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HomeMy WebLinkAboutCalifornia Professional Engineering, Inc. - 2014-07-07Y���i t4. �� r vv ' •�-r-n x"' w^.y_ a �.k-�k '- � �tti�� awn+� - , � ,, , i e*iL ,�^+,h: ",�+'v+���Fp Fier.,, .z i , , 1 RECEIVED VBY� (Name) (Date) • CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO City Treasurer FROM City Clerk DATE- I/1w //,-"o /j— SUBJECT Bond Acceptance I have received the bonds fo CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No CC No i MSC No Other No g /forms/bond transmittal to treasurer (Company Name) Approved —% (Council Approval Date) Agenda Item No City Clerk Vault No ��• SIRE System ID NoD N __ F , 0 CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION DATE. 7/24/2015 TO THOSE LISTED HEREON FROM David Verone, PW Contract Administrator SUBJECT Retention Release Payment - PO #20873 OJ Supplier #33150 Co #878 Stacey Clegg Safe Route to School, Project # CC-1426 Contractor's Name California Professional Engineegmg Inc Address 929 Otterbein Ave, Unit E City, State and Zip Code La Puenta Phone Number 626-810-1338 City Business License Number A265898 Notice of Completion 2/2/2015 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 7127%eo/S Date I certify that there are no outstanding invoices on file Date Travis K Hopkins, Director of Public Works Zacks, Deputy City Treasurer I certify that no stop notices are on file, and that a guaranty bond has been filed wit e City Clerk's Office Date Joan Flynn, City C rk Attachments 1 Notice of Completion v 2 Maintenance Bond 3 Certificate of Compliance with Prevailing Wage Laws 4 Contractor's Certificate 5 Certificate of Compliance with Title VI I of the Civil Rights Act and Equal Employment Opportunity Act of 1972 6 Consent for Release letter from the Surety Company _, 20 15 , at La Puente , California. Certification of Compliance with Prevailing Wa,e 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 CC-1426 Project Safe Routes to School Near Stacey Middle School and Clegg Elementary School I he undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards .mployed 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 th,: Statc of California, Denartment 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 ' 23 day of July California Professional Engineering,, Inc (Contractor !Name) APPROVED,AS TO FOnA By Michael E Gates City Attorney CONTRACTOR'S CERTIFICATE 1, Tracy Sooc (Nara,, of Declarant) state and certify that, is the general contractor to the City of Huntington Beach ("City") on Contract No CC-1426 (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) 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`) None Attached hereto arc the hen waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, matexials, and/oi equipment for use at the Project , Sit 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") 6 I declare under penalty If perjury under the laws of the State of California that the forgoing is true and correct. Executed at La Puente APPROVED AS T016RM r' Michael E Gates Cit\' Attorney on this 23 day of July > 2(3 15 (Sig zurr'e of Declarant) Certification of Compliance with Title VII of th,; Civil Rights Act and Equal Employment Opportunity Act of 1972 10 City of Huntington Beach Department of Public Works 2000 Main Street/P 0 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 CC-1426 Project Safe Routes to School Near Stacey Mddle School and Clegg ElemetLt�ry School 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 Opporturuty Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability The undersigned contractor also certifies that it has not maintained any segregat,;d facilities at its establishments on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability (wA the exception of access for the disabled) I declare under penalty of perjury under the laws of the State of California that the .orugoing is true and correct. Executed this 23 _ day of July , 20 15 , at La Puente , Californi Califomia Professional Eng ineenn Inc (Contractor Name) APPROVED AS T' FORA By_ ' ..� _ 2 Michael E Qntes Clt� Attorney RECEIVED BY (Name) (Date) -AMPI me] TO FROM DATE SUBJECT CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION City Treasurer City Clerk I In /J— Bond Acceptance I have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No CC No MSC No Other No. g /forms/bond transmittal to treasurer (Company Name) Approved — / (Council Approval Date) Agenda Item No. City Clerk Vault No SIRE System ID No AO� BOND NO 1971681 BOND PREMIUM INCLUDED IN PERFORMANCE BOND BOND EXECUTED IN TRIPLICATE KNOW ALL MEN BY THESE PRESENTS: That. California Professional Engineering, Inc dba California Professional Electncal Engineering icontractors name] 929 Otterbein Avenue Ste E La Puente CA 91748 [contractor's street address, city and state and zip code] as Principal (hereinafter called Contractor), and" The Hanover Insurance Company rsuretys name] 5 Hutton Centre, Suite 1060 Santa Ana CA 92707 (surety's street address, city and state and zip code] a corporation organized and existing under the laws of the State of New Hampshire with its principal office in the City of Santa Ana as Surety (hereinafter called Surety), are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of Two Hundred Sixty Seven Thousand Nine Hundred Sixty and 6011 R Dollars ($ 267,960 60 ), for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents, WHEREAS, Contractor has by written agreement dated July7, 2014 entered into a contract with Ownerfor the CC-1426, Safe Routes to.School Near Stacey Middle School _&_Clegg_ Elementary School Project in accordance with drawings and specifications prepared by which contract is by reference made a part hereof (hereinafter referred to as the Contract); and WHEREAS, the Contract provides that the principal will guarantee, for a period of one year, the work performed as part of the Contract from and against all defects in materials and workmanship, and WHEREAS, the Contract also provides that the Contractor shall secure Contractor's obligations during the one- year period with a bond executed by a surety duly admitted in the state of California; and WHEREAS, the Contract has been completed, and tie Own r Contractor and Surety/ agree that the zh omen 2� commencement date for this Guarantee and Bond shall be �a P arisi �Qaf T�re.afkPr , NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects arising in the Work, whether resulting from defective materials or defective workmanship, then this obligation shall be null and void, otherwise it will remain in full force and effect The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within thirty (30) following Owner's written notice of default, either (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall save the Owner harmless from any claims, judgments, liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner Whenever the Principal shall be, and declared by the Owner to be in default under the Contract, which shall include without limitation, any breach or default of the Contract , then, after written notice from the Owner to the Surety, as provided for below, the Surety shall either: (a) remedy the default or breach by the Principal, or (b) shall promptly and faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a contractor other than the Principal, at its own expense, and make available 10-2567150583 as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge Its obligations under this Bond shall be subject to the advance written approval of the Owner Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to (a) remedy the default(s) of the Principal promptly, or (b) arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond In said Notice of Election, the Surety shall state the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs ansing from Surety's actions or failure to act, and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages caused by delayed performance or non- performance by the Principal). The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s) of its performance of the Contract. If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its performance of the Work within thirty (30) days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond, and the Owner shall be entitled to enforce any remedy available to Owner No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner named herein or the successors of Owner Signed and sealed this 6th Principal Raised Corporate Seal [MUST SE AI= FIXED] Principal Raised Corporate Seat (MUST BE AFFIXED] NOTES day of May 2i3 t 5. 9. Acknowledgments must be completed and returned as part of the bond 2 Raised Corporate Seals are mandatory. 3 Please attach Power of Attorney California Professional Engineering, Inc dba California Professional Electrical lingineenno 0 OA 3-f tS�aCy� (Title) z AS TO FORM cGRATH, City Alt MOT 102567150583 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT ISTATE OF CALIFORNIA (COUNTY OF Los Angeles } On MAY 12 2015 before me, Diem Chu Notary I Pubhc, Date (personally appeared Van Nguyen (here insert name and title of the officer) 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. 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. DIEM CH' COMM # 2042113 rn NOTARY PUBLIC CALIFORNIA Y! LOS ANGELES COUNTY " MY COMM 64F' 8EP 21, 2011'd Slgria (Seal) Description of Attached Document Title or Type of Document Document Date Other OPTIONAL Number of Pages 2015 Apostille Service 707-992-5551 www CaliforniaAlostille us California Mobile Notary Network www CAMNN com CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document STATE OF CALIFORNIA County of Orange On May 6, 2015 before me, Christine T Hoang Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Yung T Mullick Name(s) of Signer(s) LOF *NF CHRIp�S®T1NE T. HOANG C'AP5� S9A COIR1M. # 2008757 AJ N -�; , r NOTARY PUBLIC CALIFORN A � r ORANGE COUNTY N MY COMM. EXP. FEB 26, 2017-1 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare 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 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct--,, Witness Signature OPTIONAL af�iFl� se 3ry Public Christine T H 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 the 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 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 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan, do hereby constitute and appoint James W Mollanen, Yung T Mullick, and/or Jennifer C Anaya of Mission Viejo, CA and each is a true and lawful Attorneys) -in -fact to sign, execute, seal, acknowledge and deliverfor, and on its behalf, and as its act and deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds, recognizances, undertakings, contracts of indemnity or other writings obligatory in the nature thereof, as follows Any such obligations in the United States, not to exceed Ten Million and No/100 ($10,000,000) in any single Instance and said companies hereby ratify and confirm all and whatsoever said Attomey(s)-m-fact may lawfully do in the premises by virtue of these presents These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect "RESOLVED, That the President or any Vice President, in conjunction with any Vice President, be and they are hereby authorized and empowered to appoint Attorneys -in -fad of the Company, in its name and as its acts, to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatory in the nature thereof, with power to attach thereto the seal of the Company Any such writings so executed by such Attomeys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons "(Adopted October 7, 1981- The Hanover Insurance Company, Adopted April 14, 1982 - Massachusetts Bay Insurance Company, Adopted September 7 2001 - Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSE17S BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this 3rd day of January 2012 THE HANOVER INSURANCE COMPANY " MASSACHUSETTS BAY INSURANCE COMPANY 114� CITIZENS SURANCEEOMPANY OF AMERICA 1974 OWAL x r Robert Thomas. 'Vier President n THE COMMONWEALTH OF MASSACHUSETTS) =�''� '"� COUNTY OF WORCESTER ) ss Joe �rinstrom, tee President On this 3rd day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations ,�:"�`'� BARBARAA GARLtCK �w Ceminanweagii otMass�twsefle ��i��.c— r ��E.J /�j, A{v Gamins.. Sept 2i 2053 �,�r4'F Barbara A Garlick, Notary Public My Commission Expires September 21, 2018 I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company ofAmenca, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power of Attorney issued by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect This Certificate maybe signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America "RESOLVED, That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted and executed by the President or any Vice President in conjunction with any Vice President of the Company, shall be binding on the Company to the same extent as if all signatures therein were manually affixed even though one or more of any such signatures thereon may be facsimile " (Adopted October 7, 1981 -The Hanover Insurance Company Adopted April 14, 1982- Massachusetts Bay Insurance Company, Adopted September 7, 2001- Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 6TH day of MAY 2015 THE HANOVER INSURANCE COMPANY MASSACHUSETTS SAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA qlon Margos+an, Vice President PLEASE COMPLETE THIS INFORMATION This Document was electronically recorded by City of Huntington Beach RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH Attn: David Verone P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 TITLE OF DOCUMENT Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder 111111111111111111111111111111111111111111111111111111111111111111111111111N0 FEE 2015000051241 04:30pm 02/02/15 232 407 N12 F13 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY 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 California Professional Engineering, Inc. who was the company thereon for doing the following work to -wit: SAFE ROUTES TO SCHOOL NEAR STACEY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL PROJECT, CONSTRUCTION CONTRACT-1426 W� That said work was completed January 29, 2015 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 February 2, 2015, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract The Hanover Insurance Company 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 February 2, 2015. Dilrbdoor of, is ori(s or City Engineer City of Huntington Beach, California STATE OF CALIFORNIA) 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 February 2, 2015. � —V&p Ller�.l -P-- "._� — Director of Public Works or City Engineer This document is solely the official business of City of Huntington Beach, California the City of Huntington Beach, as contemplated under Government code section. 6103 and should be recorded free of charge. THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND CALIFORNIA PROFESSIONAL ENGINEERING, INC. FOR SAFE ROUTES TO SCHOOL NEAR STACEY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL TABLE OF CONTENTS Pa e No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 4 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 5 7. NOTICE TO PROCEED 5 8. BONDS 6 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 7 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 11 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 15 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 16 27. CITY EMPLOYEES AND OFFICIALS 16 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 16 29. NOTICES 16 30. SECTION HEADINGS 17 31. IMMIGRATION 17 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 18 34. INTERPRETATION OF THIS AGREEMENT 18 35. GOVERNING LAW 18 36. DUPLICATE ORIGINAL 19 37. CONSENT 19 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 19 39. CALIFORNIA PREVAILING WAGE LAW 19 40. CALIFORNIA EIGHT -HOUR LAW 20 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 21 42. EMPLOYMENT OF APPRENTICES 21 43. PAYROLL RECORDS 21 44. FEDERAL PARTICIPATION 21 45. ADDITIONAL FEDERAL REQUIREMENTS 22 46. DAVIS-BACON ACT 22 47. DISCRIMINATION, MINORITIES, ALIENS 23 48. EQUAL EMPLOYMENT OPPORTUNITY 23 49. COPELAND "ANTI -KICKBACK" ACT 24 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 24 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 25 52. ENERGY CONSERVATION 26 53. HOUSING AND URBAN DEVELOPMENT 26 54. SIGNATORIES 26 55. ENTIRETY 26 ii FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND CALIFORNIA PROFESSIONAL ENGINEERING, INC. FOR SAFE ROUTES TO SCHOOL NEAR STACEY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL 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 CALIFORNIA PROFESSIONAL ENGINEERING, a [type of entity and State] CALIFORNIA CORPORATION, hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as SAFE ROUTES TO SCHOOL NEAR STACEY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL 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: I. 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 g/agree/ surfnet/federal const Page 1 of 27 12/11 of work, and for all other risks of any description in connection with the work, including, but not 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 Page 2 of 27 12/11 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 Page 3 of 27 12/11 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 two hundred sixty seven thousand nine hundred sixty and sixty cents Dollars ($267,960.60), 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 fifty (50) consecutive working days 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/ surfnet/federal const Page 4 of 27 12/11 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 Page 5 of 27 12/11 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 Page 6 of 27 12/11 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 five hundred Dollars ($500.00) 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 Page 7 of 27 12/11 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/ surfnet/federal const Page 8 of 27 12/11 (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 Page 9 of 27 12/11 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, five percent (5%) 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. 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. Provided, however, that in the event of a dispute between CITY and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. 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 contract price shall not be considered as a acceptance of any part of the work. 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. g/agree/ surfnet/federal const Page 10 of 27 12/11 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 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, its officers, elected or appointed officials, employees, agents, and g/agree/ surfnet/federal const Page 11 of 27 l2/11 volunteers. 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, 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 g/agree/ surfnet/federal const Page 12 of 27 12/11 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. 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 g/agree/ surfnet/federal const Page 13 of 27 12/11 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 TERMINA 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 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 g/agree/ surfnet/federal const Page 14 of 27 12/11 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. 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. g/agree/ surfnet/federal const Page 15 of 27 12/11 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: TO CITY: City of Huntington Beach ATTN: David Verone 2000 Main Street Huntington Beach, CA 92648 TO CONTRACTOR: CALIFORNIA ENGINEERING, INC. PROFESSIONAL g/agree/ surfnet/federal const Page 16 of 27 12/11 30. SECTION HEADINGS 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. 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 g/agree/ surfnet/federal const Page 17 of 27 12/11 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. 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 g/agree/ surfnet/federal const Page 18 of 27 12/11 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 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 g/agree/ surfnet/federal const Page 19 of 27 12/11 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 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. g/agree/ surfnet/federal const Page 20 of 27 12/11 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, 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 "B", which describes required contract provisions for federal -aid construction contracts. g/agree/ surfnet/federal const Page 21 of 27 12/11 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 CONTRACTOR 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 by the Department of Labor (29 CFR part 5) in accordance with the Davis -Bacon Act (40 USC Section 276a to 276a-7) for each craft or type of worker needed to perform this Agreement. g/agree/ surfnet/federal const Page 22 of 27 12/11 CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 47. 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. 48. 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. 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 g/agree/ surfnet/federal const Page 23 of 27 12/11 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. 49. 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 (29 CFR part 3), 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. 50. 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 327-330) 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 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 g/agree/ surfnet/federal const Page 24 of 27 12/11 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. 51. 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 306 of the Clean Air Act and section 508 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 nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. g/agree/ surfnet/federal const Page 25 of 27 l2/11 52. 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.). 53. 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. 54. 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. 55. 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, 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, g/agree/ surfnet/federal const Page 26 of 27 12/11 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 CONTRACTOR ITS: (circle one) Chairma Presiders ice President IM ITS: (circle one Se Secretary - Treasurer inancial Officer/Asst. CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California APPROVED: Manager jP rD AS TO FORM: Ci ttorney g/agree/ surfnet/federal const 12/11 Page 27 of 27 i SECTION C r, PROPOSA-L for the construction of Safe Routes to School In the vicinity of L:::X 14 1,617- 'A Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181(173) 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 50 working days, starting from the date of 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 prices shall govern over extended amounts, and words shall govern over figures. C-1 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 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 %00�d W1�:Mc\in the amount of* \0 A ' 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 is Signature C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For Safe Routes to School, In the Vicinity of Stacey Middle School and Clew Elementary School — CC 1426 May 9, 2014 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for the: Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School - CC1426 shall be replaced.with the following attached documents: The Federal Labor Rates dated May 9, 2014 shall be the labor rates in effect for the subject project. 2) SHEET 3 — TRAFFIC SIGNAL PLAN SPRINGDALE STREET AT CROUPIER DRIVE The following revision has been added to Pole Schedule: Traffic signal pole #5 has been revised from 26-4-100 to 29-5-100. The pole height and equipment will remain the same. This is to acknowledge receipt and review of Addendum Number One, dated May California Professional Engineering Company Name By �A� 2O f 20NA Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Proiect Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School Item No 1 Estimated Quanta 1 L.S. �r� Item .�m.r., v k3 Mobilization. rut Pri Fe` � c kh ��a��n.�a,l.� � Ex � � tended E.df.'9�xP t � $ S � 000 $ 5 loco Per L.S. 2 1 L.S. Furnish Project Traffic Control. $ 13 i00O $ 3 iQCG Per L.S. 3 1 L.S. Furnish and Install Traffic Striping\\ and Signing. $ 15 �51i $ \ ; Per L.S. 4 1 L.S. Construct Traffic Signal at Springdale Street and Croupier Drive. (excludes $ 2\2 $ gam, 2\2 interconnect conduit and interconnect cable) Per L.S. 5 2550 L.F. Furnish and Install 2"Interconnect Conduit with 6 Pair #19 Solid Interconnect Cables and Pull Boxes $ 23. ' $ Spaced Approximately 200' (Also includes installation into the traffic signal cabinets). Per L.F. 6 450 L.F. Furnish and Install 6Pair #19 Solid Interconnect Cables in Existing Conduit (Also includes installation 2c� $ — $ �2 into the traffic signal cabinets). Per L.F. 7 18 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B or Case C and Per Typical Section at $ $ New Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School Item Estimated Item " Unit Priee Extended No. Quantit Amount- 8 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case F and Sheet 2 Details for Ramp Locations 1 $ $ and 12. Also Includes Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 9 17 L.F. Furnish and Install Metal Railing Per Standard Plans for Public Works Book) (Green Plan 606-2, Type A. $ $L-t Per LF. Total Amount Bid in Figures: $ 2Q4 , q U O . 1pC Total Amount Bid in Words: sNYM- dFr10V qnd ne ll . Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes traffic signal cabinet, service cabinet and anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and a 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. Bid Item(s) Name and Address of Subcontractor State License Number Class Dollar Amount % of Contract �OQ e.c . �q5'S cqwV90 n o C'k�� � 'rc;SQO V -09 5 `oco \\�4-5g \W\AW� QWt\e \A %\'R C" jcP 0I°Uq -JJU2PW C-32 \a 1N0\ 5.210 A 11 A%MC � PaT1100t y00 E . m-m &-t . CA (� 241 o - 2 A V %� +OCC' 32 . �l By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. 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 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on s 2� �`� , at 1,d1 �Ae�W , %-� Date City State ,being first dulysworn, deposes and says tha he or she is Q�es\ e-M of Caliornia Professional En" 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. *0 Name of Bidder Signature of Bidder Address of Bidder 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 CC-1426 SRTSL-5181(173), Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School, (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: nac-\aakA CW=la Pmfeissional Engineering Contractor Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, 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. Date: Title California Professional Engineering C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name q2(�\ Business Address \9� e��`� C A cwi\ City, State Zip Telephone Number -40�2)opj , C -10 State Contractor's License No. and Class oil\u \ 2c;, '\ Original Date Issued OA\:!,C� �2c�\'--� Expiration Date The work site was inspected by J�� ��� � of our office on �A N� , 201�. The following are persons, firms, and corporations having a principal interest in this proposal: California professional Engineering, Inc. C-8 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. California Professional Engineering' Company Name Signature of BiddFr V Printed or Typed Signature `` 11 Subscribed and sworn to before me this 2� day of �n , 201 �1. 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. -* Q\,ea Q F�' Q C� 0 �AA�'m P-\AA * 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 Name 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-9 ACKNOWLEDGMENT State of California County of LOS ANGELES On before me, Diem Chu, Notary Public (insert name and title of the officer) personally appeared Van Nguyen who proved to me on the basis of satisfactoryevidence to be the erson p Kwhose name{.} are subscribed to the within instrument and acknowled ed to me that i 'e she/they executed the same in er/their authorized capacity4o , and that bygher/their signaturefsfi on the instrument the is person(�or the entity upon behalf of which the person(eacted, 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. � MY CC6MYD: 1EM � CHU oM# 20423 �Signf1v3 a NolNiA Nea) cN 60$t21101) 929 Otterbein Ave., Unit E • La Puente, CA 91748 Ph: (626) 810-1338 Fax: (626) 810-1322 www.cpengineeringinc.com y -� liforn�ia��Profession�a1-Engineering Inc: •. �yl-L- j.- ' !x*"I Old Towne Street Lighting Improvements Amount: $453,145 Owner: City of Orange Project Manager: Medel Vanes Contact Phone #: (714) 744-5535 Status: Completed Approximate Start/End Dates: Jan 2012-April 2012 Installation of Street Lighting on Mountain Street from Craig Ave t Amount: $335,166 Owner: City of Pasadena Project Manager: Chris Hernandez Contact Phone #: (626) 744-4303 Status: Completed Approximate Start/End Dates: Jan 2012-May 2012 Street Light Installation — Guinida Lane Amount: $202,345.50 Owner: City of Anaheim Project Manager: Mark Brownrigg Contact Phone #: (714) 765-4300 Ext. 4596 Status: Completed Approximate Start/End Dates: Aug 2011-March 2012 x ' Last Updated 01/O1/2013 December 4, 2013 Page 2 Traffic Signal Modification at Brookhurst Amount: $237,213.67 Owner: City of Huntington Beach Project Manager: John Griffin Contact Phone #: (714)375-5011 Status: Completed Approximate Start/End Dates: March 2011-Sept 2011 Traffic Signal System Upgrade Phase V-VIII Amount: $292,175.99 Owner: City of Santa Ana Project Manager: William Albright Contact Phone #: (714) 647-5029 Status: Completed Approximate Start/End Dates: Jan 2011-Aug 2011 (For federally funded projects, use this following page) 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 requiremnents 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: California PmbssiorW " 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-10 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 WHICHARE A PART OF THIS PROPOSAL) ATTACHMENT C EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder --\0o � A, -A , subcontractor C01bmia PM*BS� E.no� ,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 12-25 OB 12-04 c-11 June 29, 2012 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D ATTACHWNT D NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of cv-ck�'S�'e CrAi.1�� DEPART11IENT 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 12-27 OB 12-04 C -12 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment 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 belo 6,h 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 12-29 OB 12-04 C -13 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment F 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 sub recipients shall certify and disclose accordingly. Page 12-31 OB 12-04 C -14 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions E,N=IT 12-E Attachment G ATTACHMENT G DISCLOSURE OF LOBBYING ACTIVTrIES COMPLETE THIS FORM TU ll1JCLUJJ�, LUf3f3Y1NU A1;11V111t;J rUKJUAIN 1 lU J 1 U.S.U- 11m)6 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: Fla. 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 nly: e. loan guarantee year — q er f. loan insurance date of last r ort 4. Name and Address of Reporting Entity Prime ElSubawardee 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) 5. If Reporting Entity in No. 4 is S awardee, Enter Name and Address of ime: C/Number, istrict, if known 7. FName/Description: Cif applicable 9. A if known: b. Individuals Performing Services (including address if different from No. 10a) (last name, first name, MI) (attach Conflunuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply 13. Type of Payment (check all that apply) $ actual lanned a. retainer b. one-time fee 12. Form of Payment (check all that a ply): c. commission a. cash d. contingent fee b. in -kind; specify: na e e deferred 14. Brief Description of Servi officer(s), employee(s), or Ile U £ other, specify Performed or to be performed and Date(s) of Service, including mber(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet( attached: Yes No 16. Information requested ough this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: �A Z was placed by the tier�bove when his transaction was made or entered into. Thispsclosure is required pursuant to 31 print Name: �C\ 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.: Q- \3aJK Date: Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Form LLL Rev_ 09-12-97 Page 12-33 OB 12-04 C -15 June 29, 2012 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 (Ml). 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 12-34 June 29, 2012 C -16 OB 12-04 Local Assistance Procedures Manual PS&E Checklist Instructions OaDIBTT 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 12-35 OB 12-04 C -1 June 29, 2012 Local Assistance Procedures Manual EXIMIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts) Exinur 15-G LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: City of Huntington Beach LOCATION: In the vicinity of Stacey Ms and Clegg ES PROJECT D _ CRIPTION:Safe Routes To School Stacey -Clegg Project #STRSL-5181(173) CC-1426 TOTAL CONTRACT AMOUNT:$ 2 `Ql t c i Wo co BID DATE: tm 2a 1 ao\\ BIDDER'S NAME: _%NR 1 CONTRACT DBE GOAL: 10 . 2 8 % CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS TO BE PROVIDED (or contracted if the bidder is a DBE) DBE CERT NO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT DBE � 2 -l0k Catftrnla professionaln ne r ng, Ind. Ave. Un t E c7 For Local Agency to Complete: Local Agency Contract Number. Federal -aid Project Number Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number. Total Claimed DBE Participation $ � �Q � • j�� . 0 • O % Signature of Bidder U22V - ?S2 (C� Date �\ ^ (Area Code) Tel. No. Person to Contact (Please Type or Print) Local Agency Bidder DBE Connnitment (Construction Contracts) (Rev 626/09) Distribution: (1) Copy —Fax or scan a copy to the Cattrans District Local Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 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 15-1 OB 12-04 C -18 June 29, 2012 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE CONBUTMENT (CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid. 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 DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier BE 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 DBE participation 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 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 Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 C -19 June 29, 2012 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort EDIT 15-H DBE INFORMATION —GOOD FAITH EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. \"\2W VI S� - 5�� ` �\P:) Bid Opening Date �o1C\� The ity established a Disadvantaged Business Enterprise (DBE) 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 DBE Commitment" form indicates that the bidder has met the DBE 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 DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE 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 DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE 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 DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation -* W11P- M9 a V� -�, WQ a911L-) a b� -4� Wk�- q ot:k C - 2 0 Page 15-1 OB 12-04 June 29, 2012 Exhibit 15-H DBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE 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 DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (Y/N) Contract � wIQ 0&1e a 7��iE D. The names, addresses and phone numbers of rejected DBE firths, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: tick E. Efforts made to assist interested DBEs 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 DBEs: �V . Page 15-2 C - 21 June 29, 2012 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: OVA G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results 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. C - 2 2 Page 15-3 OB 12-04 June 29, 2012 Local Assist Procedures Manual EX; - 71Z-G Bidder's List of Subcontractors (DBE an4 .ion -DBE) 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. r Firm Name/ .Address/ :City, State, ZII' ; Phone/ Fax `nnual A Gross: : Receipts Perform Description of Portion: of Work to be P rmed P . +1;� � Al; ��L�y-;'` w` � � fig: :vea.v:ur.„�iLN.'J.`, Name A�1 A�1�cgn AS QUA 11 Phone �b\- $1 million YES list DBE If #: < $5 million QS a Address �(�- A00 S',x v I El < $10 million Fax c f5A -VQ - <$15 million Age of Firm (Yrs.) City State ZIP ❑> $15 million Name O, C Phone M❑< � —1 ' 3lQ 0 - < $1 million � tiP6. S,^uS ,u�zriiu 4 =' ; ' , ���J��;S,ti:p, ' �;h'L's'Hlc`i _<a'".,.i�:r.•.. $5 million Address u0�5,b Q,0\f\n0o0 ❑ < $10 million If YES list DBE #: Fax o1b\ _ � v 0 - 2(� Phone -91 ❑<$15million City State ZIP a2�oy Name ❑ > $15 million \ *�� Age of Firm (Yrs.) ai'k r v^s!s= , �•^,i°y, ^p=";a.: ;rr ,r x; �:wrlr < 1 million $ <$5 million Address �Cj� \�5 C\� ❑ < $10 million If YES list DBE #: Fax rt �q �� G 1 Phone ❑ < $15 million City State ZIP Vok Name ❑ > $15 million Age of Firm (Yrs.) LJ < $1 million Q.}17fr�a?j: tic!:""NU' Jue:- ❑<$5 million Address ❑ < $10 million If YES list Fax <$15 million City State ZIP El > $15 million '!P'"'�!%i',. yYx , •.";i-'.:,,,Y.;f''�y�4}I'RY.Lt�'„�`�'.AFq'�In.h�f!,a '=\:' �*Mti''ri.i?:*" Distribution: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14, 2006 EXHIBIT 1 Local Assistance Procce Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART II 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 'r 410 AO Qo..4:.,., ")4 n-FAA I" A n-FRnAl l V am 1atinne Phn4nrnnv thie fnrm fnr nrlrlitinnnI firms Firm,Name/:'., City; State, ZIP ;`:. r... Phone/ ` Fax . Annual Gross `. Receipts Descri lion of Portion of Work to be Performed P �„ �7 I r ` `F•"..(. rt"3t - Name Phone L1 < $1 million < $5 million Address 1\OCJ �a ��� ❑ < $10 million If YES list DBE #: Fax �.0 2A aQb ❑<$15million City State ZIP A 0 $ ❑> $15 million!�B_o,<<::;?`' _ �f tm rs Fi' tzys.., Y �;%'.!: hN;.i'•Ir :'�'ti+i.°."YL'.�;51 "e ply ..,j, �� i�y,v, R�.T; '!` I 5 ? Name Phone U <$1 million r�•.F; l�l. '•'ir,1.,i{ v .twf11ISiLlz;i„i:,r zi(i ❑ < $5 million Address ❑ < $10 million - - _-'-------------------- ---- ---- .-_-._-_.-__"--. If YES list DBE #; ;.+; .'�*. ��,k,�i�r•,� $ r�i'l���M?ir. e.>Ixf47a-f, {.'i;C+{P.*4n' i'�!�:.r7:i:13;(�!���nv: Fax ❑ < $15 million ❑>$15million -..,-, ,:.•�: rf �,�P 4'• i��,'3' 4,� City StateZlP Name Phone El <$1 million 1M:1'�XjF4�i. .li is":c.!Ii�:,�MiiOT4 A1r rc•7q',.?.�!.''4�x'jii. ,.•f,;.5;:�'�;: P'�^sJv',;;c�`'i.� s:iu:, El< $5 million Address ❑ < $10 million If YES list DBE #: Fax ❑ < $15 million 6 ''II ,', �Ittf�y1hy,,ts`i ;�'rrytt �',,��'; '7�'s:;�'•' �jV; �Y•; �1 1:�'�lu;� l:+iFfF+�� �l;):`i�'�� � >'iv 1 . s5iis City State ZIP ❑> $15 million fS �v� `�r' rT••y}W?"�-'�:,"V hr¢yI Name Phone ❑ < $1 million"fit - -- t�{ %{+fi $5 nvllion Address ❑ < $10 million If YES list DBE #: Fax ❑ < $15 million City State ZIP ❑ > $15 million A �:;, ^, , ; `' ;,; .,•gyp: :r �. i wr+. r.'t G,)��,�" !:,n)rYft Distribution: 1) Original— Local Agency File Page 12-112 November 14, 2006 LPP 06-06 THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond BOND # 20140508 KNOW ALL MEN BY THESE PRESENTS, that we CALIFORNIA PROFESSIONAL ENGINEERING, INC. DBA CALIFORNIA PROFESSIONAL ELECTRICAL ENGINEERING 929 Otterbein Avenue, Suite E Rowland Heights, CA 91748 (Here insert full name ,and address or legal title of Contractor) as Principal, hereinafter called the Principal, and THE HANOVER INSURANCE COMPANY 5 HUTTON CENTRE, SUITE 1060 Santa Ana, CA 92707 (Here insert full name ,and address or legal title of Surety) a corporation duly organized under the laws of the State of NH as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH 2000 Main Street Huntington Beach, CA 92648 (Here insert full name ,and address or legal title of Owner) as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid------------------------------------------ Dollars ($ 10.00% ), 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 SAFE ROUTE TO SCHOOL IN THE VICINITY OF STACEY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL (Here insert full name, address and description of project) 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 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 8th day of May, 2014 (Witness) AIA DOCUMENT A310 BID B INSTITUTE OF ARCHITECTS, CALIFORNIA PROFESSIO AL ENGINEERING, INC. DBA CA IF NIA PROFESSIONAL ELECTRICAL ENGINEERI (Princ (Seal) _ Yung T. Mull 0 I-EBRUARY197DED 1HEAMERIC AVE., N.W. WASHINGTON, D.C. 20006 (Title) CE (Title) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT a a' �v arr- a-`'•✓':L"'ei-y,Y-yr-y e7 d�N d' dY y a "eryC:r a»�- . d' m> u dr e7 a STATE OF CALIFORNIA County of ORANGE } On MAY 8, 2014 before me, JENNIFER C. ANAYA, NOTARY PUBLIC , Date Here insert Name and Title of the Officer personally appeared YUNG T. MULLICK Name(s) of Signer(s) �y�Eof>HFs9 JENNIFERC.ANAYA COMM # 1974168 � V o NOTARY PUBUC-CAUFORNIA WY f ORANGE COUNTY t,4 nv / AC - - — - -- -- — Place Notary Seal Above -- -- — --- who proved to me on the basis of satisfactory evidence to be the person(�44 whose nameM is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hisN*YN iKauthorized capacity(ies), and that by his/komipbeir signatureM on the instrument the person4 or the entity upon behalf of which the person4 acted, executed the instrument?. , I certify under PENALTY ERJU under the laws of the State of California tha a fore g paragraph is true and correct. Witness my hand d c --signature Signature of Notary 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: , Top of thumb here Number.of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s)T ❑ Partner — ❑ Limited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNFY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan, do hereby constitute and appoint James W. Moilanen, Yung T. Mullick, and/or Jennifer C. Anaya of Mission Viejo, CA and each is a true and lawful Attorney(s)-in-factto sign, execute, seal, acknowledge and deliverfor, and on its behalf, and as its act and deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds, recognizances, undertakings, contracts of indemnity or other writings obligatory in the nature thereof, as follows: Any such obligations in the United States, not to exceed Ten Million and No/100 ($10,000,000) in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED, That the President or any Vice President, in conjunction with any Vice President, be and they are hereby authorized and empowered to appoint Attorneys -in -fact of the Company, in its name and as its acts, to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatory in the nature thereof, with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys -in -fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons." (Adopted October 7, 1981- The Hanover Insurance Company; Adopted April 14, 1982 - Massachusetts Bay Insurance Company; Adopted September 7, 2001 - Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents; this 3rd day of January 2012. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZ�ENSSUftANCEOMPANY CiF AA+iERICA cSEAfora—_�-- l ----- RoEr�rt Thamas, Vice PrcSident THE COMMONWEALTH OF MASSACHUSETTS) 1 �`r"�— : �-- I-- — ^•'`' COUNTY OF WORCESTER ) ss. acre grerstram, Vid President On this 3rd day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. ,3, " w� BARBARA A. GARLiGK Lty Lcmmssim Ex�t�s Sept 21.2Gfa + -- .. Barbara A. Garlick, Notary Public My Commission Expires September 21, 2018 I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company ofAmerica, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power ofAttomey issued by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED, That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted and executed by the President or any Vice President in conjunction with any Vice President of the Company, shall be binding on the Company to the same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile." (Adopted October 7, 1981 - The Hanover Insurance Company; Adopted April 14, 1982 - Massachusetts Bay Insurance Company; Adopted September 7, 2001 - Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this B day of MAY 20 14 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA App n Margosian, Vice President ACKNOWLEDGMENT State of California County of LOS ANGELES On stay 20 'l before me, Diem Chu, Notary Public (insert name and title of the officer) personally appeared Van Nguyen who proved to me on the basis of satisfactory evidence to be the person(s,} hose name is re subscribed to the within instrument and acknowledged to me thaVKe)she/they executed the same in is her/their authorized capacity(ie , and that by(is her/their sighafureS, on the instrument the person(5), or the entity upon behalf of which the perso�cted, 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 se Signatu c��' DIEM CHU ^' Comm. S 2042313 N A NOTARY PUSLIC•CALIPORNIA N (Seal) LOB ANGELES COUNTY MY Comm, EXP. SIP. 21. 