ixku »�� r Dollars $ LPH $ 322 ,SLP lD Cents Per Ton 8 6015 Construct Asphalt Concrete (0.17' ARHM Overlay) Ton @ Dollars $ $ -2A Q Cents Per Ton 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface EA Dollars $ $ ZJ Cents Per EA 10 16 Adjust OCSD Manhole to finished surface EA Dollars $ $-, Cents Per EA C-2.2 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 ........................ ..... ...............w....i.t. .. ... . ........................................I. ........... ... . ..... .................... ........ ......... . vn.iCi..:::. ........ .... . A. .o.i 11 21 Adjust Water Valve to finished surface EA Dollars $ $ sa 2a—L) Cents Per EA 12 1 Adjust Monitoring Well to finished surface EA @-E__Q �-I�..Dollars $ -2 $ _S Cents Per EA 13 1 Traffic Striping LS _,�.Dollars $ $ Cents Per LS 14 33 Traffic Loop EA @ Dollars $ $ "m 0 Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, P Slot 15 1830 Pave per Std Plan 202) LF Dollars $ $ LA01'ao Cents Per LF 16 15155 Remove & Reconstruct Sidewalk per Std Plan 207 L L SF Dollars $ Cents Per SF Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining 17 12 Curb, I' Slot pave,& SW) EA Dollars $" $ Cents Per EA 18 4 Install Truncated Domes into existing Access Ramp EA Dollars $ \g"o $ Y'C4()C) Cents Per EA 19 13 Survey Monumentation EA Dollars Cents Per EA 20 1 Raise Survey Well Monument to finished surface EA __K Dollars 7 $ -22S 0 Cents Per EA C-2.3 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 HOW . . .........I....... : Estimated ..... ................. ........ ................................... ..... ....... ................. . ................................... ................................. . ..................... ...... ... ....... . . .. ............................ .. ................. ... ..nin�Qrds w.. ...... . ... ... ... .. ......... ................... 21 1654 Remove & Reconstruct Curb & X-Gutter SF @ Dollars $ $ Cents P Per SF 22 6 Remove & Install New Traffic Signal Pullbox EA @ Dollars $ 142-13 $ _2_.SS_C) Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-I-T frame. Install city furnished traffic signal head with LE-SV- I -T framework and terminal box. I ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. I ea o Install conduit into existing pullbox. I ea. o Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyle" or City approved equal. tea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1-12 conductor cable and 1-3 conductor cable. I ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. I ea • Install 3" conduit with 1-28 conductor cable and 4 DLC. I ea • Abandon existing conduit and remove conductors. I ea • Install 3" conduit into existing pullbox. I ea • Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cable and DLC's into traffic signal cabinet. I ea. LS @ —Dollars $ $ �\'('ff) Cents I Per LS Total Amount Bid in Figures: $ Total Amount Bid in Words: ---------------------------------------------- j tAte"-\ AcAf " i s j wo C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class r-� C -'y'J By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange 1/t 6 ;. 0AA " , being first duly sworn, deposes and says that he or 4,,e-is CR- cQ31 C RXI�i- of P(Y1PXkan VtiA+ the party making the foregoing bid that the bid is not made in the interest of, or on theme behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Name of Bidder 0-0 • g - of Bidder iO` , • . `PO 36X 0.-QR Coro ()a CA- 096-10 Address of Bidder Subscribed and sworn to before me this day of , 200 NOTARY PUBLIC S-e e ct `f `t a_C ` , NOTARY SEAL C-4 CALIFORNIA JURAT WITH AFFIANT STATEMENT State of California County of Riverside Subscribed and sworn to (or affirmed) before me on this 14th day of October, 2009 Date Month By (1) Robert Bradley Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (and Commissioonn # CARM (2) z 5— EN 1812634 Name of Signer 2634 :'m Notary Public - California Riverside County 9 Proved to me on the basis of satisfactory evidence My Comm. Expires Sep 8, 2012 t be the person who appeared before me.) i Signature Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document (` 1 1 C j� - ' G' �iV j I' Title or Type of Document Owl �=� J oA Document Date: o r� Number of Pages: Signer(s) Other Than Named Above: 1 V Capacity (ie Claimed by Signerol Signer's Name: Robert Bradley Signer's Name: ❑ Individual \ j ,❑ Individual %•Corporate Officer — Titleo 1� ° e. S r cI,, cto Corporate Officer — Title(s): ❑Partner— ❑ Limited ❑ General _ ❑ Partner— ❑ Limited ❑ General ❑ Attorney in Fact ❑ Attorney in Fact OF ❑ Trustee Top of thumb here ❑ Trustee Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signe is Representing: All American Asphalt UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: Ml A-W i taro fi5nhlAk Contractor W.` I =I - = Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes X No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: l i ` Im R� k �AmntAI Can Contractor ••- V+� pre-s Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to theXGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identific ton Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground rvice Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation; Dig Alert Identification Number: U- Date: Contractor Title Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of' the Work. Additional forms may be obtained.from om the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name PO C&x aaag Business Address (`amok- Ck ga211 City, State Zip qsk ) -1 �3-- -1 U-Ck) Telephone. Number a cgg l -13 A, c to State Contractor's License No. and Class ►s�01 Ita--1\ Original Date Issued Expiration Date The work site was inspected by &'(A SV `t?of our office on v I 10, 2001. The following are persons, firms, and corporations having a principal interest in this proposal: f Lime '.. • C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. i can H50WL iA- Company Name Printed or Typed Signature Subscribed and sworn to before me this day of 200_ NOTARY PUBLIC �-ef CA C/ v` NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: S4e,4e, O ,WM 1. 2. 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Naive and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Naive and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Date Completed Date Completed Contract Amount Type of Work Date Completed C-10 CALIFORNIA JURAT WITH AFFIANT STATEMENT State of California County of Riverside CARMEN MARIE OCHOA Commission # 1812634 "� Notary Public - California Z ' Riverside County t My Comm. Expires Sep 6, 2012 Subscribed and sworn to (or affirmed) before me on this 14th day of October, 2009 Date Month By (1) Robert Bradley Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) k (and (2) Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me.) Signature ot ��/LZ'i?l�'t GCS' C Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document1.�� 1 Title or Type of Document 'I C A� cy-S (\[pf M C'L 'b L� Document Date: I V Qf\-Q— Number of Pages: Signer(s) Other Than Named Above Capacity(ies`) Claimed by Signer Signer's Name: Robert Bradley Signer's Name: ❑ Individual ❑ Individual �❑ Corporate Officer — Title: �, e �� S (�2Vt ❑ Corporate Officer — Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ Gen'e ❑ Attorney in Fact ❑ Trustee ❑ Other: Signer is Representing: ❑ Attorney in ❑ Trustee , Signer is Representing: " 2008" PAST WORK REFERENCES City of Irvine One Civic Center Plaza P.O. Box 19575 Irvine, CA 92606-5268 Contract: Kal Lambaz, (949) 724-7555 City of Anaheim 200 South Anaheim Blvd. Anaheim, CA 92805 Contact: Sean Razmy, (714) 765-5069 City of Newport Beach 3300 Newport Blvd. Newport Beach, CA 92658 Contact: Andy Tran, (949) 644-3315 University Drive Rehabilitation Contract Amount: $3,445,289.40 Start: 1/2008 Completed: 6/2008 Anaheim Blvd. Improvements Contract Amount: $278,391.00 Start: 4/2008 Completed: 6/2008 Superior Avenue Improvements Contract Amount: $862,862.00 Start: 1/2008 Completed: 6/2008 City of Westminster Citywide Street Improvements 8200 Westminster Blvd. Contract Amount: $1,118,383.00 Westminster, CA 92683 Start: 3/2008 Contact: Theresa Tran, (714) 898-3311 Ext. 282 Completed: 7/2008 City of Lake Forest 25550 Commercentre Drive, Suite 100 Lake Forest, CA 92630 Contact: Luis Estevez, (949) 461-3485 City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 Contact: Ed Torres, (714) 647-5018 Street Resurfacing & Slurry Seal Contract Amount: $1,638,523.00 Start: 2/ 2008 Completed: 4/2008 Santa Clara Avenue Improvements Contract Amount: $2,219,523.00 Start: 11 /2007 Completed: 3/2008 "2007" PAST WORK REFERENCES City of Westminster Citywide Street Improvements 8200 Westminster Boulevard Contract Amount: $1,085,000.00 Westminster, CA 92683 Start: 11/2006 Contact: Theresa Tran, (714) 898-3311 Ext. 282 Completed: 6/2007 City of Irvine P.O. Box 19575 One Civic Center Plaza Irvine, CA 92606-5208 Contact: Uyenly Bui, (949) 724-7559 City of Anaheim 200 S. Anaheim Boulevard Anaheim, CA 92805 Contact: Robert Luciano, (714) 765-5286 City of San Clemente 910 Calle Negocio, Suite 100 San Clemente, CA 92376 Contact: Gary Voborsky, (949) 361-6132 City of Newport Beach 3300 Newport Boulevard Newport Beach, CA 92658 Contact: Andy Tran, (714) 644-3311 City of Seal Beach 211 Eighth Street Seal Beach, CA 90740 Karim Varshochi, (714) 412-2722 City of Tustin 300 Centennial Way Tustin, CA 92630 Contact: Benny Tenkean, (714) 573-3161 Jeronimo Road Contract Amount: $649,000.00 Start: 3/2007 Completed: 5/2007 Weir Canyon Contract Amount: $795,000.00 Start: 3/2007 Completed: 6/2007 North El Camino Real Contract Amount: $1,400,000.00 Start: 4/2007 Completed: 6/2007 Citywide Street Improvements Contract Amount: $1,392,000.00 Start: 1 /2007 Completed: 5/2007 Seal Beach Boulevard Contract Amount: $930,647.00 Start: 12/2006 Completed: 4/2007 Jamboree & Tustin Ranch Rod Contract. Amount: $2,700,000.00 Start: 11/2006 Completed: 4/2007 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or E-a� 6�0 Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person Contact Phone: Signed: Date: �•� Lis � � /� *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C The bidder (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) subcontractor EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION proposed hereby certifies that he has >/, has 5T , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a, report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-12 March 15, 2001 PUBLIC COACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not.X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certWer to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of ?l it<5\ CLL DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 .LPP O1-04 C-15 -March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CER'TIFICA'TION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; ® Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; ® Does not have a proposed debarment pending; and ® Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. NJA Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP O1-04 C-16 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: F] a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: 3. Report Type: a. bid/offer/application Fla. initial b. initial award b. material change c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) For Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional Distri if known etDescription:7. Federal Pmm CFDAber, if applicable 9. Awar Amount, if known: I� Individuals Performing Services (including address if different from No. IOa) (last name, first name, MI) (attach Co tinuation Sheet(s) if necessary) 11. Amount of Payment (check all that ap y) 13. Type of Payment (check all that apply) $ actual planned a. retainer b. one-time fee 12. Form of Payment (check all t t apply): c. commission Fa. cash d. contingent fee b. in -kind; speci . nature e deferred 14. Brief Description officer(s), employ, value LJ f. other, specify rvices Performed or to be performed and Date(s) of Service, including or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continu ion Sheets) attached: Yes ® No 16. Informa ' n requested through this form is authorized by Title 31 U. .C. Section 1352. This disclosure of lobbying reliance Signature' <� was placed by the tier above when his transaction was made Q or entered into. This disclosure is required pursuant to 31 Print Name: U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title; �1 V-i �.k person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than /� ,q� $100,000 for each such failure. Telephone No.: "BSI _T3U' _1(A) Date: Federal Use Only: Standard norm LLL Kev. UY-tl-V i Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-18 March 15, 2001 EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-19 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90«ENDIF» Page 12-89 LPP 01-04 C_20 March 15, 2001 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE "TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM �REFER AGENCY: Y) LOCATION: C(-1l^ PROJECT DESCRIPTION: CA_Vi V -Q— OTAL CONTRACT AMOUN(�T: $ BID DATE:Jo I`ri O'1QQ,,,���� IDDER'S NAME: � Po-evyi Cuyl h3 n(,�,, j L o �1,11 CONTRACT UDBE GOAL: 3. 5 S; ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED Cert. No. of UDBE AND EXPIRATION DATE NAME OF UDBEs Must be certified on the date bids are opened - include UDBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. UDBE 4-Ae o\\_ Ct- a _ 2. w-C_ C - \, For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation q ontract Award Date: Local Agency certifies that all information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number: ign11 t1 re of Bidder ,� �� �1)1311� (Poi Date �- (Area Code) Tel. No. l�rQ,�k sC.1(� U ��-� For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3/09) Distribution: (1) Copy - Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original - Local agency files Page 15-31 LPP 09-xx C-21 March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27, 2009 C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER `TKO,, ,INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM GENCY:S t hW14,YbO D0(i C-W L,O+C�ATION: ' PROJECT DESCRIPTION: ;� (,.�e_r 1"r•/ e OTAL CONTRACT AMOUNT:$ IDDATE: i 0 I k,(s l og BIDDER'S NAME: �'{v► t �i�� ��-y OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBECert.No. AND EXPIRATION DATE NAME OF DBEs Must be certified on the date bids are opened - include DBE address d phone number CONTRACT DOLLAR AMOUNT -ITEM ITEM NO. DBE G- 7�o- vtw WV For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation $ 'LS�C 'Ito ontract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Telephone Number: For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer f gnature of Bidder in I VTH 1 1 C 015> —73(0-"1 Date (Area Code) Tel. No. ej,('Q,M- SC,"y 1k Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/09) , Distribution: (1) Copy - Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original - Local agency files Page 15-32a LPP 09-xx C-26 March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and. include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b March 27, 2009 C-27 LPP 09-xx Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) n N 00 BIDDER'S LIST OF SUBCONTRACTORS (DOE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14,2006 n N Exhibit 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Number One, dated September 24, 2009 AA < Rme-- i can 1+ Company Name Zobe+ 6W Lel ' vt� I C 14— Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. G:\Construction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\ADVERTISEMENT-NISB-BIDDING PROCESS\CC-1359 Addendum Number One.doc ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 point is typically a 3 3/4" aluminum disk with said agency's stamping. Datum information for public viewing is on file at said agency. A survey monument is defined as any permanent point as shown on file at the NGS, NOAA, Caltrans, OCS, City of Huntington Beach Public Works Department or any other public agency; said point being used to establish or perpetuate horizontal control. These points include but are not limited to centerline street monuments or accessories to said centerline street monuments (i.e. tie points), property corners or accessories to said corners, or monuments established in connection with the Orange County Geodetic Control Network or accessories to said monuments. These points shall be tied out and replaced by a licensed Land Surveyor or a licensed Civil Engineer authorized to practice land surveying pursuant to sections 8700 to 8806 of the Business and Professions code of the State of California (Land Surveyors Act). The Corner Records produced from said tie -out and replacement survey shall be furnished to the City of Huntington Beach Public Works Department as well as filed with the office of the County Surveyor indicating responsible charge (stamped), within 60 days of the final survey. 2-9.2 Survey Service [Replace the first paragraph with the following] All construction surveying will be performed by the AGENCY. Monument preservation surveying necessary to complete the work shown on the plans and provided for in these contract documents and specifications shall be accomplished by or under the direction of a licensed Land Surveyor or Professional Engineer, whom is authorized to practice land surveying, retained or provided for by the Contractor. The AGENCY reserves the right to direct additional construction survey to be performed when it feels it is required to adequately construct the work. All costs to the Contractor for protecting, removing, restoring, repairing, replacing, or reestablishing monuments or accessories to monuments or costs associated with the preparation or filing of Corner Records pursuant to sections 8700 to 8806 of the Business and Professions Code shall be included in the bid item for survey monument preservation. Payment for survey monument preservation shall be per the contract lump sum bid price and no additional compensation will be allowed therefor. When the contract does not include a pay item for monument preservation and unless otherwise provided in the specifications, full compensation for all monument preservation required to complete the work shall be included in the price bid for other items of work and no additional compensation will be allowed therefor. E-5 CC-1359 Slater Avenue Addendum 1 Department Contractors State Uqeo Contractor's Lice of'e°ram°..ore Detail A,a #,. �� vim. � ::. � .1 : - DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. "CSLB complaint disclosure is restricted by law (B,&P 71.24._6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17, only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number: 776306 Extract Date: 10/15/2009 SUPERIOR PAVEMENT MARKINGS INC Business Information: 14658 INDUSTRY CIRCLE LA M I RADA, CA 90638 Business Phone Number: (714) 562-9100 Entity: Corporation Issue Date: 03/17/2000 Reissue Date: 08/13/2007 Expire Date: 08/31/2011 This license is current and active. All information below should be reviewed. CLASS DESCRIPTION Classifications: C32 PARKING AND HIGHWAY ------------- CONTRACTOR'S CONTRACTOR°S BOND This license filed Contractor's Bond number 70340656 in the amount of $12,500 with the bonding company WESTERN__SURETY COMP.ANY,. Effective Date: 08/13/2007 ConsumerDepartmentof «.. Contractors State Li o a 'W se r] Contractor's License Detail - Licensed €3 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7471.1.7, only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number: 757584 Extract Date: 10/15/2009 GLOBAL ROAD SEALING INC Business Information: 10832 DOROTHY AVENUE GARDEN GROVE, CA 92843 Business Phone Number: (714) 893-0845 Entity: Corporation Issue Date: 12/31/1998 Reissue Date: 06/28/1999 Expire Date: 06/30/2011 __._ _ ___ __ __.. _ __. .___ .__ . _ _ ....... This license is current and active. All information below License Status: should be reviewed. CLASS DESCRIPTION C10 ELECTRICAL Classifications: - - _ .._ .. __.�. _ __ _ _. _ ___ ........ __ ..... ___. C32 PARKING AND HIGHWAY IMPROVEMENT A GENERAL ENGINEERING CONTRACTOR. CONTRACTOR'S BOND This license filed Contractor's Bond number 100083751 in the amount of $12,500 with the bonding company AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 04/30/2009 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL Bonding: 1. The Responsible Managing Officer (RMO) TRI THUONG LA certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 06/28/1999 This license has workers compensation insurance with the CALIFORNIA INSURANCE_ COMPANY Workers' Policy Number: 460799450103 Compensation: Effective Date: 05/01/2009 Expire Date: 05/01/2010 Workers' Compens_ation_History Miscellaneous DATE DESCRIPTION Information: 06/28/1999 LICENSE REISSUED TO ANOTHER ENTITY Conditions of Use I Privacy Policy_ Copyright © 2009 State of California �41 t W V Fidelity and Deposit Company of Maryland Home Office: P.O. Box 1227. Baltimore. MD 21203-1227 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ALL AMERICAN ASPHALT BOND NO.085 97 423 , as Principal, (hereinafter called the "Principal'), and FIDELITY AND DEPOSIT COMPANY OF MARYLAND P.O. Box 1227, Baltimore, Maryland 21203, a corporation duty organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto City of Huntington Beach _ as Obligee, (hereinafter called the "Obligee"), in the sum of TEN PERCENT OF THE TOTAL BID PRICE IN -------- Dollars ($ 10% OF TOTAL BID PRICE ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Slater Ave Rehabilitation from Graham St to Goldenwest St, C. C. No. 1359, No. ESPL-5181(156 Bid Date: October 15, 2009 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 2nd Witness day of October A.D., 2009 ALL AMERICAN PHA (SEAL) ,<7 Prtn ob�rk rani) �c.� �reside� FIDELITY AND DEPOSIT COMPANY OF MARYLAND S4amSJkin By (SEAL) Witness Wi _ Attorney -in -Fact Printed in cooperation with the .American Institute of Architects (AIA) by Fidelity and Deposit Company of Maryland. Fidelity and Deposit Company of Maryland vouches that the language in the document conforms exactly to the language used in AIA Document A-310, February 1970 Edition. BID70000ZZ0701f CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT State of California County of Riverside On October 14, 2009 before me, Carmen Marie Ochoa, Notary Public Date Here Insert name and Title of the Officer personally appeared Robert Bradley Name of Signe;W CARMEN MARINE OCHOA."' Commission # 1812634 •ae Notary Public - California ' Riverside County My Comm. Expires Sep 8, 2012 who proved to me on the basis of satisfactory evidence to be the person whose namis/a;=e-subscribed to the within instrument and aCnowledgede)' to me that he/she/thf3 executed the same in his/ho4their authorized capacity(4e4 and that by his/ht atheir signaturejA on the instrument the personko, or the entity upon behalf of which the person(4 acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the forgoing paragraph is true and correct. WITNESS my hand and official seal. Signature &41mI /" Place Notary Seal Above Signature of Notary Public Though the information below and could prevent fl Description of Attached Title or Type of Document Document Date: Signer(s) Other Than'N_arrl Capacity Claimed Signer's Name: RON ❑Individual X Corporate Officer — ❑ Partner— ❑ Limited ❑ Attorney in Fact ❑ Trustee ❑ Other: Signer is Representing: required by law, it may prove valuable to person relying on the document mt removal and reattachment of this form to another document. Vice President Number of Pages: Signer's Name: ❑Individual ❑ Corporate Officer — ' e(s): _ ❑ Partner — ❑ Li ' ed ❑ General ❑ Attorney fact Signer is Representing: W P - c\ c14A.1 State of California County of Orange On 10-2-09 before me, R. Haas -Bates, Notary Public Date Here Insert Name and Title of the Officer personally appeared William Syrkin Name(s) of Signer(s) E,aEt.ti R. HAAS-BATES U COMM. # 1796169 (� os NOTARY PUBLIC - CALIFORNIA ORANGE COUNTY n COMM. EXPIRES APRIL 22 2012 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(&) whose name(&) is/are subscribed to the within instrument and acknowledged to me that he/shc/they executed the same in his/her#eir authorized capacity(ies-), and that by his/eiF signature(&} on the instrument the person ft or the entity upon behalf of which the person* acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature �cbL ® Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: 1D 9-ng Number of Pages: OnP (1) Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: _ William Syrkin Signer's Name: El Individual ❑ Individual El Corporate Officer — Title(s): — Partner — ❑ Limited rJ General l] Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: RIGHT THUMBPRINT ©RSiGNER ...ere ❑ Corporate Officer — Title(s): _ D Partner — 0 Limited ❑ General D Attorney in Fact Trustee Guardian or Conservator O Other: Signer Is Representing: tti1G HT,Tiiu[r1 sPRIr�T' 02007 Natronaf Notary Association • 9350 De Soto Ave.. P.O_Box 2402 • Chatsworth, CA 91313-2402- www.NationaiNotary.org Item N5907 Reorder Call ToII-Free 1-600-676-6627 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by THEODORE G. MARTINEZ, Vice President, and ERIC D. BARNES, Assistant Secretary, in pursuance of authority granted by Article V1, Section 2, of the By -Laws of said ny, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the d ereby nominate, constitute and appoint William SYRKIN, Rebecca HAAS-BATEeSe a and E. ZIMINSKY, all of Irvine, California, EACH its true and lawful agent Fit? o and deliver, for, and on its behalf as surety, and as its act and deed: an e execution of such bonds or undertakings in pursuance of these prese 1 i , as fully and amply, to all intents and purposes, as if they had been d t t a h ularly elected officers of the Company at its office in Baltimore, Md.,�p er attorney revokes that issued on behalf of William SYRKIN, Rebecca HAAS-BA io oe BIERMAN, Leonard E. ZIMINSKY, dated March 1, 2004. The said Assistant es a eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By- s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 8th day of April, A.D. 2008. ATTEST: '0V 1)EP06 _ •o 0 t State of Maryland ss. City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary By: Theodore G. Martinez On this 8th day of April, A.D. 2008, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came THEODORE G. MARTINEZ, Vice President, and ERIC D. BARNES, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn Notary Public My Commission Expires: July 14, 2011 PDXF 012-0033 � ! ! S j 130 60oz 2)(/f/J6/fi 161 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment B REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS (Exclusive of Appalachian Contracts) Page I. General...................................................................... 3 II. Nondiscrimination..................................................... 3 III. Nonsegregated Facilities ........................................... 5 IV. Payment of Predetermined Minimum Wage .............. 6 V. Statements and Payrolls ............................................. 8 VI. Record of Materials, Supplies, and Labor ................. 9 VII. Subletting or Assigning the Contract ......................... 9 VIII. Safety: Accident Prevention ..................................... 10 IX. False Statements Concerning Highway Project.......... 10 X. Implementation of Clean Air Act and Federal Water Pollution Control Act ................................................. 10 XI. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion ..................... 11 XII. Certification Regarding Use of Contract Funds for Lobbying................................................................... 12 ATTACHMENTS A. Employment Preference for Appalachian Contracts (included in Appalachian contracts only) L GENERAL 1. These contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 2. Except as otherwise provided for in each section, the con- tractor shall insert in each subcontract all of the stipulations contained in these Required Contract Provisions, and further re- quire their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. 3. A breach of any of the stipulations contained in these Re- quired Contract Provisions shall be sufficient grounds for termi- nation of the contract. 4, A breach of the following clauses of the Required Contract Provisions may also be grounds for debarment as provided in 29 CFR 5.12: Section I, paragraph 2; Section IV, paragraphs 1, 2, 3, 4, and 7; Section V, paragraphs 1 and 2a through 2g. 5. Disputes arising out of the labor standards provisions of Section IV (except paragraph 5) and Section V of these Required Contract Provisions shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accor- dance with the procedures of the U.S. Department of Labor (DOL) FR3 LPP 09-xx as set forth in 29 CFR 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the DOL, or the contractor's employees or their representatives. 6, Selection of Labor: During the performance of this contract, the contractor shall not: a. discriminate against labor from any other State, possession, or territory of the United States (except for employment preference for Appalachian contracts, when applicable, as specified in Attachment A), or b. employ convict labor for any purpose within the limits of the project unless it is labor performed by convicts who are on parole, supervised release, or probation. II. NONDISCRIMINATION (Applicable to all Federal -aid construction contracts and to all related subcontracts of$10,000 or more.) 1. Equal Employment Opportunity: Equal employment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 1630, and 41 CFR 60) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and im- posed pursuant to 23 U.S.C. 140 shall constitute the EEO and specificaffirmative action standards for the contractor's project activities under this contract. The Equal Opportunity Construction Contract Specifications set forth under 41 CFR 60-4.3 and the provisions of the American Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract. In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO: a. The contractor will work with the State highway agency (SHA) and the Federal Government in carrying out EEO obli- gations and in their review of his/her activities under the con- tract. b. The contractor will accept as his operating policy the following statement: "It is the policy of this Company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment ad- vertising, layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprentice- ship, preapprenticeship, and/or on-the-job training. " 2. EEO Officer: The contractor will designate and make known to the SHA contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively Form 1273 — Revised 3.95 08.07-95 Page 12-67 April 10, 2009 EXFIIBIT 12-E Attachment B administering and promoting an active contractor program of EEO and who must be assigned adequate authority and responsibility to do so. 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, , or who recommend such action, or who . are substantially involved in such action, will be made fully cognizant .of, and will implement, the contractor's EEO. policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and its implementation will be re- viewed and explained, The meetings will be conducted by the EEO Officer. b. AlI new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer, covering all major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor. c. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's procedures for locating and hiring minority group employees. d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees. e. The contractor's EEO policy and the procedures to im- plement such policy will be brought to the attention of em- ployees by means of meetings, employee handbooks, or other appropriate means. 4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees. the notation: "An Equal Opportunity Employer." All such adver- tisements will be placed in publications having a large circulation among minority groups in the area from which the project work force would normally be derived. a. The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minority group applicants. To meet this requirement, the contractor will identify sources of potential minority group employees, and. establish with such identified sources procedures whereby minority group applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, he is expected to observe the provisions of that agreement to the extent that the system permits the contractor's compliance with EEO contract provisions. (The DOL has held that where implementation of such agreements have the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Executive Order 11246, as amended c. The contractor will encourage his present employees to Form 1273 — Revised 3-95 08-07-95 Local Assistance Procedures Manual PS&E Checklist Instructions refer minority group applicants for employment. Information and procedures with regard to referring minority group applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff and termination, shall be taken without regard to race, color, religion, sex, national origin, age or disability. The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to ensure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage practices. c. The contractor will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is found, the contractor will promptly take corrective action. If the review indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly investigate all complaints of alleged discrimination made to the contractor in connection with his obligations under this contract, will attempt to resolve such complaints, and will take appropriate corrective action within a reasonable time. If the investigation indicates that the discrimination may affect persons other than the complainant, such corrective action shall include such other persons. Upon completion of each investigation, the contractor will inform every complainant of all of his avenues of appeal. 6. Training and Promotion: a. The contractor will assist in locating, qualifying, and increasing the skills of minority group and women employees, and applicants for employment. b. Consistent with the contractor's work force requirements and as permissible under Federal and State regulations, the contractor shall make full use of training programs, i.e., apprenticeship, and on-the-job training programs for the ge- ographical area of contract performance. Where feasible, 25 percent of apprentices or trainees in each occupation shall be in their first year of apprenticeship or training. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. c. The contractor will advise employees and applicants for employment of available training programs and entrance re- quirements for each. d. The contractor will periodically review the training and promotion potential of minority group and women employees and will encourage eligible employees to apply for such training and promotion. FR 4 Page 12-0 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions 7. Unions: If. the contractor relies in whole or in part upon unions as a source of employees, the contractor will use his/her best efforts to obtain the cooperation of such unions to increase opportunities for minority groups and women within the unions, and to effect referrals by such unions of minority and female employees. Actions by the contractor either directly or through a contractor's association acting as agent will include the procedures set forth below: a. The contractor will. use best efforts to develop, in coop- eration with the unions, joint training programs aimed toward qualifying more minority group members and women for membership in the unions and increasing the skills of minority group employees and women so that they may qualify for higher paying employment. b. The contractor will use best efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. c. The contractor is to obtain information as to the referral practices and policies of the labor union except that to the extent such information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the contractor, the contractor shall so certify to the SHA and shall set forth what efforts have been made to obtain such information. d. In the event the union is unable to provide the contractor with a reasonable flow of minority and women referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability; making full efforts to obtain qualified and/or qualifiable minority group persons and women. (The DOL has held that it shall be no excuse that the union with which the contractor has a collective bargaining agreement providing for exclusive referral failed to refer minority employees.) In the event the union referral prac- tice prevents the contractor from meeting the obligations pursuant to Executive Order 1I246, as amended, and these special provisions, such contractor shall immediately notify the SHA. 8. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. a. The contractor shall notify all potential subcontractors and suppliers of his/her EEO obligations under this contract. b. Disadvantaged business enterprises (DBE), as defined in 49 CFR 26, shall have equal opportunity to compete for and perform subcontracts which the contractor enters into pursuant to this contract. The contractor will use his best efforts to solicit bids from and to utilize DBE subcontractors or subcontractors with meaningful minority group and female representation among their employees. Contractors shall obtain lists of DBE construction firms from SHA personnel. c. The contractor will use his best efforts to ensure subcon- tractor compliance with their EEO obligations. 9. Records and Reports: The contractor shall keep such EXFIIBIT 12-E Attachment B records as necessary to document compliance with the EEO requirements. Such records shall be retained for a period of three years following completion of the contract work and shall be available at reasonable times and places for inspection by au- thorized representatives of the SHA and the FHWA. a. The records kept by the contractor shall document the following: (1) The number of minority and non -minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment op- portunities for minorities and women; (3) The progress and efforts being made in locating, hiring, training, qualifying, and upgrading minority and female employees; and (4) The progress and efforts being made in securing the services of DBE subcontractors or subcontractors with meaningful minority and female representation among their employees. b. The contractors will submit an annual report to the SHA each July for the duration of the project, indicating the number of minority, women, and non -minority group employees currently engaged in each work classification required by the contract work. This information is to be reported on Form FHWA-1391. If on-the-job training is being required by special provision, the contractor will be required to collect and report training data. III NONSEGREGATED FACILITIES (Applicable to all Federal -aid construction contracts and to all related subcontracts of $10,000 or more.) FR-5 a. By submission of this bid, the execution of this contract or subcontract, or the consummation of this material supply agreement or purchase order, as appropriate, the bidder, Federal - aid construction contractor, subcontractor, material supplier, or vendor, as appropriate, certifies that the firm does not maintain or provide for its employees any segregated facilities at any of its establishments, and that the firm does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The firm agrees that a breach of this certification is a violation of the EEO provisions of this contract. The firm further certifies that no employee will be denied access to adequate facilities on the basis of sex or disability. b. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive, or are, in fact, seg- regated on the basis of race, color, religion, national origin, age or disability, because of habit, local custom, or otherwise. The only exception will be for the disabled when the demands for accessibility override (e.g. disabled parking). Form 1273 — Revised 3-95 OS-07.95 Page 12-69 LPP 01-04 March 15, 2001 EXHIBIT 12-E Attachment B . c. The contractor agrees that it has obtained or will obtain identical certification from proposed subcontractors or material suppliers prior. to award of subcontracts or consummation of material supply agreements of $10,000 or more and that it will retain such certifications in its files. IV. PAYMENT OF PREDETERMINED MINIMUM WAGE (Applicable to all Federal -aid construction contracts exceeding $2,000 and to all related subcontracts, except for projects located on roadways classified as local roads or rural minor collectors, which are exempt.) 1. General: a. All mechanics and laborers employed or working upon the site of the work will be paid unconditionally and not less often than once a week and without subsequent deduction or rebate on any account [except such payroll deductions as are permitted by regulations (29 CFR 3)] issued by the Secretary of Labor under the Copeland Act (40 U.S.C. 276c) the full amounts of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment. The payment shall be computed at wage rates not less than those contained in the wage determination of the Secretary of Labor (hereinafter "the wage determination") which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor or its subcontractors and such laborers and mechanics. The wage determination (including any additional classifications and wage rates conformed under paragraph 2 of this Section IV and the DOL poster (WH-1321) or Form FHWA-1495) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. For the purpose of this Section, contributions made or costs reasonably anticipated for bona fide fringe benefits under Section 1(b)(2) of the Davis -Bacon Act (40 U.S.C. 276a) on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of Section IV, paragraph 3b, hereof. Also, for the purpose of this Section, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs, which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage deter- mmatton for the classification of work actually performed, without regard to skill, except as provided in paragraphs 4 and 5 of this Section IV. b. Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein, provided, that the employer's payroll records accurately set forth the time spent in each classification in which work is performed. c. All rulings and interpretations of the Davis -Bacon Act and related acts contained in 29 CFR 1, 3, and 5 are herein incorporated by reference in this contract. Form 1273 _ Revised 3-95 0"7-95 FIt 6 Local Assistance Procedures Manual PS&E Checklist Instructions 2. Classification: a. The SHA contracting officer shall require that any class of laborers or mechanics employed under the contract, which is not listed in the wage determination, shall be classified in conformance with the wage determination. b. The contracting officer shall approve an additional classification, wage rate and fringe benefits only when the following criteria have been met: (1) the work to be performed by the additional classifi- cation requested is not performed by a classification in the wage determination; (2) the additional classification is utilized in the area by the construction industry; (3) the proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination; and (4) with respect to helpers, when such a classification prevails in the area in which the work is performed c. If the contractor or subcontractors, as appropriate, the laborers and mechanics (if known) to be employed in the addi- tional classification or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the DOL, Administrator of the Wage and Hour Division, Employment Standards Administration, Washington, D.C. 20210. The Wage and Hour Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. d.In the event the contractor or subcontractors, as appro- priate, the laborers or mechanics to be employed in the addi- tional classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Wage and Hour Administrator for determination. Said Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary e. The wage rate (including fringe benefits where appropriate) determined pursuant to paragraph 2c or 2d of this Section IV shall be paid to all workers performing work in the additional classification from the first day on which work is performed in the classification. 3. Payment of Fringe Benefits: a Whenever the minimum wage rate prescribed in the con- tract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor or subcontractors, as appropriate, shall either pay the benefit Page 12-70 March 15, 2001 LPP 01-04 ILocaI Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment B as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly case equivalent thereof. b. If the contractor or subcontractor, as appropriate, does not make payments to a trustee or other third person, he/she may consider as a part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, provided, that the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to . set aside in a separate account assets for the meeting of obligations under the plan or program. 4. Apprentices and Trainees (Programs of the U.S. DOL) and Helpers: a. Apprentices: (1) Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the DOL, Employment and Training. Administration, Bureau. of Apprenticeship and Training, or with a State apprenticeship agency recognized by the Bureau, or if a person is employed in his/her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has. been certified by the Bureau of Apprenticeship and Training or a State apprenticeship agency (where appropriate) to be eligible for probationary employment as an apprentice. (2) The allowable ratio of apprentices to journeyman -level employees on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any employee listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate listed in the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor or subcontractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman -level hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. (3) Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeyman - level hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits,. apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator for the Wage and Hour Division determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. FIi-7 LPP 01-04 (4) In the event the Bureau of Apprenticeship and Training, or a State apprenticeship agency recognized by the Bureau, withdraws approval of an apprenticeship program, the contractor or subcontractor wiII no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the comparable work performed by regular employees until an acceptable program is approved. b, Trainees: (1) Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the DOL, Employment and Training Administration. (2) The ratio of trainees to journeyman -level employees on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wagerate on the wage determination for the classification of work actually performed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. (3) Every trainee must be paid at not less than the rate specified in the approved program for his/her level of progress, expressed as a percentage of the journeyman -level hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman -level wage rate on the wage determination which provides for less than full fringe benefits for apprentices, in which case such trainees shall re- ceive the same fringe benefits as apprentices. (4) In the event the Employment and Training Adminis- tration withdraws approval of a training program, the con- tractor or subcontractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. c. Helpers: Helpers will be permitted to work on a project if the helper classification is specified and defined on the applicable wage determination or is approved pursuant to the conformance procedure set forth in Section IV.2. Any worker listed on a payroll at a helper wage rate, who is not a helper under an approved definition, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. Form 1273 — Revised 3-95 08-07-95 Page 12-71 March 15, 2001 Local Assistance Procedures Manual PS&E CheckIist Instructions EXHIBIT 12_E Attachment B 5. Apprentices and Trainees (Programs of the U.S. DOT): Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal -aid highway construction programs.are not subject to the requirements of paragraph 4 of this Section IV. The straight time hourly wage rates for apprentices and trainees under such programs will be established by the particular programs. The ratio of apprentices and trainees to journeymen shall not be greater than permitted by the terms of the particular program. . b. Withholding: The SHA shall upon its own action or upon written request of an authorized representative of the DOL withhold, or cause to be withheld, from the contractor or subcontractor under this contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to Davis -Bacon prevailing wage requirements which is held by the same prime contractor, as much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the SHA contracting officer may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. 7. Overtime Requirements: No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers, mechanics, watchmen, or guards (including apprentices, trainees, and helpers described in paragraphs 4 and 5 above) shall require or permit any laborer, mechanic, watchman, or guard in any workweek in which he/she is employed on such work, to work in excess of 40 hours in such workweek unless such laborer, mechanic, watchman, or guard receives compensation at a rate not less than one -and -one-half times his/her basic rate of pay for all hours worked in excess of 40 hours in such workweek. 8. Violation: Liability for Unpaid Wages; Liquidated Damages: In the event of any violation of the clause set forth in paragraph 7 above, the contractor and any subcontractor responsible thereof shall be liable to the affected employee for his/her unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory) for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer, mechanic, watchman, or guard employed in violation of the clause set forth in paragraph 7, in the sum of $10 for each calendar day on which such employee was required or permitted to work in excess of the standard work week of 40 hours without payment of the overtime wages required by the clause set forth in paragraph 7. Form 1273 —Revised 3-95 Q8-07-95 Wage 12-72 9. Withholding for Unpaid Wages and Liquidated Damages: The SHA shall upon its own action or upon written request of any authorized representative of the DOL withhold, or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph 8 above. V. STATEMENTS AND PAYROLLS (Applicable to all Federal -aid construction contracts exceeding $2,000 and to all related subcontracts, except for projects located on roadways classified as local roads or rural collectors, which are exempt.) 