2017 w+�scl From: California Professional Engineering, Inc. 929 Otterbein Ave, Unit E La Puente, CA 91748 (626) 810-1338 14 MAY 20 PM 1= ?7 Bid for Safe Routes to School In the Vicinity of Stacey Middle School and Clegg Elementary School, CC No. 1426 SRTSL-5181(173) Bidding: Tuesday, May 20, 2014 @ 2:OOPM City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 *Do not open with regular mail Unified Certification Program Page 1 of 1 Back To Query Form Search Returned 1 Records Query Criteria Firm/DBA Name: California Professional Engineering Firm Type: DBE Firm ID 31277 Firm/DBA Name CALIFORNIA PROFESSIONAL ELECTRICAL ENGINEERING Address Line1 929 OTTERBEIN AVENUE, UNIT E Address Line2 City LA PUENTE State CA Zip Code1 91748 Zip Code2 Mailing Address Line1 Mailing Address Line2 Mailing City Mailing State Mailing Zip Code1 Mailing Zip Code2 Certification Type DBE EMail van@cpengineeringinc.com Contact Name VAN TAN NGUYEN Area Code ( 626 ) Phone Number 810-1338 Fax Area Code ( 626 ) Fax Phone Number 810-1322 Agency Name DEPARTMENT OF TRANSPORTATION Counties 10; 15; 19; 30; 33; 36; 37; Districts 06; 07; 08; 11; 12; DBE NAICS 237310; 238210; ACDBE NAICS Tue Jun 17 08:13:17 PDT 2014 Work Codes C8501 PAVEMENT MARKING; C8602 SIGNAL & LIGHTING; C8603 SIGNAL; C8604 LIGHTING; C8608 DETECTOR; C8611 RAMP METERING SYSTEM; Licenses A General Engineering Contractor; C10 Electrical Contractor; Trucks Gender M Ethnicity ASIAN PACIFIC Firm Type DBE Back To Query Form http://www.dot.ca.gov/ucp/QuerySubmit.do 6/17/2014 Local Assistance Procedures Manual ,EXY/,617- Exhibit 12-G Required Federal -aid Contract Language FHWA-1273 -- Revised May 1, 2012 REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS I. General IL Nondiscrimination III. Nonsegregated Facilities IV. Davis -Bacon and Related Act Provisions V. Contract Work Hours and Safety Standards Act Provisions VI. Subletting or Assigning the Contract VII. Safety: Accident Prevention Vill. False Statements Concerning Highway Projects IX. Implementation of Clean Air Act and Federal Water Pollution Control Act X. Compliance with Governmentwide Suspension and Debarment Requirements XI. Certification Regarding Use of Contract Funds for Lobbying ATTACHMENTS A. Employment and Materials Preference for Appalachian Development Highway System or Appalachian Local Access Road Contracts (included in Appalachian contracts only) I. GENERAL 1. Form FHWA-1273 must be physically incorporated in each construction contract funded under Title 23 (excluding emergency contracts solely intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require its inclusion in all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services). The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Form FHWA-1273 must be included in all Federal -aid design -build contracts, in all subcontracts and in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services). The design -builder shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Contracting agencies may reference Form FHWA-1273 in bid proposal or request for proposal documents, however, the Form FHWA-1273 must be physically incorporated (not referenced) in all contracts, subcontracts and lower -tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 2. Subject to the applicability criteria noted in the following sections, 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. 3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and FHWA. 4. Selection of Labor: During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal -aid highway unless it is labor performed by convicts who are on parole, supervised release, or probation. The term Federal -aid highway does not include roadways functionally classified as local roads or rural minor collectors. II. NONDISCRIMINATION The provisions of this section related to 23 CFR Part 230 are applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The provisions of 23 CFR Part 230 are not applicable to material supply, engineering, or architectural service contracts. In addition, the contractor and all subcontractors must comply with the following policies: Executive Order 11246, 41 CFR 60, 29 CFR 1625- 1627, Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The contractor and all subcontractors must comply with: the requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3. Note: The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60, and 29 CFR 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), and Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The following provision is adopted from 23 CFR 230, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements. 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 (26 CFR 35, 29 CFR 1630, 29 CFR 1625-1627, 41 CFR 60 and 49 CFR 27) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 26 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 contracting agency and the Federal Government to ensure that it has made every good faith effort to provide equal opportunity with respect to all of its terms and conditions of employment and in their review of activities under the contract. b. The contractor will accept as its 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 advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre -apprenticeship, and/or on- the-job training." 2. EEO Officer: The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so Page 8 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 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 reviewed and explained. The meetings will be conducted by the EEO Officer. b. All 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 minorities and women. 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 implement such policy will be brought to the attention of employees 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 advertisements will be placed in publications having a large circulation among minorities and women 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 minorities and women. To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority and women 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, the contractor is expected to observe the provisions of that agreement to the extent that the system meets the contractor's compliance with EEO contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions. c. The contractor will encourage its present employees to refer minorities and women as applicants for employment. Information and procedures with regard to referring such 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 insure 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 its 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 their avenues of appeal. 6. Training and Promotion: a. The contractor will assist in locating, qualifying, and increasing the skills of minorities and women who are applicants for employment or current employees. Such efforts should be aimed at developing full journey level status employees in the type of trade or job classification involved. 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 geographical area of contract performance. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. The contracting agency may reserve training positions for persons who receive welfare assistance in accordance with 23 U.S.C. 140(a). c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of employees who are minorities and women and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for minorities and women. 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 good faith efforts to develop, in cooperation with the unions, joint training programs aimed toward qualifying more minorities and women for membership in the unions and increasing the skills of minorities and women so that they may qualify for higher paying employment. b. The contractor will use good faith 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 contracting agency DLA-OB 13-06 Page 9 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 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 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 minorities and women. The failure of a union to provide sufficient referrals (even though it is obligated to provide exclusive referrals under the terms of a collective bargaining agreement) does not relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from meeting the obligations pursuant to Executive Order 11246, as amended, and these special provisions, such contractor shall immediately notify the contracting agency. 8. Reasonable Accommodation for Applicants / Employees with Disabilities: The contractor must be familiar with the requirements for and comply with the Americans with Disabilities Act and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. 9. 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. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract. a. The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract. b. The contractor will use good faith efforts to ensure subcontractor compliance with their EEO obligations. 10. Assurance Required by 49 CFR 26.13(b): a. The requirements of 49 CFR Part 26 and the State DOT's U.S. DOT -approved DBE program are incorporated by reference. b. 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 the contracting agency deems appropriate. 11. Records and Reports: The contractor shall keep such records as necessary to document compliance with the EEO requirements. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work and shall be available at reasonable times and places for inspection by authorized representatives of the contracting agency and the FHWA. a. The records kept by the contractor shall document the following: (1) The number and work hours 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 opportunities for minorities and women; and (3) The progress and efforts being made in locating, hiring, training, qualifying, and upgrading minorities and women; b. The contractors and subcontractors will submit an annual report to the contracting agency 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 Fonn FHWA- 1391. The staffing data should represent the project work force on board in all or any part of the last payroll period preceding the end of July. If on-the-job training is being required by special provision, the contractor will be required to collect and report training data. The employment data should reflect the work force on board during all or any part of the last payroll period preceding the end of July. III. NONSEGREGATED FACILITIES This provision is applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The contractor must ensure that facilities provided for employees are provided in such a manner that segregation on the basis of race, color, religion, sex, or national origin cannot result. The contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's obligation extends further to ensure that its employees are not assigned to perform their services at any location, under the contractor's control, where the facilities are segregated. The term "facilities" includes waiting rooms, work areas, restaurants and other eating areas, time clocks, restrooms, washrooms, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees. The contractor shall provide separate or single -user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. IV. DAVIS-BACON AND RELATED ACT PROVISIONS This section is applicable to all Federal -aid construction projects exceeding $2,000 and to all related subcontracts and lower -tier subcontracts (regardless of subcontract size). The requirements apply to all projects located within the right-of-way of a roadway that is functionally classified as Federal -aid highway. This excludes roadways functionally classified as local roads or rural minor collectors, which are exempt. Contracting agencies may elect to apply these requirements to other projects. The following provisions are from the U.S. Department of Labor regulations in 29 CFR 5.5 "Contract provisions and related matters" with minor revisions to conform to the FHWA-1273 format and FHWA program requirements. 1. Minimum wages a. All laborers and mechanics 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 issued by the Secretary of Labor under the Copeland Act (29 CFR part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. DLA-OB 13-06 Page 10 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph 1.d. of this section; also, 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 determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4). 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. The wage determination (including any additional classification and wage rates conformed under paragraph 1.b. of this section) and the Davis -Bacon poster (WH-1321) 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. b. (1) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (i) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (ii) The classification is utilized in the area by the construction industry; and (iii) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (2) If the contractor and the laborers and mechanics to be employed in the classification (if known), 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 Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The 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. (3) In the event the contractor, the laborers or mechanics to be employed in the 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. The Wage and Hour 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. (4) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs 1.b.(2) or 1.b.(3) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. c. Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. d. If the contractor does not make payments to a trustee or other third person, the contractor may consider as 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. 2. Withholding The contracting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor 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, so 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 contracting agency 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. 3. Payrolls and basic records a. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) 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 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. DLA-OB 13-06 Page 11 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language b. (1) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the contracting agency. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee ( e.g. , the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available for this purpose from the Wage and Hour Division Web site at http://www.dol.gov/esa/whd/formstwh347instr.htm or its successor site. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to the contracting agency for transmission to the State DOT, the FHWA or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this section for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records, without weekly submission to the contracting agency.. (2) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (i) That the payroll for the payroll period contains the information required to be provided under §5.5 (a)(3)(ii) of Regulations, 29 CFR part 5, the appropriate information is being maintained under §5.5 (a)(3)(i) of Regulations, 29 CFR part 5, and that such information is correct and complete; (ii) That each 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 Regulations, 29 CFR part 3; (iii) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (3) 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 3.b.(2) of this section. (4) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. c. The contractor or subcontractor shall make the records required under paragraph 3.a. of this section available for inspection, copying, or transcription by authorized representatives of the contracting agency, the State DOT, the FHWA, or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the FHWA may, after written notice to the contractor, the contracting agency or the State DOT, take such action as may be necessary 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 may be grounds for debarment action pursuant to 29 CFR 5.12. 4. Apprentices and trainees a. Apprentices (programs of the USDOL). 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 U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or 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 Office of Apprenticeship Training, Employer and Labor Services or a State Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen 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 worker 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 on 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 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's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. 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 journeymen 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 determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. b. Trainees (programs of the USDOL). 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 U.S. Department of Labor, Employment and Training Administration. DLA-OB 13-06 Page 12 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman 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 wage rate on the wage determination which provides for less than full fringe benefits for apprentices. 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 wage rate 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. In the event the Employment and Training Administration withdraws approval of a training program, the contractor 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. Equal employment opportunity. The utilization of apprentices, trainees and journeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR part 30. d. 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. 5. Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. 6. Subcontracts. The contractor or subcontractor shall insert Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. 7. Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. 8. Compliance with Davis -Bacon and Related Act requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein incorporated by reference in this contract. 9. Disputes concerning labor standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR parts 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 U.S. Department of Labor, or the employees, or their representatives. 10. Certification of eligibility. a. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). b. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). c. The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001. V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The following clauses apply to any Federal -aid construction contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be inserted in addition to the clauses required by 29 CFR 5.5(a) or 29 CFR 4.6. As used in this paragraph, the terms laborers and mechanics include watchmen and guards. 1. Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. 2. Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (1.) of this section, the contractor and any subcontractor responsible therefor shall be liable for the 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 or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph (1.) of this section, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1.) of this section. 3. Withholding for unpaid wages and liquidated damages. The FHWA or the contacting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor 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 DLA-013 13-06 Page 13 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 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 (2.) of this section. 4. Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (1.) through (4.) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1.) through (4.) of this section. VI. SUBLETTING OR ASSIGNING THE CONTRACT This provision is applicable to all Federal -aid construction contracts on the National Highway System. 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 contracting agency. 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 635.116). a. The term "perform work with its own organization" refers to workers employed or leased 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 or lower tier subcontractor, agents of the prime contractor, or any other assignees. The term may include payments for the costs of hiring leased employees from an employee leasing firm meeting all relevant Federal and State regulatory requirements. Leased employees may only be included in this term if the prime contractor meets all of the following conditions: (1) the prime contractor maintains control over the supervision of the day-to-day activities of the leased employees; (2) the prime contractor remains responsible for the quality of the work of the leased employees; (3) the prime contractor retains all power to accept or exclude individual employees from work on the project; and (4) the prime contractor remains ultimately responsible for the payment of predetermined minimum wages, the submission of payrolls, statements of compliance and all other Federal regulatory requirements. 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 or propose on the contract as a whole and in general are to be limited to minor components of the overall contract. 2. The contract amount upon which the requirements set forth in paragraph (1) of Section VI 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 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 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 contracting agency has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. 5. The 30% self -performance requirement of paragraph (1) is not applicable to design -build contracts; however, contracting agencies may establish their own self -performance requirements. VII. SAFETY: ACCIDENT PREVENTION This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 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 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 condition o each subcontract, which the contractor enters into pursuant 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. 3704). 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 Hours and Safety Standards Act (40 U.S.C.3704). Vill. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 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 misrepresentation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these and similar acts, Form FHWA-1022 shall be posted on each Federal -aid highway project (23, CFR 635) in one or more places DLA-OB 13-06 Page 14 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language where it is readily available to all persons concerned with the project: 18 U.S.C. 1020 reads as follows: "Whoever, being an officer, agent, or employee of the United States, or of 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 representation, false report or false claim with respect to the character, quality, quantity, or cost of any work performed or to be performed, 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 representation 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 supplemented; Shall be fined under this title or imprisoned not more than 5 years or both." IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. By submission of this bid/proposal or the execution of this contract, or subcontract, as appropriate, the bidder, proposer, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows: 1. That any person who is or will be utilized in the performance of this contract is not prohibited from receiving an award due to a violation of Section 508 of the Clean Water Act or Section 306 of the Clean Air Act. 2. That the contractor agrees to include or cause to be included the requirements of paragraph (1) of this Section X in every subcontract, and further agrees to take such action as the contracting agency may direct as a means of enforcing such requirements. X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal -aid construction contracts, design -build contracts, subcontracts, lower -tier subcontracts, purchase orders, lease agreements, consultant contracts or any other covered transaction requiring FHWA approval or that is estimated to cost $25,000 or more — as defined in 2 CFR Parts 180 and 1200. 1. Instructions for Certification — First Tier Participants: a. By signing and submitting this proposal, the prospective first tier 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 first tier 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 first tier 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 contracting agency determined to enter into this transaction. If it is later determined that the prospective participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the contracting agency may terminate this transaction for cause of default. d. The prospective first tier participant shall provide immediate written notice to the contracting agency to whom this proposal is submitted if any time the prospective first tier 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," "participant," "person," "principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). f. The prospective first 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 entering into this transaction. g. The prospective first tier 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 Transactions," provided by the department or contracting agency, entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. 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 is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (htlps://www.epls. oovv/), which is compiled by the General Services Administration. i. Nothing contained in the foregoing shall be construed to require the establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and DLA-OB 13-06 Page 15 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language information of the prospective 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 department or agency may terminate this transaction for cause or default. 2. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — First Tier Participants: a. The prospective first tier participant certifies to the best of its knowledge and belief, that it and its principals: (1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency; (2) Have not within a three-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; (3) 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 (a)(2) of this certification; and (4) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. b. Where the prospective 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 Participants: (Applicable to all subcontracts, purchase orders and other lower tier transactions requiring prior FHWA approval or estimated to cost $25,000 or more - 2 CFR Parts 180 and 1200) 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," "participant," "person," "principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant' refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant' refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). 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 exceeding the $25,000 threshold. 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 is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (hops://www.epls.gov/), which is compiled by the General Services Administration. 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 department 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 Participants: 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency. Page 16 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 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. XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING This provision is 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 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 Form to Report Lobbying," in accordance with its instructions. 2. 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 31 U.S.C. 1352. 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. 3. The prospective participant also agrees by submitting its bid or proposal that the participant shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such recipients shall certify and disclose accordingly. Page 17 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 12. FEMALE AND MIONORITY GOALS To comply with Section II, "Nondiscrimination," of "Required Contract Provisions Federal -Aid Construction Contracts," the following are goals for female and minority utilization goals for Federal -aid construction contracts and subcontracts that exceed $10,000: The nationwide goal for female utilization is 6.9 percent. The goals for minority utilization [45 Fed Reg 65984 (10/3/1980)] are as follows: MINORITY UTILIZATION GOALS Goal Economic Area (Percent Redding CA: 174 Non-SMSA (Standard Metropolitan Statistical Area) Counties: 6.8 CA Lassen; CA Modoc; CA Plumas; CA Shasta; CA Siskiyou; CA Tehama Eureka, CA 175 Non-SMSA Counties: 6.6 CA Del Norte; CA Humboldt; CA Trinity San Francisco -Oakland -San Jose, CA: SMSA Counties: 7120 Salinas -Seaside -Monterey, CA 28.9 CA Monterey 7360 San Francisco -Oakland 25.6 CA Alameda; CA Contra Costa; CA Marin; CA San Francisco; CA San Mateo 7400 San Jose, CA 176 CA Santa Clara, CA 19.6 7485 Santa Cruz, CA CA Santa Cruz 14.9 7500 Santa Rosa CA Sonoma 9.1 8720 Vallejo -Fairfield -Napa, CA CA Napa; CA Solano 17.1 Non-SMSA Counties: CA Lake; CA Mendocino; CA San Benito 23.2 Sacramento, CA: SMSA Counties: 6920 Sacramento, CA 16.1 177 CA Placer; CA Sacramento; CA Yolo Non-SMSA Counties 14.3 CA Butte; CA Colusa; CA El Dorado; CA Glenn; CA Nevada; CA Sierra; CA Sutter; CA Yuba Stockton -Modesto, CA: SMSA Counties: 5170 Modesto, CA 12.3 178 CA Stanislaus 8120 Stockton, CA 24.3 CA San Joaquin Non-SMSA Counties 19.8 CA Alpine; CA Amador; CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne Page 18 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 179 Fresno -Bakersfield, CA SMSA Counties: 0680 Bakersfield, CA CA Kern 2840 Fresno, CA CA Fresno Non-SMSA Counties: CA Kings; CA Madera; CA Tulare 19.1 26.1 23.6 Los Angeles, CA: SMSA Counties: 0360 Anaheim -Santa Ana -Garden Grove, CA 11.9 CA Orange 4480 Los Angeles -Long Beach, CA 28.3 CA Los Angeles 180 6000 Oxnard -Simi Valley -Ventura, CA 21.5 CA Ventura 6780 Riverside -San Bernardino -Ontario, CA 19.0 CA Riverside; CA San Bernardino 7480 Santa Barbara -Santa Maria -Lompoc, CA 19.7 CA Santa Barbara Non-SMSA Counties 24.6 CA In o; CA Mono; CA San Luis Obispo San Diego, CA: SMSA Counties 181 7320 San Diego, CA 16.9 CA San Diego Non-SMSA Counties 18.2 CA Imperial For each July during which work is performed under the contract, you and each non material -supplier subcontractor with a subcontract of $10,000 or more must complete Form FHWA PR- 1391 (Appendix C to 23 CFR 230). Submit the forms by August 15. 13. FEDERAL TRAINEE PROGRAM For the Federal training program, the number of trainees or apprentices is This section applies if a number of trainees or apprentices is specified in the special provisions. As part of your equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types of trades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract part, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1 st year of apprenticeship or training. Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of journeymen in the various classifications within a reasonable recruitment area. Before starting work, submit to the City/County of Page 19 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 1. Number of apprentices or trainees to be trained for each classification 2. Training program to be used 3. Training starting date for each classification Obtain the City/County's of approval for this submitted information before you start work. The City/County of credits you for each apprentice or trainee you employ on the work who is currently enrolled or becomes enrolled in an approved program. The primary objective of this section is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area. Show that you have made the efforts. In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status or in which the employee has been employed as a journeyman 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training Ask the employee if the employee has successfully completed a training course leading to journeyman status or has been employed as a journeyman. Your records must show the employee's answers to the questions. In your training program, establish the minimum length and training type for each classification. The City/County of and FHWA approves a program if one of the following is met: 1. It is calculated to: ■ Meet the your equal employment opportunity responsibilities ■ Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training, and it is administered in a way consistent with the equal employment responsibilities of Federal -aid highway construction contracts Obtain the State's approval for your training program before you start work involving the classification covered by the program. Provide training in the construction crafts, not in clerk -typist or secretarial -type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved by the division office. Off -site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. The City/County of reimburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on -site training 2. For off -site training if the apprentice or trainee is currently employed on a Federal -aid project and you do at least one of the following: ■ Contribute to the cost of the training ■ Provide the instruction to the apprentice or trainee ■ Pay the apprentice's or trainee's wages during the off -site training period 3. If you comply this section. Page 20 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language Each apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's skill 2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification or until the apprentice or trainee has completed the training program Furnish the apprentice or trainee: 1. Copy of the program you will comply with in providing the training 2. Certification showing the type and length of training satisfactorily completed 14. TITLE VI ASSURANCES During the performance of this Agreement, the contractor, for itself, its assignees and successors in interest (hereinafter collectively referred to as CONTRACTOR) agrees as follows: (1) Compliance with Regulations: CONTRACTOR shall comply with the regulations relative to nondiscrimination in federally assisted programs of the Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the REGULATIONS), which are herein incorporated by reference and made a part of this agreement. (2) Nondiscrimination: CONTRACTOR, with regard to the work performed by it during the AGREEMENT, shall not discriminate on the grounds of race, color, sex, national origin, religion, age, or disability in the selection and retention of sub -applicants, including procurements of materials and leases of equipment. CONTRACTOR shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the agreement covers a program set forth in Appendix B of the Regulations. (3) Solicitations for Sub -agreements, Including Procurements of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by CONTRACTOR for work to be performed under a Sub -agreement, including procurements of materials or leases of equipment, each potential sub -applicant or supplier shall be notified by CONTRACTOR of the CONTRACTOR'S obligations under this Agreement and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin. (4) Information and Reports: CONTRACTOR shall provide all information and reports required by the Regulations, or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the California Department of Transportation or FHWA to be pertinent to ascertain compliance with such Regulations or directives. Where any information required of CONTRACTOR is in the exclusive possession of another who fails or refuses to furnish this information, CONTRACTOR shall so certify to the California Department of Transportation or the FHWA as appropriate, and shall set forth what efforts CONTRACTOR has made to obtain the information. (5) Sanctions for Noncompliance: In the event of CONTRACTOR's noncompliance with the nondiscrimination provisions of this agreement, the California Department of Transportation shall impose such agreement sanctions as it or the FHWA may determine to be appropriate, including, but not limited to: (a) withholding of payments to CONTRACTOR under the Agreement within a reasonable period of time, not to exceed 90 days; and/or (b) cancellation, termination or suspension of the Agreement, in whole or in part. (6) Incorporation of Provisions: CONTRACTOR shall include the provisions of paragraphs (1) through (6) in every sub -agreement, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. Page 21 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language CONTRACTOR shall take such action with respect to any sub -agreement or procurement as the California Department of Transportation or FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance, provided, however, that, in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub -applicant or supplier as a result of such direction, CONTRACTOR may request the California Department of Transportation enter into such litigation to protect the interests of the State, and, in addition, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. MAINTAIN RECORDS AND SUBMIT REPORTS DOCUMENTING YOUR PERFORMANCE UNDER THIS SECTION Page 22 of 22 DLA-OB 13-06 August 12, 2013 ® DATE (MM/DD/YYYY) ,4COR� CERTIFICATE OF LIABILITY INSURANCE 7/'A1„n14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Brown & Brown Insurance Brokers of Sacramento, Inc P.O. Box 619043 Lic #OH38004 . Roseville CA 95661-9043 AFFORDING INSURED CAL-165 California Professional Engineering Inc. DBA: California Professional Electrical Engineering 929 Otterbein Avenue Unit E La Puente CA 91748 COVERAGES CERTIFICATE NUMBER: 1681744127 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I LTR TYPE OF INSURANCE ADDL INSR SU IR WVD POLICY NUMBER POLICY EFF ( MMIDDIYYYY POLICY EXP MM/DD LIMITS A GENERAL LIABILITY Y TEN13729 /26/2014 261 1.000,000 COMMERCIAL GENERAL LIABILITY DAMAG 0 RENTED PREMISES (Ea occurrence $100,000 MED EXP (Any one person) $5,000, CLAIMS -MADE � OCCUR N PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 $ POLICY 177 PRO LOC C ,X7 LIABILITY !10l2014 !10l2015 COMBINED SINGLE LIMI I Ea accident 1 000 000 BODILY INJURY (Per person) $ (_AUTOMOBILE ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED i_ AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ B UMBRELLA LIAR X OCCUR Y BE014360939 26/2014 26/2015 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 X EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- RY LIMITS AND EMPLOYERS' LIABILITYql� ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below t t DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder is included as an Additional Insured under Commercial General Liability policy per endorsements CIS 20 10 07 04 & CIS 20 37 07 04, subject to a written contract between the Named Insured and the Additional Insured. Sample endorsements attached. "Subject to company approval. City of Huntington Beach, its agents, officers, end employees. Re: CC-1426 Safe Routes to school near Stacey Middle School and Clegg Elementary School Project GER 1 IFIGAI t HULUtR I. — City of Huntington Beach 2000 Main Street PO Box 190 Huntington Beach CA 92648 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 7y00-LUIU AW.URU l.VrcrVrvaI rUrv. M11 rrynw iwcr vcu. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: TEN13729 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ Izatio ns : Location And Description Of Completed Opera - tions City of Huntington Beach, its agents, officers, and employees CC-1426 Safe Routes to school near Stacey Middle School and Clegg Elementary School Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: TEN13729 COMMERCIAL GENERAL LIABILITY CG 2010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations City of Huntington Beach, its agents, officers, and employees CC-1426 Safe Routes to school near Stacey Middle School and Clegg Elementary School Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 0 Policy Number: TEN13729 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEN0215 01 14 PRIMARY AND NON-CONTRIBUTING INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Notwithstanding the provisions of sub -paragraphs a, b, and c of this paragraph 4, with respect to the Third Party as defined below, it is understood and agreed that in the event of a claim or "suit" caused in whole or in part by the Named Insured's negligence, this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Parry below shall be excess and non-contributory. The Third Parry to whom this endorsement applies is: Absence of a specifically named Third Party above means this endorsement applies only to those third parties required to be named as an Additional Insured as Primary and Non -Contributory coverage specified in a written contract with the Named Insured under this policy, entered into prior to the loss or "occurrence". All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. Sample TEN0215 01 14 Includes copyright material of Insurance Services Office, Inc. Page 1 of 1 COMMERCIAL GENERAL LIABILITY HOUSTON SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: __ -. Only such Person or Organization where required _ired in a written contract with the Named Insured under this policy, entered into prior to the 'loss or occurrence'. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. J The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV • Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Policy No. TEN13729 Sample CG 24 04 05 09 Copyright, Insurance Services Office, Inc., 2008 Page 1 of 1 EIBEI A Human Resource Management Company July 31, 2014 CALIFORNIA PROFESSIONAL ENGINEERING 929 OTTERBEIN AVENUE UNIT E LA PUENTE, CA 91748 Re: Barrett Business Services, Inc. ("BBSI") Letter of Self -Insurance for Workers' Compensation Coverage For CALIFORNIA PROFESSIONAL ENGINEERING, CSLB license number 793907 809359 As the named addressee of this Letter, your company's required workers' compensation coverage is provided through BBSI's state approved Self -Insured Workers' Compensation Plan. As a party to a co -employment contract with BBSI, which is effective from 6/25/2014 until 6/24/2015, California Labor Code §3602 allows CALIFORNIA PROFESSIONAL ENGINEERING to obtain its workers' compensation coverage from BBSI. BBSI's California customers can also verify BBSI's state certification at http://www.dir.ca.gov/osip/PrivateRoster.pdf; then scroll down to Barrett (the list is alphabetical by company name). Additional information is as follows: State: California Workers' Compensation Limits: Employer Liability Limits: Self Insurance Certification #: 2246 Statutory $5,000,000.0 Each Accident $5,000,000.0 Disease Coverage Limit by Client $5,000,000.0 Disease; Each Employee Notice of Termination: In the event the contract between BBSI and CALIFORNIA PROFESSIONAL ENGINEERING is terminated, BBSI must provide notice of the termination within seven (7) days to the California Contractors State License Board ("CSLB"). Other Comments (place an "X" if applicable): Waiver of Subrogation: BBSI and CALIFORNIA PROFESSIONAL ENGINEERING agree to waive their right of subrogation for the benefit of: City of Huntington Beach its agents officers and employees at CC-1426; safe routes to school near Stacey Middle School and Clegg Elementary School Project. Named "Letter Holder": City of Huntington Beach 2000 Main Street PO Box 190 Huntington Beach, CA 92648 ® Other: Statutory Limites Apply,BBSI will notify "LETTER HOLDER" 30 day notice of cancellation for California Professional Engineering, Inc. Additionally, BBSI's self -insured program is further supported by an excess workers' compensation insurance policy with ACE American Insurance Co. Copy of certificate is available upon request. For additional information, please contact your local BBSI office at: SAN BERNARDINO (909)890-3633 1950 Sunwest Lane Suite 250 Very truly yours, 110 Michael L. Elich President and Chief Executive Officer San Bernardino, CA 92408 doc: LOSI-3 Barrett Business Services Workers Compensation Waiver of Subrogation Customer/Policy Number: 809359 Workers Compensation Carrier: Self Insured Cert #2246 IT IS AGREED THAT WE WAIVE ANY RIGHTS OF RECOVERY WE MAY HAVE AGAINST THE PERSON OR ORGANIZATION SHOWN IN THE SCHEDULE BECAUSE OF A PAYMENT WE MAKE FOR INJURY OR DAMAGE ARISING OUT OF "YOUR WORK" DONE UNDER A CONTRACT WITH THAT PERSON OR ORGANIZATION. SCHEDULE (Name of Persons or Organization) City of Huntington Beach, its agents, officers, and employees Re: CC-1426; safe routes to school near Stacey Middle School and Clegg Elementary School Project. Date: 7/31 /2014 Authorized Representative: Jaime F. Arrezola Company Profile Page 1 of 2 Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action/Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company, Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information HANOVER INSURANCE COMPANY (THE) 440 LINCOLN STREET WORCHESTER, MA 01653 800-955-8850 Old Company Names Agent For Service NANCY FLORES C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET LOS ANGELES CA 90017 Reference Information Effective Date NAIC #: 22292 California Company ID #: 2097-4 Date Authorized in California: 01/01/1973 License Status: UNLIMITED -NORMAL Company Type: Property & Casualty State of Domicile: NEW HAMPSHIRE back to top NAIC Group List NAIC Group #: 0088 The Hanover Ins Grp Lines Of Business 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 COMMON CARRIER LIABILITY CREDIT DISABILITY FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER https :Hinteractive.web. insurance. ca. gov/companyprofile/companyprofile?event=companyPr... 8/6/2014 Company Profile Page 2 of 2 SURETY TEAM AND VEHICLE WORKERS' COMPENSATION back to top © 2008 California Department of Insurance https : //interactive. web. insurance . ca. gov/companyprofil e/companyprofil e?event=companyPr... 8/6/2014 RECEIVED BY: (Name) (Date) • TO: City Treasurer FROM: City Clerk DATE: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION SUBJECT: Bond Acceptance I have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty.or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. Other No. g:/forms/bond transmittal to treasurer (Company Name) Approved / T (Counci Approval Date)' Agenda Item No. (� City Clerk Vault No. 4CL. SIRE System ID No. �� BOND PREMIUM: $3,617.00 WHICH IS SUBJECT TO CHANGE BASED ON THE FINAL CONTRACT AMOUNT BOND EXECUTED IN TRIPLICATE 11Zl�`"Ut�ZBond No. 1971681 KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereinafter referred to as "City") has, by written agreement dated July 7 , 20_1_4_, entered into a contract with California Professional Engineering, Inc. dba California Professional Electrical Engineering 929 Otterbein Avenue, Ste. E La Puente CA 91748 (name and address of Contractor) (hereinafter referred to as "Principal"), for performance of the work described as follows: CC-1426; Safe Routes to School Near Stacey Middle School & Clegg Elementary School Project (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract. NOW THEREFORE, we, the undersigned, as Principal, and The Hanover Insurance Compaq 5 Hutton Centre, Suite 1060. Santa Ana. CA 92707 (name and address of Surety) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of Two Hundred Sixty Seven Thousand, Nine Hundred Sixty and 60/100 Dollars ($ 267,960.60 }, 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, liability 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 the 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 277591.1 PERFORMANCE BOND Pagel of 2 Bond No. 1971681 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: July 31, 2014 ATTEST (Corporate Seal) ATTEST (Corporate Seal) (Attach Attomey-in-Fact Certificate) California Professional Engineering, Inc. dba (Principal Name By: Nai Title: President By: r Name: Yuna T (Surety Name) of Attomey-in-Facy/for Surety) 14 415-3800 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OiiINTINGTON BEACH aennifer Mc th ��f5%Al ity Attorney Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evident: of the authority of any person signingas attomey-in-fact must be attached. 