1. Compliance with Copeland Regulations (29 CFR 3): The contractor shall comply with the Copeland Regulations of the Secretary of Labor which are herein incorporated by reference. 2. Payrolls and Payroll Records: Ir R-8 a. Payrolls and basic records relating thereto shall be maintained by the contractor and each subcontractor during the course of the work and preserved for a period of 3 years from the date of completion of the contract for all laborers, mechanics, apprentices, trainees, watchmen, helpers, and guards working at the site of the work. b. The payroll records shall contain the name, social security number, and address of each such employee; his or her correct classification; hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalent thereof the types described in Section 1(b�(2)(B) of the Davis Bacon Act); daily and weekly number o hours worked; deductions made; and actual wages paid. In addition, for Appalachian contracts, the payroll records shall contain a notation indicating whether the employee does, or does not, normally reside in the labor area as defined in Attachment A, paragraph i. Whenever the Secretary of Labor, pursuant to Sec- tion IV, paragraph 3b, has found that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in Section l(b)(2)(B) of the Davis Bacon Act, the contractor and each subcontractor shall. maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, that the plan or program has been communicated in writing to the laborers or mechanics affected, and show the cost. anticipated or the actual cost incurred in providing benefits. Contractors or subcontractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprentices and trainees, and ratios and wage rates prescribed in the applicable programs. March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment B c. Each contractor and subcontractor shall furnish, each week in which any contract work is performed, to the SHA resident engineer a payroll of wages paid each of its employees (including apprentices, trainees, and helpers, described in Section IV, paragraphs 4 and 5, and watchmen and guards en- gaged on work during the preceding weekly payroll period). The payroll submitted shall set out accurately and completely all of the information required to be maintained under paragraph 2b of this Section V. This information may be submitted in any form desired. Optional Form WH-347 is available for this purpose and maybe purchased from the Superintendent of Documents (Federal stock number 029-005-0014-1), U.S. Government Printing Office, Washington, D.C. 20402. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. d. Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or sub- contractor or his/her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following; (1) that the payroll for the payroll period contains the information required to be maintained under paragraph 2b of this Section V and that such information is correct and complete; (2) that such laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without . rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in the Regulations, 29 CFR 3; (3) that each laborer or mechanic has been paid not less that the applicable wage rate and fringe benefits or cash equivalent for the classification of worked performed, as specified in the applicable wage determination incorporated into the contract. e. The weekly submission of a properly executed certification set forth on the reverse side. of Optional Form WH-347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 2d of this Section V. f. The falsification of any of the above certifications may subject the contractor to civil or criminal prosecution under 18 U.S.C. 1001 and 31 U.S.C. 231. g. The contractor or subcontractor shall make the records re- quired under paragraph 2b of this Section V available for in- spection, copying, or transcription by authorized representatives of the SHA, the FHWA, or the DOL, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the re- quired records or to make them available, the SHA, the FHWA, the DOL; or all may, after written notice to the contractor, sponsor, applicant, or owner, take such actions as may be nec- essary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available FR-9 may be grounds for debarment action pursuant to 29 CFR 5.12, VI. RECORD OF MATERIALS, SUPPLIES, AND LABOR 1. On all Federal -aid contracts on the National Highway System, except those which provide solely for the installation of protective devices at railroad grade crossings, those which are constructed on a force account or direct labor basis, highway beautification contracts, and contracts for which the total final construction cost for roadway and bridge is less than $1,000,000 (23 CFR 635); the contractor shall: a. Become familiar with the list of specific materials and supplies contained in Form FHWA-47, "Statement of Materials and Labor Used by Contractor of Highway Construction Involving Federal Funds," prior to the commencement of work under this contract. b. Maintain a record of the total cost of all materials and supplies purchased for and incorporated in the work, and also of the quantities of those specific materials and supplies listed on Form FHWA-47, and in the units shown on Form FHWA-47. c. Furnish, upon the completion of the contract, to the SHA resident engineer on Form FHWA-47 together with the data required in paragraph Ib relative to materials and supplies, a final labor summary of all contract work indicating the total hours worked and the total amount earned. 2. At the prime contractor's option, either a single report covering all contract work or separate reports for the contractor and for each subcontract shall be submitted. VII. SUBLETTING OR ASSIGNING THE CONTRACT 1. The contractor shall perform with its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the State. Specialty items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractor's own organization (23 CFR 635). a. "Its own organization" shall be construed to include only workers employed and paid directly by the prime contractor and equipment owned or rented by the prime contractor, with or without operators. Such term does not include employees or equipment of a subcontractor, assignee, or agent of the prime contractor. b. "Specialty Items" shall be construed to be limited to work that requires highly specialized knowledge, abilities, or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid on the contract as a whole and in general are to be limited to minor components of the overall contract. Form 1273 — Revised 3.95 08.07-95 Page 12-73 LPP 08-04 December 31, 2008 EXHIBIT 12-E Local Assistance Procedures Manual Attachment B PS&E Checklist Instructions 2. The contract amount upon which the requirements set forth in paragraph I of Section VII is computed includes the cost of material and manufactured products which are to be purchased or produced by the contractor under the contract provisions. 3. The contractor shall furnish (a) a competent superintendent or supervisor who is employed by the firm, has full authority to direct performance of the work in accordance with the contract requirements, and is in charge of all construction operations (regardless of who performs the work) and (b) such other of its own organizational resources. (supervision, management, and engineering services) as the SHA contracting officer determines is necessary to assure the performance of the contract. 4. No portion of the contract shall be sublet, assigned or otherwise disposed of except with the written consent of the SHA contracting officer, or authorized representative, and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the contract. Written consent will be given only after the SHA has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. VIII. SAFETY: ACCIDENT PREVENTION 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the SHA contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. . 2. It is a condition of this contract, and shall be made a con- dition of each subcontract, which the contractor enters into pur- suant to this contract, that the contractor and any subcontractor shall not permit any employee, in performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety, as determined under construction safety and health standards (29 CFR 1926) promulgated by the Secretary of Labor, in accordance with Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 333). 3. Pursuant to 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Secretary under Section 107 of the Contract Work Flours and Safety Standards Act (40 U.S.C. 333). IX. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by, engineers, contractors, suppliers, and workers on Federal -aid highway projects, it is essential that all persons concerned with the project perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or mis- representation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding re - Form 1273 — Revised 3-95 08-07-95 Page 12-74 garding the seriousness of these and similar acts, the following notice shall be posted on each Federal -aid highway project (23 CFR 635) in one or more places where it is readily available to all persons concerned with the project: NOTICE TO ALL PERSONNEL ENGAGED ON FEDERAL -AID HIGHWAY PROJECTS 18 U.S.C. 1020 reads as follows: "Whoever being an officer, agent, or employee of the United States, or any State or Territory, or whoever, whether a person, association, firm, or corporation, knowingly makes any false statement, false representation, or false report as to the character, quality, quantity, or cost of the material used or to be used, or the quantity or quality of the work performed or to be performed, or the cost thereof in connection with the submission of plans, maps, specifications, contracts, or costs of construction on any highway or related project .submitted for approval to the Secretary of Transportation; or Whoever knowingly makes any false statement, false repre- sentation, false report or false claim with respect to the character, quality, quantity, or cost of any work performed or to be per- formed, or materials furnished or to be furnished, in connection with the construction of any highway or related project approved by the Secretary of Transportation; or Whoever knowingly makes any false statement or false repre- sentation as to material fact in any statement, certificate, or report submitted pursuant to provisions of the Federal -aid Roads Act approved July 1, 1916, (39 Stat. 355), as amended and sup- plemented; Shall be fined not more that $10,000 or imprisoned not more than 5 years or both. " X. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT (Applicable to all Federal -aid construction contracts and to all related subcontracts of $100,000 or more.) By submission of this bid or the execution of this contract, or subcontract, as appropriate, the bidder, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed. to have stipulated as follows: 1. That any facility that is or will be utilized in the performance of this contract, unless such contract is exempt under the Clean Air Act, as amended (42 U.S.C. 1857 et seq., as amended by Pub. L. 91-604), and under the Federal Water Pollution Control Act, as amended (33 U.S.C. 1251 et seq., as amended by Pub. L. 92-500), Executive Order 11738, and regulations in implementation thereof (40 CFR IS) is not listed, on the date of contract award, on the U.S. Environmental Protection Agency (EPA) List of Violating Facilities pursuant to 40 CFR 15.20. 2. That the firm agrees to comply and remain in compliance with all the requirements of Section 114 of the Clean Air Act and Section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. 3. That the firm shall promptly notify the SHA of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility that is or will be utilized FR-10 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-L PS&E Checklist Instructions Attachment B for the contract is under consideration to be listed on the EPA List of Violating Facilities. 4. That the firm agrees to include or cause to be included the requirements of paragraph l through 4 of this Section X in every nonexempt subcontract, and further agrees to take such action as the government may direct as a means of enforcing such re- quirements. XI. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION 1. instructions for Certification - Primary Covered Transactions: (Applicable to all Federal -aid contracts - 49 CFR 29) a. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause of default. d. The prospective primary participant shall provide im- mediate written notice to the department or agency to whom this proposal is submitted if any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. . e. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is submitted for assistance in obtaining a copy of those regulations. f. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter .into any .lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. FR-I I g. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. h. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the el- igibility of its principals, Each participant may, but is not required to, check the nonprocurement portion of the "Lists of Parties Excluded From Federal Procurement or Nonprocurement Programs" (Nonprocurement List) which is compiled by the General Services Administration. i. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. j. Except for transactions authorized under paragraph f of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the de- partment or agency may terminate this transaction for cause or default. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; b. Have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph I b of this certification; and Form 1273 —Revised 3-95 o8-07-95 Page 12-75 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures,Manual Attachment B PS&E Checklist Instructions d. Have not within a 3-year period preceding this ap- plication/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Covered Transactions: (Applicable to all subcontracts, purchase orders and other lower tier transactions of $25,000 or more - 49 CFR 29) a. By signing .and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into, If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal .Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d. The terms 'covered transaction," "debarred," "suspended," "ineligible," "primary. covered transaction," "participant," "person," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that ,it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the el- igibility of its principals. Each participant may, but is not Form 1273 — Revised 3-95 08-07-95 Page 12-76 required to, check the Nonprocurement List. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph a of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the de- partment or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaetions 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it not its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation. in this transaction by any Federal department or agency. 2. Where the prospective lower tier participant is unable to. certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. XII. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING (Applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 - 49 CFR 20) 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any funds other than Federal appropriated funds have been paid or will be aid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, FR 12 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment B grant, loan, or cooperative agreement, the undersigned shall be subject to a civil penalty of not less than $10,000 and not more complete and submit Standard Form-LLL, "Disclosure Form to than $100,000 for each such failure. Report Lobbying," in accordance with its instructions. 3. The prospective participant also agrees by submitting his or 2. This certification is a material representation of fact upon her bid or proposal that he or she shall require that the language of which reliance was placed when this transaction was made or en- this certification be included in all lower tier subcontracts, which tered into. Submission of this certification is a prerequisite for exceed $100,000 and that all such recipients shall certify and making or entering into this transaction imposed by 31 U.S.C. disclose accordingly. 1352. Any person who fails to file the required certification shall FEDERAL -AID FEMALE AND MINORITY GOALS In accordance with Section II, "Nondiscrimination," of 177 Sacramento, CA: "Required Contract Provisions Federal -aid Construction Contracts" the following are the goals for female utilization: SMSA Counties: Goal for Women 6920 Sacramento, CA .................................. 16.1 CA Placer; CA Sacramento; (applies nationwide)..............(percent) ......... 6.9 CA Yolo. The following are goals for minority. utilization: CALIFORNIA ECONOMIC AREA 174 Redding, CA: Non-SMSA Counties .................................... CA Lassen, CA Modoc; CA Plumas; CA Shasta; CA Siskiyou; CA Tehama. 175 Eureka, CA: Non-SMSA Counties .................................... CA Del Norte; CA Humboldt; CA Trinity. 176 San Francisco -Oakland -San Jose, CA: SMSA Counties: 7120 Salinas -Seaside - Monterey, CA ............................................ CA Monterey. 7360 San Francisco -Oakland, CA ................. CA Alameda; CA Contra Costa; CA Marin; CA San Francisco; CA San Mateo. . 7400 San Jose, CA ........................................ CA Santa Clara. 7485 Santa Cruz, CA ..................................... CA Santa Cruz. 7500 Santa Rosa, CA .................................... CA Sonoma. 8720 Vallejo -Fairfield -Napa, CA ................. CA Napa; CA Solano Non-SMSA Counties ........................................ CA Lake; CA Mendocino; CA San Benito. Goal (Percent) Non-SMSA Counties ........................................ 14.3 CA Butte; CA Colusa; CA El Dorado; CA Glenn; CA Nevada; CA Sierra; CA Sutter; CA Yuba. 178 Stockton -Modesto, CA: SMSA Counties: 6.8 5170 Modesto, CA ....................................... 12.3 CA Stanislaus. 8I20 Stockton, CA ....................................... 24.3 CA San Joaquin. Non-SMSA Counties ................ ........ I............... 19.8 CA Alpine; CA Amador; 6 b CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne. 179 Fresno -Bakersfield, CA: SMSA Counties: 0680 Bakersfield, CA ................................... 19.1 CA Kern. 28.9 2840 Fresno, CA .......................................... 26.1 CA Fresno. 25.6 Non-SMSA Counties ........................................ 23.6 CA Kings; CA Madera; CA Tulare. 19.6 180 Los Angeles, CA: SMSA Counties: 14.9 0360 Anaheim -Santa Ana -Garden 9.1 Grove, CA. ................................................ 11.9 CA Orange. 4480 Los Angeles -Long 17.1 Beach, CA ................................................. 28.3 CA Los Angeles. 6000 Oxnard -Simi Valley- 23.2 Ventura, CA .............................................. 21.5 CA Ventura. FR-13 Form 1273 — Revlsod 3-95 08-07-95 Page 12-77 LPP 09-xx April 10, 2009 EXHIBIT 12-E Local Assistance Procedures Manual Attachment B PS&E Checklist Instructions i 6780 Riverside -San Bernardino - Ontario, CA ......................................... I..... 19.0 CA Riverside; CA San Bernardino. f 7480 Santa Barbara -Santa Maria- I Lompoc, CA ............................................... 19.7 CA Santa Barbara. Non-SMSA Counties ..................... 24,6 CA Inyo; CA Mono, CA San Luis Obispo. J 181 San Diego, CA: (((( SMSA Counties 7320 San Diego, CA . .................. ................. 16.9 CA San Diego. Non-SMSA Counties ........................................ 18.2 CA Imperial. In addition to the reporting requirements set forth elsewhere in this contract the Contractor and subcontractors holding subcontracts, not including material suppliers, of $10,000 or more, shall submit for every month of July during which work is performed, employment data as contained under Form FHWA PR-1391 (Appendix C to 23 CFR, Part 230), and in accordance with the instructions included thereon. Form 1273 —Revised 3-95. 08-07-95 RECEIVED BY: (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Cleric's Office after signing/dating CITY OF HUNTINGT®IV BEACH INTERDEPARTMENTAL COMMUNICATION TO: Sh Freidenrich, City Treasurer FROM: f f I DATE: SUBJECT: Bond Acceptance I have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved Coun it Appro at Datij Agenda Item No. City Clerk Vault No. #27 g1followup/bondletter.doc Premium: $4,427.00 Bond No. 761301300 Premium subject to adjustment upon completion Executed in Two (2) Parts 41` -w,_a > it �¢ I; KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereinafter referred to as "City") has, bywrttten agreement dated 20 , entered into a contract with All American Asphalt 92879 (rutim and address (hereinafter referred to as "Principal"), for performance of the work described as follows: CC-1359, Slater Avenue Rehabilitation. from Graham to Goldenwest Project (Project Title) i WHEREAS, said contract, and all documents referenced therein (hereinafter collectively *Contract'), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, sold Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract NOW THEREFORE, we, the undersigned, as Principal, and Fidelity and Deposit Cpm-panv 9f Maryland 801 North Brand Blvd, Glendale, CA. 91203 (name and addross of Sunaty) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of une Million. rorty une I nousana. jeven munarea i weniv une ano ivoi i uums --------------------- Dollars ($ 1.041 721.00 1, this amount being not less than one hundred percent of the price set forth In the Contract, in lawful money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION iS SUCH THAT if the Principal shall promptly, fully and faithfully perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall indemnify and save harmless City and all of City's officers, agents and employees (hereinafter collectively referred to as "Obligees") from any and all losses, Iiabildy and damages, claims, judgments, stop notices, fees and costs of every description, whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal In the performance of any or all of time terms or the obligations of the Contract, Including all alterations, amendments and modifications thereto, and any warranties or guarantees required thereunder; then this obligation shall be void; otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees, for value received, that no adjustment of the time or price in the Contract or any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract time or contract price, and PERFORMANGE BOND Page 1 of 2 Bond No. 761301300 any other alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, and agrees to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations, changes, deletions, additions or other modifications. Surety agrees to provide written confirmation of such adjustments -in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code §§ 2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the Individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: January 13, 2010 ATTEST All American Asphalt (Corporate Seal) (Principal Name) By: Na Title: A 1 C e- R ATTEST (Corporate Seal) (Attach Attomey-in-Fact Certificate) 8( 18 1 409-2800 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OUNTINGTON BEACH Tall 13 enntier Mc th ity Attomey Note: This bond must be executed In duplicate and dated an sbgnawres must be notedzed, and evidenoe of me authodly of any person signmgaa atinmmyNn-fact must be ettaofwd. xrrs9ia PERFORMANCE BOND Page 2 oi2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT State of California County of Riverside On January 19, 2010 before me, Carmen Marie Ochoa, Notary Public Date Here Insert name and Title of the Officer personally appeared Robert Bradley Name(e) of SignerW who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ate subscribed to the within instrument and acknowledged to me that he executed the same in his/ii€ authorized capacity(ies), and that by his�i€ CARMEN MARIE OCHOA signature(s) on the instrument the person(s), or the entity upon behalf Commission # 1812634 of which the person(s) acted, executed the instrument. $ (@My Comm. Expires Sep 8, 2i)12 Notary Public -California 9 1 certify under PENALTY OF PERJURY under the laws of the State of Riverside County California that the forgoing paragraph is true and correct. WITNESS my hand and official seal.19 Signature L 1111XM Antuieloh—,tary Place Notary Seal Above Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Documen Pe r �D rr ✓r �/� I ctn A Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(} Claimed by SignerW Signer's Name: Robert Bradley ❑Individual X Corporate Officer— Title(s): Vice President ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Other: Signer is Representing: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ Ge ❑ Attorney in Fact ❑ Trustee ❑ Other: __ is Representing: �S�ca. � s svca -a T.,gsa..• sa.:a>.:Qa �,� . ,fl,�zs sz w �<+�5,.. .� c, �, sa. ��..oi..� � a s�. �a. A -' .�pa..�. �a. sa.. State of California County of Orange On 1-13-10 before me, A. Wilkison, Notary Public Date Here insert Name and Title of the Officer personally appeared William Syrkin Name(s) of Signer(s) d A A. WILKISON Commission # 1866283 & -� Notary Public - California z Z : '-}� - D "` Orange County My Comm. Expires Sep 26, 2013 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(s) whose name( is/aye subscribed to the within instrument and acknowledged to me that he/ executed the same in his/ authorized capacity(!"), and that by his/he#the# signature(-} on the instrument the person(-}, or the entity upon behalf of which the person* acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 9 Signature �—/—� Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Performance Bond No. 761301300 Document Date: 1-13-10 Signer(s) Other Than Named Above: All American Capacity(ies) Claimed by Signer(s) Signer's Name: William Syrkin ❑ Individual Corporate Officer — Title(s): Partner — Ell Limited 0 General Attorney in Fact $' Trustee Top of thumb here Guardian or Conservator Other: Signer Is Representing: Fidelitv and Deposit Company of Maryland Number of Pages: Two alt Signer's Name: Individual 01 Corporate Officer — Title(s): �] Partner — ❑ Limited ❑ General * Attorney in Fact * Trustee L Guardian or Conservator [I Other: Signer Is Representing: Top of thumb here I i 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402• www.Nationa]Notary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 Bond No. 761301300 P""ENT BOMB Executed in Two (2) Parts (LABOR AND MATERIALS) Premium Charge for this Bond Included in Charge for Performance Bond KNOW ALL PERSONS BY THESE PRESENTS that. WHEREAS, the City of Huntington Beach (hereinafter referred to as "City") has awarded to All 61nerican Asphalt _ 400 East Sixth Street, Corona, CA. 92879 (name and addrefs of Gotsraetm) (hereinafter referred to as "Principal"), a contract (°Contract") for the work described as follows: CC-1359, Slater Avenue Rehabilitation, from Graham to Goldenwest Proiect (Project title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW THEREFORE, we, the undersigned Principal, and Fidelity and Deposit Company of Maryland 801 North Brand Blvd, Glendale, CA. 91203 (name and addrese of Su") (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City In the penal sum of One Million, Forty One Thousand, Seven Hundred Twenty One and No/100ihs=---------- ------------------------------ dollars, (3 1,041,721.00 1, this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns, Jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, If the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code (Claimants") for all labor, materials or services used or reasonably required for use In performance of the work described in the Contract, or any amounts due under the Unemployment Insurance Code with respect to worts or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor peftnned under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action Is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. Surety stipulates and agrees, for value received, that no change, extension of time, alteration, addition or modification to the terms of the Contract, or any contract document or any work to be performed thereunder, whether made after notice or not, shall in any way affect, impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such change, 1"329.1 PAYMENT BOND Page 1 of 2 Bond No. 761301300 extension of time, alteration, addition, or modification to the terms of the Contract, the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849, IN WITNESS WHEROF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such patty's proper legal name and that the Individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, wolves any defense which Surety has or may have by reason of any fallure of the Principal to execute or properly execute this bond. Dated: January 13, 2010 ATTEST (Corporate Seal) ►�ii�ii (Corporate Seal) Fidelity and Deposit Company of Maryland (Surety Name) By: Name: illiarn Svrkin tor�ne n-Facia (Signature homey -in -Fact for Surety) 8( 18) 409-2800 (Attach Attorney -In -Fact Certificate) (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH BIn"niferMcGrath y ttamey 5/1 e.164 /Vote: This bond must b9 executed in duplicate and dated, all signaftims must ba notadred, and aWdence of the authonfy ofWYMMM slgnftlg as attOMPY-"d must be attached. " 399.1 PAYMENT BOND Page 2 of 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT State of California County of Riverside On January 19, 2010 before me, Carmen Marie Ochoa, Notary Public Date Here Insert name and Title of the Officer personally appeared Robert Bradley Names) of Signer(r CARMEN MARIE OCHOA Commission # 1812634 Notary Public - California Riverside County My Comm. Expires Sep 8, 2012 who proved to me on the basis of satisfactory evidence to be the personW whose name( is/tee subscribed to the within instrument and acknowledged to me that hem executed the same in his/hed#4& authorized capacity(, and that by his signature() on the instrument the person(s), or the entity upon behalf of which the persons acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the forgoing paragraph is true and correct. WITNESS my hand and official seal. Signature d'NW,4q od� Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Date: Signer(s) Other Than Named Above I Capacity{ Claimed by SignerW 'J Number of Pages: U lice Signer's Name: Robert Bradley Signer's Name: ❑Individual ❑ Individual X Corporate Officer — Title(s): Vice President ❑ Partner— ❑ Limited ❑ General -- ❑ Attorney in Fact • ❑ Trustee Top of thumb here ❑ Other: Signer is Representing: ❑ Corporate Officer — T ❑ Partner — ❑ Limited ❑ Attorney in Fac ❑ Trustee ❑ Other' Signer is Representing: WWII 19• ,, . z.?�Rf State of California County of Orange On 1-13-10 before me, A. Wilkison, Notary Public Date Here Insert Name and Title of the Officer personally appeared William Syrkin Name(s) of Signer(s) �. '� A. WILKISON Commission # 1866283 _ c'"� »` Notary Public - California z Z Orange County My Comm. Expires Sep 26, 2013 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(64 is/are subscribed to the within instrument and acknowledged to me that he#jhMhey executed the same in his authorized capacity(ies), and that by his/l' e0heiF signatures} on the instrument the person ft or the entity upon behalf of which the person* acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS myhandand official seal. Place Notary Seal Above Signature Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Payment Bond No. 761301300 Document Date: 1-13-10 Signer(s) Other Than Named Above: All American Capacity(ies) Claimed by Signer(s) Signer's Name: William Syrkin ❑ Individual Corporate Officer—Title(s): _ El Partner — ❑ Limited ❑ General Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: Fidelitv and Deposit Company of Marvland A-g i Top of thumb here Number of Pages: Two (2) halt Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General Attorney in Fact Trustee Guardian or Conservator ❑ Other: __ Signer Is Representing A-. '�' c Top of thumb here 02007 National Notary Associaton- 9350 De Soto Ave.. P.O. Box 2402 -Chatsworth, CA 91313-2402- www NationalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6a27 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and GREGORY E. MURRAY, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said ny, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the d ereby nominate, constitute and appoint William SYRKIN, Rebecca HAAS-BATES an f Irvine, California, EACH its true and lawful agent and Attorney -in -Fact, to mak k e 'u r behalf as surety, and as its act and deed: any and all bonds and undert ecu ' or undertakings in pursuance of these presents, shall be as binding upon v 1 d 1 ' ents and purposes, as if they had been duly executed and acknowled y ele ompany at its office in Baltimore, Md., in their own proper persons er rn e on behalf of William SYRKIN, Rebecca HAAS-BATES, Sergio D. BECHAR� and _,'-fte'd April 8, 2008. The said Assistant esie eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By-L s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 25th day of September, A.D. 2009. ATTEST: '�� DfoOs�i � icA�'Oj4, o _ o c W t State of Maryland ss., City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND Gregory E. Murray Assistant Secretary By: William J. Mills Vice President On this 25th day of September, A.D. 2009, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J. MILLS, Vice President, and GREGORY E. MURRAY, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day, and year first above written. t+�6ll`�ili����� Maria D. Adamski Notary Public My Commission Expires: July 8, 2011 POA-F 012-0033 EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND , "Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice -President, or any of the Senior Vice -Presidents or Vice -Presidents specially authorized so to do by the Board of .Directors or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice -Presidents, Assistant Vice -Presidents and Attorneys -in -Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages,... and to affix the seal of the Company thereto." CERTIFICATE I, the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that the Vice -President who executed the said Power of Attorney was one of the additional Vice -Presidents specially authorized by the Board of Directors to appoint any Attorney -in -Fact as provided in Article VI, Section 2, of the By -Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 1 Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company, this 13th da of January 2010 Y At Assistant Secretary Client#: 4475 ALLAMER12 /AC®R®TM CERTIFICATE OF LIABILITY INSURANCE DATE 01/1912010YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Edgewood Partners Ins. Center Lic #OB29370 (714) 937=1824 One City Blvd West #700 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orange, CA 92868-2947 INSURERS AFFORDING COVERAGE NAIC # INSURED "- All American Asphalt P.O. Box 2229 Corona, CA 92878-2229 INSURER A: Arch Specialty Insurance Co. INSURERS: Ins. Co. of the State of PA INSURERC: Seabright Insurance Co INSURER D: Hartford Fire Insurance Co. INSURER E: COVERAGES 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. IN LTR NSR TYPE OF INSURANCE POLICY NUMBER IVE POLICY EFFECT/YY DATE MWDD POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY GPP002265801 08/01/09 08/01/11 EACH OCCURRENCE $1 000 000 X COMNTED MERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR Cert Holder is named additional ccurrr n e PREMIDAMASES I . occurrence) $100 000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $1 000 000 insured if GENERAL AGGREGATE s2,000,000 required by GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 written contract POLICY X PROJECT LOC D AUTOMOBILE X LIABILITY ANY AUTO 72UENGK5491 Cert Holder is 08/01/09 08/01/10 COMBINED SINGLE LIMIT (Ea accident) $1 ,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS named additional insured if X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS required by written co ED AS TO F RM X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY - ° y AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO 4 0,I1 O $ B EXCESS/UMBRELLA LIABILITY 7517073 08/01/09 08/01/10 EACH OCCURRENCE $10000 000 X OCCUR CLAIMS MADE AGGREGATE $10 000 000 $ RDEDUCTIBLE $ X RETENTION $ 10000 C WORKERS COMPENSATION AND BB1090243 08/01/09 08/01/10 X WC STATU- DER E.L. EACH ACCIDENT $1 000 000 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: CC-1359, Slater Avenue Rehabilitation, from Graham to Goldenwest Project GLap EK City of Huntington Beach P.O. Box 190 Huntington Beach, CA 92648 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILLxJt $$M MAIL I0_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFTJDUR)I;ARX50(J0=A9 A%0IAX ACORD 25 (2001/08) 1 of 2 #M44253 ZORE1 v A%,UKU UUKrUKA I wry roan 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. ACORD 25-S (2001108) 2 of 2 #M44253 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY SELF -INSURED RETENTION COVERAGE FORM SECTION II — WHO IS INSURED is amended to include as an additional insured those persons or organizations who are required under a written contract with you to be named as an additional insured, but only with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of your subcontractors: A. In the performance of your ongoing operations or "your work", including "your work" that has been completed; or B. In connection with premises owned by or rented to you. As used in this endorsement, the words "you" and "your" refer to the Named Insured. All other terms and conditions of this Policy remain unchanged. Schedule City of Huntington Beach, its agents, officers, and employees Project RE: CC-1359, Slater Avenue Rehabilitation, from Graham to Goldenwest Project Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein (The information below is required only when this endorsement is issued subsequent to the preparation of the policy.) Policy Number: GPP002265801 Named Insured: All American Asphalt Endorsement Effective Date: 8/1/09 00 CGL0006 00 05 07 Page 1 of 1 1895 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE — BROAD FORM, CGL POLICY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY SELF -INSURED RETENTION COVERAGE FORM Under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, the following paragraph is added to Condition 4. Other Insurance: Where the Named Insured is required by a written contract to provide insurance that is primary and non-contributory, and the written contract so requiring is executed by the Named Insured before any "occurrence" or offense, this insurance will be primary, but only if and to the extent required by that written contract. All other terms and conditions of this Policy remain unchanged. Schedule City of Huntington Beach, its agents, officers, and employees Endorsement Number: Project RE: CC-1359, Slater Avenue Rehabilitation, from Graham to Goldenwest Project This endorsement is effective on the inception date of this policy unless otherwise stated herein (The information below is required only when this endorsement is issued subsequent to the preparation of the policy.) Policy Number: GPP002265801 Named Insured: All American Asphalt Endorsement Effective Date: 8/1/09 00 CGL0130 00 09 06 Page 1 of 1 1895 CONTRACTOR'S CERTIFICATE L , state and certify that: (Name of Declarant) 1. is the general contractor to the City of Huntington Beach ("City) on Contract No. (the "Contract") for the construction of the public work of improvement entitled: (the "Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3. Except for the claims listed below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at on this day of 120 (Signature of Declarant) APPROVED AS TO FORM By: 1 -7/01-71J 3 . yo OCP Name: [Type Name] Title: [Type Title] 245914 1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VII of the Civil Rights. Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20_, at , California. (Type Contractor Name) By: Name: [Type Name] Title: [Type Title] E IF R A ORNEY -P-) 3--,)6-Cp 245911 1 Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit 'requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of 20 , at , California. (Type Contractor Name) By: Name: Title: [Type Name] [Type Title] W11mr, AV, 1 i1S o3 _ ab - o_�n 247542.1 City of Huntington Beach 2000 Main Street o Huntington Beach, CA. 92646 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK February 11, 2010 All American Asphalt P. O. Box 2229 Corona, CA 92878-2229 Re: Slater Ave. Rehabilitation from Graham St. to Goldenwest St. — CC-1359 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5437. JF:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid Bond (original) Sister Ci?iN�A4R)ffs%?Mfia%'Ch1 0P , New Zealand (Telephone: 714-536-5227 ) Council/Agency Meeting Held: v�/ To Deferred/Continued to: *Appr ve ❑ Conditionally Approved ❑ Denied CI ler ' Ign t re Council Meeting Date: 12/21/09 Department ID Number: PW 09-55 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY C#OF MEMBERS SUBMITTED BY: FRED A. WILSON, CITY ADMINIST,--` PREPARED BY: TRAVIS K. HOPKINS, PE, DIRECTI�BLIC WORKS SUBJECT: Award Construction Contract for Slater Avenue Rehabilitation from Graham Street to Goldenwest Street, CC No. 1359 Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: On October 15, 2009, bids were publicly opened for the Slater Avenue Rehabilitation from Graham Street to Goldenwest Street, CC-1359, Federal Aid Project ESPL-5181 (166). City Council action is requested to award the construction contract to Ali American Asphalt, Inc., the lowest responsive and responsible bidder. Funding Source: Grant funds in the amount of $1,773,750 are budgeted in the Gas Tax Fund, Federal Funded Street Improvements Account No. 20790015.82300. Recommended Action: Motion to: 1. Approve the plans and specifications for the Slater Avenue Rehabilitation Project, CC- 1359; 2. Accept the lowest responsive and responsible base bid submitted by All American Asphalt, Inc. in the amount of $1,110,616.00; and 3. Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids, and provide staff with an alternative direction. REQUEST FOR CITY COUNCIL ACTION MEETING DATE: 12/21/09 DEPARTMENT ID NUMBER: PW 09-55 Analysis: The American Recovery and Reinvestment Act of 2009 (ARRA) provided $27.5 billion for highway infrastructure investment. California received approximately 10% of those funds and the City of Huntington Beach portion is $1.7 million. In September the City of Huntington Beach obtained E-76 approval from California Department of Transportation (Caltrans) to proceed with advertising and bidding of the Slater Avenue Rehabilitation, CC- 1359 project. The project is tracked as Federal Aid Number ESPL-5181 (166) by Caltrans. Full ARRA reimbursement is anticipated. The City's objective is to replace the worn pavement on Slater Avenue from Graham Street to Goldenwest Street and replace the failed cross gutter at Via Espana and Slater Avenue. The project primarily consists of grinding the existing pavement, removal of failed roadway sections, asphalt base course paving of failed areas, and overlaying the entire street with rubberized asphalt. Also part of the project is limited removal and installation of concrete curb and gutter, concrete sidewalk, curb access ramps, adjusting manholes, monuments and valves to grade, and installing traffic loops with striping. The project utilizes rubberized asphalt concrete (RAC) which contains crumb rubber derived from scrap tires. A two-inch layer of RAC uses over 2,000 waste tires per lane mile. The project will divert more than 10,000 waste tires, that otherwise would end up in a landfill. Including this project, the use of RAC in the rehabilitation of the City's arterial, streets has resulted in the diversion of over 193,000 waste tires. Bids were opened publically on October 15, 2009. The verified bid amounts are listed below: g 13ID A►IIflQ,UN1 T VERIFIED _SUBMITTED MAI BIDDER°S'NAE a 6� = (Amount Read A d 4TAIw AID k�►�I®uNT �l- . �- at pia ®pe�Ing>> °'� gqq Al All American Asphalt $1,110,616.00 $1,110,616.00 EBS Inc. (Elite Bobcat Service) $1,123,338.20 $1,123,338.20 Sequel Contractors Inc. $1,164,321.00 $1,124,316.50 The RJ Noble Company $1,154,087.75 $1,154,087.75 Hardy & Harper $1,176,000.00 $1,176,000.00 Imperial Paving Co. $1,220,985.75 $1,220,985.75 Excel Paving Company $1,248,362.80 $1,248,362.80 Pave West $1,297,305.00 $1,297,305.00 All American Asphalt, Inc. has previously provided acceptable performance and was awarded three street improvement projects that were completed in 2007. The total construction cost is estimated to be $1,350,000, which includes the construction contract, project management, construction contingency, and supplementals (soils and materials .2- 12/2/2009 9:03 AM REQUEST FOR CITY COUNCIL ACTION MEETING DATE: 12/21/09 DEPARTMENT ID NUMBER: PW 09-55 testing, construction support services by outside firms, in-house inspection services and additional engineering support). Public Works Commission Action: The Public Works Commission reviewed and recommended the project on May 20, 2009, with a vote of 5-0-2 (Kirkorn and Rivera absent). Strategic Plan Goal: Maintain, improve and obtain funding for public improvements. Environmental Status: The project is categorically exempt pursuant to Class 1, section 15031 c of the California Environmental Quality Act and on June 3, 2009, the State determined that the project is a categorical exclusion under National Environmental Protection Act (NEPA) 23 CFR 771.117(d); activity (d) (1). Attach ment(s): -3- 12/2/2009 9:03 AM moo. sj4 Off, 7 BOLSA AVE CO U c cn V) NTS = Mc FADDEN AVE. U W J ~ Q o EDING R N AVE. J Z J p = Z Ff V) o �HEILm z Qif 0- N AVE. m � } 0 w o V) Q WAR ER LLI- a z AVE. o z SLATER w AVE. 405 � A 9 U TALBERT AVE. ELLIS AVE. GARFIELD o AVE. m V) Ln V) ( ct 3 YORKTOWN AVE. c� s� � z ADAM$ AVE. o\Q�v 9� �y MEMPI- AVE. Ld Z Q 71 cF LLJ INDIANAPOLIS z AVE.o I— � �� C� 3 U ATLANTA AVE. _ _ PROJECT LOCATION oc m m o O Slater (Graham—Goldenwest) HAMILTON AVE. Im LEGEND ® ARTERIAL STREET LOCATION REV 2/18/09 REHAB OF SLATER FROM GRAHAM TO G.WEST CC-1359 PROJECT LOCATION MAP '�• >� CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS 1 OF 1 INITIATING DEPARTMENT: PUBLIC WORKS SUBJECT: SLATER AVENUE REHABILITATION, CC NO.1359 FEDERAL AID PROJECT COUNCIL MEETING DATE: December 21, 2009 MCA 4TTACHNIENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Tract Map, Location Map and/or other Exhibits Attached Not Applicable ❑ Contract/Agreement (w/exhibits if applicable) Attached ❑ (Signed in full by the City Attorne) Not Applicable Subleases, Third Party Agreements, etc. Attached ❑ Approved as to form by City Attorne) Not Applicable Certificates of Insurance (Approved by the City Attorney) Attached ❑ Not Applicable Fiscal Impact Statement (Unbudgeted, over $5,000) Attached ❑ Not Applicable Bonds (If applicable) Attached ❑ Not Applicable Staff Report (If applicable) Attached ❑ Not Applicable Commission, Board or Committee Report (If applicable) Attached ❑ Not Applicable Findings/Conditions for Approval and/or Denial Attached ❑ Not Applicable RCA Author: J. Wagner CITY OF HUNTINGTON BEACH SLATER STREET REHABILITATION FROM GRAHAM STREET TO G®LDWEST STREET C.C. NO. 1359 BID OPENING DATE: October 15, 2009 TIME: 2:OOPM ENGINEER'S ESTIMATE: $1,500,000 MorBBDD::S::NJ►iE K::.:.:A, ENT: _PAS......................................... 1 All American Asphalt, Corona O / i 2 EBS Inc. (Elite Bobcat Service), Corona I'A3--lO 3 Hardy & Harpers ti,A ev 14 1744000 4 Excel Paving Company, Long Beach ,36 5 GSCI, Huntington Beach 1jrA PUCAW(`.sE�'°E3� 7 HMK Engineering, Calabasas Imperial Paving Co., Santa Fe Springs o 9 Lincoln Pacific, Baldwin Park 10 Ortiz Asphalt Paving, Colton 11 Pave West, La Habra C 12 Pavement Recycling Systems, Mira Loma 13 Pima Corporation, Los Angeles 14 Sequel Contractors Inc., Santa Fe Springs i 15 Steiny and Company,inc., Baldwin Park 16 Sterndahl Enterprises, Sun Valley 17 The RJ Noble Company, Orange C1 18 19 20 G:\Construction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\PGPY\Bid Opening Worksheet Slater Ave 10/15/2009 .1130 Goal SECTION A NOTICE INVITING SEALED BIDS for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated project and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 P.M. on Thursday, October 15, 2009. Bids will be publicly open in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $60.00 nonrefundable fee if picked up, or payment of an $85.00 nonrefundable fee if sent by an overnight service provider (bidder shall pay additional costs for special delivery). This is a Davis -Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 10% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the California Government Code, Section 4590. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. O\Documents and Settings\esparzap\Local Settings\Temporary Internet Fi1es\0LK15B\NISB For Advertisementirw.doc No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: The project consists primarily of grinding of the existing pavement, removal of failed roadway sections, asphalt paving of failed areas, overlaying the streets with rubberized asphalt, limited removal and installation of concrete curb and gutter, concrete sidewalk, curb access ramps, adjusting manholes, monuments and valves to grade, and installing traffic loops with striping. • The contract allows the Contractor 75 working days to complete the contract. • The engineer's estimate for the work included in the base bid portion of this contract is $1,500,000.00. • The Project Disadvantage Business Enterprises (DBE) goal is 5.29% (UDBE [Race Conscious]: 3.55% and DBE [Race Neutral]: 1.74%). The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 8th day of September 2009, by RESOLUTION 2009-50. Attest: /s/ Joan L. Flynn CITY CLERK THE CITY OF HUNTINGTON BEACH C:\Documents and Settings\esparzap\Local Settings\Temporary Internet Files\OLK15B\NISB For Advertisement jrw.doe 1� e CITY OF HUNTINGTON BEACH 2000 Main Street P.O. Box 1 90 Huntington Beach, CA 92 64 8 LETTER OF TRANSMITTAL Attention: Joan L. Flynn To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 Fax (714) 374-1573 Date: September 17, 2009 Project/C.C. No.: C.C. No. 1359 Regarding: Slater Avenue from Graham to Goldenwest ❑ We are sending you: ❑ By Mail ❑ By Fax Mail(Number of pages including this sheet:) ® We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other: Notice Inviting Sealed Bids Item # Copies Pa es Description, 1 1 1 Notice Inviting Sealed Bids for CC-1359, Slater Avenue Rehabilitation Graham Street to Goldenwest Street These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other: Remarks: Per Resolution 2009-50 (adopted on 9/8/09), the City Council authorized the advertisement of the above listed arterial rehabilitation project. Please find attached the Notice Inviting Sealed Bids for advertisement on 9/24/09, 10/1/09, and 10/8/09. The bid opening is scheduled for 10/15/09 at 2:00 PM. Please contact me at 536-5467 with any questions you may have. BYC Jim Wagner, Senior Civil Engine c: file GACONSTRUCTION CONTRACTS (CCs)\CC1359 REHABILITATION Or SLATER FROM GRAHAM TO GOLDENwEST\SFECIFICATIONS\NISB TRANSMITAL TO CLERK- CC-1359.DOC City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Number One, dated September 24, 2009 Company Name Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. WConstruction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\SPECIFICATIONS\Addendum 1\CC-1359 Addendum Number One.doc For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 point is typically a 3 3/4" aluminum disk with said agency's stamping. Datum information for public viewing is on file at said agency. A -survey monument is defined as any permanent point as shown on file at the NGS, NOAA, Caltrans, OCS, City of Huntington Beach Public Works Department or any other public agency; said point being used to establish or perpetuate horizontal control. These points include but are not limited to centerline street monuments or accessories to said centerline street monuments (i.e. tie points), property corners or accessories to said corners, or monuments established in connection with the Orange County Geodetic Control Network or accessories to said monuments. These points shall be tied out and replaced by a licensed Land Surveyor or a licensed Civil Engineer authorized to practice land surveying pursuant to sections 8700 to 8806 of the Business and Professions code of the State of California (Land Surveyors Act). The Corner Records produced from said tie -out and replacement survey shall be furnished to the City of Huntington Beach Public Works Department as well as filed with the office of the County Surveyor indicating responsible charge (stamped), within 60 days of the final survey. 2-9.2 Survey Service [Replace the first paragraph with the following] All construction surveying will be performed by the AGENCY. Monument preservation surveying necessary to complete the work shown on the plans and provided for in these contract documents and specifications shall be accomplished by or under the direction of a licensed Land Surveyor or Professional Engineer, whom is authorized to practice land surveying, retained or provided for by the Contractor. The AGENCY reserves the right to direct additional construction survey to be performed when it feels it is required to adequately construct the work. All costs to the Contractor for protecting, removing, restoring, repairing, replacing, or reestablishing monuments or accessories to monuments or costs associated with the preparation or filing of Corner Records pursuant to sections 8700 to 8806 of the Business and Professions Code shall be included in the bid item for survey monument preservation. Payment for survey monument preservation shall be per the contract lump sum bid price and no additional compensation will be allowed therefor. When the contract does not include a pay item for monument preservation and unless otherwise provided in the specifications, full compensation for all monument preservation required to complete the work shall be included in the price bid for other items of work and no additional compensation will be allowed therefor. E-5 CC-1359 Slater Avenue Addendum 1 Huntington Beach Independent has been adjudged a newspaper of general circulation in Huntington Beach and Orange County by Decree of the Superior Court of Orange County, State of California, under date of Aug. 24, 1994, case A50479. STATE OF CALIFORNIA) )SS. COUNTY OF ORANGE ) I am the Citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the below entitled matter. I am a principal clerk of the HUNTINGTON BEACH INDEPENDENT, a newspaper of general circulation, printed and published in the City of Huntington Beach, County of Orange, State of California, and the attached Notice is a true and complete copy as was printed and published on the following. date(s): October 1, 8, 2009 I declare, under penalty of perjury, that the foregoing is true and correct. Executed on October 8, 2009 at Costa Mesa, California CGS" Signatur` SECTION A . NOTICE INVITING SEALED BIDS for the construction of ' SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET; C.C. NO. 1359 FEDERAL AID. PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITYOF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated project and will such bids in `the office of the ' City Clerk; Second Floor, 2000 Main Street, F Huntington Beach, California 92648,.up to the hour, of. 2:00, P.M. on Thursday, October 15, 2009. Bids will be publicly open in the Council Chambers unless otherwise. posted. Copies of the, Plans, Specifications, and con - Tract documents "are available from , the Office of the•, Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $60.00 nonrefundable fee.if picked up, or payment of�an $85:00 nonrefundable fee if sent by an overnight service provider (bidder shall pay, additional costs for special delivery). This is a Davis -Bacon project and the Federal Regulations will be 'enforced: Any contract entered into pursuant to this notice will incor- porate the provisions'..of'the Federal Labor Standards, which are,on'file at the office of the i Director, of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 10% retention from all progress :payments. The Contractor_ may substitute an escrow ,holder surety of equal value to the retention in accordance with the provisions of the California -Government Code, Section 4590. The Contractor shall be beneficial owner ofr the' surety and shall receive' any nterest thereon... , I I The AGENCY hereby affirmatively ensures that i minority business enterprises. will .be afforded full opportunity to submit bids inresponse to this notice and will, not be discriminated'against on the, basis of,; race, color, national origin, ancestry, sex; or religion in,any. consideration leading to the award of contract., No bid shall be considered unless it is prepared on the ap proved 'Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a .certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% .of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall'possess a'State Contractor's. License Class A at the time of the bid opening: The successful Contractor and his 'subcontractors will be required to possess .business ,licenses ' from the AGENCY. Project Description: The project consists pri- marily, of grinding of .the existing .pavement, removal of failed roadway sections, asphalt paving of failed' areas, overlaying the, streets With rubberized asphalt;' limited removal and installation .of concrete curb and gutter, con -. crete, sidewalk,. curb access, ramps,, adjusting manholes, monuments and valves to grade, and installing traffic loops with striping. ❑ The contract' allows the Contractor 75 working days to complete the contract. , LI The engineer's estimate for the -work. included in the base bid portion of this contract is . $1,500,000.00: ❑ The Project Disadvantage Business Enter- prises (DBE) goal is 5.29% (UDBE . [Race Conscious]: 3.55% and DBE' [Race Neutral]: 1.74%). The. AGENCY reserves the right to reject any or all bids, to'waiye any irregularity and to take all bids under, advisement for a`maximum period of 60 days. BY,ORDER of the CITY COUNCIL of the CITY I OF HUNTINGTON BEACH, CALIFORNIA,. the 8th f day of September 2009, by RESOLUTION 2009- 50: Attest: /s/ Joan L. Flynn CITY CLERK THE CITY OF HUNTINGTON BEACH Published Huntington Beach, lndependent Sep- tember 24, October 1, 8, 2009 094-882 Huntington Beach Independent has been adjudged a newspaper of general circulation in Huntington Beach and Orange County by Decree of the Superior Court of Orange County, State of California, under date of Aug. 24, 1994, case A50479. PROOF OF PUBLICATION STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) I am the Citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the below entitled matter. I am a principal clerk of the HUNTINGTON BEACH INDEPENDENT, a newspaper of general circulation, printed and published in the City of Huntington Beach, County of Orange, State of California, and the attached Notice is a true and complete copy as was printed and published .on the following date(s): October 1, 8, 2009 I declare, under penalty of perjury, that the foregoing is true and correct. Executed on October 8, 2009 at Costa Mesa, California SECTION A NOTICE INVITING SEALED BIDS for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181(166) in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites'sealed bids for. the above stated project and will receive such bids in the office, of the City Clerk,". Second ."Floor, 2000 Main 'Street, Huntington Beach, California 92648,'• up to the hour' of 2:00 P.M. on Thursday, October 15, 2009. Bids will be publicly open in the -Council Chambers unless otherwise posted. Copies of the Plans, Specifications;.and ,con, tract documents are available from 'the, Office Df the Director of Public .Works, 2000 Main Street, Huntington : Beach, CA 92648,'' upon payment of a.$60.00 nonrefundable fee if picked up, or payment of an $85.00 nonrefundable fee if sent by an overnight; service provider (bidder shall pay additional costs for special delivery)." , This is a Davis -Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice -will incor- porate the provisions of the. Federal Labor Standprds, which are on file at the office of the Director, of Public'. Works; 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 10% retention from all. progress, payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the California Government Code, Section 4590. The Contractor shall be beneficial owner of. the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated "against on' the basis of race, -color,national origin, ancestry, sex, or religion. in any consideration leading to the award of contract. No bid shall be considered,unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. . The bid must be laccompanied by a certified check, cashier's check, or bidder's bond made payable to the..AGENCY. for an amount no'less than 10% of the amount bid. The successful bidder shall . be licensed in accordance with provisions. of the Business and Professions Code and shall possess a State Contractor's License Class A at the .time of the bid :opening.. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. . Project Description: The project consists pri- marily of. grinding, of the existing pavement, removal of failed roadway sections, asphalt paving of failed `areas, • overlaying ;the streets with .rubberized asphalt, limited removal and installation of concrete curb and gutter, "con- crete _ sidewalk, curb access ramps, adjusting manholes,'mondments and valves to grade, and installing.traffic loops with -striping. 1. ❑ The contract allows the , Contractor 75 working days to complete'the contract. ❑ The engineers estimate for the'work included in the base ,bid, portion of this contract is $1,500,000.00. ` ❑ The Project Disadvantage• Business Enter- prises (DBE) goal is • 5.29% (UDBE [Race Conscious]: 3;55% and DBE [Race Neutral]: 1.74%). The,AGENCY reserves the right to,reject any or all bids, to "waive any irregularity and to take all bids under advisement for a maximumperiod of 60 days.' . BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 8th day of 'September 2009, by RESOLUTION 2009- 50. Attest: /s/ Joan L. Flynn CITY CLERK THE CITY OF HUNTINGTON BEACH Published" Huntington. Beach Independent Sep: tember24. October 1. 8, 2009" 0947882 Unsuccessful Bids City ®f Huntington Beach 2000 Main Street . Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK February 11, 2010 R. J. Noble 15505 E. Lincoln Avenue P. O. Box 620 Orange, CA 92856 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest St. Enclosed please find your original bid bond for CC-1359. Sincerely, Joan L. Flynn, CMC City Clerk J F: pe enclosure Sister G?i ?1oXq6a 5tAeU11New Zealand 1 Telephone: 714-536-5227 ) R AVENUE REHABILITATION 181(166) I . - - A -T- n . AA DA 4 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-6431, Fax (714) 374-1573 For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Number One, dated r mber 24, 2009 R.J. NOBLE COMPANY X 00, Company Name B CHAEL J. CARVER, PRESIDENT OCTOBER 22, 2009 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. GlConstruction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\ADVERTISEMENT-NISB-BIDDING PROCESSICG1359 Addendum Number One.doc ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 point is typically a 3 3/4" aluminum disk with said agency's stamping. Datum information for public viewing is on file at said agency. A survey monument is defined as any permanent point as shown on file at the NGS, NOAA, Caltrans, OCS, City of Huntington Beach Public Works Department or any other public agency; said point being used to establish or perpetuate horizontal control. These points include but are not limited to centerline street monuments or accessories to said centerline street monuments (i.e. tie points), property corners ' or accessories to said corners, or monuments established in connection with the Orange County Geodetic Control Network or accessories to said monuments. These points shall be tied out and replaced by a licensed Land Surveyor or a licensed Civil Engineer authorized to practice land surveying pursuant to sections 8700 to 8806 of the Business and Professions code of the State of California (Land Surveyors Act). The Corner Records produced from said tie -out and replacement survey shall be furnished to the City of Huntington Beach Public Works Department as well as filed with the office of the County Surveyor indicating responsible charge (stamped), within 60 days of the final survey. 2-9.2 Survey Service [Replace the first paragraph with the following] All construction surveying will be performed by the AGENCY. Monument preservation surveying necessary to complete the work shown on the plans and provided for in these contract documents and specifications shall be accomplished by or under the direction of a licensed Land Surveyor or Professional Engineer, whom is authorized to practice land surveying, retained or provided for by the Contractor. The AGENCY reserves the right to direct additional construction survey to be performed when it feels it is required to adequately construct the work. All costs to the Contractor for protecting, removing, restoring, repairing, replacing, or reestablishing monuments or accessories to monuments or costs associated with the preparation or filing of Corner Records pursuant to sections 8700 to 8806 of the Business and Professions Code shall be included in the bid item for survey monument preservation. Payment for survey monument preservation shall be per the contract lump sum bid price and no additional compensation will be allowed therefor. When the contract does not include a pay item for monument preservation and unless otherwise provided in the specifications, full compensation for all monument preservation required to complete the work shall be included in the price bid for other items of work and no additional compensation will be allowed therefor. E-5 CC-1359 Slater Avenue Addendum 1 SECTION C for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER. understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE, AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, Lunt price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find 10 o BID BONDin the amount of $ - - - - - - - - - which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received i is Signature #1 09 24 09 x MI HART. J. CARVER, PRESIDENT C-2 SECTION C PROJECT BID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STPL-5181 (166) BASE BID: TOTAL AMOUNT BASE BID IN FIGURES: $ I i5� , W1. -16 TOTAL AMOUNT BASE BID IN WORDS: nnP rn► h7')n Dnfe NinAivr Fi-Fha iw 4-nomanA seve n do iW s o n � 5Jeve Ov'v-, C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 ...... ...... . .. 4:mfit ... .......... ......... .... ...... NOi:�: . �:::Q04 y.. .... .... ............... W j�lj:ftvw T., Jt ..... ............... .::.U. i jn.'t: LS . Mobilization @ .4 h 0A Ah o e, w sanJ Dollars 2a lb( $ ?0i orul (B —Cents Per LS 2 1 Traffic Control Plan LS @ three thousand five hundred Dollars $3,500.00 $ 3,500.00 and no cents Cents Per LS 3 1 Furnish Project Traffic Control LS @ thirty four thousand Dollars $ 34,000.00 $ 34,000.01 no —Cents Per LS 4 96430 Cold Milling & Header Cutting incl. disposal of material SF @ zero Dollars $0.10 $ 9,643.0 ten Cents Per SF 5 195300 Surface Grind (0. IT) including dipsosal of material SF @ zero Dollars $0.13 $ 25,389.0( thirteen Cents Per S 6 1325 CY Unclassified Excavation @ hoDollars $ dl, 00 $ S 413 2 5, yttl Cents Per CY 7 5040 Ton Construct Asphalt Concrete (0-0. IT, 0. IT, 0.42'& 0.50') @ stl w �buf Dollars $. 0,15 $ 1'tA Vy -Cents Per Ton J 8 6015 Construct Asphalt Concrete (0. ITARHM Overlay) Ton @_811hA L(a0— Dollars oo $ noCents Per Ton 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface EA @ six hundred twenty five Dollars $625.00 $ 1,875.0 no Cents Per EA 10 16 Adjust OCSD Manhole to finished surface EA @ seven hundred seventy five Dollars $775.00 $ _12,400. 0 no Cents Per EA M Eolf C-2.2 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 Item::T I ...� fiftiAte& ...... I ...... ...... ­.. I ..... I ... ­ I ­ I I ............... ........ ................. Ni)*:J ....... ::9u.'�a'tjty:: ....... ...... ...... ....... ..... .. . _.................. i t t en' � i H' �' Worris::::::' .. . ......... . ... .. . ......... 11 21 Adjust Water Valve to finished surface EA @four hundred forty five Dollars $445.00 $ 9,345.00 no Cents Per EA 12 1 Adjust Monitoring Well to finished surface EA @ six hundred fifty four Dollars $654.00 $_654.00 no -Cents Per EA 1.3 1 Traffic Striping LS @ 41rjaUA i orle- 1-71-lawd, Dollars .J no Cents Per LS 14 33 Traffic Loop EA @ one hundred ninty Dollars $ $ nn Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, F Slot 15 1830 Pave per Std Plan 202) LF @ thirty three -_Dollars $33.00 $ 60,390.0( no Cents Per LF 16 15155 Remove & Reconstruct Sidewalk per Std Plan 207 SF @ four Dollars $4.85 $ 73,501, eighty five Cents Per SF Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining 17 12 Curb, 1' Slot pave, & SW) EA @ two thousand two hundred Dollars $2,200.00 $ 26,400.0( no Cents Per EA 18 4 Install Truncated Domes into existing Access Ramp EA @Pix hundred tweni-y five Dollars $625.00 $ 2,500.00 no Cents Per EA 19 13 Survey Monumentation. EA @ two hundred seventy_ five Dollars $275.00 $ 3�,575-00 no Cents Per EA 20 1 Raise Survey Well Monument to finished surface 560.00 $ 560.00 EA @ five hundred sixty Dollars no Cents Per EA C-2.3 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 ty ..... ...... ............................... ............ ........................ ..... ...................... . ... nit: Pi ...... 21 1654 Remove & Reconstruct Curb & X-Gutter SF @ ten Dollars $ 10.00 $ 16,540.00 _nQ_ Cents Per SF 22 6 Remove & Install New Traffic Signal Pullbox EA @ three hundred ten Dollars 310.00 $ 1,860.00 Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-l-T frame. Install city furnished traffic signal head with LE-SV-1-T framework and terminal box. I ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. Ica • Install conduit into existing pullbox. I ea. • Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. 2ea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1- 12 conductor cable and 1-3 conductor cable. I ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. I ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. I ea o Abandon existing conduit and remove conductors. I ea o Install 3" conduit into existing pullbox. I ea o Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cable and DLC's into traffic signal cabinet. I ca. LS --MOV, _�aa%0d_D,llars $ $ T� Cents I Per LS Total Amount Bid in Figures: $ 1 IS4 I Total Arnou t Bid in Words-PALA V1 .............. S ... --- ------- --------- ..... 'C4" 0 " Ai . _A_ _.wnd UGKtA OlAd 5. C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class SURVEY CASE LAND SURVEY, 614 N.. ECKHOFF ST ORANGE. CA 92868 LS5411 LS UTILITIES EBS, MANHOLE ADJUSTING 1320 E. SIXTH CORONA, CA 92879 932798 A CONCRETE ELITE BOBCAT SERVICE, 1320 E. SIXTH ST CORONA, CA 92879 720016 A LOOPS GLOBAL ROAD SEALING 10832.DOR0THY AVE, GARDEN GROVE, CA 757584 C-32 rl�,n Su 1'rfor ave.ment Mortin P I� S t30 C-32 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLL,USION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange MICHAEL J. CARVER , being first duly sworn, deposes and says that he or she is PRESIDENT of R . J. NOBLE COMPANY the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization., bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. R.J. NOBLE COMPANY Name of Bidder MICHAEL J. CARVER, PRESIDENT X nature of Bidder 15505 E. LINCOLN AVE. ORANGE, CA 92865 Address of Bidder JENN ER DE IONGH Subscribed and sworn to before me this 15 day of OCTOBER 200 9 commission # 177118e Notary Public - California z . , Orange County MyComm. Expires Oct28, 2011 NOTARY DE IONGH C-4 NOTARY SEAL UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein.. Date: OCTOBER 15, 2009 C-5 R.J. NOBLE COMPANY Contractor X 13 MICHAEL J. CARVER, PRESIDENT Title DISQUUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes K1 No If the answer is yes, explain the circumstances in the space provided. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: OCTOBER 15, 2009 C-7 R.J. NOBLE COMPANY Contractor X By MICHAEL J. CARVER, PRESIDENT Title UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: R.J. NOBLE COMPANY Contractor X By MICHAEL J. CARVER, PRESIDENT Title Date: OCTOBER 15, 2009 Note: This form is required .for every Dig Alert Identification Number issued by U.S.A. during the course of'the Work. Additional forms may be obtained filom the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: R.J. NOBLE COMPANY Bidder Name 15505 E. LINCOLN AVE. Business Address ORANGE, CA 92865 City, State Lip (714 ) 637-1550 Telephone Number A-782908 CLASS A State Contractor's License No. and Class AUGUST 14, 2000 Original Date Issued AUGUST 31, 2010 Expiration Date The work site was inspected by STEVE MENDOZA of our office on 10/12 , 200 9 The following are persons, firms, and corporations having a principal interest in this proposal: R.J. NOBLE COMPANY MICHAEL J. CARVER. PRESIDENT CRAIG PORTER, VICE PRESIDENT STEVE MENDOZA, SECRETARY JAMES N. DUCOTE, TREASURER C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. R.J. NOBLE COMPANY Company Name BIZ • - • : •• MICHAEL J. CARVER, PRESIDENT Printed or Typed Signature Subscribed and sworn to before me this 15 day of OCTOBER , 200 9 NOTARY DE IONGH GO JENNIFER DE IONGH Commission # 1771186 "-1 Notary Public - California = a Orange County WCamm. BOWOW28, 2011 NOTARY SEAL Listed below are th-C--iamesVaddress and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. COUNTY OF ORANGE, 1152 E. FRUIT ST., SANTA ANA, CA 92701 Name and Address of Public Agency Name and Telephone No. of Project Manager: HIRAM T . DOWNARD (714) 567 - 7812 $1,593,153.00 A.C. OVERLAY Contract Amount Type of Work 12/07 - 10/08 Date Completed 2, CITY OF SAN CLEMENTE, 910 CALLE NEGOCIO, STE 100, SAN CLEMENTE, CA 92673 Name and Address of Public Agency Name and Telephone No. of Project Manager: GARY VOBORSKY (94 9) 3 61- 6118 $1,686,943.55 VARIOUS ST. REHAB. 12/07 - 10/08 Contract Amount Type of Work Date Completed 3. COUNTY OF RIVERSIDE, P.O. BOX 1090, RIVERSIDE, CA 92502 Name and Address of Public Agency Name and Telephone No. of Project Manager: STAN DERY (951) 955 - 6742 $4,628,247.70 STREET IMPROVEMENTS 02/08 - 10/08 Contract Amount Type of Work Date Completed C-10 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): X Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: R.J. NOBLE C Contact Person: MICHAEL J Contact Phone: (714) 6377 Signed: Date: x I • VER, PRESIDENT OC;L�6BER 15, 2009 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and. Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 1.2-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder R . J . NOBLE COMPANY subcontractor proposed hereby certifies that he has X has not_, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a, report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-12 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has - , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. N/A C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. G14 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of ORANGE DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: b Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; ® Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; ® Does not have a proposed debarment pending; and ® Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. N/A Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page12-83 LPP O1-04 C-16 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F N®NL®BBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: F� a. contract ❑ a. bid/offer/application ❑ a. initial b. grant b. initial award b. material chat c, cooperative agreement c. post -award / d. loan e. loan guarantee f. loan insurance 4. Name and Address of Reporting Entity ® Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) For Material CKange Only: year quarter _ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address df Prime: CongressionalDistrict, if known 7. Federal Program Name/Description: CFDA,'Number, if applicable 9. Aryarrd Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply 13, Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash / d. contingent fee b. in -kind; speci jilature e deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s)/or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuationeet(s) attached: Yes ❑ No El 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: X was placed by"the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 7CHAEL J . CARVER � Print Name: U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: PRESIDENT - - - hall b b to a $lQ ho fails to file the requred disclosure s e su ject penalty of not less than $10,000 and not more than 1 for each such failure. Telephone No.: (714) 6 3 7 -15 5 0 Date:10 / 15 / 0 9 F,Zeral Use Only: Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C_18 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant, or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or S. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-19 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-instn<ctions Rev.06-04-90<(ENMF» Page 12-89 LPP 01-04 C-20 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-G . Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DEE and NON -DBE)- PART Y The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. IVIIt, r!'1fy, fate ZIP Name Address 2 1.31015- 00 Oity Vtntn 7IP Name Address G�'?G�1.�1t7�1 VA State Firm Nam, Address/ 1 Ve.(ll M S� Phone/ Fax Annual Gross Receipts V/1 Y I Phone � — 9 A E ❑ < $1 million <$5 million ��Q ❑ < $10 million Fax {�� ❑<$15million ❑ > $15 million Phone S1 \ ❑ <$1 million 0 <$5 million 0 < $10 million Fax �C f Jl) t� �3Z ❑ < $15 million ,10 >$15million Phone 1 ❑ < $1 million < $5 million 0 <$10 million Fax <$15 million > $15 million Phone / �'� ��(� El<$1 million < $5 million ❑ < $10 million 07 <$15 million > $15 million Distribution: 1) Original - Local Agency File Description of Portion of Work to be Performed r Page 12-111 LPP 06-06 November 14,2006 0 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) n N 00 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- DART B The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14,2006 Local Assistance Procedures Manual EXHIBIT 12-G ii Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Na*/ Address/' City, State iIP Phone/ Fax Annual Gross Receipts E Description of Portion of Work to be Performed Name Phone ❑ <$1 million < $5 million __......__._._._._._._____.._...__ ...... ........ _—_-• Address ❑ < $10 million h� Fax ❑ <$15 million ❑ > $15 million U ._....... _..-....... _............._.....__......................_...................................... .......................... IA City State ZIP Name Phone ❑ <$1 million ED <$5 million ._.._._.__ Address < $10 million Fax ❑ < $15 million a City State ZIP > $15 million _ _ _ ._.--........ ---- ........... ....... - _........ -_ ❑ <$1 million Name Phone < $5 million 6 Address < $10 million Fax < $15 million City State ZIP ❑ > $15 million ❑ <$1 million _.__ ...... _................... ____..._-_.�._ Name Phone ----.__..--•---_-...._.... _..._......_._. < $5 million -------.._.__.......... Address < $10 million Fax <$15 million > $15 million City State ZIP Distribution: 1) Original - Local Agency File Page 12-1 It November 14,2006 LPP 06-06 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File Page12-111 LPP 06-06 November 14,2006 Exhibit 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) n N BIDDER'S LIST OF SUBCONTRACTORS (DBE used NON -DBE)- PART 99 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File )Page 12-112 November 14, 2006 LPP 06-06 Exhibit 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) n 10 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49Section "zo of the lode of r ecteral K Firm Namle/ AddressA City, State, tip ame L—Duc) Mx��V-:5 Address CW State m(n G\ � uM Rl\ qml Q&6im I(Ak n� 1 C1� ress ,City State ZJP,()��I%�t� Distribution: 1) Original — Local Agency File notocopy inis IOrm Ior aaamonal Iums. Phone/ Annual Fax I Gross Description of Portion of Work to be Performed Phon I� Li <$1 million P< $5 million 0'<"$l0 million Fax 0,5 $15 million ❑ > $15 million �] Pho \ ❑<$1 million < $5 million ��� ❑ $10 million Fax <$15 million 3' > $15 million INEW Phone ❑<$1 million $5 million <$10 million Fax ❑ <$15 million �� vL ✓ l�U ❑ > $15 million Phhonee ❑ <$1 million WEl <$5 million <$10 million Fax <,$15 million �� � , r > $15 million Page 12-112 LPP 06-06 November 14, 2006 Exhibit 12-G Local Assistance Procedures Manual Bidder's Fist of Subcontractors (DBE and Non -DBE) n BIDDER'S LIST OF SUBCONTRACTORS (®SE and NON -DBE)- FART 01 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49 Section 26 of the Code of Federal Regulations. Pliotoco this Corm for auaitionai rums. Firin Namle/ Phone/ Annual AddressA,, Fax Gross Description of Portion of Work to be Performed Ci State :SLIP Recei is N e Phon ❑ <$1 million ..- _----_.__.___._....___._.____-___. _._....-....---.......--_.........................__ ........... ❑ < $5 million i . Add, ss ❑ <$10 million 1 1 rA0 J� Fax $15 million --- ---- -- -__ - ................. . E ty State 2 1 i State 121 1QA r ���� ��e�/ ❑>$15million F ' 1(_ � Ph0"`7 1 �y ° � 1 t C�v 01 �1 Name Pf -` Fax State 71P e tI Phone less G �,D UkuW S Fax St to ZI t C q � Distribution: 1) Original — Local Agency File <$1 million n < $5 million <$10 million < $15 million > $15 million <$1 million <$5 million < $10 million <$15 million > $15 million <$1 million < $5 million < $10 million <$15 million > $15 million Page 12-112 LPP 06-06 November 14, 2006 Exhibit 12-G Local Assistance Procedures Manual Bidder's List of Subcontrhetors (DBE and Non -DBE) N �O E;� 11� ' (•'' : i ,. ,�I�� .. I �,. �, i, ti - t'. � � :o i.. �k i ,•, 4 ,�? ''� �� 1:. F- i; �., -i� ` E The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49_ Section 26 of the C.nrle of Federal Remilstinns. Photoconv this form for additional firms. Firm Name/ • i lGross Al City Stqte Phone/ Receivts of Portion 1 1 1 Performed 5 �i� t bF Vai `t .1:+i•�l�Lt •�'I'%�4,'�F -- _. ..,� ! Itli',,pr9 a` -_ , � , wil • • . • ■ • OEME ■ • ■ H..°i..r..�•. v5+a 3": 1 IJhi� �' I�j'°(a�!rt�.�l�{ie�l '. ryl );t �)>, 4111 <rYh7141! l�rrl ir' +;�r . � ' +y ""�i���i ii;: 9 .r— .y� 9�+. -... , t'e,. :lf!',al: we ��U{ 1'1k Vclly �y �I��a;S;;•�b i'l�:iK..t>„ - � � • ' e , III �Ief � j ■ 1 . it ➢ r y � rA : I �ijmi�rlr! e{�111 a* a{ ..,•��`f''+il$�n`^�� �+„�� � $..��sier�ituriY.�sv�. .. ' / � � 11' 1 i5 f� �3. .: � r ;.;i 1 °! 1. a n,. I j , I � '� I �' I ' �., � • i ■ • ■ • ■ 1 \ i I ��� � ° �f� u�'3w.irlr{'el�rli'i11i Jt,?�;Ii�Pt1. i, 1,,•-,`, � utt°�i�'�1�"'"'}i� y^Syy;ilk ) !, Dl l� Ibf7���j'R!j�'j}l�l l I��Wy `;1 1 ?;rd°��T61� ,jI�AFkxr, �I�7°�na.q� `'Csiiviil��7..._.n. tio9 WERE RS ; �' .'+►all • ■ •'E�i. r i5iiull:GN - - --- - LIM 1 , I _ � • i � � ■ - -- -- �,���1�k'r ep �I � ,�.11,a�,l 5 rep � T''S'" N�' >5'. t (}bl fth11P,�.il?�lurl h'�'1pg"rx�y. ,�,I..�� „,i t��,����� err J�Y� �1� r �1�,1� a I�,ts� . R :+F trY ,} t rlllT{ai a "1 r ka 1 ,µ� � 51 ��� 4r�L�Y�� I�`al y �� t'i'A� ` "i •Iv 'F 1'.. Loa1Ln"ur'burMn!%!.. • n161 ■ 1 . •.5 �I' �. l •11 I l ! J t,j ,� 14.... Distribution: 1) Original — Local Agency File' Page 12-112 November 14, 2006 Ll'1? 06-06 Exhibit 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) n N 110 KIDDER'S LOST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 01 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution; 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 f� N Exhibit 12-G Local Assistance Procedures Manua4 Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -OBE)- PART 91 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49 Section 26 of the Code of Federal Regulations. Firm NamW Address/ CM, State ilp Name Photocopy this Corm Phone/ Fax Phone for aaaltionat Annual Gross Recei is ❑ <$1 million < $5 million terms. Description of Portion of Work to be Performed ......__.._.._...... ........_......................................................................,. Address ❑ <$l0 million Fax <$15 million ❑ > $15 million City State ZIP Name Phone ❑ < $1 million < $5 million ❑ <$10 million Address Fax < $15 million Cl > $15 million .._._..._.......-.........__...__..... ....... ............._......................_...._................................... ....... .. City State ZIP Name Phone ❑ <$1 million <$5 million <$10million ................................ . ... ................. I .............. ............... _....... ... ................................._...._............._..... Address Fax ❑ <$15 million City State ZIP ❑ > $15 million Name I Phone I ❑ <$1 million [] <$5 million Address < $10 million Fax < $15 million Ctty State ZIP > $15 million Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 Local Assistance Procedures Manual Exhibit 15-Cl Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: CITY OF HUNTINGTON BEACH LOCATION: HUNTINGTON BEACH PROJECT DESCRIPTION: SLATER AVENUE REHABILITATION TOTAL CONTRACT AMOUNT: $ 1,154,087.75 BID DATE: OCTOBER 15, 2009 [DDER'S NAME: R . J . NOBLE COMPANY CONTRACT UDBE GOAL: TEM OF WORK AND DESCRIPTION OR SERVICES TO BE OR MATERIALS O BE PROVIDED Cert. No. of UDBE AND EXPIRATION DATE NAME OF UDBEs Must be certified on the date bids are opened - include UDBE ddress and phone number) CONTRACT DOLLAR AMOUNT ITEM N0. UDBE —SUBCONTRACTED portion of 7 _ PORTION OF ASPHALT CT-002822 W.C. GOOLBY $103,500.00 OIL 2012 P.O. BOX 489 X 60% _ YORBA LINDA,_(A _ =$62,100.00 92885 _ 858-509-2900 For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation $ 62,100.00 5.3 Contract Award Date: Local Agency certifies that all information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Tele hone Number: X Signidder 10 9 (714) 6 3 7 -15 5 0 Date (Area Code) Tel. No. MICHAEL J. CARVER, PRESIDENT For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3/09) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-31 LPP 09-xx C-21 RECD OCT 2 0 2009 March 27, 2009 W.C. . 970 N. Tustin Avenue; Suite 102, Anaheim, CA 92807-1276 (Nailing Address: P. O. Box 489, Yorba Linda, CA 92885-0489 ASPHALT QUOTE PATTY GOOLSBY CAL TRANS CERTIFICATION #002822 CUCP FILE # 17202 DATE: 10-15-09 COMPANY: R. J. Noble FAX NUMBER: 714 637-6321 PROJECT: City of Huntington Beach ESPL 5181(166)-Slater Avenue Approx. 230 Tons Liquid Binder PG 64-10 @ 450.00 Per Ton Freight @ 20.00 Per Ton + FSC EX ALL TAXES -Office: (800) 839-9697 -Fax: (858) 509-2900 RECD OCT 2 0 2009 Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: CITY OF HUNTINGTON BEACH LOCATION. HUNTINGTON BEACH PROJECT DESCRIPTION: SLATER AVENUE REHABILITATION TOTAL CONTRACT AMOUNT: $ 1,154,087.75 ID DATE: OCTOBER 15, 2009 BIDDER'S NAME: R . J . NOBLE COMPANY ITEM OF WORK AND DESCRIPTION R SERVICES TO BE OR MATERIALS O BE PROVIDED DBE Cert. No. AND EXPIRATION DATE NAME OF DBEs Must be certified on the date bids are opened - include DBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. DBE —SUBCONTRACTED 14,22,23 LOOPS, ELECTRICAL CT-031176 GLOBAL ROAD SEALIN $T9, 02-01-10 10832 DOROTHY_AVE GARDEN GROVE, CA _ 92683 714-893-0845 For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation $ 19,455.00 1.6 ontract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Tele hone Number: X — re of Bidder 10 / 15 / 0 9 (714) 6 3 7 -15 5 0 Date (Area Code) Tel. No. MICHAEL J. CARVER, PRESIDENT For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/09) , Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page15-32a LPP 09-xx C-26 RECD OCT 2 0 2009 March 27, 2009 10/19/2009 11:24 AM FROM: GRSI 714-893-0945 TO: 7146376321 PAGE: 001 OF 001 GLOBAL ROAD SEALENG INC 10832 Dorothy ave, Garden Grove ,Ca 92843. LIC. #757584 Ph: (714) 893-0845 FAX (714)893-0945 Subcontract Quotation Project: Slater ave Rehab Location: City of Huntington beach Bid Date/Time: 10-15-09 @ 2:00 pm Item Description Quantity Unit Price Extenstion 14 Traffic loops 33 185.00 6,105.00 22 Remove and Install new Traffic Sig PB 6 400.00 2,400.00 23 Modify traffic signal and conduit 1 LS 10,950.00 PRICES ARE GOOD FOR 45 DAYS FROM THE DATE OF THIS PROPOSAL INCLUSIONS: 1 Install traffic loops 2 remove and install new traffic signal Pullbox 3 modify traffic singal and conduit per plan 4 traffic controll EXCLUSIONS: - Insurance premium in excess of $2 million, bond premium - utility permits and fees, inspection fee, advance sign posting of any kinds, weekend work - notify resident, and any items not specifically included under inclusion section. Estimator: Tri La Two weeks notice required for scheduling REM OCT 2 0 2009 , FedEx Ship Manager - Print Your Label(s) Page 1 of 1 From: Origin IU: FULA (f14) 6J/-15bU Ship Uate: 19UGIU9 Jennifer De longh ® AcOgt: 1.0 LB R J Noble Company 1�1-e9 CAD: 5293310ANET9090 AccountS .... 15505 E. Lincoln Ave. ® Delivery Addresres s Bar Code Orange, CA 92865 msaoom73+-1 11�1111[11111111 I I I I1111111111 Ref # Slater Ave 111 SHIP TO: (714) 374-1619 BILL SENDER Jim Wagner Invoice# City of Huntington Beach 2000 MAIN ST Dept # HUNTINGTON BEACH, CA 92648 0 0# 7960 4545 7788 TUE - 20OCT Al STANDARD OVERNIGHT I 1 r 92648 �� I WZ A PVA SNAS After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing, charges, along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic valueof the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $500, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. Global Home I Small Business Center I Service Info I About FedEx I Investor Relations I Careers I fedex.com Terms of Use I Security & Privacy I Site Map This site is protected by copyright and trademark laws under US and International law. All rights reserved.© 1995- 2009 FedEx RECD OCT 20 Z009 https://www.fedex.com/shipping/confirmAction.handle?method=doContinue 10/19/2009 TRAVELERS CASUALTY AND SUIRETY COMPANY OF AMERICA Hartford, Conniecticut 06183 Bond No. N/A KNOW ALL MEN BY THESE PRESENTS, That we, R.J. NOBLE COMPANY as Principal, hereinafter called the Principal, and TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, of Hartford, Connecticut, a corporation duly organized under the laws of the State of Connecticut, as Surely, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH 2s Oh!!aea, Here!^af!Pr called the nbrn P in ... c��m or TEN PERCENT OF THE AMOUNT OF THE BID Dollars ($ 10% OF BID ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for SLATER AVENUE REHABILITATION FROM GRAHAM ST. TO GOLDENWEST ST. NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of tabor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Coniract and give such bond or bonds, if the Frinc:ipai shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform fire k4%'o& covered by said bid, then !his obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 8TH day of OCTOBER (Witness) (Wilness) , 2009 R.J. NOB COMPANY (Principal) (seal) CHAEL J. CARVER, PRESIDENT (Title) TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA 0 M CHAEL D , - S G ttorriey-in Fad} Printed in cooperation with the American Institute of Architects (AIA) by Travelers Casualty and Surety Company of America. The language in this document conforms exactly to the language used in AIA Document A310, February 1970 edition. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ?aC:c�> c,:t..s�C!-�25:'%�>.:a.'v: �S�S;v1>,�a'.s�.,�S;�;S.c.S.!s�S 5,�. pa.'v.�aS S S..a�C M;t;�S;tA.�.•�S.:�ti,c�v!c�S�.,�1, a�DS,!ciS���,.c�vaDS;� S,y,S.y2S.i�.Yc4L ��. State of California County of ORANGE On 10 / 0 9 / 0 9 before me, JENNIFER DE IONGH, NOTARY PUBLIC Date - Here Insert Name and Title of the Officer personally appeared MICHAEL J . CARVER Name(s) of Signer(s) 4 JENNIFER DE 15NGH Commission # 1771186 z . - Notary Public - California z Z Orange County My Comm. Expires Oct 28, 2011 who proved to me on the basis of satisfactory evidence to be the personjj whose name/fs) War,&subscribed to the within instrument and acknowledged to me that helfgheAhey executed the same in his/l;o4their authorized capacityliesj, and that by his/l;@;#wirr signature�fff on the instrument the personA, or the entity upon behalf of which the personV acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS y hand ano offici seal- Signa e _ Place Notary Seal Above p7•�/ p� q � nature of Notary Pubtic O (1ONA Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual 17 Corporate Officer — Title (s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact O Trustee Guardian or Conservator Ci Other: Signer Is Representing: RIGHTTHUMBPRINT' _tOP;SIGNM; _ Top of thumb here Number of Pages: Signer's Name: O Individual ❑ Corporate Officer— Title(s): _ O Partner — D Limited ❑ General 0 Attorney in Fact O Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: `RIGHTcTHUMBPRINTR DO SIGNER - I Top of thumb here ©2007 National Notary Association• 9350 De Soto Ave., P.O. Box 2402-Chatsworth, CA 91313-2402-www.NationaiNotaryorg Item#5907 Reorder: Call Toll -Free 1-8004376-6527 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of RIVERSIDE On kCl before me, R. NAPPI "NOTARY PUBLIC" (Here insert name and title of the officer) personally appeared MICHAEL D. STONG who proved to me on the basis of satisfactory evidence to be the person•(.a'jwhose name(sf is/are subscribed to the within instrument and acknowledged to me that he/sheMwy executed the same in his/heFA4wir authorized capacitykic4 and that by hisAw441agir signature(<on the instrument the person,K, or the entity upon behalf of which the persongacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. �— R. NAPPI COMM. #1796916 ie Cr NOTARY PUBLIC - CALIFORNIA cc RIVERSIDE COUNTY Signature of Notary Publi (Notary Seal)Expires June 7, 2012 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exacrty as appears above in the notarp section or a separate arknowledgnrent form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances. any alternative acknmwledgment verbiage as may be printed at such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the aulhod:ed copaci), of the signer). Please check the document carefully for proper notarial warding and attach this form tf required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. ketshrJd+ey- is tare ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary)- • Securely attach this document to the signed document 2008 Version CAPA 02.10.07 800-873-9865 trlvw.NolaryClasses.com POWER OF ATTORNEY TRAVELERS J Attorney -In Fact No. -),)1100 Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. Seaboard Surety Company St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company Certificate No. 0 0 3 0 419 5 7 KNOW ALL MEN BY THESE PRESENTS: That Seaboard Surety Company is a corporation duly organized under the laws of the State of New York, that St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Michael D. Stong, Shawn Blume, Rosemary Nappi, and Jeremy Pendergast of the City of Riverside , State of California , their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument.to-be signed and their, corporate seals to be hereto affixed, this 2nd day of June 2009 Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. Seaboard Surety Company St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company or.su,� suFlEr YNW SUg(n,"'^"ruWtEOrne1 � i"i 105 .7G N0.mot.COPUI. 1951 N,O �,SEALio; •o:SEAL:��= �, o 9�' # wxtis� cc° d�-........i a•!�r d:•..,, OFt�`N �+om M�nm� ls`� AN�..� !g ..'.. t� 61 'Na t • r� � Attu M State of Connecticut City of Hartford ss. By: Georg Thompson, enior ice President On this the 2nd day of June 2009 before me personally appeared George W. Thompson, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., Seaboard Surety Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. G.TET In Witness Whereof, I hereunto set my hand and official seal. s�i WJ w" • _ V My Commission expires the 30th day of June, 2011.e Marie C. Tetreault, Notary Public 58440-5-07 Printed in U.S.A. WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER City of Huntington Beat 2000 Main Street • Huntington Beach, CA. 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK February 11, 2010 Elite Bobcat Service, Inc. 1320 E. Sixth, Suite 100 Corona, CA 92879 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest St. Enclosed please find your original bid bond for CC-1359. Sincerely, I � 0 "-Jr4c) Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister CR/M'OiiS��rAe4rWgYfga4PE� New Zealand �'1 (Telephone: 714-536-5227) - ELITE BOBCAT SERVICE GENERAL ENGINEERING 1320 E. SIXTH, SUITE 100 • CORONA, CA 92879 Tel: (951) 279-6869 • FAX: (951) 279-6832 City of Huntington Beach City Cleric 2000 Main St, FL 2 Huntington Beach, CA 92648 LO Lo _-_ r_ _. i ..� G5l SEALED BID FOR Slater Avenue Rehabilitation Project No. 1359 t � Z SECTION C )PROPOSAL for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE � COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature 1 09/24/2009 C-2 SECTION C PROJECT BID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENVVEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STFL-5181 (166) BASF BID: TOTAL AMOUNT BASE BID IN FIGURES: $ TOTAL AMOUNT BASE BID IN WORDS: oxj� 11 Tw�✓l d�/ r� c�Sa�(L c1. (� inu� Scc,k- 44, i 4 C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1359 :: ..:.:.:.:::....:.:.:..........:.:..:.:.::.....:.:.:.................................. stiuiaYe :::::::::::::::::rice;::....................... :::::;:;:;:;:;:;:;:::;:;:;:::;::::: ............................................................................ ::::::::::::::::::::::1i F:uteri:�tt: Pk Ards :::':::=:: :::............::::.:::::�7�...�!t'.C.. .... zfi... a .. . ...A1t11� ou ' :: 1 1 Mobilization LS @ l�e�-�r ��tlG I�ww;a o Dollars $ Ua0 06.0� $ Z� Cents Per LS 2 1 Traffic Control Plan LS @ thpU-art,� Dollars $ 9,7oo $ 51700_ Cents Per LS 3 1 Furnish Project Traffic Control LS @ ro Hvt,'�tg'Dollars $ �O!/y®U' $ �Cl O Cents Per LS 4 96430 SF Cold Milling & Header Cutting incl. disposal of material @ Dollars $ Zo $ L-5' doe t'Qea(•� ) Cents Per SF S 195300 SF Surface Grind (0.1 T) including dipsosal of material @ Dollars ) vveL'X0 Cents Per SF 6 1325 Unclassified Excavation CY @ %wci(. k 5i X Dollars $ $ Cents Per CY 7 5040 Construct Asphalt Concrete (0-0.IT, 0.1T, 0.42' & 0.50') Ton @ on e— Dollars $ $ Cents Per Ton 8 6015 Construct Asphalt Concrete (0.1 T ARHM Overlay) Ton @ �rdevtfk Dollars $ 5 $ 11394015 Cents Per Ton 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface EA @"St �C v.�tic GCS ��' qk-k C: J C_ Dollars $ �y $ J 7S Cents Per EA 10 16 EA Adjust OCSD Manhole to finished surface @ �1 @I�i� Hu���e6 �'�eVi� Cci�e Dollars $ `dZ6 $ 15 ZA Cents Per EA PROJECT BID SCHEDULE Slater Avenue, CC-1359 S . .. afe .::.:' ..::............ i ....... ..... rtce::::::::::::::::::: :::;::.::::::::::::::_::::::::::::::::: P.........................................I............................. tii :: Q�da>n.. ty ..... ... uteri ` .or ::::::::::::wlr .....><».vr...ds..:::::::::::::::::::::::::::::::TTan�t...x :F'.' e::;:::::.:.. ►c......... ou..:. rta... nt .: : 11 21 Adjust Water Valve to finished surface EA @ 6'Je AtAv A2,ze,> �t k - Dollars $ $ t Cents Per EA 12 1 Adjust Monitoring Well to finished surface EA @ 1/tt1C ky.X-Jce,k f_IT-�-Y Dollars Cents Per EA 13 1 Traffic Striping I @ n61 �?LS sb© $ Z 7 sum Cents Per LS 14 33 Traffic Loop EA @6k, kbWttl XC'e6 Dollars Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, P Slot 15 1830 Pave per Std Plan 202) LF @ 7hl,rl Sr lwc, Dollars Cents Per LF 16 15155 Remove & Reconstruct Sidewalk per Std Plan 207 SF @ r, ve, Dollars $ $ 76, Cents Per SF Remove & Reconstruct/ Access Ramp (Intl. Depressed C&G, Retaining 17 12 Curb, F Slot pave, & SW) EA @ %utA {L'Cl SGUl't L {Lt��(1�� Dollars $z7ob$ Cents Per EA 18 4 Install Truncated Domes into existing Access Ramp EA @ 3 SC'y s CC Dollars $ oo $ z4o� d Cents Per EA 19 13 Survey Monumentation EA @ /tP rt[AP4" l;ryrgI. Q,- t Q if Dollars $ 7-5 Cents Per EA 20 1 EA Raise Survey Well Monument to finished surface @ r ht n-_ � lt�`lt�� �i t�k k Dollars C $ > $ 3�0_ Cents Per EA PROJECT BID SCHEDULE Slater Avenue, CC-1359 Iterii: ; st�iriafe : .....: ;......::. t.....vi... u�i�1..:i icc::::::: : ::::>.>.::::: ; :>:;:.:;:::.::«;::::::::.:> P ::..;:::;;: EXten ed':: ' ualiti<ty::' .........................................:................................................................. :>::.:;> ::::..? wtte n words . >..................... ;. .. .....a 'oee :? 21 1654 Remove & Reconstruct Curb & X-Gutter SF @ ytLae' Dollars $ pp $ C� Cents Per SF 22 6 Remove & Install New Traffic Signal Pullbox EA @ oua- YL'aJ.&A, �Weg i'k Dollars $ ��� $ Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-1-T frame. Install city furnished traffic signal head with LE-SV-1-T framework and terminal box. I ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. I ea o Install conduit into existing pullbox. 1 ea. o Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. tea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1-12 conductor cable and 1-3 conductor cable. 1 ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. I ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. 1 ea o Abandon existing conduit and remove conductors. I ea o Install 3" conduit into existing pullbox. 