2r5e1.1 PERFORMANCE BOND Page 2 of 2 ACKNOWLEDGMENT State of California County of Los Angeles ) On August 1, 2014 before me, personally appeared Van Nguyen Diem Chu, Notary Public (insert name and title of the officer) 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. 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. _ e DIEM CHU 042 CoMM. # 2042313 'n N NOTARY PUBLIC-CALIFORNIA N LOS ANGELES COUNTY Cignature Sea) MY COMA. EXP. SEP. 21, 2017 "� F--T01 If Me-] State of California County of Orange ) On July 31, 2014 before me, Christine T. Hoang, Notary Public (insert name and title of the officer) personally appeared Yung T. Mullick who proved to me on the basis of satisfactory evidence to be the person() whose name() is/ate; subscribed to the within instrument and acknowledged to me that he%k*&bft executed the same in hisbbed&jek authorized capacity(, and that by his/fovx6ft 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. �pL OF ���F CI.IRISTIIEiE T. i1Oi91`f 17 WITNESS y han and official seal. N P� few,; s �.aS T. HOAN Cn NOTARY PUPLIC•CALIFORNIA M Cn Y ORANGE: COUNTY1V � �aOF MAY COMM. EXP. FEB 25, 2017 Signature (Seal) THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan, do hereby constitute and appoint James W. Moilanen, Yung T. Mullick, and/or Jennifer C. Anaya of Mission Viejo, CA and each is a true and lawful Attorney(s)-in-fact to sign, execute, seal, acknowledge and deliver for, and on its behalf, and as its act and deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds, recognizances, undertakings, contracts of indemnity or other writings obligatory in the nature thereof, as follows: Any such obligations in the United States, not to exceed Ten Million and No/100 ($10,000,000) in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED, That the President or any Vice President, in conjunction with any Vice President, be and theyare hereby authorized and empowered to appoint Attorneys -in -fad of the Company, in its name and as its ads, to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatory in the nature thereof, with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys -in -fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company i n thei r own proper persons." (Adopted October 7, 1981 -The Hanover Insurance Company, Adopted April 14, 1982 - Massachusetts Bay Insurance Company; Adopted September 7, 2001 - Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this 3rd day of January 2012. THE HANOVER INSURANCE COMPANY C , r MASSACHUSETTS BAY INSURANCE COMPANY LON le Z� CITIZENS SURANCE OMPANY OF AMERICA a Robert Thomas. Vice Aresident THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER ) ss. Joe r�nstrom, Vie,i President - On this 3rd day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. 3 Y � ws�. BARBARAA.CsARltCif Notary PuWiC �.' Cermwn«eaAhotRlxssachusens 7���:/ J5� ��/j ��y�`"% �y '�- f ` L1yC-omr,�siianExyr�sSept.2t.zAtB f"� -" � �� % � Barbara A. Garlick, Notary Public My Commission Expires September 21, 2018 I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company ofAmerica, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power of Attorney issued by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED, That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted and executed by the President or any Vice President in conjunction with any Vice President of the Company, shall be binding on the Company to the same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile." (Adopted October 7, 1981 - The Hanover Insurance Company, Adopted April 14, 1982- Massachusetts Bay Insurance Company; Adopted September 7, 2001 - Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 31 day of JULY 20 14 THE HANOVER INSURANCE COMPANY MASSACHUSETTS SAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA I ,n Margosian, Vice President BOND PREMIUM INCLUDED IN PERFORMANCE BOND BOND EXECUTED IN TRIPLICATE 0� ®fit-[.� Bond No. 1971681 a � •� � ��3 � zit 1 i Y KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS, the City of Huntington Beach (hereinafter referred to as "City") has awarded to California Professional Engineering Inc. dba California Professional Electrical Engineering _ 929 Otterbein Avenue, Ste. E, La Puente, CA 91748 (name and address of Contractor) (hereinafter referred to as "Principal"), a contract ('Contract") for the work described as follows: CC-1426; Safe Routes to School Near Stacey Middle School & Clegg Elementary School Protect (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 The Hanover Insurance Company 5 Hutton Centre Suite 1060 Santa Ana CA 92707 (name and address of surety) (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 Two Hundred Sixty Seven Thousand Nine Hundred Sixty and 60/100 dollars, ($ 267,960.60 ), 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 work 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 performed 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, 2775a9.1 PAYMENT BOND Page 1 of 2 Bond No. 1971681 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 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: July 31, 2014 ATTEST (Corporate Seal) ATTEST (Corporate Seal) (Attach Attomey-in-Fact Certificate) California Professional Engineering, Inc. dba (Principal By: — Name: Its: The Hanover Insurance Qompany (Surety Name) By: ' of Attorney -in -Fact fc/Surety) (Area Code & Telephone N urftber of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH If i/1 Byjen"niferM i &_-= �__ athy Attorney 5/15%6 Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached. 2775 .T PAYMENT BOND Page 2 of 2 ACKNOWLEDGMENT State of California County of Los Angeles ) on August 1, 2014 before me, Diem Chu, Notary Public (insert name and title of the officer) personally appeared Van Nguyen 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. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WIT SS my ha nd official seal. W7 nature DIEM CH 'n Comm. $ 2042313 r�n� ul :�A NOTARY PUBLIC•CALIfORNIA UI SE: MY Los ANGELES COUNTY COMM lxpP S@P: 21, 2011'� F-1101 r, A I RITA 4 4 a` State of California County of Orange ) On July 31, 2014 before me, Christine T. Hoang, Notary Public (insert name and title of the officer) personally appeared Yung T. Mullick who proved to me on the basis of satisfactory evidence to be the person(x) whose name(z) is/&R% subscribed to the within instrument and acknowledged to me that he% &ftW executed the same in hiskPeMvk. authorized capacity), and that by his/hv%btMA signature(g) on the instrument the person(s), or the entity upon behalf of which the person(ja) 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. WITN Signa GHRISTINE T. HOANG C', p % °� Sr,. Gomm. # 2008757 ;0 U) NOTAR'!PU LIO C�+LIFORNIA ®RANG COUNTY yR (Seal) " P my COMM, EXR FEB 25, 2017 �lh(- " THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNFY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan, do hereby constitute and appoint James W. Moilanen, Yung T. Mullick, and/or Jennifer C. Anaya of Mission Viejo, CA and each is a true and lawful Attorney(s)-in-fact to sign, execute, seal, acknowledge and deliverfor, and on its behalf, and as its act and deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds, recognizances, undertakings, contracts of indemnity or other writings obligatory in the nature thereof, as follows: Any such obligations in the United States, not to exceed Ten Million and No/100 ($10,000,000) in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED, That the President or any Vice President, in conjunction with any Vice President, be and they are hereby authorized and empowered to appoint Attorneys -in -fact of the Company, in its name and as its acts, to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatoryin the nature thereof, with power to attach thereto the seal ofthe Company. Any such writings so executed by such Attorneys -in -fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers ofthe Company in their own proper persons." (Adopted October7, 1981 -The Hanover Insurance Company; Adopted April 14, 1982 - Massachusetts Bay Insurance Company, Adopted September 7, 2001 - Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this 3rd day of January 2012. u THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY r CITIZENS SURANCE OMPANY OF AMERICA 1974 Rottcrt 'Fhomas, Vice PrcSident THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER ) ss. Ioc rsnstrom, jet President On this 3rd day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. ,3;" `" k'g� BARBARAA. GAflttCl< ' hlOiary Public ' y femanenwearthofMassadweetts tby 4:01 4� �� 4,ty Ccmrta€tion Es�;�s SePf. 21. 2G68 -s 'tl` .. .S.' Barbara A. Garlick, Notary Public My Commission Expires September 21, 2018 I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company ofAmerica, hereby certify that the above and foregoing is a full, true and correct copy ofthe Original Power of Attorney issued by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED, That any and all Powers of Attorrieyand Certified Copies of such Powers of Attorney and certification in respectthereto, granted and executed by the President or any Vice President in conjunction with any Vice President ofthe Company, shall be binding on the Company to the same extent as fall signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile." (Adopted October 7, 1981 - The Hanover Insurance Company; Adopted April 14, 1982- Massachusetts Bay Insurance Company, Adopted September 7, 2001 - Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 31 day of JULY 20 14 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA q.l.n Margosian, Vice President CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS California Professional Engineering, Inc. FROM: PROJECT: Suk CZcy.1 S SC-)C>r_-A l ,IF (Contractor Name) S_Edwndow 1�1 C1,�_ F_,e v ScSZc� 1 P�t�L� q2q �c��Izgtrl AcN'J►� }��N1T E (Street Address) _ 1-A RUrcN-VE i CA a\-14b (City, State and Zip) TO: CITY OF HUNTINGTON BEACH DECLARATION 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 that the above statement is true and correct. Signed on _ tW\IJ 3\ 208 at (Date) (Signature'4f Individual Who is Making WARRANTY 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 �uw a\ , 20_h at LA Puy_n-k-Q } Cfl (Date) (City, State) CONTRACTOR: C Ornia Professlohal Engineering, Inc. Name: By _.._ IF Name: van guyen Title: 277621.2 MINUTES OF THE ANNUAL MEETING OF SHAREHOLDERS AND DIRECTORS CALIFORNIA PROFESSIONAL ENGINEERING, INC. The annual meeting of the shareholders of the above named Califomia Corporation was duly held at the principal office of the corporation on January 3, 2012. The Director present was VAN TAN NGUYEN. President acting as Chairman, same being VAN NGUYEN. The Chairman then presented and read to the meeting a Waiver of Notice of Meeting, subscribed by all of the Directors of the Corporation. Upon motion duly made, it was: Resolved, that the Chairman be requested to cause the same to be spread at length upon the minutes. Resolved, that the following persons were nominated and thereupon elected to the position opposite their names to serve until their successors are elected and qualified: VAN NGUYEN, PRESIDENT VAN NGUYEN, SECRETARY VAN NGUYEN, TREASURER Resolved, that the corporation seek 8 (a) SBA certification in order to more aggressively peruse government contracts. The President, Secretary, and Treasurer thereupon assumed their respective offices. The President then presented and read the minutes of the annual meeting of shareholders of this Corporation, and the same were, on motion duly made, seconded and unanimously carried, in all aspects ratified and adopted by this Board of Directors. There being no further business to come before the meeting, upon motion duly made, seconded and unanimously carried, the same was adjourned. The VAN NGUYEN, Presi VAN NGUYEN, 2012 are approved: 111�11/ 116 `1O11,y WAIVER OF NOTICE AND CONSENT TO HOLDING OF FIRST MEETING OF ±: INCORPORATORS AND DIRECTORS OF CALIFORNIA PROFESSIONAL ENGINEERING INC. A California Corporation We, -the undersigned, being all of the incorporators, first directors and/or the directors named in the Articles of Incorporation of the above -named California corporation duly formed by the filing of said Articles of Incorporation in the office of the California Secretary of State on August 18, 2000, and desiring to hold .the first meeting of the Incorporators and Directors of said corporation for the purpose of completing the organization of its affairs, DO HEREBY WAIVE NOTICE of said meeting, and CONSENT to the holding thereof at 9316 Mabel Avenue, South El Monte, California 91733, on October 1, 2000, at 10:00 a.m. of said day, for the purpose of adopting Bylaws, electing directors and officers, adopting a form of corporate seal and share certificate, authorizing a notice of the California Commissioner of Corporations that stock has been issued in compliance with all the terms and conditions of Section 25102,of the California Corporations Code, or the filing of an application for a permit, as the case may be, with said office, and transacting such other business as may be brought before said meeting; and do hereby further agree that any business transacted at said meeting shall be as valid and legal and of the same force and effect as though said meeting were held after notice duly given. WITNESS our signatures this day, October 1, 2000. �J) Van Nguyen, AT corporator i MINUTES - 1 - Fll�co Ay MINUTES OF FIRST ORGANIZATIONAL MEETING OF INCORPORATORS AND DIRECTORS OF CALIFORNIA PROFESSIONAL ENGINEERING INC. A California Corporation The undersigned, being the Incorporator named in the .Articles of Incorporation of the above -named California corporation, duly formed by the filing of said Articles of Incorporation in the office of the California Secretary of State on August 18, 2000, and desiring to hold the first organizational meeting for the purpose of completing the organization of its affairs, in accordance with the powers conferred upon Incorporators by Section 210 of the General Corporation Law,: held such meeting at 9316 Mabel Avenue, South E1 Monte, California 91733, on October 1, 200.0, at 10:00 a.m. of said day. Present at this session of the meeting: Van Nguyen, being the Incorporator of said corporation named in its Articles of Incorporation. On motion and by unanimous vote, Van Nguyen was elected temporary Chairperson and temporary Secretary of the meeting. ARTICLES OF INCORPORATION FILED The Temporary Chairperson stated that the original Articles of Incorporation of the corporation had been filed in the office of the California Secretary of State, and had been assigned the following filing date and State Corporation filing number: Filing Date: August 18, 2000 Official Filing Number: 2196373 The Temporary Chairperson then presented to the meeting a certified copy of said Articles of Incorporation, showing filings as stated and the Temporary Secretary was directed to insert said copy in the Book of Minutes of the corporation. MINUTES - 2 - RYT , ATAM The matter of the adoption of Bylaws for the regulation of the affairs of the corporation was next considered. The temporary secretary presented to the meeting a form of Bylaws which were duly considered and discussed. On motion duly made and unanimously carried, the following resolutions were adopted: RESOLVED: That the Bylaws presented to this meeting and discussed thereat be, and the same hereby are, adopted as and for Bylaws of this corporation. RESOLVED FURTHER: That the temporary secretary of this corporation be and hereby is authorized and directed to execute a certificate of the adoption of said Bylaws and to insert said Bylaws, as so certified in the Book of Minutes of this corporation, and to see that a copy of said Bylaws, similarly certified, is kept at the principal office for the transaction of business of this corporation, in accordance with Section 213 of the California Corporations'Code. ELECTION OF DIRECTORS The temporary Chairperson stated that the Bylaws adopted by the Corporation provide that the number of Directors shall be one (1). The temporary Chairperson advised that the Incorporator, on motion and by unanimous vote, had elected the following person as the first Directors of the Corporation to serve until successors. are duly elected pursuant to the Bylaws, or until resignation or removal, as the case may be, and effective upon their acceptance of their position, to exercise the powers of further organization and direction of the Corporation. Each of the newly elected Directors signified acceptance: DIRECTOR'S NAME AND ADDRESS SIGNATURE Van Nguyen 2574 S. Pepperdale Drive r Rowland Heights, CA 91748 J! MINUTES - 3 - i0�-14116 RESIGNATION OF INCORPORATOR The meeting continued. Present at this session of said meeting, in addition to the Incorporator were Van. Nguyen, the Director duly elected herein. In the interests of maintaining continuity of action, the Director waived notice of" said organizational meeting, took his place and the meeting then proceeded further. The temporary. Chairperson advised that the Incorporator, having completed the necessary steps in organizing the Corporation and having elected the appropriate number of Directors to carry forward the management of the Corporation, now wished to submit his resignation: The undersigned Incorporator herewith resigns: 1 Van Nguyen ji The temporary Chairperson stated that they Incorporator's tasks had now been accomplished and upon motion duly made and recorded, said resignation was accepted. WA. TVRP The temporary. Chairperson announced that the meeting was held pursuant to written Waiver of Notice and Consent thereto and was signed by all of the participants and upon motion made and unanimously carried, was made a part of the records of the meeting, and now precedes the minutes of this meeting in the Book of Minutes of the corporation. ELECTION OF OFFICERS The meeting then proceeded to the election of officers. The following were duly elected to the offices indicated after the names of each: Van Nguyen, President Van Nguyen, Secretary Van Nguyen, Chief Financial Officer Each officer so elected being present accepted his office, and thereafter, the president presided at the meeting as Chairperson, and the secretary acted as secretary of the meeting. CORPORATE SEAL The secretary presented for approval of the meeting a MINUTES -- 4 - proposed seal of the corporation, consisting of two concentric circles with the name of the corporation in one circle and the words and figures in the form as follows: (SEAL) On motion duly made.and unanimously carried, the following resolution was adopted: RESOLVED: That the corporate seal, in the form, words and figures presented to this meeting be, and the same hereby is, adopted as the seal.of this corporation. SHARE CERTIFICATE The secretary presented to the meeting a proposed form of share certificate for use by the corporation. On motion duly made and unanimously carried, said form of share certificate was approved and adopted, and the secretary was instructed to insert a copy thereof in the Book of Minutes immediately following the minutes of the meeting. ORGANIZATIONAL EXPENSES - In order to provide for the payment of expenses of incorporation and organization of the corporation, on motion duly made and unanimously carried, the following resolution was adopted: RESOLVED: That the President or Vice President and the Chief Financial Officer of this corporation be, and they hereby are authorized and directed to pay the expenses of incorporation and organization of this corporation. ACCOUNTING YEAR The Chairperson suggested that ,the meeting consider the adoption of an accounting year, either fiscal or calendar, so that the Franchise Tax Board could be notified thereof. On motion duly made, seconded and unanimously carried, the following resolution was adopted: . RESOLVED: That this corporation adopt an accounting year as follows: DATE ACCOUNTING YEAR BEGINS: November 1 DATE ACCOUNTING YEAR ENDS: October 31 MINUTES - 5 - PRINCIPAL OFFICE LOCATION After some discussion, the location of the principal office of the corporation for the transaction of the business of the corporation was fixed pursuant to the following resolution, adopted, on motion duly made, seconded and unanimously carried: RESOLVED: That 9316 Mabel Avenue, South E1 Monte, California 91733 be and.the same hereby is designated and fixed as the principal office for the transaction of the business of this corporation in the State of California. OFFICERS AUTHORIZED TO CONTRACT To authorize the officers to contract and obligate the corporation, in the ordinary course of business, the following resolution was, upon motion duly made, seconded and carried, adopted: RESOLVED: That the following officers be, and the same hereby are authorized to sign contracts and obligations on behalf of the corporation: Van Nguyen, President MINUTES - 6 - 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 WageLaws Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers,__mechanics,_apprent ices, 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 (Type Contractor Name) By: Name: [Type Name] Title: [Type Title] California. -TLS o3- ab - 01P 247542_ I CONTRACTOR'S C]ER'TMCA'TE L , state and certify that: (Name of Declarant) l . 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 , 20_ (Signature of Declarant) APPROVED AS TO FORM By: l 7/a -A:J 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-T-itle-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] A M Title: [Type Title] E 1 IF R cGRA a-- t� �Y_ A C KNEY JL) 3-'�Fb-C(p 2459l1A City Of Huntington Beach 2000 Main Street o Huntington Beach, CA 92648 (714) 536-5227 ® www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk August 21, 2014 California Professional Engineering, Inc. 929 Otterbein Ave., Unit E La Puente, CA 91748 Re: Safe Routes to School/Stacey-Clegg — CC-1426 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 536-5517. JF:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid Bond (original) Sister Cities: Anjo, Japan 0 Waitakere, New Zealand T� J, Dept. ID PW 14-032 Page I of 3 Meeting Date: 7/7/2014 "Oil _L$11WjAN N MEETING DATE: 7/7/2014 SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Award and authorize execution of a contract in the amount of $267,960.50 to California Professional Engineering, Inc, for the Safe Routes to School Project in the Vicinity of Stacey Middle School and Clegg Elementary School, CC-1426; authorize fifteen (15) percent in change orders; and, declare Unique Performance Construction, Inc. as non -responsive Statement of Issue: On May 20, 2014, bids were opened for the construction of Safe Routes to School Improvements in the vicinity of Stacey Middle School and Clegg Elementary School. The apparent low bidder was deemed non -responsive and was disqualified. City Council action is requested to award the contract to California Professional Engineering, Inc., the lowest responsive and responsible bidder. Financial Impact: Funds in the amount of $440,000 were appropriated for the construction of this project. Funding is $440,000 from a Federal Safe Routes to School grant (87890007.82700). Recommended Action: A) Declare the apparent low bid from Unique Performance Construction, Inc., as non -responsive: and, B) Accept the lowest responsive and responsible bid submitted by California Professional Engineering, Inc., in the amount of $267,960,50; and, C) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney; and, D) Authorize the Director of Public Works to execute change orders not to exceed a total of 15 percent of the contract construction costs or $40,194. Alternative Action(s): Reject all bids and provide staff with alternative direction. Analysis: In July 2011, City staff, working in conjunction with the Westminster School District, applied for a grant for traffic safety improvements in the vicinity of Stacey Middle School and Clegg Elementary School under the federal Safe Routes to School program. The grant was approved and construction funds were allocated in April 2014. Item 3. - I HB -20- Dept. ID PW 14-032 Page 2 of 3 Meeting Date: 7/712014 The goals of the Safe Routes to School program include facilitating the planning, development and implementation of projects that improve safety in the vicinity of schools, especially those targeting pedestrian and bicycle safety. This will enable and encourage children to walk and bicycle to school and make walking and bicycling a safer and more appealing lifestyle choice. The project includes the installation of a new traffic signal at the intersection of Springdale Street and Croupier Drive. This traffic signal will provide a controlled pedestrian crossing for students living in the area west of Springdale Street. Also included are curb ramp installations on the local streets near the two schools along with signing and striping improvements. The locations of these improvements are included as Attachment 2. These improvements not only help the students but also provide improved facilities for the surrounding neighborhoods. Bids were opened pubfically on May 20, 2014, and are listed in ascending order-. Bidder Submitted Bid i Corrected Bid 1 Unique Performance Construction, Inc. $265,550.00 2 California Professional Engine�in , Inc. $267,960.60 $267,960-50 3 PTIVI General Engineering Services, Inc. $269,692.00 4 Elecnor Belco Electric, Inc. $275,550.00 5 Select Electric, Inc. $295,666.00 6 Dynaiectric $358,100.0 The bid from Unique Performance Construction, Inc. was found to be non -responsive due to their failing to meet the goal for Disadvantaged Business Enterprise (DBE) subcontracting. In consultation with Caltrans Local Assistance staff (who manages the Federal Funds in this region), the DBE issue was deemed significant enough to warrant disqualification of the bid and the bidder was promptly notified of the decision. A bid protest was received on June 16, 2014 from Unique Performance Construction's attorney. The bid protest was reviewed by both Public Works staff and the City Attorney's office and the non- responsive determination was substantiated. The bid protest and a memorandum of City staff's review is included as Attachment 3. The engineer's estimate for the bid items was $300,000. The total estimated cost for this project is $440,000 which includes the City's direct purchase of all major equipment. This practice ensures consistency of equipment among the traffic signals and street lighting maintained by the City. Direct purchase also provides the added benefit of reduced costs to the City due to elimination of contractor mark-ups, typically in excess of 20 percent on this type of equipment. Staff is requesting that the Director of Public Works be given authorization to approve change orders on this project up to 15 percent of the construction cost rather than the standard 10 percent. The request equates to a 10 percent contingency based on the total of the construction contract and the materials purchased by the City. This authorization will provide the added flexibility needed to complete a typical construction project yet still be consistent with the intent of the 10 percent limit. Public Works Commission Action: The Public Works Commission recommended this project on April 17, 2013, by a vote of 6-0. Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c). Strategic Plan Goal: Improve the City's infrastructure T-1B -21 - Item 3. - 2 Dept. ID PW 14-032 Page 3 of 3 Meeting Date: 7/7/2014 A tack ent(s): 1. Project Location Map 2. Proposed Improvements 3. Bid Protest Documents Item 3. - 3 HB -22- _ - T-ActlmF=NT - TRAFFIC SIGNAL AT SPRINGDALE/CROUPIER p. ¢ PROJECT AREA s,� o y ~i BOLSA STACY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL conv Mc FADDEN AVE. EDINGER z -j s~n N AVE, Y J 4 (n ~ a > 0 a m ¢ HEIL a AVE, m Z �0vi a, _ z o- w 0 V) ¢ WARNER a �`' 0 AVE. 0 SLATER U AVE. w TALBERT AVE. 445 eaLsa PACIFIC A cHICWETLANDS ELLIS LAVE. n0 GARFIEJ -' AVE. u~i YORKTOWN AVE, ADAMS AVE. c INDIANAPOLl5 AVE. Y OCEAN `t `L i a 0 F a c 0 AVE. I� IATLANTA < z = o w < a w HAMILTON AVE. m I �'lyy BANNING AVE- N.T.S. HB -23- Item 3. - 4 CHINOOK DR SAN SOUCI FRO) Igo —------- INDUSTRIAL COMPLEX G SKYLAB RD. INDUSTRIAL COMPLEX DR. U.S.N.R.R. z d LL ki;71: A-];ce11Ul d u LEGEND a = EXISTING ACCESS RAMP = PROPOSED ACCESS RAMP ® = EXISTING TRAFFIC SIGNAL PRIVATE SCHOOL = PROPOSED TRAFFIC SIGNAL NTS lb INDUSTRIAL COMPLEX U.S.N.R.R. u zMA; RETAIL CENTER � W ROYAL OAK DR. LARKSPUR CR. RETAIL CENTER G VIKING CR. ;E z i z HELEN F. STACEY ADA. L. CLEGG MIDDLE SCHOOL ELEMENTARY SCHOOL 9 HARMONY CR. r LARCHtiWOOD DR. LARCHWOOD DR. RETAIL CENTER BOLSA AVE. IEYI a {�J 'cF PROPOSED IMPROVEMENTS FOR HELEN F. STACEY AND a D / L. CLEGG O BEACHCl TY OF HUNTINGTON DEPARTMENT OF PUBLIC WORKS Item 3. - 5 xB -24EMMMM - i �j - -Moon ALACHMENT City of Huntington Beach 2000 Main Street PO Box 190 CA 92648 Travis K, Hopkins, PE Director To: File Subject: Bid Protest Unique Performance Construction, Inc. Safe Routes to School Project Stacey and Clegg Schools CC-1426 From: William F. Janusz ,*� Date: June 30, 2014 Department of Public Works -1 (7141536-5431 Bids for the Safe Routes to School project (CC-1426) were opened on May 20, 2014. The low apparent bidder, Unique Performance Construction, Inc. (Unique) was found to be non -responsive due to the fact that their Disadvantaged Business Enterprise (DBE) utilization of 3.35% was significantly short of the goal of 10.28%. Unique was notified of the decision on June 16, 2014 and the City received a bid protest.from their attorney, Kevin M. Flannifan of Feldman & Associates, Inc.. dated June 23, 2014. It appears that the basis of their protest is that, the 2 nd and 3d low apparent bidders did riot submit any documentation of good faith efforts. The 2nd and 3 d bidders did meet the DBE goat as stated in their Local Agency Bidder DBE Commitment form which was included with their bids. The letter from Unique's attorney calls attention to Attachment I of the bid documents which outlines the requirements for the DBE Commitment Submittal and the: Good Faith Efforts Submittal. His claim is that all bidders, regardless of whether or not the DBE goal has been met, must submit good faith documentation. The first sentence under the heading of Good Faith Efforts Submittal, included with our bid documents, states: If you have not met the DBE goal, complete and submit the DBE Information - Good Faith 4f 7 .Ibrts, Exhibit 15-1-Tform with the bid showing that you made adequate good faith efforts to meet the goal. HB -25- Item 3. - 6 Memorandum June 30, 2014 Page 2 For a bidder that has met the DBE goal, the phrase "If you have not met the DBE goal indicates that this submittal is not necessary. The letter from Unique's attorney quotes the second paragraph, of this section as: the basis for all bidders submitting documentation of a Good Faith Effort: Ifyour DBE Commitment form shows that you have met the DBE goal, you must also submit good faith efforts documentation within the specified time to protect your eligibility for award of contract in the event the Agency finds that the DBE goal has not been met. This is strictly to maintain eligibility in the case that the DBE goals fall short of what was originally stated in the bid. If after review of the; bids, the DBE goals continue to be met, the submittal of a good.faith effort documentation is not a consideration. The final sentence of the Good Faith Efforts Submittal section states The agency may consider DBE commitments of the 2 d and 3rd bidders when determining, whether the low bidder made good faith efforts to meet the goal. The emphasis is on the term "commitments", which the 2 n1 and 3 d bidders achieved. As further documentation, of the City's position, Exhibit 15-H DBE Iqformation — Good Faith Efforts form includes the following statement: Lowest, second and third lowest bidders shall submit the. following information to, document adequate good faith qfforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment form indicates that the bidder has met the DBE 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 fear various reasons, e.g. a DBE firm was not certified at bid opening, or the bidder made a mathematical error. The word "shall" is used in the first sentence with respect to documenting good faith efforts. The term "should" is used in the second, The third sentence outlines the protection of eligibility. While encouraged, there is no language here that makes submitting Good Faith Effort documentation a requirement if the.DBE commitment has been met. The bidder places him/herself at risk of falling short after evaluation of the DBE commitment, but there are no grounds for disqualifying or finding these bids non- responsive because Good Faith Effort documentation was not included. Item 3. - 7 HB -26- On the second page of the attorney's letter it is stated: In addition, the instructions to Ekhibit 15-H, which appear at Page 15-2, explicitly state: PLEASE NOTE: This information may be submitted with your bid. 1f,it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required'DBE, commitment will be grounds for finding the bid nonresponsive. The attorney's letter omits the fact that the section title on this page reads: Instructions — .Local Agency Bidder DBE Commitment (Construction Contracts) and the header at the top of the page refers to Exhibit 15-G. The DBE Information — Good Faith Efforts form. is Exhibit 1. 5-H. This statement does not refer to the Good Faith Efforts form and is therefore not applicable to the Good Faith Efforts form The remainder of the attorney's letter continues to discuss Good Faith Efforts of the 2d and 3 d low bidders. There is not much direct discussion of bid document language. City Public Works staff met with Paul D*Alessandro, Assistant City Attorney, on June 26, 2014. At that meeting, Mr. D*Alessandro concurred that Unique's bid continues to be non -responsive and Public Works can continue to recommend contract award to the second lowest bidder. Attachments- Notification Letter to Unique dated June 116., 2014 8id. Protest from Feldman & Associates, Inc. dated June. 23, 2014 HB -27- Item 3. - 8 f A 55 N a,: *3 %---ity of 2(�)00 Main Street Travis K. Hopkins, PE Director Huntington 41 PO Box 190 Mr. Moumtaz Kabany Unique Performance Construction, Inc. 1321 N. Jefferson Street Anaheim, CA 92807 �Beach CA 92648 Department of Public, Works 1714) 536-5431 Subject: Safe Routes to School Project in the Vicinity of"Stacey and Clegg Schools (CC-1426) Bid Opening — May 20, 201:4 At the bid opening on May 20, 2014 for the subject projectf the bid that we received frol your firm was the low apparent bid. We, have reviewed your bid and must declare it no responsive. I, , A 0-4 0 ! .,# s is is . T V 0-111011160; a off Your bid 'has been declared non -responsive. Should you have questions, please call. me at (714) 536-5431. Sincerely, W Item 3. - 9 JIB -28- ELL AN & ASSOCIATES, INC. ATTORNEYS AT LAW 11030 SANTA MONICA BOULEVARD SUITE 109 CALIFORNIA Los ANGELES, 9002,5 (3,10) 312-5401 FACSIMILE (310) 312-5409 June 23, 2014 Mr. Robert Stachelski Mr. William F. Janusz City of Huntington Beach 2000 Main Street, P.O. Box 190 Huntington Beach, CA 92648 Re: Unique Performance Construction/General - Safe Routes to School Project in the Vicinity of Stacey and Clegg Schools (CC-1426) Dear Mr. Stachelski and Mr. Janusz, As you know, this firm represents Unique Performance Construction, ("Unique") with regard to its recent bid for the above-referenced enced Safe. Routes to School project. I received Mr. Stachelsk-i's email of June 23 containing scanned copies of the bidders' DBE documentation. Thank you for promptly responding to my request. The documents I received, however, indicate that the bids submitted by Van Nguyen, the second low bidder, and PTM General Engineering Services, Inc., the third low bidder, are both non -responsive. While 'I received all bidders' DBE Commitment forms (Exhibit, 15-G). I did not receive any, documents showing that any bidder other than Unique submitted, DBE Good Faith Efforts documentation (Exhibit 15-H). The bid documents clearly require the first; second, and third low, bidders to complete� and submit the Good Faith Efforts form whether or not the DBEparticipation target has been reached. The final paragraph of Exhibit 12-E,, Attachment 1, page 12-3 9,. states: "If your DBE Commitment form shows that you have met the DBE goal or if you are required to submit the DBE Commitment form, you must also submit good faith efforts documentation within the specified time to protect you eligibility for award of the contract in the event the Agency finds that the DBE goal has not been met." As the second and third low bidders, Van Nguyen and PTM General Engineering Services were required to submit the DBE Commitment forms within four days after the bid opening (pursuant to the second paragraph under the heading "DBE Commitment Submittal" on page 12-319), which triggers the requirement to submit the Good Faith Efforts form under the paragraph cited above. HB -29- Item 3. - 10 June 23, 2014 Mr. Robert Stachelski Mr. William E. Janusz Page No. 2 state: In addition, the instructions to Exhibit '15-14, which appear at. page 15-2, explicitly "PLEASE MOTE: This information may be submitted with your bid. If it is not, and you are the apparent love bidder or the second or third low bidders it must be submitted and received. as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive." Both Van Nguyen and PTM General. Engineering Services failed to submit all required bid documents, and consequently their bids are non -responsive. Furthermore, while Van Nguyen and PTM General Engineering Services' DBE Commitment forms do indicate a participation rate of 10.28% or greater, their failure to submit any good faith efforts documentation prevents the City from fully and fairly. analyzing Unique's good faith efforts, and no basis exists for the City's determination that Unique's bid was non -responsive. Exhibit 15-H, the good faith efforts form, documents a process. It is a record of specific acts a contractor undertakes to solicit and encourage DBE contractors' participation in a project. Exhibit 15-G, on the other hand, records an outcome. It only states the dollar amount of work that will be perforined by DBE subcontractors. Mr. Stachelski's June 16 letter to Unique states that the second and third. low bidders' commitments were considered in the City's review process. However, because Van Nguyen and PTM General Engineering Services failed to submit Good Faith Efforts form 15.-11, the City was forced to compare apples to oranges. On the one hand there is Unique's good faith efforts process. Unique published two general advertisements in DBE publications seeking subcontractors for the project, emailed and faxed project' information and requests for bids to 25 separate DBE contractors, and called each of those 25 contractors on two occasions. Unique's 1,02 contact attempts only yielded two interested subcontractors. While Unique was ultimately unable to secure 10.28% participation, its good faith efforts process was more than adequate and reasonably directed toward securing the participation of DBE subcontractors On the other hand are Van Nguyen and PTM General Engineering. Services' DBE commitment outcomes; no information was submitted about theirprocess. ocess. Their respective. DBE participation outcomes could have been the result of a single telephone call, or an extensive and methodical effort like the one Unique doctunented in its bid. That information, however, has not been provided. Only their DBE commitment outcomes exists in the record. Item 3. - 11 IIB -30- June 23, 2014 Mr. Robert Stachelski Mr. William F. Janusz Page No.3 Comparing outcomes to processes is a fundamentally flawed approach. By using Van Nguyen and PTM's DBE outcomes to determine the sufficiency of Unique's good faith efforts process, the City has effectively changed the DBE participation target into a minimum requirement. Moreover, no specific deficiencies in Unique's process, were noted in Mr. Stacheiski'.9 letter, only ,the .fact that it failed to achieve outcomes similar to Van Nguyen and PTM. Without a record of each of the'three lowest bidders' good faith efforts processes', the City has no basis to determine that Unique's process was deficient and its bid non- responsive, and the City's use of other bidders' DBE outcomes to evaluate Unique's good faith efforts is an abuse of discretion. Furthermore, Van Nguyen and PTM General Engineering Sel-Vices! bids are non -responsive on their face, as required forms are missing. For these reasons, Unique hereby requests that the City of Huntington Beach rescind its determination that Unique's bid was non -responsive, and award. the contract to Unique as the lowest responsible bidder. Furthermore, Van Nguyen and PTM General Engineering Services' bids must be declared non -responsive. Therefore, please consider this letter a formal protest of the award to Van Nguyen and PTM General Engineering Services, as both bids are non -responsive for failing to submit the mandatorily required Good Faith Efforts documentation. Please feel free to contact me at the number above if you have any questions about this letter. cc: Client Q& Very �trul ers, evin M. l Iannif For FELDMAN & ASSOCIATES, INC. UB -31 - Item 3. - 12 Engineer's Estate: $ "BID LIFT BfDDERW-NAAM - RANK -. TOTAL JBID "OUNTLL It CIA k7 C :l rev :C 7. $ �. $ 9. $ 10. $ 12. $ 13. $ 14. $ -` os Anneles Mmes E D I , GROUP RECEIVED 2814 MAY 22 FM 4: 49 CITY CLERK CITY Of HUNTINGTON BEACH Sold To: City Of Huntington Beach (Parent) - C000070479 PO Box 784 Huntington Beach,CA 92648 Bill To: City Of Huntington Beach (Parent) - C000070479 PO Box 784 Huntington Beach,CA 92648 NOTICE INVI'TIN SEALED sips for the Construction of Sate Routes to I" the YitiiiltY a [.: Stacey h+lidale 5ittibc 9 end Clegg-Elootent"y Savool - CC No: 1426 SM1,4591(173) in the CITY OF HUNTINGTONAEACH.. 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'vtte5f:. _ ban L. Flyi,,n C%TvfijRaOr, Tiff urfor F%FI'€TtTlsSF.Kfa 2356364 - Huntington Beach Independent 14MAY 2o Fwig..o PM CD , SECTION A NOTICE INVITING SEALED BIDS for the construction of Safe Routes to School In the Vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181(173) 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 projects 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 PM on May 20, 2014. 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 $30.00 nonrefundable fee if picked up, or payment of a $45.00 nonrefundable fee if sent by UPS ground delivery (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 5% 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 Public Contract Code, Section 10263. 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 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. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: The project consists primarily of constructing anew traffic signal, installing new curb ramps and signing and striping improvements. • The contract shall allow the Contractor 50 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $420,000. • The Project Disadvantage Business Enterprises (DBE) goal is 10.28%. 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 3rd day of September 2013, by Resolution No. 2013-48. Attest: Joan L. Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH Esparza, Patty From: Emanuele, Allison [aemanuele@tribune.com] Sent: Thursday, May 01, 2014 12:10 PM To: Esparza, Patty Cc: Deasy, Kyle Subject: FW: HUNTINGTON BEACH INDEPENDENT LEGAL AD FOR 4/24/2014, 5/1/2014 & 5/8/2014 Attachments: SECTION A-1426.docx; LAT ad# 2356364.pdf; DOC.PDF Importance: High Patty, I apologize again for the error with this notice. I've reschedule the notice to run on 5/8 and 5/15 in the Huntington Beach Independent under Bids Wanted. Please see the attached proof and confirmation and let me know if you need to make changes. I've also attached your letter of apology for your records. Additionally, I will refund the costs associated with the original notice. Please let me know if there is anything else I can help you with. Thank you, Allison Emanuele Team Lead I Advertising Contact Center aemanuele@tribune.com Direct: (312) 981- 7215 Our calls may be recorded for quality and training purposes Great customer service is our top priority.We encourage feedback on our performance, just click on the link below to send us your comments. Our Quality Assurance team will review your email promptly. excellencObtribune.com From: Esparza, Patty [mailto:PEsparza@surfcity-hb.org] Sent: Monday, April 21, 2014 11:35 AM To: LA Legal Subject: HUNTINGTON BEACH INDEPENDENT LEGAL AD FOR 4/24/2014, 5/1/2014 & 5/8/2014 Importance: High Hi All —Attached is a legal ad for the Huntington Beach Independent that needs to be published 3 weeks in a row beginning this week. The publishing dates are: APRIL 24, 2014, MAY 1, 2014, and MAY 8, 2014 Please send confirmation of publication as soon as possible. Thanks! Los An geles fir:: k� Order ID: 2356364 GROSS PRICE * : $0.00 PACKAGE NAME: Legal-HBl-Bids Wan4nrl Product(s): Huntington Beach Independent, hbindependent.com, CApublicnotice.com_HBI AdSize(s): 2 Column, Run Date(s): Thursday, May 08, 2014, Thursday, May 15, 2014 Color Spec. B/W Preview Printed: 5/1/2014 2:04:11 PM Page 1 of 3 " Agency Commission not included & 0S j�w An-gelesMf Order 2356364 GROSS PRICE * : $0.00 PACKAGE NAME: ��LA�egal-HlBl-Bids CIF t+Jxl flTat€e #`=T' 4JfCeC�, � �',II'iPY T1 titglY ii!'i 't RF 11 R l' :tipr� �y`fFv� ri 3 k Feu t�sr Azt,sV' kah L FIrmn Printed: 5/1/2014 2:04:11 PM Page 3 of 3 * Agency Commission not included s ,An le iii s Tribune Results Group 435 N Michigan Ave Chicago, IL 60605 To whom it may concern, 4/30/2014 I regret to inform you that your advertisement request for your notice for Bids Wanted for Safe Routes Construction No. 1426 failed to run on the 5/1 in the Huntington Beach Independent. These advertisements were submitted and confirmed with you by the normal deadline, but our department failed to schedule the notice correctly and it did not print due to a system migration on 4/23/2014. The Los Angeles Times Community Newspapers and Times Community Newspapers including the Huntington Beach Independent accept responsibility of the failure to print and will reschedule the notice on an upcoming date of your choosing. I sincerely apologize for the inconvenience this has caused you and your clients. We appreciate your patience during this transition and we will do better in the future. Please don't hesitate to reach out to me should you have any further questions. Regards, Allison Emanuele Team Lead — Legal Classifieds 312-981-7215 aemanuele0tribune.com CITY OF HUNTINGTON 2000 Main Street P.O. Box 1 90 Huntington Beach, CA LETTER OF TRANSMITTAL Attention: Joan L. Flynn To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 BEACH 92648 Fax (714) 374-1573 Date: April21, 2014 Project/C.C. No.: C.C. No. 1426 Regarding: Safe Routes to School, Stacey/Clegg Schools ❑ 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 Invitina Sealed Bids Item#= ..:Co les. , ; Pages ` _ - _ ,.,. w Description.... v 1 1 1 Notice Inviting Sealed Bids for CC-1426, Safe Routes to School, in the vicinity of Stacey Middle School and Clegg Elementary School. 