1 ea o Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cableandDLC's into traffic signal cabinet. 1 ea. LS @ ((U)M fk0VAe Vz,4 1 4eC VtcxA1 4QA Dollars $ !J® $ e Cents per LS Total Amount Bid in Figures: $ 14 )z3 3� 7-0 Total Amount Bid in Words: 0) Y� �s � %w� -- ----------- -� ------------------------------------------- --- - --- - b-� ' LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the naive and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class 7-3 4 WbA Roa�, .5,fAu .,-&c_ you c 7 7,59t( C [3 776 30 4 L 4 ►o it 141Z7W A S� ���,4mettc a5 'Z(,-70? /1c By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOI.LUSION AFFIDAVTT TO BE EXECUTED BY BIDDER AND SUBMITTED T'TED WITH BID State of California ss. County of Orange Joseph Nanci , being first duly sworn, deposes and says that he or she is President of Elite Bobcat Service, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged inforination or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Elite Bobcat Service, Inc. Name of Bidder Signature of Bidder Joseph Nanci 1320 E 6th St # 100, Corona, CA 92879 Address of Bidder Subscribed and sworn to before me this day of , 200 _ NOTARY PUBLIC NOTARY SEAL C-4 State of California County of Riverside On October 14, 2009 before me, Jeff Lee, a notary public, personally appeared Joseph Nance, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my han4 and official seal. Signature UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is, familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 10/ 14/2009 Elite Bobcat Service, Inc. Contractor By Joseph Nanci Title President C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? 0 Yes L(No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 10/14/2009 Elite Bobcat Service, Inc. Contractor 121---e By Joseph Nanci President Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Pen -nit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor I1 Title Date: Note: This form is requiredfir for every Dig Alert Identification Number issued by U.S.A. during the course. of*the Work. Additional forms may be obtained.fi•onz the AGENCY upon request. C-8 BIDDER'S INFORMArTION BIDDER certifies that the following information is true and correct: Elite Bobcat Service, Inc. Bidder Name 1320 E 6th St #100 Business Address Corona CA 92879 City, State Zip ( 951 ) 279-6869 Telephone Number 720016A State Contractor's License No. and Class 03/1994 Original Date Issued 03/31/2010 Expiration Date The work site was inspected by Joe Nanci of our office on October 7 12009 The following are persons, firms, and corporations having a principal interest in this proposal: Joseph Nanci, President C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Elite Bobcat Service, Inc. Company N Signature of Bidder Joseph Nanci Printed or Typed Signature Subscribed and sworn to before me this — day of , 200� NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has perfonned similar work within the past two years: 2 3. City of Corona 400 S Vicentia Ave Ste 125, Corona, CA 92882 Name and Address of Public Agency Name and Telephone No. of Project Manager Linda Abushaban (951)739-4960 $2,738,209 Median Island Improvements 06/2009 Contract Amount Type of Work Date Completed of Walnut Naive and Address of Public Agency 21201 La Puente Rd, Walnut, CA 91789 Name and Telephone No. of Project Manager: Jason Welday (626) 331-8323 $1,584,665 Street Improvements 05/2009 Contract Amount Type of Work Date Completed City of Loma Linda 25541 Barton Rd, Loma Linda, CA 92354 Name and Address of Public Agency Name and Telephone No. of Project Manager: Jarb Thaipejar (909) 799-4400 _ $451,000 Street Improvements 04/2009 Contract Amount Type of Work Date Completed C-] 0 3M M State of California County of Riverside On October 14, 2009 before me, Jeff Lee, a notary public, personally appeared Joseph Naanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my d and official seal. Signature �N-4 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): //t�Will ensure that 10% of all new hires as a result IV of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. X_'Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Elite Bobcat Services, Inc. Contact Person: Joe Nanci Contact Phone: (951) 2 -6869 Signed: Joseph Nanci Date: October 14, 2009 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Elite Bobcat Service, Inc. , proposed subcontractor hereby certifies that he has, has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a• report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 r vn m-nd ("_t7. March 15, 2001 PUBLIC COACT CODE Public Contract Code Section 10285.1 Statement . conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares ider penalty of perjury under the laws of the State of California that the bidder has — , has not been convicted ithin the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, )nspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, • performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as ;fined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the alifornia State University. The term "bidder" is understood to include any partner, member, officer, director, responsible anaging officer, or responsible managing employee thereof, as referred to in Section 10285.1. ote: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire L conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following iestionnaire: as the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been squalified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project ;cause of a violation of law or a safety regulation? Yes No V the answer is yes, explain the circumstances in the following space. !`_ 1 'i Public Contract Coyle 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. f4 1A Local Assistance Procedures Manual PS&E Checklist Instructions Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. EXHIBTI' 12-E Attachment ID In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note; The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 d,PP 01_n4 r-19 March t_5. 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; a Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; 0 Does not have a proposed debarment pending; and S Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15. 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F N®NL®BBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 r_17 March 15. 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES FORM YU DISCLOSE 1. Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: ❑ a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) EXHIBIT 12-E Attachment G 1'UKJUANI 1VJ1 U.J.L. rJJL 3. Report Type: a. initial b. material change For Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I0a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) $ ® actual planned 12. Form of Payment (check all that apply): a. cash b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a, retainer b. one-time fee a commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including offrcer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ® No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: Joseph Nanci U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: President person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than 279-6869 $100,000 for each such failure. Telephone No.: (951 ) Date: 10/14/09 Federal Use Only: Authorized for Local Reproduction Standard Form - LLL Form LLL Page 12-87 LPP 01-04 C:-18 March 15. 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request. for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00 L" 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15. 2001 C`_t U LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officers) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL Ins"etions Rev. 06-04-90«ENDIFu Page 12-89 I,PP 01-64 t~-20 March 15, 2001 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY. City of Huntington Beach LOCATION: Huntington Beach, CA PROJECT DESCRIPTION: Slater Avenue Rehabilitation Z C7 TOTAL CONTRACT AMOUNT: S Zee 3 BID DATE: October 15, 2009 IDDER'S NAME: Elite Bobcat Service, Inc. CONTRACT UDBE GOAL: 3.55% ITEM OF WORK AND DESCRIPTION R SERVICES TO BE OR MATERIALS O BE PROVIDED Cert, No. of UDBE AND EXPIRATION DATE NAMEOF UDBEs Must be certified on the date bids are opened - include UDBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. UDBE —SUBCONTRACTED ZZ. za t4 Ladr.5 a 5 CZ S IL 1, i 6, G Q l Qo 15 c Y. For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: ederal Share: Total Claimed Participation $ g 44 i •'d Contract Award Date: Local Agency certifies that all information is complete and accurate. Tint Name Signature Date Local Agency Representative (Area Cod!2 Telephone Number: Signature of Bidder Joseph Nanci 10/ 14/2009 (951) 279-6869 Date (Area Code) Tel. No. Joe Nanci For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3/09) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. eauure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-31 I mn nn ... �+_ f 1 March 27.2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ffgm��.� PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27. 2009 C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-II UDBE INFORMATION --GOOD FAITH EFFORTS Federal -aid Project No. ESPL-5181 (166) Bid Opening Date 10/15/2009 The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of 3.55 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to -meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of Initial Solicitation Follow Up Methods and Dates California Professional 10/13/2009 Phone - 10/15/2009 Electrical Engineering, Inc. Loop Masters, Inc. 10/13/2009 Phone - 10/15/2009 Super Seal & Stripe, Inc. 10/13/2009 Phone - 10/15/2009 Payco Specialties, Inc. 10/13/2009 Phone - 10/15/2009 C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4, 2009 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBE Information - Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names,- addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Page t5-34 March 4, 2009 LPP 09-xx C-24 ]Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort Name of Method/Date Results Agency/Organization of Contact H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-xx March 4, 2009 ("'-25 Tuesday, October 13, 2009 Dear California Professional Electrical Engineering, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Slater Avenue Rehabilitation" bid that takes place on October 15, 2009 @ 2:00 PM. We would be interested in receiving a quote from you along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee G INC. ELITE fiCt8L475E R1�I�E EBS 1320 E. 6th St # 100 Corona, CA 92879 (951) 279-6869 (951) 279-9112 FAX TRANSMISSION VERIFICATION REPORT TIME 10/13/2009 18:08 NAME EBS FAX 9512799112 TEL 9512799112 SER.# BROE8J807087 DATE DIME 10/ 13 18: 08 FAX NO./NAME 16264480470 DURATION 00:00:14 PAGE(S) 01 RESULT OK MODE STANDARD ECM Tuesday, October 13, 2009 Dear Loop Masters, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Slater Avenue Rehabilitation" bid that takes place on October 15, 2009 @ 2:00 PM. We would be interested in receiving a quote from you along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee INC, ELRE 110 €.{T SERYI€E EBS 1320 E. 6th St # 100 Corona, CA 92879 (951) 279-6869 (951) 279-9112 FAX TRANSMISSION VERIFICATION REPORT TIME 10/13/2009 18:07 NAME EBS FAX 9512799112 TEL 9512799112 SER.# BROE8J807087 DATE,TIME 10/13 18:07 FAX NO./NAME 17146301783 DURATION 00: 00: 19 PAGE(S) 01 RESULT OK MODE STANDARD ECM Tuesday, October 13, 2009 Dear Super Seal & Stripe, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Slater Avenue Rehabilitation" bid that takes place on October 15, 2009 @ 2:00 PM. We would be interested in receiving a quote from you along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee c, INC. ELITE 11 -SE!!! atfitfiAi EBS 1320 E. 6th St #100 Corona, CA 92879 (951) 279-6869 (951) 279-9112 FAX TRANSMISSION VERIFICATION REPORT TIME 10/13/2009 18:06 NAME EBS FAX 9512799112 TEL 9512799112 SER.# BROE8J807087 DATE DIME 10/ 13 18: 05 FAX NO./NAME 18055247428 DURATION 00: 00: 13 PAGE(S) 01 RESULT OK MODE STANDARD ECM Tuesday, October 13, 2009 Dear Payco Specialties, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Slater Avenue Rehabilitation" bid that takes place on October 15, 2009 @ 2:00 PM. We would be interested in receiving a quote from you along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YIES NO COMPANY NAME Thank you, Jeff Lee E� INC. ELITE Ed7@GRT3EkYI€E r,'M &Ai tNd1 iffifl:Wd EBS 1320 E. 6th St #100 Corona, CA 92879 (951) 279-6869 (951) 279-9112 FAX TRANSMISSION VERIFICATION REPORT TIME 10/13/2009 18:04 NAME EBS FAX 9512799112 TEL 9512799112 SER.# BROEBJ807087 DATE DIME 10/13 18:04 FAX NO./NAME 16194271620 DURATION 00:00:14 PAGE(S) 01 RESULT OK MODE STANDARD ECM Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: City of Huntington Beach LOCATION: Huntington Beach, CA PROJECT DESCRIPTION: Slater Avenue Rehabilitaton ? .ZU TOTAL CONTRACT AMOUNT: BID DATE: October 15, 2009 BIDDER'S NAME. Elite Bobcat Service, Inc. ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBE Cert. No. AND EXPIRATION(Must DATE NAME OF DBEs be certified on the date bids are opened - include DBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. D13E For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation $ ' Contract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. LocPrint Name Signature Date al Agency Representative Area Code Telephone Number. Signature of Bidder Joseph Nanci 10/15/2009 (951) 279-6869 Date (Area Code) Tel. No. Joe Nanci For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3109) , Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DL.AE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a T vm flQ_vv r-76 March 27, 2009 1 . k . ..1 I Exhibit 15-G2 Local Assistance Procedures Manual Focal Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER OBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL, BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit I5G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. L®CBI agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b nq hnnn lf+ -117 i.PP no-yy Bidder's List of Subcontractors (DBE and Non -DBE) - A BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Phone/ Annual Address/' Fax Gross --TDescription of Portion of Work to be Performed, Ci State �12 Receipts Name Phone ❑ < $i million �/X f j + (� Q------------ --- - -- - -- -- r Ltt©�?Ce ` l`C�l�Y� Z fLl 7� d� (] <$5 million i` �0.� y�L)<� ----- `� rm Address < $10 million i�z �O�v' r►i C Fax ❑ <$15 million City State ZIP 7( ❑ > $15 million tL(T. Name Phone O <$1 million jit��CtoC-�ay n� rlcin Zf`t SQL 9fi� <ssmillion Address ❑ <$10 million. f ' �1 l�Lcl`jCi fG(G Fax ❑ <$15 million ---- R City State ZIP -9(�i 4611460 > $15 million Name Phone ❑ <$1 million ` qSt ZTi`i G4��� �aYL ko (e-5 --- - F- 6 M.M ha ju t < $S million —� Address i <S10 million 13ZO % S't A 5 tG /G m Fax efrl 0 < $l5 million ---- ---- t C1 State ZIP ?� r 1(Z ❑ > $15 million ro el CA- CA Name Phone ❑ <$I million < 55 million Address ❑ <$10 million FaxC1 <$15 million Citv.4tnre 71P ❑ > $15 million , £f Dlstributlon: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14,2006 Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49 Section 26 of the Code of Federal Re lations Photoconythis form for additional firms. - FirmNaml / Phone/ Annual Addressll Fax Gross Description of Portion of Work to be Performed���- CI State '`LIP ]Receipts Name 16, St ncc Phone <$1 million ❑ <$5 million ❑ <$10 million � t il­ Address f' Fax < $15 million "+ CityState ZIP ❑ > $15 million mc�5 Ck g 17Z3slow Name Phone E0 < $ l: million �_.., ....... _.._ __-._.___ .___._............. ...... � . (� (J� t < $S million __- ----- - -- - -- - h r aD ra Address Cl <$10 million Fax c S15 million - --- — -- .............. __... _..-.. 1 City State ZfP > $15 million ; f' y Name Phone (]-e$1 million �. tom' . • ;�;:�. j < $5 million ❑ <$10 million . ------ -_ . . Address Fax ❑ <$15 million -- city state ZIP ❑> $15 million - -- � t - Name Phone ❑ < $1 Million --_._ -.-.._ �� � �• ) Q <$S million Address 0 <$10 million -------_____._...... --- Fax <$15 million - -- -^ ^- -- City State Z(P > $15 million --__---_ Distribution: 1) Original - Local Agency File Page 12-112 LPP 06-06 November 14, 2006 i ,'. . , f v City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET,. C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Surrey staking shall be provided by Contractor" to "Surrey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Surrey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Number One, ted September 24, 2009 Elite Bobcat Service, Inc. Company Name By Joseph Nanci October 14, 2009 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. A. , ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 point is typically a 3 3/4" aluminum disk with said agency's stamping. Datum information for public viewing is on file at said agency. A survey monument is defined as any permanent point as shown on file at the NGS, NOAA, Caltrans, OCS, City of Huntington Beach Public Works Department or any other public agency; said point being used to establish or perpetuate horizontal control. These points include but are not limited to centerline street monuments or accessories to said centerline street monuments (i.e. tie points), property corners or accessories to said corners, or monuments established in connection with the Orange County Geodetic Control Network or accessories to said monuments. These points shall be tied out and replaced by a licensed Land Surveyor or a licensed Civil Engineer authorized to practice land surveying pursuant to sections 8700 to 8806 of the Business and Professions code of the State of California (Land Surveyors Act). The Corner Records produced from said tie -out and replacement survey shall be furnished to the City of Huntington Beach Public Works Department as well as filed with the office of the County Surveyor indicating responsible charge (stamped), within 60 days of the final survey. 2-9.2 Survey Service [Replace the first paragraph with the following] All construction surveying will be performed by the AGENCY. Monument preservation surveying necessary to complete the work shown on the plans and provided for in these contract documents and specifications shall be accomplished by or under the direction of a licensed Land Surveyor or Professional Engineer, whom is authorized to practice land surveying, retained or provided for by the Contractor. The AGENCY reserves the right to direct additional construction survey to be performed when it feels it is required to adequately construct the work. All costs to the Contractor for protecting, removing, restoring, repairing, replacing, or reestablishing monuments or accessories to monuments or costs associated with the preparation or filing of Corner Records pursuant to sections 8700 to 8806 of the Business and Professions Code shall be included in the bid item for survey monument preservation. Payment for survey monument preservation shall be per the contract lump sum bid price and no additional compensation will be allowed therefor. When the contract does not include a pay item for monument preservation and unless otherwise provided in the specifications, full compensation for all monument preservation required to complete the work shall be included in the price bid for other items of work and no additional compensation will be allowed therefor. E-5 CC-1359 Slater Avenue Addendum 1 Department Consumer Contractors oard Contractor's License Detail License-l-W DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 714._6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7471.17, only construction related civil judgments reported to the CSLB are disclosed. "Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number: 720016 Extract Date: 10/15/2009 ELITE BOBCAT SERVICE INC Business Information: 1320 E SIXTHE ST #100 CORONA, CA 92879 Business Phone Number: (909) 279-6869 Entity: Corporation Issue Date: 03/13/1996 Expire Date: 03/31/2010 License Status: This license is current and active. All information below should be reviewed. The license may be suspended on 10/28/2009 if the workers' Additional Status' compensation insurance policy is not filed with the CSLB. CLASS DESCRIPTION Classifications: A GENERAL ENGINEERING CONTRACTOR ..... - ........ --- .. CONTRACTOR'S BOND This license filed Contractor's Bond number 134033 in the amount of $12,500 with the bonding company AMERICAN CONTRACT ORS_INDEMNITY COMPANY,. Effective Date: 01/01/2007 Contractor's Bonding-Hist"r BOND OF QUALIFYING INDIVIDUAL Bonding: I The Responsible Managing Officer (RMO) JOSEPH ANTHONY NANCI certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 03/13/1996 This license has workers compensation insurance with the SEA -BRIGHT INSURANCE COMPANY Workers' Policy Number: BB1071560 Compensation: Effective Date: 09/28/2007 Expire Date: 09/28/2009 Workers' Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. ConditionsofUse I Privacy- Policy Copyright@ 2009 State of California Contractor's License De•rcq j t.., 267073 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should.be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7.124._6). If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17, only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number: 267073 Extract Date: 10/15/2009 ALL AMERICAN ASPHALT Business Information: P O BOX 2229 CORONA, CA 92878 Business Phone Number: (951) 736-7600 Entity: Corporation Issue Date: 01/19/1971 Expire Date: 01/31/2010 License Status: This license is current and active. All information below should be reviewed. CLASS DESCRIPTION Classifications: A GENERAL ENGINEERING CONTRACTOR C12 EARTHWORK AND PAVING CONTRACTOR'S BOND This license filed Contractor's Bond number 08727441 in the amount of $12,500 with the bonding company FIDELITY AND DEPOSIT COMPANY OF MAR.YLAND. Effective Date: 01 /01 /2007 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL 1. The Responsible Managing Officer (RMO) DANIEL Bonding: DAYTON SISEMORE certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Effective Date: 01/12/2000 BQI's Bonding History This license has workers compensation insurance with the SEABRIGHT-1 NSU RANC E. CO-M PANY Workers' Policy Number: BB1090243 Compensation: Effective Date: 08/01/2009 Expire Date: 08/01/2010 Workers' Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses. Conditions -of-Use I Privacy Policy @ Copyright 2009 State of California Bond No. --------08739262. -------------- Fidelity and Deposit Company POST OFFICE BOX 1227 OF MARYLAND KNOW ALL MEN BY THESE PRESENTS; That we, _________ Elite Bobcat Service, Inc_ BALT7MORE, MD 21203 --_----------------------- ----------_-------_- ._.—---__-•_- as Principal, (hereinafter called the "Principal"), and ,the FIDELITY AND DEPDSI7- COMPANY OF MARYLAND, P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly —organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto ----City of Huntington Beach Obligee, (hereinafter called the "Obligee"), ten percent of amount bid _ _ Dollars 10 0 in the sum of_ ------------ ($-------- ---- - for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for- Slater Avenue Rehabilitation _---------_ _ Project No. 1359 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this--_-_ A D 2009 g _..---12th October ------- --�_ day of_—_--____.------------------------ Elite Bobcat --Service, Inc__• ---- (SEAL.) Principal Witness BY.* Ab-t� BLS\�j� -'� --- - — SOS�ph �ovwC\ FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety - - - - --- ---- -- - By., - (SEAL) Witness ATT RNEY-,.N-FACT Title c325f-50M. 7-92 Richard A. Coon Cn rm o Amcr:caa buthute of A�hk=U Doc.W& µ A-310.. . Fcbnmrp 1970 FAW00. - - s CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On 10/12/09 Date before me, Lexie Sherwood, Notary Public , Here Insert Name and Title of the Officer personally appeared Richard A. Coon Name(s) of Signer(s) LEXIE SHERWOOD COMM. #1856389 NOTARY PUBLIC *CALIFORNIA ORANGE COUNTY Comm. Exp. JULY 27, 2013 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct - Witness my hand and official seal. Signature Place Notary Seal Above Signature o ry Publi OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name. - El Individual ❑ Corporate Officer — Title(s):_ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here 0 2007 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 - Chatsworth, CA 91313-2402 - www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1-500-876-6827 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said Company, are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date h e cfds by nominate, constitute and appoint Richard A. COON, Charles L. FLAKE, David L. CULB + n e S OOD, all of Anaheim, California, EACH its true and lawful agent and a W d deliver, for, and on its behalf as surety, and as its act and deed: any an o n xecution of such bonds or undertakings in pursuance of these prese l in i as fully and amply, to all intents and purposes, as if they had been d U t ac h ularly elected officers of the Company at its office in Baltimore, Md., p Per o attorney revokes that issued on behalf of Richard A. COON, Charles L. FLAKE, ew P_ FLAKE, Lexie SHERWOOD, dated November 7, 2005. The said Assistant es eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By- s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of November, A.D. 2006. ATTEST: 'gyp DfPps�t a o ✓ lOs9 i 4,wn� State of Maryland ss. City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND 9, '_ '3, / � X 1� Eric D_ Barnes Assistant Secretary By: William J. Mills Vice President On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland; duly commi-_L ;,iic: aid qualified, cane WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal'of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn Notary Public My Commission Expires: July 14, 2011 POA-F 012-4150H State of California County of Riverside On October 14, 2009 before me, Jeff Lee, a notary public, personally appeared Joseph Nanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my hand and official seal. Signature ti q5%�o y9, (Seal) so� QJNN G0 City ®f Huntington Beat 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK February 11, 2010 Hardy & Harper, Inc. 1312 E. Warner Ave. Santa Ana, CA 92705 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest Ste Enclosed please find your original bid bond for CC-1359. Sincerely, l Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister C�Pi�gOO1�4 j'�a °a ie "`( Me`16, New Zealand (Telephone: 714-536-5227 ) +-� i � � i r"�.4 .0 3_ ...'�i rr '" l i} _ t � l � .-.l. 6 � r +� ry � r r y. �� ; X '� _ � P " � �,: "4, '� . a. .. 7l .' � M1j1 _ r} 1 k k„ �. ". s � :� N. '. •l. �•�" .y. .� .,y .. d t,� 4 - ae� 4 �� �q i t� L: . .. ,. :. �� �'� .�. .. .. w � - .. _... � �., � 4 ` kq,.. � e t'r i l # � � � �t,� rT �h �N � ` _ A _ 2, `t '� • a v i $ .r. �. J.4 4' , SECTION C for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO.1359 FEDERAL AID PROJECT ESPL-5181(166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Bidder's Accompanying this proposal of bid, find Bond in the amount of $ 10 o which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 SECTION C SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO.1359 FEDERAL AID PROJECT S'TPL-5181 (I66) BASE BID: TOTAL AMOUNT BASE BID IN FIGURES: TOTAL AMOUNT BASE BID IN WORDS: IDV%c va ve-vJ- so,-, -4fr%.-o (�PA C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 ............ ........ .......... meta" ....... ................ 0b.: . ....... Tt ..... I Mobilization LS Dollars $ 4�, ODD - Cents Per LS 2 1 Traffic Control Plan LS @ Qpe_ "J Dollars $ $ 2=, Sh Q Cents Per LS 3 1 Furnish Project Traffic Control LS @ :T Dollars $ Z'7_0 000 K10 Cents Per LS 4 96430 Cold Milling & Header Cutting incl. disposal of material SF @ Dollars $ .13 $ 572, Cents Per SF 5 195300 Surface Grind (0.17') including dipsosal of material SF @ PIJ Dollars $ AZ $ 2Z:, +�' i t- ma c. Cents Per SF 6 1325 Unclassified Excavation CY @ Dollars $ 2- Cents Per CY 7 5040 Construct Asphalt Concrete (0-0. 17'. 0. IT, 0.42' & 0.50') Ton @ a n - 0 Dollars %J $ (0130( $ ai—as - 0 tn2 Cents Per Ton 0 8 6015 Construct Asphalt Concrete (0.17'ARHM Overlay) Ton @ �evg" Dollars $ -4 $ _8 - K e-V e !3 -C d*X Cents Per Ton U 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface EA @ F71 Dollars $ 5-co - $ I g-00 - Cents Per EA 10 16 Adjust OCSD Manhole to finished surface EA @ Dollars $ $ R, OCK:) Ing Cents Per EA a M C-2.2 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 to.. ............afe .. ............................ .............. ....................... ................. .......................................................... ................................. . .. ......... ........ .. .............. ................. .... 11 21 Adjust Water Valve to finished surface EA @ C3�� LAIIILIA Dollars $ 19tQ-0— ^10 Cents Per EA 12 1 Adjust Monitoring Well to finished surface EA @ Dollars $ Q�o $ C'-00 — Cents Per EA 13 1 Traffic Striping LS @ Dollars Cents Per LS 14 33 Traffic Loop EA @ ollars $ Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, I' Slot 15 1830 Pave per Std Plan 202) LF Dollars $ Cents Per LF 16 15155 Remove & Reconstruct Sidewalk per Std Plan 207 SF @ 4:'v r Dollars $ $ (00,(" Cents Per SF Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining 17 12 Curb, I' Slot pave,& SW) EA ars too — Cents Per EA 18 4 Install Truncated Domes into existing Access Ramp EA @ FN"— L"Pe"a Dollars $ �00 — $ Cents Per EA 19 13 Survey Monumentation EA @ Dollars 31 VIVO Cents Per EA 20 1 Raise Survey Well Monument to finished surface �-fee- EA @ ollars $ Y\-A? Cents ,Per EA ?0 C-2.3 PROJECT BID SCHEDULE Slater Avenue, CC-1359 tetii:::..stgitiat:� .: ........... . :::'::::::=:=:; , tem:;..:u®it`liinco:.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: �iiaiitity:::�:�:�:���:�:�..�vriaett.an:ir%ards .. :.......:................:.......�I>iii¢:.Prei=.:.:.:��uaurii�:�:�:� 21 1654 Remove & Reconstruct Curb & X-Gutter SF @•ev Dollars $ $ Cents Per SF 22 6 Remove & Install New Traffic Signal Pullbox((��,, EA @ —T�..l-t't�tr Dollars $ Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-1-T frame. Install city furnished traffic signal head with LE-SV-1-T framework and terminal box. Ica o Install 3" conduit with 1.12 conductor cable, 1.3 conductor cable and 4 DLC. 1 ea o Install conduit into existing pullbox. I ea. o Remove existing, Furnish & Install no. 6 pullbox into existing conduit tun. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. tea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1-12 conductor cable and 1-3 conductor cable. 1 ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. I ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. 1 ea o Abandon existing conduit and remove conductors. I ea o Install 3" conduit into existing pullbox. 1 ea o Remove conductors for northwest comer poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. ,Install 28 23 1 conductor cable and DLC's into traffic signal cabinet. 1 ea. LS @ E' er if,-. t-S Dollars $ � $ Cents Per LS Total Amount Bid in Figures: $ j bDO — TotalAmount Bid in Words: r ;Cf�ov, ---.....---... ........................................... U. -- - ............................ t '�� i'-0 cep-$s. C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. W, �00 Portion of Work Name and Address of Subcontractor State License Number Class ,terms t ZZ 23 e C_ 'Q I Ilk � � . o.� ��„ 4-6 30 C 3 der, C4 ja43� By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH DID State of California ss. County of Orange Steve Kirschner , being first duly sworn, deposes and says that he or she is Vic PreS d n _ of Hardy & Harper, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Signature of Vice President 1312 E. Warner Ave.,Santa Ana, CA 92705 Address of Bidder Subscribed and sworn to before me this day of , 200 _ . NOTARY PUBLIC C-4 NOTARY SEAL CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of October 14, 2009 Jo -Ann Lyons, Notary Public On before me, , Date Here Insert Name and Title of the Officer personally appeared Steve Kirschner Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person() whose name(q is/49 subscribed to the within instrument and acknowledged to me that he/t*/tjwy executed the same in his/law/tWir authorized capacity(id%), and that by his/W9r/t1air signature(o on the instrument the person(,O, or the entity upon behalf of JO-ANN LYONS which the person(ip acted, executed the instrument. K COMM. #1841329 n Notary Public-Californiar I certify under PENALTY OF PERJURY under the laws . ORANGE COUNTY - of the State of California that the foregoing paragraph is My Comm. Expires Apr. 17. 2013 true and correct. WITNESSy h d and o ial seal. Place Notary Seal Above Signature Signature of Notary ublic OPTIONAL 1.01 Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: NonCollusion Affidavit Document Date: October 14, 2009 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Staves Kirschner Signer's Name: ❑ Individual ❑ Individual IJK Corporate Officer — Title(s): Vice President ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact • ❑ Trustee Top of thumb here ❑ Guardian or Conservator ❑ Other: Signer Is Representing: HaFdy &Harper, Inrr, ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing RIGWTTHUMBPRINT' OP�SIGNER " 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 10/12,/09 C-5 lay. Title Vice President DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 10/12%02 C-7 Hardy & Harper, Inc. Conpoctor 1W (AaMl By Steve Kirschner Vice President Title UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Pen -nit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for emery Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional ,Forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Hardy & Harper, Inc. Bidder Name 1312 E. Warner Ave. Business Address Santa Ana CA 92705 City, State Zip ( 714) 444-1851 Telephone Number 215952 A,C8,C12 State Contractor's License No. and Class 3 /13 /09 - Original Date Issued 12/31/09 Expiration Date The work site was inspected bycorey Kirschner of our office on 10/7 , 2009. The following are persons, firms, and corporations having a principal interest in this proposal: See Attachment A C-9 Attachment A Yfardy e0farper, Inc. Corporate Officers re:7rl ,President, , !-,.......... e:. . Avenue 3 Santa AT, A,927053.. P hone 3.1 1444U8 Dan T 1Vlaas, CEO MU; Avenue i OFF- '31 Warner (71,' 1 4) i4il' C`A`-I� -.9 r: eve, lu hii Pregiaetit., n R t 13 --E Warner -g -5 0v-cWjW hone 444-an . . . .... a 92705:_- KristenL,, Corporate 312-� Avenue nue P6 ': 5"T a.n....t . .w '2 70 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Steve Kirschner Vice President Printed or Typed Signature Subscribed and sworn to before me this _ day of , 200_ NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1• See Attachment B Name and Address of Public Agency 2. 3. Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Type of Work C-10 Date Completed Date Completed Date Completed CALIFORNIA-POSE ACKNOWLEDGMENT State of California County of October 14, 2009 Jo -Ann Lyons, Notary Public On before me, , Date Here Insert Name and Title of the Officer Steve Kirschner personally appeared Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(o whose name(e) is/aW subscribed to the within instrument and acknowledged to me that he/eM/0=y executed the same in his/WtMir authorized capacity(OW), and that by his/hgr/t=r signature(o on the instrument the person(@), or the entity upon behalf of JO-ANN LYONS which the person(e) acted, executed the instrument. COMM.#1841329 r. Notary Public -California I certify under PENALTY OF PERJURY under the laws s ORANGE COUNTY MyComm.Expires Apr. 17.2013 ( of the State of California that the foregoing paragraph is true and correct. WITNESS y h nd and o i ial seal. Signature — 6�� Place Notary Seal Above Signature of Notary ublic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bidders Information Document Date: October 1142009 Number of Pages: 2 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Gtpvp Mrschner Signer's Name: ❑ Individual ❑ Individual It Corporate Officer — Title(s): vice PresirtPnt ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Hardy & Harper, Inr, ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing iRIGHTTHUMBPRI-, OF SIGNER, ©2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 Attachment B ifardy c, 9farper, Inc. Owner/Agency Contact Project (Amount & End Date) City of Tustin John Herrell, PE Major Pavement 300 Centennial Way (714)573-3134 Maintenance Project Tustin, CA 92780 f. (714)259-8128 2008-2009 $ 1,109,000.00 8/09 City of Cypress Nick Mangkalakiri, PE 08/09 Overlay Project 5275 Orange Ave (714)229-6729 Cypress, CA 90630 f. (714) 229-0154 $ 1,366,000.00 6/09 City of Carlsbad Kevin Davis, PE 2008 Pavement Overlay 5950 El Camino Real (760)602-2466 Project Carlsbad, CA 92008-7314 f. (760)602-8562 $ 1,599,000.00 5/09 City of Indio Celina Miller, AA Avenue 46 Pavement 150 Civic Center Mall (760)391-4017 Rehabilitation Indio, CA 92201 Cmiller@indio.org $ 1,027,500.00 2/09 City of Santa Fe Springs Tom Lopez, PE Washington Boulevard 11710 Telegraph Rd. (562)868-0511 Rehabilitation Santa Fe Springs, CA TomLopez@santafesprings.org $ 570,500.00 2/09 90670 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Hardy & Harper, Inc. Contact Person: Corey Kirschner Contact Phone: 714-444-1851 Signed: s Steve Kirschner Date: 10/12/09 Vice President *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc. , proposed subcontractor , hereby certifies that he has X has notparticipated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a• report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-12 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has - , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section I0232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual PS&E Checklist Instructions Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach _ DEPARTMENT OF PUBLIC WORKS. EXHIBIT 12-E Attachment D In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: ® Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; ® Does not have a proposed debarment pending; and a Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C_16 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions N®NL®BBXING CERTIFICATION FOR FEDERAL -AID CONTRACTS EXHIBIT 12-E Attachment F The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES THIS FORM TO DISCLOSE LOBBYING 1. Type of Federal Action: FAI a. contract b. grant c. cooperative agreement d. loan c, loan guarantee f. loan insurance 2. Status of ]Federal Action: FA] a. bid/offertapplication b. initial award c. post -award 4. Name and Address of Reporting Entity ® Prime ® Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: S. Federal Action Number, if known: N/A ; PURSUANT !U 31 U.J.G. 13:16 3. Report: Type: a. initial b. material change For Material Change Only: year_ quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: N/A Congressional District, if known 7. Federal Program NametDescription: CFDA Number, if applicable 9. Award Amount, if known: N/A 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (if individual, last name, first name, MI) address if different from No. 10a) (last name, first name, MI) None None (attach Continuation Sheets) if necessary) 11. Amount of Payment (check all that apply) S None ® actual planned 12. Form of Payment (check all that apply): 8 a. cash — b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred X f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: Hardy & Harper has not paid funds to anyone in regards to this project. (attach Continuation Sheet(s) if n ) 15. Continuation Sheet(s) attached: Yes ® No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature. was pieced by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 print Name- Steve Kirschner U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: Vice President person who fails to rile the required disclosure shall be subject to a civil penalty of not less than $10.000 and not more than $100,000 for each such failure. Telephone No.: 714 - 4 4 4 -18 51 Date: 10 / 12 / 0 Federal Use Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-18 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COIVII'LETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-Il9 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF•1.11,kammdons Rcv.06-04-90aEMFu Page 12-89 LPP 01-04 C-20 March 15, 2001 Local Assistance Procedures Manual Exhibit 15-C1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-Gl Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM[ GENCY:City of Huntington Beach LOCATION: Huntington Beach, CA PROJECT DESCRIPTION: Slater Avenue R(-hahilit.atian TOTAL CONTRACT AMOUNT: S I �%p oDo BIDDATE: 10/15/09 1DDEWSNAME: Hardy & Harper, Inc. CONTRACT UDBE GOAL: 3 . 5 5 % TEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED CcrLNo.ofUDBE AND EXPIRATION'Must DATE 4AME OF UDBEs be certified on the date bids ire opened - include UDBE iddress and hone number ONTRACf DOLLAR AMOUNT ITEM NO. UDBE -X01- ilia For Local Agency to Complete: Local Agency Contract Number. Federal Aid Project Number. Federal Share: Contract Award Date: Local Agency ccrtiftes that all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Telephone Number Total Claimed Participation INA" $ cF ';7" :VMkLjft��Ve Kir Signature of Bidder Vice Pres 10 / 12 / 0 9 714 - 4 4 4 -18 51 Date (Area Code) Tel. No. Corey Kirschner For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3109) chner dent Distribution: (1) Copy - Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy - include in award package to Caltrans District Local Assistance (3) Original -Local agency files Page 15-31 LPP 09-xx C-21 March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONS'TRUC'TION CONTRACTS) (Revised 03/09) s I C i1- ;11 1 h PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27, 2009 C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION-BOOD FAITH EFFORTS Federal -aid Project No. E S PL - 5181 (16 6) Bid Opening Date 10 / 15 / 0 9 The (Ci !County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of . 5 5 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement DBFY;nndfait.h -com 10f9f09 B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up UDBEs Initial Methods and Solicited Solicitation Dates See accompanying DBEGoodfaith documentation C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4, 2009 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBE Information - Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (YIN) Contract See accomLDanying N 100o UDBE See Bid DBEGoodfaith Subrontractnr Sch . uI dnrilmpntat; nn D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: See accompanying DBEGoodfaith documentation If bidder was not selected, either they did not submit a quote, they were not a Union company, or their price was not the lowest for the portion of work indicated. Names, addresses and phone numbers of firms selected for the work above: See List of Suncontractors on 12acae C-3 E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: Plans and specs were made available to interested UDBE firms F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: Plans and specs were made available to interested UDBE firms G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Page 15-34 March 4, 2009 C-24 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort Name of Method/Date Results Agency/Organization of Contact See accompanying DBEGoodfaith documentation H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): See accompanying DBEGoodfaith documentation NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. L,PP 09-xx C-25 Page 15-34a March 4, 2009 Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON TIME REVERSE SIDE OF THIS FORM GENCY:City of Hunt1n!;It.nn Reach LOCATION: Huntington Bea .h CA PROJECT DESCRIPTION: Slater y P n i r a TOTAL CONTRACT AMOUNT: S (`�-��OU 0 — BIDDATE: 10/15/09 IDDEWSNAME: Hardy & Harier. Tnc-- ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBE Cat No. AND EXPIRATION DATE NAME OF DBEs Must be certified on the date bids am opened - include DBE address and hone number CONTRACT DOLLAR AMOUNT ITEM NO. DBE 2 L--Xs,t ( o ( 1-fo a t czs-- .e V t 10 For Local Agency to Complete: Local Agency Contract Number. Federal Aid Project Number. Federal Share: Contract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Print Name Signature Date LocalAgency Representative Area Code Tel! hone Number. Total Claimed Participation $ 0 r � �— t eve Ki Signature of Bidder Vice Pre 10/12/09 714-444-1851 Date (Area Code) Tel. No. Corey Kirschner ®r Caltrans Review: Print Name Signature Date t,-alttans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/09) schner ident Distribution: (l) Copy -tax or scan a copy to the Caltrans District Local Assistance Engineer (DL.AE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original —Local agency files Page 15-32a LPP 09-xx C-26 March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineersigns and dates the form. Page 15-32b March 27, 2009 C-27 LPP 09-xx 0 tJ 00 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) DIDDER93 LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form ror additional firms. DleMbntion; 1) Original - Local Agency File Page12-111 LPP 06-06 November 14,2006 Exhibit 12-G Local Assistance Procedures Manual Bidder's List of SubcontrActors (DBE and loon -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART !S The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original —Local Agency File Page 12-1112 LPP 06 06 November 14, 2006 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 6 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 Indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Numb da to b r 24, 20 Hardy & Harper, Inc. Company Name By Steve Kirschner Vice President 10/12/09 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. G-%C*vArudw CantmcW (CCs)ICC1359 Rehabili ebw of Shaer from Graham to C WdemwosfODVERTiSEN ENT-NIS"IDDING PROCESS1CG1359 Addendum NumberOne.due DBE Goodfaith Inc. - ---------- Good Faith Transaction Log Company Details Company Name Hardy & Harper, Inc. Department Contracts Address 1312 E. Warner Ave. Suite # City Santa Ana State California Zip 92705 Phone # 714-444-1851 Fax # 714-444-2801 Email # ckirschner@hardyandharper.com Solicitation Transaction Log (STL) Bid # C.C. No. 1359, ESPL-5181(166) Bid Date 1011512009 1 Bid Description Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave Rehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara i i County. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, STRIPING, AND TRAFFIC LOOPS. This document contains all information pertaining with solicitations made on behalf of/for Hardy & Harper, Inc. of Santa Ana, California by DBE Goodfaith Inc. (a California -based Corporation). These solicitations have been done in good faith. DBE Goodfaith has participated with Hardy & Harper, Inc. in i communicating with selected DBE,UDBE firms. DBE Goodfaith has contacted the California Department of Transportation (Office of Civil Rights) on 10/09/2009 on your behalf. Please write this information on the appropriate forms if required. DBE Goodfaith Inc. Good Faith Transaction Log Total Companies Solicited NMVe��� I I The following information is a summary of the different types of Business that have been solicited by DBE Good ( Faith Inc. on behalf of Hardy & Harper, Inc. 3 DVBE (Disadvantaged Veteran Business Enterprises) 0 DBE (Disadvantaged Business Enterprises) 12 j UDBE (Underutilized Disadvantaged Business Enterprise) 13 i i i MBE (Minority Owned Business Enterprises) 0 i E WBE (Women Owned Business Enterprises) 0 t SBE (Small Business Enterprises) 0 E Total - 25 I Page No: 2 DBE Goodfaith Inc. Good Faith Transaction Log Minority Focus Journal Ad posted to website www.dbegoodfaith.com on 10/0912009 at 10:23AM Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE Bid Due Date : 10/15/2009 at 2:00 P.M Bid No: C.G. No. 1359, ESPL-5181(166) Contact Estimator : Corey Kirschner Project Name : Slater Ave Rehabilitation from Graham Street to Goldenwest Street Agency Name: City of Huntington Beach Project City : Orange Project County : Santa Barbara Project State : California Project Details Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave Rehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara County. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, STRIPING, AND TRAFFIC LOOPS. Contact Details : Corey Kirschner 1312 E. Warner Ave. Santa Ana, California 92705 Tel: 714-444-1851 Fax: 714-444-2801 We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. Page No: 3 DBE Goodfaith Inc. Good Faith Transaction Log Minority Trade Journal Ad posted to website trade.dbegoodfaith.com on 10/09/2009 at 10:23AM Trade Journal Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE Bid Due Date : 10/1512009 at 2:00 P.M Bid No: C.C. No. 1359, ESPL-5181(166) Contact Estimator : Corey Kirschner Project Name : Slater Ave Rehabilitation from Graham Street to Goldenwest Street Agency Name: City of Huntington Beach Project City : Orange Project County : Santa Barbara Project State : California Project Details Hardy and Harper, Inc. is seeking qualified DBE and'UDBE subcontractors and suppliers for the Slater Ave Rehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara County. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, STRIPING, AND TRAFFIC LOOPS. Contact Details : Corey Kirschner 1312 E. Warner Ave. Santa Ana, California 92705 Tel: 714-444-1851 Fax: 714-444-2801 We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. Page No: 4 DBE Goodfaith Inc. Good Faith Transaction Log Recipient List (Fax/Email) Company Name/Speclaity Fax Email Log Page# ,EXENI PAVING & GRADING, INC.,ROWLAND HEIGHTS,CA,Earthwork 10/09/2009 No Mail and Paving Contractor (� Address - 1905 CALLE BOGOTA L \� Phone - 6269650703 {t Fax - 8056505208 Email - TRAFFIC MANAGEMENT, INC., CYPRESS, CA, Construction Zone 10/09/2009 10/09/2009 Traffic Control Contractor n� Address - 4861 CAMP STREET Phone - 7142369990 Fax - 7142369981 VVV Email - cspano@trafficmanagement.com THE LOPEZ GROUP CONTRACTORS INC, NUEVO,CA,Highway, 10/09/2009 10/09/2009 Street, and Bridge Construction Address - 29971 NUEVO RD j Phone - 9099280695 ,Fax - 9099280989 Email - steve@thelopezgroup.net MIRAMAR CONSTRUCTION, POMONA,CA, Electrical Contractor 10/09/2009 10/09/2009 Address - 1521 E. GRAND AVENUE �v Phone - 9098651511 Fax - 9098651522 ttt Email - jpinedo@miramarinc.com LOOP MASTERS INC.,ANAHEIM,CA,Highway, Street, and Bridge 10/09/2009 10/09/2009 ,Construction Address - 4740 E BRYSON ST Phone - 7146308894� 6 Fax - 7146301783 vvv Email - andreanorth@loopmastersinc.com GLOBAL ROAD SEALING, I NC,WESTMI NSTER,CA, Parking and 10/09/2009 10/09/2009 Highway Improvement Contractor 'Address - 6341 KLAMATH DR. Phone - 7148930845 Fax - 7148930945 Email - Ialatri@yahoo.com CECILIA'SSAFETY SERVICE, ,INC_,SOLANA.BEACH.CA.Construction._1.0/09/2009,..,,,.1.0/09/2009....,,,,_,,,,,,,,,,,,,,,,;, Page No: 5 DBE Goodfaith Inc. Good Faith Transaction Log Zone Traffic Control Contractor �\J) Address - 525 STEVENS AVENUE, SUITE 200 Phone - 8587934465 Fax - 8587934495 Email - cecilias@pacbell.net L C PAVING & SEALING,SAN MARCOS,CA, Earthwork and Paving 10/09/2009 10/09/2009 Contractor Address - 996 BORDEN RD.© t (Phone - 7607521743 Fax - 7607521674 Email - marisa@lcpaving.com J R PINA ASPHALT PAVING,SAN MARCOS,CA,Parking and Highway 10/09/2009 10/09/2009 Improvement Contractor Address - 197 WOODLAND PKWY STE 104-591 Phone - 7607467677� \\\ Fax - 7607466847 w y Email- 9@ ina avin aol.com P P DCN CORPORATION,SAN MARCOS,CA, Highway, Street, and Bridge 10/09/2009 10/09/2009 Construction Address - 2123 SEA ISLAND PLACEre� Phone - 6192534247 \N Fax - 7605987226 Email - dcnconstruction@yahoo.com ` PAYCO SPECIALTIES, INCORPORATED,CHULA VISTA,CA,Parking 10/09/2009 10/09/2009 and Highway Improvement Contractor Address - 120 NORTH SECOND AVE. Phone - 6194229204 Fax - 6194271620 ° F \n Email - Ilewellyn4436@msn.com V CO'S TRAFFIC CONTROL, INC, DEL MAR,CA,Construction Zone Traffic 10/09/2009 10/09/2009 Control Contractor AN Address 2201 S DIEG IT U O DRIVE Phone - 8582590300 C " Fax - 8582590357 Email - co@costraffic.com 'CALIFORNIA TRAFFIC MAI NTENANCE,BU RBAN K,CA,Parking and 10/09/2009 10/09/2009 Highway Improvement Contractor Address - 641 N. KEYSTONE STREET, UNIT D Page No: 6 DBE Goodfaith Inc. Good Faith Transaction Log Phone - 8189548271 Fax - 8189549266 ,Email - crmcorp@aol.com EAGLE ASPHALT CONSTRUCTION, I NC.,WALNUT,CA, Highway, 10/09/2009 10/09/2009 Street, and Bridge Construction Address - 21450 GOLDEN SPRINGS DRIVE, SUITE J Phone - 9094445566 Fax - 9094448311 Email - eagle.aspahlt@verizon.net SUPER SEAL & STRIPE, INC,FILLMORE,CA,Parking and Highway 10/09/2009 10/09/2009 Improvement Contractor Address - P. O. BOX 755 Phone - 8055247345 NV Fax-8055247428 Email - brenda@supersealandstripe.com HAL HAYS CONSTRUCTION, INC., RIVE RSI DE,CA, Earthwork and 10/09/2009 10/09/2009 'Paving Contractor Address - 3421 GATO COURT SUITE A� Phone - 9517880703 ,Fax - 9517881517 ` Email - hhaysconst@aol.com .MWR CONSTRUCTION, NEWHALL,CA, Highway, Street, and Bridge 10/09/2009 10/09/2009 Construction Address - 24377 NEWHALL AVE. #212 Phone - 8186746716 Fax - 6612879267 Email - mwrconstruction@dslextreme.com DORADO & DORADO CONSTRUCTION,YUCAIPA,CA,Highway, Street, 10/09/2009 10/09/2009 and Bridge Construction�po, Address - 34475 YUCAIPA BLVD #213 Phone - 9097979299 Fax - 9097970400 V Email - dorado_dorado@virizon.net RIO JORDAN CONSTRUCTION, PICO RIVERA,CA,Highway, Street, 10/09/2009 10/09/2009 and Bridge Construction t ,Address - 7432 LEMORAN AVE Phone - 5629420228 :'Fax - 5622612102 ...... ........................ ..................... .............. ................_............ ...-_........,.................: Page No: 7 DBE Goodfaith Inc. Good Faith Transaction Log Email - jordan@riojordaninc.com SUKAN, INC.,ROWLAND H El GHTS,CA, Highway, Street, and Bridge 10/09/2009 10/09/2009 Construction Address - 18412 FARJARDO STREET Phone - 6268549467 Fax - 6268549469 Email - suzanne@sukaninc.com E-NOR INNOVATIONS INC.,LONG BEACH, CA, Construction Zone 10/09/2009 10/09/2009 Traffic Control Contractor Address - 3513 MAINE AVENUE Phone - 5627567591 Fax - 3107645219 Email - ronnie@enortraffic.com DHAKA PACIFIC CORPORATION,ARCADIA,CA,Highway, Street, and 10/09/2009 10/09/2009 Bridge Construction Address - 1100 ARCADIA AVENUE SUITE C j t c Phone - 6264462081 Fax - 6264462967 l Email - dhakapacific@aol.com BITECH CONSTRUCTION CO., INC.,BUENA PARK,CA,Highway, 10/09/2009 10/09/2009 Street, and Bridge Construction Address - 6980 ARAGON CIRCLE, UNIT #5 Phone -7149042686 Fax - 7145520302 Email - bitech_ben@yahoo.com A CONE ZONE, INC, CORONA, CA, Construction Zone Traffic Control 10/09/2009 10/09/2009 Contractor i j Address - 1128 QUARRY STREET \ / l Phone - 9517349535 Fax - 9517342887 Email - elaine@aconezone.com A M CONSTRUCTION,GARDEN GROVE,CA,Highway, Street, and 10/09/2009 10/09/2009 Bridge Construction Address - 12622 GLEN STREET Phone -7143057263 Fax - 7145344240 Email - a.m.construction@yahoo.com Page No: 8 DBE Goodfaith Inc-. Good Faith Transaction Loci DBE Goodfaith Inc. Fax Confirmation Report for Hardy & Harper, Inc. Bid Number: C.C. No. 1359, ESPL-5181(166) No. Company Name Type PhoneNumber Fax Number Status Date/Time 1 A M CONSTRUCTION DBE 7143057263 7145344240 Success 10/09/2009 13:55 2 CALIFORNIA TRAFFIC DBE 8189548271 8189549266 Failed 10/09/2009 14:32 MAINTENANCE ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 3 DHAKA PACIFIC CORPORATION DBE 6264462081 6264462967 Success 10/09/2009 13:53 -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 4 DORADO & DORADO DBE 9097979299 9097970400 Success 10/09/2009 13:53 CONSTRUCTION --------------------------------------------- 5 ------------------------------------------------------------------------------------------------------------------- EAGLE ASPHALT DBE 9094445566 9094448311 Success ------------------- 10/09/2009 13'50 CONSTRUCTION, INC. --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 6 J R PINA ASPHALT PAVING DBE 7607467677 7607466847 Failed 10/09/2009 14'36 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 7 L C PAVING & SEALING DBE 7607521743 7607521674 Success 10/09/2009 14:09 --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 8 MIRAMAR CONSTRUCTION DBE 9098651511 9098651522 Failed 10/09/2009 14,53 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 9 MWR CONSTRUCTION DBE 8186746716 6612879267 Failed 10/09/2009 14,02 -------- ------------------------------------------------------------------------------------------------------------------I------------------------------------------------------ 10 RIO JORDAN CONSTRUCTION DBE 5629420228 5622612102 Failed 10/09/2009 14,44 -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 11 THE LOPEZ GROUP DBE 9099280695 9099280989 Failed 10/09/2009 14:50 CONTRACTORSINC ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 12 TRAFFIC MANAGEMENT, INC. DBE 7142369990 7142369981 Success 10/09/2009 13'26 13 A CONE ZONE, INC UDBE 9517349535 9517342887 Success 10/09/2009 13'44 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ 14 BITECH CONSTRUCTION CO., UDBE 7149042686 7145520302 Failed 10/09/2009 14'30 INC. ----------------------------------------------- 15 ----------------------------------------------------------------------------- CECILIA'S SAFETY SERVICE, UDBE 8587934465 ------------------------------------------------------- 8587934495 Success 10/09/2009 13:39 INC. ----------------------------------------------------------------------------------------------------------------------------- 16 CO'S TRAFFIC CONTROL, INC UDBE 8582590300 ----------------------------------------------------- 8582590357 Success 10/09/2009 13:39 -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 17 DCN CORPORATION UDBE 6192534247 7605987226 Success 10/09/2009 13:31 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 18 E-NOR INNOVATIONS INC. UDBE 5627567591 3107645219 Success 10/09/2009 13 35 ---------- ------------------------------------------------------------------------------------------------------------------- 19 EXENI PAVING & GRADING, INC. UDBE 6269650703 ------------------------------------------------------ 8056505208 Success 10/09/2009 14:07 ---------- ----------------------------------------------------------------------------- 20 GLOBAL ROAD SEALING, INC UDBE ------------------------------------------------------------------------------------------ 7148930845 7148930945 Success 10/09/2009 14:04 Page No -. 1 DBE Goodfaith Inc. Good Faith Transaction Log No. Company Name Type PhoneNumber Fax Number Status Date/Time 21 HAL HAYS CONSTRUCTION, UDBE 9517880703 9517881517 Success 10/09/2009 14 06 INC. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 22 LOOP MASTERS INC. UDBE 7146308894 7146301783 Success 10/09/2009 13:30 -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 23 PAYCO SPECIALTIES, UDBE 6194229204 6194271620 Success 10/09/2009 14:01 INCORPORATED ----- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 24 SUKAN, INC. UDBE 6268549467 6268549469 Success 10/09/2009 13:27 --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 25 SUPER SEAL & STRIPE, INC UDBE 8055247345 8055247428 Success 10/09/2009 14:09 Page No: 2 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: TRAFFIC MANAGEMENT, INC. CONTACT NAME Corey Kirschner Phone Number: 7142369990 ADDRESS 1312 E. Warner Ave. Fax Number: 7142369981 Santa Ana, California, Date : 10/09/2009 1:26PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:Oo P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME" Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, -RIPING, AND TRAFFIC LOOPS. ne are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 3 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: SUKAN, INC. CONTACT NAME Corey Kirschner Phone Number: 6268549467 ADDRESS 1312 E. Warner Ave. Fax Number: 6268549469 Santa Ana, California, Date : 10/09/2009 1:27PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/1512009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave !habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara aunty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 4 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: LOOP MASTERS INC. CONTACT NAME Corey Kirschner Phone Number: 7146308894 ADDRESS 1312 E. Warner Ave. Fax Number: 7146301783 Santa Ana, California, Date : 10/09/2009 1:30PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave )habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara )unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, G, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 5 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: DCN CORPORATION CONTACT NAME Corey Kirschner Phone Number: 6192534247 ADDRESS 1312 E. Warner Ave. Fax Number: 7605987226 Santa Ana, California, Date: 10/09/2009 1:31 PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DSE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave !habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara >unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 6 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: E-NOR INNOVATIONS INC. CONTACT NAME Corey Kirschner Phone Number: 5627567591 ADDRESS 1312 E. Warner Ave. Fax Number: 3107645219 Santa Ana, California, Date : 10/09/2009 1:35PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS. Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara )unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, 'RIPING. AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 7 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: CO'S TRAFFIC CONTROL, INC CONTACT NAME Corey Kirschner Phone Number: 8582590300 ADDRESS 1312 E. Warner Ave. Fax Number: 8582590357 Santa Ana, California, Date : 10/09/2009 1:39PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graharn Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave ihabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 8 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: CECILIA'S SAFETY SERVICE, INC. CONTACT NAME Corey Kirschner Phone Number: 8587934465 ADDRESS 1312 E. Warner Ave. Fax Number: 8587934495 Santa Ana, California, Date: 10/09/2009 1:39PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave tehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara ;ounty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 9 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: A CONE ZONE, INC CONTACT NAME Corey Kirschner Phone Number: 9517349535 ADDRESS 1312 E. Warner Ave. Fax Number: 9517342887 Santa Ana, California, Date: 10/09/2009 1:44PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE : California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. JVe are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 10 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: EAGLE ASPHALT CONSTRUCTION, INC. CONTACT NAME Corey Kirschner Phone Number: 9094445566 ADDRESS 1312 E. Warner Ave. Fax Number: 9094448311 Santa Ana, California, Date : 10/09/2009 1:50PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://Www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara )unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, "RIPING, AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office o we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 11 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: DHAKA PACIFIC CORPORATION CONTACT NAME Corey Kirschner Phone Number: 6264462081 ADDRESS 1312 E. Warner Ave. Fax Number: 6264462967 Santa Ana, California, Date : 10/09/2009 1:53PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITYICOUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave Rehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara ounty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 12 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: DORADO & DORADO CONSTRUCTION CONTACT NAME Corey Kirschner Phone Number: 9097979299 ADDRESS 1312 E. Warner Ave. Fax Number: 9097970400 Santa Ana, California, Date : 10/09/2009 1:53PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara ,unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 13 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: A M CONSTRUCTION CONTACT NAME Corey Kirschner Phone Number: 7143057263 ADDRESS 1312 E. Warner Ave. Fax Number: 7145344240 Santa Ana, California, Date : 10/09/2009 1:55PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME : Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave tehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara ;ounty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, (PING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 14 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: PAYCO SPECIALTIES, INCORPORATED CONTACT NAME Corey Kirschner Phone Number: 6194229204 ADDRESS 1312 E. Warner Ave. Fax Number: 6194271620 Santa Ana, California, Date : 10/09/2009 2:01 PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave ihabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, "RIPING, AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No:15 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: MWR CONSTRUCTION CONTACT NAME Corey Kirschner Phone Number: 8186746716 ADDRESS 1312 E. Warner Ave. Fax Number: 6612879267 Santa Ana, California, Date : 10/09/2009 2:02PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE : California PROJECT DETAILS Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave tehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara ;ounty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, ING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 16 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: GLOBAL ROAD SEALING, INC CONTACT NAME Corey Kirschner Phone Number: 7148930845 ADDRESS 1312 E. Warner Ave. Fax Number: 7148930945 Santa Ana, California, Date : 10/09/2009 2:04PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara ,unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, ING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 17 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: HAL HAYS CONSTRUCTION, INC. CONTACT NAME Corey Kirschner Phone Number: 9517880703 ADDRESS 1312 E. Warner Ave. Fax Number: 9517881517 Santa Ana, California, Date : 10/09/2009 2:06PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME : Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. VVe are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No:18 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: EXENI PAVING & GRADING, INC. CONTACT NAME Corey Kirschner Phone Number: 6269650703 ADDRESS 1312 E. Warner Ave. Fax Number: 8056505208 Santa Ana, California, Date : 10/09/2009 2:07PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: BID No: PROJECT NAME: 10/15/2009 at 2:00 P.M C.C. No. 1359, ESPL-5181(166) Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave rehabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara � ounty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, �TRIPING, AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 19 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: L C PAVING & SEALING CONTACT NAME Corey Kirschner Phone Number: 7607521743 ADDRESS 1312 E. Warner Ave. Fax Number: 7607521674 Santa Ana, California, Date : 10/09/2009 2:09PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME : Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, G, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 20 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: SUPER SEAL & STRIPE, INC CONTACT NAME Corey Kirschner Phone Number: 8055247345 ADDRESS 1312 E. Warner Ave. Fax Number: 8055247428 Santa Ana, California, Date : 10/09/2009 2:09PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit hftp://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE : California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, -RIPING, AND TRAFFIC LOOPS. JVe are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 21 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: BITECH CONSTRUCTION CO., INC. CONTACT NAME Corey Kirschner Phone Number: 7149042686 ADDRESS 1312 E. Warner Ave. Fax Number: 7145520302 Santa Ana, California, Date : 10/09/2009 2:30PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY: Orange PROJECT STATE : California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave ihabilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, 'RIPING, AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office o we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 22 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: CALIFORNIA TRAFFIC MAINTENANCE CONTACT NAME Corey Kirschner Phone Number: 8189548271 ADDRESS 1312 E. Warner Ave. Fax Number: 8189549266 Santa Ana, California, Date: 10/09/2009 2:32PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME. City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 23 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: J R PINA ASPHALT PAVING CONTACT NAME Corey Kirschner Phone Number: 7607467677 ADDRESS 1312 E. Warner Ave. Fax Number: 7607466847 Santa Ana, California, Date : 10/09/2009 2:36PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit hftp://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME : Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave :habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 24 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: RIO JORDAN CONSTRUCTION CONTACT NAME Corey Kirschner Phone Number: 5629420228 ADDRESS 1312 E. Warner Ave. Fax Number: 5622612102 Santa Ana, California, Date: 10/09/2009 2:44PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara unty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, RIPING, AND TRAFFIC LOOPS. Ne are an equal opportunity employer. The plans and specs are available for your review at our office of we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 25 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: THE LOPEZ GROUP CONTRACTORS INC CONTACT NAME Corey Kirschner Phone Number: 9099280695 ADDRESS 1312 E. Warner Ave. Fax Number: 9099280989 Santa Ana, California, Date : 10/09/2009 2:50PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME, Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave ;habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, , AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 26 DBE Goodfaith Inc. Good Faith Transaction Log INVITATION TO BID Good Faith Solicitation Fax FROM Hardy & Harper, Inc. TO: MIRAMAR CONSTRUCTION CONTACT NAME Corey Kirschner Phone Number: 9098651511 ADDRESS 1312 E. Warner Ave. Fax Number: 9098651522 Santa Ana, California, Date : 10/09/2009 2:53PM 92705 Phone 714-444-1851 Fax 714-444-2801 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Hardy & Harper, Inc. For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Hardy & Harper, Inc. Is Seeking Qualified DBE,UDBE BID DUE DATE: 10/15/2009 at 2:00 P.M BID No: C.C. No. 1359, ESPL-5181(166) PROJECT NAME: Slater Ave Rehabilitation from Graham Street to Goldenwest Street AGENCY NAME: City of Huntington Beach PROJECT CITY/COUNTY : Orange PROJECT STATE: California PROJECT DETAILS: Hardy and Harper, Inc. is seeking qualified DBE and UDBE subcontractors and suppliers for the Slater Ave !habilitation from Graham Street to Goldenwest Street project for the City of Huntington Beach in Santa Barbara runty. We are soliciting quotes for the following trades: TRAFFIC CONTROL, COLD MILLING, ADJUST UTILITIES, PING, AND TRAFFIC LOOPS. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. RETURN SECTION You can use this page to fax back your response on whether you will bid on this project or not to the following fax number: 714-444-2801 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Page No: 27 aicSuely-Tond C&Ace 19w One Newark Center International Fidefily Newark, New Jersey 07102 1 N S U R A N C E C O M P A N Y (973) 624-7200 KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, HARDY & HARPER, INC. as Principal, and THE INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation of the State of New Jersey, as Surety, are hereby held and firmly bound unto CITY OF HUNTINGTON BEACH in the penal sum of TEN PERCENT OF THE TOTAL AMOUNT BID ------------------- ($ 10%---- ------- for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors and assigns. Signed, this 12TH day of OCTOBER , 20 09. The condition of the above obligation is such that whereas the Principal has submitted to CITY OF HUNTINGTON BEACH a certain bid, attached hereto and hereby made a pars: hereof, to enter into a contract in writing for SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, CC NO. 1359, FEDERAL AID PROJECT ESPL-5181 (166) NOW, THEREFORE, (a) If said bid shall be rejected, or in the alternate (b) If said bid shall be accepted and the Principal shall execute and deliver a contract in the form of contract attached hereto, properly completed in accordance with said bid, and shall furnish a bond for the faithful performance of said Contract, and for the payment of the persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the agreement created by the acceptance of said bid; THEN, THIS OBLIGATION SHALL BE VOID, otherwise the same shall remain in force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligation of said Surety and its bond shall be in no way impaired or affected by any extension of time within which the said bid may be accepted; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety have hereto set their hands and seals, and such of them as are corporations have caused their corporate seals, to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. Signed, sealed and delivered in the presence of: HAR & I ATTEST: "/ Prind al Steve Kirschner, Vice Pres. ATTEST: INTERNATIONAL FIDELITY INSURANCE CO. By: DWIGHT REILLY Bid Bond Date 10/12/09 Attomey-In-Fact CALIFORNIA ACKNOWLEDGMENT �J.'- :..�. ^.a,'..�J. 'aJ.' �..� ...'.�...�'...�- � :?.'..:��C./•^.'.;t�s�.A1. ��'�. �aJS„ �. �. � �� ��a �.' � �aS.�. �. �. �.Q.. :..� � .3J. �k'�J. '3.'.. :..� State of California County of Orange October 14, 2009 Jo -Ann Lyons, Notary Public On Date before me, , Here Insert Name and Title of the Officer Steve Kirschner personally appeared Name(s) of Signer(s) JO-ANN LYONS COMM. #1841329 ¢ 2 Notary Public -Califon,,,: s� ORANGECOuNTY hly Comm. Expires Apr. 17, Place Notary Seat Above who proved to me on the basis of satisfactory evidence to be the person(o whose name(Q istlim subscribed to the within instrument and acknowledged to me that he/ /thy executed the same in hister/ tr authorized capacity(P), and that by his/haWtIAW signature(al on the instrument the person4P), or the entity upon behalf of which the person(49) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNES my In nd and Iclal seah .6 Signature Signature of Nota ublic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: O .tobe[ 12, 2009 Number of Pages: l Signer(s) Other Than Named Above: Dwight Reilly Capacity(ies) Claimed by Signer(s) Signer's Name: Steve Kirschner ❑ Individual Corporate Officer — Title(s): Vice President ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Harris & Harper, Inc. Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing yRIGliTTHUMBPRINT _ ,OF:SIGNER _ • . i.thumb here I ©2007 National Notary Association • 9350 De Soto Ave., PO. Box 2402-Chatsworth, CA 91313-2402- www.NationalNotaryorg Item #5907 Reorder, Call Toll -Free 1-800-876-6827 State of California ORANGE County of On October 12th, 2009 ACKNOWLEDGMENT before me, ALLISON RITTO, NOTARY PUBLIC (insert name and title of the officer) personally appeared DWIGHT REILLY 9 who proved to me on the basis of satisfactory evidence to be the person(&) whose name(s) is/al"e subscribed to the within instrument and acknowledged to me that he><sh fth ry executed the same in his/-O�r authorized capacity(tes), and that by his+er/their signature(&) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. ALLISON RITTO WITNESS m hand and official seal. �� commission # 1824932 Y -: z Notary Public -California n >, Orange County My Comm. Expires Oec 23, 2012 Signature (Seal) ALLISON RITTO Tel (973) 624-721J0 HOME OFFICE: ONE NEWARK CENTER, 20TH FLOOR NEWARK, NEW JERSEY 07102-5207 FOR BED BONDRUDER/CONSENTS/AMIDAVUS KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing laws of the State of New Jersey, and having its principal office in the City of Newark, New Jersey, does hereby constitute and appoint DWIGHT REILLY, HAL DUECK Anaheim, CA. its true and lawful atWmey(s)-m-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, eo tcsets of indemnity and other writings obligatory, ul tte nature thereof, which are or may be allowed, required or permitted by law, statute rule reggulation, eohtrsct or otherwise and the execuaon of such instrument(s) in pursuance of these presents, shall be as binfnng upon the said Mb N4 NAL FIDELITY INSURANCE COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regulardy elected officers at its principal office. This Power of Attorney is executed, and may be revoked pursuant to and by authority of Article 3-Section 3, of the Fly -Laws adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a mectina called and held on the 7th day ofT-ebruarv. f974. The President of any Vice President, Executive Vice President, Secretary of Assistant Secretary- shall have power and authority (1) To appoint Attorneys -in -fact. and to authorize them to execute on behalf of the Company. and anach the Seal of the Company thcreto, hands and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and, (2) To remove, at any torte, any such attorney -in -fact and revoke the authority given. Further, this Power of Atto is si;net and seated by facsimile pursuant to resolution of the Board of Directors of said Company adopted at a meeting duly called and held on the 29111 y of April, 1992 of which the fallowing is a true excerpt: Now therefore the signatures of such officers and die seal of the Company. may be affixed to any such power of attorney or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsiriWc signatures or facsimile seal shall be valid and bimbng upon the Company and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in die future with respect to any bond or undertaking to which it is aroched. IN TESTIMONY WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 29th day of August. A.D. 2003. INTERNATIONAL FIDE4 LITY INSURANCE CO NY STATE OF NEW JERSEY County of Essex Sccreis On this 29th day of August 2003, before me came the individual who executed the prang uumment to me petsonailp known and, being by me duly sworn, said the he is the therein described and authorized officer of the INTERNATIONAL $T-RELI7'Y dNSURAPICE CQMPAN�t; that the seal affixed to said instrument is the Corporate Seal of said Company: that the said Corporate Seal and his signature were duly affixed by order of the Board of Directors of said Company, %�1�►R�G IN TESTIMONY WHEREOF, I have hereunto set ,try hand affixed my Official Seal. at the City of Newark, New Jersey the day and year first above written. O NOTARY t✓ PUBLIC tom+ sir q� � y " JE 1.5 A NOTARY PUBLIC OF NEW JERSEY CERTIFICATION My Commission Expires Nov. 21, 2010 1, the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Section of the By -Laws of said Company as set forth in said Power of Attorney, with the ORIGINALS ON IN THE HOME OFFICE OF SAID COMPANY, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect IN TESTIMONY WHEREOF, I have hereunto set my hand this 12th day of October, 2009. Assistant Secretary City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK February 11, 2010 Imperial Paving Co. 10715 Bloomfield Ave. Santa Fe Springs, CA 90670 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest St. Enclosed please find your original bid bond for CC-1359. Sincerely, Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Ci�i�uo�ri&as�t�c�t�ei New Zealand ( Telephone: 714-536-5227 ) REALE BID ON ON Tkm.- 'as d--t c City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Nu C mpany Name Date mbe O at Se e ber 24, 2009 B ,&72 All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. G \Construction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\ADVERTISEMENT-NISB-BIDDING PROCESS\CC-1359 Addendum Number One.doc SECTION C for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 ]FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", o id er's Bond" the case may be). Bidder shall signify receipt of all Addenda hery f any: / _d � Addenda No. Date Received er's Signature oi- C-2 SECTION C PROJECT BID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STPL-5181 (166) TOTAL AMOUNT BASE BID IN FIGURES: TOTAL AMOUNT BASE BID IN WORDS: C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 ..imated ............. .................... ............. ... ...... .. ...................... ............. ............... ............... .......... .................. . ............ ................... . ..... ........................... ....... . .... Unit'-Wi ..... ce:`.:. .''.'';moil...... t::, Mobilization LS &t��tDollars $ ':7q, 0 d& $ Cents Per LS 2 1 LS Traffic Control Plan oars ffi'MC&4d1l s $,judo ✓ $ Cents Per LS 3 1 LS Furnish1V Project Traffic Control : vq\� Dollars $ Cents Per LS 4 96430 Cold Milling & Header Cutting incl. disposal of material SF @ Dollars $ $ 2, -r01eT7 Cents Per SF 5 195300 Surface Grind (0. IT) including dipsosal of material SF @ Dollars $ $ MP&k,e-il Cents Per SF 6 1325 Unclassified Excavation CY @ Dollars $ Fr $ Cents Per CY 7 5040 Construct Asphalt Concrete (0-0.17', 0.17', 0.42' & 0.50') 7) iJ — W— Dollars $ Ton Cents Per Ton 8 6015 Construct Asphalt Concrete (0. 17' ARHM Overlay) 'e"/ $ Ton @ Dollars Cents Per Ton 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface EA Dollars $ Cents Per EA 10 16 Adjust OCSD Manhole to finished surface $ 12- Dollars JEA Cents Per EA C-2.2 PROJECT BII) SCHEDULE Slater Avenue, CC-1359 Iterii:: Estimate :::::::::: ....I .. Itel<n:v►tti>�iiit::irtce:::::::::::::::::::::::::::::::::::::::::::::::: ................ ..... ......... P.....................................................I.:................ Exteride.::::: ..................... .................... ............................... ............... ... :.::::::......::Uni#:F .............. ................. .ice::::::.:.> .........I........ _iri.... : : 11 21 EA Adjust Water Valve to finished surface @lU`r�UlIV(//Dollars nk i _i!56e4_ Cents Per EA 12 1 EA Adjust Monitoring, Well to tto finished surface �/ @ �'° �'�'� 1`' Y "I � Dollars $ i1 ..� $ Cents Per EA 13 1 LS Traffic Striping�q j_ 1 iJ Y��rl� �rly�� �' I 1 $ `I66. q $ a lq @ Cents Per LS 14 33 EA Traffic Loop @ � �1//''6 MKollars $ D ! $ Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, 1' Slot 15 1830 Pave per Std Plan,202) �/`^', �0 $ ®°� 57 $ 74, J LF @ Dollars Cents Per LF 16 15155 SF Remove & Reconstruct Sidewalk per Std Plan 207 @ Dollars $ Cents Per SF e 17 12 Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining Curb, P Slot pave, & SW) ',,/4 d �V EA @ � /l�j�liY' Do arrs $ ���iU• $ �1° _ Cents Per EA 18 4 EA Install Truncated Domes into existing Access Rapm !�, q� l ,, �f� $ 4`1 $ ollars " Cents Per EA 19 13 EA Survey jM�onumentation�_/ 1i ' � �YC��E �/�Dollars 1 $ ' ' / / /- $ �''J �"> @ Cents Per EA 20 1 Raise Survey Well Monument to finished burface wyY��/✓lv.��J EA @ l Dollars Cents Per EA C-2.3 PROJECT BID SCHEDULE Slater Avenue, CC-1359 Item:. Estimated ::::::::::::::::::..fieiii:witli unifi::iriee:::::::::::::::::::::::::::::: P....................................................... :::::::::::::.... ::: Extoide.::::: I ................ ........................... Q ............................................................................... rifle in . .orris ::::::: :::::: ;::::::::::::::: W......1�....w................................................................... :: Unifi :Priee::::::;;:Aniou .................. 21 1654 Remove &'Recooinstruct Curb & X-Gutter SF ZI Re ` @ 42an Dollars $ $ -2-1 50a-- ` Oe Cents Per SF 22 . 6 Remove &/ Install New Traffic Signal Pullbox EA @ ► s�lDollars $ `f oy ` � �/ $ 2 7 o v ' Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-1-T frame. Install city furnished traffic signal head with LE-SV-1-T framework and terminal box. 1 ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. I ea o Install conduit into existing pullbox. 1 ea. o Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. 2ea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1-12 conductor cable and 1-3 conductor cable. 1 ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. 1 ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. I ea o Abandon existing conduit and remove conductors. 1 ea o Install 3" conduit into existing pullbox. I ea o Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cable and DLC's into traffic signal cabinet. 1 ea. LS @ v__ / " "'✓� ��7 Dollars Cents Per LS Total Amount Bid in Figures: $ Total Amount Bid in Words: d �j 0 NVI iY r t _ -- - ----- --- - --- - - - C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the naive and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. 0 6V Portion I Name and Address of Subcontractor I State License I Class of Wnr/r Number � � �, � CILI Z 001(� By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange 1Zv�w r� c� being first duly sworn, deposes and says that he or she is of I" D012- Ise L- the party making the foregoing bid that the bid is not made in t interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Address of Bidder Subscribed and sworn to before me this day of 200 NOTARY PUBLIC NOTARY SEAL C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of LOS ANGELES On jV,f before me, FRITZ DOW COY, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared ROBERT COLLINS,, ASST . SECRETARY who proved to me on the basis of satisfactory evidence to be the person( whose name) is/aYXsubscribed to the within instrument and acknowledged to me that he/AU%I executed the sari e in his/l f4Xauthorized capacity(jpX), and that by his/hiWMNir signature( on the instrument the person(, or the entity upon behalf of which the person( acted, executed the instrument. FRITZ DOW COY I certify under PENALTY OF PERJURY under the laws Commission # 1801776 of the State of California that the foregoing paragraph is Notary Public - California r true and correct. Los Angeles County My Comm. Expires Jun 15, 2012 WITNESS my d Of al. Place Notary Seal Above Signature Signature of Notary Pu is OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Individual Corporate Officer —Title(s): Partner Limited General Attorney In Fact Trustee Guardian or Conservator Other: Signer Is Representing: 0 1 Top of thu�nc here I I j I � Number of Pages: Signer's Name: __ C Individual —1 Corporate Officer — Title(s): Partner — _; Limped L_ General Attorney In Fact Trustee Guardian or Conservator Other: Signer Is Representing Ton .,f o 2007 National Notary Asscciaticn • 9350 De Soto Ave, PO_ Box 2402 • Chatsworth, CA 91313-2402 • w,.vv� Nationa!Notary org Item N5907 Reorder Call Toll -Free 1-800-876-E827 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL. CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 1 ol, 5-1 o Title C-5 DISQUALIFICATI®N QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes 125 /No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 1 u l-/ o 1 Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: 1"��31-12-1 �-C�l.l.-a.rJS i %�''�"�'T- PLC 12ClTA'✓�'y Title 1 Date: Note: This form is required ,for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained firom the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: Av t _3 Bidder Name 1 Q --7 1 S Business Address City, State Zip ( 15(eZ) I <-H - C ct •-7 5 Telephone Number Zle(.e a1c:) State Contractor's License No. and Class 1 2' t -71 t ct -7 D Original Date Issued 2/Z�6/2-11 Expiration Date The work site was inspected by ��AI�Voflour office on C)/l 200A. The following are persons, firms, and corporations having a principal interest in this proposal: '�/t C� i�►��� cam--+�,,"'.� C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. �7 O 1 Jic_l�"f- �t� l..a�t—S � /- � S`�"T• �.� t-G-t�C l Y�'t'�"'�% Printed or Typed Signature Subscribed and sworn to before me this day of , 200` . NOTARY PUBLIC - "�' rr' � A-ri NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. �� f�-r-r�►c��� 2. 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 9 State of California County of LOS ANGELES On IdIS1o`9 before me, FRITZ DOW COY, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared ROBERT COLLINS, ASST. SECRETARY who proved to me on the basis of satisfactory evidence to be the person( whose name) is/aYiKsubscribed to the within instrument and acknowledged to me that he/s'158A � executed the sarrie in his/hW i4i]Kauthorized capacity("), and that by his/%KMNir signature( on the instrument the person(�j, or the entity upon behalf of which the person(!] acted, executed the instrument. FRITZ DOW COY I certify under PENALTY OF PERJURY under the laws Commission # 1801776 of the State of California that the foregoing paragraph is Z Notary Public - California > true and correct. Los Angeles County RAY Comm. Expires Jun 15, 2012 WITNESS my d of al. Signature Place Notary Seal Above Signature of Notary ublic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: _. Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name. Individual El Individual Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): -! Partner — Limited General Partner — Limited F_' General --_' Attorney in Fact • Attorney in Fact • Oki Top of thumb here Top of lhu;rb here Trustee U Trustee Guardian or Conservator Guardian or Conservator Other: Other: i Signer Is Representing: Signer Is Representing: � I I G2007 national Notary Association • 9350 De Sob Ave., PO Box 2402 • Chats:jorth. CA 91313-2402 • n!.v:, NationalNotartorg Item =5907 Reorder. Call Toll -Free t-800-87e-6827 STATEMENT OF EXPERIENCE Agency: City offUrea Civic Cent-tY.Circle Brea, CA 922,22 1 M-0ject: Traffic Managerrient Plan Valuation: $210,000.00 Completion Date: Q/30/08 Contact: Brian Ingal finera Phone Number: (714) 990-7667 Age �nu, City ofPalmd,,:ile 38250 Sierra Highway Palmdale, CA 93550 Project: 2008 Street Res-uifkling Program Valu.atlonl: $2,692,000.00 Corsi ipletion Date: 9/30/08 o n t a ct: l4ike Livingston honc Nurnber: (661) 267-5312 A; City OfEl Centno 1275 Main Street Li Centro, C-A 922431 Dogwood Avenue Phase 11 ha uatioil: /9,00.00 Com,pletion Dafr--, 19/30/08 Abrahun Campos Num ber: (7 6 O)l 3 41 6 - 8511210 32130 Penn Street U i CA 900505 CDBk'j Tar -et Area Suxface Trcatll--I-A' i-omole-bon Date- 0/0 U rl 1-1 Y. 1-4 1) Sll:oiie T:l u m b e r: (5) 6 2- '/, 9/ -5 - 8 2 0 0 '4 4:. -C �J•ij - i City of Alhan�L;_z 111 So_ltl, first Street A lhan nbra, CA. 9180 =r?levt Atkaitic Blvd Phase Valuation: %9R9.0O.00 Completion Date.: 5/30/08 contact: Anumda Eitet Phone Numbeh (.626) 5 /0-506-2 -. Agency: City of Sea, Beach th 211 n� StrPei Sea! Beach, CA 90740 i i• 1: Main JCieei_f'4'3-t'iUn`:', Lon p aiLiatlril: $35,000.00 =_`.r�,1211'.�leiiol2.l�ate: �!-/3v/OS. Contact- 'David Spitz One Number (562) 4-33 1 --252 / Ca"Of Lake Men t 25 -)0 Col I IIerc.ntre Dr, Suite I Of,,, Lake Forest, M 92630 AC impmvemcrits West of AM My (G) `I�tivatio,�: $6277000.00 Completipi-i Date- / 31 /C 7 Contact: BiH Seitz Nu.,Aer: (949) 4.7W3 505 •'�" i -_ tti•,• U:y of Me Oi= 2550 Cor. memo tre Dq Ahe 100 Lake Forem; CA 92630 /'.CInIpme1<entsFast,?fToiedo Way, (1-1) Valuation: $671100.00 i V 1 M7 Contact: SiL1 Seitz (94`9' �'j 7 �-350- 'i , �S � � � il•',�I'y..-j'iilJ•I�`� 'I }�i��'- I}) � 1 '�`���"'.(„I'. y� I, �'inr- Agency: City of Whitti 13230 Pemi Met Whittier, CA 90605 N-orwalk Vaiu�-aion. $285100.00 ConWRon Ell: W30M7 Comm Sunny Ng i562` 945--8200 City of'San -Dimas 245 E. BmIm mt .'anyDimas, CA 91773 POW: A I I --y s "D " a. i "vv V.-aluation: t 11 (tyoauo CompkWiDaw: SROM 3ontact: &Wt YMMgTM 1"'101-le NLimber: (909) 394-6246 Cit ef Pain]. Spripq�s 3200 j---. Tahpi'LZ C'Inyon 'NV,-!,y Pain, Springs, (,--'A 92263-2743 project: 2,,'U'5/'—)006 ARI-IM Ovmlay V,Iluation: $650,000.010 Compi letion, Data: 3/30/07 Mikf-, Lytar Phone NwOm (760) 323-8253 xS734 2. Agmay: Cit-Y OfFluntington Nrk .6550 MiNsAve u, 9025H,gmiA5, loco ye, improvement of Pacific Blvd. 71. uati oil: S209A0010 M07 C;l2t2i isCOMPINOnDayl Pair ck ., --,. Phone Nulbeir: f-33'23", 1 C ANSI OCR, AT T W nRI ch, 9057,-- of?i;lilg 300 E. Chnnlcn.r.VC. Ora-,ge, rA 92")66 pro, Ject: Santiago Right ! Llrn L alZe 1i1�L1 1.1, hlation- $125MO.00 C ,n; 1etem L<ts - 10/31 /06 :,nl act:. Randy Nguyen ! r!one 1�_�li;her: (714) 744-5531 =' 1$25 Co01ey Dr- Diamond Bar, '-.A 91765 4178 prl ,fect: Neighborhood Traffic Management o , Valuation: l 135,000.00 ,Vi'7plPiii}l1 f �,t': 10/3) 1 /06 Jorge Garcia Phone M n ber: (909) E39-704 ;• City .t"'90al Furl-wl c. ' 7 I�ac'e- 1 1- li Q'ID t'er173!i o, r_': £ 91 �t�-7cFo� ora� ;street r-: Alley 1r1 provprf-;. i, "J C rnp1elioi% Date: 9/_� 1 /06 Manuel 1' a D' a.?', 1 l :one. ] iiniber: (91 g) Q"98-1 24" i l_. !�_l �:, f1 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder ► obi' �n-1 pc L 1�Av , Cam. x� t t�zt, , proposed subcontractor hereby certifies that he has , has not-- /, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a, report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-12 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder here y declares under penalty of perjury under the laws of the State of California that the bidder has _ ,has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of i-d<-:,, Avp-�G- DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member'or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment E (DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; o Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; ® Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. PIP - Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: F] a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: 3. Report Type: Fla. bid/offer/application Fla. initial b. initial award b. material change c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) A/o.✓6�:7 For Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) �1� (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) $ El actual planned 12. For of Payment (check all that apply): 8 a. cash b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred / f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated i tem 11: A/ 4 (attach Continuation Sheet(s) if neces ) 15. Continuation Sheet(s) attached: Yes No 16. Information requested through this form is authorized by Title , 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: 1 t_ o ;.c .. { U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: /,SST. St%T t to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: '---IFZ 16 tiH -Cci - S Date: d r D Federal Use Only: Standara rotor r.t,t, Kev. VY-rL-y i Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-18 March 15, 2001 EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00 L" 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected,to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-19 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90c<ENDIF» Page 12-89 LPP 01-04 C-20 March 15, 2001 The Guarantee Company of North America USA 25800 Northwestern Highway, Suite 720, Southfield, Ml 48075 M BID BOND BOND NO. N/A KNOW ALL MEN BY THESE PRESENTS, That we, Imperial Paving Company, Inc. as Principal, and The Guarantee Company of North America USA, a corporation duly organized under the laws of the State of Michigan, as Surety, are held and firmly bound unto City of Huntington Beach as Obligee, in the sum of Ten Percent of Amount Bid ($ 10% ) Dollars for the payment of which Principal and Surety bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally. WHEREAS, Principal has submitted a bid for Slater Avenue Rehabilitation the Project. NOW, THEREFORE, if the Obligee accepts the bid of the Principal and the Principal enters ��to a Contract with the Obligee for the Project; or, if the Principal pays the Obligee the amount of this Bond or the difference between Principal's bid and the next lowest bid for the Project, whichever is less: this obligation is null and void, otherwise to remain in full force and effect. Signed and sealed this 12th day of October 2009 (Witness) ITS: (a�-Y1 r Lo �r .1S , /4�5 (�i i R►'zi� The Guarantee Company of North America USA BY: SyrkinAttorney-In-Fact) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of LOS ANGELES On 10'IS/09 before me, FRITZ DOW COY, NOTARY PUBLIC. Date Here Insert Name and Title of the Officer personally appeared ROBERT COLLINS,, ASST. SECRETARY FRITZ OOw COY Commission # 1801776 a - Notary Public - California i z' Los Angeles County My Comm. Expires Jun 15, 2012 ------------ Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person( whose name) is/a}Ksubscribed to the within instrument and acknowledged to me that he/s`fig/d � executed the sarrie in his/i t`fl4i�authorized capacity(}M), and that by his/MKt& Nr signature(A on the instrument the person(, or the entity upon behalf of which the person( acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature c3c—_ Signature of Note ublic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Individual _. Corporate Officer — Title(s): Partner — ___ Limited General Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: ,RIG HTTHUMSPRI OF SIGNETop Df thumb here RNi. Number of Pages: Signer's Name:_ _ individual Corporate Officer — Title(s) _ Partner — -_1 Limited `..-_ General Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: RIGHTTHUMBPRIN _OF,SIGNER y .° Z�j2007 National Notary Association • 9350 De Soto Ave , ?O. Box 2402 CA 91313-2102.. P,, NatianalNotary arg Item =590' Reori, a': ,\c,%a>; -s�:�s��;aaCs�a :�..: �.�.�.`�.�'t� .� .v!�3¢.paSS.T...s?.�T�.: �i,.�a� c�,•�.'>.7<� 5 �....: �.L%>��i,� ?G!?�..T tea. ��.,tin ..:��t?.' �...c�' �R!3���:��,.: State of California County of Orange On 10/12/09 before me, R. Haas -Bates, Notary Public Date Here Insert Name and Title of the Officer personally appeared William Syrkin Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(&) whose name(&) is/afe subscribed to the within instrument and acknowledged to me that he/she/ ey executed the same in his/hwA4@ F authorized capacity(ie6), and that by hisA*wA4& signature(&} on the instrument the person(*, or the entity upon behalf of which the person* acted, executed the instrument. 01PCOMM. R. HAAS-BATES COMM. # 1796169 i certify under PENALTY OF PERJURY under the laws (�NOTARY PUBLIC CUNTYNIA 0of the State of California that the fore oin ara rah is ORAWGf COUNTY n g g p g p EXPIRES APRII 22, 2012 " true and correct. WITNESS my hand and official seal. Place Notary Seal AboveSignature V-0KNJI Signa re o otary Pudic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: 10/12/09 Number of Pages: One (1) Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: William Syrkin D Individual Corporate Officer — Title(s): _ G Partner — C. Limited ❑ General p Attorney in Fact Trustee Guardian or Conservator Other: Signer Is Representing: The Guarantee Company of North America USA RIGHT THUMBr''RINT OF SIGNER. Signer's Name: Individual ❑ Corporate Officer — Title(s): _ 01 Partner — 0 Limited C General _i Attorney in Fact Ci Trustee L Guardian or Conservator Other: Signer Is Representing RIGHT THUkIAPRIN XT, Top of thumb here OFistGNE 02007 National Notary Association • 9350 De Soto Ave.. P.O. Box 2402 • Chatsworth, CA 91313-2402 • www_NationalNotaryorg Item 45907 Reorder Call Toll -Free 1-800-876-6827 THE GUARANTEE COMPANY OF NORTH AMERICA USA Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the laws of the State of Michigan, having its principal office in Southfield, Michigan, does hereby constitute and appoint William Syrkin, Matthew C. Welty, Sergio Bechara Millennium Corporate Solutions, Inc. its true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31" day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority: 1. To appoint Attomey(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attorney -in -fact and revoke the authority given, except as provided below 3. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 31" day of December 2003, of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused �e,N OJw_ Tc�; this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 22nd day of July, 2009. THE GUARANTEE COMPANY OF NORTH AMERICA USA p, J H AME0. - C J STATE OF MICHIGAN Stephen Dullard, Vice President Randall Musselman, Secretary County of Oakland On this 22"d day of July, 2009 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of said Company. Cynthia A. Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Notary Public, State of Michigan Company of North America USA offices the day and year above written. County of Oakland My Commission Expires February 27, 2012 0"/nd �G�'%2/ Acting in Oakland County l/' 1, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect. IN WITLESS WHEREOF, 1 have thereunto set my hand and attached the seal of said Company this 12th day of October 2009 a ANTE,. VJ p� 0-°` Randall Musselman, Secretary �RrHAMbR�P City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK February 11, 2010 Palp, Inc., dba Excel Paving Company 2230 Lemon Avenue Long Beach, CA 90806 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest St. Enclosed please find your original bid bond for CC-1359. Sincerely, JF:pe Enclosure Sister Ci@fig?!1gXh1Na1r TgVfeZu%gWjW New Zealand (Telephone: 714-536-5227 ) 2230 LEMON AVENUE LONG BEACH, CA 90806 bT� c4v4AL lowT.-ocl Q 2-,.Oo U City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 I- ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 — ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Number One, dated September 24, 2009 nor+P',��•� ��3.."s��ia ���a'�'�,��`.