2 3 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 reviewicomment ❑ Other: Remarks: Per Resolution 2013-48 (adopted on September 3, 2013), the City Council authorized the advertisement of the above Safe Routes to School, Project CC-1426. Please find attached the Notice Inviting Sealed Bids for advertisement on 4/24/14, 5/1/14 & 5/8/14. The bid opening is scheduled for 5/20/14. Please contact me at 374-1628 with any questions you may have. cc: fileCC-1426 By;,�/�-. - William F. Janu rincipal Civil E.WKeer STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) I am a citizen of the United States and a resident of the County of Los Angeles; I am over the age of eighteen years, and not a party to or interested in the notice published. I am a principal clerk of the HUNTINGTON BEACH INDEPENDENT, which was adjudged a newspaper of general circulation on September 29, 1961, case A6214, and June 11, 1963, case A24831, for the City of Huntington Beach, County of Orange, and the State of California. Attached to this Affidavit is a true and complete copy as was printed and published on the following date(s): Thursday; April 24, 2014 Thursday; May 1, 2014 I certify (or declare) under penalty of perjury that the foregoing is true and correct. Executed on May 12, 2014 at Los Angeles, California SECTION A NOTICE INVITING SEALED 61DS for the construction of Safe Routes to School I In the Vicinity of Stacey Middle School and Clegg Elementary School CC No.1426 SRTSL-5181(173) in the CITY OF HUNTINGTON BEACH l PUBLIC NOTICE IS HEREBY GIVEN thatthe CITY OF HUNTINGTON BEACH, as 1 AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, 1 Huntington Beach, California 92648, up to the hour of 2:00 PM on May 20, 2014. Bids will be publicly open in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available II from the Office of the Director, of Public Works, 2000 Main Street, ` Huntington Beach, CA 92648, upon payment of a $30.00 nonrefundable fee if picked up, or payment of a $45.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). i 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 Reach, CA 92648. The AGENCY will deduct 5% 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 Public Contract Code, Section 10263, The Contractor shall be beneficial owner of the•surety and shall receive any interest thereon. The AGENCY hereby affirmatively enures that minority business enterprises will be afforded full opportunity to subprit bids in response to this notice and will not be discriminated against on the basis of race, dolor, 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 fors 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 l o% of the amount bid. The successful bidder shall be licensed i 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 Iopening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of, unit prices will be subject. to verification by the AGENCY. In case of a !, variation between the unit price and the extension, the unit price will govern. Project Description: The project consists primarily of constructing anew traffic signal, installing new curb ramps and signing and striping improvements. The contract shall allow the Contractor 50 working days • to complete the contract. The engineer's estimate of probable construction cost for the work included in the basis of awardis$420,000. j l . The Project Disadvantage Business Enterprises (OBE) goal is 10.28%. 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 i of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA,the3rddayofSeptember2013,byResolution No. 2013-48. Arrest: JoanL.Fl nn CITY CLERK OF.THE CITY OF HUNTINGTON BEACH Unsuccessful Bids CC-1426 CleggSafe Routes to School in the vicinity of St�cey Middle School and Elementary School City of Huntington Beach 2000 Main Street ® Huntington Beach, CA 92648 (714) 536-5227 ® www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk August 26, 2014 Dynalectric 4462 Corporate Center Dr. Los Alamitos, CA 90720 RE: Safe Routes to School/Stacey-Clegg — CC-1426 Enclosed please find your original bid bond for CC-1426. Sincerely, 7 Joan L. Flynn, CIVIC City Clerk JF:pe enclosure Sister Cities: Anjo, Japan 4 Waitakere, New Zealand 14 MAY 20 ®ynalectr®c An EMCOR Company 4462 Corporate Center Drive Los Alamitos, CA 90720-2539 "SEALED BID" For CC-1426 SRTSL-5181 (173) Safe Routes to School in the Vicinity of Stacey Middle School and Clegg Elementary School in the CITY OF HUNTINGTON BEACH — DO NOT OPEN WITH REGULAR MAIL DELIVER TO THE OFFICE OF THE CITY CLERK, 2000 MAIN STREET, SECOND FLOOR SECTION C PROPOSAL for the construction of Safe Routes to School In the vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181(173) 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 50 working days, starting from the date of 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 prices shall govern over extended amounts, and words shall govern over figures. C-1 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 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 OOM� ,AND in the amount of $ )0% W ELwhich 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 Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School � ¢ a �� Yts��� `' A L � 'ad{� J �'Z,X d�� � 4X 2 .C'Y�'Z�`�.x'4 4 T%�� M4+� j' }� � .A�'S �.ii`rw"� p .� : a^ 3-i➢'r� �� 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Furnish Project Traffic Control. Per L.S. 3 1 L.S. Furnish and Install Traffic Striping and Signing. $ 070, $ 169 870 Per L.S. 4 1 L.S. Construct Traffic Signal at Springdale Street and Croupier Drive. (excludes $ ql, $ q1 �Ct� interconnect conduit and interconnect cable) Per L.S. 5 2550 L.F. Furnish and Install 2"Interconnect Conduit with 6 Pair #19 Solid Interconnect Cables and Pull Boxes $ , SO $ Spaced Approximately 200' (Also includes installation into the traffic signal cabinets). Per L.F. 6 450 L.F. Furnish and Install 6Pair #19 Solid Interconnect Cables in Existing Conduit (Also includes installation $ 2 $ CO s into the traffic signal cabinets). Per L.F. 7 18 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B or Case C and Per Typical Section at $ 7 $ Y 7gl New Ramps Adjacent to AC Paving Detail. Ll Per EA. C-2.1 Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School 8 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case F and Sheet 2 Details for Ramp Locations 1 $ and 12. Also Includes Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 9 17 L.F. Furnish and Install Metal Railing Per Standard Plans for Public Works _ (Green Book) Plan 606-2, Type A. $L $ Per LF. rNAN i ��a� zR r T�tY'�t-£ t u Total Amount Bid in Figures: $35-0r I ov Total Amount Bid in Words: au'170f&�--J3 1-1 (-' 4 6�L' - Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes traffic signal cabinet, service cabinet and anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 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. Name and Address of Subcottracto� State ' CCass Dollar, ItemO , ; Lacense Amount Contract Number S��cP 6A 9z �l5 T�C,��GIt- ��iy✓�yN�'{ �-12G�1�C-.i {NC: 776,3,N,° / /p/ l� 767J S ��r r�C ©� pia-l"Z 'Z2 J� q« Z3 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. 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 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on q / t q , at Los Alamitos , CA Date City State William B. Davenport , being first duly sworn, deposes and says that he um ska is Treas., C.F.O., V.P. of KDC Inc., dba Dynalectric 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. William B. Name of Bi of 4462 Corporate Center Drive Los Alamitos, CA 90720 Address of Bidder 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 CC-1426 SRTSL-5181(173), Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School, (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. KDC Inc., dba Dynalectric Contractor William B. Davenport By Date: May 9, 2014 C-5 Treas., C.F.O., V.P. Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, 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. Date: May 9, 2014 C-7 KDC Inc., dba Dynalectric Contractor William B. Davenport I: Treas., C.F.O., V.P. Title BIDDER certifies that the following information is true and correct: KDC Inc., dba Dynalectric Bidder Name 4462 Corporate Center Drive Business Address Los Alamitos CA 90720 City, State Zip ( 714 ) 828-7000 Telephone Number 550173, Class C10, A State Contractor's License No. and Class 12/06/88 Original Date Issued 12/31/14 Expiration Date The work site was inspected by Richard Shackleton of our office on May 9 , 2014. The following are persons, firms, and corporations having a principal interest in this proposal: Michael Parry, President William B. Davenport, Treas., C.F.O. V.P. Dusty Lord, Secretary c-s 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 fortly KDC Inc., dba Company Name Signature William B. Davenport Printed or Typed Signature sworn to before me this _ day of 52014 . NOTARY PUBLIC :Sc "C" oal-+ 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. City of Los Angeles / 1149 S. Broadway Ste. 200, Los Angeles, CA 90015 Name and Address of Public Agency Name and Telephone No. of Project Manager: Robert Tom / 213-847-1811 $362,205.00 Security Lighting Unit 16 July 2011 Contract Amount Type of Work Date Completed 2. City of Santa Monica / 2500 Michigan Ave., Santa Monica, CA 90404 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mike Morgan / 310-458-8520 $180,590.00 Street Lighting, Traffic Signal 2010-2013 Contract Amount Type of Work Date Completed 3. City of Burbank / 275 East Olive Ave., Burbank, CA Name and Address of Public Agency Name and Telephone No. of Project Manager: Bobola Famuyibo $500,000.00 Burbank as needed / Street Light July 2013 Contract Amount Type of Work Date Completed C-9 CALIFORNIA. JURAT WITH AFFIANT STATEMENT X See Attached Document (Notary to cross out lines 1-6 below) El See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer No. I State of California County of Orange VEND'Y BOWLING Commission # 2006966 Notary Public - California 2z Orange County k, Comm. FabI8.211111171 Place Notary Sea] Above Signature of Document Signer No. 2 (if any) Subscribed and sworn to (or affirmed) before me on this 20th day of May _ 20-14— by Date Month Year (1) William B. Davenport Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me (.) (j (and Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me.) Signature Sign lure Notary Public OPTIONAL 1� Though the information below is not required by law, it may prove .. , P4 valuable to persons relying on the document and could prevent MOM&-i Lpicl k I:ql;guj fraudulent removal and reattachment of this form to another document. Top of thumb here Top of thumb her Further Description of Any Attached Document Title or Type of Document: Bidder's Information Document Date: None Number of Pages: 2 Signer(s) Other Than Named Above: None C2007 National Not" Association - 9360 De Soto Ave., P.O. Box 2402 -Chatsworth, CA 91313-2402 - www.Nationa[Notary.org ltern#6910 Reorder:,Cal[Toll-Freel-800-876-6827 (For federally funded projects, use this following page) 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 requiremnents 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: KDC Inc., dba Dynalectric Contact Person. William B. Daven Contact Phone: 714-828-7000 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-10 Local Assistance Procedures Manual EXIIIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON TBE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WBICHARE A PART OF THIS PROPOSAL) ATTACHMENT C EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder William B. Davenport proposed subcontractor KDC Inc.dba Dynalectric 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 subjectto 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 suclyother period specified by the Federal Highway Administration or by the Director,*OfficepfFederal Contract Compliance, U.S. Department of Labor. Page 12-25 OB 12-04 c-11 Jane 29, 2012 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D ATTACHMENT D NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach / 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 of the Proposal. Signing this Proposal on the signature portion thereof shall also constitut signature of this Noncollusion Affidavit. Bidders are cautioned that m gg a false certification may subject the certifier to criminal prosecution. Page 12-27 OB 12-04 C -12 June 29, 2012 Local Assistance Procedures Manual EXIMIT 12-E PS&E Checklist Instructions Attachment 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; • 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 12-29 OB 12-04 C -13 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions EXMIT 12-E Attachment F ATTACHMENT F NONLOBBYING CERTIFICATION FOR FEDERAL-ALD 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 sub recipients shall certify and disclose accordingly. Page 12-31 OB 12-04 C -14 Jane 29, 2012 Local Assistance Procedures Manual NON -APPLICABLE FAIT 124 PS&E Checklist Instructions Attachment G ATTACHMENT G DISCLOSun OF LOBBYING ACTIVITIES FORM TO 1. 'Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan c, loan guarantee £ loan insurance 2. Status of Federal Action: Ela. 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 DepartmentlAgency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, W 10 31 U.S.U. 1352 3. Report Type: a initial b. material change For Material Change Only: year _. quarter date of last reuort 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. 10a) (last name, first name, W) (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 -tune fee c. commission d. contingent fee e deferred £ other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including ofHcer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheets) attached: Yes ❑ No 16. Information requested through this font is authorized by Title 31 U.S.0 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 wrll 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.: _ Federal Use Only: Date: Authorized for Local Reproduction Standard Form - LLL Page 12-33 OB 12-04 C -15 June 29, 2012 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 awardiloan 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 navies of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). I L 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. Npayment 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. N other, specify nature. Page 12-34 June 29, 2012 C-16 OB 12-04 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(<ENDIF)) Page 12-35 OB 12-04 C -1 June 29, 2012 Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts) EXHIBIT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF'THIS FORM L:OCALAGENCY: City of Huntington Beach LOCATION: In the vicinity of Stacey mS and Clegg ES PROJEGTDJ�gCRrTON:Safe Routes To school Stacey -Clegg Project #STRSL-5181(173) CC-1426 TOTAL CONTRACT AMOUNT: / T: $ � f Oc' BID DATE: B>DDEWS NAME: kQC t'nc.. cj �k t c, i-1 e c —f- c. CONTRACT DBE GOAL: 10 .2 8 % CONTRACT NO. UT-M OFIWORK AND DESCRIPTION OR SERVICES TO BE CONTRAt,TED OR MATERIALS TO BE PROVIDED (or contracted if the bidder is a DBE) DBE CERT NO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT BE rt�FE�C �C�Ee7' P t'S 33 PaLz!FC m � 6>ur ��, _ 30- For Local Agency'to Local Agency Contract Nu Federal -aid Project Number Federal Share: Contract Award Date_ Local Agency certifies that all information is complete and Complete: her Total Claimed DBE Participation / 7 $ / 2�7 Z % DBE certifications have been verified and accurate. Signature of Bidder 05L20 i �F �� 1 +) b9-5 - Dot Date (Area Code) Tel, No. VJ ( t—L I f i DP0 (� Print Name Local. Agency Rrpresentatrvc (Area Code) Telephone Number. Signature Date Person to Contact (Please Type or Print) Local Agency Bidder DBE Commi6ncnt (Coushaction Contracts) (Rev 6126109) Distribution: (1) Copy —Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract execution, Failure to send a copy to the DLAE within 30 days of contract execution may remit in de -obligation of funds for this project (2) Copy — Include in award package to Caitrans District Local Assistance (3) Original �� Local agency tiles Page 15-1 OB 12-04 C -18 June 29, 2012 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) INSTR[TCTIONS - LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) PLEASE NOTE: This information may be submitted with your bid. 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 DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier BE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the ,.games and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation 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 contrasts), to determine how to count the participation of DBE firms. Exhibit 15-G 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 Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 C -19 June 29, 2012 ©B 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort Exmff 15-H DBE INFORMATION --GoGD T+ AiTH EFFORTS Federal -aid Project No. Bid Opening Date The _ (Cites nniy of) established a Disadvantaged Business Enterprise (DBE) 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 DBE Commitment" form indicates that the bidder has met the DBE 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 DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE 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 DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE 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 DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation C - 2 0 ]Page 15-1 oB 12-04 June 29, 2012 Exhibit 15-H Local Assistance Procedures Manual DBE Information -Good Faith Effort C. The items of work which the bidder made available to DBE 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 DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (YN Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs 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 DBEs: Page 15-2 C - 21 June 29, 2012 OD 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE 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 DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results 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. C - 2 2 Page 15-3 OB 12-04 June 29, 2012 Local Assist Procedures Manual WT. 'T 12-G Bidder's List of Subcontractors (DBE anl.. on -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 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/ Address/ ...City; State,.ZIP Phone/ =-Annual-.­:,-.:y` .:.: Fax ' :.. Gross:::.' Receipts : Description of Portion of Work to be Performed . s..ry Name ` .h�lC S �r%.� LGru,.-L /il Phone / / [� `t - ('' <$l millionP',3i i� zaa, If YES list DBE #: ❑ < $s million Address < $ l0 million Fax 71q- 520- 4,Oz? 0 < $15 million Age of firm (Yrs.) Ct State ZIP �� - ❑> $15 million " Name (.lA2 U 'J �` Phone �! s �j �! Gib LJ < $1 million �� G1/� ��' ✓� ,z.e x 4 <$5 m11110II A s f) El < $10 million If YES list DBE #.• Fax 7 , sue yr f� ❑ <$15 million Ct -State ZIP ' 1 > $15 million Age of Firm (Yrs.) Name %' 4g, C�1�? � rJC' a �`vicej Phone 3,W-;?tV <$1 million r 4I tk' ,jf'YES list DBE #: ❑<$5million Address -7/,-0 0 < $10 miillon Fax <$15 million CM State ZIP ,� L?/11i C:/41V - El > $15 million Age of Firm (Yrs.) Name Phone U <$1 million j Address < $10 million If YES list DBE #: Fax < $15 million City State7lP > $15 million '" iS' 35 Distribution:1) Original - Local Agency file Page 12-111 LPP 06-06 November 14, 2006 Document A310 TM ® 2010 Conforms with The American Institute of Architects AIA Document 310 Bid Bond CONTRACTOR: SURETY: 'cane, legal status crud addramv) (,Marne, legal.slalus turdin incilrallrlace c f business) Dynalectric Travelers Casualty and Surety Company of America 4462 Corporate Center Drive Los Alamitos, CA 90720 OWNER: (,Vwue. legal status and addr ess) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 One Tower Square Hartford, CT 06183-9062 Mailing Address for Notices One Tower Square Hartford, CT 06183-9062 BOND AMOUNT: $ 10% Ten Percent of Amount Bid PROJECT: (,' mne, location or add= audl'rojecturuuber.. lfau}) This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CC-1426 SRTSL-5181(173) Safe Routes to School in the Vicinity of Stacey Middle School and Clegg Elementary School in the City of Huntington Beach The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointlyand severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract %with the Owner in accordance %with the temis of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof. or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to peribmt the wort: covered by sid bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of our ugreentent between the Owner and Contractor to extend the time in which The Owner may accept the bid. Waiver at'notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond rite time liar acceptance of bids spectled in tlne bid documents, and the 0%%iier and Contractor shall obtain the Surety's consent liar an extension beyond sixty (60) days. If this Bond is issued in connection Frith a subcontractor's bid to a Contractor. the tcmr Contractor in this Bond shall be deemed to be Subcontractor and the terns Owner shall be deemed to be Contractor. When this Bond has been fumished to comply with a statutory or other legal requirement in the location ofthe ProjecL any provision in this Bond conflicting %with said statutory or legal requirement shall be deemed deleted hereliom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Dond shall be construed us a statutory band and not as a common law bond. Signed and scaled this 9th day of May, 2014 (I1'luressl (1J inress) Dynalectric (Seal) IL DAVENPORT, EXEC. VP & CFO Travelers Casualty and Surety Company -of America (.Strrel}j .(Seal) By: rtle) Rita aagistad Attorney -in -Fact S•0054/AS 8110 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Orange On:. 05/19/2014 before me, Wendy Bowling, Notary Public Dale Here Insert Nameand.Title of the Officer personally appeared William B. Davenport Names) -of Slgner(s). WENDY BOWLING. Commisslon * 200620 z : -� Notary Public California z Orange County > My Comm. Ea ires Fa 1, 22017 Place Notary_ Seal Above who proved to me on the. basis of satisfactory evidence to be the. personfe) whose name(Q) 'is4Fs subscribed to the within instrument and acknowledged. to me that he+'O@Aha� executed the same in hisA;e� authorized capacity#@@, and that by hisAss4l�eir signature¢e) on the instrument the Pbrsohf*, or the entity upon behalf of which the persoriH 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 hang and official s 'Signature. OPTIONAL. Though the information below is not required bylaw, it may prove valuable to) and could prevent fraudulent removal and reattachment of this form Description of Attached Document Title or Type of Document: Bid Bond Document 05/09/14 Signer(s) Other Than Named Above:. Rita Sagistano Capacity(ies) Claimed by Signers) Si gner's Name: William B. Davenport 1-1 Individual X :Corporate 'Officer—Titie(s): Exec VP/CFO I I Partner — C�. Limited ❑ General ❑ Attorney in Fact. ❑ Trustee. • T of th nb e ❑ Guardian or Conservator ❑ Other: Signer Is Representing: IBC Inc. dba Dynalectric dba s Number of Pages: Public the document ❑ In ual ❑ Corpora Dfficer — Title(s): ----- Partner— r L:. ited ❑ General ❑,`Attorney in Fact 0 Trustee G'>Guardian or Consery f_t:Other: Signer Top of'tr umb here 020U7 National Notary Association • 9350 06 Soto -Ave., P.O. Box 2402 • Chatsworth, CA 91315�2402-w wr.NadbnalNotary.org Ilem b5907. Reorder. Call Toll -Free 1-800-876-6827 WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER I POWER OF ATTORNEY TRAVELERS" Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 227047 Certificate No. 005734512 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty 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 are corporations duly organized under the laws of the State of Connecticut, 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 Thomas Bean, Rita Sagistano, Gerard S. Macholz, Susan Lupski, Robert T. Pearson, Camille Maitland, George O. Brewster, Colette R. Chisholm, Virginia M. Lovett, Vincent A. Walsh, and Lee Ferrucci of the City of Uniondale , State of New York , 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 13th day of December 2013 Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company pASU.,� � yF\REr6�W'� C\t•N..� � 'Y fNSUq 'r PITY AMC Wunr. Y i dy 3•,�P,...........'p.�.r% 9J SG ,(�t7W^q�TY ��F 'WO 5 l"J C1 0 191 / WC z rLORPOR�>jc. m r r' W r4oPPOR4l�.: �? 9�\\ O 19 8 Z�• O � ��� s» � � e F F -- : � ; c HARTFDRD, a • HARTFDRD,j � < � Z cer� = ' 'a 1951 ; �'•SEAL.o9 `�` o` w CONN. o° �ca+t+• J£ 1696 < �dr a�a zti o€s ��•.. ,Ar ,,��:_SEAL.aa >s e'� r 1 �''Mmo eAu`w•d� =SN ANC= tr ...... r� d1 nNa t „ N>� "af AN/ State of Connecticut City of Hartford ss. By: ZX49 Robert L. Raney, teifior Vice President On this the 13th day of December 2013 before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., 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. p,7eY In Witness Whereof, I hereunto set my hand and official -seal. � My Commission expires the 30th day of June, 2016. �'0lIBL1G$ Mane C. Tetreault, Notary Public 58440-8-12 Printed in U.S.A. TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA HARTFORD, CT. 06183 ATTORNEY 3N-FACT JUS'PI1rICATION PRINCIPAL'S ACKNOWLEDGMENT— IF A CORPORATION State of New York, County of ) ss. On tills day of , 20 , before me personally appeared , to me known, who, being by me duly sworn, deposes and says: That he/she resides In the City of that he/site is the of the corporation described In and which executed the within instrument; that he/she knows the seal of said corporation; that the seal affixed to said instrwnent Is such corporate seal; that it was so affixed by order of tire Board of Directors of said corporation, and that he/she signed his/her name thecto by like order. State of New York, County of PRINCIPAL'S ACKNOWLEDGMENT— IF INDIVIDUAL OR FIRM ) ss. On tins day of , 20 , before me personally appeared to Inc known to be (the individual) (one of the firm of ) described in and who executed the within instrument, and he/she thereupon duly acknowledged to me that he/she executed the same (as the act and deed of said firm). SURETY CO,AIPANY'S ACKNOWLEDGMENT State ofNew York; County or Nassau } ss. On this 9th day of May .2014 before me personally appeared Rita SagiStano to nteknown, who, being by me duly sworn, did depose and say: That he/he resides in the t1(9 & Nassau County, NY ; that he/site is Attorney -In -Fact of TRAVELERS CASUALTY AND SURETY CO,IIPANY OF AMERICA, the corporation described In and which executed the within instrument; that he/she knows the corporate seal of said Company; that the seal affixed to said instrument Is such corporate seal; and that A�ashe dined said instrument as Attorney -in -Fact by authority of the Board of Directors of said Company; and afi3ant did further depose and say that the Su endenl d'Insurance of the State of Now York has, pursuant to Chapter 882 of the Laws of the State of New York for the year 1939, constituting chapter 28 of the nsolid�ting Law; of the $tale Af AT��eew rk as the Insurance Law as amended, issued. to TRAVELERS CASUALTY AND SURETY COt11PANY OF AMERICA h s/her cer�tficete t� at)saidtim� ylsl �alified to become and be accepted as surety or guarantor on all bonds, undertakings, recognizances, guaranties, and other obu`9016 r ircet o ppt 0tted, .taw ahh that such certificate has not been revoked. 1 1 f J I V'. j I i I; i TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA----PONNA MfARIR.SPIELMAN Hartford, Connecticut 06183 Notary Public, State of New York No.01SP6248741 FINANCIAL STATEMENT AS OF DECEMBER 31, 2013 y�� Qualified In Nassau County AS FILED WITH THE INSURANCE DEPT. OF THE STATE OF NEW YORK""m F-xpims September 19, 2015 CAPITAL STOCK $ 6,480,000 ASSETS LIABILITIES CASH AND INVESTED CASH BONDS 3 67,799,624 UNEARNED PREMIUMS S 808,717,671 INVESTMENT INCOME DUE AND ACCRUED 3,48ZN4,808 47,768,502 LOSSES LOSS ADJUSTMENT EXPENSES 809,8e3,176 400,070.453 OTHERINVESTEDASSETS PREMIUM BALANCES 265,009,610 COMMISSIONS 31,781,138 NET DEFERRED TAXASMT 190,838,462 01,675,098 TAXES, LICENSES AND FEES OTHER EXPENSES 12,482,322 REINSURANCE RECOVERABLE SECURITIES LENDING REINVESTED COLLATERAL 11,881,414 ASSETS FUNDS HELD UNDER REINSURANCE TREATIES 38.437,893 94.401,464 4,010,772 RECEWABLESFROM PARENT. SUBSIDIARIES AND AFFILIATES 30,772,481 CURRENT FEDERAL AND FOREIGN INCOME TAXES REMITTANCESANDITEMSNOTALLOCATED 18 387,407 13,677,603 STATE SURCHARGES RECEIVABLE OTHER ASSETS 268,771 AMOUNTS WITHHELD I RETAINED BY COMPANY FOR OTHERS 23,616,367 14,872.822 RETROACTIVE REINSURANCE RESERVE ASSUMED i4f 1,674 POLICYHOLDER DIVIDENDS 6,462,W PROVISION FOR REINSURANCE 3,970,484 ADVANCE PREMIUM 1,078,609 PAYABLE FOR SECURITIES LENDING 4,9f0,772 DERIVATIVES 112,003 CEDED REINSURANCE NET PREMIUMS PAYABLE (84.9U.254) ESCHEAT LIABILITY 471,948 OTHER ACCRUED EXPENSES AND LIABILITIES 242,236 TOTAL LIABILITIES $ 2.285.740.387- CAPITAL STOCK S 6,480,000 PAID IN "PLUS 433,803,760 OTHER SURPLUS 1,441,438,327 TOTAL SURPLUS TO POLICYHOLDERS S 1,881,720.088 TOTALASSETS 3 4,147,460,454 TOTALLUOLMES&SURPLUS S 4,147,480484 Securities carried at $8,174,873 In the above statement are deposited with public authorities, as required by law. City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ® www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk August 26, 2014 Elecnor Belco Electric, Inc. 4331 Schaefer Ave. Chino, CA 91710 RE: Safe Routes to School/Stacey-Clegg — CC-1426 Enclosed please find your original bid bond for CC-1426. Sincerely, f- Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand LM 9 -sG #v e C- }100 ► CA-117 > 0 14 MAY 20 PM I= t-A e" F-Fl c..P- OF L ITS/ CI Leal- r SIE7"fj o Ft-001-- Z060 M?r l 0 '!�,T 4vwrp.1(.Tv,J f3empv r CA 112-6 4 t etojc,c.-.r i to Peopusm, SPrFv,;?xv-res -r% gc ftoL- SECTION C PROPOSAL for the construction of Safe Routes to School In the vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181(173) 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 50 working days, starting from the date of 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 prices shall govern over extended amounts, and words shall govern over figures. C-1 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 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. Bea»�w'S c Accompanying this proposal of bid, find �r'`� in the amount of $ ( a to 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 Si nature . C_2 Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Furnish Project Traffic Control. $ 3,600. $ 3,00D,v® Per L.S. 3 1 L.S. Furnish and Install Traffic Striping and Signing. $ 6 (of 0 0y ° (A $ 1(o® 00 0. I/O Per L.S. 4 1 L.S. Construct Traffic Signal at Springdale Street and Croupier Drive. (excludes $ Or7l ddo• La $ 17' a ad ° &o interconnect conduit and interconnect cable) Per L.S. 5 2550 L.F. Furnish and Install 2"Interconnect Conduit with 6 Pair #19 Solid Interconnect Cables and Pull Boxes 3a. vp $ $ ��1U• Spaced Approximately 200' (Also includes installation into the traffic signal cabinets). Per L.F. 6 450 L.F. Furnish and Install 6Pair #19 Solid Interconnect Cables in Existing Conduit (Also includes installation $ 3'� $ �/ �� ° Ob into the traffic signal cabinets). Per L.F. 7 18 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B or Case C and Per Typical Section at ` $ a. &D New Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School 8 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case F and Sheet 2 Details for Ramp Locations 1 $ 31®Ue $ e®U . (/D and 12. Also Includes Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 9 17 L.F. Furnish and Install Metal Railing Per Standard Plans for Public Works (Green Book) Plan 606-2, Type A. $ �d� • $ 5t 10 0 . fP8 Per LF. Total Amount Bid in Figures: Total Amount Bid in Words: Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes traffic signal cabinet, service cabinet and anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 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. Bid Name and Address of Subcontractor State '' Class Dollar %.of " Items) License Amount " Contract Number - �/�012A 4S V4%J1Qmw'lT -7 ` �io�oa- r 53,60o• ��OX p`G6 12.1= Tt2Airvi c, u CR-AmM 4 PqJ I 4 . (A- (3 G T ': S 3 t��► CA G-�� 6�®y�.r• �a By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 N®NC®1LLUSI®N AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH DID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 51111 /#at G1�1 N 0 C4- Date City State J 0 PW worjc, , being first duly sworn, deposes and says that he or she is "C"1 tJS f o$-TAono►J ViV- Aw . of 0-LO-0n10-4- FSeW fL=7 U,,/tk?e 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. t-:LZG#,J 0A- B F—LCA E t l-'r0AC, I fJ(-- J04-��J W a t'j Gl Name of Bidder '\4 W'/ Aw�ture of Bidd r 43?1 S G4**PZu-- AVD . C.4+11-J (J► W 4) 1 -1 it Address of Bidder 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 CC-1426 SRTSL-5181(173), Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School, (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: 51 tot I -,?,o 1 C-5 t n10 VI-- j peL.IA 1 n1C Contractor 'C"IJ5M_iWA-n0-J 191VIS►0# M*-#JPfW-lti-- Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, 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? Q 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 COMPlENSATION INSURANCE CIERTIFICATIE 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: 51 e 01/ f l y C-7 ELV.tj0(L %3CL4o 6LeL-fVt1Cg itJ4 . Contractor �4 W , 1"k-W?0 4M0,'j Vo/151W M61t. Title BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: LE4401- 6E tIGO ELIC& W- t I M L Bidder Name g331 s( ti*z Mom-- 4yLr - Business Address C,t�irJID C16 011-7)o City, State Zip (a tl01 ) 6PI 3 -9%4 -7D Telephone Number State Contractor's License No. and Class %%L$ / IaA1 Original Date Issued -7/31 J zoo Expiration Date The work site was inspected byJbVmA Wdtj (n of our office on % a , 201 L4 The following are persons, firms, and corporations having a principal interest in this proposal: G—I.mtto Pr- SM - eyercum Vim. V•10 C-s 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. C1.FC.t�10 �- Q��LGo EI.�EL—f 12� ( nl L Company Name of 1�► wa&J(A Printed or Typed Signature Subscribed and sworn to before me this Voi day of M 4 y , 2014. 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. IZP.JO FLOa p— Sdi4 I3F-40AYWIJJO, h Name and Address of Public Agency Name and Telephone No. of Project Manager: 010e) "(.03(p0 'fit, ZG aoo•ab Contract Amount S(6f.lns STVW 1AWII'� 0W7013 Type of Work Date Completed 2. Go�rrty o� 1?,1��V-s t 4ofo Q L�>�lo� sT •�, c C12 SO Z Name and Address of Public Agency 3. Name and Telephone No, of Project Manager: I VA-1,A M91-J O!A 05W) ?jq 9351 4V0,0o®. n Contract Amount Name and Address of public Agency Type of W, Date Completed Name and Telephone No. of Project Manager: Vgy 1 1-i L.Pfl L (02 (0! Contract Amount Type of Work Date Completed t3 C-9 State of California ) CALIFORNIA ALL-PURPOSE County of San Bernardino ) CERTIFICATE OF ACKNOWLEDGMENT On May 19, 2014 before me Jessica L. DuBois, Notary Public (here insert name and title of the officer) personally appeared John Wong 1 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,'she/they executed the same in (!91 /her/their authorized capacity(y6), and that b his her/their 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 Axuqj] Uv OPTIONAL INFORMATION eJESSICA L. DIIM COMM. #2019421 a Notary Public Calitomia o San Bernardino County Comm, res 12 2Q17 (Seal) Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this acknowledgment to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document The preceding Certificate of Acknowledgment is attached to a document titled/for the purpose of Council of the City of Huntington Beach containing 1 pages, and dated May 19, 2014 The signer(s) capacity or authority is/are as: ❑ Individual(s) Attorney -in -Fact ❑ Corporate Officer(s) Tit ❑ Guardian/Conservator ❑ Partner-Limited/General ❑ Trustee(s) (� Other: representing: Name(s) of Person(s) or Entityfles) Signer is Representing 77= __factory evidence: Lo forrn(s) of identification 0 credible witness(es) Notarial event is detailed in notary journal on: Page # Entry # Notary contact: Other _ ❑ Additional Signer(s) ❑ Signer(s) Thumbprint(s) El 0 Copyright 2001 2012 Notary Rotary, Inc. PO Box 41400, Des Moines. IA 50311-0507 All Rights Reserved. Part Number 101772. Please contact your Authorized Reseller to purchase copies OF tnis tone. (For federally funded projects, use this following page) 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 requiremnents 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: EI_C-PJOg_ ova" 0t,(-TNA LI I JJ L Contact Person: t-w vv m c^ Contact Phone: Signed: Date: Alls e 14 0 i *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-10 Local Assistance Procedures Manual E3aDBIT 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) ATTACHMENT C EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder ELEW O It- Q E 1-'G®C' L / 4C • , 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 12-25 OB 12-04 C-11 June 29, 2012 Local Assistance Procedures Manual P5&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 Audi i r-J GT 0 tJ SeA-LO 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 12-27 OR 12-04 C -12 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions ATTACHMENT E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 EXHIBIT 12-E Attachment E 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. NONE 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 12-29 OR 12-04 C -13 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment F ATTACHMENT F NONLO13BYWG 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 sub recipients shall certify and disclose accordingly. Page 12-31 OR 12-04 C -14 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions ATTACHMENT G DISCLOSun OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G COMPLETE THIS FORM TO DISCLOSE LOBBYINU AC:'1_l VIIIE5 ruKNuA1y! !u sl u.a.c:. 1jDL 1. Type of ]Federal Action: 2. Status of Federal Action: 3. Report 'cge on a. bid/offer/application Ela. initia b. grant b. initial award b. matec. cooperative greement c, post -award d. loan For MaterOnly: e, loan guarant year _ quarter f. loan insurance d e o£ last report 4. Name and Address of ing Entity 5. If Reporting Entity ' No. 4 is Subawardee, Enter Name and ddress of Prime: Prime ® Subawar Tier if known Congressional District, if Down 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Addr of Lobby Entity (If individu ast name, first name, MI) 11 12. 14. 1j/b- congressional District, if Down Federal Program Name/Description: \ifdiffer , if applicable 9. , if known: b. forming Services (including t from No. 10a) r 'e, Mi) Z(attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all t $ actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in -kind; specify: nature e deferred value E 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 Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) apply) 15. Continuation Sheet(s) attached: Yes No 16. Infonnation requested through this form is authorized by Title 1 A 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: VVV VVV V �' 0,'/ was placed by the tier above when his transaction was made p or entered into. This disclosure is required pursuant to 31 Print Name: U.S.C. 1352. This information will be reported to Congress I �/,�t� semiannually and will be available for public inspection. Any Tide'TIA�< Cy*r"y 1J 4 R- yy 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 E`j®��t3-s�� ,f `� 0 t� $100,000 for each such failure. Telephone No.: Date: A 7 Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard TFnr LLL Rev. 09-12-97 Page 12-33 OB 12-04 C -15 June 29, 2012 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 (Ml). 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 12-34 June 29, 2012 C -16 OB 12-04 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(<END1F» Page 12-35 OB 12-04 C -1 7 June 29, 2012 FIDELITY AND DEPOSIT COMPANY OF MARYLAND 600 Red Brook Blvd., Suite 600, Owings Mills, MD 21117 Statement of Financial Condition As Of December 31, 2013 ASSETS Bonds............................................................................................................................................... $ 139,272,722 Stocks.......................................... .................................................................................................... 22,258,887 Cash and Short Term Investments................................................................................................... 6,595,113 Reinsurance Recoverable........................................................................ ... 17,970,134 ..................................... Other Accounts Receivable........................................................... ........... 33,409,916 ....................................... TOTAL ADM1TrmASSLts......................................................................................................... $ 219,506,772 LIABILITIES, SURPLUS AND OTHER FUNDS Reserve for Taxes and Expenses..................................................................................................... $ 1,787,480 Ceded Reinsurance Premiums Payable............................................................................................ 42,146,005 Securities Lending Collateral Liability ............................................................................................ 6,613,750 TOTAL LIABILITIES.................................................................................................................... $ 50,547,235 Capital Stock, Paid Up......................................................................................... $ 5,000,000 Surplus................................................................................................................. 163,959,537 Surplus as regards Policyholders..................................................................................................... 168,959,537 TOTAL........................................................................................................................................ $ 219,506,772 Securities carried at $58,378,690 in the above statement are deposited with various states as required by law. Securities carried on the basis prescribed by the National Association of Insurance Commissioners. On the basis of market quotations for all bonds and stocks owned, the Company's total admitted assets at December 31, 2013 would be $223,222,696 and surplus as regards policyholders $172,675,461. 1, DENNIS F. KERRIGAN, Corporate Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing statement is a correct exhibit of file assets and liabilities ofthe said Company on the 31st day of December, 2013. i Secretcy State of Illinois City of Schaumburg SS: Subscribed and stivorn to, before me, a Notary Public of the State of Illinois, in the City of Schaumburg, this 15th day of March, 2014. U Notary Public e Al.. OFFICIAL SEAL DARRYL JOINER Notary Public . State of Illinois My Commission Explres May 3, 2014 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, In the Vicinity of Stacey Middle School and Cleg, Elementary School — CC 1426 May 9, 2014 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for the: Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School - CC1426 shall be replaced with the following attached documents: The Federal Labor Rates dated May 9, 2014 shall be the labor rates in effect for the subject project. 2) SHEET 3 — TRAFFIC SIGNAL PLAN SPRINGDALE STREET AT CROUPIER DRIVE The following revision has been added to Pole Schedule: Traffic signal pole #5 has been revised from 26-4-100 to 29-5-100. The pole height and equipment will remain the same. This is to acknowledge receipt and review of Addendum Number One, dated May 9, 2014. Company Name Y S Ili �20 I L4 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. EX71 712-G Local Assist Procedures Manual Bidder's List of Subcontractors (DBE any :on -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. Annual .... < $1 million _ Description of Porfion:of Work to be Performed u4 = N�'t �q.'� '' �` IfYESIistDBE#: 30 Firm Name/ Addressl :City; State;.ZTP;Receipts- Name t p ��S J f+�L If PA� . Phon Fait!Gross.:: Phone [���Uc p '-1 l 6 ' O 3� <$5million ❑ < $lo million /� .�tJ C4,CTIE W Address W5 NA-#,J ST `City Fax `�`y` Phone � III iti tc, 0 ❑<$15million S ((is N aJ G S -T vt- 1P) e-J Age of Firm (Yrs.) ,� R . ''� . State ZIP`L�j��/ZC el"xVE Name L Tt* f r`c, S �ST ❑ > $15 million <$l million..*,��,,r� $5 million < $10 million If YES list DBE#: Address ,, S(f(rnIWia*, t" . FaxG�l�� `t, y- t 5 3 Phone C9) 41 I / 52p �Q�j ❑<$15miIlion ❑> $15 million � � i� S l �� u! Age of Finn (Yrs.) Q ' '" ,. 4�1\I� ;�,��, .. �� tfYES list DBE #: O33 Ct State ZIP OieATJ rrt c� a 2 5 Name T Lb S < $1 million� ❑ < $5 million < $10 million AAddress s • F-0 b S T • Fax G-7 l L0 'S2+u LAY), Phone ❑ <$15 million ❑ > $15 million Age of Firm (Yrs.) City State ZIP �r o ILA �tZ�uy Name Yi 1` fI s�� ill-i��.l�. � < $1 million �4•t,,��jjttt `Jt i ��w t �a .`#�rc�+ f` y, a-:.. x '. t ❑ < $5 million ❑ < $10 million If YES list DBE #: Address Fax ❑ < $15 million ❑> $15 million Epp 3"ys a ,$n�(w .i`'3Fd..'.g.f,:` City State ZIP ,t• Distributional) Original - Local Agency File Page 12-111 November 14, 2006 LPP 06-06 EXHIBIT i Local Assistance Proced Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DEE and NON -DOE)- 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 44 Section 26 of trie coae of reuerat m Firm Name/::' . City; State, ZIP :.. _ Name ulanons. rLIOLOUUpy Phoine/ '. ' Eax. ::.., Phone Luis wilu 1U1 CLUULU.,,.a. A hnual = : Gross : `. eipt < $1 million •Description of Portion of Work to be Performed. r a i rIf F1 < $5 million --- Address ❑ < $1 o million YES list DBE #: rAg°f��� . xr" . E�x rills !.- c..- : 5a''tE'w..:.,�n?_..-Z.^a"�,,.,w - :; Fax Phone ❑ < $15 million ❑> $15 million < $1 million�� CityState ZIP Name < $5 million Address ❑ < $10 million If YES list DBE #.- P�� � . 