� Company Name Date By PRESIDENT All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. G:\Construction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\ADVERTISEMENT-NISB-BIDDING PROCESS\CC-1359 Addendum Number One.doc A 0 " ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 ~ FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 point is typically a 3 3/4" aluminum disk with said agency's stamping. Datum information for public viewing is on file at said agency. A survey monument is defined as any permanent point as shown on file at the NGS, NOAA, Caltrans, OCS, City of Huntington Beach Public Works Department or any other public agency; said point being used to establish or perpetuate horizontal control. These points include but are not limited to centerline street monuments or accessories to said centerline street monuments (i.e. tie points), property corners or accessories to said corners, or monuments established in connection with the Orange County Geodetic Control Network or accessories to said monuments. These points shall be tied out and replaced by a licensed Land Surveyor or a licensed Civil Engineer authorized to practice land surveying pursuant to sections 8700 to 8806 of the Business and Professions code of the State of California (Land Surveyors Act). The Corner Records produced from said tie -out and replacement survey shall be furnished to the City of Huntington Beach Public Works Department as well as filed with the office of the County Surveyor indicating responsible charge (stamped), within 60 days of the final survey. 2-9.2 Survey Service [Replace the first paragraph with the following] All construction surveying will be performed by the AGENCY. Monument preservation surveying necessary to complete the work shown on the plans and provided for in these contract documents and specifications shall be accomplished by or under the direction of a licensed Land Surveyor or Professional Engineer, whom is authorized to practice land surveying, retained or provided for by the Contractor. The AGENCY reserves the right to direct additional construction survey to be performed when it feels it is required to adequately construct the work. All costs to the Contractor for protecting, removing, restoring, repairing, replacing, or reestablishing monuments or accessories to monuments or costs associated with the preparation or filing of Corner Records pursuant to sections 8700 to 8806 of the Business and Professions Code shall be included in the bid item for survey monument preservation. Payment for survey monument preservation shall be per the contract lump sum bid price and no additional compensation will be allowed therefor. When the contract does not include a pay item for monument preservation and unless otherwise provided in the specifications, full compensation for all monument preservation required to complete the work shall be included in the price bid for other items of work and no additional compensation will be allowed therefor. E-5 CC-1359 Slater Avenue Addendum 1 SECTION C for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. "TLf PERCENT OF AMOUNT BID" Accompanying this proposal of bid, find 00 in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice _ Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Rec®®eived Bidd is Signature 1 0i`— '0"1 I- r PRESIDENT C-2 SECTION C PROJECT DID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STPL-5181 (166) HIMM-A IT "I TOTAL AMOUNT BASE BID IN FIGURES: 0 TOTAL AMOUNT BASE BID IN WORDS: C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1359 Item:: Estimated :::: ::::::::::: Itein:v�itli gnat: :rrce:::::::::::.:::::.:::::::::::;:::::;::::::;:::;:;:::::::::::::::::::::: .............P....,....................,.................................................. Exteride::::. N.o;. (�uai�:tty.:.:::'.>::::.... .wri#ten.�tt.cwords..:.............. .. �Tnit.P�ri�e.: ... Amount:':`: 1 1 Mobilization LS ��-- @ � l.'l� 4 L4 >�t•tl, Dollars ���y��� $ ��" $ Cents Per LS 2 1 Traffic Control Plan LS �' n @ '(1,��0 ` bA..� ��,{ �w-ewv� Dollars $ ��� $ asoo ' Cents Per LS 3 1 Furnish Project Traffic Control LS @ �t1►,}e�t,e }Q,►.o�SQ, Dollars $ kX000- $ \@Loa7. �--�' Cents Per LS 4 96430 SF Cold Milling & Header Cutting incl. disposal of material @ Dollars $ 0,1 $ toogl30_ G.-_L Cents Per SF 5 195300 Surface Grind (0.17) including dipsosal of material SF @ Dollars $ 0. (f $ Za 2c��-, �" ► >J Cents Per SF 6 1325 Unclassified Excavation CY @ _ Dollars $ 0, ' $ 53 000 -- Cents Per CY 7 5040 Construct Asphalt Concrete (0-0.17', 0.17', 0.42' & 0.50) Ton Dollars $ $ Cents Per Ton 8 6015 Construct Asphalt Concrete (0.17' ARHM Overlay) Ton @ Dollars $ $ $-7 1 Li e Cents Per Ton 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface EA @'(bb^L �A441a F, pleaj Dollars $ 31 j - $ o1gk- �® Cents Per EA Adjust OCSD Manhole to finished surface jEA @ ii5yy �eV ___Dollars $ tioa— $ (P Cents Per EA C-2.2 PROJECT BID SCHEDULE Slater Avenue, CC-1359 : Estiriiated .:::::::::::::3fie;n:v�itli iiit::riee::::::::::::::::::::::::::::::::...::::::::::::::::::::::::: .................................................................................................................. Eicfi.. I ... fitty: yyiritteri:t words..iJnifi:=Prue .:: 11 21 Adjust Water Valve to finished surface EA @ &.h@_ l X 4"(A Dollars $ J1 s -�' Cents Per EA 12 1 Adjust Monitoring Well to finished surface EA @ &t _ L6„ (, Dollars $ $ Cents Per EA 13 1 Traffic Striping LS @ !Fn-Ae T J.��A Add Dollars $ t� C%) 0.— $ ^ Cents Per LS 14 33 Traffic Loop EA @ dvi- � jk�m YU Lr e `? Dollars $ MCI — $ (D 2-1 Q -- Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, P Slot 15 1830 Pave per Std Plan 202) LF @ VW rA--' �+/Y'L Dollars $ 33. $ (190 01 ' Cents Per LF 16 15155 SF Remove & Reconstruct Sidewalk per Std Plan 207 @ �✓ Dollars �o $ � $ Cents Per SF Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining 17 12 Curb, I' Slot pave, & SW) EA @ 4WU `+JA4o S-Ao_0 ortm-t Oe-1^-J Dollars $ 'ZIOD - $ ZS' Zail Cents Per EA 18 4 Install Truncated Domes into existing Access Ramp EA @ �bof NWvW 'f ge�4t 11R Dollars $ ,- $ 3 0O �-' Cents Per EA 19 13 Survey Monumentation EA @ `-kyyt_ [A-.,P.J!ao Dollars $ 3t3J. $ ao Cents Per EA 20 1 Raise Survey Well Monument to finished surface EA @ rAWi t Nam- V-0'0 Dollars $ 30c) $ :3 gAa - — `-'/ Cents Per EA C-2.3 PROJECT DID SCHEDULE Slater Avenue, CC-1359 Itetri .'Estimated :: ;>:::::::::::: Ifietti:a ttli unit. :rice:::::...: > ::::::.:.. P........................................................................ : Extende llti .. . t3 .: :.......:............................................ ................. ;:.wrItten:�n:WQrds:.:. :Unit.t'riee.:.:....:::Airiotrnt..::::::: 21 1654 Remove & Reconstruct Curb & X-Gutter SF @ Dollars $ 1 $ 2L TOT �—^ Cents Per SF 22 6 Remove & Install New Traffic Signal Pullbox EA @ AAAVu— Dollars $ 5001— $ t 5w --- Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-1-T frame. Install city furnished traffic signal head with LE-SV-1-T framework and terminal box. 1 ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. 1 ea o Install conduit into existing pullbox. I ea. o Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. tea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1-12 conductor cable and 1-3 conductor cable. 1 ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. 1 ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. I ea o Abandon existing conduit and remove conductors. I ea o Install 3" conduit into existing pullbox. 1 ea o Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cable and into traffic signal cabinet. I ea. LS `D�L"C''s� @��d kC2� �UUAn� Dollars $ 1woo— $ Cents Per LS Total Amount Bid in Figures: $ 1 V2, Total Amount Bid in Words: ink.. p, A-0;1 , -I U + � Of 11A.� S-, - - - - ----------------- -- ------------------- C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class taw G ( �r by1V14- C, I2 / LI 1015 15y1 &A Ac-C. -7 -Iy VS 4 JJ ,rt2 /f // 0/ SJ,r U,A Gct"Frz . laa� o Lss�tt� By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of 6 n e 10RAINROAg C _ py BROWN ,being f rst,duly sworn, deposes and says that he or she is PRESIDENT of PWNI 911MUP s_,M the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. P'X 11tM.00A IEEL u Sao" P16 C06VTa -rmf Name of Bidder �l,d-vim' ' a= COMM OJF,09 59 � Signature of Bidder C. Po BRO°�f P�"; PRE510EF9T Q Notary Public -California W 1 'OS ANGELES COUWy u� y fwlyCOMM, Expires Aug.16,2012 2230 LEMON AVENUE LONG BEACH, CA 90806 Address of Bidder Subscribed and sworn to before me this day of OCT 15 20091200 NOTARY PUBLIC NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: OCT 15 2009 i° .C�Lo� u#C8til��tyuUlr�J Contractor By Title C-5 DISQUALIJF'ICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes 52 No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. - I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: OC 15 2009 f"'Werch nMW1Arn ftnMil"aRnI 'O"),31VU r au ti A Contractor By �- Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required .for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained _from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: Bidder Name PALP INC, OQA EXCEL PAVING COMPANY 2230 LEMON AVENUE LOING Rcrmm ra anana Business Address City, State Zip 1..562) 599-5841 Telephone Number STATE UC. 688659 `A0 State Contractor's License No. and Class I `«1 A4 Original Date Issued Expiration Date The work site was inspected by of our office on�,1200 _ The following are persons, firms, and corporations having a principal interest in this proposal: CURTIS P. BROWN, PRESIDENT & CHIEF OPERATING OFFICER , SECRETARY R GEORGE R. McRAE, SENIOR VICE PRESIDENT CURTIS P. BROWN III, VICE PRESIDENT MICHELE E. DRAKULICH, ASSISTANT SECRETARY C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans an�d1 Specifications set forth. -,CEP,. PAMI G Ca INh,��ADN Company Name Signature of Bidder 0_P. BROI M, PRESICEPAT Printed or Typed Signature Subscribed and sworn to before me this — day of OCT 15 2009 , 200_ . C C, PHILLIPS COMM.#1809758 Notary PublimCalifornia LOS ANC€LES COUNTYNOTARY PUBLIC � s�..7_MyCOMM, Wires Aug. 16,2012 NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. 2. 3. Name and Address of Public Agency Name and Telephone No. of Project Manager. Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Naive and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Date Completed Date Completed C-10 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: 'P Contact Person:� Contact Phone: mrmgg.5841 Signed: Date: O(fT 15 2009 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) The bidder subcontractor EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION proposed hereby certifies that he has., has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a, report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-12 March 15, 2001 Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not Z been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of WSMSMS DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone' else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP O1-04 C-15 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment E u TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; ® Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F N®NLGBBXING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G ALP? 2230 LONG DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: [—A] a. contract b, grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: Wa, bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity 91prime Subawardee DGA EXCEL PAVING COMPAWfier , if known )N AVENUE CH, CA 90806 Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 3. Report Type: ® a. initial b. material change For Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) $ 11 actual planned 12. For of Payment (check all that apply): Ea. cash b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ❑ No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 print Name: r P F21 riwAt U.S.C. 1352. This information will be reported to Congress - • • ��.rr ra k semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than $10,000 and not more than I LQi $100,000 for each such failure. Telephone No.:;582) 59M841 Date: Federal Use Only: Standard Form LLL Rev. 09-12-97 Authorized for Local Reproduction Standard Form - LLL Page 12-87 LP? 01-04 C-18 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at 'the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00 1. " 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-19 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employees) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Ins"c6ons Rev.06-04-90«ENDIFa Page 12-89 LPP 01-04 C-20 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) n N 00 BIDDER'S LIST OF SUBCONTRACTORS (I)BE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. v. Distribution: 1) Original - Local Agency File Page12-111 LPP 06-06 November 14,20 Exhibit 12-G Local Assistapce Praced'ures Manual Bidder's List of Subcontractors (DBE and Non -DBE) n N 14 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 CERTIFICATE OF ACKNOWLEDGMENT State of California County of Los Angeles On 0 T� before me, C. PHILLIPS, NOTARY PUBLIC (Herz inuri name and tide of the officer) personally appeared PALP DBA EXCEL PAVING COMPANY BY C.P. BROWN, PRESIDENT who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/= subscribed to the within instrument and acknowledged to me that heM"Isyexecuted the same in his/hWAM11authorized capacity(ies), and that by his/horkh& signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. C. PH;LU 3 `' `k1 CQiM1N11 iS09y-98 iNOtnry Pis: i :�s3!Iit)fnl$ N WITNE my hand and official seal. LOS .;cuw, LL omvrt, 4 arr'as Avg 18, 2012 Signa fNotary Public (Notary sew) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Tide or description of attached document) (Tide or description of attached document continued) Number of Pages Document Date ---- (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Tide) ❑ Partner(s) O Attorney -in -Fact ❑ Trustee(s) ❑ Other 2008 Version CAPA v12 10 07 800-873-9865 wow NouryCimses corn INSTRUC IONS FOR COMPLETING THIS FORM Any acknowledgment completed in Calrfornta mutt contain verbiage exactly as appears above in the notary section or a separate ack wwledgmenu form must be properly completed and attached to that document. The only exception is if a down ig is to be recorded muside of Caltfornia In such instances, any alternadve acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the rotary to do something that is dlegat for a notary in California (i.e. cerroft the authorised ceraciry of the signer). Please chuck the docwnew carefully for proper notarial wording and attach thus form tf required • State and County information must be the State and County whue the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears widtin his or her commission followed by a comma and then your tide (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notamation. • Indicate the correct singular or plural forms by crossing off incorrect forms (Le Wshelttwt is lam) or circling the correct forms Failure to correctly indicate this information may lead to rejection of document recording.- • The notary seat impression must be clear and photographically reproducible Impression must not cover text or lines. If seal impression smudges, re -scat if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. <• Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document Indicate tide or type of attached document, number of pages and date r Indicate the capacity claimed by the signer If the claimed capacity is a corporate officer, indicate the tide (!.e CEO, CFO, Secretary) • Securely attach this document to the signed document ADJUST UTILITIES SUBCONTRACTORS Flame: Manhole Adjusting Contractors Phone: (323) 558-8000 Address: 9500 Beverly Rd. Fax: (323) 558-8055 Pico Rivera, CA 90660 Type of Work: Crackseal, Seal Coat, Striping ('dumber of Years In Business: 25+ Annual Gross Receipts Last Year: Contact Person: John Less Than $1 Million Certified DBE?: 1:1YES ® NO Less Than $5 Million State License: 396627 Less Than $10 Million Fed M 33-0694618 Less Than $15 Million CT #: 7 EMore Than $15 Million Name: Ramirez Construction Phone: (626) 967-5790 Address: 656 E. San Bernardino Rd. Fax: (626) 967-5688 Covina, CA 91723 Type of Work: Adjust Utilitites Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Art Ramirez Less Than $1 Million Certified DBE?: YES ® NO Less Than $5 Million State License: 683241 Less Than $10 Million Fed M 95-4464683 Less Than $15 Million CT M 24273 More Than $15 Million Name: Elite Bobcat Service (EBS) Phone: (951) 279-6869 Address: 1320 E 6th St., Suite 100 Fax: (951) 279-9112 Corona, CA 92879 Type of Work: Utility Adjusting/Concrete Number of Years In Business: 14 Annual Gross Receipts Last Year: Contact Person: Hugh Lee Less Than $1 Million Certified DBE?: 0 YES ® NO Less Than $5 Million State License: 720016 A Less Than $10 Million Fed M 33-0634599 Less Than $15 Million ■More Than $15 Million ADJUST UTILITIES SUBCONTRACTORS Name: Ells Tech Underground Phone: (909) 790-8453 Address: 35026 Avenue E Fax: (909) 790-8457 Yucaipa, CA 92399 Type of Work: Manhole/Utility Adjusting Number of Years In Business: 1 Annual Gross Receipts Last Year: Contact Person: Erik Williams Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 893529 A Less Than $10 Million Fed #: 20-5434449 Less Than $15 Million CT #: I ❑More Than $15 Million AC DIKE SUBCONTRACTORS Name: AC Dike Phone: (916) 645-7747 Address: 2788 Venture Dr. Fax: (916) 645-9618 Lincoln, CA 95648 Type of Work: Dike Placement, Specialty Paving Number of Years In Business: 26 Annual Gross Receipts Last Year: Contact Person: Dave McClain Less Than $1 Million Certified DBE?: 0 YES ❑ NO Less Than $5 Million State License: 407417 Less Than $10 Million Fed M 94-2748922 Less Than $15 Million CT #: 000219 [—]More Than $15 Million COLD MILL SUBCONTRACTORS Name: All -American Asphalt Phone: (909) 736-7600 Address: 400 E. 6th Street Fax: (909) 739-4671 / (909) 736-3848 Corona, CA 91718 Type of Work/Materials Provided: Cold Plane/Asphalt Number of Years In Business: 45+ Annual Gross Receipts Last Year: Contact Person: Joe Less Than $1 Million Certified DBE?: ❑ YES NO 1:1Less Than $5 Million State License: 267073-A Less Than $10 Million Fed #: 95-2595043 Less Than $15 Million CT #: N/A MMore Than $15 Million COLD MILL SUBCONTRACTORS Name: Lind 's Cold Planing Phone: 562) 697-2286 AcIdress: 541 W. Mountain View Fax: (562) 697-2039 La Habra, CA 90631 Type of Work/Materials Provided: Cold Mill Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Lindy Less Than $1 Million Certified DBE?: El YES ® NO ®Less Than $5 Million State License: 711072 Less Than $10 Million Fed #: 33-0702884 Less Than $15 Million CT #: More Than $15 Million Name: Pavement Recycling Systems Phone: (909) 682-1091 Address: 10240 San Sevaine Fax: (909) 682-1094 Mira Loma, CA 91752 Type of Work/Materials Provided: Cold Mill Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Don/Theresa Less Than $1 Million Certified DBE?: ❑ YES ® NO Less Than $5 Million State License: 569352 Less Than $10 Million Fed #: 33-0353433 ®Less Than $15 Million CT #: DMore Than $15 Million Name: Precision Cold Planing Phone: (909) 721-2461 Address: 8657 Riverside Drive Fax: (909) 923-8007 Ontario, CA 91761 Type of Work/Materials Provided: Cold Plane Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Tom Lynch Less Than $1 Million Certified DBE?: El YES ® NO ®Less Than $5 Million State License: 801059 Less Than $10 Million Fed #: 43-2022382 Less Than $15 Million CT #: N/A ToMore Than $15 Million CONCRETE SUBCONTRACTORS Name: AA&P Contractors Phone: (805) 647-1806 Address: PO Box 4153. Fax: (805) 647-2791 Saticoy, CA 93007 Type of Work: Concrete Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Ed Pillado Less Than $1 Million Certified DBE?: ® YES ❑ NO Less Than $5 Million State License: 626248 Less Than $10 Million Fed #: Less Than $15 Million CT #: 002041 ❑More Than $15 Million Name: AM Concrete Phone: (818) 768-4767 Address: 9050 N. Norris Ave. Fax: (818) 768-7228 Sun Valley, CA 91353 Type of Work: Concrete Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Shane Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 446850 Less Than $10 Million Fed #: 95-3830420 Less Than $15 Million CT #: ❑More Than $15 Million Name: CL Concrete Phone: (626) 334-2357 1035 W. Gladstone Fax: (626) 334-3517 Azusa, CA 91702 Type of Work: Concrete Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: Camilo ❑Less Than $1 Million Certified DBE?: ® YES ❑ NO Less Than $5 Million State License: 488722 ®Less Than $10 Million Fed #: 95-4020503 Less Than $15 Million CT #: 0010504 ❑More Than $15 Million CONCRETE SUBCONTRACTORS Name: Damon Construction Phone: (714) 995-5490 Address: 8851 Watson St. Fax: (714) 995-5707 Cypress, CA 90630 Type of Work: Concrete Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: And Less Than $1 Million Certified DBE?: ❑ YES ■ NO Less Than $5 Million State License: 280588-A Less Than $10 Million Fed M 95-2679953 ■Less Than $15 Million CT #: More Than $15 Million Name: Deco Pave, Inc. Phone: (877) 707-3326 Address: 15535 E. Arrow Hwy. Fax: (626) 480-1557 Irwindale, CA 91706 Work: Street Print/Stamped Aphalt/Duratherm Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Terry/Mindy Davis Less Than $1 Million Certified DBE?: ❑ YES ® NO Less Than $5 Million State License: 761655 ®Less Than $10 Million Fed M 95-4732952 Less Than $15 Million CUPC#: More Than $15 Million Name: Dial Construction Phone: (805) 988-0194 Address: PO Box 940010 Fax: (805) 988-0334 Simi Valley, CA Type of Work: Concrete/Manhole/Root Barrier Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Randy Wagner Less Than $1 Million Certified DBE?: ® YES NO Less Than $5 Million State License: 397464 Less Than $10 Million Fed #: 95-4090956 Less Than $15 Million CT #: More Than $15 Million CONCRETE SUBCONTRACTORS Name: Elite Bobcat Service (EBS) Phone: (951) 279-6869 Address: 1320 E 6th St., Suite 100 Fax: (951) 279-9112 Corona, CA 92879 Type of Work: Utility Adjusting/Concrete Number of Years In Business: 14 Annual Gross Receipts Last Year: Contact Person: Hugh Lee Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 720016 A 1�1Less Than $10 Million Fed M 33-0634599 Less Than $15 Million MMore Than $15 Million Name: G&F Concrete Cutting Phone: (714) 648-0397 Address: 1006 E. Chestnut Fax: (714) 550-0624 Santa Ana, CA 92701 Type of Work: Concrete Cutting Number of Years In Business: 25+ Annual Gross Receipts Last Year: Contact Person: Greg Ferguson Less Than $1 Million Certified DBE?: YES NO Less Than $5 Million State License: 590310 Less Than $10 Million Fed #: 33-0142173 Less Than $15 Million CUPC#: 30936 0 More Than $15 Million Name: Griffith Co. Phone: (562) 929-1128 Address: 12200 Bloomfield Ave. Fax: (562) 864-8970 Santa Fe Springs, CA 90670 Type of Work: Minor Concrete Number of Years In Business: 104 Annual Gross Receipts Last Year: Contact Person: Pete Jezowski Less Than $1 Million Certified DBE?: YES ❑ NO Less Than $5 Million State License: 88 Less Than $10 Million Fed M 95-0795590 Less Than $15 Million CUPC#: MMore Than $15 Million CONCRETE SUBCONTRACTORS Name: JD Jimenez Concrete Inc. Phone: (909) 989-3615 Address: 9583 8th St. Fax: (909) 980-3588 Rancho Cucamonga, CA 91730 Type of Work: Concrete Number of Years In Business: 40+ Annual Gross Receipts Last Year: Contact Person: Amanda Cruz Less Than $1 Million MBE/SBE?: WES "O ®Less Than $5 Million State License: 415692 C-8 Less Than $10 Million Fed M 95-3614004 Less Than $15 Million CALTRANS# 2571 SBE#12246 ❑More Than $15 Million Name: Jezowski & Markel Contractors Phone: (714) 978-2222 Address: 748 N. Poplar St. Fax: (714) 978-6931 Orange, CA 92868 Type of Work: Concrete Number of Years In Business: 40+ Annual Gross Receipts Last Year: Contact Person: John Bennett Less Than $1 Million Certified DBE?: ® YES ❑ NO Less Than $5 Million State License: 2428981-ess Than $10 Million Fed M 95-2428873 Less Than $15 Million CT #: 0008074 ❑More Than $15 Million Name: Ranco Corporation Phone: (714) 992-2547 Address: PO Box 9007 Fax: (714) 992-2500 Brea, CA Type of Work: Concrete Number of Years In Business: 12+ Annual Gross Receipts Last Year: Contact Person: Dale Jones 0 Less Than $1 Million Certified DBE?: ❑ YES ® NO Less Than $5 Million State License: 638000 Less Than $10 Million Fed M 33-0694618 Less Than $15 Million CT #: ❑More Than $15 Million CONCRETE SUBCONTRACTORS Name: Reyes Construction Phone: (909) 622-2259 Address: 1295 S. East End Ave. Fax: (909) 622-3053 Pomona, CA 91766 T e of Work: Concrete Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Joe Reyes ❑Less Than $1 Million Certified DBE?: ■ YES ❑ NO ❑Less Than $5 Million State License: 507561 Less Than $10 Million Fed #: 95-4090956 ❑Less Than $15 Million CT #: ❑More Than $15 Million Name: Sullivan Concrete Textures Phone: (714) 556-7633 Address: 1111 Baker St. Fax: (714) 755-5541 Costa Mesa, CA 92626 Type of Work: Concrete Number of Years In Business: 42 Annual Gross Receipts Last Year: Contact Person: Reenie Sullivan ❑Less Than $1 Million Certified DBE?: 0 YES ❑ NO ❑Less Than $5 Million State License: 408047 Less Than $10 Million Fed #: 95-3431496 ❑Less Than $15 Million CT #: D-0946170 ❑More Than $15 Million Name: Trademark Concrete Systems To Be Inserted ELECTRICAL SUBCONTRACTORS Name: B&D Enterprises. Phone: (562) 694-5445 Address: 621 S. Walnut St. Fax: (562) 691-8695 La Habra, CA 90631 Type of Work/Materials Provided: Electrical Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Steve Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 802002 ®Less Than $10 Million Fed #: ❑Less Than $15 Million CT #: El More Than $15 Million Name: California Professional Engineers Phone: (626) 452-8658 Address: 9316 Mable Ave. Fax: (626) 448-0470 S. El Monte, CA Type of Work/Materials Provided: Electrical Number of Years In Business: 3+ Annual Gross Receipts Last Year: Contact Person: Van ®Less Than $1 Million Certified DBE?: ® YES ❑ NO Less Than $5 Million State License: 793907 Less Than $10 Million Fed #: Less Than $15 Million CT #: 31277 ❑More Than $15 Million Name: CMV Electric Phone: (909) 931-5700 Address: 1638 Huntington Dr. Unit A Fax: (909) 931-5701 Upland, CA 91786 Type of Work/Materials Provided: Electrical Number of Years In Business: 1.5 Annual Gross Receipts Last Year: Contact Person: Carlos Villegas Less Than $1 Million Certified DBE?: EYES ❑ NO Less Than $5 Million State License: 711072 ®Less Than $10 Million Fed #: 33-0702884 ❑Less Than $15 Million CT #: ❑More Than $15 Million ELECTRICAL SUBCONTRACTORS Name: CSI Electrical Phone: (562) 946-0700 Address: 10623 Fulton Wells Ave. Fax: (562) 946-0701 Santa Fe Springs, CA 90670 Type of Work/Materials Provided: Electrical Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Steven Kujawa Less Than $1 Million Certified DBE?: ❑ YES ❑ NO Less Than $5 Million State License: 538211 Less Than $10 Million Fed #: Less Than $15 Million CT M ❑More Than $15 Million Name: CT & F Electrical Phone: (562) 927-2339 Address: 7228 Scout Ave. Fax: (562) 927-3338 Bell Gardens, CA 90201 Type of Work/Materials Provided: Electrical Number of Years In Business: 42+ Annual Gross Receipts Last Year: Contact Person: Todd Simons Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 181572 C-10 ❑Less Than $10 Million Fed M 33-0702884 E Less Than $15 Million ICT #: ❑More Than $15 Million Name: Dynalectric Phone: (714) 828-7000 Address: 4462 Corporate Center Drive Fax: (714) 484-2389 Los Alamitos, CA 90720 Type of Work/Materials Provided: Electrical Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Tim Erno Less Than $1 Million Certified DBE?: ❑ YES ® NO Less Than $5 Million State License: 550173 Less Than $10 Million Fed M 95-3041910 ®Less Than $15 Million CT #: ❑More Than $15 Million ELECTRICAL SUBCONTRACTORS Name: Highlight Electric Phone: (951) 352-9646 Address: 7000 Juru a Ave. Fax: (951) 352-2498 Riverside, CA 92504 Type of Work/Materials Provided: Electrical Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: Jose Less Than $1 Million Certified DBE?: ■ YES ❑ NO Less Than $5 Million State License: 806335 Less Than $10 Million Fed M ELess Than $15 Million CT M 10383 ❑More Than $15 Million Name: JFL Electrical Phone: 323 581-4400 Address: 8257 Compton Ave. Fax: (323) 581-4404 Los Angeles, CA Type of Work/Materials Provided: Electrical Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Less Than $1 Million Certified DBE?: ■ YES ❑ NO Less Than $5 Million State License: 578969 B, C-36, C-10 Less Than $10 Million Fed M MLess Than $15 Million CT M 007536 ❑More Than $15 Million Name: L.A. Signal Phone: (626) 968-3771 Address: 15100 E. Nelson Fax: La Puente, CA 91744 Type of Work/Materials Provided: Electrical Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Less Than $1 Million Certified DBE?: ❑ YES ❑ NO Less Than $5 Million State License: 749255 Less Than $10 Million Fed M Less Than $15 Million CT #: ❑More Than $15 Million ELECTRICAL SUBCONTRACTORS Name: Lincoln Pacific Phone: (626) 960-7738 Address: 4501 Littlejohn St. Fax: (626) 960-7739 Baldwin Park, CA 91706 Type of Work/Materials Provided: Electrical Number of Years In Business: 5+ Annual Gross Receipts Last Year: Contact Person: ❑Less Than $1 Million Certified DBE?: YES ❑ NO Less Than $5 Million State License: 828467 Less Than $10 Million Fed #: 20-0804624 ❑Less Than $15 Million CT #: 35831 ❑More Than $15 Million Name: Loopmasters Phone: (714) 630-8894 Address: 4740 E. Bryson Fax: (714) 630-1783 Anaheim, CA 92807 Type of Work/Materials Provided: Traffic Loops Number of Years In Business: 8 Annual Gross Receipts Last Year: Contact Person: Andrea or Dori Less Than $1 Million Certified DBE?: 0 YES ❑ NO Less Than $5 Million State License: 755319 Less Than $10 Million Fed M Less Than $15 Million CT M ❑More Than $15 Million Name: Moore Electrical Phone: (909) 371-4202 Address: 463 N. Smith Ave. Fax: (909) 278-3406 Corona, CA 92880 Type of Work/Materials Provided: Electrical Number of Years In Business: 19+ Annual Gross Receipts Last Year: Contact Person: Rusty Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 610382 ❑Less Than $10 Million Fed M Less Than $15 Million CT M EMore Than $15 Million ELECTRICAL SUBCONTRACTORS Blame: MSL Electrical Phone: (714) 693-4837 Address: 4511 Eisenhower Circle Fax: (714) 693-4838 Anaheim, CA Type of Work/Materials Provided: Electrical Dumber of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Less Than $1 Million Certified DBE?: YES ® NO ®Less Than $5 Million State License: 822450 Less Than $10 Million Fed #: 0 Less Than $15 Million CT #: More Than $15 Million Dame: Pouk & Steinle Phone: (909) 682-2982 Address: 3000 E. Coronado St. Fax: (714) 632-8569 Anaheim, CA 92806 T pe of Work/Materials Provided: Electrical Number of Years In Business: 14+ Annual Gross Receipts Last Year: Contact Person: Danny/Landon Less Than $1 Million Certified DBE?: El YES ® NO Less Than $5 Million State License: 576274 A-C10 Less Than $10 Million Fed #: 33-0364913 Less Than $15 Million CT #: ®More Than $15 Million Name: Rural Electric Phone: (480) 986-1488 Address: 9502 E. Main St. Fax: (480) 984-0319 Mesa, AZ 85207 Type of Work/Materials Provided: Electrical Number of Years In Business: 30 Annual Gross Receipts Last Year: Contact Person: Brett Bieberdorf 0 Less Than $1 Million Certified DBE?: DYES ® NO Less Than $5 Million State License: 860933 Less Than $10 Million Fed #: 86-0360401 ®Less Than $15 Million CT #: More Than $15 Million ELECTRICAL SUBCONTRACTORS Name: Smithson Electric Phone: (714) 997-9556 Address: 1938 E. Katella Ave. Fax: (714) 997-9559 Orange, CA Type of Work/Materials Provided: Electrical Dumber of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Tom Smithson Less Than $1 Million Certified DBE?: 11 YES ® NO 0 Less Than $5 Million State License: 614518 Less Than $10 Million Fed M 33-0447874 Less Than $15 Million CT M ElMore Than $15 Million Name: Steiny & Company Phone: (213) 382-2331 Address: 221 N. Ardmore Ave. Fax: (213) 381-6781 Los Angeles, CA 90004 Type of Work/Materials Provided: Electrical Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: Bill Less Than $1 Million Certified DBE?: 1:1YES NO 17 Less Than $5 Million State License: 161273 E:lLess Than $10 Million Fed M 95-1889828 OlLess Than $15 Million CT M ®More Than $15 Million Name: Taft Electric Phone: (805) 642-0121 Address: 1694 Eastman Ave. Fax: (805) 644-6488 Ventura, CA 93003 Type of Work: Signals, Lighting, Security Number of Years In Business: 60+ Annual Gross Receipts Last Year: Contact Person: Rick Harwood Less Than $1 Million Certified DBE?: 0 YES 0 NO Less Than $5 Million State License: 772245 A,B, C10 Less Than $10 Million Fed #: 1:1Less Than $15 Million CT #: MMore Than $15 Million ELECTRICAL SUBCONTRACTORS Name: Terno Phone: (714) 228-9631 15701 Heron Ave. Fax: (714) 228-9635 La Mirada, CA 90638 Type of Work: Traffic Signal/Street Lighting Number of Years In Business: 1+ Annual Gross Receipts Last Year: Contact Person: Richard Ku"awa Less Than $1 Million Certified DBE?: ❑ YES ® NO ❑Less Than $5 Million State License: 862724 ❑Less Than $10 Million Fed #: 20-3076612 ®Less Than $15 Million CT M N/A ❑More Than $15 Million Name: Traffic Loops & Crackfilling Inc. Phone: (714) 520-4026 Address: 946 S. Emerald St. Fax: (714) 520-4027 Anaheim, CA 92804 Type of Work/Materials Provided: Electrical Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Lee Nguyen Less Than $1 Million Certified DBE?: ® YES ❑ NO Less Than $5 Million State License: 652926 ®Less Than $10 Million Fed M 33-0702884 Less Than $15 Million CT M 012886 ❑More Than $15 Million FENCE SUBCONTRACTORS Name: Ace Fence Phone: (626) 333-0727 Address: 15135 Salt Lake Ave. Fax: (626) 333-7843 City of Industry, CA 91746 Type of Work: Fence and Gates Number of Years In Business: 14+ Annual Gross Receipts Last Year: Contact Person: Mike Albania Less Than $1 Million Certified DBE?: EYES El NO ■Less Than $5 Million State License: 01674 Less Than $10 Million Fed #: 031347 E:ILess Than $15 Million CT #: 031347 OMore Than $15 Million Name: Alcorn Fence Phone: (818) 983-0650 Address: 9901 Glenoaks Blvd. Fax: (818) 768-9719 Sun Valley, CA 91352 Type of Work: Fence Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Eric Less Than $1 Million Certified DBE?: YES NO Less Than $5 Million State License: 122954 I:ILess Than $10 Million Fed #: 95-1659211 Less Than $15 Million CT #: ■More Than $15 Million Name: Built Rite Fence Phone: (562) 804-4828 Address: 9518 Jefferson St. Fax: (562) 920-3929 Bellflower, CA 90706 Type of Work: Fence Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Victor Less Than $1 Million Certified DBE?: D YES ® NO •Less Than $5 Million State License: 341514 Less Than $10 Million Fed #: 72-1521679 Less Than $15 Million CT #: More Than $15 Million FENCE SUBCONTRACTORS Name: Crown Fence Phone: (562) 864-5177 Address: 12118 Bloomfield Ave. Fax: (562) 864-2529 Santa Fe Springs, CA 90670 Type of Work: Fence/Chain Link Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: Jim Less Than $1 Million Certified DBE?: D YES ® NO Less Than $5 Million State License: 1315 El Less Than $10 Million Fed M 95-4205283 Less Than $15 Million CT M ®More Than $15 Million Name: Goldenwest Fence Phone: (714) 893-0034 Address: 6381 Industry Way Fax: (714) 373-1873 Westminster, CA 92683 Type of Work: Fence Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Evan Less Than $1 Million Certified DBE?: El YES NO Less Than $5 Million State License: 395395 ®Less Than $10 Million Fed M Less Than $15 Million CT M More Than $15 Million Name: Quality Fence Phone: (323) 585-8585 Address: 14929 Garfield Ave. Fax: (562) 869-7804 Paramount, CA 90723 Type of Work: Fence Number of Years In Business: 40+ Annual Gross Receipts Last Year: Contact Person: Ty Less Than $1 Million Certified DBE?: YES NO, Less Than $5 Million State License: 382736 Less Than $10 Million Fed M 95-3310585 Less Than $15 Million CT M More Than $15 Million LANDSCAPE/IRRIGATION SUBCONTRACTORS Name: BRM Equipment Phone: (562) 254-5621 Address: PO Box 50032 Fax: (562) 597-2251 Long Beach, CA Type of Work: Land sca a/Irri ation Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Bruce Less Than $1 Million Certified DBE?: ❑ YES ® NO ®Less Than $5 Million State License: 689524 ❑Less Than $10 Million Fed #: 91-592461 Less Than $15 Million CT M ❑More Than $15 Million Name: Kato Landscape, Inc. Phone: (714) 963-4615 1812 Bushard St. Fax: (714) 963-6424 Fountain Valley, CA 92708 Type of Work: Landscaping Construction Number of Years In Business: 25 Annual Gross Receipts Last Year: Contact Person: Mike Kato Less Than $1 Million Certified DBE?: ■ YES ❑ NO M Less Than $5 Million State License: 806122-C-27 Less Than $10 Million ed M 33-0980907 ❑Less Than $15 Million LCT M 35398 (DBE Cert#) ❑More Than $15 Million Name: Marina Landscape Phone: (714) 939-6600 Address: 1900 S. Lewis St. Fax: (714) 935-1199 Anaheim, CA 92805 Type of Work: Landscape/Irrigation Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: John Less Than $1 Million Certified DBE?: ❑ YES ❑ NO Less Than $5 Million State License: 507561 ®Less Than $10 Million Fed M 95-4090956 Less Than $15 Million CT #: ❑More Than $15 Million LANDSCAPE/IRRIGATION SUBCONTRACTORS Flame: Phoenix Landsca a Phone: (714) 572-1410 Address: 521 E. Walnut Fax: (714) 572-1412 Fullerton, CA 92832 Type of Work: Landscape/Irrigation Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Sergio D Less Than $1 Million Certified DBE?: EYES ❑ NO Less Than $5 Million State License: 284586 ®Less Than $10 Million Fed M 95-2816277 Less Than $15 Million CT #: 002534 ❑More Than $15 Million Name: Pierre Sprinkler Phone: (626) 214-9323 Address: 5035 Bleecker Fax: (626) 214-9328 Baldwin Park, CA 91706 Type of Work: Landscape Number of Years In Business: 3+ Annual Gross Receipts Last Year: Contact Person: Rigoberto Sanchez Less Than $1 Million Certified DBE?: ❑ YES ® NO Less Than $5 Million State License: 638989 ®Less Than $10 Million Fed M 95-4351034 Less Than $15 Million CT M ❑More Than $15 Million Name: Rivera Irrigation Phone: (714) 639-0400 Address: 2105 W. Collins Fax: (714) 639-7523 Orange, CA Type of Work: Irrigation Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Joe Reyes Less Than $1 Million Certified DBE?: EYES ❑ NO ®Less Than $5 Million State License: 439229 Less Than $10 Million Fed #: 95-2807816 Less Than $15 Million CT #: OCTA 23251 ❑More Than $15 Million LANDSCAPE/IRRIGATION SUBCONTRACTORS Name: S&M Landscape Phone: (626) 969-1863 Address: 346 S. Motor Ave. Fax: (626) 812-0902 Azusa, CA 91702 T pe of Work: Landscape Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Al Macias 0 Less Than $1 Million Certified DBE?: ® YES NO Less Than $5 Million State License: 638473 Less Than $10 Million Fed #: 95-4341030 Less Than $15 Million CT #: CCA-3276 DMore Than $15 Million Name: Stevens Tree Experts Phone: (626) 794-6911 Address: 2570 Walnut St. Fax: (626) 449-7464 Pasadena, CA Type of Work: Lansca e/Treework/Pruning Number of Years In Business: 25+ Annual Gross Receipts Last Year: Contact Person: Steven Schultz Less Than $1 Million Certified DBE?: 0 YES NO Less Than $5 Million State License: 658284 Less Than $10 Million Fed #: 95-4350783 Less Than $15 Million CT #: 01VIore Than $15 Million Name: V&E Tree Service Phone: (714) 997-0903 Address: PO Box 3280 Fax: (714) 637-4070 Orange, CA 92857 Type of Work: Landscape/Irrigation Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Jay Less Than $1 Million Certified DBE?: 1:1YES ® NO ®Less Than $5 Million State License: 654506 Less Than $10 Million Fed #: 95-3685966 Less Than $15 Million CT #: More Than $15 Million LANDSCAPE/IRRIGATION SUBCONTRACTORS Name: Granstrom masonry Phone: (310) 327-2527 Address: 19530 Normandie Fax: Torrance CA 90502 T pe of Work: Masonry Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Joe Reyes Less Than $1 Million Certified DBE?: 1:1YES El NO Less Than $5 Million State License: 629489 Less Than $10 Million Fed M Less Than $15 Million CT M More Than $15 Million Name: Dynacon Phone: (714) 840-3257 Address: 16401 Saratoga Ln. Fax: Huntington Beach, CA Type of Work: Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Cindy Less Than $1 Million Certified DBE?: 0 YES NO Less Than $5 Million State License: 600044 Less Than $10 Million Fed M 33-0510701 Less Than $15 Million CT M More Than $15 Million PAVING FABRICITACK OIL/PRIME COAT Name: ContinentaI Western Transportation CWT Phone: 805 268-0121 Address: P.O. Bix 26636 Fax: (858) 268-9461 San Diego, CA 92196 Type of Work: Oil Spread in /Geos nthetics Number of Years In Business: 28 Annual Gross Receipts Last Year: Contact Person: Greg Smith Less Than $1 Million Certified DBE?: YES NO 0 Less Than $5 Million State License: 532967 ■Less Than $10 Million Fed #: 0 Less Than $15 Million CT #: More Than $15 Million Name: E.M. Oil Transport, Inc. Phone: 323 722-9088 Address: 1145 S. Taylor St. Fax: (323) 816-5169 Montebello, CA 90640 Type of Work: Oil Spread in/Fabric Install Number of Years In Business: 20 Annual Gross Receipts Last Year: Contact Person: Cristina Rodriguez Less Than $1 Million Certified DBE?: ■ YES NO 0 Less Than $5 Million State License: 838893 C-12 Less Than $10 Million Fed #: Less Than $15 Million CT #: DMore Than $15 Million Name: Western Oil Spreading Phone: 805 647-0693 Address: 736 Mission Rock Rd. Fax: (805) 525-4438 Santa Paula, CA 93060 Type of Work: Oil Spreading/Fabric Install Number of Years In Business: 18 Annual Gross Receipts Last Year: Contact Person: Jim Miller/Brian Corrie Less Than $1 Million Certified SBE?: ® YES ❑ NO Less Than $5 Million State License: 625519 C-32 ■Less Than $10 Million Fed #: Less Than $15 Million CT #: D More Than $15 Million PLUMBING SUBCONTRACTORS Name: Suttles Plumbing Phone: (818) 718-9779 Address: 10839 Andora Ave. Fax: (818) 718-9799 Chatsworth, CA 91311 Type of Work: Plumbing Number of Years In Business: 35+ Annual Gross Receipts Last Year: Contact Person: Brian/Steve Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 268688 Less Than $10 Million Fed M 95-2660016 Less Than $15 Million CT #: More Than $15 Million RUBBER MATTING SUBCONTRACTORS Name: Safeguard Surfacing Phone: (818) 504-4810 Address: 9245 Glen Oaks Blvd. Fax: Los Angeles, CA 91352 Type of Work: Rubber Matting Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Mark Less Than $1 Million Certified DBE?: YES NO Less Than $5 Million State License: 785448 Less Than $10 Million Fed M 11-3115081 Less Than $15 Million CT #: More Than $15 Million Name: Spectraturf, Inc. Phone: (951) 736-3579 Address: 310 Reed Circle Fax: (951) 734-3630 Corona, CA 92879 Type of Work: Rubber Matting Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: Chris Wolf Less Than $1 Million Certified DBE?: 1:1YES NO Less Than $5 Million State License: 854429 Less Than $10 Million Fed #: 23-2562001 Less Than $15 Million CT #: More Than $15 Million SIGNS SUBCONTRACTORS Name: Statewide Safety & Signs Phone: (951) 736-3579 Address: Fax: (951) 734-3630 Corona, CA 92879 Type of Work: Rubber Matting Number of Years In Business: 20+ Annual Gross Receipts Last Year: Contact Person: Chris Wolf Less Than $1 Million Certified DBE?: ❑ YES NO ❑Less Than $5 Million State License: 854429 Less Than $10 Million Fed M 23-2562001 Less Than $15 Million CT M ❑More Than $15 Million SPECIALTY PAVING SUBCONTRACTORS Name: APCO Phone: (559) 651-7900 Address: P.O. Box 790 Fax: (559) 651-7905 Goshen, CA 93227 Type of Work Provided: Specialty Paving Number of Years In Business: 35+ Annual Gross Receipts Last Year: Contact Person: Greg Graham Less Than $1 Million Certified DVBE?: ■ YES ❑ NO Less Than $5 Million State License: 283095 Less Than $10 Million Fed M 77-0515768 Less Than $15 Million CT #: 20321 ❑More Than $15 Million Name: AC Dike Phone: (916) 645-7747 Address: 2788 Venture Dr. Fax: (916) 645-9618 Lincoln, CA 95648 Type of Work Provided: Dike Placement Number of Years In Business: 26 Annual Gross Receipts Last Year: Contact Person: Dave McClain ❑Less Than $1 Million Certified DVBE?: M YES ❑ NO Less Than $5 Million State License: 407417 Less Than $10 Million Fed #: 95-2748922 Less Than $15 Million DVBE M 000219 ❑More Than $15 Million Name: Diversified Asphalt Products Phone: (714) 449-8666 Address: 1227 N. Olive St. Fax: (714) 449-8660 Anaheim, CA 92801 Type of Work Provided: Pav/Conc/Landsca e Number of Years In Business: 15 Annual Gross Receipts Last Year: Contact Person: Steve Dye Less Than $1 Million Certified DVBE?: E YES ® NO Less Than $5 Million State License: 681726 Less Than $10 Million Fed #: ®Less Than $15 Million DVBE #: More Than $15 Million STRIPING/SEALCOAT/SLURRY SUBCONTRACTORS Name: Chrisp Co. Phone: (510) 656-2840 Address: 43650 Osgood Rd. Fax: (510) 490-2703 Fremont, CA 94539 Type of WorklMaterials Provided: Striping Number of Years In Business: 30 Annual Gross Receipts Last Year: Contact Person: Roger Weisbrod Less Than $1 Million Certified DBE?: ❑ YES ® NO Less Than $5 Million State License: 374600 A, C-32, C-13 Less Than $10 Million Fed #: 94-2578099 Less Than $15 Million More Than $15 Million Name: Global Road Sealing Inc. Phone: (714) 893-0845 Address: 10832 Dorothy Ave. Fax: (714) 843-5194 Garden Grove, CA 92683 Type of Work/Materials Provided: Crackseal Number of Years In Business: 7+ Annual Gross Receipts Last Year: Contact Person: Less Than $1 Million Certified DBE?: ■ YES ❑ NO Less Than $5 Million State License: 757584 ®Less Than $10 Million Fed #: 33-0836547 Less Than $15 Million CT #: 031176 ❑More Than $15 Million Name: J&S Striping Phone: (562) 777-2411 Address: 10715 Bloomfield Ave. Fax: (562) 777-2499 Santa Fe Springs, CA 90670 Type of Work: Striping/Signs Number of Years In Business: 25+ Annual Gross Receipts Last Year: Contact Person: Adam Heckathorn Less Than $1 Million Certified DBE?: ❑ YES ® NO ■Less Than $5 Million State License: 538211 Less Than $10 Million Fed #: 95-3463575 Less Than $15 Million CT #: ❑More Than $15 Million STRIPING/SEALCOAT/SLURRY SUBCONTRACTORS Name: Mission Paving & Sealing, Inc. Phone: (626) 452-8200 Address: 2213 Rosemead Blvd. Fax: (626) 452-9200 South El Monte, CA 91733 Type of Work: Slurry Seal Number of Years In Business: 67 Annual Gross Receipts Last Year: Contact Person: Mike Miller Less Than $1 Million Certified DBE?: 11 YES ■ NO Less Than $5 Million State License: 624257 Less Than $10 Million Fed #: 95-4051800 Less Than $15 Million CT #: More Than $15 Million Name: Orange County Striping Phone: (714) 639-4550 Address: 183 N. Pixley Fax: (714) 639-6353 Orange, CA 92868 Type of Work: Striping Number of Years In Business: 31+ Annual Gross Receipts Last Year: Contact Person: Doug Patterson Less Than $1 Million Certified DBE?: 1:1YES NO ■Less Than $5 Million State License: 346095 Less Than $10 Million Fed #: 95-3077158 Less Than $15 Million CT #: More Than $15 Million Name: Pavement Coatings Phone: (714) 826-3011 Address: P.O. Box 1491 Fax: (714) 826-3129 Cypress, CA 90630 Type of Work: Slurry Seal Number of Years In Business: 33 Annual Gross Receipts Last Year: Contact Person: Van Duncan Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 303609 Less Than $10 Million Fed #: 95-2916670 Less Than $15 Million CT #: E More Than $15 Million STRIPING/SEALCOAT/SLURRY SUBCONTRACTORS Name: PCI Phone: (562) 218-0504 Address: PO Box 16118 Fax: (562) 218-0634 Long Beach, CA 90806 Type of Work: Striping, Markin Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Bill / Gary Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 823802 Less Than $10 Million Fed #: 33-0885888 M Less Than $15 Million CT M More Than $15 Million Name: RE Schaeffer Phone: (909) 460-6870 Address: 1529 W. State St. Fax: (909) 460-0220 Ontario, CA 91761 Type of Work: Crackseal, Seal Coat, Striping Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Bob / Jim Less Than $1 Million Certified DBE?: ❑ YES NO Less Than $5 Million State License: 727370 Less Than $10 Million Fed #: 33-0694618 D Less Than $15 Million CT M EMore Than $15 Million Name: Rubberized Crackfiller Sealant Inc. Phone: (714) 843-5192 Address: 800 E. Walnut Ave. Fax: (714) 843-5194 Fullerton, CA 92831 Type of Work/Materials Provided: Crackseal Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Ron Bieber Less Than $1 Million Certified DBE?: 0 YES NO E:ILess Than $5 Million State License: 484758 Less Than $10 Million Fed #: 33-0110950 Less Than $15 Million CT #: T ElMore Than $15 Million STRIPING/SEALCOAT/SLURRY SUBCONTRACTORS Name: Sudhakar Inc. Phone: (909) 879-2933 Address: 1450 Fitzgerald Fax: (909) 879-2939 Rialto, CA Type of Work: Striping, Slurry Seal Number of Years In Business: 6+ Annual Gross Receipts Last Year: Contact Person: Gary Less Than $1 Million Certified DBE?: ® YES NO Less Than $5 Million State License: 752367 Less Than $10 Million Fed #: 33-0805730 Less Than $15 Million CT #: 028984 More Than $15 Million Flame: Sterndahl Enterprises Phone: (818) 834-8199 Address: 11861 Branford St. Fax: (818) 834-8618 Sun Valley, CA 91352 Type of Work: Striping, Traffic Control, K Rail Plumber of Years In Business: Annual Gross Receipts Last Year: Contact Person: DennyLess Than $1 Million Certified DBE?: E YES ❑ NO Less Than $5 Million State License: 421823 A, C31, C32 Less Than $10 Million Fed #: Less Than $15 Million Cert. Small Business#0023707 More Than $15 Million Name: Southcoast Striping Phone: (951) 966-2662 Address: 3161 Cutting Horse Rd. Fax: (951) 735-2803 Norco, CA 92860 Type of Work: Striping Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Darren Veltz Less Than $1 Million Certified DBE?: El YES NO Less Than $5 Million State License: 759627 Less Than $10 Million Fed #: Less Than $15 Million CT #: More Than $15 Million STRIPING/SEALCOAT/SLURRY SUBCONTRACTORS Name: Superior Pavement Markings Phone: (714) 562-9100 Address: 14658 Industry Circle Fax: (714) 562-9400 La Mirada, CA 90638 Type of Work: Striping, Thermoplastic, Signs Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: James ❑Less Than $1 Million Certified DBE?: 0 YES ❑ NO Less Than $5 Million State License: 776306 C-32 Exp. 3/31/08 ❑Less Than $10 Million Fed #: 20-4518251 Less Than $15 Million CT #: ❑More Than $15 Million Name: Superseal & Stripe Phone: (805) 524-7345 Address: PO Box 755 Fax: (805) 524-7428 Fillmore, CA 93016 Type of Work: Crackseal/Stripe/Truncated Domes Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Sharon Less Than $1 Million Certified DBE?: ❑ YES NO M Less Than $5 Million State License: 396627 Less Than $10 Million Fed #: 95-3548835 OLess Than $15 Million CT #: ❑More Than $15 Million Name: Traffic Operations Phone: (909) 865-2935 Address: 216 Toby Way Fax: (909) 865-7140 Pomona, CA 91767 Type of Work: Striping Number of Years In Business: 21+ Annual Gross Receipts Last Year: Contact Person: Mike Izzy Less Than $1 Million Certified DBE?: ❑ YES 0 NO Less Than $5 Million State License: 376858 0 Less Than $10 Million Fed #: 95-3384840 OLess Than $15 Million CT #: ❑More Than $15 Million SURVEY SUBCONTRACTORS Name: Case Land Surveying Phone: (714) 628-8948 Address: 614 N. Eckoff St. Fax: (714) 628-8905 Orange, CA 92868 Type of Work: Survey Number of Years In Business: 15+ Annual Gross Receipts Last Year: Contact Person: Larry Case 0 Less Than $1 Million Certified DBE?: YES ® NO Less Than $5 Million State License: PL55411 ■Less Than $10 Million Fed M 33-0169862 Less Than $15 Million CT M More Than $15 Million SWPPP/SOIL TESTING SUBCONTRACTORS Name: Global Environmental Network, Inc. Phone: (714) 479-1199 Address: 106 W. 4th St. Ste. 201 Fax: (714) 479-0809 Santa Ana, CA 92701 Type of Work: SWPP Number of Years In Business: 10+ Annual Gross Receipts Last Year: Contact Person: Mike Horner Less Than $1 Million Certified DBE?: El YES NO Less Than $5 Million State License: Less Than $10 Million Fed #: 33-0493685 Less Than $15 Million CT #: DVBE More Than $15 Million Name: Patriot Environmental Services Phone: (562) 436-2614 Address: 1900 W. Anaheim St. Fax: (562) 436-2688 Long Beach, CA 90813 Type of Work: SWPP , Soil Testing Number of Years In Business: Annual Gross Receipts Last Year: Contact Person: Dale Strieter Less Than $1 Million Certified DBE?: YES NO Less Than $5 Million State License: 809990 Less Than $10 Million Fed #: 95-3894635 Less Than $15 Million CT #: More Than $15 Million Name: RMA Group Phone: (909) 989-1751 Address: 10851 Edison Ct. Fax: (909) 989-4287 Rancho Cucamonga, CA 91730 Type of Work: Material Testing Number of Years In Business: 44 Annual Gross Receipts Last Year: Contact Person: Karin Ashley Less Than $1 Million Certified DBE?: D YES NO Less Than $5 Million State License: C0604784 Less Than $10 Million Fed #: 95-2657590 E Less Than $15 Million CT #: More Than $15 Million TRUCKING SUBCONTRACTORS Name: REH Trucking Phone: 909 591-0871 Address: PO Box 880 Fax: 909 591-0506 Chino Hills, CA 91709 Type of Work: Truck Broker Number of Years In Business: 55 Annual Gross Receipts Last Year: Contact Person: Virginia Hernandez ❑Less Than $1 Million Certified DBE?: ® YES ❑ NO ❑Less Than $5 Million State License: N/A Less Than $10 Million Fed #: 94-2506543 Less Than $15 Million CT #: 798 ❑More Than $15 Million t CEL PAVING COMPANY P.O. BOX 16405 A GENERAL ENGINEERING CONTRACTOR LONG BEACH, CA 90806-5195 STATE LICENSE NO. 688659A (562) 599-5841 FAX (562) 591-7485 C. P. Brown, President: 30+ years experience working for other general contractors with the past 24 years being self employed in own general engineering contracting business. PALP INC. DUA E cEi. PAVING COMPANY A GENERAL ENGRGERING CONTRACTOR STATE LICENSE NO.688659A DESCRIPTION OF OPERATIONS P.O. BOX 16405 LONG MACH, CA 908065195 (SM 5994"1 FAX (562) 591-7486 Excel Paving Company is a general engineering and paving contractor that has been in business for the past 25+ years. The company is a corporation owned by C.P. Brown, Jr. Their operations include street and road construction, widening, and repairs; related sidewalk, curb and gutter construction; paving of school yards and parking lots; pipe work; and excavation and grading of "pads" for building sites. On approximately 80% of their jobs the company will operate as a general contractor, responsible for all off -site improvements, grading, removal, etc., but will subcontract any work which is not specifically within their domain. Occasionally the company will perform work at airports. They may also occasionally perform work in the "THUMS " area of Long Beach Harbor, requiring them to transport their equipment and personnel by barge to these islands, approximately % mile from the harbor. The company estimates 2006 2007 gross revenues of $85 Million, $60 Million of which Is subcontractor and material costs. All work is performed In Southern California, with most in Los Angeles and Orange County. A great deal of work is done for public entities, repairingtwidening existing surface streets and roads (75% public entities and 26% private entities); concrete, landscaping, electrical, cold milling, highway, bridge, or overpass work is subcontracted out to other firms. Excel Paving Company also repairs a great number of school yards and parking lots (30%) and usually has a small amount of ongoing work at the Los Angeles, Burbank, and Long Beach airports. INCUMBENCY AND SIGNATURE CERTIFICATE OF PALP, INC. The undersigned, Marcia S. Miller, being the duly elected and Incumbent Secretary of PALP, Inc., dba Excel Paving Company, a California corporation (the "Corporation"), hereby certifies that the persons named below are, on and as date hereof, the duly qualified, elected and acting Officers of the Corporation holding the office set forth opposite their names below, such officers being authorized to sign, in the name of and on behalf of the Corporation. Curtis P. Brown President and Chief Operating Officer Marcia S. Miller Secretary and Chief Financial Officer George McRae Senior Vice President Curtis P. Brown III Vice President Michele E. Drakulich Assistant Secretary IN WITNESS WHEREOF, the undersigned has executed this Certificate as of the date set forth below. Date: August 20, 2008 PALP, INC. DBA EXCEL PAVING COMPANY A GENERAL ENGINEERING CONTRACTOR STATE LICENSE NO. 688659A CREDIT APPLICATION Excel Paving Company 2230 Lemon Avenue Long Beach, CA 90806 Telephone: 562/599-5841 Fax: 562/599-3679 Type of Business: General Engineering Contractors Contractors License # 688659A Fed I.D. # 95-3672914 Excel Paving Company is a Corporation Owner: Palp, Inc. 2230 Lemon Avenue Long Beach, CA 90806 In business since October 1981 Same location since October 1981 Property Owned by Brown & Mills Financial rating with Dun & Bradstreet: Rating 3A2, SIC#0161 U.S. Bank: Account Representative Phone #: Fax #: Account #: TRADE REFERENCES: 4100 Newport Pl. #130 Newport Beach, CA 92660 Robin Woods 949/863-2462 949/863-2336 153491958689 Company Phone Fax Vulcan Materials 626/334-4913 626/334-4161 R.E.H. Trucking 909/591-0871 909/591-0506 Blue Diamond Materials 714/578-9600 714/449-2295 Savala Equipment 800/223-2473 949/552-8597 P.O. BOX 16405 LONG BEACH, CA 90806-51'95 (562) 599-5841 FAX (562) 591-7485 C''nntart Bill Watt Gina Mendiola Rich Shoan Yoganda Ellis I certify that the above information is true and correct, and that we can and will comply with your terms. V C.P. Brown - President Bonding Agent: Rapp Surety Services 23481 South Pointe Drive Suite 345 Laguna Hills CA 92653 Office: (949) 457-1060 Fax: (949) 457-1070 Contact: Douglas A. Rapp Surety: Federal Insurance Company C/O Surety Department 801 South Figueroa Street 23`d Floor Los Angeles CA 90017 P.O. Box 30127 Los Angeles CA 90030-0127 Insurance Carrier: The Wooditch Company One Park Plaza Suite 400 Irvine CA 92614 Contact: William Wooditch Office: (949) 553-9800 Fax: (949) 553-0670 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSBILITY STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: Jefferson Blvd. Widening PROJECT DESCRIPTION: Street widening, Infrastructure reconstruction, Street lighting, traffic signals, landscape & irrigation, Storm drain impvts, and LOCATION: Jefferson Blvd., Playa Vista, Los Angeles "sewer. CONSTRUCTION VALUE: 6, 306, 687.