3� pax Phone ❑ < $15 million > $15 million CiState ZIP City Name < I million $ ❑ < $5 million Address ❑ < $lo million If YES list DBE #: Fax Phone ❑ < $15 nrillion El> $15 million �� i r �r4ry' 0 , �� ....,•.ak�`h�.4,-¢s,�rw"�:����h,=.:�, City State ZIP Name .1 k, . r .... ❑ < $l million -------_--___..._------------------------ � E]<$Smillion ❑ < $10 million If YES list DBE #: Address p <$15 million City State ZIP ❑> $15 million—_---_--- Distribution:1) Original —Local Agency File Page 12-112 LPP 06-06 November 14, 2006 Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts) EXIT 15-G FOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCALAGENCY: City of Huntington Beach LOCATION: In the vicinity of Stacey MS and Clegg ES PROJECTDE'CRIPTION:Safe Routes To School Stacey -Clegg Project #STRSL-5181(173) CC-1426 TOTAL CONTRACT AMOUNT:, t • V v BID DATE: 5�2rdIZdO' 0`Lf BIDDERS NAME: G l.l�C 6W-, NSu-u CONTRACT DBE GOAL: 10 . 2 8 0 ONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS DBE CERT NO. AND EXPIRATION DATE KAlvM OF EACH DBE (Mast be certified on the date bids are opened - include DBE address DOLLARAMOUNT DBE 0 BE PROVIDED (or contracted if the and phone number) bidder is a DBE) Its e 3 1 5316 00. 45 �fHJ SS' dLL� Kofh.- ion w eJ .E S ILA Z t++ -'(402,10 For Local Agency to Complete: Total Claimed DBE $ . Local Agency Contract Number: Federal -aid Project Number. Participation �+f % Federal Share: Contract Award Date: W Si e of Bidder Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. 12-ally CSa1*i3 7o Date Code) Tel. No. �� j `(/Area Print Name Signature Date MI6 /v Y �+ o t3(0 Person to Contact (Plefise Type or Print) Local Agency Representative (Area Code) Telephone Number. Local Agency Bidder DBE Commitment (Construction Contracts) (Rev 626109) Distribution: (1) Copy— Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 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 15-1 OB 12-04 C -18 June 29, 2012 D THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, THAT WE Elecnor Belco Electric, Inc. 4331 Schaefer Avenue Chino CA 91710 as Principal, hereinafter called the Principal, and Fidelity and Deposit Company of Maryland 1400 American Lane, Tower I, 18th Floor, Schaumburg, IL 60196-1056 a corporation duly organized under the laws of the State of MD as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach Department of Public Works, 2000 Main St., Huntington 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 Safe Routes to School in the Vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426-SRTSL-5181 (173) 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 Lucy Bernatchy 20th day of May 1 2014 Elecnor Belco Electric, Inc. ve- v • . a ,tea s (Witness) V", Fidelitv and AIA DOCUMENT A310 • BID BOND • AIA ® FEBRUARY 1970 ED. ® THE AMERICAN INSTITUTE OF ARCHITECTS,1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 nd (seal) tTtte) CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT State of Connecticut County of Hartford On May 20, 2014 before me, Julie Perry Notary Public Date Name and Title of Notary personally appeared Aiza Lopez Name and or Names 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 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. 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. /J �J Signature Julie erry, Notary Pub�Itary Publrc Signature Place Notary Public Seal Above My commission expires: 7/31/2015 OPTIONAL Though the information below is not required by law, it may prove valuable to the 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 Name: ❑ Individual ❑ Individual ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Partner - ❑ Limited ❑ General ❑ Partner - ❑ Limited ❑ General ❑ Guardian or Conservator Top or thumb El Guardian or Conservator Top or thumb El Attorney-i n -Fact El Attorney -in -Fact ❑ Trustee ❑ Trustee ❑ Other: ❑ Other: Signer is representing Signer is representing EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attomey-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and 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 Article V, Section 8, of the By -Laws of the Companies is still in force. 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 ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." 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 COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and 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 loth 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 seals of the said Companies, this 20 day of MaV , 20 14. s i• ipC SEAL 'A Geoffrey Delisio, Vice President PTM General Engineering Services Inc. 5942 Acorn St. Riverside, CA 92504 (951) 710-1000 Rid Receipt Attn: City Clerk City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 (714) 536-5431 Date of Bid: May 20' 2014 Time of Bid: 2:00 PM Project #: CC No. 1426 Project Description: Stacey Middle School and Clegg Elementary School SR2SL-5181(173) 14 MAY 20 PM 1 5' SECTION C PROPOSAL for the construction of Safe Routes to School In the vicinity of Stacey Middle School and Clegg Elementary School CC No.1426 SRTSL-5181(173) 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 50 working days, starting from the date of 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 summ 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 prices shall govern over extended amounts, and words shall govern over figures. C-1 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 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 bond 10% total bid amount 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", or "Bidder's Bond", as the case may be). Bidder shall sienifv receipt of all Addenda here_ if anv_ Addenda .. 13aie=XZeceived:`rtder`'s Sig 1 5-9-14 C-2 Proiect Bid S chedul.e Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School 1 1 L.S. Mobilization. $ �y3`� 00 $ IaSO•c�o Per L.S. 2 1 L.S. Lpunush.Proj ect Traffic Control. 3 1 L.S. Furnish and Install Traffic Striping and Signing. $ lle 2a� $ ��es Zo • ©r� Per L.S. 4 1 L.S. Construct Traffic Signal at Springdale Street and Croupier Drive. (excludes $ I)q con, cc $ gct@oo.o a interconnect conduit and interconnect cable) Per L.S. 5 2550 L.F. Furnish and Install 2"Interconnect Conduit with 6 Pair 419 Solid Interconnect Cables and Pull Boxes $ L o $ ('0 b, s cZo - o 0 Spaced Approximately 200' (Also includes installation into the traffic signal cabinets). Per L.F. 6 450 L.F. Furnish and Install 6Pair #19 Solid Interconnect Cables in Existing Conduit (Also includes installation $ '� `' a $ ► S s.a into the traffic signal cabinets). Per L.F. 7 18 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B or 2-b ep . Q� Case C and Per Typical Section at $ $ New Ramps Adjacent to AC Paving Detail_ Per EA. G2.1 Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School .� : �... l r �.rl'.L� � �i a��.•. PT � +�y� -. '" a .d"rik.ti,�yF,4*�C �jt�'s d Elirrr �'Nt"� � �,• A�gal� kyes11vJ. v w,x 8 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case F and Sheet 2 Details for Ramp Locations 1 $�" Qo $ and 12. Also Includes Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 9 . 17 L.F. Furnish and Install Metal Railing Per Standard Plans for Public Works (Green Book) Plan 606-2, Type A. $ �o� ° o $ —� too • o� Per LF. 11 Total Amount Bid in Figures: $ - -2 U"-N L.to 0 Total Amount Bid in Words: $ 1r`u�Si,c Yv,� s h.in,•� du.� ���eL`v� GP.r Note: The City will provide the traffic signal equipment, as liswa in the pole scncumu, �zu6u includes traffic signal cabinet, service cabinet and anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 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. ���i�" �ame alxa'GA'd1�rEss af;Subcon�ractbr mate � GY�aai� .I?ollar ` °o of `� � Conixact ✓ S: `' ATy.: _ % , ' '� .. i. :'t- :?,:, ; iimTleti .f' l-�. CT & T Construction Inc. �y iZ 324 S. Diamond Bar Blvd. PMB 275, Diamond Bar, 91765 (b License No. 868434 Exp 11-30-.IS Class C12 & C8 i Tel: 909) 396-8453 Fax: 909) 396-0522 QtC 1 Superior Pavement Markings 14656Industry Circle, La Mirada, CA 90638 0 License No. 776306 Exp: 8/31/13, Class C32, C31 Tel: 714) 562-9100 Fax: 714) 995-9400 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. i 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds fuurnished by subcontractor for this project. C-3 x A °' ; NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 5-19-14, at Riverside CA Date City State _Elizabeth H. Mendoza de McRae , being first duly sworn, deposes and says that he or she is President/CFO of PTM General Engineering Services 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 fax 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. C-4 PTM General Engineering Services Inc. Name Bidder Elizabeth H. Mendoza de McRae President/CFO Signature of Bidder 5942 Acorn St. Riverside, CA 92504 Address of Bidder 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 CC-1426 SRTSL-5181(173), Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School, (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: 5-19-14 C-5 PTM General Engineering Services Inc. President/CFO Title Elizabeth H. Mendoza de McRae DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, 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 �. A 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 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. i j PTt l General Engineering Services Inc. Contractor Elizabeth H. Mendoza de McRae ByG President/CFO Title Date: 5-19-14 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: PTM General Engineering Services Inc. Bidder Name 5942 Acorn St. Business Address Riverside, CA 92504 City, State Zip ( 951 ) 710-1000 Telephone Number 891265 A C10 C31 C27 C32 B C61/D42 HAZ C-7 C13 C61/D09 State Contractor's License No. and Class 10-6-06 Original Date Issued 2-21-15 Expiration Date The work site was inspected by Brian Mendoza of our office on 5-19 , 2014 . The following are persons, firms, and corporations having a principal interest in this proposal: Elizabeth H. Mendoza de McRae President/CFO Brian Mendoza Secretary/V.P. PTM General Engineering Services Inc. C-8 CERTIFICATE OF CORPORATE RESOLUTION 1 Brian Mendoza , Secretary of PTM General Engineering Services Inc. (Corporation) do hereby certify that at a duly constituted meeting of the Stockholders and Directors of the Corporation held at the office of the Corporation on December 30 2 0 07 (year), it was upon motion duly made and seconded, that it be VOTED: Elizabeth H. Mendoza de McRae, President/CFO ..... OR.... Brian Mendoza, Vice President/Secretary Authorized to sign & execute contracts and submit bids with either one of the corporate officer's signatures. It was upon further motion made and seconded that it be further VOTED: That Elizabeth H. Mendoza de McRae, President/CFO .....OR. ... Brian Mendoza, Vice President/secretary in the capacity as of the Corporation is empowered, authorized and directed to execute, deliver and accept any and all documents and undertake all acts reasonably required or incidental to accomplish the foregoing vote, all on such terms and conditions as he in his discretion deems to be in the best interests of the Corporation. I further certify that the foregoing votes are in full force this date without rescission, modification or amendment. Signed this / O day of M>,- � (year). A TRUE RECORD ATTEST (Corporate Seal) 53 Brian Mendoza — a Secretary/Clerk Vice President/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. PI General Engineering Services Inc. Name Signature of Bidder Elizabeth H. Mendoza de McRae President/CFO Printed or Typed Signature Subscribed and sworn to before me this 19th day of Mav___— 2014 I,, - 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. City of Rosemead 8838 E. Valley Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr. Rafael Fajardo 626.569.2100 Hellman/San Gabriel $482,024.30 PTM Pr - 12/13 Contract Amount Type of Work Date Completed 2. Ci1y of Placentia 401 E. Chapman Ave Placentia Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr, Michael McConahan 714.993.8117 Rose Dr. & Yorba Linda 12/ 13 $124,533.43. PT -07 Date Completed Contract Amount Type of Work g City of Huntington Beach 2000 Main St Huntington Beach, CA 99649 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr. David Verone 714.536.5431 Safe Routes to School -Golden View $146,703.60 PTM Project No. 12-12 9/13 �'P Contract Amount Type of Work Date Completed C-9 �e�'.,��'1'�=�.i-�..s^i-'.r4�,e�-�$re'�-e• .ti - ..c- „ter•'C^..r5^,c"o^.'c�ec'cct'--1".,.T.�—,:':�s2i,�.-`,".mac'sec.'ZY��.�i'rc��q�•;�6�•C�'���";� Uzi'. State of Cailtomia County of ORANGE On 4�7' 5 `( 1 • Lid l �f before me, Philip Vega, Notary public Dale Here nsari Name and Tilt a al t o Qtflcer personally appeared ELIZABETH H. MENDOZA de MCRAE sma ^ of Slgnar(,%) who proved to me on the basis of satisfactory evidence to be .the person(/i) whose names) is/gre subscribed to the within Instrument and acknowled to me that heMW/Iexecuted the same in hid/Ml6lr authorized PHILIP VEGA CapaCtty(1 5), and that by hIdNei/Meir signat:A(s) on the o COMM. 1111977088 instrument the person(g), or the entity upon behalf of m NOTARYPUBLIC- CALIFORNIA o which the person(g) acted, executed the Instrument LOSANGELESCOUNTY My Comm. Expires MAY 31,2018 I certify under PF-NALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and o eal Signature Plaoa Notary Seal Above �atlrre of Noinry Puhllc ------ OPTIONAL 4Though the information below is not required by law, It may prove valudble to persons re ing on the dc4umenf and could prevent fraudulent remove) and reattachment of this form to another document, Description of Attached Document Title or Type of Document: Document bate: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer Title(s): ❑ Partner — U Limited ❑ General ❑ Attorney in Fact F.1 Trustee Top of thumu nete ❑ Guardian or Conservator 0 Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer -- Titie(s): * Partner —❑ Limited ❑ General ❑ Attorney in Fact Q Trustee n Guardian or Conservator Other: Signer Is Representing: RISKDTHUMBP,flINi ' QFSIGNER . Ni U2007NedonalIslalaryAaaodatlori•9350DoSol.Ave,P,O,Box2g02•Chataworli,CA81313.2a02•www,NallonalNolaryAfg [lam05907 Roordnr.CallYol)-Fres1.800.878.8027 Original Bid Contract Amaunt Class } of Work Date Ca m let Describe any Claims Mediation Amount and TvnP of Name, C0nut Mdx� ess and Arbitration or lawsuits amount Chan,--- e Qtders d resulfis Original Bid xe man Ban e Tele hon of Own 428824.30 PM Project No.13-13 gyn� A Eric g y Project No. ESPL 5358 12 2013 / None City of Rosemead 482024,30 53200_00 . 8838 B. Valley Blvd, Contract award Rosemead CA 91770 Mr. Rafael Fajardo date : • Yr . 2013 (626) 569-210o Ongi 39333.00 Pedestrian Crossing PTM Project No.13-20 12/2013 City of Norwalk Final Agency Project No_ 7191 None 12700 Norwalk Blvd 1215.00 Norwalk CA 90651 40548.0 Contract award Mr_ Julia Jimenez 562-929-5700 date: Yr. 2013 Orlginal BZd 89899.00 Safe Route to School PTN Project No_13-21 Project No. 61114 12/2013 City of Placentia Final None 401 E,Chapman Ave. 7800.00 Placentia,CA 92870 97699.00 Contract award „ Mr_ Michael McConaha (714) 993-8117 date: Yr. 2013 Oxi91n 218812.0 Ramona Road and Monterrey Avenue Final PTM Project No.13-01 12/2013 None County of Riverside 3525 34th Street 244021.60 Agency Project No, C2-0151 Contract award 25209.60 Riverside, CA 92501 Mr_ Joel Jimenez 951 624-7200 date: Yr. 2013 Original Bid Contract amount Class Date Describe Claims_ 1�V my e,�zation ,Amount and. T s,oe of Name, Contact, Com eted AxbirEration ox lawsuits amount Change Oxdexrs s nd 1 Traffic signal andx is _ Tel n o Owner City of Garden Grove 553333.0 PTM Project No.13-05 Agency Project No. 7125 22/2013 None 11222 Acacia Parkway Final award Garden CA 92840Contract 22465.00 Mr. Dai_C. VIu 575798.0 date: Yr. 2013 Y 714-7415186 Original Bid 116611.00 Monroe Street & Orange PTM Project N0.13-06 City of Pomona Agency Project No. 418-73371 22/2013 None 505 South Garay Ave, Final 5781.00 PomonatCA 91769, Mr. Atl Eakandari 122392.00 Contract award (909) 620-2261 date: Yr. 2013 Original Bid 31399.50 Rose Dr R Yorba Linda City of Placentia PTM Project No.13-07 Agency Project No. 61095 12/2013 None 401 E. Chapman Ave. Final Contract award 93139.00 92870 124533.43 Mr.PlaMitia,CA Mr_ chael MCConaha date: Yr. 2013 (714) 993-8117 Original 0 2673500. 00 Ave & Frazier at At City of Baldwin Park r Ave. Traffic Signal FStewart llationFinal roject No_12-OS 06/201.3 None 14403 E. Pacific Avenue293852_00tract award 26602.00 Baldwin .91706 or H.CA avezMr_ Victor H. Chaveze : Yr. 2 012 973 624-7200 Original Bid CVS Phar7Gmmacy PTM Project No.12-07 25000.00 CVS Pharmacy 09/2012 5176 E. Whittier Blvd Final Contract award None 2829.00 Los Angeles,CA 90022 27829.00 date: Yr . 2012 Mr. Michael Madrid • sr ' 909-821-5422 Original Bid Accessible Pedestrian Signal City of Palm Desert • 144944.00 Project Final PTM Project No.12-08 06/203.3 - 73-510 Fred Waring Drive Agency Project No.562-12 None 0 Palm Desert.CA 92260 144944.00 Contract award Ms. Rachelle D_ Klassen Idate' Yr. 2012 310-395-7887 9rignal Bid Contract Amount Class ) of Work Rate Completed Des9de any Claims Mediation. Amount and Tyne of Chansme Orders Name Co tac, A ess and Axbitrati on or Iawspits amount and =esuZts Te one of er Original Bid SBEe Routes To School Cycle A City of Rosemead 6SSOAS.00 Project 03/2013 PTM Project N0.12-9 None 8838 E. Valley Blvd, Final Contract award 30988.00 Roaemead,CA 9i77o 686033.00 date: Yr. 2012 / Mr. Rafael Fajardo 973 624-7200 Original Bid Safe Routes To School Go an 141141.00 View Project City of Huntington Beach PTM Project No.12-12 09/2013 None 5562 2000 Main Street Final Agency Project No. CC 1402 .00 Huntington Beach,C4 92640 146703.60 Contract award Mr. David verone date : Yr. . 2012 714 536-5431 Brian Mendoza P.O. Box 7745 Riverside, CA 92513-7745 Email: brian@ptm-eng.com • Cell 951.722.5755 Chief Estimator and Supervisor of Outside Operations Supervisor of outside operations with over 18 years of experience. Electrician with over 20 years of experience. An effective communicator and team leader; experienced in coordinating and executing large and fast -paced projects. CAREER EXPERIENCE Freeway E►ectric/PTM General Engineering Services, Inc. Riverside, CA 06/2006 to Date Chief Estimator/Supervisor of Outside Operations In charge of managing the estimating department and finalizing bid packages; coordinating the beginning phase of an awarded project between the company and agency. Project submittals, contract review. Coordinated and managed crews California region; handled various sized projects ranging in size from $1,000 to $4.5 million dealing with dry utilities, wet utilities, traffic signals, and road improvements. Maintained coordination Freeway Electric/PTM General Engineering and subcontractor, and project owners. In charge of handling project's administrative work; monthly gross estimates, project progress schedule, materials requisitions, contract change order negotiations and equipment purchase and rentals. High Light Electric Inc./Pete & Sons Construction Inc. Riverside, CA 10196 to 06/2006 Chief Estimator In charge of managing the estimating department and finalizing bid packages. Coordinating the beginning phase of an awarded project between the company and agency or prime contractor; project submittals, contract review. Successfully bid on projects totaling $12 million with an average spread 6%. Area Supervisor Coordinated and managed 10 crews consisting of 6 members per team in the southern California region; handled various sized projects ranging in size from $1,000 to $4.5 million dealing with dry utilities, wet utilities, traffic signals, and road improvements. Maintained coordination between High Light Electric Inc and subcontractor, general contractor and project owners. In charge of handling project's administrative work; monthly gross estimates, project progress schedule, materials requisitions, contract change order negotiations and equipment purchase and rentals. Continued... BRIAN MENDOZA • Page 2 CAREER EXPERIENCE CONTINUED MBE Electric Inc. in Riverside, CA 10/1998-10/1996 Vice President and Head of Outside Operations Managed outside operations for all projects ranging in size from $1 to $2.5 million. Headed an around the clock electric crew and coordinated with CC Meyes to repair the I-10 Santa Monica Freeway after it collapsed during the 1994 Northridge Earthquake to complete the fast paced project in 66 days: Maintain coordination between MBE Electric and subcontractors, general contractor and project owners; implemented and enforced safety guidelines. Handled administrative work; monthly progress estimates, material requisitions, contract change order negotiations. Vasco Corporation in San Fernando, CA 10/1987-06/1998 Foreman (Part Time) Managed day to day operations of work crews and various projects ranging in size from $1,000 to $5,000 in Eastern Los Angeles County; traffic signals, street lighting, signal interconnect. Raymor Electric in. Rosemead, CA 06/1986-10/1987 Crew Leader (Part Time) In charge of work crew on projects ranging from $25,000 to $250,000 through out Los Angeles County. WORK SHILLS • Capable of operating heavy equipment such as skip loaders, cranes, and backhoes; • Hands-on experience with hand tools and power tools; • Capable of overseeing fast -paced and high profile projects; • An effective communicator and leader; EDUCATION • International Brotherhood of Electrical Workers Completed training course (1988-1989) in street lighting and traffic signal installations, code enforcement and blue print reading. • South Gate High School Received High School diploma in 1988 BRIAN MENDOZA • Page 3 CAREER EXPERIENCE CONTINUED PROFESSIONAL MEMBERSHIPS • International Brotherhood of Electrical Workers (IBEW) • National Electrical Contractors Association (NECA) ACCREDITATION e IBEW-Journeyman Wireman; CSLB-Electrical Contractors; Certified Trench Safety Coordinator. • English (Native) • Spanish (Fluent) LANGUAGES AWARD RECEIVED • Recipient of the U.S. Small Business "Young Entrepreneur of the Year" Award in 1996, nationally. • Recipient of the Certificate of Recognition by the City of Los Angeles for "Small Business" in 1997. • Recipient of the Certificate of Recognition by the City of Riverside for "Small Business" in 1997. • Recipient of the Certificate of Recognition by the State Assembly, Assemblyman Mr. Rod Pacheco, for the "top 500 Inland Empire Small Business" in 1997. • Ranked among the "Top 500 Inland Empire Hispanic Owned Companies" since 1997. • Certification of Appreciation for our participation and maximization in the "Century Freeway Affirmative Action" by CFAAC. PROFESSIONAL AND PERSONAL REFERENCES Caltrans project #07-1224U4 (Electrical contract amount $4.5 million) Project completed in 2005 Description of project: Installation of traffic signals, ramps metering, sign illumination, Highway lighting, fiber optic communication, and electrical irrigation along the I-10 Freeway in Los Angeles County. • Doug Dwason-Project Manager for prime contractor, Balfour Beatty Cell (949)232-3276 and Office (909)397-8040 • Patty Galvan- Resident Engineer. Office (909)594-4270 • Veronica Ross -Electrical Inspector. Cell (714)606-6311 BRIAN MENDOZA • Page 4 CAREER EXPERIENCE CONTINUED City of Redlands Contract #208300-72304/41008 (Electrical contract amount is $218,800) Project completed in 2003 Description of project: Installation of traffic signals, modification of ramp metering, lighting and sign illumination. Bill Hensley -Senior Civil Engineer- Office (909)798-7586 ext 2 Juan Olvera-Project Manager for general contractor, H&H Construction- Cell (951)453-7712 and Office (909)473-7331. Caltrans project #08-4567V4) Electrical contract amount is $938,238) Project completed in 2005 Description of project: Installation of lighting system along the I-5 Freeway in San Bernardino County. • Gary Vogel -Project Manager form prime contractor, Granite Construction Cell: (661)549-3953 and Office (661)726-4447 Sanbag Projects, Segment 1, 2, 3, early segment 9, segment 9, and alder Ave. (Total electrical contract amount was $3.2 million) Project completed in 2004. Description of projects: Installation of traffic signals, ramp metering, sign illumination, highway lighting, fiber optic communication, and electrical irrigation along the I-10 Freeway in San Bernardino County. Harold Lantis-Sanbag Contract Manager- Cell (760)802-7730 and Office (909)875-8029 ext 213. Tim Hanable-Caltrans Inspector- Cell (951)712-0021 Al Ortega- Project Manager for prime contractor, Yeager Shanska- Cell (714)240- 5333. City of Indio Project #ST0137 (Electrical contract amount was $1.4 million) Project completed in 2005 Description of project: Installation of street lighting system, traffic signals, electrical irrigation, and dry utilities. • Gary Baxter -Area Manager for prime contractor, Yeager Shanska Construction - Cell (909)721-9749 and Office (760)343-5472 • Tommy Young -Project Manager for prime contractor- Cell (951)232-6618 and Office (760)343-5472 • Mehran Sepehri-City Engineer- Cell (760)250-2201 Additional Professional References: • Zale Harris-Caltrans Inspector- Cell (951)289-0047 • Ray Robles-Caltrans area supervisor- Cell (909)799-0646 (For federally funded prof ects, use this following page) BIDDER'S CERT'F'CA'T10TN* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AIv1MENDED 1N 1992, Code of Federal Regulations, Part 135* SECTION 3 TITLE 24, Economic Opportunities for Low and Very Low -Income Persons ed certifies that except as noted below, any person associat The bidder, under penalty of perjury, 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 xequiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or X Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. LM- This certification shall apply to the prime contractors sub -contracts related to this project. PTM General Engineering Services Inc. Contractor: Contact Person: Elizabeth endoza de McRae Contact Phone: 951.722. 8 i Signed: Date: 5-19-14 *Note: The above certification is required by the Department of Housing and Urand ban (24 CFR 135 and Subtitle A et al) and anbe subc subcontracts whichsubmitted by eareddbJ ct to Development in connection with contracts proposed sub -contractors only amended in 1992 (IiITD)• Section 3 of the 1969 Housing and Urban Development Act, as Will adhere to project specs and be in compliance at all times. C-10 Local Assistance Procedures Manual PS&E Checidist-Instrnctions a The �xmoarr z2-E Attachment C (1TiE B)IDDER'S EXECUTION ON THE SIGNATURE PORTION OF THES' PROPOSAL 1YON OF SHAD .CERTIFICATIONS WNCHARE A �RT OF � PROPO AL) THOSE ATT,A,CMMNT C EQIIALFWLOYNMNT orroRTUMW 0FRT1FXCAT10N• PTM General Engineering Services Inc. , proposed hereby certifies that he has_x--, subcontractor pp clauses as r aired eot to the equal e9. has not_, participated in a previous co12tract orris -thAw aerte e�utred, he has filed with the joint Reporting by Executive Orders 10925, 11114, or 11246, Committee, the Director of the Office of Federal Contract Compliance, aFederal Govem�mennitLyco�l��� due administering agency, or the former Presidents Committee on Equal EmploymentOPP under the applicable filling requirements. O Note: The above certification is required by the Equal Employmentt pportunity Regulations of the Secretary of Labor (41 CFR. 60-1.7(b) (1)), and must be submitted by bidders and proposed o bcontraa�e. Only in connection with contracts and subcontracts, which are o b ty claequal et f � 41 CFR 60-1.5. and subcontracts which are exempt from the equal racts oPP (Generally only contracts or subcontracts of $10,000 or under are exempt) Currently, Standard F orm 100 (EEO-1) is the only report required by the Executive Orders or (heir implementing regulations. Proposed prime contractors and subcontractors Who have participated in a -previous contract or fil:od the required reports should note that subcontract subj ect to the Executive orders and have and subcontracts unless such contractor submits a 1 CFR 60-1.7(b) (1) prevents the award ofntracts report covering the delinquent period or such other period specified by the Federal liighWay Administration or by the Tirector, Office of Federal Contract Compliance, U.S. Department of Labor. OS 12-04 Page 12-25 C-11 Jt[ne 29, 2012 kcal Asdstance Procedures Manual PS&E CIiecldistf-str rdom C� ATT ,,cw, Te.NT D NONCOLLYJSION AFM AVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) F,)M"n 12-E ,A.ttachment D To the CITY /COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In accordance ovith Title 23 'United States Code Section 112 and public Contract Code 7106 the bidder declares an undisclosed Person' partnersb1P� °Ompa'°-y° P that the bid is not made in the interest of, or on behalf of, y that the bidder has not association, organization, or corporation; that the bid'zs genuine and not collusive or sham; . tl or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or drrec y indirectly colluded, conspired, connived, or agreed with- any bidder or anyone else to put in a sham bid, or at refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by anyone shall other bidder, onto agreement, communication, or conference with anyone to fix the bid price of the bidder or any rof t, or cost element of the bid price, or of that of any other bidder, or to secure any advantage fix any overhea � P against the public body awarding the contract of anyone interested in the proposed contract; that all statements twined in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid con any breakdown thereof, or the contere con -tents thereof, or divulged mfo�nation or data relative thereto, or pas Price or lion, bid depository, or to and will not pay, any fee to any corporation, partnership, company association, organim any member or agent thereof to effectuate a collusive or sham bicL Note: The above NoncOUusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature ofthis Noncollusion A$tcerti bidders are cautioned that making a false certification may subj ect the certifier to criminal prosecution. Pace 12 27 June 79, 2012 C-12 OB IZ-04 Local Assistance procedures Manual Attachment E pS&E Checklist Instructions ATTACHMENT E DEgAMmNT AND SUSPENSION CER'TMCATION 'I`ITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty&Petuxy> certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager• debarment, voluntary exclusion, or determination of ineligibility by Is not currently under suspension, • any federal agency; . d, voluntarily excluded or determined ineligible by any federal agency Has not been suspended, debarre 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 in fraud or o$tcial misconduct within the pass 3 years- Tf there are any exceptions to this certification, insert the exceptions in the following space. if in denial of award, but will be considered in determining bidder Exceptions will not necessarily agency' and dates of responsibility Fox anY exception noted above, indicate below to whom it apptieS, nutaating action. e information may result in criminal Prosecution or a.dminislxa o sanctionstion thereof Notes: Providing fall Proposal.Signing this Proposal on the signature por The above certification is part of the shall also constitute signature of this Certification - page 12-29 June 29, 2012 C-13 oB 12-04 Local Assistance Procedures Manual FOUMIT 12-E PS&E Checklist Instructions Attachment F �. ATTACBN NT F NONI.OBByfNG CERTunCATION FOR FEDERA71-AM 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 o�ftcer 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 ofthis certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. page 12• 31 n _ a June 29, 2012 OR 12-04 N/A= Not Applicable Local Assistance Procedures Manual PS&E Checklist Instructions ATTACHMENT G DIsCLoSIIRE OF LOBBYING ACTIVnUS ExiaBIT 12-E Attachment G i. �.1352 1. Type of Federal Action: 2. Statas of Federal Action: 3. Report Type: ❑ a contract ❑ a. bid/ofter/applicadon F-1 a- initial n/a b. grant n/a b. initial award b. material change e, cooperative agreement c. post -award n/a d. loan e, loan guarantee f: loan insurance 4. Name and Address of Reporting Entity ❑ Prime Subawardee n/a Tier , if known Congressional District, if known 6. Federal Department(Agency: n/a 8. Federal Action Number, iflmown: n/a 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) n/a For Material Change Only: year ^ quarter date of last report 5. rf Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: n/a Congressional District, if known 7. Federal Program Name/Description: n/a CFDA Number, if applicable 9. Award Amount, if known: n/a b. Individnals Performing Services (including address if different from No. 10a) (last name, first name,1v11) n/a (attach Continuation Sheets) if necessary) II. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) ` $ actual planned a. retainer n/a b. one-time fee n/a 12. Form of Payment (check all that apply): c. commission d. contingent fee a_ cash n/a nature---- e e b. itr-kind; sp ify: £ other, specify value 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: n/a (attach Continuation Shwt(s) i(f'laces 15. Continuation Sheets) attached: Yes L1 No IX! 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 fierabovewhen his transactionWas made Elizabeth H. Mendoza de McRae or entered into. This disclosure is required pursuant to 31 print Name. US.C.1352. This information will be reported to Congress president/CFO smajannually and will be available for public inspection. Any Title - person who farts to file the required disclosure shall be subject to a cWA penalty of not less than $10,000 and not more than Telephone No.- 951-722-5678 Date; 5-19-14 Sloo,000 for eaoh such falore• Authorized for Local Reproduction Standard Form - LLL Federal Use Only: C-15 OR 12-04 Page 12-33 June 29, 2012 A. 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 Ming 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 amaterial 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. S. 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 aI FP) number, Invitation for Bid (XFB) 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 awardlloan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the fall 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 12-34 C-16 OB 12-04 June 29, 2012 L Local Assistance Procedures Manual E-IM"1T 12 E PS&E Checklist instructions Attachment G 14. Provide a specific and detailed description ofthe 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 of 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, A.C. 20503. SF-LLL-Instruction Rev.06-04-90t<RNDIF» Page 12-35 C -17 June 29, 2012 OB 12-04 Local Assistance Procedures 1Glanual EYEEB CT 15-G Local Agency Bidder )DBE Commitment (Constmction Contracts) EXE0031T 15—G LOCAL AGENCY BIDDER DBE COM sffrl 7TNT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO iNSTR'O MOMS ON TBTE REVERSE SIDE OF THMS FORM LOCAL AGENCY: City of Huntington_ Beach LOCATION:In the vicinity of Stacey MS and Clegg ES PR07pX_7DE.gCRIP"I`T0N:Safe Routes To School Stacey -Clegg Project #STRSL-5161(173) CC-1426 TOTAL CONTRACT AMOUNT: $ BIDDATE: 5-20-14 13IDDERSNAME: PTM General Engineering Services Inc CONTRACT DBE GOAL: 10 2 8 % NTRAGTCTEM NO. OF WORRAND DESCRIPTION DR SERVICES TO BE s,mcoNTRACTED OR MATERIALS O BB PROVIDED (or contracted if the idder is a DBE) BE CERTNO. W(PIRATION (Must DATE AME OF F-AC14 DBE be certified on the date bi e opened - include DBE address phone number) I LARAMOUNT BE e orms DBE: 37133 3841 Roswe I Ave. Unit hino CA 91710 For Local Agency to Complete: Local Agency Contract Number.Parac Federal aid Project Number: Federal Share: Contract Award Date' Local Agency certifies that all DBE certifications have been verified and information is complete and accurme. 7?rintxame 5igu3luro Date Local Agency Representa&c; (Area Cade) Telephone Number. Total claimed DBE pat on o/0 Signature of Bidder 5-19-14 951-710-1000 Date (Area Code) TeL No. Elizabeth H. Mendoza de McRae Person to Contact (Please Type orPrint) Local Agwey Biddor DBE Commitment (Constnutioa Contracts) (Rev 6/26/09) Distribution: (1) Copy -Fax or scan a copy to the Caltrans District Local Assistance Engineer (DI AFC Within 30 days of contract cxcaxfion Failure to send a copy to the DIAE within 30 days of contract execution may result in oject de -obligation offonds ds for this pr (2) Copy -Include in award package to Caltrans District Local Assistance (3) Original -Local agency files C-18 OB 17-04 Page 15-1 Jenne 29, 2012 Local Assistance Procedures Manual EXkmrr 15-G Local AgeacyBidderDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) ALL BIDE+ RS: PLEASE NOTE: This information may be submitted with your bid. 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 )DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract_ Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and'Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBB. �� Esa�rProvtde a certification number to the Contractor and expiration date. Enter the DBE prime's certification numbers -The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). RVTOItTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier BE Subcontractors and their respective item(s) of work listed should b e 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 DBE participatiob submitted with your bid pursuaIlar amount Enter the T nt to the Special 7rovisions (if dollars 0%Sof and percentage amount of items of work s Y item is not to be performed or Punished 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 15-0 mast 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 Local Agency Con is Award, a fete and accurate before tuber, and � Share, Contract Award Date fields and verify that all informationP filing. Page 15-2 C 19 big 32 -04 June 29, 2o12 Exhibit 15-EC Local Assistance Procedures Manual DBE Information - Good Faith Effort EDIT 15-H DBE XNFORMA.TION --GWD FA'M EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. SR2SL-5181(173) Bid opening Date 5-20-14 Huntington Beach,. A � Business Ente rise (DBE) goal of The County ofl establi2d a Disadvantaged i7' 10.28 % 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 DBE Commitment" form indicates that the bidder has e the DBE go bidderal. This will protect to me trthe goal fore variolitY us award of the contract if the administering agency reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment' form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. ission of DBE Commitment" of the Special The following items ate listed in the Section entitled "Subm Provisions: for for this P ipation A. The names and dates achease attach o adveertis men Dor proo£scof pubUcation)roject was placed by the bidder (p Publications Go Dates of Advertisement B. The names and dates of written notices sent to oeertifi d initial D-B soliciting to ds for t1 iPrt� Y and the dates and methods used for following up whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.)-- Names ofDBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation Page 15-1 C - 2 0 June 29, 2012 OB 12.-04 Exhibit IS-H Local Assistance Procedures Manual DBE Information -Good Faith Effort l~ C. The items of work which the bidder made available to DBE 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 DBE participation.. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of (YfN) Contract Goals met D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the fnms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's r6j ection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: Roswell Ave. Unit Chino, CA 91710 909-680-8123 E. Efforts made to assist interested DBEs 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 DBEs: Goals met Page 15-2 C-21 0$12-04 June 29, 2012 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: Goals me G. The names of agencies, organizations or groups contacted to provide assistance in. contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of A ency/Or anization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): Goals met NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECES SARY. page 15-3 C- 2 2 June 29, 2012 OD VA4 Local Assist : Procedures Manual W Bidder's List of Subcontractors WE an" �On-ABF SIDDERIS LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (bothDBE and non DBL) accordance ttwith Section 2-1.054 of the actor elsewhere i11 the proposal. Pho ard Specifications form for additional firms.dper Title 49, Section 6 ll of the Cade of Federal Regulations• This listing is required in addition to listing D 1 t.. ?Itorie%' ' r: Ai1I1Ual1;,, Firut Name% - orfioxi of Worl to die Pex£ormed : Gross=;;" Descripiion:of 'Address'" : �F v,�: r r ,... .City' Sfate;.DPReceYPfs <$1 million a 5 million ,' CT & T Construction Inc. p lY'k IfYESIistDBE #: 324 S. Diamond Bar <$lOmillion Blvd. PMB 275, Diamond Bar, 91765 License No. 868434 Exp 11-30 t� Class C12 & C8 <$15million Tel: 909) 396-8453 Fax: 909) 396-0522 Age ofFirm (Yrs-) ❑> $15 million CttyBtateZIP i A'fii"•fa.` ,. <$1 million Superior Pavement Markings 5mulloa 14656 Industry Circle, La Mirada, CA 90638 [j<$10.11ion License No. 776306 Exp: 8/31/13, Class C32, C31 <$15 million Tel:714) 562-9100 Fax: 714) 995-9400 Cf>$15million 1 Ctty State ZIP Phone <$1 million :a Nam¢ Address City State ZIP Fax million 0 <$IS million > $15 million Phan¢ < $1 million Name [' <$5 million million Address Fax <$15 million > $15 million City State ZIP Distributlom 1) Original -LoealAgenoyFile Age Age DBE Page 12-111 November 14, 2006 LPP 06-06 Local .Assistance Procedures Manual BXSIBJ.T Bidder's List of Subcontractors (D)3B and Non BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PARTY per Title 49, Section26.11 ofthe Cod of The bidder shall list all subcontractors (both DBE and non-D F) DBE Sub ontrac o s eccordance with sewhereon ointhe proposal. 54 of the Standard eathis fotiOns arm for additional firms. Federal Regulations. Thus listing is -required in addition to listing ._ ua''d ; �oiie% :;Annl,::=> :' - 'on "of Woxkto 1)eF forme n a �+irmNamie/: .;? Descxxptioitioirta. s' .'T+ax' Gxossr:: s. Sfate, `LIIj ' eCBI is ^_. •:City, `."•: <$i million S Name - Phone [] <$5 million j} YBS list DBE ff: <$10 million Address ❑<$15 million Fax Age of Firm (Yrs.) City State ZIP Fax <$1 million <$5m ionllionll Phone ❑<$1 million Nante []< $5 million <$10 million Address Fax < $15 mWlon ❑> $15 million City State ZIP Phone EJ <$1 million Name rm,$5 roillion Fax ZIP Distribution.. l) Original - Loud AgonoYFile UP 06-06 > $15 Ago list list Page 1 -111 Nov,- her 14, 2006 Local Assistance Pro ced .tual EMMIT1 Bidder's List of Subcontractors BE and Non -DBE) BIDDER'S LIST OF S9Ji�C01�1'TRACTOItS (DBE and NON -DBE PART' This is required for complianceW" 4 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on p J ' 1; al Re ations. Photoc this form for additional Title 44 Section 26 of the Coda of Feder Aiauual : �r " :: = ' :''. _ ••: ' ' "' ' `` Plioxie! • " -; `' 'escxi tion of Portion'of Workto'be Perfoxu><ed " L'ityi S�tate,'ZIP <$1 million r---- -- __ --- — Sterndahl Enterprises, Inc. <$5 million k if Bfi# 11861 Branford St, Sun Valley, CA 91352 <$10 million License No. 421823 Exp: 4/30/14, Class A, C31 & C32 <$15 million $ i Tel: 818) 834-8199 Fax: 818) 834-8618 n>$15million 14656 Industry Circle, La Miraa �Te1 714) 562 9100 F x4) 995 9400 \ f(y i C2 B &T Works Inc 23905 Clinton Keith Rd, Suite 114-351, Wildomar, CA 92595 Licenses # 784833 Exp 9-30-14, Class A & C12 Tel (951) 775-6617 Fax: (951) 696-3749 M. State w Chrisp Company P.O. Box 1368, Fremont, CA 94538 License No. 374600 Exp 5-3-13, Class A, C13 & C32 Tel: 909) 746-0356 Fax: 909) 820-1311 City State ZIP Distribation,1) Od&d—LooalAgenOyPile ❑ �$1 million Uhoa [] <$10 million rl—<$15m Ilion ❑<$1rz ❑<$11 UP 06-06 Page 12-112 November 14, 2006 Local. Assistance Proced- ,--aual MXMZT z BE and Non -DBE) Bidder's List of subcontractors (DBE and NON-DB1E)- FART 11 BIDDERIS LIST OF SUBCONTRACTORS This is required for compliance wi � a subcontractor on tbis project. 4; • er shalt list all subcontractors who provided Thebldd a quote or bid but were not dditional ftrms?pate tbisformf • Title 49 Section 26 of the Coda of Feder alRe aiions, Photoco Ahnuat :•`r: ..+•. ,: :' :.;: ` Plio e/:.'" ; : ,.., .:'' :' M ::: :t= •Z+'irmNam ,. _ _ orkto'bePerformea - +'-�xossT'-Descziption ofPortzon'oiW •-j_• _ ,,' � Addiress/"_:,as• .;,' ir: r• �:; •.w�.2.ecei fs' •,.= •} - - CT &_T. ....rrx n n 7 Di r moon If XES IlstDBE #' $10 —2g ❑ G million ;—L-ice a o. 868434 Ex Class C12 & C8 <$15million � Ys r Tel: 999� 3/ _-9�99j r >$15million City State Z1P Phone <$l million r Name ��i LkSbg2t $5moon C If IDBE#- ❑<$lOmillion Address ❑ G $15 million Fax aka `�p 1a35"L [j'$15mi1tioa C�ityState7dP tii GG <$1miW n ' Phone G�'Dk � $5 mon d ,p If yE BE #• V M ❑<$IOZIWion Address Far E1<$151ni110n '6�'o.2 0>$15million Cityaate ZIP bpts co '�1Cle 5 � rl<$1million Traffic Loops Crackfilling, Inc. 946 S Emerald Street, Anaheim, CA 92804 License No. 652956 Exp: 8/31/14, Class C10, C32 DBE # 38033 El< Tek 714520-4026, Fax: 714-520-4027 Elf T E:I> City State ZIP II` Dlsf bution.1)OdOW—LOMI-49enay-I"" LPP 06-06 Local Assistance Proced. -,lual EXHIBIT 1 Bidder's List of Subcontractors BYand Non -DBE) (1D13E and NON -DBE PART 1'z1lils gIp®ERIS LIST OF SUBCONTRACTORS is required for compliance with bid but were not selected to participate as 4; The bidder shall list all subs actors who provided a quote or this form for additional. Code of Federal Re ations. Photoco Title Section Annual ` `- Pho< e/* _ : 4° : to'b6 Ferforn�ed h+ rn :Name_ .: - -�xossK' :•D.eseription ofPoa�txori ofWork. 4 .3•,:�' <$1 minion — Phone Name 0 <$5 million If XES Ifst DBE <$lo million Address Fax < $15 minion rF ❑> $15 million "; City Side ZIP �• Phone <$l mnnon s Name []<$5 million ffYES ltstDBEA. ❑<$10 million Address Fax []<$15minion ana s ❑>$15miul0II-- CttysweZff ^T' N Phone <$1 minion *�ti sP Name [] <$5 minion IfYES list DBE <$lOmillion Address F= 0<$15muflon ❑> $15 million _ City 8 ow ap Phone ❑ <$1 millioa Name _ <$5 million ifYES List DBE Address<$15minion Fax "-- n F 0> $15 million City Stale ZIP "---- . Distribution;1) OdOwl—Local AgencyPne DPP 06-06 Page 12-112 November 14, 2006 Exx>Br�.. Bidder's List of Subcontractors (DBE and Non -DBE) Local. Assistance Prod: :e�, lylival SIDDEWS LIST OF . - (I)SE NON -DBE)- The bidder shan Est aU subcontmetas who provided a quote or bid but were not selected to participate as a subcontractor on this project This is required for compliance wift�l Title 49. Section 26 of the Code offederal Roeulations, Photocopythis form for -additional firms. 1, n Wad. �. 1 1 1• 1 1 /•• ■ eripiphs /1, /1 / / ■{..1�r.;. d � { tu���sf{F lL.� �:'. �drFXJT {t�SY;� ■ ', •r • r vh� �p � �"r f, it ��r� r ■ 1 • I: • r �.. fair f 121(� 7:, 1 ���:�`1i i i .�ri .` .e c U. ® s iV f,�� r it ■ ', r . • € S" ��s s� try t ,c aS$ •p�"?p1�'Z�Ef;'.. �, `'i!� Dui, Fart � � :,.�� ��� ,'� 5 ■ rr ■ 1 u . I: 10 `" �4� y;+�ftji'h,�ii .` + Dlstrlbutions 1) Original —Loos! AgenoyPile Page 12-112 November 14, 2006 LPP APPENDIX H PART 1 r FEDERAL & STATE REQUIREMENTS FOR FEDERAL -AID CONSTRUCTION PROJECTS IMPORTANT DISCLAIMER THE ATTACHED WAGE RATES ARE FOR REFERENCE ONLY. THE CONTRACTOR IS SOLELY RESPONSIBLE FOR PAYING THE ACTUAL AND CURRENT WAGES REQUIRED BY THE LAWS APPLICABLE FOR THIS PROJECT EIm3TI' 12.