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR: ARCHITECT: KATZ, OKITSU & ASSOC. PSOMAS GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company CONTACT: David Cook TELEPHONE: 562) 599-5841 Ext. 239 OWNER INFORMATION. - NAME: Playa Capitol Company, LLC CONTACT: Mr. Lary Chambers TELEPHONE: 310)448-4705 or 310)345-7856 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: Slauson Ave/ SR-90 Impvts. PROJECT DESCRIPTION: On ramp & off ramp widening on SR90, Traffic Mitigation added left turn on Slauson Signalization & Signing & Storm Drain Impvts. LOCATION: Slauson Ave @ SR90 Culver City, Los Angeles CONSTRUCTION VALUE: 2.136.269.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR: ARCHITECT: KATZ, OKITSU & ASSOC PSOMAS GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company CONTACT: David Cook TELEPHONE: 562)599-5841 Ext. 239 OWNER INFORMATION: NAME: Playa Capitol Company LLC _ CONTACT: Mr. Lary Chambers TELEPHONE: 310)448-4705 or 310)345-7856 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE THE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: SANTA MONICA TRANSIT PARKWAY PROJECT PROJECT DESCRIPTION: UNDERGROUND, RETAINING WALLS, FWY. ON RAMPS, A/C PAVE, SIDEWALK, CURB & GUTTER, SIGNALIZATION, LANDSCAPING, STORM DRAIN IMPVTS,SEWER, WATER, AND RETAINING WALL. LOCATION: FROM 405 FWY. TO BEVERLY HILLS CITY LIMIT, LOS ANGELES CONSTRUCTION VALUE: $14, 455 ,152.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: C/O LOS ANGELES GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAWING COMPANY CONTACT: -BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: CITY OF LOS ANGELES CONTACT; CARL NELSON TELEPHONE; 21 485_4474 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSEBILM STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: Alameda Street PROJECT DESCRIPTION: Redesign of Arterial Streets and Storm Drain Impvts. LOCATION: Intersection of Alameda Street and N. Spring St Los Angeles CONSTRUCTION VALUE: 3, 197, U43. UU IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR ARCHITECT: City of Los Angeles GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company CONTACT: Boh Pace TELEPHONE: 562) 599-5841 Ext. 248 OWNER INFORMATION: NAME: City of Los Angeles Board of Public Works CONTACT: Raphael Villegas TELEPHONE: 213) 485-4556 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: Phase 3 Container Yard Expansion Pier T PROJECT DESCRIPTION: Container Yard Parking Lot Expansion, Storm Drain Impvts, Sewer and Water. LOCATION -.Pier T, Long Beach, Ca. CONSTRUCTION VALUE: 21,703,834.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR. ARCHTTECT: Port of Long Beach GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company CONTACT: Bob Pace TELEPHONE: 562)599-5841 ext 246 OWNER INFORMATION: NAME: The Port of Long Beach CONTACT: Gary Cardemone TELEPHONE: 562) 590-4172 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSESELI[TY STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: Piece F. Rerrhs. E24-326 PROJECT DESCRIPTION: Asphalt Utility Removals, Grade, New Asphalt Paving and New Concrete RTG Runways, Storm Drain Impvts, Sewer and Water. LOCATION: Pier CONSTRUCTION VALUE: 5,251,800.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR: ARCHITECT: Port of Long Beach GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company CONTACT: Bob Pace TELEPHONE: 562)599-5841 Ext. 246 OWNER INFORMATION: NAME: The Port of Long Beach CONTACT: Peter Forsythe TELEPHONE: 562) 244-9077 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSBILM STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: Highland Avenue Widening PROJECT DESCRIPTION: Redesign of Highland Ave and Adjacent Streets, Storm Drain Impvts. LOCATION: Ili ghl and Ave @ Franklin Ave, City of Los Angeles CONSTRUCTION VALUE: 2, 754, 889.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR: ARCHITECT: City of Los Angeles GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company CONTACT: Bob Pace TELEPHONE: 562) 599-5841 Ext 246 OWNER INFORMATION: NAME: City of Los Angeles Board of Public Works CONTACT: Rafael Villegas TELEPHONE: 213)485-4556 CONTRACTOR'S NAME: PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSEBEL T1' STATEMENT) PROVIDE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: North Maclay Ave PROJECT DESCRIPTION: Street Beautification and Improvement of North Maclay Ave LOCATION: North Maelay Ave from 1st Street to Eighth Street CONSTRUCTION VALUE: 3,682,624.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACTOR: ARCHITECT: City of San Fernando GENERAL CONTRACTOR INFORMATION: NAME: Excel Paving Company. CONTACT: Bob Pace TELEPHONE: 562) 599-5841 Ext 246 OWNER INFORMATION: NAME: City of San Fernando CONTACT: Daniel Wall/ City Engineer TELEPHONE: 818) 898-1225 WORK EXPERIENCE MAY 31, 2009 • OPEN JOBS 2ND QUARTER 2009 EXCEL PAVING CO. EST. FINAL WORK WORK 8-6-09 CONTRACT COMPL. BACKLOG 4042 TUDOR WEST/UCLA JOBS 2,339,610 100.0% 1,020.00 i 4093 SAN FERN VLY LA 1,473,973 100.0% -- 4232 VALENCIA MESA FULLERTON 930,000 99.9% 1,145.00 4240 LINCOLN BLVD. CALTRANS 12,138,000 98.4% 231,084.00 4242 CHANDLER/LANKERSHIM LOS ANGELES 5,421,529 100.0% 4245 LINNIE CANAL LOS ANGELES 351,920 100.0% 4266 CENTINELA AVE. LOS ANGELES 2,880,145 100.0% 4295 CULVER BLVD VISTA DEL MAR 1,601,060 100.0% 4302 VERMONT AVE. LOS ANGELES 1,392,670 100.0% 4324 USC, FIGUEROA & JEFFERSON 1,584,799 100.0% 4328 HIGHLAND AVE. LOS ANGELES 3,449,332 99.8% 6,582.00 4329 SUNSET BLVD. LOS ANGELES 2,062,587 100.0% 4330 HARBOR GATEWAY LOS ANGELES 2,744,039 99.8% 3,679.00 4340 SLAUSON AVE. CULVER CITY 2,570,504 97.3% 60,893.00 4348 PH 3-PIER T LONG BEACH 23,538,665 100.0% 4370 ALAMEDA ST. LOS ANGELES 2,687,109 97.2% 50,216.00 4408 HOLLYWOOD WAY BURBANK 23,710 82.7% 2,900.00 4413 VERMONT LOS ANGELES 182,915 99.4% 1,000.00 4425 FIRST ST-LOS ANGELES 255,000 69.6% 53,211.00 4442 SEPULVEDA BLVD. LA/CC 594,814 86.4% 80,015.00 4454 UCI IRVINE 59,976 100.0% 4458 TAPO CYN SIMI VLY 2,957,391 100.0% 4466 FIGUEROA/SEPULVEDA LACO SANI 2,453,930 100.0% 4481 CERRITOS/EL RITO GLENDALE 1,197,605 100.0% 4482 ALAMITOS RODGE LONG BEACH 408,474 100.0% 4483 BOB HOPE AIRPORT BURBANK 13,177,103 99.4% 68,346.00 4492 TIERRA REJADA RD MOORPARK 3,167,306 100.0% 4497 CALIFORNIA BLVD. CSI ELECT 14,892 100.0% 4499 CANTARA KAISER FOUND 100,078 81.6% 14,190.00 4502 GARDEN GROVE SANI 1,964,738 100.0% 4505 TOPANGA/VICTORY WESTFIELD 2,597,572 99.9% 1,488.00 4507 BRAND BLVD. HATHAWAY 217,460 100.0% 4508 ALVARDO TRANSIT LACRA 2,140,870 72.6% 523,426.00 4522 BELMONT PLAZA LONG BEACH 514,419 100.0% 4523 BESS/LEORETTA KAISER 347,000 100.0% 4524 VERDUGO/BARRINGTON GLENDALE 585,432 100.0% 4526 LAKEWOOD BLVD. DOWNEY 2, 047, 150 99.2% 18,801.00 4534 7TH/CATALINA HENSEL PHELPS 73,954 100.0% 4535 SHENANDOAH EIS LAUSD 744,408 100.0% 4549 RAMIREZ CANYON TORRES 400,835 99.5% 2,080.00 4552 JOHN WAYNE AIRPORT ORANGE CO 1,538,269 90.7% 126,667.00 4553 PACIFIC OCAST HWY DANA POINT 5,973,934 68.0% 2,114,492.00 4566 CLEVELAND HIS LAUSD 1,304,212 98.9% 16,024.00 4567 NO HOLLYWOOD ST LACRA 1, 143, 779 8.5% 934,049.00 4568 NUEVA VISTA ES BELL 206,362 100.0% 4573 ATHERTON ST. LONG BEACH 1,308,318 95.5% 56,457.00 4585 VARIOUS LOC WESTLAKE VILLAGE 2,125,397 100.0% 4586 7TH ST. LONG BEACH 1,782,650 100.0% 4586 EAGLE ROCK HS LAUSD 1,145,867 99.4% 6,158.00 4590 ROYAL AVE. SIMI VLY 1,791,856 98.5% 24, 569.00 4592 MADERA RD. SIMI VLY 711,585 100.0% 4593 LOWELL EIS LBUSD 541,572 100.0% Page 1 of 4 WORK EXPERIENCE MAY 31, 2009 OPEN JOBS 2ND QUARTER 2009 EXCEL PAVING CO. 8-6-09 EST. FINAL WORK WORK CONTRACT COMPL. BACKLOG 4595 MARINA H/S HBUHSD 3, 305, 000 99.5% 14,887.00 4596 EMAS SYS BURBANK ARPRT 3,642,247 100.0% 1,358.00 4597 WILSHIRE/FAIRFAX MATT CONST 1,125,815 76.6% 207,466.00 - 4598 CHEVIOT HILLS LOS ANGELES 777,869 55.0% 312,655.00 4603 INGLEWOOD/CULVER PLAYA CAP 386,070 92.6% 28,623.00 4604 MADISON EIS REDONDO BEACH USD 45,000 85.5% 5,698.00 4605 MWD WATERLINE RUDOLPF/SLET 1,809,170 27.2% 1,097,224.00 4607 LACC CHILD DEV CTR CA CONSTR 36,549 100.0% 4608 TAXIWAI D LON BEACH 816,228 100.0% 4609 JUVENILE HALL ALCORN FENCE 476,412 78.1% 65,652.00 4611 USC ST IMPRV USC 1,800,000 75.2% 414,662.00 4613 STORM DRAIN POL POLB 4,127,471 27.8% 2,783,997.00 4615 PIER A WEST TUTOR SALIBA 121,706 22.1% 41,302.00 4616 PIER A WEST TUTDOR SALIBA 327,832 28.1% 235,691.00 4618 FED EX RAMP FEX EX BURB ARPRT 3, 949,667 8.3% 3,210,502.00 4619 SO REGION ES LAUSD 415,870 98.4% 4,961.00 4620 EAST LA HS TUCKER ENGR 175,225 79.0% 32,499.00 4621 VARIOUS LOC DANA POINT 60,527 70.4% 18,050.00 4623 CANDLEBERRY AVE SEAL BEACH 1,508,369 2.3% 1,344,057.00 4624 WASHINGTON/IND BNSF JOJMSPM CONTROLS 152,759 59.0% 45,180.00 4625 EL PRESIDO LAINE AIRE 13,122 100.0% 4628 LIMECREST DR. LACPW 220,002 99.5% 1,119.00 4629 WASHINGTON BLVD PCL CONST 129,305 72.2% 32,476.00 4631 4 TH ST. REMPREX 1,438,337 99.0% 9,478.00 4632 LACMA PH II MATT CONST 431,836 22.3% 291, 350.00 4635 JOHN WAYNE AIRPORT BALI CONS 15,536 100.0% 4636 VARIOUS STS ROLLING HILLS EST 178,414 100.0% 4637 DISNEYLAND TRENCH BALI CONS 9,985 100.0% 4638 DICKSON, ENT,FOSTER COMPTON USD 89,200 85.9% 11,941.00 4639 VARIOUS INTER BOEING CO. 1,475,312 44.9% 732,546.00 4640 BERTH 7 3/ 191 POLA 237,765 9.6% 192,277.00 4641 PUENTE HILLS LANDFILL LACO SANI 474,349 99.2% 3,700.00 4643 CAMPUS CAP PLAYA VISTA 443,335 1.6% 423,216.00 4646 CALIFORNIA HATHAWAY 37,708 100.0% 4647 WOOD AVE. FULLERTON 1,075,000 10.6% 880,962.00 4648 BANDINI BNSF 454,993 0.6% 421,809.00 4649 SUNNYMEAD BLVD, MORENO VLY 2,456,972 0.7% 2,214,886.00 4651 BALBOA/VICTORY LOS ANGELES 1,397,499 2.9% 1,233,522.00 4652 LA AIR FORCE BASE RMA LAND 10,890 100.0% 4653 GETTY CENTER HATHAWAY 6,700 100.0% 4654 WESTERN AVE MOOG, INC 7,240 92.6% 444.00 4655 ARTESIA PILAR SANTA ANA 1,676,293 2.1% 1,509,603.00 4656 RTE 23/118 SIMI VLY 31,998 100.0% 4657 FREMONT ST ALHAMBRA 4,617 4.6% 2,199.00 4658 LA PALMA AVE PCL CONT 723,223 0.0% 592,186.00 4659 VARIOUS STS PV EST 204,212 1.3% 183,842.00 4660 GOODE AVE HATHAWAY 262,440 22.1 % 132,477.00 4661 BIKE ROUTES LONG BEACH 277,703 0.6% 258,334.00 4662 VARIOUS ACHOOLS COMPTON 127,142 1.8% 105,600.00 Page 2 of 4 WORK EXPERIENCE FEBRUARY 28, 2009 CLOSED JOBS 1ST QUARTER 2008-2009 EXCEL PAVING CO. 8-6-09 FINAL CONTRACT JOB NO. PROJECT NAME AMOUNT 3843 LAUREL CYN BLVD. LOS ANGELES 807,100 4103 HOWLAND CNL CRT LA 299,025 4129 MT. SAC WALNUT 910,385 4211 VARIOUS LOC LONG BEACH 306,515 4282 LOOP & PARK PL. IRVINE 1,112,969 4319 REDONDO AVE. LONG BEACH 221,979 4339 VARIOUS LOCATIONS LONG BEACH 1,353,277 4415 CASE AVE. LOS ANGELES 186,308 4416 STIMSON AVE. LA PUENTE 396,099 4434 IMPERIAL HWY DOWNEY 2,427,816 4443 INGLEWOOD AVE. REDONDO BCH 540,525 4468 LACC LOS ANGELES 6,085 4490 VARIOUS LOC LB TRANSIT 879,832 4515 GRAND AVE. MT. SAC 224,919 4516 TUSTIN & 1ST ST MCCARTHY 233,937 4530 VARIOUS LOCATIONS CULVER CITY 801,667 4531 LONG BEACH CALCARTAGE 18,500 4541 CAMINO REAL REDONDO BCH 444,555 4545 BERTHS 261-267 CONNELLY-PACIFIC 174,979 4548 NORMANDIE KAISER 58,823 4558 LA PALMA AVE. PENNER 15,895 4559 BERTH 302-305 POLA 0 4569 MIDWAY/39TH PL LONG BEACH 6,353 4571 AVE. 45 HUNTINGTON PARK 76,100 4572 VARIOUS LOC LONG BEACH 147,364 4574 SOUTHERN/GARFIELD SO GATE 27,300 4577 SLAUSON OVERPASS BELL 74,614 4578 PACOIMA MS TORRES 13,892 4582 ST IMROV INGLEWOOD 548,259 4583 OLYMPIC/CENTINELLA SANTA MONICA 1,961,558 4584 VARIOUS LOC SANTA ANA 3,570,920 4587 COLUMBUS EIS PANKOW 224,715 4591 LAS BRISAS SIGNAL HILL 146,749 4594 ALDRICH PARK UCI 907,704 4599 VARIOUS SCHOOLS 837,133 4600 ANCHORAGE/SHOR RE SCHAFER 7,710 4606 PERRY LINDSEY ACADEMY LBUSD 1,074,447 4612 KAISER VENTURA BLV KAISER PERM 43,997 4626 VAN NESS BUNTICH 4,850 4627 SHEILA ST. ELECTRO 2,698 4630 LAMAR/MAIN ELECTRO 33,320 4633 DISNEYLAND BAKERY BALI CONS 16,876 4642 JAMES WOOD AVE FED OF LABOR 8,388 4645 USC SCH ARTS HATHAWAY 19,130 4650 SPEED HUMPS PASADENA 38,130 Page 3 of 4 WORK EXPERIENCE NOVEMBER 30, 2008 CLOSED JOBS 4TH QUARTER 2008 EXCEL PAVING CO. 8-6-09 FINAL CONTRACT JOB NO. PROJECT NAME AMOUNT 4240 CMB QTY/PLAYA VISTA 8,938 4247 7TH/710 FRWY LONG BEACH 606,153 4296 GLENDALE BLVD LOS ANGELES 597,309 4359 MICHELSON BLVD. IRVINE 2,909,722 4359 LOOP ROAD 0 4359 MICHELSON DR. 0 4367 GRANADA AVE. LA MIRADA 564,180 4377 PIER E PORT LB 5,295,408 4393 JEFFERSON BLVD. PLAYA VISTA 7,938,248 4417 PROSPECT TUSTIN 941,017 4421 LB TAXIWAY LONG BEACH 59,379 4427 05-'06 ST. REHAB LAGUNA BCH 3,848,764 4448 MARYMOUNT HS 856,482 4452 GLENCOE LOS ANGELES 309,434 4463 SERVICE MOD EL CAMINO COLLEGE 147,800 4464 WASHINGTING/GRANDE BNSF 1,122,915 4467 VALLYHEART ST. FRANCIS 135,875 4469 HALDEMAN RD. RUSTIC CYN HOA 58,395 4470 LATIMER RD. RUSTIC CYN HOA 66,500 4480 EAST OLIVE AVE BURBANK 313,656 4500 CAMPUS/ARTISAN CSI ELECT 0 4501 GAGE AVE BELL 25,375 4504 BERENDO M.S. TORRES CONST 207,053 4506 VARIOUS LOC CO OF ORANGE 32,744 4509 ROSCOE BLVD. KAISER FOUND 100,937 4518 NORMANDIE ARB STRUCTURES 94,545 4521 ZANE GREY H/S TORRES 75,326 4525 TAPER AVE SCH TORRES 108,842 4527 SUNNY BRAE SCH TORRES 15,345 4528 GETTY CENTER HATHAWAY 37,887 4529 NORTHRIDGE M/S TORRES 6,542 4532 SAN MIGUEAL EIS TORRES 315,091 4536 W. 4TH ST BNSF 265,323 4538 PERSHING DR CSI ELECT 76,194 4547 WRIGHT M/S TORRES 99,389 4554 BLUFF CREEK FINVEST 91,269 4555 VICTORY BLVD, NO. HOLLYWOOD 429,749 4557 DACOTAH EARLY ED TORRES 159,273 4561 BESS/LEORITA BALDWIN PARK 15,866 4563 NICHOLS/BELSITO BALI CONST 405,647 4579 KAISER/NORMANDIE KAISER 8,225 4580 CAL ST NORTHRIDGE 6,200 4581 E. 26THST BNSF 296,935 4601 SHEILA/INDIANA ELECTRO CONST 8,784 4610 SEPULVEDA BLVD B & D CONST 8,939 4617 SEPULVEDA BLVD B & D CONST 16,600 4634 RIVERA RD. SPRKLR UNION 27,441 4644 MGM DR. HATHAWAY 47,068 Page 4 of 4 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG Job No. PROJECT NAME AMOUNT COMPL. 3843 LAUREL CYN BLVD. LOS ANGELES 807,100 100.0% 4042 TUDOR WEST/UCLA JOBS 2,339,610 100.0% 4093 SAN FERN VLY LA 1,473,973 100.0% 4103 HOWLAND CNL CRT LA 299,925 100.0% 4126 UNIVERSITY AVE RIVERSIDE 2,067,233 99.9% 2,486 4129 MT. SAC WALNUT 910,385 100.0% 4165 EL TORO RD LK FOREST 11,091,333 99.6% 41,984 4211 VARIOUS LOC LONG BEACH 306,515 99.8% 4232 VALENCIA MESA FULLERTON 930,000 92.8% 66,955 4240 LINCOLN BLVD. CALTRANS 11,970,000 100.0% 4240 CMB QTY/PLAYA VISTA 8,938 0.0% 8,938 4242 CHANDLER/LANKERSHIM LOS ANGELES 5,421,529 100.0% 4245 LINNIE CANAL LOS ANGELES 351,920 100.0% 4247 7TH/710 FRWY LONG BEACH 606,153 99.9% 4266 CENTINELA AVE. LOS ANGELES 2,880,145 100.0% 4282 LOOP & PARK PL. IRVINE 1,112,969 100.0% 4295 CULVER BLVD VISTA DEL MAR 1,601,060 100.0% 4296 GLENDALE BLVD LOS ANGELES 597,309 100.0% 4302 VERMONT AVE. LOS ANGELES 1,392,670 100.0% 4319 REDONDO AVE. LONG BEACH 221,979 100.0% 4324 USC, FIGUEROA & JEFFERSON 1,585,000 100.0% 4328 HIGHLAND AVE. LOS ANGELES 3,582,540 96.0% 142,898 4329 SUNSET BLVD. LOS ANGELES 2,062,587 99.9% 1,291 4330 HARBOR GATEWAY LOS ANGELES 2,722,826 100.0% 4339 VARIOUS LOCATIONS LONG BEACH 1,353,277 100.0% 4340 SLAUSON AVE. CULVER CITY 2,550,397 90.2% 249,935 4348 PH 3-PIER T LONG BEACH 23,552,507 100.0% 2,291 4359 MICHELSON BLVD. IRVINE 2,909,722 99.7% 8,529 4367 GRANADA AVE. LAMIRADA 564,180 100.0% 4370 ALAMEDA ST. LOS ANGELES 3,163,392 90.3% 308,049 4377 PIER E PORT LB 5,295,408 100.0% 4393 JEFFERSON BLVD. PLAYA VISTA 7,938,248 100.0% 4408 HOLLYWOOD WAY BURBANK 23,710 100.0% 4413 VERMONT LOS ANGELES 182,915 100.0% 4415 CASE AVE. LOS ANGELES 186,308 100.0% 4416 STIMSON AVE. LA PUENTE 397,215 100.0% 4417 PROSPECT TUSTIN 938,817 99.6% 3,312 4421 LB TAXIWAY LONG BEACH 59,379 100.0% 4425 FIRST ST-LOS ANGELES 230,000 58.4% 95,597 4427 05206 ST. REHAB LAGUNA BCH 3,848,764 100.0% 4434 IMPERIAL HWY DOWNEY 2,427,816 99.7% 8,309 4442 SEPULVEDA BLVD. LA/CC 596,857 100.0% 4443 INGLEWOOD AVE. REDONDO BCH 540,525 100.0% 4448 MARYMOUNT HS 856,482 100.0% 11-30-08 WIPS 12-14-2008-Open Jobs Page 1 of 14 1-21-09 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG 4452 GLENCOE LOS ANGELES 309,434 100.0% 4454 UCI IRVINE 59,976 100.0% 4458 TAPO CYN SIMI VLY 2.957,391 100.0% 758 4463 SERVICE MOD EL CAMINO COLLEGE 147,800 100.0% 4464 WASHINGTING/GRANDE BNSF 1,122,915 100.0% 4466 FIGUEROA/SEPULVEDA LACO SANI 2,453,930 100.0% 4467 VALLYHEART ST. FRANCIS 135,875 100.0% 4468 LACC LOS ANGELES 6,085 100.0% 4469 HALDEMAN RD. RUSTIC CYN HOA 58,395 100.0% 4470 LATIMER RD. RUSTIC CYN HOA 66,500 100.0% 4480 EAST OLIVE AVE BURBANK 313,656 100.0% 4481 CERRITOS/EL RITO GLENDALE 1,197,605 100.0% 4482 20TH/REDONDO LONG BEACH 408,474 100.0% 4483 BOB HOPE AIRPORT BURBANK 13,177,103 99.3% 91,795 4490 VARIOUS LOC LB TRANSIT 879,832 100.0% 4492 TIERRA REJADA RD MOORPARK 3,167,306 100.0% 4497 CALIFORNIA BLVD. CSI ELECT 14,982 100.0% 4499 CANTARA KAISER FOUND 82,000 21.2% 64,631 4500 CAMPUS/ARTISAN CSI ELECT 4,200 0.0% 4,200 4501 GAGE AVE BELL 25,375 100.0% 4502 GARDEN GROVE SANI 1,967,739 100.0% 4504 BERENDO M.S. TORRES CONST 207,053 100.0% 4505 TOPANGA/VICTORY WESTFIELD 2,520,000 98.9% 27,394 4506 VARIOUS LOC CO OF ORANGE 32,744 99.9% 4507 BRAND BLVD. HATHAWAY 217,460 96.7% 7,193 4508 ALVARDO TRANSIT LACRA 2,140,870 69.0% 663,657 4509 ROSCOE BLVD. KAISER FOUND 100,937 100.0% 4515 GRAND AVE. MT. SAC 224,919 100.0% 4516 TUSTIN & 1ST ST MCCARTHY 233,937 100.0% 4518 NORMANDIE ARB STRUCTURES 94,545 100.0% 4521 ZANE GREY H/S TORRES 75,326 100.0% 4522 BELMONT PLAZA LONG BEACH 427,634 100.0% 4523 BESS/LEORETTA KAISER 251,657 100.0% 4524 VERDUGO/BARRINGTON GLENDALE 577,656 99.9% 4525 TAPER AVE SCH TORRES 108,842 100.0% 4526 LAKEWOOD BLVD. DOWNEY 2,047,150 92.0% 164,456 4527 SUNNY BRAE SCH TORRES 15,345 100.0% 4528 GETTY CENTER HATHAWAY 37,887 100.0% 4529 NORTHRIDGE M/S TORRES 6,542 100.0% 4530 VARIOUS LOCATIONS CULVER CITY 801,667 100.0% 4531 LONG BEACH CALCARTAGE 13,577 100.0% 4532 SAN MIGUEAL E/S TORRES 315,091 100.0% 4534 7TH/CATALINA HENSEL PHELPS 73,954 100.0% 4535 SHENANDOAH E/S LAUSD 744,408 99.8% 1,585 11-30-08 WIPS 12-14-2003-Open Jobs Page 2 of 14 1-21-09 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % CONTRACT WORK 4536 W. 4TH ST BNSF 265,323 100.0% 4538 PERSHING DR CSI ELECT 76,194 100.0% 4541 CAMINO REAL REDONDO BCH 444,555 100.0% 4545 BERTHS 261-267 CONNELLY-PACIFIC 174,979 99.9% 4547 WRIGHT M/S TORRES 99,389 100.0% 4548 NORMANDIE KAISER 68,500 83.7% 4549 RAMIREZ CANYON TORRES 400,836 99.5% 4552 JOHN WAYNE AIRPORT ORANGE CO 1,538,269 90.7% 4553 PACIFIC OCAST HWY DANA POINT 5,792,241 46.6% 4554 BLUFF CREEK FINVEST 91,269 100.0% 4555 VICTORY BLVD. NO. HOLLYWOOD 429,749 100.0% 4557 DACOTAH EARLY ED TORRES 159,273 100.0% 4558 LA PALMA AVE. PENNER 15,895 100.0% 4559 BERTH 302-305 POLA 35,000 3.5% 4561 BESS/LEORITA BALDWIN PARK 15,866 100.0% 4563 NICHOLS/BELSITO BALI CONST 405,647 100.0% 4566 CLEVELAND H/S LAUSD 1,269,712 95.2% 4567 NO HOLLYWOOD ST LACRA 1,143,779 8.5% 4568 NUEVA VISTA ES BELL 206,362 100.0% 4569 MIDWAY/39TH PL LONG BEACH 6,853 100.0% 4571 AVE. 45 HUNTINGTON PARK 76,100 100.0% 4572 VARIOUS LOC LONG BEACH 153,371 37.8% 4573 ATHERTON ST. LONG BEACH 1,322,726 92.3% 4574 SOUTHERN/GARFIELD SO GATE 27,300 100.0% 4577 SLAUSON OVERPASS BELL 74,614 100.0% 4578 PACOIMA MS TORRES 13,894 100.0% 4579 KAISER/NORMANDIE KAISER 8,225 100.0% 4580 CAL ST NORTHRIDGE 6,200 100.0% 4581 E.26THST BNSF 296,935 100.0% 4582 ST IMROV INGLEWOOD 548,259 100.0% 4583 OLYMPIC/CENTINELLA SANTA MONICA 1,961,558 98.9% 4584 VARIOUS LOC SANTA ANA 3,636,816 99.9% 4585 VARIOUS LOC WESTLAKE VILLAGE 2,125,397 100.0% 4586 7TH ST. LONG BEACH 1,713,347 99.9% 4587 COLUMBUS E/S PANKOW 225,945 94.6% 4588 EAGLE ROCK HS LAUSD 991,991 92.3% 4590 ROYAL AVE. SIMI VLY 1,791,856 93.6% 4591 LAS BRISAS SIGNAL HILL 142,749 99.5% 4592 MADERA RD. SIMI VLY 711,585 100.0% 4593 LOWELL E/S LBUSD 541,662 100.0% 4594 ALDRICH PARK UCI 907,704 100.0% WORK BACKLOG 9,559 2,001 143,001 3,095,493 33,773 60,824 1,046,619 95,447 102,324 21,525 5,446 927 12,270 76,168 113,798 Page 3 of 14 1-21-09 11-30-08 WIPS 12-14-2008 - Open Jobs Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG 4595 MARINA H/S HBUHSD 3,215,000 86.6% 432,035 4596 EMAS SYS BURBANK ARPRT 3,642,247 99.9% 1,957 4597 WILSHIRE/FAIRFAX MATT CONST 1,071,699 46.5% 572,826 4598 CHEVIOT HILLS LOS ANGELES 777,869 54.2% 356,169 4599 VARIOUS SCHOOLS 837,132 100.0% 4600 ANCHORAGE/SHOR RE SCHAFER 7,710 100.0% 4601 SHEILA/INDIANA ELECTRO CONST 8,784 100.0% 4603 INGLEWOOD/CULVER PLAYA CAP 374,797 86.4% 51,113 4604 MADISON E/S REDONDO BEACH US 39,300 100.0% 4605 MWD WATERLINE RUDOLPF/SLET 1,809,170 1.9% 1,774,728 4606 PERRY LINDSEY ACADEMY LBUSD 1,034,834 99.9% 1,516 4607 LACC CHILD DEV CTR CA CONSTR 29,079 71.2% 8,389 4608 TAXIWAI D LON BEACH 816,228 100.0% 4609 JUVENILE HALL ALCORN FENCE 452,834 10.4% 405,839 4610 SEPULVEDA BLVD B & D CONST 8,939 100.0% 4611 USC ST IMPRV USC 1,717,400 34.9% 1,118,308 4612 KAISER VENTURA BLV KAISER PERM 43,997 98.2% 807 4613 STORM DRAIN POL POLB 4,688,404 12.1% 4,119,191 4615 PIER A WEST TUTOR SALIBA 121,706 12.3% 106,720 4616 PIER A WEST TUTDOR SALIBA 327,832 28.1% 235,691 4617 SEPULVEDA BLVD B & D CONST 16,600 91.0% 1,489 4618 FED EX RAMP FEX EX BURB ARPRT 3,493,821 2.8% 3,395,388 4619 SO REGION ES LAUSD 590,518 9.7% 533,215 4620 EAST LA HS TUCKER ENGR 57,000 100.0% 4621 VARIOUS LOC DANA POINT 94,600 17.5% 78,040 4622 D & E YARD CROSSINS LA JUNC RR 44,041 100.0% 4623 CANDLEBERRY AVE SEALBEACH 1,415,869 1.7% 1,391,826 4624 WASHINGTON/IND BNSF JOJMSPM CONTROLS 74,988 91.6% 6,326 4625 EL PRESIDO LAINE AIRE 13,500 100.0% 4626 VAN NESS BUNTICH 4,850 100.0% 4627 SHEILA ST. ELECTRO 2,698 100.0% 4628 LIMECREST DR. LACPW 228,859 0.7% 227,325 4629 WASHINGTON BLVD PCL CONST 124,000 35.0% 80,638 11-30-08 WIPS 12-14-2008-Open Jobs Page 4 of 14 1-21-09 Work Experience Report November 30, 2008 _ Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG " 4630 LAMAR/MAIN ELECTRO 31,900 100.0% 4631 4TH ST. REMPREX 1,420,000 49.4% 719,049 4632 LACMA PH II MATT CONST 352,051 17.6% 290,001 4633 DISNEYLAND BAKERY BALI CONS 16,876 100.0% 4634 RIVERA RD. SPRKLR UNION 27,441 100.0% 4635 JOHN WAYNE AIRPORT BALI CONS 15,536 100.0% 4636 VARIOUS STS ROLLING HILLS EST 178,414 82.3% 31,653 4637 DISNEYLAND TRENCH BALI CONS 9,985 100.0% 4638 DICKSON, ENT,FOSTER COMPTON USD 94,603 1.4% 93,299 4639 VARIOUS INTER BOEING CO. 1,303,476 0.1% 1,301,812 4640 BERTH 73/191 POLA 237,765 0.0% 237,765 4641 PUENTE HILLS LANDFILL LACO SANI 447,645 2.8% 435,270 4642 JAMES WOOD AVE FED OF LABOR 8,388 100.0% 4643 CAMPUS CAP PLAYA VISTA 336,600 1.0% 333,330 4644 MGM DR. HATHAWAY 47,068 57.1% 20,196 4645 USC SCH ARTS HATHAWAY 19,130 19.4% 15,417 4646 CALIFORNIA HATHAWAY 37,426 0.0% 37,426 4647 WOOD AVE. FULLERTON 1,090,322 0.8% 1,081,204 4648 BANDINI BNSF 454,993 0.0% 454,993 11-30.08 WIPS 12-14-2008 - Open Jobs Page 5 of 14 1-21-09 Work Experience August 31, 2008 Excel Paving CO. 01 /20/09 JOB NO. PROJECT NAME Closed Jobs 3rd. Quarter 2008 FINAL CONTRACT AMOUNT 3947 TUSTIN AVE., ANAHEIM 4,370,876 3959 SANTA MONICA BLVD., LOS ANGELES 49,757,848 4062 SANTA MONICA/MWD 7,739,622 4164 KENNEDY HS ANAHEIM 1,037,004 4316 MONTROSE AVE. LACPW 2,447,026 4332 SO. BRAND BLVD GLENDALE 2,011,346 4336 VERMONT AVE. GARDENA 1,204,230 4337 MCFADDEN AVE. 1,121,382 4374 WOODRANCH PKWY SIMI VALLEY 1,982,642 4401 NO. MCLAY ST SAN FERNANDO 4,981,426 4414 TOPANGANICTORY LOS ANGELES 2,166,954 4420 VERMONT AVE. LOS ANGELES 915,500 4429 RANDALL ST. ORANGE CO. 824,976 4435 NATIONAL BLVD. CAL TRANS 90,524 4440 226TH ST HAWTHORNE 92,155 4451 OVERLAY SANTA CLARITA 5,503,565 4471 ANAHEIM ST. LB TRANSIT 244,032 4474 NO. LOOP RD. HATHAWAY 2,996,158 4479 UNION AVE SNYDER LANGSTON 55,297 4486 BLUFF CREEK DR COUCH & SONS 207,560 4491 WESTFIELD CENTER ARCADIA 29,118 4493 FREEMAN DR. CALABASAS 82,619 4495 PORT OF LB RYAN CO. 16,091 4498 VAGABOND STRM DRN MONTEREY PARK 89,325 4514 FOOTHILL BLVD. BERNARDS 81,317 4520 AMBLER AVE SCH TORRES 134,849 4537 26TH ST.NERNON CBRE 52,143 4540 EVEWARD RD. DLSB 47,967 4544 BURBANK AIRPORT BURBANK AIRPORT 16,585 4551 GEPRGE BURNS AVE. WEST HOLLYWOOD 39,219 4556 GARVEY AVE. REYES CONST 38,218 4565 AVE OF STARS HATHAWAY 9,375 4575 DOUGLAS/EL SEGUNDO EL SEGUNDO 4,300 4589 WILSHIRE DR PSOMAS 32,190 4602 CALSTATE HATHAWAY DIN 9,386 4614 LOMITA BLVD ELECTRO CONST 3,486 3rd.otr 8.31-2008 WIPS-Closed Jobs - Sorted 1-20-20M Page 6 of 14 1-21-09 Work Experience May 31, 2008 Excel Paving CO. Closed Jobs 2nd. Quarter 2008 0'1 /20/09 FINAL CONTRACT JOB NO. PROJECT NAME AMOUNT 4123 ANAHEIM ST LONG BEACH 3,249,006 4365 WEIDLAKE IMPRV LOS ANGELES 465,183 4373 CENTURY PKG LOT E. LOS ANGELES 736,152 4404 UCI IRVINE 22,443 4444 ALLEN AVE. GLENDALE 279,890 4453 ST. IMPRV INGLEWOOD 479,793 4456 EL DORADO HS LAUSD 794,632 4462 VIRGINIA ST. EL SEGUNDO 92,774 4489 ENT PKG LOT BURBANK AIRPORT 380,925 4503 GRANADA HILLS TORRES CONST 50,496 4510 LIGGETT E.S. TORRES CONST 84,479 4513 LEAPWOOD E.S. TORRES CONST 142,331 4519 MOORPARK HIGHLANDS CHAPARRAL 616,202 4533 USC CINEMATIC HATHAWAY 2,134 4539 W. BURBANK LOT BURBANK AIRPORT 63,382 4542 PASEO DEL MAR VAL VERDE 13,374 4546 ORCHARD ST. BELL 19,375 4550 4TH ST. CHLS KING 18,527 4560 ROSCOE BLVD WEST HILLS 2,200 4562 J PAUL GETTY LOS ANGELES 17,079 4564 SPAZIER BURBANK 1,600 4570 LOST E BURBANK AIRPORT 37,158 4576 VARIOUS LOC DANA POINT 94,080 2nd.Otr. 5-31-08 WIPS - Closed Jobs Only - Sorted 1-20.2009 Page 7 of 11 1-21-09 Work Experience February 28, 2008 Excel Paving Co. CLOSE® JOBS 2007- 2008 07/08/08 JOB SALES NO. PROJECT NAME AMOUNT 3704 TAXIWAY D L.B. AIRPORT 3,720,722 3865 2627 HOLLYWOOD, BURB/GLEN/AIRP 377,031 4084 SAND CANYON IRVINE 720,447 4088 ANNUAL RD RESURF DANA POINT 1,490,592 4099 03 ST IMPRV INGLEWOOD 593,520 4144 CASE AVE LA 432,963 4157 YUPLACENTIA FULLERTON 137,338 4176 SILVER LAKE LOS ANGELES 1,317,464 4182 UCLA LOS ANGELES 38,066 4182 UCLA CAMPUS LOS ANGELES 103,828 4218 ASHCROFT/ROBERTSON LOS ANGELES 52,900 4233 VAN BUREN VLD. CO RIVERSIDE 2,461,429 4237 S/W AREA LAX 4,876,048 4253 S.A. STADIUM SANTA ANA 397,289 4257 MIRAMONTE ES LOS ANGELES 677,111 4269 KINNELOA DEBRIS BASIN LOS ANGELES 237,063 4274 HARBOR BLVD LOS ANGELES 1,249,459 4275 CLAY MS LOS ANGELES 620,819 4281 HILLCREST ES LOS ANGELES 903,237 4306 10TH ST. LONG BEACH 1,192,729 4307 NEWPORT SHORES NEWPORT BEACH 1,584,279 4309 KING MS LOS ANGELES 985,753 4314 PARK PLACE IRVINE 998,231 4314 PARK PL PKG 76,267 4317 BERTHS 226-236 POLA 2,811,047 4334 710 FRWY CALTRANS 700,680 4344 PKG LOT PH 1 RANCHO SANTIAGO CC 896,694 4346 DAMON, CONSTELL OF STARS 202,454 4347 HAMILTON HS LOS ANGELES 603,569 4349 FIRESTONE BLVD. SEPULVEDA DEV 325,075 4353 FOUNTAIN VLY HS HUNT BCH UHSD 1,074,427 4354 LA BREA AVE. WEST HOLLYWOOD 496,890 4361 ORANGE AVE LAWNDALE 209,832 4362 ST. REHAB LEISURE VILLAGE 799,326 4366 ANNUAL ST. ALHAMBRA 651,988 4371 VARIOUS STS REDONDO BCH 960,788 4372 WALNUT ST. SIMI VALLEY 412,988 4380 POINT FERMIN PASCHEN 359,607 4383 VERMONT AVE. KAISER FOUND 117,035 4384 VERMONT AVE KAISER FOUND 182,820 HISTORY REPORT 248&200& 7B08-S Lalw WIPS -Cb Jobe 3,UAMh.OTRS. 2007 & 10 OTR 2008 Page 8 of 14 1-21-09 V11®r8c Experience February 28, 2008 Excel Paving Co. CLOSE® JOBS 2007- 2008 07/08/08 SALES AMOUNT 4385 VARIOUS STS INGLEWOOD 379,574 4387 PALOS VERDES DR. PV EST 95,060 4394 CLARA ST. CUDAHY 556,434 4395 E. LOOP RD. IRVINE 363,771 4407 ORANGETHORPE BUENA PARK 1,038,513 4412 TRUNK SEWER REHAB CARSON 16,824 4418 PCH WILMINGTIN 22,830 4419 MICHELSON DR. IRVINE 460,419 4424 BNSF-TRACK 114 VERNON 1,108,470 4426 BNSF-SHEILA AVE. COMMERCE 528,245 4430 BNSF-ESPARANZA YORBA LINDA 352,990 4431 HAVEN AVE. RANCHO CUCUMONGA 155,069 4433 TRADE MARK IRVINE 29,025 4436 FULLER/GARNER WEST HOLLYWOOD 235,383 4439 DESOTO CHATSWORTH 9,437 4445 RAYMOND ST. PASADENA 25,155 4446 EASTERN/BANDINI BNSF 73,995 4449 WILLOW LANE WESTMINSTER 132,524 4450 ST. IMPRV LYNWOOD 766,795 4455 MAIN ST. NT2 PRODUCTIONS 2,700 4457 ACCESS RD. LOS ANGELES 499,954 4459 CLARK/SPRING LONG BEACH 70,775 4460 WASHINGTON/IND BNSF 171,668 4461 CDR 233 UPGRADE 374,942 4465 CANTERA ST. KAISER PERM 106,978 4472 BALUHARBOR CHLS KING 16,626 4473 FIRST/BOYLE LOS ANGELES 60,771 4475 6TH/PCH BOVIS 10,886 4476 SLAUSON/VAN NESS MLADEN BUNTICH 23,570 4477 WEST LA COLLEGE LOS ANGELES 186,054 4478 VALLEY BLVD. INDUSTRY 7,900 4484 UNIVERSITY HS TORRES CONST 88,537 4485 FLINTRIDGE HS LA CANADA/FL 1,400 4487 ROSEMEAD/SLAUSON BNSF 96,849 4488 GETTY CENTER GETTY TR 3,020 4494 SPAZIER ENVIRON 25,977 4496 POL SHOOTING LAGUNA BCH 51,837 4511 PIER F-POLB B & D 3,100 4512 L ST-WILLMINGTON BNSF 146,806 4517 18TH ST. SANTA MONICA 15,198 4543 AMELIA AVE. ROYAL ELECT 21,950 HISTORY REPORT 2-28-20DS. 760&S Lotus W IPS - Closed Jobe Jed SMh.OTRS, 2007 S It. OTR 2006 Page 9 of 14 1-21-09 At Excel Paving Co. Work Experience May 31, 2007 JOB Closed Jobs 2006 SALES NO. PROJECT NAME AMOUNT 3716 710 FWY PCH TO 405 21,510,942 3990 OCEAN BLVD LONG BEACH 1,196,229 4004 GREEN VALLY CIRCLE CULVER CITY 1,173,791 4024 UCLA KINROSS 2,329,669 4045 5 FRWY, OR. CO 180,290 4057 PALO VERDE HSG 611,836 4061 PANKOW BLDRS M.B. 720,917 4064 WALGROVE E.S. L.A. 767,069 4083 HARBOR BLVD FULLERTON 214,172 4098 BLEND E.S LA 273,966 4102 DENA E.S. LA 177,306 4104 MOULTON PKWY CO OF ORANGE 478,612 4106 PIER S BRTH S 102-S 110 LONG BEACH 4,077,253 4109 VARIOUS STS REDONDO BEACH 761,751 4115 WASHINGTON BLVD CULVER CITY 741,069 4117 VANUYS AIRPORT VAN NUYS 620,336 4120 SOUTHGATE HS LOS ANGELES 681,858 4142 ROSECRANS LAWNDALE 233,216 4143 CALLE MIRAMAR REDONDO BCH 536,987 4156 STERRY E.S. LA 223,520 4160 WARNER ES LA 988,639 4161 ST OVERLAY SIMI VLY 704,970 4168 MARINA DEL REY LA 459,915 4169 CEN PK WEST LA 50,550 4174 SHERMAN OAKS CNTR RESEDA 1,044,265 4175 GLEDHILL ES NO HILLS 506,079 4181 STATE ST ES LAUSD 334,787 4185 WHITTIER/PRESBY WHITTIER 7,400 4186 GETTY TRUST LOS ANGELES 850 4191 HARVARD AVE. IRVINE 329,938 4192 COMPTON/61 ST LOS ANGELES 17,722 4195 NEW JOB SAN CLEMENTE 10,966 4196 MWD/SEARL HEMET 9,109,427 4197 LYNOOD USD LYNWOOD 1,520,919 4198 AGOURA BIKE AGOURA HILLS 1,032,236 4209 PCH/CATALINA LONG BEACH 657,469 4210 GLENDALE BLVD LOS ANGELES 36,630 4212 GLENDORA/HILL LA PUENTE 11,833 P*q yFl"2DD6-2007 tt u537-20V-A &77-2007 Page 10 of 1-21-09 Excel Paving Co. Work Experience May 31, 2007 JOB Closed Jobs 2006 SALES NO. PROJECT NAME AMOUNT i ti 4213 ALDAMA ST SCH 19,097 4214 PCH/ZUMIREZ MALIBU 453,886 4215 THE TOLEDO LONG BEACH 7,449 4216 REEVES/NAVY PORT OF LB 268,611 4217 KANAN RD/101 FRWY 13,589 4220 SO CENTRAL HS LOS ANGELES 54,026 4222 PKG LOT 6 MONROVIA 406,899 4224 SUNSET BLVD. W. HOLLWOOD 166,602 4227 SEWER REHAB REDONDO BCH 550,196 4229 BLDG 10 & 28 24,697 4230 VARIOUS LOC LOS ANGELES 441,551 4235 VICTORY BLVD, CANOGA PARK 687,374 4243 ANDASOL ES NORTHRIDGE 131,502 4246 SOUTH ST. ANAHEIM 492,994 4248 MANHATTAN & AVIATION REDONDO BEACH 49,589 4249 CAL TECH PKG PASADENA 39,406 4250 2 FRWY GLENDALE 13,200 4251 5M FRWY CAL TRANS 188,210 4254 PCH CAL TRANS 1,204,048 4256 GARDENA HS GARDENA 1,009,381 4258 N/E INTER SEWER LOS ANGELES 360,460 4259 LOMA VISTA ES LOS ANGELES 277,404 4261 MULHOLLAND DR. LOS ANGELES 17,598 4263 BEVERLY VISTA ES BEVERLY HILLS 734,246 4265 INDIANA/WASH BNSF 15,290 4271 GETTY CENTER DR. CENT. CITY 28,907 4276 GETTY CENTER DR. CENT. CITY 262,399 4277 GETTY CENTER DR. CENT. CITY 4,384 4278 CLARK AVE. LONG BEACH 517,203 4279 41 ST ST. LOS ANGELES 440,218 4280 VIA ROSA/PV BLVD. PV ESTATES 504,157 4284 CENT/LINC CULVER CITY 263,999 4286 WESTERN AVE. TORRANCE 28,640 4287 GRAND AVE. EL SEGUNDO 144,403 4289 LUGO E.S. LYNWOOD 15,435 4291 05-06 St.Maint AGOURA HILLS 831,113 4292 PICO BLVD. LOS ANGELES 67,308 4293 HOLLYWOOD WAY BURBANK ARPRT 38,800 4294 5 FRWY MISSION VIEJO 3,359 Page 11 of 14 HW"F%m W0&2W thry"I-2107-A&27-2M 1-31-09 - Excel Paving Co. Work Experience May 31, 2007 JOB Closed Jobs 2006 SALES -- NO. PROJECT NAME AMOUNT 4297 VICTORY/TOPNGA LOS ANGELES 606,202 4298 ST. JOSEPH'S SCH LONG BEACH 2,000 4300 PV LANDFILL LA SANI DIST 19,650 4301 MICHELSON IRVINE 201,698 4304 MEDIA STUDIOS BURBANK 18,700 4310 VAIL/CLEVELAND MONTEBELLO 10,790 4311 PLAYA VISTA LOS ANGELES 16,854 4312 INDIANA/WASHINGTON BNSF 147,323 4315 190TH/GREENLANE REDONDO BEACH 2,000 4318 RON REAGON FRWY SYLMAR 16,304 4321 SO. EAST HS SOUTH GATE 12,000 4322 E. PCH WILMINGTON 14,216 4325 BLUFF CREEK PLAYA VISTA 50,310 4326 BNSF, IND & WASH COMMERCE 334,616 4327 UNION STATION LOS ANGELES 10,000 4331 OLIVE & LAKE BURBANK 12,876 4333 VINEYARD & SATURN LOS ANGELES 8,545 4335 CSI/BOEING-BOLSA HUNT. BCH 101,500 4338 BNSF, WASH & IND NERVON 37,840 4341 FIRE STATION BURBANK 0 4342 MOOG, WESTERN WAY TORRANCE 37,031 4345 3355 EMPIRE BURBANK 79,193 4351 LAX -SO VAULT LOS ANGELES 26,514 4355 HAWTHORNE BLVD TORRANCE 4,000 4356 LAAFB RMA LAND 3,858 4357 PICO BLVD. LOS ANGELEWS 20,400 4363 DUESLER LANE DUESLER ASSOC 36,000 4364 WASHINGTON BLVD. PICO RIVERA 23,265 4375 VAN NUYS BLVD. ARLETA 6,140 4376 OBSERVATORY RD. LOS ANGELES 13,151 4379 E. SOUTH ST. MARKET RECYCLE 1,885 4382 FIGUEROA/JEFF LOS ANGELES 5,995 4386 INDIANA/WASH BNSF 83,456 Hway f0m 2OW-2007 Mry 5.31-2W7-P &27,2007 Page 12 of 14 1-31-09 Excel Paving Co. Work Experience May 31, 2007 JOB CLOSED JOBS 2007 SALES NO. PROJECT NAME AMOUNT - 3876 PARTHENIA, LA 1,153,774 4067 DEL AMO BLVD LONG BEACH 393,459 4076 JESSE OWENS PK INGLEWOOD 562,447 4077 CHAPMAN/ST COLL FULLERTON 135,411 4112 BELMONT PIER LONG BEACH 479,513 4113 NO LONG BEACH LONG BEACH 1,673,247 4127 UNION STATION LOS ANGELES 429,149 4154 STS & ALLEYS W. HOLLYWOOD 205,131 4177 COLD CANYON LOS ANGELES 481,211 4179 PE BIKE TRAIL UPLAND 2,418,540 4183 CAHUENGA LOS ANGELES 33,205 4169 AVE OF STARS CENT CITY 465,184 4205 DREW MID SCH LOS ANGELES 1,097,527 4206 107TH ST ES LOS ANGELES 400,544 4207 93RD ST ES LOS ANGELES 348,165 4226 MONTANOSO DR. MISSION VIEJO 163,838 4236 THOMAS EDISON MS LAUSD 814,878 4241 BRACKETT ARFLD POMONA 373,977 4252 W. PICO BLVD. LOS ANGELES 518,766 4255 ROMOLAND CALTRANS 200,540 4260 WESTLAKE VILLAGE 958,888 4264 BELLA TERRA MALL HUNT. BCH 3,166,715 4268 RANCHO CUCAMONGA RANCHO CUCAMONG. 234,424 4272 CHIQUITA BLDG PORTOF LB 6,922,874 4273 UCLA CAMPUS LOS ANGELES 71,597 4281 PALISADES HS 1,942 4285 MARLTON ES LOS ANGELES 278,427 4305 JEFF/CENTINELLA LOS ANGELES 1,486,623 4308 LAX AA MAINT AMERICAN AIRLINES 57,975 4313 SSA PKG LOT CO ORANGE 189,508 4320 CERRITOS PARK GLENDALE 305,537 4323 6TH & PCH HUNTINGTON BCH 16,092 4350 SHEILA ST. BNSF 256,660 4352 PREV MAINT REDONDO BEACH 254,596 4358 EL MODENA ALLEY ORANGE 97,222 4360 BESS/LEORITA KAISER FOUND 300,107 4368 SCHOOLWOOD DR. LA HABRA 170,908 4369 SHERMAN OAKS CNTR KBR SRV 39,323 4378 E. SLAUSON AVE. MARMOL RADZINER 60,718 4361 E. 7TH ST. INTERSCAPE 16,995 4388 PICO BLVD LOS ANGELES 22,255 HIYary FIIeI Xg6M7 MN "I-20%- A 5-27-2W Page 13 of 14 Excel Paving Co. Work Experience May 31, 2007 JOB CLOSED JOBS 2007 SALES NO. PROJECT NAME AMOUNT 4389 UPPER CLOVERLEAF RD MONROVIA 178,395 4390 COLDWATER CYN NO. HOLLYWOOD 10,855 4391 U OF WEST ROSEMEAD 351,139 4392 OLDEN ST. SYLMAR 92,684 4396 BURBANK AIRPORT BURBANK 18,283 4397 DURFEE/MICHAEL HUNT 17,989 4398 DIEMER PLANT MWD 116,205 4399 WARDLOW/CHERRY BOEING 156,900 4400 ELSMERE CARSON 7,780 4402 MOORPARK COLLEGE 91,578 4403 BNSF/WASH VERNON 506,615 4405 HAALAND DR THOU OAKS 148,500 4406 TROY H/S FULLERTON 321,451 4409 MAARKET ST SWR CHLS KING 5,270 4410 LOT A BURBANK ARPRT 47,124 4411 BRAVO BASE REPAIR LOS ANGELES 17,390 4422 PUENTE HILLS LACO SANI 12,500 4423 PIER J-BERTH 247 LONG BEACH 8,200 4428 SIXTH ST. SAN PEDRO 3,200 4432 BURBANK AIRPORT BURBANK 43,500 4441 INDIANA/3RD BNSF 3,900 4447 PIER F LONG BEACH 8,300 HW-y Flb4 Zoos-mm ft. 6a1-2W7-A 8.21-2W7 Page 14 of 14 1-21-09 Fur, „� 1z . BID BOND The American Institute of Architects, AU Document No. A310 (February,1970 Edition) KNOW ALL MEN BY THESE PRESENTS, that we PALP Inc. dba Excel Paving Company Bid Bond as Principal hereinafter called the Principal, and Federal Insurance Company a corporation duly organized under the laws ofthe state of Indiana as Surety, hereinafter called the Surety, are held and firn►ly bound unto City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten percent of the total amount of the bid Dollars (S 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. V4MREAS, the Principal has submitted a bid for Slater Avenue improvements NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material fivaished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 14th day of October 2009 ORSC 21328 (5/97) witness PALP Inc. dba Excel Paving Company Pmicrpal C. P, BROWN By: (. �1f�--__� PRESIDEN'C Namelritle Federal Insurance Company Surety (Seal) A"�' a Witness By: ` Doug A. Rapp Attorney -in -Fact t State of California County of Orange On 10/14./2()09 before me, Debra Swanson, Notary Public , (Herz insert name and tide of the officer) personally appeared Douglas A Rapp who proved to me on the basis of satisfactory evidence to be the person() whose name() is/t;* subscribed to the within instrument and acknowledged to me that he/sWexecuted the same in his/ / authorized capacity(iss), and that by his/ /t>l signature(&) on the instrument the person(&), or the entity upon behalf of which the person(.&) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ML_ Vi �— _ IU k 1.1,N�a I " ft., -0 P ra N iT�$ OF ryF@ DEBRA B NSON ;a COMM. # 1822117 X V NOTARY PUBLIC CWFORNIA ;V ORANGE COUNTY kly lrturon. EzPir� NOV 14, 2012 (Notary Seal) ADDITIONAL, OPTIONAL. INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (rick or description of attached documau) (Title or description of attached document continued) Number of Pages Docuunent Date (Additional information) CAPACITY CLAIMED BY THE SIGNER O Individual (s) ❑ Corporate Officer (Tide) ❑ Partner(s) ❑ Attorney -in -Fast O Trustec(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any aekeowledgatent .completed In California must contain verbiage esacity as appoint above in the tiotary tsetion or a sepw%ut acknowledgmem form must be prgpenly eorrepdeted and attached to that document. Tier Drily exception is if a documeae is to be recorded otaside of California In such Instances, any alrernarrve acknowledgment verbiage as may be printed on such a doclmera so long as the verbiage does not require the notary to do somethm thw a illegal for o notary rn California (Le. eert{fying the authorized capacity of the signer). Please check the document cvry ftdy for proper notarial Wording and attach this fare, ;frequired • Stow and County infortnatioa must be the State and County where the document s4ncr(4) pataottatly appeared before the notary public for acknowicdgmcnt • Data of notarization mutt be the data that the signers) personally appeared which must also be the Sarre date the acknowlodgment is completed. • The notary public must print his or her nine as it appears wrrhtn his or her commission followed by a coauna and then your title (notary public) • Print the narite(s) of document signers) who personally appear at the Lune of notarization. • Indicate the cotrect singular or plural forms by crossing off irteoaca forms (Ix - harsh ,- is iwv ) or girding the correct forms. Failure to owvcdy indicate this infon adon may bed to rejection of document recording. • TU notary seal impression must be clear and photographically rcproducible- Impression must not cover text or lines. if sea) impression smudges, rc-seal if a sufficient arts permits, otherwise complete a different acknowledgment form • Signature of the notary public must thatch the signature on file with the office of dxo ootuuy derL Additional iufonmation is not roquirtd but could help to ensure this acknowbdgmowt is not misusod or attached to a different documcnr_ -0, Indicate title or type of attachod document, number of pages and date O Indicate fhe capacity claimed by the signer. If the claimed capacity a a torporau officer, indicate the tide (i.e. CEO. CFO, Secretary) • Securely attach this document to the signed document M version CAPA YI2.IO.07 80D-1173-M5 www.NouryClasm.com � �� POWER Federal Insurance Company Attn: Surety Department OF y-Igllant Insurance Company 15 Mountaln yle*,Road Stlroty ATTORNEY Pacific indemnity Company Warren, NJI,07059 Know Ail" by These -Presents,. That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each here ,Constituje'and ap} oint Linda D. Coats; Matthew J. Coats, Douglas A- Rapp acid Timothy D- Rapp of Laguna fillies Calif6rrilla=-=»---• each as their true and lawful Attorney- in- Fad to execute'undor such desigeaCwn in their names and to affix their corporate seals to and deliver for and on their behalf as surety theremf or oawwtse, bonds end xutdertafuirrgs and other writings `ob8galory in.ttw'natute thereof (offer than bail hands) given orexecuw in the course or business. and;aw instruments amendrtg or altering the same, and consents to rate modification or alteration of any inshumerA referred to in said bonds or obligations. In Wknesa Wherool. saki MOEnAL MBURANCE COMPANY, V1G1tAmr amupAwx OOMPANv: and 1PAO*-7C tNDEatawnv COMPANY have each executed and attested these presents and ataxed their corporate seals on this 3AMh day o� March, 2009. iZerare� O. wondab, Assistasecretary David rrls. '"Ice STATE OF NEW JERSEY County of Somerset On this 30th, day of March, 2009 before rne, a Notary Public of New Jersey, personalty came Kenneth C..Wendel, to me knower to, be Assistant Secretaryof FEDERAL. MURANGE COMPANY, VQLANT INSURANCE (: UPANY, and PACIFIC INDEMNITY COMPANY, the companies xh" e,Vct>ted'',#w faegang"Power of Atbarthe ,, and, ft •said Kenneth C. Wendel, being by ase d* swom, old dWW and say that he is Assistant Sacretary,of FEWRRt- INSURANCE C060ANY, VIGILANT INSURANCE; COMPANY; and PACIFIC INDEMNITY COMPANY and knows the corporate seats thereof, that the seals affixed to the 96,49oing' Ponar of Ahomey are sveh cogp to sauja'and wane tharaio atfu-4 by authority of the er Laws of said Comparniea: and that he signed said Por at Attorney as Assistant Secretary of said Companies by like autttoW,, and that he is acquaimed.with David 8. Norris, Jr., and knows hunt to be Vice President of said Comparms; and that the 'signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris. Jr., and was thereto subscribed by authority of said By - Laws and.in dWOnertts presence. Noffirial sea+ - i{A7l ME XM&CHIM y HOP&ILiAkOFNEWARMY TAR No.,Iil6m, 7L 'f! 0CMINIT11881164 t'J ohm wily 8, 2009 Notary Pubflc dCERTtFiCATION Extract from the By taws of FEDERAL INSURANCI COMPANY, VFQLWV INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY. "Afl` povers of attorney for and on behalf of the CoFnp" may and shall be executed in the name and on behalf of the Company, either by the merman or the President or "a Vice President or an, Assistant Vice President. jointly wifh the Secretary or, an Assistant Secretary, under their respactfve designations The signature of such officers may be engraved, printed a lithographed. The signature of each of ttw following officers: Chairman, President: any Woo President, any Assistant Vice President, any Secretary, any Assistant Secretary and thess" of the Company may be affixed by facsimile to any power of attorney or to any, certificate relating thereto appainnq Assistant Secretaries or Attorneys- it Fact for purposes only of execukintt and attesting bonds antl undertaKngs and cow writings'of>tigatory in the rhatt" thereof, and.a' such power of attorney or certificate beamtg-such facsmile signature or facsimile seal shall be valid and.binhdng upon the Company and any such po t so exacuted and earl fled by such facairrae signature and facsimile ,seal shall be valid and binding upon the Company with respect to"acry bond or undertaking to which a is attached.` 1, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE OOMf ANY, VIGILANT INSURANCE COMPANY, and'PACIRC INDEMNITY COMPANY (the "Companies") do hereby certify, that (j) the, foregoing extract of the By- taws of the Companies is true and correct, (k) the Companies are duty licensed and authorized to'transact surety business in ail 50 of the United States of America and the IJistitt of Columbia and are authorized by the U.S. Treasury Depattuttert; further, Federal and Vigilant are licensed in Puerto Rloo and the U.S. Virgin Islands- and Federal is licensed in Ameilican Siinv , tiu9m..9?W ash of tho Prv%*,Oes of Canada oxeapr P4EJhw Maria; and (ta) rise foregoing Power of Attorney Is true, correct and in hill force and effect Given under my hand and seals of said Companies at Warren, NJ this 14th (Jay of October, 2009 y esmetht C. W , Assistant Secregry IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS SOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE C`,ONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephorfe (908) 903- 3M FAA (908) 803- 36M e-mail: sure"chubb.twm Fong 15-10- 0225B- U (Ed. 5- 031 CONSENT City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK February 11, 2010 D. P. Mangan, Inc. dba Pave West 401 S. Harbor Blvd. F385 La Habra, CA 90631 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest St. Enclosed please find your original bid bond for CC-1359. Sincerely, Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Ci?iY.0AJ6a ' f4eU'"9YffP0I&, New Zealand (Telephone- 714-538-5227) 111 401 S. Harbor Blvd. F385 La Habra, CA 90631 1 2 0 Pu 91 03 C "'I' I Sealed Bid For: Slater Avenue Rehabilitation BIDS: Thursday October 15TH @2:OOPM City Of Huntington Beach ATTN: City Clerk 2000 Main Street FL2 Huntington Beach CA 92648 SECTION C PROPOSAL for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. d , Accompanying this proposal of bid, find the amount of $ � which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received id er', Si u C-2 SECTION C PROJECT BID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STPL-5181 (166) BASE BID: TOTAL AMOUNT BASE BID IN FIGURES: C-2.1 PROJECT BID SCHEDULE Slater Avenue, CC-1359 Iteiri : Estit;iatecl :::::::::::::::: ......... Ite�n:w�fli tiriit: :rice::::::.::::::::;::::::;::::;:;:::;:;:::;:;::;::;:::;:::;:::;::;::::: .................................P........................................................................ ................. EXtezrde::;:: .................. ,...(. ................................................................................... u .nti...: a....::::::::::::w.......................... ri#teti i t words:::::::::::...::.::.::.:::.::::::::::::::IJriit::P ' e::::::::Airiouat:: : 1 1 LS Mobilization `' @ ' ^ li Dollars $ $i� °"" Cents Per LS 2 1 LS Traffic Control Plan P ITollars Q� cop, $ $ Cents Per LS 3 1 LS Furnish Project Traffic Control 5 Dollars � �$s @ Cents Per LS 4 96430 Cold Milling & Header Cutting Incl. disposal of material x• �i �y y— SF @ Dollars $ $ Cents Per SF 5 195300 Surface Grind (0.17) including dipsosal of material Dollars $ $��� 4i SF @ Cents Per SF 6 1325 Unclassified Excavation CY @ Dollars $ $ Cents Per CY 7 5040 Construct Asphalt Concrete (0-0.IT, 0.17, 0.42' & 0.50') Ton Dollars $ $ lJ U @�RXRA 4,N `)ft� —Cents Per Ton 8 6015 Construct Asphalt Concrete (0.17' ARHM Overlay) j Ton @ Dollars $ $ Cents Per Ton 9 3 Adjust Sewer/Storm Drain Manhole to finshed surface '�1,� Dollars $ (� $ EA @ y� �� Cents Per EA 10 16 Adjust OCSD Manhole to finished surface ollars AS �. 1 j���p�tA� Cents Per EA 0 C-2.2 PROJECT BID SCHEDULE Slater Avenue, CC-1 359 * .... . ... .................. .................... ................ . ... ........................ ......... . ................. ....... ....... . ......... ..................................................... .Q�i4 ...... .. .... .............. 1i *' 0�ft :jjj:W .......................... ............ ....... t:WW6:::: . 11 21 Adjust Water Valve to finished surface i�t M, %4ollars $ 0 EA Cents Per EA 12 1 AdjuIonitoring Well to finished surface 'M EA Dollars $ CJ Cents Per EA 13 1 LS Traffic Striping (iR� lars $ Cents Per LS 14 33 Traffic Loop eLlj L2� $ PIZ EA Dollars Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8 includes AB, P Slot 15 1830 LF Pave per Std Plan) JAW Dollars _A\N1kn_A Cents Per LF 16 15155 Remove & Reconstruct Sidewalk per Std Plan 207 C;A_ SF @ Dollars $ ISMS — LUG Cents Per SF 17 12 EA Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining Curb, I Slot pave, & SW) % & @ $ Cents Per EA 18 4 Install Truncated Domes into existing Access Ramp $ EA @ Dollars $ —Cents Per EA 19 13 Survey Monumentation CX) �U_Dollars $ EA Cents Per EA 20 1 % fin., �ed �surfac�e Raise urvey Well W;\IMonument �Ioh d f LIU EA Dollars Vz Cents — I Per EA C-2.3 PROJECT BID SCHEDULE Slater Avenue, CC-1359 t; tw ... : Estitiiated :::::::::::::: .............. :::..teth:with pojt::rtce:::::::::: ........ .. .................... P...................................................................... ::::::::::::::: 1�TO;. .:: :uai1t�: :: Q ty :;;:::::::::::::::::::::: >:: n. w..................................................... >:Unit:Fi :. Amouif:: .... 21 1654 Remove & Reconstruct Curb & X-Gutter T-e. �" a��j) SF @ if\ Dollars $ l� $ -bk!��k Cents Per SF 22 6 Remoove& Install New Traffic Signal Pullbox EA ,gyps @ ®\��� y vllollars $ _ $ uRt Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-1-T frame. Install city furnished traffic signal head with LE-SV-1-T framework and terminal box. 1 ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. 1 ea o Install conduit into existing pullbox. 1 ea. o Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. 2ea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1-12 conductor cable and 1-3 conductor cable. 1 ea o Install 1-28 conductor cable, 1-12 conductor cable and 1-3 conductor cable in existing conduit. 1 ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. I ea o Abandon existing conduit and remove conductors. 1 ea o Install 3" conduit into existing pullbox. 1 ea o Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cable and DLC's into traffic signal cabinet. 1 ea. LS 0 ars $ $ 4i Cents Per LS Total Amount Bid in Figures: $ ------- Total Amount Bid in Words: C-2.4 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class a fy� t r ` 6 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange M.Parmnt , being first duly sworn, deposes and says that he,,K she is i0jm or"ouL44irv- of -?hz e W441 - the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. D.P. MANGAN INC. dbe PAVE WEST Name Signatur+c:idder Address of Bidder Subscribed and sworn to before me this 104% day of 0 ek , 200". Pnatt®l 4D n%-L trm ba s i s 0 f -'Ares f-A W i A.In " 9k, b- P t r s �- NOTARY PUBLIC .&bL — —- _ _ _ _ _ _ _ _ _ _ _ _ _ _ PAT 80'DE NOTARY SEAL Commiaelon 10 17A1162 s Notary Public • California Orange County _, UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: D.P. MANGAN INC. dba PAVE WEST Contractor By Title C-5 DISQUALIFICATI®N QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. D.P. MANGAN INC. dba PAVE WEST Contractor By C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identi facation Number: Contractor :A Title Date: Note: This .form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained ./rom the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: D.P. MMAN INC. dba PAVE WEST er Name .5nS *MM �� Business Address 010U-�Akl Wnw-A ` City, State Zip A Telephone Number State Contractor's License No. and Class Original Date Issued �e tion Date The work site was inspected bY � %�Mof our office P—ku—1, 200_. )? The following are persons, firms, and corporations having a principal interest in this proposal: 1 C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. D.P. MANGAN INC. dba PAVE WEST Company Name Pn>t Cotnmiaalon##t 1"IS 1 T8416Z �A'k�MVN UW Notary Public - Caiitotnio Signature oy Bidder Orange County - Printed or)Typed Signature Subscribed and sworn t!o� before me this l day of d a , 2000 q Pig jai 4V M L M 014 bA61 S o f .S,%,�s f�% w, �o lac f� P sue.. NOTARY BLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: r% I t' *"(A -- �?Al r-1-1 k-A-k\A 6--� M.)9& maAdt-f, Ryfil"W hv-e- Name a1JAddress of Public Agency �j'� Name and Telephone No. of Project Manager: ul idf Ms,� \4— uo"A an IVS3 tuo U �,��� Contract Amount o Type of Work Date Complet d 2. Q�-W\ Naive Ad Address of Public Agency Name and Telephone No. of Project Manager: ,��qq o�Tll Contract Amount Type of Work Date Completed69 3. Name and Address of Public Agency Olt . 6A' Name and Telephone No. of Project Managenk M APP ( —�� � l� C-10 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Persor Contact Phone Signed: Date: D.P. MANGAN INC. dba PAVE WEST *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder D.P. MANGM INC. dbe PAVE WEST proposed subcontractor ��� , hereby certifies that he has , has not, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits & report covering the delinquent period or such other period specified by the Federal Highway. Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-12 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has. , has notbeen convicted P h' P rJmY within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No )< If the answer is yes, explain the circumstances in the following space. -0 C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of pedury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a Use certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of U MA DEPARTMENT OF P BLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP O1-04 C-15 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; O Does not have a proposed debarment pending; and a Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. 0 Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: ❑ a. contract a. bid/offer/application b. grant b. initial award c. cooperative agreement c po ward d. loan e. loan guarantee f. loan insurance 3. Report Type: Fla. initial b. material change For Material Change Only: year quarter date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime � Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) $ ❑ actual planned 12. Form of Payment (check all that apply): 8 a, cash b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ® No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: Date: Federal Use Only: Standard POrnt LLL KOV. UY-1L-Y / Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-18 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-19 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90«ENDIFn Page 12-89 LPP 01-04 C_20 March 15, 2001 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE_: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: �; � MIA LOCATION: -NA N)4n PROJECT DESCRIPTION: l \ k 09✓4 TOTAL CONTRACT AMOUNT: $ ✓ i BID DATE: ¢��\\ JU cA _' IDDER's NAME: D.P. MANGAN.I . i a PAVE WEST ®� CONTRACT UDBE GOAL: f I OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED Cert.No.ofUDBE AND EXPIRATION DATE NAME OF UDBEs Must be certified on the date bids are opened - include UDBE address and phone number CONTRACT DOLLAR AMOUNT —ITEM ITEM NO. UDBE kwo e r i o, wtLq AA e6 For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation 1 �` �� ontract Award Date: Local Agency certifies that all information is complete and accurate. rintName Signature Date Local Agency Representative (Area Code) Telephone Number: 4 Signature of"Viler Date (Area Code) Tel. No. I RI Person to ontact (Please Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3/09) For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer R] Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-31 LPP 09-xx C-21 March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27, 2009 C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION —GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date t The (City/Couniy of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of Initial Solicitation Follow Up Methods and Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4, 2009 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBE Information - Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: l F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Page 15-34 March 4, 2009 LPP 09-xx C-24 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort Name of Method/Date Results y/Organization of Contact H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): , . A NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. LPP 09-xx Page15-34a March 4, 2009 C-25 Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: LOCATION: PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT: $ ID DATE: BIDDER'S NAME: OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBECert.No. AND EXPIRATION DATE NAME OF DBEs Must be certified on the date bids are opened - include DBE address and phone number CONTRACT DOLLAR AMOUNT —ITEM ITEM NO. DBE For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation ontract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Telephone Number: Signature of Bidder Date (Area Code) Tel. No. For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/09) , Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a LPP 09-xx C-26 March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b March 27, 2009 C-27 LPP 09-xx Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) (7 N 00 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File Yageil-iii 1LPP 06-06 November I4,2006 Exhibit 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) MUM The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File Page 12-112 LPP 06-06 November 14, 2006 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowledge receipt and review of Addendum Number One, dated September 24, 2009 01 C mpany Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. G \Construction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\ADVERTISEMENT-NISB-BIDDING PROCESS\CC-1359 Addendum Number One.doc AIA Document A31 D Bid Bond KNOW ALL MEN BY THESE PRESENTS, THAT WE D.P. Mangan, Inc. dba Pave West 401 S. Harbor Blvd. F385 La Habra CA 90631 as Principal, hereinafter called the Principal, and Safeco Insurance Company of America 1001 Fourth Ave Safeco Plaza Seattle WA 98154 a corporation duly organized under the laws of the State of WA as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach 2000 Main St, Huntinqton Beach, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid Dollars ($ 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for C.C. No. 1359 -Slater Avenue Rehabiliation NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and materials furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 13th day of } rtness) C11S Brandy L. Baich (Witness) a 19516 October 2009 D.P. Mangan, Inc. dba Pave West ncipat) (Seat) F By: (True) Safeco Insurance Company of America (Surety) (Seal) B: Attorney -in -Fact David nsen (Title) AIA DOCUMENT A310 • BID BOND ® AIA ® FEBRUARY 1970 ED. ® THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 GENERAL ALL-PURPOSE ACKNOWLEDGMENT State of Arizona County of Maricopa On 10/13/2009 before me, Ethan Baker, Notary Public Date Name and Title of Officer (e g, "Jane Doe, Notary Public") personally appeared David G. Jensen " Name(s) of Signer(s) ® personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacities and that by his/her/their 0FRC1,.L SPAL signature(s) on the instrument the person(s), or the entity upon ETHAN BAKER behalf of which the person(s) acted, executed the said instrument i;t;C - SATE OF ARIZONA MARICOPA COUNTY My Comm. Expires 07-17-2011 WITNESS m hand and official seal. Y Signature of Notary Public OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT Bid Bond (_) INDIVIDUAL TITLE(S) (_) PARTNER(S) (_) LIMITED GENERAL (x) ATTORNEY -IN -FACT (_) TRUSTEE(S) (� GUARDIAN/CONSERVATOR (� OTHER SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) Safeco Insurance Company of America TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of 0 r" On 0 Q,t t: j &0 u g before me, r /t-T" 2) D t d.4_ personally appeared ----- A l-a, , Notary Public who proved to me on the basis of satisfactory evidence to be the personN whose nameN is/Xe subscribed to the within instrument and acknowledged to me that he/she/t%y executed the same iri h s/her/thtir authorized capacity(), and that by lis/her/tRt�ix-signature(.$) on the instrument the person, or the entity upon behalf of which the person( acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature of Notary E commission • 17Sl162 POWER OF ATTORNEY No. KNOW ALL BY THESE PRESENTS: That SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA, each a Washington corporation, does each hereby appoint David G. Jensen Phoenix, AZ its true and lawful attomey(s)-in-fact, with full authority to execute on its behalf the following surety bond: Surety Bond Number. Bid Bond Principal: D.P. Mangan, Inc. dba Pave West Obligee: City of Huntington Beach Amount of Bond: See Bond Form IN WITNESS WHEREOF, SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA has executed and attested these presents Dx* R'kj Dexter R. Legg, Secretary this 13th day of October 1 2009 Timothy A. Mikolajewski, Vice President CERTIFICATE Extract from the By -Laws of SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA: "Article 8, Section 8.1 1. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attomeys-in-fact or under other appropriate titles with authority to execute on behalf of the corporation fidelity and surety bonds and other documents of similar character issued by the corporation in the course of its business . . . On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the corporation, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." I, Dexter R. Legg, Secretary of SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 13th COAjpgy` PACE COMP GocwoRar� v CORPORATE 9 SEAL y SEAL y a 1s2y � Al``Uf aAsM� �j�of WaS��\� S-4910/DA3 5/09 day of October , 2009 Dx* a. kj Dexter R. Legg, Secretary XFT City ®f Huntington Reach 2000 Main Street e Huntington Beach, CA 92848 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK February 11, 2010 Sequel Contractors, Inc. 13546 Imperial Hwy. Santa Fe Springs, CA 90670 RE: CC-1359 — Slater Avenue Rehabilitation Project from Graham St. to Goldenwest St. Enclosed please find your original bid bond for CC-1359. Sincerely, op�- J4") Jo L. Flynn, CIVIC City Clerk J F: pe enclosure Sister C9i9'0AJ6a,"9e'4'"9"P4PcQ, New Zealand (Telephone: 714-536-5227 ) SEQUELI CONTRACTO- R.S, INC, 1354,6 imper,161 Hwy, Santa':F , e'Spring's, ','QAW670 -') A '�;'fvoo PA;A gt.,4n;��,A �.eoteA, CA } i 4 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ,. 1101 - bill ; For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) REVISED GENERAL NOTE ON PLAN SHEET 1 OF 13 —ADDENDUM 1 Changed General Note No. 5 last sentence from "Survey staking shall be provided by Contractor" to "Survey Staking to be provided by Agency". 2) REVISED SECTION 2-9-2 SURVEY SERVICES —ADDENDUM 1 Replaced Page E-5 with New Page E-5 with revised Section 2-9.2 Survey Services. New Section 2-9.2 indicates, "All construction survey will be performed by Agency". (Replacement Page E-5 labeled Addendum 1 attached) This is to acknowle ge receipt and review of Addendum Number One, d September 4, 2009 Comp4hy Name / By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. G \Construction Contracts (CCs)\CC1359 Rehabilitation of Slater from Graham to Goldenwest\ADVERTISEMENT-NISB-BIDDING PROCESS\CC-1359 Addendum Number One.doc ADDENDUM NUMBER ONE For SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) In the CITY OF HUNTINGTON BEACH September 24, 2009 point is typically a 3 3/4" aluminum disk with said agency's stamping. Datum information for public viewing is on file at said agency. A survey monument is defined as any permanent point as shown on file at the NGS, NOAA, Caltrans, OCS, City of Huntington Beach Public Works Department or any other public agency; said point being used to establish or perpetuate horizontal control. These points include but are not limited to centerline street monuments or accessories to said centerline street monuments (i.e. tie points), property corners or accessories to said corners, or monuments established in connection with the Orange County Geodetic Control Network or accessories to said monuments. These points shall be tied out and replaced by a licensed Land Surveyor or a licensed Civil Engineer authorized to practice land surveying pursuant to sections 8700 to 8806 of the Business and Professions code of the State of California (Land Surveyors Act). The Corner Records produced from said tie -out and replacement survey shall be furnished to the City of Huntington Beach Public Works Department as well as filed with the office of the County Surveyor indicating responsible charge (stamped), within 60 days of the final survey. 2-9.2 Survey Service [Replace the first paragraph with the following] All construction surveying will be performed by the AGENCY. Monument preservation surveying necessary to complete the work shown on the plans and provided for in these contract documents and specifications shall be accomplished by or under the direction of a licensed Land Surveyor or Professional Engineer, whom is authorized to practice land surveying, retained or provided for by the Contractor. The AGENCY reserves the right to direct additional construction survey to be performed when it feels it is required to adequately construct the work. All costs to the Contractor for protecting, removing, restoring, repairing, replacing, or reestablishing monuments or accessories to monuments or costs associated with the preparation or filing of Corner Records pursuant to sections 8700 to 8806 of the Business and Professions Code shall be included in the bid item for survey monument preservation. Payment for survey monument preservation shall be per the contract lump sum bid price and no additional compensation will be allowed therefor. When the contract does not include a pay item for monument preservation and unless otherwise provided in the specifications, full compensation for all monument preservation required to complete the work shall be included in the price bid for other items of work and no additional compensation will be allowed therefor. E-5 CC-1359 Slater Avenue Addendum 1 SEQUE- CONTRACTORS, WO' I SECTION C for the construction of SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET, C.C. NO. 1359 FEDERAL AID PROJECT ESPL-5181 (166) in the CITE' OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL. OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 75 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the C-1 SEQUEL CONTRAC O Sp INO". proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, the amount of $ /01, which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bi r Si nature ,� a9 s VVd C_2 SEQUEL CONTRACTORS, Nlw". SECTION C PROJECT BID SCHEDULE SLATER AVENUE REHABILITATION FROM GRAHAM STREET TO GOLDENWEST STREET C.C. NO. 1359 FEDERAL AID PROJECT STPL-5181 (166) RASE RID! TOTAL AMOUNT BASE BID IN FIGURES: E11 TOTAL AMOUNT BASE BID IN WORDS: C-2.1 SEQUEL C08jIt°eA' d J'i ' PROJECT BID SCHEDULE Item:: -Estimated :::::.:::::: ....... Item: itti snit: :rtce:::.:.::::::......:::......::::: p................................................................................ Eactended:: : Quan ;::vYri#tei:iti:vvords.:::::... .. �Jy►it. Prue .: ... Ainounf ,..: 1 1 LS Mobilization @�W _140us ! Dollars $ �713�• — $ ���3m. Cents Per LS 2 1 LS Traffic Control Plan @ eo Dollars . $ "— _ Cents Per LS 3 1 LS Furnish Project Traffic ntrolet @ Dollars ev ff&� Cents Per LS 4 96430 Cold Milling & Header Cutting incl. disposal of material A;_ '� / SF @ — Dollars $ $ " 4 f ( Cents Par CF 5 195300 Surface Grind (0.I T) including dipsosal of material 45" SF @ Dollars $ Cents Per SF 6 1325 CY Unclassified Excavation @ 17^ e /1 - - Dollars $ Cents Per CY 7 5040 Construct Asphalt Concrre�te�(0---0.17', 0.17', 0.42' & 0.50') /-1-` r � � dg7, 3 Ton ,Ty NI''C Dollars @ $ $ Cents Per Ton 8 6015 Construct Asphalt Concre e (0.17' ARHM Overlay) Ton v @ Se e-A i D� _Dollars —7 � $ /t, /ten $ Cents Per Ton 9 3 Adjust Sewer/Storm 1n M ole ttofinsh^ed surface 04 O!/f ® 00 EA @ i� �/ to Dollars $ W $ —' Cents Per EA 10 16 Adjust OCSD Manhofin^hedturface ,'^1(%` 1�1V16yJ� Dollars EA @ �— --�` Cents Per EA 9 I C-2.2 SEQUEL CONRAnOR('5139PROJECTBID SCHEDULE Estsmated :::::::::::: .............. Itein:wiiinit::rcce:::::::::::::::::::;:::::::::::::::::: ............... ................. P................................................................,.......... Exteude:::::: .................... .......... w ytteWAH WOrris:::::::::::::::::::. ::::::::::::::::::. ... i e::::::: ii#:..1.C.................. . 11 21 Adjust Water Valve t ished sur ace h 66 $ W $ EA @ V V ! ollars Cents Per EA 12 1 Adjust Monitors ell to finished surface L) 60 "!w EA @ r "� Dollars $ $ Cents Per EA 13 1 LS Traffic Striping ter/ @ ,-TV1 [ 40 U SP Dollars fiP ,1 $ /l Cents Per LS 14 33 Traffic Los,-_--, 60 r EA @ Y ollars $ r $ Cents Per EA Remove & Reconstruct Curb & Gutter (CF = 8", includes AB, P Slot 15 1830 Pave per Std Plan 2 ) r�l' ` Dollars $ LF @ ,v/ — -�-' Cents Per LF 16 15155 Remove & Reconstruct.WMalk per Std Plan 207 �f SF @ Dollars $ $ Cents Per SF Remove & Reconstruct/ Access Ramp (Incl. Depressed C&G, Retaining 17 12 Curb, 1' Slot pave, & SW) -rWV _[A0t rA^d 1`<jU/4�D-►14- $ ��• � $ 33 6Qo• EA o�,/ars @ Cents Per EA 18 4 Install Truncated Domes into e fisting Access Ramp x yVLr� Dollars $ $ EA @ `�� t� , t;�(•�/ Cents Per EA 19 13 Survey Monu ntation EA Allvlollw Dollars $ C_' $ @ Cents Per EA 20 1 Raise Survey WelI�+IB, nument to finished//surface EA @ UAU 4'.a Dollars $ $ �' Cents Per EA C-2.3 PROJECT BID SCHEDULAI-QUEL GQhffpftj, 1,359, Item:: ....... Estimated . . ..... ............. ....... ..... .... ................. .... ...... a�q:. Quantity ...... . .......1.................... .. ............... . .... ... ..... .. .......... r+d ...... ...... .I ..... ......... . 21 1654 Remove & Reconstruct Cub 4 X-Gutter SF Dollars 60 $ $ Cents Per SF 22 6 Remove & Install New Traffic Signal Pullbox 00 EA @ 1/ Dollars 6 $ $ Cents Per EA Modification of Traffic Signal Conduit & Equipment at Goldenwest (Includes all work for Const. Notes 21 through 30): o Remove existing traffic signal head with SV-I-T frame. Install city furnished traffic signal head with LE-SV- I -T framework and terminal box. I ea o Install 3" conduit with 1-12 conductor cable, 1-3 conductor cable and 4 DLC. I ea • Install conduit into existing pullbox. I ea. • Remove existing, Furnish & Install no. 6 pullbox into existing conduit run. Pull box w/ fiberglass lid shall be "Fiberlyte" or City approved equal. 2ea o Connect new 2" conduit to existing conduit. Install new conduit into existing pullbox. Install 1- 12 conductor cable and 1-3 conductor cable. I ea o Install 1-28 conductor cable, 1- 12 conductor cable and 1-3 conductor cable in existing conduit. I ea o Install 3" conduit with 1-28 conductor cable and 4 DLC. I ea • Abandon existing conduit and remove conductors. I ea • Install 3" conduit into existing pullbox. I ea • Remove conductors for northwest corner poles. Install 1-28 conductor cable and 4 DLC. Protect remaining conductors. Install 28 23 1 conductor cable and DLC's into traffic signal cabinet. I ea. LS @ 1paA4'Aous�o/ Dollars $ $ 01(10, Cents Per LS Total Amount Bid in Figures: $ Total Amount Bid in Words: _jj2A4 ------------------------- ------------------------------------------------------------------------------------- -- arm C-2.4 SEQUEL. CONT CTO , LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion o�fi�Work Name and Address of Subcontractor State License Number Class A-m e ' i caA , C®rD,j �P(oN ` �T u� A Q By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Thomas S. Pack , being first duly sworn, deposes and says that he or she is PM61d of SEQUEL CONTRACMRSB Ip the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Subscribed and sworn to before me this NOTARY PUBLIC SEQUEL CONTRACTORS, t O. Name oeiddeThonalass, Si tuS. Pack Prooddad 13546 IMPERIAL # ��AJY. Address of Bidder day of , 200 _ NOTARY SEAL C-4 CALIFORNIAALL-PURPOSE ACKNOWLEDGMENT State of California County of On ®CT 15' 2009 before me, Daniel Bustamantey Notary Public Date Here tnsert Name and Title of the Officer personally appeared I hol-1las S, rack President Name(s) of Signer(s) 10001000♦01000000000ifl000110100/00001l100® 1 DANIEL BUSTAMANTE U�v �uRFrcq p �._� �Z " COMM, #1825827 NOTARY PUBLIC - CALIFORNIA C) LOS ANGSLES COUNTY My Commission Expires Dessritet 20, 2012 j 1010001000010100011l00100001010101001101111 who proved to me on the basis of satisfactory evidence to be the person(,( whose name(iK) is/W subscribed to the within instrument and acknowledged to me that he/sbeAl4ey executed the same in his/heffftir authorized capacity(ies), and that by his/be#ti°►eir signatureN) on the instrument the personX, or the entity upon behalf of which the personoo acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature a4;al� Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): — El Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT.: OF°SIGNER, - - .. of thumb here Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRIN. �OF SIGNER - 02007 National Notary Asweiation • 9350 De Soto Ave., P.O. Box 2402 -Chatsworth. CA 91313-2402 • www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 - UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the SLATER STREET REHABILITATION PROJECT, C.C. NO. 1359, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: OCT 15 2009 Title Thomas S. Pack r—,n eIdant C-5 SEQUEL CON dMT �� Nry, DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes M No If the answer is yes, explain the circumstances in the space provided. A - Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: OCT 1 5' 2C- E $► 1 Q,a. Contractor y Thomas S. Pack Predded Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Thor alas S. Pack President Title Date: ®CT 15 20 Note: This form is required for every Dig Alert Identification Nannber issued by U.S.A. during the course of the Work. Additional forms may be obtained.from the AGENCY upon request. C-8 , BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name SEQUEL CCONTMACT01,6, INC 13546 Imperial Hwy. Santa Fn, Srincs, C�19fl67Q Business Address City, ( ) (562) 802-7227 Telephone Number 6,10 00A State Contractor's License No. and Class yi z .--ar-.9 Original Date Issued JAN 3 120 a i Expiration Date State Zip Thomas S. Pack of our office on /O4-2/® The work site was inspected by 200_. The following are persons, firms, and corporations having a principal interest in this proposal: Thomas S. P cask Pro l ed Abel Magallanes, V.P. & SecrGtarV CORM A. MAHLES, ASST. SECRETARY C-9 SEQUEL CONTRACTORS, INC. ST. LIC #610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office ACTION BY UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTOS OF SEQUEL CONTRACTORS, INC. The undersigned being all of the Directors of SEQUEL CONTRATORS, INC. a California Corporation, do hereby take the following action by this written consent at a meeting of the Board of Directors held on April 4, 2004 in accordance with the Bylaws of the Corporation and the California Corporation Code. WHEREAS, the Board of Directors deems it advisable to authorize the officers of the Corporation, Abel Magallanes, Thomas S. Pack and Michael A. Mahler, respectively, to execute bid bonds on behalf of the Corporation with any agency, person, company or municipality; RESOVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler are authorized to execute labor, material, and faithful performance bonds in connection with contracts to be entered into with any agency, person, company or municipality; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler are authorized and directed to execute and deliver street improvement contracts and related agreements with any agency, person, company or municipality on such terms conditions as they deem advisable in their sole discretion; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler be, and they hereby are authorized by their sole signatures on any document to bind this corporation to contract, bids, bonds, etc.; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler be, and they hereby are authorized and directed to take any and all such other actions and execute such other documents as may be necessary or appropriate to cant' out the purposes of the foregoing authorizations. In witness thereof, the undersigned Directors have executed this unanimous written consent to indicate this adoption of the consent of the foregoing resolution and the action set forth therein. Dated: Alv iL6C4, 2004 S. Abel Mgallsdies & President Director, Vice President & Secretary 0��O� I - Michael A. Mahler Assistant Secretary The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Company N Thomas S. Puck prad ant Printed or Typed Signature Subscribed and sworn to before me this _ day of , 200_ NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed " 2. c Name and Address of Public Agency ' Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 CALIFORNIA ALL-PURPOSE as p r •,S ACKNOWLEDGMENT .,g��,.-a.'.-T�,�.�,s�.�:�t,�a_,�L� ���..•�.'..-�5�>'� ��.,� A�.'...��t�>-a.,����� g�.�. S;s�t�a�.,aC,�t,aa �a T.,c�..?a.:a a.%c�S,�.,� State of California County of On OCT 1 5 2 0 before me, Daniel Bustamanteg Notary Public Date Here Insert Name and Title of the Officer personally appeared Th01-1n,au Sb P a0 preddent Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person04 whose nameX is4im subscribed to the within instrument and acknowledged to me that 0000000000000000000000011000000000000000000 he/sheAhep executed the same in his/herfftir authorized DANIEL BUSTAMANTE o capacity(ies), and that by his/heff heir signatures on the 0 �Pa Eaexn ``sy COMM. #1825827 instrument the person, or the entity upon behalf of NOTARY PUBLIC • CALIFORNIA p which the person acted, executed the instrument. LOS ANGELES COUNTY My Commission Expires December 20, 2012 * I certify under PENALTY OF PERJURY under the laws ♦000000®00000000040000000400`mo�eooeoaoaao® of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer — Title(s): ❑ Corporate Officer— Title(s): ❑ Partner — ❑ Limited ❑ General _ ❑ Partner — ❑ Limited ❑ General _ ❑ Attorney in Fact ° �'. ❑ Attorney in -Fact ° El Trustee Top of thumb here El Trustee Top of thumb here ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 -Chatsworth, CA 91313-2402 • www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 SEQUEL CONTRACTORS, INC. ST. LIC #610600A 13546 IMPERIAL. HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 1. OWNER: CITY OF INDUSTRY ADDRESS: 255 NORTH HACIENDA BLVD. INDUSTRY, CA 91744 PHONE NO.: (626) 333-0336 CONTACT: GERRY PEREZ PROJECT: AZUSA AVE / RAILROAD STREET. WIDENING PROJECT AMOUNT: $3,884,998.75 COMPLETION DATE SEPTEMBER 2008 2. OWNER: CITY OF WESTMINSTER ADDRESS: 8200 WESTMINSTER BLVD. WESTMINSTER, CA 92683 PHONE NO.: (714) 898-3311 CONTACT: JAKE NGO PROJECT: WESTMINSTER BLVD. MEDINA ISLANDS PROJECT AMOUNT: $2,157,180.00 COMPLETION DATE FEBRUARY 2008 3. OWNER: CITY OF COSTA MESA ADDRESS: 77 FAIR DRIVE COSTA MESA, CA 92628 PHONE NO.: (714) 754-5223 CONTACT: TOM BANKS PROJECT: 17T" STREET BEAUTIFICATION PROJECT AMOUNT: $2,801,689.75 COMPLETION DATE OCTOBER 2007 4. OWNER: CITY OF RANCHO PALOS VERDES ADDRESS: 30940 HAWTHORNE BLVD. RANCH PALOS VERDES, CA 90275 PHONE NO.: (310) 544-5252 CONTACT: BINDU VAISH PROJECT: ANNUAL STREET MAINTENANCE PROJECT AMOUNT: $1,500,000.00 COMPLETION DATE DECEMBER 2005, 2006, 2007 5. OWNER: CITY OF DOWNEY ADDRESS: 11111 BROOKSHIRE AVE. DOWNEY, CA 90241 PHONE NO.: (562) 904-7118 CONTACT: NOE NEGRETE PROJECT LAKEWOOD BLVD. IMPROVEMENTS PHASE 1 A PROJECT AMOUNT: $6,274,630.00 COMPLETION DATE AUGUST 2006 SEQUEL CONTRACTORS, INC. ST. LIC #610600A 13546 IMPERIAL KIWI' SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 6. OWNER: PORT OF LONG BEACH ADDRESS: 925 HARBOR PLAZA LONG BEACH, CA 90802 PHONE NO.: (562) 590-4172 CONTACT: GARY CARDAMONE PROJECT: PIER E BERTH D28-E27 NEW GATE PROJECT AMOUNT: $6,279,157.00 COMPLETION DATE APRIL 2006 7. OWNER: CITY OF TUSTIN ADDRESS: 300 CENTENNIAL WAY TUSTIN, CA 92780 PHONE NO.: (714) 573-3030 CONTACT: DENNIS JUE PROJECT: IRVINE & NEWPORT INTERSECTION PROJECT AMOUNT: $4,034,000.00 COMPLETION DATE APRIL 2006 8. OWNER: CITY OF SEAL BEACH ADDRESS: 211 EIGHTH STREET SEAL BEACH, CA 90740 PHONE NO.: (714) 431-2527 CONTACT: RAYMOND VELASCO PROJECT: VARIOUS STREET IMPROVEMENTS PROJECT AMOUNT: $917,329.50 COMPLETION DATE AUGUST 2006 9. OWNER: CITY OF LAGUNA BEACH ADDRESS: 505 FOREST AVE. LAGUNA BEACH, CA 92805 PHONE NO.: (949) 497-0345 CONTACT: FRED SHAHIDI PROJECT: VARIOUS DOWNTOWN STREET IMPROVEMENTS PROJECT AMOUNT: $791,357.15 COMPLETION DATE JANUARY 2006 10. OWNER: CITY OF ANAHIEM ADDRESS: 200 S. ANAHIEM BLVD. ANAHIEM, CA 92805 PHONE NO.: (714) 765-5776 CONTACT: CHUCK SMITH PROJECT: LINCOLN & STATE COLLEGE. INTERSECTION PROJECT AMOUNT: $1,757,836.00 COMPLETION DATE AUGUST 2005 SEQUEL CONTRACTORS, INC. ST. LIC #610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 11. OWNER: CITY OF SIGNAL HILL ADDRESS: 2175 CHERRY AVE.. SIGNAL HILL, CA 90806 PHONE NO.: (310) 329-0102 CONTACT: DERRY MACMAHON PROJECT: SPRING STREET WIDENING PROJECT AMOUNT: $3,674,380.00 COMPLETION DATE MAY 2004 12. OWNER: CITY OF EL SEGUNDO ADDRESS: 350 MAIN STREET EL SEGUNDO, CA 90245 PHONE NO.: (310) 524-2361 CONTACT: MARYAM JONAS PROJECT: MAIN STREET & GRAND AVE IMPROVEMENTS PROJECT AMOUNT: $3,419,623.00 COMPLETION DATE MARCH 2O04 13. OWNER: CITY OF ANAHIEM ADDRESS: 200 S. ANAHIEM BLVD. ANAHIEM, CA 92805 PHONE NO.: (714) 765-5776 CONTACT: CHUCK SMITH PROJECT: KATELLA AVE. BEAUTIFICATION PHASE II PROJECT AMOUNT: $17,500,000.00 COMPLETION DATE MARCH 2O01 14. OWNER: CITY OF ANAHIEM ADDRESS: 200 S. ANAHIEM BLVD. ANAHIEM, CA 92805 PHONE NO.: (714) 765-5776 CONTACT: CHUCK SMITH PROJECT: KATELLA AVE. BEAUTIFICATION PHASE I PROJECT AMOUNT: $19,941,735.00 COMPLETION DATE JUNE 1999 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: SEQUEL CONTRACTORS, WO Contact Person: TS 0`MaS S. P2 P 1&MA t' Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder SEQUEEL CONTRACTORS,, lr,0 , proposed subcontractor , hereby certifies that he has , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a, report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C_12 March 15, 2001 PUBLIC COILTR r`i; :OILTROD E0U(L G0 a a GF-1S AG , ins 1). Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder here y declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Coate Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 10232 Stat84MLON-y A, In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 1°x' �° EXHIBIT 12-E ' Local Assistance Procedures Manual � ��� � ®��a u��,:�_ � ..��: PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of I.OS ANGELES DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions � � � ''�`; ' I' �;`"i EXHIBIT 12-E SEQUEL CON 1 alto. ' 0n `S, a-b— Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; O Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. #4 Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15, 2001 Local Assistance Procedures Manual BEQUEL CONTRAG 8 6EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLODBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP O1-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions �_. ,,.t _ - EXHIBIT 12-E '.SEQUEL C�i i ° ° =`y," Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a. contract Fla. bid/offer/application Fla. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Na a and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: NffA-- Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. 10a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. 12. 14. 15. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission e 1 /1A a. cash d. contingent fee ' V b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payy ent Indicated in Item 11: (attach Continuation Sheet(s) if nece ary) Continuation Sheet(s) attached: Yes ❑ No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Print Title: smas S.. Pack Pr o4dent Telephone No.: (562) 802-7Z27Date: OCT If. Standard Norm LLL Rev. 09-12-9-1 Authorized for Local Reproduction Standard Form - LLL LULl Page 12-87 LPP 01-04 C_18 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions SEQUEL CO 9 L du wC 4 0f iS,y INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for -both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-19 LPP 01-04 Local Assistance Procedures Manual ' PS&E Checklist Instructions SEQUEL Cot a 1RAQ 1 P1S, ��� EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90sENDIF» Page 12-89 LPP 01-04 C-20 March 15, 2001 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF TINS FORM GENCY: L! / rr` �!�10�T0/t Ze"4 LOCATION: h. µ�4!A_OIOA �CaG PROJECT DESCRIPTION: 5tA ( A� . TOTAL CONTRACT AMOUNT: $ BID DATE: OCT BIDDER'S NAME: SEQUEL CONTRACTORS, Vt,10 ONTRACT UDBE GOAL: i4 ITEM OF WORK AND DESCRIPTION R SERVICES TO BE OR MATERIALS O BE PROVIDED Cert. No. of UDBE AND EXPIRATION DATE NAME OF UDBEs Must be certified on the date bids are opened - include UDBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. UDBE —SUBCONTRACTED - aQn rbGd° For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation $ i ontract Award Date: Local Agency certifies that all information is complete and accurate. rint Name Signature Date cal Agency Representative (Area Code) Tele hone Number: t B ® T 1 L Is,g 562) 802-72 Date (Area Code) e . No. ����?�� S. Pack For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3/09) j., �J Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-31 LPP 09-xx C-21 March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Ld`calO'Agency Bidder UDBE Commitment (Construction Contracts) � s k4i a INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27, 2009 C-22 LPP 09-xx DUEL a s � a t . Local Assistance Procedures Manual Exhibit 15-H tit r UDBE Information - Good Faith Effort EXHIBIT 15-II UDBE INFORMATION- —GOOD FAITH EFFORTS Federal -aid Project No. 93;01 �-S(8r (14 -/ � Bid Opening Date OCT 15 2009 The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of Initial Solicitation Follow Up Methods and Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4, 2009 C-23 Exhibit 15-H era r s"`w '"�`� a"' €�°�' Local Assistance Procedures Manual � UDBE Information - Good Faith Effori`t�� ,ice participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Page 15-34 March 4, 2009 LPP 09-xx C-24 S EQU EL C 0 N T RA T 0R3, lilt �. Local Assistance Procedures Manual Exhibit 15-H ' UDBE Information - Good Faith Effort Name of Method/Date Results Agency/Organization of Contact H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. i Page15-34a LPP 09-xx March 4, 2009 C-25 Local Assistance Procedures Manual Exhibit 15-G2 r Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) ON THE REVERSE SIDESOF HIS FORM NOTE:[ PLEASE REFER TO INSTRUCTIONS9"1;4!A7L0^ GENCY: � 7 OT T A �vA �{d1G^LOCATION: y PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT: $ ID DATE: OC T R -g 5 tJ(� C �2 BIDDER'S NAME: SEQUEL CO �T CTORS I'Mr,04 ITEM OF WORK AND DESCRIPTION R SERVICES TO BE OR MATERIALS O BE PROVIDED DBE Cert. No. AND EXPIRATION DATE NAME OF DBEs Must be certified on the date bids are opened - include DBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. DBE —SUBCONTRACTED .-,,cvc C41 dA• p G b For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number: Federal Share: Total Claimed Participation $ Q�' 97 n ontract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. rint Name Signature Date cal Agency Representative Area Code Telephone Number: / PSrg'nJaturfJrid44i—TP� OCT 15 2009 (5R2 RQ2-7 Date (Area Code) Tel. No. Thor S • Pack President as For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/09) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a LPP 09-xx C-26 March 27, 2009 • SEQUEL C0NTF,'ACT0i,S,4,X Exhibit 15-G2 Local Assistance Procedures Manual LocalfAgency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b March 27, 2009 C-27 LPP 09-xx SEQUEL CONTRA g � j Sa 11"'iIBIT 12-G. Local Assistance Procedures Manual ` Bidder's List of Subcontractors (DBE and Non -DBE) n N 00 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART i The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.1 l of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File A / 14A(i Tyre— esrj /O M i l f Z 6 G� LPP 06-06 c rAAW Page12-111 Ilia November 14,2006 Sit AZ fWJ 4 SEQUEL COVI�,A�q sT, spftpp��J!` Exhibit 12-G ddures Manuhl Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49. Section 26 of the Code of Federal KeLyulations. Fhotocol)y this torm tor additional toms. Fim NamW Annual RIP AddressA Gross Description of Portion of Work to be Performed gu ;�A? City,_State i1P Receipts A A ., . . . . . . . . . . . 34, 'JAY .", ` ............. MIN'ttyl Distribution: 1) Original — Local Agency File Page 12-112 LPP 06-06 November 14,2006 Bond No. Bid Bond The American Institute of Architects, AU Document No. A310 (February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS, that we Sequel Contractors, Inc. as Principal hereinafter called the Principal, and Vigilant Insurance Company a corporation duly organized under the laws of the state of New York as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten percent of the total amount of the bid Dollars (S I o% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Slater Avenue - Project 1359; ESPL-5181(166) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithfid performance of such Contract and for the prompt payment of labor and material famished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 13th day of October 2009 Witness Witness ORSC 21328 (5I97) 0 off Vigilant Insurance Company Surety (Seal) By. Dou 1 A. Rapp Attomey-in-Fact Gitalb POWER Federal Insurance Company AtIA: Surety Department (3F Miigilant Insurance- ComParIV 15 Mountain View Road SUrety ATtORNEY Pacific andamnity'Cotmparty Warren, NJ 07059 Know All by These Presents, That FEDERAL, INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a Now 'York corporation, and PACIFIC ,IINDEM INDEMNITY COMPANY , a"Wisodnsin corporation, do each hereby constitute and appoint -Linda D. Coats, attttew J. Cams; Wugiaa A; Ralsp and.Tiretothy D: Ropy of Laguna Hills, California-- ------ each as their" and lawful Attorney- in- Fad to execute under such designation in theirnames and to affix fir corporate seats to and deliver for and on their behalf as surety ttnerear or 6alaimse; bands and w4eaakMs and ocher wrftt W o Rattly in the nature therett (outer than trail ) gtyart orexecutad ar(tte course of'ousiness..and'any Instruments anw*dng or altering the same, and consents to the modification or akoration of any instrument referred M d said bonds or dogatidns-, to W7tewAa Wtrorook trod mov AL muR mx coMPANY. YKitt:Aicr w4unAms DOMPANY, and C01APAW have each ex cuwd and aft ttod these presents and affixed their corporate seats on this SM day a Match, 2U09, eon C. Wamdel, Assistant Secretr7 David tt4s. Jr, Vtoe STATEOFNEW JERSEY ss. C4u* et Sonfetset On this 30th day of March, 2009 before me, a Notary Public of New Jersey, persondy came Kenneth C. Wendel, to me Iloilo to be -Assistant Secretary:of FEDERAL INSURANCE COMPANY, V"ANT INSURANCE.COMPANY; and PACIFIC INDEMNITY,L', PANY, the companies witttoh executed the foregoing Poway of Altorrtey, and the said Kenneth C. Wertdet, bekq by me A* Swoon did depose and-sahe is Assistant 3eae1;&ry,of FEWRAL INSURANCE COMPANY, VIGILANT INSURANCE CbWANY, and PANIC INDEMNITY COMPANY and knows the corporate seals theted,.that the seals affixed "to the tonegoing Power of Attorney are such cogg to seals and mite thereto afriaed by nu fwity of the or taws of, saw Compar"Z;: and that he.atgrhed saw Power of Ao may as Assistant Secretary of said Companies by like authonly, and that he is acquainted with David B. Norris, Jr., and know; tfm to be Vice Pmsidettt'af'said Corgi: and that the signature of Dawd 8. N rrle, Jr. shed to said powan of -Attorney is in the genuine handwriting of David B. Nouls, Jr:, and was thereto -subscribed by authority of said Sy - Laws and in depOwfs presence. Notwiaf Sean KATH&W t`�JTARY NOTARY moi6m OF New 3 r �PItBt.3 .` July It,Notary Public .IEA�' Gi:RTiF4CATIOPI Extract korn,ibe By- Laws of FEDERAL INSURANCE 0OMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY CnVPANY_ "All powers d attorney for and on behalf of the Company may and shalt be executed In the name and on behalf of the"Company, either by the Chairman or the President or -a Vice President or an Assistant Vice President. to ntly with be Secretary or, an Assistant Secretary, under their respectfye desigrraiions, The signature of such officers may be en graved, Printed or lithographed. Ilia signatue of eactkoilha following officers, Chairman, President, any Vice President, any Assistant Vice President, any Secretary, arT Assistant Secretary and dte'seat of ate Company may be ftflixed by jaceimate to any power of attorney or'to any certificate relating thereto appointing Assistant Secretaries or Attorneys- in- Fact for purposes only of axecutino and atteanobonds and undertalOngs and othor wrifirtgs obligatory in the nature thereof; and any such fog of 42mwyor certificate beamtg such facsimile signature or facsimile seat shade be vaiid.and binding +ipon the Company anti any Such power so exacut6 d and cartitied by such facsiode signahxe and taasitnile-seel shall be valid and trtding upon the company with respect to any bond or undertaking to which it is agached." i, icermth C. Wendel, Assistant Secretary of FEDERAL INSURANCECOMPANY. VIGILANT INSURANCE COMPANY. and PACIFIC INDEMNITY COMPANY (the "Cwnpaniesj do hereby certify that (i) the foregoing extract of the By- Laws of the Companies is true and Correct, (ink the Companies are duly licensed and authorized to transact surety business in aI Sty of the Unfted States of America and the District of Columbia and are authorized by the U.S, Treasury Departrrient; further. Federal and Vigilant are roansed in Puerto Rlw and the U-S. Virgin Islands, AM Federal is poensed in .4mwican Samna. taugm, aOd each Of, tho Pe*va tie or Canada ". W Princes Stkuard lshcend; and (fv) the foregoing Power of Attomy Is true. correct and1n M torte and effect Given under my hand and seals of -said companies at Warren, NJ this 13th day of October, 2009 r 1 4 &- Kenneth C. Wdfldol, ASSAUR Secretary fN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTfCrTY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTEn, PLEASE CONTACT US AT AMMM USTED ABOVE, OR BY Teieph orrxta (tt08) 909- 3493 Pax (908) 903- 30M e mail: slue fflchubb.com Form 15-14- 02258- U (Ed. 5- 03) CONSENT CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of LGS ANGELES On OCT 12 �� before me, Daniel Bustamante, Notary Public at Here Insert Name and Title of the Officer personally appeared Thomas S. Pack pfwkwm Name(s) of Signer(s) /@♦0♦♦11@10000/00001000000111100100//000010 @ gEPL O� TK 1 �wP E�aExA Fsr DANIEL BUSTAMANTE COMM. #1825827 4.. NOTARY PUBLIC -CALIFORNIA p LOS ANGELES COUNTY —' My Commission Expires December 20, 2012 0110414100001010001000100040041400040110114 who proved to me on the basis of satisfactory evidence to be the person(( whose name() is/w subscribed to the within instrument and acknowledged to me that helsheAhe,t executed the same in his/herAheir authorized capacity(ies), and that by his/taerfth& signatureN on the instrument the person(, or the entity upon behalf of which the personto acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS m hand and official eal. Signature Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT oF.'SIGNERsTop of thumb here Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Titie(s): ❑ Partner — ❑ Limited ❑ General Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: fRIGHTTHUM8PRINTt Top of thumb here AFESIGNER��_-,' 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827