-E Attachment B 2. The contract amount upon which the requirements set forth in paragraph 1 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 funoish (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 organi7Ational resources (supervision, management; and engineering services) as the SHA contracting officer determines is necessary to assure the performance ofthe 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 VI1I. SAFETY: ACCIDENT PREVXNTXON 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 CPR 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 ofLabor, in accordance with Section 107 of the Contract Work Fours and Safety Standards Act (40 U.S.C. 333). 3. Pursuant to 29 CFR 19263, 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 peformanee 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 Hours and Safety Standards Act (40 U.S.C. 333). I% FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS In order to assure high quality and durable construction in conformity with approved plans and specification 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- Fam r273 —Revised 3-95 09-07-95 Page 12-18 Local Assistance Procedures Manual PS&E ChecklistTnstraetions garding the seriousness of these and similar acts, the following notice shall be posted on each Federal -aid highway ProjOd (23 CFR 635) in one or more places where it is readily available to all persons concerned with the project: NOTICEENGAGED ON FE ERAL-AID MGHWA.X PROJECTS 18 U.S.C. 1020 reads as follows: "Whoever being an oSieer, 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, orfalse report as to the character, quality, quantity, or cost of the material used or to be use4 or the quantity or quality of the work performed or to be performed or the cost thereof in connection with the submission ofplans, 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 materals furnished or to be furnished in connection with the construction of arty 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 arty statemen4 certificate, or report submitted pursuant to provisions of the Federal -aid .Roads Zct approved July 1, 1916, (39 Stat. 355), as amended and sup- plemente4- Shall be fined not more that $10,000 or imprisoned not more than 5 years or both " X. )WLEMENTATION 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 Rib. 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. 92r500� Executive Order 11738, and regulations in implementation thereof (40 CFR 15) 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 fum shall promptly notify the SHA of the receipt of any communication from the Director, Office o£Federal Activities, EPA, indicating that a facility that is or will be utilized FR 10 rune 29, 2012 OB 1Z -04 Local Assistance Procedures Manual PS&E Checklist Instructions for the contract is under consideration to be listed on the EPA List of Yzolating Facilities. 4. That the firm agrees to include or cause to be included the requirements of paragraph 1 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. XL CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION L 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 (L 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 certitication 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 ofthose 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. ;ERR-11 EDIT 12-E Attachment B g. The prospective primary participant further agrees by submitting this proposal that it will molude, 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 Iower 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 orNonprocurement Programs" (Nonprocurement List) which is compiled by the General Services Administration. i. Nothing contained is 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 I. The prospective primary participant certifies to the best of its laiowledge and beliet; 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, bribexy, 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 lb ofthis certification; and Form.12n—Rcvued 3-95 OM7-95 Page 12-19 OB 12-04 June 29, 2012 R)OMIT 12-B Attachmeut B Local Assistance Procedures Manual PS&B Checklist Instructions 179 Fresno-Bakersfiead, CA SMSA Counties: 0680 Bakersfield, CA CA Kem 2840 Fresno, CA CA Fresno Non-SMSA Counties: CA Kings; CA Madera; CA Tulare 19.1 26.1 '6 180 Los Angeles, CA: SMSA Counties: 11.9 0360 Anaheim -Santa Ana. -Garden Grove, CA CA Orange 28.3 4480 Los Angeles -long Beach, CA CA Los Angeles 21 $ 6000 Oxnard -Simi Valley-'V'entiva, CA xn CA Ventura. 19-0 6780 Riverside -San Bernardino -Ontario, CA CA Riverside; CA San Bernardino 7480 Santa Barbara -Santa. Maria -Lompoc, CA 19.7 CA Santa Barbara. Non-SMSA Counties 24.6 CA Inyo; CA Mono; CA San Luis Obispo 181 San Diego, CA: SMSA Counties 7320 San Diego, CA 16.9 CA San Diego Non-SMSA Counties 18.2 CA Imperial For each. July during which work is performed under the contract, you and each non -material -supplier subcontractor with a subcontract of $10,000 or more must complete Pozen FHWA PR-1391 (Appendix C to 23 CPR 230)- Submit the forms by August 15. Training This section applies if a number of trainees or apprentices is specified in the special provisions. As part of your equal opportunity affirmative action program, provide on -the -job training to develop full journeymen in the types of trades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract part, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1 st year of apprenticeship or training. +M-14 Page 17-22 OR 12-04 June 29, 2012 Local Assistance Procedures Manual EX.,EL IT 12-E PS&E -Checklist Instructions Attachment B Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of j ourneymen in the -various classifications within a reasonable recruitment area_ Before starting work, submit to the City/County of Huntington Beach, CA 1. Number of apprentices or trainees to be trained for each classification_ 2. Training program to be used. 3. Training starting date for each classification. Hu tington Beach Obtain the City/County of approval for this submitted information before you start work The City/County of°ntington Bea` edits.you for each apprentice or trainee you employ on the work who is currently enrolled or becomes mrolled`t an approved program. The primary objective of this section is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area. Show that you have made the efforts_ In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status, or in which the employee has been employed as a journeyman. 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training. Ask the employee if the employee has successfully completed a training course leading to journeyman status, or has been employed as a journeyman_ Your records must show the employee's answers to the questions. in-y our traininghprogram, establish the minimum length and training type for each classification. The City/County Of" Bead FHWA approves a program if one of the following is met: A Lo• 6 1. It is calculated to: 1.1. Meet your equal employment opportunity responsibilities. 1.2. Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period. 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training and it is administered in a way consistent with the equal employment responsibilities of federal -aid highway construction contracts. Obtain the State's approval for your training program before you start work involving the classification covered by the program. FR-15 Page 1Z-23 OB 12-04 June 29, 2012 EXHmTT 12-E Attachment B X,ocal Assistance Procedures Manual p8&E Checklist Instructions Provide training in the construction crafts, not in clerk -typist or secretarial -type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved by the division office. Off -site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. Huntington Beach (p �/ ' The City/County of refamburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on -site training. 2_ For off -site training if the apprentice or trainee is currently employed on a federal -aid project and you do at least one of the following: 2.1. Contribute to the cost of the training. 2.2. Provide the instruction to the apprentice or trainee. 2.3. Pay the apprentice's or trainee's wages during the off site training period. 3. If you comply with this section. Each. apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's skill- 2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification, or until the apprentice or trainee has completed the training program. Furnish the apprentice or trainee: 1. Copy of the program you will comply with in providing the training. 2. Certification. showing the type and length of training satisfactorily completed. Maintain records and submit reports documenting your performance under this section. FR-16 Page 12-24 OD 12-04 .Tune 29, 2012 Local Assistance Procedures Manual PS&E Checklist hastructions RMEBIT 12-B Attachment C (THE BIDDER S =CMION ON TM SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENTAND EXECUTION OF THOSE •CERTIFICATIONS WHICHARE A PART OF TM S' PROPOSAL) ATTACHMENT C EQUAL EwLOYMxNx OI'PORTUNi l" Y CERTIFICATION The bidder PTM General Engineering Services Inc subcontractor proposed hereby certifies that he haste_, 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 tilling 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 ortheir 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 25 OB 12-04 June 29, 2012 EXIDBI.T I.2 9 Local Assistance Procedures Manual Attachment D PS&E Checklist YnstruchMs A.TTAcEmNT A NONCOLLDSION AFMA'VIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPA_R17WEENT OFPOBLIC 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 bidden 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 anyother 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, fiuther, 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 the shall also constitute signature of this Noncollusion Affidavit Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. rage u.-.o r OB 1.2-04 June 29, 2012 Local Assistance Procedures Manual PS&E Cheeldict Instructions A.TTACmmw E DUP ARNMNT AND SUSPENSION CERTIFICATION TTI'L,E 49, CODE OF FEDERAL REGULATIONS, PART 29 FUMnIT 12-E Attachment l 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, initialing 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 12-29 OB I2-04 3une 29, 2012 Local Assistance Procedures Manual Attachment ttacnt F th mel¢�' PS&E Checklist Instructions ATTAcwoxNT F NONLODD YWG CERnmAnON FOR FEbERAI 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 aMember 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) 7f 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 wiih 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 requited 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 shalt require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. - rage 17rJ1 OB 72-04 June 29, 2012 N/A=Not Applicable Local Assistance Procedures Manual EMMIT 12-B PS&E Checklist Instructions Attachment G A,WF S- 1. Type of Federal Action: Z. Status of Federal Action: 3. Report Type: ❑ a contract n/a 1-1 a. bid/offer/applicatiton Fla. initial n/a b. grant b. initial award n/a b_ material change e, cooperative agreement c. post -award d. loan e. loan guarantee £ loan insurance 4. Name and Address of Reporting Entity Prime Subawardee n/a Tier , ifkaowa Congressional District, if known 6. Federal DeparlmentlAgency: n/a 8. Federal Action Number, ifknoym n/a 10. a Name and Address of Bobby Entity (If individual, last name first name Na) n/a For Material Change Only: year T quarter date of last report 5. If Reporting Entity in No. 4 is Subavvardee, Enter Name and Address of Prime: n/a Congressional District, if known 7. Federal Program Name/Description: n/a MA Number, if applicable 9. Award Amount, ifk sown: n/a b. Individuals Performing Services (including address if different from No. l0a) (last name, first name, MI) n/a (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ actual planned a retainer n/a b. one-time fee n/a 7Z_ Form of Payment (check all that apply): c. commission a cash d. contingent fee b. in -kind; specify: nab= a deferred n/a value LJ £ other, specify 14. Brief Description of Services Performed or to be performed and Dates) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: n/a (attach Continuation Sheets) if n ) Is- Continuation Shcet(s) attached: Yes No x 16. hrformation 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. Ibis disclosure is required pursuant to 31 p tN e; Elizabeth H. Mendoza de McRae U.S.C.1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Tittle: president/CFO person who fails to file the required disclosure shall be subject to a civil penalty of not less than S10,000 and notram than $100,000for each such faiilwe. TelephoneNo.: (951)710-1000 Date: 5-19-14 Federal Use Only: FOMIU Rev Authorized for Local Reproduction Standard Form - LLL Page 12-33 OR 12-04 June 29, 2012 RXIM ' 12E Local .Assistance Procedures Manual PS&E Checklist Instructions INSTRUCUONS FOR CONTLETTON OF SF-LLL, DISCLOSURE OF LOBBYING ACMES This disclosure form shall be completed by the reporting entity, whether subawardee or prune 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. S. If the organization filing the report in Item 4 checks "Subawardee" then enter the full came, 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 nine or description for the covered federal action (item 1). If known, enter the fall Catalog of Federal Domestic Assistance, (CRDA) number for grants, co operative 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 (RR) number, Invitation for Bid (1FB) 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 engagedd 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). Eater LastName, First Flame and Middle Initial (NR). 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 Ether, specify nature. Page 12-34 3'une 29, 2012 O$ 72-04 Loral Assistance Procedures Manual PS&E Checklist xnstractions EX Mrr 1Z-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 officers) employees) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The cert&3 g 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 3 0 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and coanpleting 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, A.C. 20503. SF-LLL-Tnshuctions Rev.06-04-90(0,TDIF)> ,rage xL-na OB 12-04 June 29, 2012 EXHIBIT 12 E Local .Assistance Procedures Manual Attachment H I'S&E Checklist instructions ATTACHMENT H SECTION 2. PROPOSAL REQUIREMENTS .AND CONDITIONS z-x.oi GENERAL The bidder's attention is directed to the provisions in Section 2, "Proposal Requirements and Conditions," of the Standard Specifications and these special provisions for the requirements and conditions which the bidder must observe in the preparation of and the submission of the bird. The bidder's bond shall conform to the bond form in the Bid book for the proj ect and shall be properly filled out and executed. The bidder's bond form included in that book may be used. In conformance with Public Contract Code Section 7106, a Noncollusion Affidavit is included in the Bid book. Signing the Bid book shall also constitute signature of the Noncollusion Affidavit. The Contractor, sub -recipient 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 Title.49 CFR (Code of Federal Regulations), Part 26 in the award and administration of US 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 the recipient deems appropriate. Each subcontract signed by the bidder must include this assurance. Failure of the bidder to fulfill the requirements of the Special Provisions for submittals required to be furnished after bid opening, including but not limited to escrowed bid documents, where applicable, may subjcot the bidder to a determination of the biddees responsibility in the event it is the apparent low bidder on a future public works contracts. 2_1.oIS -FEDERAL LOBBYING RESTRICTIONS. —Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower -tier sub -recipient of a Federal -aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal -aid contract, time making of any Federal grant or loan, or the entering into of any cooperative agreement If any funds other than Federal funds have been paid for the same purposes in connection with this Federal -aid contract, time recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal. -aid contracts regarding payment of funds to lobby Congress or aFederal agency is included in the Bid book Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Bid book. Signing the Bid book shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower -tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower -tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower -tier contractors. An event that materially affects the accuracy of the information reported includes: Page 122 37 OB 12.04 June 29, 2012 MWEIRIT 12-E Attachment H Focal Assistance Procedures MannaI PS&E Checklist Instructions (1) A cumulative increase if $25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered federal action; or (2) A change in the person(s) or individual(s) influencing or attempting to influence a covered federal action; or (3) A change in the officer(s), employees(s), or member(s) contacted to influence or attempt to influence a covered Federal Action. 2-1-02 DISADVANTAGED BUSINESS ENTERPRISE (I)DE),—This project is subject to Title 49 CFR 26.13(b): The Contractor, sub -recipient 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 the recipient deems appropriate. Take necessary and reasonable steps to ensure that DBEs have opportunity to participate in the contract (49 CFR 26). To ensure there is equal participation of the DBE groups specified in 49 CFR 26.5, the Agency specifies a goal for Disadvantaged Business Enterprises (DBEs). DBE is a firm that meets the definition of DBE. Make work available to DBEs and select work parts consistent with available DBE subcontractors and suppliers. Meet the DBE goal shown in the Notice to Bidders or demonstrate that you made adequate good faith efforts to meet this goal. It is your responsibility to verify that the DBE firm is certified as DBE at date of bid opening. For a list of DBEs certified by the California Unified Certification Program, go to: htt).//www.dot.ca ggy1hq/bep/find certified.htm All DBE participation will count toward the California Department of Transportation's federally mandated statewide overall DBE goal. Page 12-38 June 29, 2012 OB 12-04 Local Assistance Procedures Manual PRA,V.. C'hecklict Instructions EXEaBiT 12-B Attachment I Credit for materials or supplies you purchase from DBEs counts towards the goal in the following manner: 1. 100 percent counts if the materials or supplies are obtained from a DBE manufacturer_ 2. 60 percent counts if the materials or supplies are obtained from a DBE regular dealer. 3_ Only fees, commissions, and charges for assistance in the procurement and delivery of materials or supplies count if obtained from a DBE that is neither a manufacturer, nor a regular dealer. 49 CFR 26.55 defines "manufacturer" and "regular dealer." You receive credit towards the goal if you employ a DBE trucking company that performs a commercially useful function as defined in 49 CFR 26.55. DBE Commitment Submittal Submit DBE information on the Local Agency B idder DBE Commitment (Construction Contracts), Exhibit 15-G form, included in the Bid book. If the form is not submitted with the bid, remove the form from the Bid book before submitting your bid. If the DBE Commitment form is not submitted with the bid, the apparent low bidder, the 2nd low bidder, and the 3rd low bidder must complete and submit the DBE Commitment form to the Agency. DBE Commitment form must be received by the Agency no later than 4:00 pm. on the 4th business day after bid opening. Other bidders do not need to submit the DBE Commitment fora unless the Agency requests it If the Agency requests you to submit a DBE Commitment fora, submit the completed form within 4 business days of the request. Submit written confirmation from each DBE stating that it is participating in the contract Include confirmation with the DBE Commitment form. A copy of a DBE's quote will serve as written confirmation that the DBE is participating in the contract. If you do not submit the DBE Commitment form within the specified time, the Agency finds your bid nonresponsive. Good Faith Efforts Submittal If you have not met the DBE goal, complete and submit the DBE Information - Good Faith Efforts, Exhibit 15 H form with the bid showing that you made adequate good faith efforts to meet the goal. Only good faith efforts directed towards obtaining participation by DBEs will be considered. If good faith efforts documentation is not submitted with the bid, it must be received by the Agency no later than 4:00 p m. on the 4th business day after bid opening. If your DBE Commitment form shows that you have net the DBE goal or if you are required to submit the DBE Commitment form, you must also submit good faith efforts documentation within the specified time to protect your eligibility for award of the contract in the event the Agency finds that the DBE goal has not been met Page 12-39 OD 12-04 June 29, 2012 =1113 r 12-E Attachment I Local Assistance Procedures Manual PS&E Checklist Instructions 'a Good faith efforts documentation must include the following information and supporting documents, as necessary. 1. Items of work you have made available to DBE farms. Identify those items of work you might otherwise perform with its own forces and those items that have been broken down into economically feasible units to facilitate DBE participation. For each item listed, show the dollar value and percentage of the total contract. It is your responsibility to demonstrate that sufficient work to meet the goal was made available to DBE farms. 2. Names of certified DBEs and dates on which they were solicited to bid on the project. Include the items of work offered- Describe the methods used for following up initial solicitations to determine with certainty if the DBEs were interested, and the dates of the follow-up. Attach supporting documents such as copies of letters, memos, facsimiles sent, telephone logs, telephone billing statements, and other evidence of solicitation. You are reminded to solicit certified DBEs through all reasonable and available means and provide sufficient time to allow DBEs to respond_ 3. Name of selected firm and its status as a DBE for each item of work made available. Include name, address, and telephone number of each DBE that provided a quote and their price quote. If the firm selected for the item is not a DBE, provide the reasons for the selection. 4. Name and date of each publication in which you requested DBE participation for the project Attach copies of the published advertisements. S. Names of agencies and dates on which they were contacted to provide assistance in contacting, recruiting, and using DBE harms_ If the agencies were contacted in writing, provide copies of supporting documents. 6. List of efforts made to provide interested DBEs with adequate information about the plans, specifications, and requirements of the contract to assist them in responding to a solicitation. If you have provided information, identify the name of the DBE assisted, the nature ofthe information provided, and date of contact. Provide copies of supporting documents, as appropriate. 7. List of efforts made to assist interested DBEs in obtaining bonding, lines of credit, insurance, necessary equipment, supplies, and materials, excluding supplies and equipment that the DBE subcontractor purchases or leases from the prime contractor or its affiliate. If such assistance is provided by you, identify the name of the DBE assisted, nature of the assistance offered, and date. Provide copies of supporting documents, as appropriate- S . Any additional data to support demonstration of good faith efforts. The agency may consider DBE commitments of the 2nd and 3`d bidders when determining whether the low bidder made good faith efforts to meet the goal. Page 12-40 June 29, 20122 OB 12-04 Local Assistance Procedures Manual pS&E Checklist Instructions EXHIBIT 12-E Attachment I ATTACT3lvD?,NT I SECTION 3. AWARD AND EXECUTION OF CONTRACT The bidder's attention is directed to the provisions in Section 3, "Award and Execution of Contract," of the Standard Specifications and these special provisions for the requirements and conditions concerning award and execution of contract_ Bid protests are to be. delivered to the following address: fAgency to provide information) The award of the contract, if it be awarded, will be to the lowest responsible bidder whose bid complies with all the requirements prescribed_ The contract shall be executed by the successful bidder and shall be returned together with the contract bonds, to the Agency so that it is received within 10 days, not including Saturdays, Sundays and legal holidays, after the bidder has received the contract for execution. Failure to do so shall be just cause for forfeiture of the proposal guaranty. The executed contract documents shall be delivered to the following address. [Agency to provide detailed information if this paraj! am h is used] SECTION 4. BEGINNING OF WORK, TDIE OF COMPLETION .AND LIQUIDATED DAMAGES Attention is directed to the provisions in Section 8-1.03, `Beginning of Work" in Section 8-1.06 "Time of Completion," and in Section 8-1.07, `Liquidated Damages," of the Standard Specifications and these special provisions. The Contractor shall begin work within 15 calendar days after the contract has been approved by the attorney appointed and authorized to represent the City/County of Huntington Beach/O.C. jx This work shall be diligently prosecuted to completion before the expiration of_ -WORKING DAYS beginning on the 15 calendar day after approval of the contract_ (INSERT AMOUNT o>F LIQUIDATED DAMAGES) Huntington Beach/O.C. The Contractor shall pay -to the City/Cow3.ty of _ the sum. of $ Y^ per day, for each and every calendar day's delay in finishing the work in excess of the number of working days prescribed above. Page 122-41 OR 12-04 June 29, 2012 EXHIBIT 12-E Local Assistance Procedures Manual Attachment][ PS&E Checklist instructions Ugwidated Damages Liquidated Damages are based on the estimated cost of field construction engineering. In special cases, liquidated damages greater than the estimated field construction engineering cost may be specified, provided detailed reasons are given to support the greater amount. In every case, show the calculations that support the recommended rate. Liquidated damages are not to be used as disincentives to encourage timely completion. Use the following formula for highway constmoti.on projects to avoid excessive liquidated damages: L% (See Table below) x Eng,ineees Estimate + RE Office Expenses * = Liq Dam/calendar day Working Days ** * Resident Engineer office expenses over the life of the contract should be added unless the cost is already included in the Engineer's Estimate_ ** Working days used to calculate liquidated damages should not include water pollution establishment or plant establishment days. LIQUIDATED DAMAGES TABLE (L%) Project Type Project Estimate Resurfacing*/Rehab New Highway Realignment/ Widening Landscaping Soundwall Others Over $30 million 10 % 10 % 13°l0 15% 15 % 15% $10million to $30 million 10% 12% 15% L 15% 15% 15% $5 million to $10 million 10 % 15% 15% 15% 15 % 15 $750k to $5 million 15% 15% 15% 18 % 18 % 15 Less Than $750k 15 % 20 % 20 % 18 % 20 % 15% * Resurfacing projects include AC Surfacing, seal coats, slurry seals, and so on. The calculated liquidated damages should be rounded up in $100 increments to determine the amount to be specified. Page 12-42 OB 12-04 June 29, 2012 ATTACHMENT J SUBCOMMACTOR AND DBE RECORDS Required for ALL constractiion contracts administered under the Caitrans Standard Specifications 5-1. SUBCONTRACTOR AND DBE RECORDS Use each DBE subcontractor as listed on the List of Subcontractors form and the Local Agency Bidder DBE Commitment (Construction Contracts), Exhibit 15-(3, forms unless you receive authorization for a substitution. The Agency requests the Contractor to: 1. Notify the Engineer of any changes to its anticipated DBE participation 2. Provide this notification before starting the affected work Maintain records including: 1. Name and business address of each 1st -tier subcontractor 2. Name and business address of each DBE subcontractor, DBE vendor, and DBE trucking company, regardless of tier 3. Date of payment and total amount paid to each business If you are a DBE contractor, include the date of work performed by your own forces and the corresponding value of the work. Before the 151h of each month, submit a Monthly DBE Trucking Verification form_ If a DBE is decertified before completing its work, the DBE must notify you in writing of the decertification date. If a business becomes a certified DBE before completing its work, the business must: notify you in writing of the certification date. Submit the notifications. On work completion, complete a Disadvantaged Business Enterprises (DBE) Certification Status Change, Exhibit 17-0, form. Submit the form within 3 0 days of contract acceptance. Upon work completion, complete a Final Report — Utilization of Disadvantaged Business Enterprises (DBE), First -Tier Subcontractors, Exhibit 17-F, form_ Submit it within 90 days of contract acceptance. The Agency withholds $10,000 until the form is submitted. The Agency releases the withhold upon submission of the completed form. Page 12-44 June 29, 2012 OB 12-04 ATTACHMENT K PFwoRm[ANcE of SUBCONTRA CTo12s S I. PERFORMANCE OF SUBCONTRACTORS DBEs must perform work or supply materials as listed in the Local. Agency Bidder DBE Commitment (Construction Contracts), Exhibit 15-G, included in the Bid. Do not terminate or substitute a listed DBE for convenience and perform the work with your own forces or obtain materials from other sources without authorization from the Agency. The Agency authorizes a request to use other forces or sources of materials if it shows any of the following justifications: 1. Listed DBE fails or refuses to execute a written contract based on plans and specifications for the project. 2. You stipulated that a bond is a condition of executing the subcontract and the. listed DBE fails to meet your bond requirements. 3. Work requires a contractor's license and listed DBE does not have a valid license under Contractors License Law. 4. Listed DBE fails or refuses to perform the work or furnish the listed materials. S. Listed DBHs work is.unsatisfactory and not in compliance with the contract. 6. Listed DBE is ineligible to work on the project because of suspension or debarment. 7. Listed DBE becomes banimrpt or insolvent. 8. Listed DBE voluntan'ly withdraws with written notice from the Contract 9. Listed DBE is ineligible to receive credit for the type of work required. 10. Listed DBE owner dies or becomes disabled resulting in the inability to perform the work on the Contract. 11. Agency determines other documented good cause. Notify the original DBE of your intent to use other forces or material sources and provide the reasons. Provide the DBE with 5 days to respond to your notice and advise you and the Agency of the reasons why the use of other forces or sources of materials should not occur. Your request to use other forces or material sources must include: 1. 1 or more ofthe reasons listed in the preceding paragraph 2. Notices from you to the DBE regarding the request 3. Notices from the DBEs to you regarding the request If a listed DBE is terminated, make good faith efforts to fund another DBE to substitute for the original DBE. The substitute DBE must perform at least the same amount of work as the original DBE under the contract to the extent needed to meet the DBE goal. The substitute DBE must be certified as a DBE- at the time of request for substitution. Unless the Agency authorizes (1) a request to use other forces or sources of materials or (2) a good faith effort for a substitution of a termiinated DBE, the Agency does not pay for work listed on the Local Agency Bidder DBE Commitment (Construction Contracts), Exhibit 15-G, form unless it is performed or supplied by the listed DBE or an authorized substitute. Page 12-46 June 29, 2012 OB 12-04 Local. Assistance Procedures Manual SIT 12'E ME Checklist Instructions Attachment L ATTACHMENT L SUBCONTR&C ING 5-1. SUBCONTRACTING No subcontract releases the Contractor from the contract or relieves the Contractor of their responsibility for a subcontractor's work. If the Contractor violates Pub Cout Code § 4100 et seq., the City/County of Huntington Beaclmay exercise the remedies provided under Pub Cont Code § 4110. The City/County of Huntington Beacbmay refer the violation to the Contractors State License Board as provided under Pub Cont Code § 4111. The Contractor shall perform work equaling at least 30 percent of the value of the original total bid with the Contractor's own employees and equipment, owned or rented, with or without operators. Each subcontract must comply with the contract. Each subcontractor must have an active and valid State contractor's license with a classification appropriate for the work to be performed (Bus & Prof Code, § 7000 et seq.). Submit copies of subcontracts upon request by the Engineer. Before subcontracted work starts, submit a Subcontracting Request form. Do not use a debarred contractor; a current list of debarred contractors is available at the Department of Industrial Relations web site at: http•//www.dir ca_gov/dlse/debarhtml Upon request by the Engineer, immediately remove and not again use a subcontractor who fails to prosecute the work satisfactorily. Each subcontract and any lower -tier subcontract that may in turn be made shall include the "Required Contract Provisions Federal -Aid Construction Contracts" in Section 14 of these special provisions. Noncompliance shall be corrected. Payment for subcontracted work involved will be withheld from progress payments due or to become due, until correction is made. Failure to comply may result in termination of the contract. 5-1. PROMPT PROGRESS PAYMENT TO SUBCONTRACTORS A prime contractor or subcontractor shall pay any subcontractor not later than 10 days of receipt of each progress payment in accordance with the provision in Section 7108.5 of the California Business and Professions Code concerning prompt payment to subcontractors. The 10 days is applicable unless a longer period is agreed to in writing. Any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of Section 7108.5 shall subjectthe violating contractor or subcontractor to the penalties, sanctions and other remedies of that section. This requirement shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance, or noncompliance by a subcontractor. Page 12-49 OB 12-04 June 29, 2012 Attachment X, Local. Assistance Procedures Manual PS&E Checklistlnstructions 5-1._ PR.OWT PAYAMNT OF FUNDS WPiMIELD TO SUBCONTRACTORS The local agency must include one of the following three provisions (if using Caltrans ,Standard Specifzccdion, modify or delete paragraphs 9-1.06 and 9-1.065) to ensure prompt and full payment of any retainage from the prime contractor, or subcontractor to a subcontractor. - -................- - .............. n � M-1 ------ The agency shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the agency, of the contract work and pay retainage to the prime contractor based on these acceptances. The prime contractor or subcontractor shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49 CFR 2629) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the pupae contractor or subcontractor, in the event of a dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance or noncompliance by a subcontractor. Page IZ-50 June 29, 2012 OB I2-04 Local Asslstance Procedures Manual F'SIT 12r- PS&E checustInstructions A.ttachmeatM ATTACWYIENT M 13TJY AMERICA REQUMEMENTS 5--1. )BUY AIYMRICA REQUMEMENTS. — Attention is directed to the `Buy America" requirements of the Title 23 United States Code, Section 313 and the regulations adopted pursuant thereto. Tn accordance with said law and regulations, all manufacturing processes for steel and iron materials furnished for incorporation into the work oathis project shall occur in the United States; with the exception that pig iron and processed, pelletized and reduced iron ore manufactured outside of the United States may be used in the domestic manufacturing process for such steel and iron materials. The application of coatings, such as epoxy coating, galvanizing, painting, and any other coating that protects or enhances the value of such steel or iron materials shall be considered a manufacturing process subject to the `Buy America" requirements. A Certificate of Compliance, conforming to the provisions in Section 5-1.07, Certificates of Compliance, of the Standard Specifications, shall be furnished for steel and iron materials. The certificates, in addition to certifying that the materials comply with the specifications, shall also specifically certify that all manufacturing processes for the materials occurred iu the United States, except for the exceptions allowed herein_ The requirements imposed by said law and regulations do not prevent a minimal use of foreign steel and iron materials if the total combined cost of such materials used does not exceed one tenth of one percent (0.1%) ofthetotal contract cost or $2,500, whichever is greater. The Contractor shall furnish the Engineer acceptable documentation of the quaritity and value of any foreign steel and iron prior to incorporating such materials into the work - Page 17-53 OD IZ-04 June 29, 2012 Local Assistance Procedures Manual Mal Business EXHMIT 1' First Tier Subcontrac STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION ADA NoticeinFINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES caoll(0 dsaI64641nsnTDD s e)etlsqa3aeoc°wrii Rlaodoa`nndFormseManagsmmmats. J12014SLMe4 (DBE), fIRST-TIER SUBCONTRACTORS Ms es,sammento,CA95614 c6M-2ao2F(REV 0212008) CONIRACT COMPLETION DATE CONTRACTNUMBER COUNTY ROUTE POST MILES FEDERAL AIDPRDJECTNO. ADMINISTERINGAGENCY ESTIMATED CONTRACT AMOUNT BUSINESS ADDRESS $ PRIME CONTRACTOR CONTRACT PAYMENTS DATE WORK COMPLETE DESCRIPTION OF ITE WORKPERFORMED M AND MATERIAL NO. PROVIDED ORIGINAL COMMITMENT COMPANYNAMEAND BUSINESS A DRESS 1 NUMBER NON -DBE DBE a were List all First -Tier subcontractors, Droved staged ofaward, Enter rises (ents regardless baforth 6f wh9th4r Or Ustactual amountipaldnto each entlly elly acted for goal eredlt. If actual DBE uallzaaon (or Item fwork)waa dlfferentthanthet pp I Ci RTIFY THATTHE ABOVE INFORMATION IS COMPLETE AND CORRECT CONTRACTOR REPRESENTATIVE'S BUSINESS PHONE NUMBER DATE SIGNATURE Tn THE HEST OF MY INFORMATION AND BELIEF THE ABOVE 1NFORMARi0c FSS PHONE N MBELF-TF- AND RRRECT DATE origiaal-DstiotConshncdon Copy- EwlnwsEaterpAsaprogram Copy -Contactor Cop7�d0°tBngtnaer CopyDiawWdon-Caltrans eoatads: Copy-1,ocalAgency file Copy DlatAbndon-1.00alAa�oyaontaeh: Original•DrlthttTRvortned salstanaeEnBtnear CopyDlrtrictioad 1w9steneoHaglneer (sobmiaad wlththeReport ofBapanditure Page Tuly 1) EXHIBIT 17-F Local Assistance Procedures Manual Final Report Utilization of Disadvantaged Business Enterprises (DBE), First -Tier Subcontractors .INAL REPORT —UTILIZATION OF DISADVANTAGED BUSINESS 'ENTERPRISES (DBE), FIRST -TIER SUBCONTRACTORS CEM 2402(1) (Rev. 02M08) The form requires specific information regarding the construction project: Contract Number, County, Route, Post Miles, Federal -aid Project No., the Administering Agency, the Contract Completion Date and the Estimated Contract Amount It requires the prime contractor name and business address. The focus of the form is to describe who did what by contract item number and descriptions, asking for specific dollar values of item work completed broken down by subcontractors who performed the work both DBE and non -DBE work forces. DBE prime contractors are required to show the date of work performed by their own forces along with the corresponding dollar value of work The forra has a column to enter the Contract Item No. (or Item No's) and description of work performed or materials provided, as well as a column for the subcontractor name and business address. For those firms who are DBE, there is a column to enter their DBE Certification Number. The DBE should provide their certification number to the contractor and notify the contractor in vo dting with the date of the decertification if their status should change during the course ofthe project The form has six columns for the dollar value to be entered for the item work performed by the subcontractor. The Non -DBE column is used to enter the dollar value of work performed for firms who are not certified DBE. The decision of which column to be used for entering the DBE dollar value is based on what programs) status the firm is certified. This program status is determined by the California Unified Certification Program by etimicity, gender, ownership, and control issues at time of certification. To confirm the certification status and programs status, access the Department of Transportation Civil Rights web site at: bitp://www.dot.ca og y&q/bei) or by calling (9I6) 324-1700 or the toll free number at (888) 8I0-6346. Based on this DBE Program status, the following table depicts which. column to be used: DBE Program Status Column to be used If program status shows DBE only with no other programs listed DBE :d If a contractor performingwork as a DBE on the project becomes decertified and still performs work after their decertification date, enter the total dollar value performed by this contractor under the appropriate DBE identification column. If a contractor performing work as a non -DBE on the project becomes certified as a DBE, enter the dollar value of all work performed after certification as a DBE under the appropriate identification column. Enter the total of each of the six columns in Form CEM 2402(F). Any changes to DBE certification must also be submitted on Form-CEM 2403(F). Enter the Date Work Completed as well as the Date of final Payment (the date when the prime contractor made the "final payment" to the subcontractor for the portion of work listed as being completed). The contractor and the resident engineer sign and date the form indicating that the information provided is complete and correct. 'age 17-22 Scaly 1, 2012 LPP 09-02 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, In the Vicinity of Stacey Middle School and Clegg Elementary School — CC 1426 May 9, 2014 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for the: Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School - CC1426 shall be replaced with the following attached documents: The Federal Labor Rates dated May 9, 2014 shall be the labor rates in effect for the subject project. 2) SHEET 3 — TRAFFIC SIGNAL PLAN SPRINGDALE STREET AT CROUPIER DRIVE The following revision has been added to Pole Schedule: Traffic signal pole #5 has been revised from 264-100 to 29-5-100. The pole height and equipment will remain the same. This is to acknowledge receipt and review of Addendum Number O ay 9, 2014. xa}�otb H. Mendoza de MoRae Cohpany Name U V By t --i . 2,611 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Page 1 of 25 General Decision Number: CA140035 05/09/2014 CA35 Superseded General Decision Number: CA20130035 State: California Construction Types: Building, Heavy (Heavy and Dredging) and Highway County: Orange County in California. BUILDING CONSTRUCTION PROJECTS; DREDGING PROJECTS (does not include hopper dredge work); HEAVY CONSTRUCTION PROJECTS (does not include water well drilling); HIGHWAY CONSTRUCTION PROJECTS Modification Number 0 1 2 3 4 5 6 7 ASBE0005-002 07/01/2013 Publication Date 01/03/2014 01/10/2014 01/24/2014 02/21/2014 03/07/2014 03/14/2014 04/25/2014 05/09/2014 Rates Fringes Asbestos Workers/Insulator (Includes the application of all insulating materials, protective coverings, coatings, and finishes to all types of mechanical systems) ..... $ 34.51 16.55 Fire Stop Technician (Application of Firestopping Materials for wall openings and penetrations in walls, floors, ceilings and curtain walls) ...........................$ 24.34 16.09 ASBE0005-004 06/24/2013 Rates Fringes Asbestos Removal worker/hazardous material handler (Includes preparation, wetting, stripping, removal, scrapping, vacuuming, bagging and disposing of all insulation materials from mechanical systems, whether they contain asbestos or not) .... $ 16.95 10.23 * BRCA0004-010 05/01/2014 http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 2 of 25 Rates Fringes BRICKLAYER; MARBLE SETTER ........ $ 36.35 13.22 *The wage scale for prevailing wage projects performed in Blythe, China lake, Death Valley, Fort Irwin, Twenty -Nine Palms, Needles and 1-15 corridor (Barstow to the Nevada State Line) will be Three Dollars ($3.00) above the standard San Bernardino/Riverside County hourly wage rate ---------------------------------------------------------------- BRCA0018-004 06/01/2012 Rates Fringes MARBLE FINISHER ..................$ 27.04 10.66 TILE FINISHER ....................$ 22.37 9.19 TILE LAYER .......................$ 33.55 13.55 ---------------------------------------------------------------- BRCA0018-010 09/01/2.011 Rates Fringes TERRAZZO FINISHER ................$ 26.59 9.62 TERRAZZO WORKER/SETTER ........... $ 33.63 10.46 --------------------------------------------------------- CARP0409-001 07/01/2010 Rates Fringes CARPENTER (1) Carpenter, Cabinet Installer, Insulation Installer, Hardwood Floor Worker and acoustical installer ...................$ 37.35 li.08 (2) Millwright ..............$ 37.85 11.08 (3) Piledrivermen/Derrick Bargeman, Bridge or Dock Carpenter, Heavy Framer, Rock Bargeman or Scowman, Rockslinger, Shingler (Commercial)... ...........$ 37.48 11.08 (4) Pneumatic Nailer, Power Stapler ...............$ 37.60 11.08 (5) Sawfiler...............$ 37.44 11.08 (6) Scaffold Builder ....... $ 28.55 11.08 (7) Table Power Saw Operator ....................$ 37.45 11.08 FOOTNOTE: Work of forming in the construction of open cut sewers or storm drains, on operations in which horizontal lagging is used in conjunction with steel H-Beams driven or placed in pre- drilled holes, for that portion of a lagged trench against which concrete is poured, namely, as a substitute for back forms (which work is performed by piledrivers): $0.13 per hour additional. ---------------------------------------------------------------- http://www.wdol.gov/wdol/scafiles/davisbacon/CA3 5.dvb?v=7 5/9/2014 Page 3 of 25 CARP0409-005 07/01/2.010 Rates Fringes Drywall DRYWALL INSTALLER/LATHER .... $ 37.35 11.08 STOCKER/SCRAPPER ............ $ 10.00 6.67 ---------------------------------------------------------------- CARP0409-008 08/01/2010 Rates Fringes Modular Furniture Installer ...... $ 17.00 7.41 --------------------------------------------------------------- ELEC0011-002 11/25/2013 COMMUNICATIONS AND SYSTEMS WORK Rates Fringes Communications System Installer ...................$ 27.75 12.36 Technician ..................$ 29.55 12.42 SCOPE OF WORK: Installation, testing, service and maintenance of systems utilizing the transmission and/or transference of voice, sound, vision and digital for commercial, educational, security and entertainment purposes for the following: TV monitoring and surveillance, background -foreground music, intercom and telephone interconnect, inventory control systems, microwave transmission, multi -media, multiplex, nurse call systems, radio page, school intercom and sound, burglar alarms, fire alarm (see last paragraph below) and low voltage master clock systems in commercial buildings. Communication Systems that transmit or receive information and/or control systems that are intrinsic to the above listed systems; inclusion or exclusion of terminations and testings of conductors determined by their function; excluding all other data systems or multiple systems which include control function or power supply; excluding installation of raceway systems, conduit systems, line voltage work, and energy management systems. Does not cover work performed at China Lake Naval Ordnance Test Station. Fire alarm work shall be performed at the current inside wireman total cost package. ---------------------------------------------------------------- ELEC0441-001 02/24/2014 Rates Fringes CABLE SPLICER ....................$ 43.03 15.24 ELECTRICIAN ......................$ 41.14 15.18 ---------------------------------------------------------------- * ELEC0441-003 11/25/2013 COMMUNICATIONS & SYSTEMS WORK (excludes any work on Intelligent Transportation Systems or CCTV highway systems) http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 4 of 25 Rates Fringes Communications System Installer ...................$ 28.49 11.58 Technician ..................$ 30.29 11.64 SCOPE OF WORK The work covered shall include the installation, testing, service and maintenance, of the following systems that utilize the transmission and/or transference of voice, sound, vision and digital for commercial, education, security and entertainment purposes for TV monitoring and surveillance, background foreground music, intercom and telephone interconnect, inventory control systems, microwave transmission, multi -media, multiplex, nurse call system, radio page, school intercom and sound, burglar alarms and low voltage master clock systems. A. Communication systems that transmit or receive information and/or control systems that are intrinsic to the above listed systems SCADA (Supervisory control/data acquisition PCM (Pulse code modulation) Inventory control systems Digital data systems Broadband & baseband and carriers Point of sale systems VSAT data systems Data communication systems RF and remote control systems Fiber optic data systems B. Sound and Voice Transmission/Transference Systems Background -Foreground Music Intercom and Telephone Interconnect Systems Sound and Musical Entertainment Systems Nurse Call Systems Radio Page Systems School Intercom and Sound Systems Burglar Alarm Systems Low -Voltage Master Clock Systems Multi-Media/Multiplex Systems Telephone Systems RF Systems and Antennas and Wave Guide C. *Fire Alarm Systems -installation, wire pulling and testing. D. Television and Video Systems Television Monitoring and Surveillance Systems Video Security Systems Video Entertainment Systems Video Educational Systems CATV and CCTV E. Security Systems, Perimeter Security Systems, Vibration Sensor Systems Sonar/Infrared Monitoring Equipment, Access Control Systems, Card Access Systems *Fire Alarm Systems 1. Fire Alarms -In Raceways: Wire and cable pulling in raceways performed at the current electrician wage rate and fringe benefits. 2. Fire Alarms -Open Wire Systems: installed by the Technician. ------------------------------------------------------------------ ELEC0441-004 02/24/2014 Rates Fringes http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 5 of 25 ELECTRICIAN (TRANSPORTATION SYSTEMS, TRAFFIC SIGNALS & STREET LIGHTING) Cable Splicer/Fiber Optic Splicer .....................$ 41.74 15.20 Electrician .................$ 41.14 15.18 Technician ..................$ 30.86 14.88 SCOPE OF WORK: Electrical work on public streets, freeways, toll -ways, etc, above or below ground. All work necessary for the installation, renovation, repair or removal of Intelligent Transportation Systems, Video Surveilance Systems (CCTV), Street Lighting and and Traffic Signal work or systems whether underground or on bridges. Includes dusk to dawn lighting installations and ramps for access to or egress from freeways, toll -ways, etc. Intelligent Transportation Systems shall include all systems and components to control, monitor, and communicate with pedestrian or vehicular traffic, included but not limited to: installation, modification, removal of all Fiber optic Video System, Fiber Optic Data Systems, Direct interconnect and Communications Systems, Microwave Data and Video Systems, Infrared and Sonic Detection Systems, Solar Power Systems, Highway Advisory Radio Systems, highway Weight and Motion Systems, etc. Any and all work required to install and maintain any specialized or newly developed systems. All cutting, fitting and bandaging of ducts, raceways, and conduits. The cleaning, rodding and installation of "fish and pull wires". The excavation, setting, leveling and grouting of precast manholes, vaults, and pull boxes including ground rods or grounding systems, rock necessary for leveling and drainagae as well as pouring of a concrete envelope if needed. JOURNEYMAN TRANSPORTATION ELECTRICIAN shall perform al.l. tasks necessary toinstall the complete transportation system. JOURNEYMAN TECHNICIAN duties shall consist of: Distribution of material at job site, manual excavation and backfill, installation of system conduits and raceways for electrical, telephone, cable television and comnmunication systems. Pulling, terminating and splicing of traffic signal and street lighting conductors and electrical systems including interconnect, dector loop, fiber optic cable and video/data. ELEC1245-001 06/01/2013 Rates Fringes LINE CONSTRUCTION (1) Lineman; Cable splicer..$ 50.30 15.00 (2) Equipment specialist (operates crawler tractors, commercial motor vehicles, backhoes, trenchers, cranes (50 tons and below), overhead & http://www.wdol.gov/wdoUseatiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 6 of 25 underground distribution line equipment) ........... $ 40.17 14.56 (3) Groundman...............$ 30.73 13.48 (4) Powderman...............$ 44.91 13.48 HOLIDAYS: New Year's Day, M.L. King Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day and day after Thanksgiving, Christmas Day ---------------------------------------------------------- ELEV0018-001 01/01/2014 Rates Fringes ELEVATOR MECHANIC ................$ 49.03 26.785 FOOTNOTE: PAID VACATION: Employer contributes 8% of regular hourly rate as vacation pay credit for employees with more than 5 years of service, and 6% for 6 months to 5 years of service. PAID HOLIDAYS: New Years Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day, Friday after Thanksgiving, and Christmas Day. ---------------------------------------------------------------- ENGI0012-003 08/26/2013 Rates Fringes OPERATOR: Power Equipment (All Other Work) GROUP 1 ....................$ 38.20 21.10 GROUP 2 ....................$ 38.98 21.10 GROUP 3 ....................$ 39.27 21.10 GROUP 4 ....................$ 40.76 21.10 GROUP 5 ....................$ 41.86 21.10 GROUP 6 ....................$ 40.98 21.10 GROUP 8 ....................$ 41.09 21.10 GROUP 9 ....................$ 42.19 21.10 GROUP 10 ....................$ 41.21 21.10 GROUP 11 ....................$ 42.31 21.10 GROUP 12 ....................$ 41.38 21.10 GROUP 13 ....................$ 41.48 21.10 GROUP 14 ....................$ 41.51 21.10 GROUP 15 ....................$ 41.59 21.10 GROUP 16 ....................$ 41.71 21.10 GROUP 17 ....................$ 41.88 21.10 GROUP 18 ....................$ 41.98 21.10 GROUP 19 ....................$ 42.09 21.10 GROUP 20 ....................$ 42.21 21.10 GROUP 21 ....................$ 42.38 21.10 GROUP 22 ....................$ 42.48 21.10 GROUP 23 ....................$ 42.59 21.10 GROUP 24 ....................$ 42.71 21.10 GROUP 25 ....................$ 42.88 21.10 OPERATOR: Power Equipment (Cranes, Piledriving & Hoisting) GROUP 1 ....................$ 39.55 21.10 GROUP 2 ....................$ 40.33 21.10 http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 7 of 25 GROUP 3 ....................$ 40.62 21.10 GROUP 4 ....................$ 40.76 21.10 GROUP 5 ....................$ 40.98 21.10 GROUP 6 ....................$ 41.09 21.10 GROUP 7 ....................$ 41.21 21.10 GROUP 8 ....................$ 41.38 21.10 GROUP 9 ....................$ 41.55 21.10 GROUP 10 ....................$ 42.55 21.10 GROUP 11 ....................$ 43.55 21.10 GROUP 12 ....................$ 44.55 21.10 GROUP 13 ....................$ 45.55 21.10 OPERATOR: Power Equipment (Tunnel Work) GROUP I ....................$ 40.05 21.10 GROUP 2 ....................$ 40.83 21.10 GROUP 3 ....................$ 41..12 21.10 GROUP 4 ....................$ 41.26 21.10 GROUP 5 ....................$ 41.48 21.10 GROUP 6 ....................$ 41.59 21.10 GROUP 7 ....................$ 41.71 21.10 PREMIUM PAY: $3.75 per hour shall be paid on all Power Equipment Operator work on the followng Military Bases: China Lake Naval Reserve, Vandenberg AFB, Point Arguello, Seely Naval Base, Fort Irwin, Nebo Annex Marine Base, Marine Corp Logistics Base Yermo, Edwards AFB, 29 Palms Marine Base and Camp Pendleton Workers required to suit up and work in a hazardous material environment: $2.00 per hour additional. Combination mixer and compressor operator on guni.te work shall be classified as a concrete mobile mixer operator. SEE ZONE DEFINITIONS AFTER CLASSIFICATIONS POWER EQUIPMENT OPERATORS CLASSIFICATIONS GROUP 1: Bargeman; Brakeman; Compressor operator; Ditch Witch, with seat or similar type equipment; Elevator operator -inside; Engineer Oiler; Forklift operator (includes loed, lull or similar types under 5 tons; Generator operator; Generator, pump or compressor plant operator; Pump operator; Signalman; Switchman GROUP 2: Asphalt -rubber plant operator (nurse tank operator); Concrete mixer operator -skip type; Conveyor operator; Fireman; Forklift operator (includes loed, lull or similar types over 5 tons; Hydrostatic pump operator; oiler crusher (asphalt or concrete plant); Petromat laydown machine; PJU side dum jack; Screening and conveyor machine operator (or similar types); Skiploader (wheel type up to 3/4 yd. without attachment); Tar pot fireman; Temporary heating plant operator; Trenching machine oiler GROUP 3: Asphalt -rubber blend operator; Bobcat or similar type (Skid steer); Equipment greaser (rack); Ford Ferguson (with dragtype attachments); Helicopter radioman (ground); Stationary pipe wrapping and cleaning machine operator http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 8 of 25 GROUP 4: Asphalt plant fireman; Backhoe operator (mini -max or similar type); Boring machine operator; Boxman or mixerman (asphalt or concrete); Chip spreading machine operator; Concrete cleaning decontamination machine operator; Concrete Pump Operator (small portable); Drilling machine operator, small auger types (Texoma super economatic or similar types - Hughes 100 or 200 or similar types - drilling depth of 30' maximum); Equipment greaser (grease truck); Guard rail post driver operator; Highline cableway signalman; Hydra-hammer-aero stomper; Micro Tunneling (above ground tunnel); Power concrete curing machine operator; Power concrete saw operator; Power -driven jumbo form setter operator; Power sweeper operator; Rock Wheel Saw/Trencher; Roller operator (compacting); Screed operator (asphalt or concrete); Trenching machine operator (up to 6 ft.); Vacuum or much truck GROUP 5: Equipment Greaser (Grease Truck/Multi Shift). GROUP 6: Articulating material hauler; Asphalt plant engineer; Batch plant operator; Bit sharpener; Concrete joint machine operator (canal and similar type); Concrete planer operator; Dandy dagger_; Deck engine operator; Derrickman (oilfield type); Drilling machine operator, bucket or auger types (Calweld 100 bucket or similar types - Watson 1000 auger or similar types - Texoma 330, 500 or 600 auger or similar types - drilling depth of 45' maximum); Drilling machine operator; Hydrographic seeder machine operator (straw, pulp or seed), Jackson track maintainer, or similar type; Kalamazoo Switch tamper, or similar type; Machine tool operator; Maginnis internal full slab vibrator, Mechanical berm, curb or gutter(concrete or asphalt); Mechanical finisher operator (concrete, Clary -Johnson -Bidwell or similar); Micro tunnel system (below ground); Pavement breaker operator (truck mounted); Road oil mixing machine operator; Roller operator (asphalt or finish), rubber -tired earth moving equipment (single engine, up to and including 25 yds. struck); Self-propelled tar pipelining machine operator; Skiploader operator (crawler and wheel type, over 3/4 yd. and up to and including 1-1/2 yds.); Slip form pump operator (power driven hydraulic lifting device for concrete forms); Tractor operator -bulldozer, tamper -scraper (single engine, up to 100 h.p. flywheel and similar types, up to and including D-5 and similar types); Tugger hoist operator (1 drum); Ultra high pressure waterjet cutting tool system operator; Vacuum blasting machine operator GROUP 8: Asphalt or concrete spreading operator (tamping or finishing); Asphalt paving machine operator (Barber Greene or similar type); Asphalt -rubber distribution operator; Backhoe operator (up to and including 3/4 yd.), small ford, Case or similar; Cast -in -place pipe laying machine operator; Combination mixer and compressor operator (gunite work); Compactor operator (self-propelled); Concrete mixer operator (paving); Crushing plant operator; Drill Doctor; Drilling machine operator, Bucket or auger types (Calweld 150 bucket or similar types - Watson 1500, 2000 2500 auger or similar types - Texoma 700, 800 auger or similar types - drilling depth of 60' maximum); Elevating grader operator; http://www.wdol_gov/wdol/scaftles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 9 of 25 Grade checker; Gradall operator; Grouting machine operator; Heavy-duty repairman; Heavy equipment robotics operator; Kalamazoo balliste regulator or similar type; Kolman belt loader and similar type; Le Tourneau blob compactor or similar type; Loader operator (Athey, Euclid, Sierra and similar types); Mobark Chipper or similar; Ozzie padder or similar types; P.C. slot saw; Pneumatic concrete placing machine operator (Hackley-Presswell or similar type); Pumperete gun operator; Rock Drill or similar types; Rotary drill operator (excluding caisson type); Rubber -tired earth -moving equipment operator (single engine, caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds. up to and including 50 cu. yds. struck); Rubber -tired earth -moving equipment operator (multiple engine up to and including 25 yds. struck); Rubber -tired scraper operator (self -loading paddle wheel type -John Deere, 1040 and similar single unit); Self- propelled curb and gutter machine operator; Shuttle buggy; Skiploader operator (crawler and wheel type over 1-1/2 yds. up to and including 6-1/2 yds.); Soil remediation plant operator; Surface heaters and planer operator; Tractor compressor drill combination operator; Tractor operator (any type larger than D-5 - 100 flywheel h.p. and over, or similar -bulldozer, tamper, scraper and push tractor single engine); Tractor operator (boom attachments), Traveling pipe wrapping, cleaning and bendng machine operator; Trenching machine operator (over 6 ft. depth capacity, manufacturer's rating); trenching Machine with Road Miner attachment (over 6 ft depth capacity): Ultra high pressure waterjet cutting tool system mechanic; Water pull (compaction) operator GROUP 9: Heavy Duty Repairman GROUP 10: Drilling machine operator, Bucket or auger types (Calweld 200 B bucket or similar Lypes-Watson 3000 or 5000 auger or similar types-Texoma 900 auger or similar types -drilling depth of 105' maximum); Dual drum mixer, dynamic compactor LDC350 (or similar types); Monorail locomotive operator (diesel, gas or electric); Motor patrol -blade operator (single engine); Multiple engine tractor operator (Euclid and similar type -except Quad 9 cat.); Rubber -tired earth -moving equipment operator (single engine, over 50 yds. struck); Pneumatic pipe ramming tool and similar types; Prestressed wrapping machine operator; Rubber -tired earth -moving equipment operator (single engine, over 50 yds. struck); Rubber tired earth moving equipment operator (multiple engine, Euclid, caterpillar and similar over 25 yds. and up to 50 yds. struck), Tower crane repairman; Tractor loader operator (crawler and wheel type over 6-1/2 yds.); Woods mixer operator (and similar Pugmill equipment) GROUP 11: Heavy Duty Repairman - Welder Combination, Welder - Certified. GROUP 12: Auto grader operator; Automatic slip form operator; Drilling machine operator, bucket or auger types (Calweld, auger 2C0 CA or similar types - Watson, auger 6000 or similar types - Hughes Super Duty, auger 200 or similar http://www.wdol.gov/wdoUscafiles/davisbaconJCA35.dvb?v=7 5/9/2014 Page 10 of 25 types - drilling depth of 175' maximum); Hoe ram or similar with compressor; Mass excavator operator less tha 750 cu. yards; Mechanical finishing machine operator; Mobile form traveler operator; Motor patrol operator (multi -engine); Pipe mobile machine operator; Rubber -tired earth- moving equipment operator (multiple engine, Euclid, Caterpillar and similar type, over 50 cu. yds. struck); Rubber -tired self- leading scraper operator (paddle -wheel -auger type self -loading - two (2) or more units) GROUP 13: Rubber -tired earth -moving equipment operator operating equipment with push-pull system (single engine, up to and including 25 yds. struck) GROUP 14: Canal liner operator; Canal trimmer operator; Remote- control earth -moving equipment operator (operating a second piece of equipment: $1.00 per hour additional); Wheel excavator operator (over 750 cu. yds.) GROUP 15: Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (single engine, Caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds. and up to and including 50 yds. struck); Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (multiple engine -up to and including 25 yds. struck) GROUP 16: Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (single engine, over 50 yds. struck); Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (multiple engine, Euclid, Caterpillar and similar, over 25 yds. and up to 50 yds. struck) GROUP 17: Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (multiple engine, Euclid, Caterpillar and similar, over 50 cu. yds. struck); Tandem tractor operator (operating crawler type tractors in tandem - Quad 9 and similar type) GROUP 18: Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - single engine, up to and including 25 yds. struck) GROUP 19: Rotex concrete belt operator (or similar types); Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - single engine, Caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds.and up to and including 50 cu. yds. struck); Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - multiple engine, up to and including 25 yds. struck) GROUP 20: Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - single engine, over 50 yds. struck); Rubber -tired http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 11 of 25 earth -moving equipment operator, operating in tandem (scrapers, belly dumps, and similar types in any combination, excluding compaction units - multiple engine, Euclid, Caterpillar and similar, over 25 yds. and up to 50 yds. struck) GROUP 21: Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - multiple engine, Euclid, Caterpillar and similar type, over 50 cu. yds. struck) GROUP 22: Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (single engine, up to and including 25 yds. struck) GROUP 23: Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (single engine, Caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds. and up to and including 50 yds. struck); Rubber -tired earth -moving equipment operator, operating with the tandem push-pull system (multiple engine, up to and including 25 yds. struck) GROUP 24: Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (single engine, over 50 yds. struck); Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (multiple engine, Euclid, Caterpillar and similar, over 25 yds. and up to 50 yds. struck) GROUP 25: Concrete pump operator -truck mounted; Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (multiple engine, Euclid, Caterpillar and similar type, over 50 cu. yds. struck) CRANES, PILEDRIVING AND HOISTING EQUIPMENT CLASSIFICATIONS GROUP 1: Engineer oiler; Fork lift operator (includes loed, lull or similar types) GROUP 2: Truck crane oiler GROUP 3: A -frame or winch truck operator; Ross carrier operator (jobsite) GROUP 4: Bridge -type unloader and turntable operator; Helicopter hoist operator GROUP 5: Hydraulic boom truck; Stinger crane (Austin -Western or similar type); Tugger hoist operator (1 drum) GROUP 6: Bridge crane operator; Cretor crane operator; Hoist operator (Chicago boom and similar type); Lift mobile operator; Lift slab machine operator (Vagtborg and similar types); Material hoist and/or manl.i.ft operator; Polar gantry crane operator; Self Climbing scaffold (or similar type); Shovel, backhoe, dragline, clamshell operator (over http://www.wdol.gov/wdoUseafiles/davisbaconJCA35.dvb?v=7 5/9/2014 Page 12 of 25 3/4 yd. and up to 5 cu. yds. mrc); Tugger hoist operator GROUP 7: Pedestal crane operator; Shovel, backhoe, dragline, clamshell operator (over 5 cu. yds. mrc); 'Power crane repair; 'Tugger hoist operator (3 drum) GROUP 8: Crane operator (up to and including 25 ton capacity); Crawler transporter operator; Derrick barge operator (up to and including 25 ton capacity); Hoist operator, stiff legs, Guy derrick or similar type (up to and including 25 ton capacity); Shovel, backhoe, dragline, clamshell operator (over 7 cu. yds., M.R.C.) GROUP 9: Crane operator (over 25 tons and up to and including 50 tons mrc); Derrick barge operator (over 25 tons up to and including 50 tons mrc); Highline cableway operator; Hoist operator, stiff legs, Guy derrick or similar type (over 25 tons up to and including 50 tons mrc); K-crane operator; Polar crane operator; Self erecting tower crane operator maximum lifting capacity ten tons GROUP 10: Crane operator (over 50 tons and up to and including 100 tons mrc); Derrick barge operator (over 50 tons up to and including 100 tons mrc); Hoist operator, stiff legs, Guy derrick or similar type (over 50 tons up to and including 100 tons mrc), Mobile tower crane operator (over 50 tons, up to and including 100 tons M.R.C.); Tower crane operator and tower gantry GROUP 11: Crane operator (over 100 tons and up to and including 200 tons mrc); Derrick barge operator (over 100 tons up to and including 200 tons mrc); Hoist operator, stiff legs, Guy derrick or similar type (over 100 tons up to and including 200 tons mrc); Mobile tower crane operator (over 100 tons up to and including 200 tons mrc) GROUP 12: Crane operator (over 200 tons up to and including 300 tons mrc); Derrick barge operator (over 200 tons up to and including 300 tons mrc); Hoist operator, stiff legs, Guy derrick or similar type (over 200 tons, up to and including 300 tons mrc); Mobile tower crane operator (over 200 tons, up to and including 300 tons mrc) GROUP 13: Crane operator (over 300 tons); Derrick barge operator (over 300 tons); Helicopter pilot; Hoist operator, stiff legs, Guy derrick or similar type (over 300 tons); Mobile tower crane operator (over 300 tons) TUNNEL CLASSIFICATIONS GROUP 1: Skiploader (wheel type up to 3/4 yd. without attachment) GROUP 2: Power -driven jumbo form setter operator GROUP 3: Dinkey locomotive or motorperson (up to and including 10 tons) GROUP 4: Bit sharpener; Equipment greaser (grease truck); Slip form pump operator (power -driven hydraulic lifting http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 13 of 25 device for concrete forms); Tugger hoist operator (1 drum); Tunnel locomotive operator (over 10 and up to and including 30 tons) GROUP 5: Backhoe operator (up to and including 3/4 yd.); Small Ford, Case or similar; Drill doctor; Grouting machine operator; Heading shield operator; Heavy-duty repairperson; Loader operator (Athey, Euclid, Sierra and similar types); Mucking machine operator (1/4 yd., rubber -tired, rail or track type); Pneumatic concrete placing machine operator (Hackley-Presswell or similar type); Pneumatic heading shield (tunnel); Pumperete gun operator; Tractor compressor drill combination operator; Tugger hoist operator (2 drum); Tunnel locomotive operator (over 30 tons) GROUP 6: Heavy Duty Repairman l GROUP 7: Tunnel mole boring machine operator ENGINEERS ZONES $1.00 additional per hour for all of IMPERIAL County and,the portions of KERN, RIVERSIDE & SAN BERNARDINO Counties asp defined below: That area within the following Boundary: Begin in San i Bernardino County, approximately 3 miles NE of the intersection of I-15 and the California State line at that point which is the NW corner of Section 1, T17N,m R14E, San Bernardino ' Meridian. Continue W in a straight line to that point which is the SW corner of the northwest quarter of Section 6, T27Si1, R42E, Mt. Diablo Meridian. Continue North to the intersection with the Inyo County Boundary at that point which is the NE corner of the western half of the northern quarter of Section 6, T25S, R42E, MDM. Continue W along the Inyo and San Bernardino County boundary until the intersection with Kern County, as that point which is the SE corner of Section 34, T24S, R40E, MDM. Continue W along the Inyo and Kern County boundary until the intersection with Tulare County, at that point which is the SW corner of the SE quarter of Sectionl32, T24S, R37E, MDM. Continue W along the Kern and Tulare County boundary, until that point which is the NW corner of T25S; R32E, MDM. Continue S following R32E lines to the NW corner of T31S, R32E, MDM. Continue W to the NW corner of T31S, R31E, MDM. Continue S to the SW corner of T32S, R31E, MDM. Continue W to SW corner of SE quarter of Section 34, T32S, R30E, MDM. Continue S to SW corner of T11N, R17W, SBM. Continue E along south boundary of T11N, SBM to SW corner of T11N, R7W, SBM. Continue S to SW corner of T9N, R7W, SBM. Continue E along south boundary of T9N, SBM to SW corner of T9N, R1E, SBM.I Continue S along west boundary of R1E, SMB to Riverside County line at the SW corner of T1S, R1E, SBM. Continue E alonglsouth boundary of Tls, SBM (Riverside County Line) to SW cornerlof T1S, RI.OE, SBM. Continue S along west boundary of R10E, SBM to Imperial County line at the SW corner of T8S, R10E, SBM. 11 Continue W along Imperial and Riverside county line to NW corner of T9S, R9E, SBM. Continue S along the boundary between Imperial and San Diego Counties, along the west edge of R9E, SBM to the south boundary of Imperial County/California state line. Follow the California state line west to Arizona state http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 14 of 25 line, then north to Nevada state line, then continuing NW back to start at the point which is the NW corner of Section 1, T11N, R14E, SBM $1.00 additional per hour for portions of SAN LUIS OBISPO, KERN, SANTA BARBARA & VENTURA as defined below: That area within the following Boundary: Begin approximately 5 miles north of the community of Cholame, on the Monterey County and San Luis Obispo County boundary at the NW corner of T25S, R16E, Mt. Diablo Meridian. Continue south along the west side of R16E to the SW corner of T30S, R16E, MDM. Continue E to SW corner of T30S, R17E, MUM. Continue S to SW corner of T31S, R17E, MDM. Continue E to SW corner of T31S, R18E, MDM. Continue S along West side of R18E, MDM as it crosses into San Bernardino Meridian numbering area and becomes R30W. Follow the west side of R30W, SBM to the SW corner of T9N, R30W, SBM. Continue E along the south edge of T9N, SBM to the Santa Barbara County and Ventura County boundary at that point whch is the SW corner of Section 34.T9N, R24W, SBM, continue S along the Ventura County line to that point which is the SW corner of the SE quarter of Section 32, T7N, R24W, SBM. Continue E along the south edge of T7N, SBM to the SE corner to T7N, R21W, SBM. Continue N along East side of R21W, SBM to Ventura County and Kern County boundary at the NE corner of T8N, R21W. Continue W along the Ventura County and Kern County boundary to the SE corner of T9N, R21W. Continue North along the East edge of R21W, SBM to the NE corner of T12N, R21W, SBM. Continue West along the north edge of T12N, SBM to the SE corner of T32S, R21E, MDM. [T12N SBM is a think strip between T11N SBM and T32S MDM]. Continue North along the East side of R21E, MDM to the Kings County and Kern County border at the NE corner of T25S, R21E, MDM, continue West along the Kings County and Kern County Boundary until the intersection of San Luis Obispo County. Continue west along the Kings County and San Luis Obispo County boundary until the intersection with Monterey County. Continue West along the Monterey County and San Luis Obispo County boundary to the beginning point at the NW corner of T25S, R16E, MDM. $2.00 additional per hour for INYO and MONO Counties and the Northern portion of SAN BERNARDINO County as defined below: That area within the following Boundary: Begin at the intersection of the northern boundary of Mono County and the California state line at the point which is the center of Section 17, T10N, R22E, Mt. Diablo Meridian. Continue S then SE along the entire western boundary of Mono County, until it reaches Inyo County at the point which is the NE corner of the Western half of the NW quarter of Section 2, T8S, R29E, MDM. Continue SSE along the entire western boundary of Inyo County, until the intersection with Kern County at the point which is the SW corner of the SE 1/4 of Section 32, T24S, R37E, MDM. Continue E along the Inyo and Kern County boundary until the intersection with San Bernardino County at that point which is the SE corner of section 34, T24S, R40E, MDM. Continue E along the Inyo and San Bernardino County boundary until the point which is the NE corner of the Western half of the NW quarter of Section 6, T25S, R42E, MDM. Continue S to that point which is http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 1 5/9/2014 Page 15 of 25 the SW corner of the NW quarter of Section 6, T27S, R42E, MDM. Continue E in a straight line to the California and Nevada state border at the point_ which is the NW corner of Section 1, T17N, R14E, San Bernardino Meridian. Then continue NW along the state line to the starting point, which is the center of Section 18, T10N, R22E, MDM. REMAINING AREA NOT DEFINED ABOVE RECIEVES BASE RATE ---------------------------------------------------------------- ENGIOCl2-004 08/05/2013 Rates Fringes OPERATOR: Power Equipment (DREDGING) (1) Leverman................$ 47.70 21.20 (2) Dredge dozer ............ $ 41.73 21.20 (3) Deckmate................$ 41.62 21.20 (4) Winch operator (stern winch on dredge) ............ $ 41.07 21.20 (5) Fireman -Oiler, Deckhand, Bargeman, Leveehand...................$ 40.53 21.20 (6) Barge Mate ..............$ 41.14 21.20 IRON0377-002 07/01/2013 Rates Fringes Ironworkers: Fence Erector ...............$ 26.58 17.74 Ornamental, Reinforcing and Structural ..............$ 33.00 26.30 PREMIUM PAY: $6.00 additional per hour at the following locations: China Lake Naval Test Station, Chocolate Mountains Naval Reserve-Niland, Edwards AFB, Fort Irwin Military Station, Fort Irwin Training Center -Goldstone, San Clemente Island, San Nicholas Island, Susanville Federal Prison, 29 Palms - Marine Corps, U.S. Marine Base - Barstow, U.S. Naval Air Facility - Sealey, Vandenberg AFB $4.00 additional per hour at the following locations: Army Defense Language Institute - Monterey, Fallon Air Base, Naval Post Graduate School. - Monterey, Yermo Marine Corps Logistics Center $2.00 additional per hour at the following locations: Port Hueneme, Port Mugu, U.S. Coast Guard Station - Two Rock --------------------------------------------------------------- LAB00300-005 01/01/2014 http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 16 of 25 Rates Fringes Asbestos Removal. Laborer ......... $ 28.00 15.25 SCOPE OF WORK: Includes site mobilization, initial site cleanup, site preparation, removal of asbestos -containing material and toxic waste, encapsulation, enclosure and disposal of asbestos- containing materials and toxic waste by hand or with equipment or machinery; scaffolding, fabrication of temporary wooden barriers and assembly of decontamination stations. ---------------------------------------------------------------- LAB00345-001 07/01/2013 Rates Fringes LABORER (GUNITE) GROUP 1.....................$ 33.04 17.86 GROUP 2.....................$ 32.09 17.86 GROUP 3.....................$ 28.55 17.86 FOOTNOTE: GUNITE PREMIUM PAY: Workers working from a Bosn'n's Chair or suspended from a rope or cable shall receive 40 cents per hour above the foregoing applicable classification rates. Workers doing gunite and/or shotcrete work in a tunnel shall receive 35 cents per hour above the foregoing applicable classification rates, paid on a portal-to-portal basis. Any work performed on, in or above any smoke stack, silo, storage elevator or similar type of structure, when such structure is in excess of 75'-0" above base level and which work must be performed in whole or in part more than 75'-0" above base level, that work performed above the 75'-0" level shall be compensated for at 35 cents per hour above the applicable classification wage rate. GUNITE LABORER CLASSIFICATIONS GROUP 1: Rodmen, Nozzlemen GROUP 2: Gunmen GROUP 3: Reboundmen ---------------------------------------------- LAB00652-001 07/01/2013 Rates LABORER (TUNNEL) GROUP I .....................$ 34.84 GROUP 2.....................$ 35.16 GROUP 3.....................$ 35.62 GROUP 4.....................$ 36.31 LABORER GROUP 1.....................$ 28.99 GROUP 2.....................$ 29.54 GROUP 3.....................$ 30.09 Fringes 16.02 16.02 16.02 16.02 16.02 16.02 16.02 http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 17 of 25 GROUP 4.....................$ 31.64 16.02 GROUP 5.....................$ 31.99 16.02 LABORER CLASSIFICATIONS GROUP 1: Cleaning and handling of panel forms; Concrete screeding for rough strike -off; Concrete, water curing; Demolition laborer, the cleaning of brick if performed by a worker performing any other phase of demolition work, and the cleaning of lumber; Fire watcher, limber, brush loader, piler and debris handler; Flag person; Gas, oil and/or water pipeline laborer; Laborer, asphalt -rubber material loader; Laborer, general or construction; Laborer, general clean-up; Laborer, landscaping; Laborer, jetting; Laborer, temporary water and air lines; Material hose operator (walls, slabs, floors and decks); Plugging, filling of shee bolt holes; Dry packing of concrete; Railroad maintenance, repair track person and road beds; Streetcar and railroad construction track laborers; Rigging and signaling; Scaler; Slip form raiser; Tar and mortar; Tool crib or tool house laborer; Traffic control by any method; Window cleaner; Wire mesh pulling - all concrete pouring operations GROUP 2: Asphalt shoveler; Cement dumper (on 1 yd. or larger mixer and handling bulk cement); Cesspool digger and installer; Chuckterider; Chute handler, pouring concrete, the handling of the chute from readymix trucks, such as walls, slabs, decks, floors, foundation, footings, curbs, gutters and sidewalks; Concrete curer, impervious membrane and form oiler; Cutting torch operator (demolition); Fine grader, highways and street paving, airport, runways and similar type heavy construction; Gas, oil and/or water pipeline wrapper - pot tender and form person; Guinea chaser; Headerboard person - asphalt; Laborer, packing rod steel and pans; Membrane vapor barrier installer; Power broom sweeper (small); Riprap stonepaver, placing stone or wet sacked concrete; Roto scraper and tiller; Sandblaster (pot tender); Septic tank digger and installer(lead); Tank scaler and cleaner; Tree climber, faller, chain saw operator, Pittsburgh chipper and similar type brush shredder; Underground laborer, including caisson bellower GROUP 3: Buggymobile person; Concrete cutting torch; Concrete pile cutter; Driller, jackhammer, 2-1/2 ft. drill steel or longer; Dri-pak-it machine; Gas, oil and/or water pipeline wrapper, 6-in. pipe and over, by any method, inside and out; High scaler (including drilling of same); hydro seeder and similar type; Impact wrench multi -plate; Kettle person, pot person and workers applying asphalt, lay-kold, creosote, lime caustic and similar type materials ("applying" means applying, dipping, brushing or handling of such materials for pipe wrapping and waterproofing); Operator of pneumatic, gas, electric tools, vibrating machine, pavement breaker, air blasting, come-alongs, and similar mechanical tools not separately classified herein; Pipelayer's backup person, coating, grouting, making of joints, sealing, caulking, diapering and including rubber gasket joints, pointing and any and all other services; Rock Slinger; Rotary scarifier or multiple head concrete chipping scarifier; Steel headerboard and guideline setter; http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v--7 5/9/2014 Page 18 of 25 Tamper, Barko, Wacker and similar type; Trenching machine, hand -propelled GROUP 4: Asphalt raker, lute person, ironer, asphalt dump person, and asphalt spreader boxes (all types); Concrete core cutter (walls, floors or ceilings), grinder or sander; Concrete saw person, cutting walls or flat work, scoring old or new concrete; Cribber, shorer, lagging, sheeting and trench bracing, hand -guided lagging hammer; Head rock clinger; Laborer, asphalt- rubber distributor boot person; Laser beam in connection with laborers' work; Oversize concrete vibrator operator, 70 lbs. and over; Pipelayer performing all services in the laying and installation of pipe from the point of receiving pipe in the ditch until completion of operation, including any and all forms of tubular material, whether pipe, metallic or non-metallic; conduit and any other stationary type of tubular device used for the conveying of any substance or element, whether water, sewaae, solid gas, air, or other product whatsoever and without regard to the nature of material from which the tubular material is fabricated; No -joint pipe and stripping of same; Prefabricated manhole installer; Sandblaster (nozzle person), water blasting, Porta Shot -Blast GROUP 5: Blaster powder, all work of loading holes, placing and blasting of all powder and explosives of whatever type, regardless of method used for such loading and placing; Driller: All power drills, excluding jackhammer, whether core, diamond, wagon, track, multiple unit, and any and all other types of mechanical drills without regard to the form of motive power; Toxic waste removal TUNNEL LABORER CLASSIFICATIONS GROUP 1: Batch plant laborer; Bull gang mucker, track person; Changehouse person; Concrete crew, including rodder and spreader; Dump person; Dump person (outside); Swamper (brake person and switch person on tunnel work); Tunnel materials handling person GROUP 2: Chucktender, cabletender; Loading and unloading agitator cars; Nipper; Pot tender, using mastic or other materials (for example, but not by way of limitation, shotcrete, etc.); Vibrator person, jack hammer, pneumatic tools (except driller) GROUP 3: Blaster, driller, powder person; Chemical grout jet person; Cherry picker person; Grout gun person; Grout mixer person.; Grout pump person; Jackleg miner; Jumbo person; Kemper and other pneumatic concrete placer operator; Miner, tunnel (hand or machine); Nozzle person; Operating of troweling and/or grouting machines; Powder person (primer house); Primer person; Sandblaster; Shotcrete person; Steel form raiser and setter; Timber person, retimber person, wood or steel; Tunnel Concrete finisher GROUP 4: Diamond driller; Sandblaster; Shaft and raise work ------------------------------------------------------------ LAB00652-003 07/01/2013 http://www.wdol.gov/wdoUscafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 19 of 25 Rates Fringes Brick Tender ...................... $ 28.37 15.78 --------------------------------------------------------- LABO1184-001 07/01/2013 Rates Fringes Laborers: (HORIZONTAL, DIRECTIONAL DRILLING) (1) Drilling Crew Laborer ... $ 30.11 11.83 (2) Vehicle Operator/Hauler.$ 30.28 11.83 (3) Horizontal Directional Drill Operator .............. $ 32.13 11.83 (4) Electronic Tracking Locator .....................$ 34.13 11.83 Laborers: (STRIPING/SLURRY SEAL) GROUP 1.....................$ 31.06 14.53 GROUP 2.....................$ 32.36 14.53 GROUP 3.....................$ 34.37 14.53 GROUP 4.....................$ 36.11 14.53 LABORERS - STRIPING CLASSIFICATIONS GROUP 1: Protective coating, pavement sealing, including repair and filling of cracks by any method on any surface in parking lots, game courts and playgrounds; carstops; operation of all related machinery and equipment; equipment repair technician GROUP 2: Traffic surface abrasive blaster; pot tender - removal of all traffic lines and markings by any method (sandblasting, waterblasting, grinding, etc.) and preparation of surface for coatings. Traffic control person: controlling and directing traffic through both conventional and moving lane closures; operation of all related machinery and equipment GROUP 3: Traffic delineating device applicator: Layout and application of pavement markers, delineating signs, rumble and traffic bars, adhesives, guide markers, other traffic delineating devices including traffic control. 'Phis category includes all traffic related surface preparation (sandblasting, waterblasting, grinding) as part of the application process. Traffic protective delineating system installer: removes, relocates, installs, permanently affixed roadside and parking delineation barricades, fencing, cable anchor, guard rail, reference signs, monument markers; operation of all related machinery and equipment; power broom sweeper GROUP 4: Striper: layout and application of traffic stripes and markings; hot thereto plastic; tape traffic stripes and markings, including traffic control; operation of all related machinery and equipment ---------------------------------------------------------------- LABO1414-001 08/07/2013 http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 20 of 25 Rates Fringes LABORER PLASTER CLEAN-UP LABORER .... $ 27.45 16.36 PLASTER TENDER ..............$ 30.00 16.36 Work on a swing stage scaffold: $1.00 per hour additional. ---------------------------------------------------------------- PAIN0036-001 01/01/2014 Rates Fringes Painters: (Including Lead Abatement) (1) Repaint (excludes San Diego County) ...............$ 26.49 11.73 (2) All Other Work .......... $ 29.82 1.1.73 REPAINT of any previously painted structure. Exceptions: work involving the aerospace industry, breweries, commercial recreational facilities, hotels which operate commercial establishments as part of hotel service, and sports facilities. ---------------------------------------------------------------- PAIN0036-008 01/01/2014 Rates Fringes DRYWALL FINISHER/TAPER ........... $ 34.03 ---------------------------------------------------------------- 15.41 PAIN0036-015 02/01/2014 Rates Fringes GLAZIER ..........................$ 38.95 22.08 FOOTNOTE: Additional $1.25 per hour for work in a condor, from the third (3rd) floor and up Additional $1.25 per hour for work on the outside of the building from a swing stage or any suspended contrivance, from the ground up ---------------------------------------------------------------- PAIN1247-002 01/01/2014 Rates Fringes SOFT FLOOR LAYER .................$ 29.85 12.56 ---------------------------------------------------------------- PLAS0200-009 08/07/2013 Rates Fringes PLASTERER ........................$ 36.11 13.13 ---------------------------------------------------------------- PLAS0500-002 07/01/2013 Rates Fringes http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 21 of 25 CEMENT MASON/CONCRETE FINISHER...$ 30.85 21.00 ---------------------------------------------------------------- PLUM0016-001 07/01/2013 Rates Fringes PLUMBER/PIPEFITTER Plumber and Pipefitter All other work except work on new additions and remodeling of bars, restaurant, stores and commercial buildings not to exceed 5,000 sq. ft. of floor space and work on strip malls, light commercial, tenant improvement and remodel work .......................$ 43.60 20.16 Work ONLY on new additions and remodeling of bars, restaurant, stores and commercial buildings not to exceed 5,000 sq. ft. of floor space .................$ 42.26 19.18 Work ONLY on strip malls, light commercial, tenant improvement and remodel work ........................$ 34.11 17.51 PLUM0345-001 01/01/2014 Rates Fringes PLUMBER Landscape/Irrigation Fitter.$ 28.56 19.55 Sewer & Storm Drain Work .... $ 32.50 17.23 ---------------------------------------------------------------- ROOF0036-002 08/01/2012 Rates Fringes ROOFER ...........................$ 34.65 11.38 FOOTNOTE: Pitch premium: Work on which employees are exposed to pitch fumes or required to handle pitch, pitch base or pitch impregnated products, or any material containing coal tar pitch, the entire roofing crew shall receive $1.75 per hour "pitch premium" pay. ---------------------------------------------------------------- SFCA0669-008 07/01/2013 DOES NOT INCLUDE SAN CLEMENTE ISLAND, THE CITY OF SANTA ANA, AND THAT PART OF ORANGE COUNTY WITHIN 25 MILES OF THE CITY LIMITS OF LOS ANGELES: Rates Fringes http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 22 of 25 SPRINKLER FITTER .................$ 34.19 19.37 --------------------------------------------------------- SFCA0709-003 01/01/2014 SAN CLEMENTE ISLAND, THE CITY OF SANTA ANA, AND THAT PART OF ORANGE COUNTY WITHIN 25 MILES BEYOND THE CITY LIMITS OF LOS ANGELES: Rates Fringes SPRINKLER FITTER (Fire) .......... $ 40.61 24.02 ---------------------------------------------------------------- SHEE0105-003 01/01/2014 LOS ANGELES (South of a straight line drawn between Gorman and Big Pines)and Catalina Island, INYO, KERN (Northeast part, East of Hwy 395), MONO ORANGE, RIVERSIDE, AND SAN BERNARDINO COUNTIES Rates Fringes SHEET METAL WORKER (1) Commercial - New Construction and Remodel work ........................$ 40.79 22.88 (2) Industrial work including air pollution control systems, noise abatement, hand rails, guard rails, excluding aritechtural sheet metal work, excluding A-C, heating, ventilating systems for human comfort ... $ 40.79 22.88 --------------------------------------------------------- TEAM0011-002 07/01/2013 Rates Fringes TRUCK DRIVER GROUP 1....................$ 27.59 22.69 GROUP 2....................$ 27.74 22.69 GROUP 3....................$ 27.87 22.69 GROUP 4....................$ 28.06 22.69 GROUP 5....................$ 28.09 22.69 GROUP 6....................$ 28.12 22.69 GROUP 7....................$ 28.37 22.69 GROUP 8....................$ 28.62 22.69 GROUP 9....................$ 28.82 22.69 GROUP 10....................$ 29.12 22.69 GROUP 11....................$ 29.62 22.69 GROUP 12....................$ 30.05 22.69 WORK ON ALL MILITARY BASES: PREMIUM PAY: $3.00 per hour additional. [29 palms Marine Base, Camp Roberts, China Lake, Edwards AFB, E1 Centro Naval Facility, Fort Irwin, Marine Corps Logistics Base at Nebo & Yermo, Mountain Warfare Training Center, Bridgeport, Point Arguello, Point Conception, http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 15/9/2014 Page 23 of 25 Vandenberg AFB] TRUCK DRIVERS CLASSIFICATIONS GROUP 1: Truck driver GROUP 2: Driver of vehicle or combination of vehicles - 2 axles; Traffic control pilot car excluding moving heavy equipment permit load; Truck mounted broom GROUP 3: Driver of vehicle or combination of vehicles - 3 axles; Boot person; Cement mason distribution truck; Fuel truck driver; Water truck - 2 axle; Dump truck, less than 16 yds. water level; Erosion control driver GROUP 4: Driver of transit mix truck, under 3 yds.; Dumperete truck, less than 6-1/2 yds. water level GROUP 5: Water truck, 3 or more axles; Truck greaser and tire person ($0.50 additional for tire person); Pipeline and utility working truck driver, including winch truck and plastic fusion, limited to pipeline and utility work; Slurry truck driver GROUP 6: Transit mix truck, 3 yds. or more; Dumperete truck, 6-1/2 yds. water level and over; Vehicle or combination of vehicles - 4 or more axles; Oil spreader truck; Dump truck, 16 yds. to 25 yds. water level GROUP 7: A Frame, Swedish crane or. similar; Forklift driver; Ross carrier driver GROUP 8: Dump truck, 25 yds. to 49 yds. water level; Truck repair person; Water pull - single engine; Welder GROUP 9: Truck repair person/welder; Low bed driver, 9 axles or over GROUP 10: Dump truck - 50 yds. or more water level; Water pull - single engine with attachment GROUP ll: Water pull - twin engine; Water pull - twin engine with attachments; Winch truck driver - $1.25 additional when operating winch or similar special attachments GROUP 12: Boom Truck 17K and above WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 24 of 25 (29CFR 5.5 (a) (1) (ii)). The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of "identifiers" that indicate whether the particular rate is union or non -union. Union Identifiers An identifier enclosed in dotted lines beginning with characters other than "SU" denotes that the union classification and rate have found to be prevailing for that classification. Example: PLUM0198-005 07/01/2011. The first four letters , PLUM, indicate the international union and the four -digit number, 0198, that follows indicates the local union number or district council number where applicable , i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. The date, 0*710112011, following these characters is the effective date of the most current negotiated rate/collective bargaining agreement which would be July 1, 2011 in the above example. Union prevailing wage rates will be updated to reflect any changes in the collective bargaining agreements governing the rates. 0000/9999: weighted union wage rates will be published annually each January. Non -Union Identifiers Classifications listed under an "SU" identifier were derived from survey data by computing average rates and are not union rates; however, the data used in computing these rates may include both union and non -union data. Example: SULA2004-007 5/13/2010. SU indicates the rates are not union majority rates, LA indicates the State of Louisiana; 2004 is the year of the survey; and 007 is an internal number used in producing the wage determination. A 1993 or later date, 5/13/2010, indicates the classifications and rates under that identifier were issued as a General Wage Determination on that date. Survey wage rates will remain in effect and will not change until a new survey is conducted. ---------------------------------------------------------------- WAGE DETERMINATION APPEALS PROCESS http://www.wdol.gov/wdol/scafiles/davisbacon/CA35.dvb?v=7 5/9/2014 Page 25 of 25 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling On survey .related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis -Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, -initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7). Write to: Wage and :lour Administrator U.S. Department of Labor 200 Constitution: Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requester considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. END OF GENERAL DECISION http://www.wdol.gov/wdoUscafiles/davisbacon/CA3S.dvb?v=7 5/9/2014 (800)683-7648 overniteexpress.com - Mozilla/5. Page 1 of 1 To:Mr. Wiliam Janusz, R.C.E. City of Huntington Beach 2000 Main Ste: Next Day Overnite -- P Zone:161 SPECIAL INSTRUCTIONS: Signature Required Number of Pieces: 1 Huntington Beach, CA 92648 7143741628 Signature Required =OVEERNITE Please fold this page in half and place it in the pouch on your shipment. Only one copy is required by Norco Overnite. WARNING, Use only the printed label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with cancellation of your Norco Overnite account or OvemiteShip Online Profile. Shipments with invalid account or credit card numbers will not be delivered. http://www.shipovernite.com/overniteshiponline/direction/shipmentform.... 5/22/2014 Local Assisftuce Procedures Manual EXIMT 15-G LomIA,gency Bidder D)BE Commitraeut (Constnictioa Coutracts) Enwrr 15-G LocAL AaENcy WDDER D13E ColvolMTENT (CONSTRUCI-ION CONTRAX-7S) NOTE: PLEASE REFER TO INSTRIGM ONS ON THE REVERSE SWE OF TWS FO)W LOCAL A(3F-XCYt GizX. of Huntington Beach LOCA-410W.' Tri tlg- vicanity-of-af-;i ,i,l5 3nr�d 11 1 pRo)-Rcrr7; car-uON: safe Routes To School Stacey -Clegg P3:oject 4SITSL75187t;73 (1(1-1426 'TOTAL CONTRACT AMOUNT- S 269692.00 BjDPAT& 05.20,2014 aznDnitsrrAz PTM General Engineering Services. Inc. CONTRACT DBE GOAL; 0 - 2 8 CONTRACT -MAOF-WOIUCAND DESCRRTXYN DBECEM\10. Avis OF BACH DBE LLAXAMOUNT 3F r UEM NO, DR SERVICLS, TO BE 3TMCONTRACTED OR, INUTERMS AND M.PrRAUCTT DATE Cylust be; c-ertifi-od on the daft ,; bids opened - inch)(fe, IRE a( � f= rO 13B PRONMED (or contracted if the phone number) �iddcrisaDBE) - — Ptn. #2, 4, Conduit, Cable, DLC 37177 - -- Lyte� orma, 55 000.00 5,6, & 9 _LQOS_e, an ,Var_� Reb , Sigu,s. R -k 13841 Roswell Ave. #A , �ino, 91710 Misc. Const —&-Equipinalit- —.-- 909.680.8123 00.00x 60.1/o=33,000.00------ For Local Agency to Complete: Local Agency Contract Nuwl3cr: Total Cl:,-i,-ucd DBE 33,000.00 Participation Federal -aid PmjwtNumbcr 12.28 o/, Fedtfal shnt, Contract Award huts: Local Agency cufiffimN that all T)BE, cct ufiratia 7 have bt-m *,voted and inklmation, is C*MPI('.-- and Ica a3tc. 0522.2014 951.722.5678 (,Area Co4c.) Tel. No. —si—guature Date PriatNamcPerson Elizabeth H, Mendoza de Mcp to Contact (P,c c 'Fy�-- or print) (Alta COW, TclephoneNumbar; Biddrr DPE co=anmt (Canst- Oa Distribution: (1) Copy -Fax or scati a copy to 111e. CaItTuns District UczA Assis-:wcz Eugiztctr (DLAB) wilhin 30 days of contract cxtcuti0n, Failure to Page 15-1 01312-04 C-18 ,rune 29, 2012 Date: 05/19/2014 To : PTM General Engineering Services Inc. Attn: Estimating Dept. Fax No. 951.710.1006 Re: Date of Bid: 05/20/2014 Description: City of Huntington Beach SRTS CC-1426 Dear PTM: We are pleased to quote the following Line Bid Item # Description of Material Unit Unit Price Item Total A Ptn.2 Signs LS 2000.00 2000.00 B Ptn. 4,5,6 Conduit, Cable, Wire LS 37000.00 37000.00 C Ptn. 4,5 Pull Boxes EA 150.00 1500.00 D Ptn.4 Rebar LS 3000.00 3000.00 E Ptn. 4,5,6 Misc Material & Equipment LS 8000.00 8600.00 F Ptn.9 Rail LS 1500.00 1500.00 G Ptn.4 Sealant LS 2000.00 2000.00 55000.00 Plus Tax cerIly yours, To ` Lee 13841 Roswell Ave Unit A Chino, California 91710 Ph 909-680-8123 13!efonias@ginail.com DBE: 37133 Notes: Option to purchase separate line items with no unit price change. Esparza, Patty From: Janusz, Bill Sent: Monday, August 25, 2014 8:36 AM To: Esparza, Patty Subject: RE: Bid Bond - cc-1426 Attachments: PTM Construction (Bid#3).pdf Patty I checked our scan and did not find a bid bond. ME William F. Janusz, P.E., PTOE Principal Civil Engineer City of Huntington Beach 2000 Main Street, P.O. Box 190 Huntington Beach, CA 92648 (714) 536-5431 FAX (714) 374-1573 From: Esparza, Patty Sent: Friday, August 22, 2014 3:49 PM To: Janusz, Bill Subject: Bid Bond - cc-1426 Hi Bill — In going through the 'unsuccessful' bids for CC-1426 (Safe Routes to School) in preparation of returning the bid bonds, I could not find a bid bond in the package for PTM General Engineering Services. Do you recall that is the case or perhaps it has been misplaced? Thanks for your help! Patty Esparza, C WC Senior Deputy City Clerk City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 (714) 536-5260 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Joan L. Flynn, City Clerk August 26, 2014 Select Electric, Inc. 13250 Kirkham Way Poway, CA 92064 RE: Safe Routes to School/Stacey-Clegg — CC-1426 Enclosed please find your original bid bond for CC-1426. Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand 14 Mai Y 20 PM 1: 4 SELECT E I. E C T R I C, INC. 13250 Kirkham Way Poway, CA 92064 License # 297034 A, B, C-7, C-10 City of Huntington Beach City Clerk Second Floor 2000 Main Street Huntington Beach CA 92648 SEALED BID BOND: Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181 (173) May 20, 2014 at 2:00 p.m. SECTION C PROPOSAL for the construction of Safe Routes to School In the vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181(173) 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 50 working days, starting. from the date of 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 prices shall govern over extended amounts, and words shall govern over figures. C-1 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, In the Vicinity of Stacey Middle School and Clegg Elementary School — CC 1426 May 9, 2014 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for the: Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School - CC1426 shall be replaced with the following attached documents: The Federal Labor Rates dated May 9, 2014 shall be the labor rates in effect for the subject project. 2) SHEET 3 — TRAFFIC SIGNAL PLAN SPRINGDALE STREET AT CROUPIER DRIVE The following revision has been added to Pole Schedule: Traffic signal pole #5 has been revised from 26-4-100 to 29-5-100. The pole height and equipment will remain the same. This is to acknowledge receipt and review of Addendum Number One, dated May 9, 2014. n � � Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School ti# y ,yc Lrr��Sa 3 :57sxi3t' •.K+" s �.n i" .. �"L ./ y ,"! Y k3 ✓f iyi N C `� `yv3 "? Y .6 f .�"' N a}}a, 1 1 L.S. Mobilization. •� $ oa $ Per L.S. 2 1 L.S. Furnish Project Traffic Control. Per L.S. $ �� �',w �1 J $ � � �_6'3_ 3 1 L.S. Furnish and Install Traffic Striping and Signing. $) Z $ 16 2- Per L.S. 4 1 L.S. Construct Traffic Signal at Springdale 0 -L 02,06Z Street and Croupier Drive. (excludes $R interconnect conduit and interconnect cable) Per L.S. 5 2550 L.F. Furnish and Install 2"Interconnect Conduit with 6 Pair #19 Solid Interconnect Cables and Pull Boxes $ _ $1~���`i�� Spaced Approximately 200' (Also includes installation into the traffic signal cabinets). Per L.F. 6 450 L.F. Furnish and Install 6Pair 419 Solid Interconnect Cables in Existing 33 �—T Conduit (Also includes installation $_ Z, $ U into the traffic signal cabinets). Per L.F. 7 18 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B or Case C and Per Typical Section at $ 1 O' New Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School - CC-1426 SRT'SL-5181(173) Stacey Middle School and Clegg Elementary School Tt�m F.- G :i ESiTnt ed y jet r kt�. -+ '. � Items '� Syyx !gym' v ' ..r �e. ., y t Fkn Y.1 4 } t. nilPr�ce11dVAi 3'�,'�`"= ✓ { ; .x V; i 1 s�C�`v ou i+ t 8 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case F and Sheet 2 Details for Ramp Locations 1 rr 2 $) J and 12. Also Includes Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 9 17 L.F. Furnish and Install Metal Railing Per Standard Plans for Public Works Book) Plan 606-2, Type A. q (Green Per LF. IL I Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes traffic signal cabinet, service cabinet and anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 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 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. , kzr;ABand co 16le0�161�f 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 a able to the AGENCY. (Please insert the words "Cash", "Certified Check", or Bidder's Bond" ` s the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 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. Ll% -11 -L." r A7 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 N®NC®LLUSI®N AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed onS-lq-IS at Poway , CA Date City State Craig Degenfelder , being first duly sworn, deposes and says that he or she is Executive Vice President of Select Electric, Inc. the parry 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. Craig Degenfelder-Exec.kA---We k'ce �('-eskcke-ice Name of Bidder Sigma ;er 13250 Kirkham Way Poway CA 92064 Address of Bidder 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 CC-1426 SRTSL-5181(173), Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School, (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. Select Electric, Inc. Contractor Date: IS0—M MW IF 1:11l�11111 �r �- Executive Vice President Title C-5 In accordance with Government 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? El 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: Select Electric, Inc. Contractor Executive Vice President Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Select Electric, Inc. Bidder Name 13250 Kirkham Wa Business Address Powa City, (619 ) 460-6060 Telephone Number 297034 ABC-7 C-10 State Contractor's License No. and Class 11-10-1974 Original Date Issued 10-31-14 Expiration Date CA 92064 State Zip The work site was inspected by of our office on 7 V' 201y. The following are persons, firms, and corporations having a principal interest in this proposal: Dan Zupp-President Craig Degenfelder-Executive Vice President Mario Tapanes-Secretary Alex Meruelo-Treasurer Meruelo Enterprise Inc. C-s 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. Select Electric, Inc. Company Name Craig Degenfelder Exe c_.uak\) e, \) Ice- Rt'e"_Ae_C tt Printed or Typed Signature Subscribed and sworn to before me this day of , 201 KATHRYN JOY PARKINGTON C COMM. # 2039052 W ., NOTARY PUBLIC -CALIFORNIA M a SAN DIEGO COUNTY O My Commission Expires '• August 26, 2017 NOTARY PUBLI 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. City of Solan Beach 635 S. Highway 101 Solana Beach CA 92075 Name and Address of Public Agency Name and Telephone No. of Project Manager: Paul Smith 1,065 216.37 Light and Traffic Signal Installation 6/26/12 - 10-31-13 Contract Amount Type of Work Date Completed 2. Diablo Construction 113 W. G Street San Diego CA 92101 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mark Diablo 2,234,977 73 Constructing Freeway Electrical, Traffic Signals 3/18/11 - 11/1/13 Contract Amount Type of Work Date Completed 3. Flatiron West Corp. 1770 La Costa Meadows Drive San Marcos CA 92078 Name and Address of Public Agency Name and Telephone No. of Project Manager: Justing Klug 1,930,182.21 Underground Cable & Track Wire, Signaling & Ped Crossings 5/16/12 - 12/31/13 Contract Amount Type of Work Date Completed C-9 CML CODE § 1189 State of California County of San_.Diego On r Irry _Q+j., Q1H before me, Kathryn Joy Parkington, Notary Public IDate j�c Here Insert Name and Title of the Officer personally appeared . i-)&_V- / ( Name(s) of Signer(s) KATHRYN JOY PARKINGTON '- COMM. # 2039052 'p NOTARY PUBLIC -CALIFORNIA M a '°ilk SAN OIEGO COUNTY O My Commission Expires August 26, 2017 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. 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: Place Notary Seal Above Signa of ary 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. Descr ' onon of Attached Document Title or Typed Document Date: Signer(s) Other Than Name bov Capacity(ies) Claimed by Sig Signer's Name: 11 Corporate Officer — Title(s): _ L__ Individual Cl Partner — Limited ! s General F-1 Attorney in Fact C! Trustee 1_1 Guardian or Conservator L' Other: Signer Is Representing: Number of Pages: Signer's Name: -----__—_-` Corporate Officer — Title(s): CJ Individual Top of thumb here [vI ner — :: ! Limited f l General Top of thumb here I_ Attorn n Fact D Trustee F! Guardian or Conse for Other: Signer Is Representing: Item #5907 ,t; 2010 National Notary Association • Nationa]Notary.org • 1-800-US NOTARY (1-600-876-6827) (For federally funded projects, use this following page) 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 requiremnents 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: Select Electric, Inc. Contact Person: Craig Degenfelder Contact Phone: 619-460-6060 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-10 Local Assistance Procedures Manual EIIBTT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONST=E AN ENDORSEAMNT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) ATTACHMENT C EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Select Electric, Inc. proposed subcontractor hereby certifies that he, hasx , has notes 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 12-25 OB 12-04 C-11 .tune 29, 2012 Local Assistance Procedures Manual Pq&F Checklist Instructions ATTACHMENT D NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of � U.L~CIJF\ DEPARTMENT OF PUBLIC RKS. 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 12-27 OB 12-04 C -12 June 29, 2012 Local Assistance Procedures Manual PS&E Checklist Instructions ATTACHMENT E DEBARMENT AND SUSPENSION CERTIFICATION TTTLE 49, CODE OF FEDERAL REGULATIONS, PART 29 EXHIBIT 12-E Attachment E 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 12-29 OB 12-04 C -13 June 29, 2012 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F 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 sub recipients shall certify and disclose accordingly. Page 12-31 OB 12-04 C -14 June 29, 2012 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G ATTAcHWNT G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVIMS PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: Qa. contract Fla. bid/offer/application ❑ a. initial b. grant b. initial award b. material ge c. cooperative agreement c, post -award d. loan For Ma 'al Change Only: e. loan guarantee quarter f loan insurance date of last report 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: 5. If Reporting En . in No. 4 is Subawardee, Enter Name d Address of Prime: /Congressional District, if known . Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: 10. a. Name and Address of Lobby En b. Individuals Performing Services (including (If individual, last name, first e, MI) address if different from No. 10a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (c eck all that apply) 13. Type of Payment (check all that apply) $ actual planned a. retainer b. one-time fee 12. Form of Paymen (check all that apply): c. commission a. cash d. contingent fee b. in- d, specify: nature a deferred value f. other, specify 14. Brief Des iption of Services Performed or to be performed and Date(s) of Service, including officers) employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach continuation Sheet(s) if necessary) 15. Con nation 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 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.��`�" �lP�- d (P Date:S'� Federal Use Only: Authorized for Local Reproduction Standard Form - LLL FormLLL Rev. Page 12-33 OB 12-04 C -15 June 29, 2012 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 (k&). 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 12-34 June 29, 2012 C -16 OB 12-04 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-LUAnstructions Rey.06-04-90((ENDIF)) Page 12-35 OR 12-04 C -1 7 June 29, 2012 Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts) E7IDBTT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THLS FORM LOCALAGENCY. City of Huntington Beach LOCATION: In the vicinity of Stacey MS and Clegg ES PROJECTDE�CRRM0N:Safe Routes To School Stacey -Clegg Project #STRSL-5181(173) CC-1426 TOTAL CONTRACT AMOUNT: $ BIDDATE: 'Z r BIDDER'S NAME: CONTRACT DBE GOAL: 10.2 8 % CONTRACT' lTEMNO. rrEM OF WORK AND DESCRIPTION OR SERVICES TO BE CONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a DBE) DBECERTNO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLARAMOUNT BE For Local Agency to Complete: Local Agency Contract Number. Federal -aid Project Number. Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Print Name Si9aaturc Date Local Agency Representative (Area Code) Telephone Number. Total Claimed DBE Participation % Si f Bidder ' 9 lo\ (D (.0 G Date (� _ (Area Code) Tel. No. cx� k!i VC.SI'l. 'r A Er Perso o Con t (Please Type or Print) Local Agency Bidder DBE CommAmenr (Consavdion Contacts) (Rev 6t26J09) Distribution: (1) Copy —Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 days of contract exxution 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 15-1 OB 12-04 C -18 June 29, 2012 EXMIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE CONMUTMENT (CONSTRUCTION CONTRACTS) E-1111; :11 PLEASE NOTE: This information may be submitted with your bid. 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 DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier BE Subcontractors and their respective items) of work listed should be consistent, where applicable, with the .lames and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation 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 enact 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 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 Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 C -19 June 29, 2012 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - mood Faith Effort EXHIBIT 15-H DBE INFORMATION --GOOD FAITH EFFORTS Federal -aid Project No. DBE INFORMATION - GOOD FAITH EFFORTS Bid Opening Date The (Gifu/County ofl established a Disadvantaged Business Enterprise (DBE) 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 DBE Commitment" form indicates that the bidder has met the DBE 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 DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE 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 DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE 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 DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation c - 2 0 Page 15-1 OB 12-04 Jnne 29, 2012 Exhibit 15•H DBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE 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 DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of ('yam Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involve.), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs 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 DBEs: Page 15-2 C - 21 June 29, 2012 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE 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 DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results 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. C - 2 2 Page 15-3 OB 12-04 June 29, 2012 Local Assist Procedures Manual EX :. 7T 12-G - Bidder's List of Subcontractors (DBE anu :ion -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and PION -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. Farm Name/:: Address/ . C><ty; State, ZIP Name Phonel ::. F ' . ., :.: Phone Gross •. � Recel is P < $l million . ;` Descriptionof.Portion of'Work.fo be Performed r.. k� S.�l� F •R "1A :.�: �•:�f , ' k If YES list DBE #: ❑ < $5 million Address < $10 million Fax 0 < $15 million Age of Firm (Yrs.) _f- City State ZIP ❑ > $15 million_ Name Phone LJ <$1 million M < $5 million < $10 million If YES list DBE #. Address Fax 0 -<$15 million > $15 million Age of Firm (Yrs.) City State ZIP Name Phone 0 < $1 million ^ tf YES list DBE #: ❑ < $5 million ❑ < $10 million Address Fax Phone ❑ <$15 million ❑ > $15 million Age of Firm (Yrs.) City State ZIP Name < $1 million }'f' 101 < $5 million ❑ < $10 million If YES list DBE A Address Fax El < $15 million > $15 million City State ZIP Distribution:1) Original - Local Agency File Page 12-111 November 14, 2006 LPP 06-06 KNOW ALL MEN BY THESE PRESENTS: That we, Select Electric, Inc. as Principal, (hereinafter called the 'Principal"), and Fidelity and Deposit Company of Maryland , a corporation duly organized under the laws of the State of Maryland as Surety, (hereinafter called the "Surety"), are held and firmly bound unto City of Huntington Beach as Obligee, (hereinafter called the "Obligee"), in the sum of Ten Percent of the Total Bid Amount Dollars ($ 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 the construction of Safe Routes to School in the Vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 - SRTSL-5181(173) 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 13 day of May A.D., 2014 Select Electric, Inc. al Witness (SEAL) Witness Fidelity and Deposit Company of Maryland / Surety By-{�(SEAL) Cristin Nolette 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 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any, time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and 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 Article V, Section 8, of the By -Laws of the Companies is still in force. 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 ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney.. -Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." 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 COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and 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 l 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 seals of the said Companies, this 13 day of May 120 14 itg0' SEAL M Geoffrey Delisio, Vice President CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On t before me, Marie Engstrom, Notary Public (Here insert name and title of the officer) personally appeared Cristin Nolette who proved to me on the basis of satisfactory evidence to be the person(&) whose nam i Subscribed to the within instrument and acknowledged to me that sh fey executed the same in Iris e authorized capacity(ies) and that by I is signature(o on the instrument the persono), or the en ity 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. WI,-S my h and official seal. (Notary Seal) Signature of Notary Public CRAW EMNTWW ommission No. 1 g7'1N " NOTARY PUBLIC-MIFORNIA ORANGE COIJUN My Comm. E*M MW 3b. 2015 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT Title of document or description (Title or description of attached document) Title or description continued (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 exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. 1n such instances, any alternative acknowledgment verbiage as may be printed on 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 authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form if 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. he/she/they- is /ere ) 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 v12.10.07 800-873-9865 www.NotaryClasses.com CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of ; San Diego CIIAL C06E A 1189 OnNL before me, Kathryn Joy Parkington, Notary Public Date Here Insert Name and Title of the Officer ' personally appeared Ca,a be genuder KATHRYN JOY PARKINGTON COMM. # 2039052 O . NOTARY PUBLIC,CALIFORNIA m d 3AN DIEGO COUNTY O My Commission Expires ' August 26, 2017 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/herAheir 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. 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: -*:C.J Place Notary Seal Above Sign/ re Notary Publlc OPT IONA 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. ®escr -on of Attached D®ca�ment Title or Type ocument: _ Document Date: Signer(s) Other Than Name bcN Capacity(ies) Claimed by Sig Signer's Name: _ C:l Corporate Officer — Title(s): EII Individual s) Partner — Limited ! i General Top of thumb here D Attorney in Fact Ci Trustee C; Guardian or Conservator [ -' Other: Signer Is Representing: Number of Pages: Signer's Name: C' Corporate Officer — Title(s): ;__1 Individual C:iPallner — :. i Limited I i General Top of thumb heie C Attorn ' Fact Trustee C' Guardian or Cor C:i Other: Signer Is Representing: tt, 2010 National Notary Association • NationalNotarv.orc • 1-800-US NOTARY f1-800-878-88771 it.- itrow City ®f Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Joan L. Flynn, City Clerk August 26, 2014 Unique Performance Construction, Inc. 1321 N. Jefferson St. Anaheim, CA 92807 RE: Safe Routes to School/Stacey-Clegg - CC-1426 Enclosed please find your original bid bond for CC-1426. Sincerely, JF:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand Unique Performance Coast, Me. 1321 N.Jefferson St. Anaheim, cA 92887 License # 801860 "SEALED BID" For CC-1426 SRTSL-5181 (173) Safe Routes to School in the Vicinity of Stacey Middle School and Clegg Elementary School in the CITY OF HUNTINGTON BEACH — DO NOT OPEN WITH REGULAR MAIL DELIVER TO THE OFFICE OF THE CITY CLERK, 2000 MAIN STREET, SECOND FLOOR SECTION C PROPOSAL. for the construction of Safe Routes to School In the vicinity of Stacey Middle School and Clegg Elementary School CC No. 1426 SRTSL-5181(173) in the CITY OF HUNTTINGTON 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 50 working days, starting from the date of 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 prices shall govern over extended amounts, and words shall govern over figures. C-1 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 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", or "Bidder's Bond", as the case may be). T2iAAar An]] eicmifv rPrF.int of all Addenda here_ if anv: C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, In the Vicinity of Stacey Middle School and Clegg Elementary School — CC 1426 May 9, 2014 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for the: Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School - CC1426 shall be replaced with the following attached documents: The Federal Labor Rates dated May 9, 2014 shall be the labor rates in effect for the subject project. 2) SHEET 3 — TRAFFIC SIGNAL PLAN SPRINGDALE STREET AT CROUPIER DRIVE The following revision has been added to Pole Schedule: Traffic signal pole #5 has been revised from 26A-100 to 29-5-100. The pole height and equipment will remain the same. This is to acknowledge receipt and review of Addendum Number One, dated May 9, 2014. 01 Q (tE PEf --F RMA1VCF M/VSiiZVCL/0A' INC. Company Name By 1-7 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School VOW 91 C �{ AMJ.g': 1 1 L.S. MN, �tslit"! t5 .` Mobilization. $ \C)dovo $ 2 1 L.S. 3 1 L.S. Per L.S. Furnish Project Traffic Control. Per L.S. Furnish and Install Traffic Striping and Signing. $ Our $ G( O J-i4 $ $ O O� Per L.S. 4 1 L.S. Construct Traffic Signal at Springdale Street and Croupier Drive. (excludes $ O-4 $ 2/ C) V interconnect conduit and interconnect cable) Per L.S. 5 2550 F. Furnish and Install 2"Interconnect Conduit with 6 Pair #19 Solid Interconnect Cables and Pull Boxes $ $ Spaced Approximately 200' (Also includes installation into the traffic signal cabinets). Per L.F. 6 450 L.F. Furnish and Install 6Pair #19 Solid Interconnect Cables in Existing Conduit (Also includes installation $ $ o into the traffic signal cabinets). Per L.F. 7 18 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B or Case C and Per Typical Section at ° $ / $ New Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School - CC-1426 SRTSL-5181(173) Stacey Middle School and Clegg Elementary School 8 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case F and Sheet 2 Details for Ramp Locations 1 $ d u $ b and 12. Also Includes Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. _ 9 17 L.F. Furnish and Install Metal Railing Per Standard Plans for Public Works (Green Book) Plan 606-2, Type A. IF — Total 11 Total Amount Bid in Words: TI__ l,:./._. —411 ,.. .,;A +1,a +—ffin e;rrnn1 Pnii;nmP.nt_ ss, listed in the hole schedule, (also 1\VLV• 111V Vl�� v♦aaa k' ♦awv .��- ------ --� 1 a - includes traffic signal cabinet, service cabinet and anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 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. lkt K By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. 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 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 3 h+ at Ay'o""- , Date City State /W O -n t6i2� e � y�i/ , being first duly sworn, deposes and says that he or she is il of uh i ay& '1 maneel 0�r p �,making the foregoing bid that the bid is not made in thAnterest ofs 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. 010006 PE-f -r&J 11l 11&t gokc,71�ucrlolV INC, Name of Bidder Signature of Bidder l �z 1 /V � '.Jc')qersa N Oy,)gAe-i m, & C/z 9 D i Address of Bidder 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 CC-1426 SRTSL-5181(173), Safe Routes to School in the vicinity of Stacey Middle School and Clegg Elementary School, (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 he 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 s are necessary tot may be retained oassureloyed compliance bythe undersigned, any said and that the undersigned shall takesteps subcontractor or subcontractors with the requirements contained herein. Date: Ne- Contractor By 1W 0 LIUM Tfi Z- /V y PkC- 5i E-AIT C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, 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 WINo 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: ° Contractor Title P/zrsl Pt-111' C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name Business Address AIXIME nil eA 9.2907 City, State Zip Telephone Number Rai. (0 A S8 State Contractor's License No. and Class _ 3 _3) / 2-.► ) Original Date Issued Expiration Date The work site was inspected by 0 ✓ 4 0 b ty- of our office on 1571412,4) 41 201 Li The following are persons, firms, and corporations having a principal interest in this proposal: M m/mA q- 1446A O C-s 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. RJV/Gtjt� ffnF701 Company Name Signature of Bidder Al 0 a /0 T/9 14A&A /V Printed or Typed Signature Subscribed and sworn to before me thisday of 201 BARDIA SADEGNI COMM. #2042367 Notary Public - Ca, a: California z Orange County 0 Comm. Expires Oct. 17, 2017 f NOTARY PUBLIC SEAL NOTARY 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 /Z E E r 9/cA VdK6 010.1 A?'AA1 r1Z1VA-kWA9t L 0,06LALN Name and Address of Public Agency Name and Telephone No. of Project Manager: /v Iz)Hp, 1v i- P,,A YES 902- 0 7- M--� I to IV MFM Contract Amount Type of Work Date Completed 2. OF LDS /I/V6671-t,-,S 0 '60 Name and Address of Public Agency 3. -- A-r-i k--,-No of Project Manager: '4 /- H 0 , li)w 0/4/D EAJAA1 Name ep . S MAtrlc, V61VAL 11V�'174Le- VOAI Contract Amount D'tPAt?TAqt1VT Of' Type of Work SPOIV-,� T- 10 A/ Name and Address of Public Agency Date Completed A4^ R IMF A)/9 11902- Name and Telephone No. of Project Manager: 00� TIYA / — Wq-Ne I - 9 Contract Amount /AJ C, !A I- I Ll 47 & T r-7 1-44 /7 Type q_P IILL Date completed C-9 (For federally funded projects, use this following page) 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 requiremnents 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-10 Local Assistance Procedures Manual PR9TV Checklist Tmtructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) ATTACHMENT C EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Qw: a m n!—Ar !� P., --0 r 1—Q -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 12-25 OB 12-04 C-11 June 29, 2012 F,KM T 12-E Local Assistance Procedures Manual Attachment D 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 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 12-27 C -12 June 29, 2012 OR 12-04 EXMIT 12-E Local Assistance Procedures Manual Attachment E PS&E Checklist Instructions ATTACHMENT E DEBARMTNT 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 currentlyiunder 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 d above, indicate below to whom it applies, initiating agency, and dates of responsibility. For any exception note 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 12-29 June 29.2012 OB 12-04 C-13 Local Assistance Procedures Manual EXHIBIT 12-E Attachment F 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 malting 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 fiords 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 sub recipients shall certify and disclose accordingly. Page 12-31 0-1 a June 29, 2012 OB 12-04 Local Assistance Procedures Manual EXHWIT 12-E PS&E Checklist Instructions Attachment G ATTACTIM-ENT G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVE 1. Type of Federal Action: 2. Status of Federal Action: Fla. contract ❑ a. bid/offer/application b. grant b. initial award 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. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Sub awardee, Enter Name and Address of Prime: ❑ Prime ❑ Subawardee Tier , if known Congressional District, if known G. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 'PURSUANT TO 31 U.S.C. 3. Report Type: a initial b. material change 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. l0a) (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) $ actual planned a retainer b, one-time fee 12. Form of Payment (check all that apply): c. commission ❑a cash d. contingent fee b. in -kind; specify: nature e deferred value £ 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_ Cnntinuation 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: H a u O-- t4f—"—,� U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection Any Title: emncA ' -- 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 Telephone No.: 114 S 1 �° �?7oDate: $100,000 for each such failure. O Federal Use Only: Form UJ, Rev. Authorized for Local Reproduction Standard Form - LLL rage OB 12-04 C -15 June 29, 2012 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. S. 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 (Ml). 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 12-34 C -16 OB 12-04 June 29, 2012 Local Assistance Procedures Manual EXHIBIT 12-E Attachment G PS&E Checklist instructions 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(&NDIF)) Page 12-35 C -17 June 29, 2012 OB 12-04 E7MTT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) ExBiBrr 15-G LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS (FORM LOCAL AGENCY: -City of Huntington Beach LOCATION: In the vicinity of Stacey M4 and Clegg ES PROJECT DESCRIPTION: Safe Routes To School Stacey -Clegg Prcject #STRSL-5181(173) CC-1426 TOTAL CONTRACT AMOUNT: $ Z G BID DATE: BIDDER'S NAME: CONTRACT DBE GOAL: 10.28 DBE vI OF WORK AND DESCRIPTION BE CERT NO. A u t OF EACH on SERVICES TO BE D E)TIRATION (Must be certified on the date bid 3CONTRACTFD OR MATERIALS DATE e opened - include DBE address BE PROVIDED (or contracted if the d phone number) ler is a DBE) For Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Print Name Signature Local Agency Representative (Area Code) Telephone Number. Total Claimed DBE I $� Participation Signature of Bidder 5-1131 N Date (Area Code) Tel. No. Date 1/� Person to Contact (Please Type of Print) Local Agency Bidder DBE Commitment (Constrnchon Contracts) . (Rev 6/26109) Distribution: (i) Copy —Fax or scan a copy to the Caltrans District LAX, Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 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 15-1 C -18 June 29, 2012 OB 12-04 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY ]BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent Iow bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and'Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration daze. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). HVIPORTANT: Identify aII DBE firms participating in the project regardless of tier. Names of the First -Tier BE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the .,►ames and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation 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 contrasts), to determine how to count the participation of DBE firms. Exhibit 15-G 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 Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 C-19 June 29, 2012 OB I2-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort Exnwff 15-H DBE INFORMATION —GOOD FATTII EFFORTS Federal -aid Project No. DBE INFORMATION - GOOD FAITH EFFORTS Bid Opening Date Al 1. N The (City/County of) established a Disadvantaged Business Enterprise (DBE) 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 DBE Commitment' form indicates that the bidder has met the DBE 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 DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE 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 DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE 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 DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation C - 2 0 Page 15-1 OB 12-04 June 29, 2012 Exhibit 15-H Local Assistance Procedures Manual DBE Information -Good Faith Effort C. The items of work which the bidder made available to DBE 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 DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of (Yll) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rej ection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs 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 DBEs: 0 iTH LfTOP WKA6Eritr� � Page 15-2 C - 21 June 29, 2012 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE 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 DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results ITN T H. Any additional data to support a demonstration of good faith efforts (use additional sheets if CA 0- LO NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-22 Page 15-3 OR 12-04 June 29, 2012 DBE Goodfaith Inc. Good Faith Transaction Log Company Details Company Name Unique Performance Construction, Inc Department Accounting Address 1321 N.Jefferson St. Suite # City Anaheim State California Zip 92807 Phone # Tel : 714-528-2220 Fax # Fax: 714-528-2225 Email # upc.construction@gmail.com Solicitation Transaction Log (STL) Bid # CC1426 Bid Date 05/20/2014 Bid Description Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. This document contains all information pertaining with solicitations made on behalf of/for Unique Performance Construction, Inc of Anaheim, California by DBE Goodfaith Inc. (a California -based Corporation). These solicitations have been done in good faith. DBE Goodfaith has participated with Unique Performance Construction, Inc in communicating with selected DBE firms. DBE Goodfaith has contacted the California Department of Transportation (Office of Civil Rights) on 05/06/2014 on your behalf. Please write this information on the appropriate forms if required. Advertisements published in DBE GoodFaith's Minority Focus and Trade Journals run from the publication date until the bid date listed on the advertisements. i nr, uooaiaun inc. uooa r aun i ransaction Eog Total Companies Solicited The following information is a summary of the different types of Business that have been solicited by DBE Good Faith Inc. on behalf of Unique Performance Construction, Inc DVBE (Disadvantaged Veteran Business Enterprises) - 0 DBE (Disadvantaged Business Enterprises) - 25 UDBE (Underutilized Disadvantaged Business Enterprise) - 0 MBE (Minority Owned Business Enterprises) - 0 WBE (Women Owned Business Enterprises) - 0 SBE (Small Business Enterprises) - 0 Total - 25 "Dr. voouiann inc. tiooa r aun i ransaction Eog Minority Focus Journal Ad posted to website www.dbegoodfaith.net on 05/06/2014 at 4:39PM The advertisement published in DBE GoodFaith's Focus Journal runs from the publication date until the bid date listed on the advertisement. Estimator Jose Vega Project Coordinator Matt Kabany Contact Information 1321 N.Jefferson St. Anaheim, California 92807 Tel: 714-528-2220 Fax: 714-528-2225 Unique Performance Constructlon,Inc is seeking qualified DBEs Project Name Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school Awarding Agency city of Huntington Beach Project Location Huntington Beach , Orange County, California Bid Date & Time 05/20/2014 at 2:00 P.M Bid/Contract # CC1426 Project Details Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. Lrsr; uwaiann inc. uoou r ann i ransaction Log Minority Trade Journal Ad posted to website trade. d beg oodfa ith. net on 05/06/2014 at 4:39PM The advertisement published in DBE GoodFaith's Trade Journal runs from the publication date until the bid date listed on the advertisement. Unique Performance Construction, Inc is Seeking Qualified Project Name Agency Name Project City Project County Project State Project Details Contact Details 1 DBE Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school city of Huntington Beach Huntington Beach Orange County California Matt Kabany 1321 N.Jefferson St. Anaheim, California 92807 Tel: 714-528-2220 Fax: 714-528-2225 urst✓ uooaiaitn inc. uooa r ann i ransaction Eog Recipient List (Fax/Email) Set No 1 ;'ompanv Name/Specialty ' Fax Date Email Date Log.P__age#, 3TION ENTERPRISES 05/06/2014 05/06/2014 ddress - 2150 COWLES STREET hone - 5625918880 , Fax - 5622185637, Email - actiontruckingent@yahoo.com UIERICA PACIFIC CONSTRUCTION 05/06/2014 05/06/2014 ddress - 201 LAUREL AVE. #13 hone - 5595779999, Fax - 7143843988, Email - apconstruction09@gmaii.com ?EX UNIVERSAL, INC 05/06/2014 05/06/2014 ddress - 11033 FOREST PLACE hone - 5629448878, Fax - 5629442298, Email - janet@apexmarker.com ABLEMASTERS 05/06/2014 05/06/2014 ddress - 2281 W. 205TH STREET SUITE 101 hone - 3107830081, Fax - 3107830082, Email - jaynakamoto@cable-masters.com ALIFORNIA PROFESSIONAL ELECTRICAL ENGINEERING 05/06/2014 05/06/2014 ddress - 929 OTTERBEIN AVENUE, UNIT E hone - 6268101338, Fax - 6268101322, Email - van@cpengineeringinc.com D MONTGOMERY INC. 05/06/2014 05/06/2014 ddress - 1077 PCH, #186 hone - 5628262983, Fax - 5622965125, Email - cmontgomery@cdmiconstruction.com MV ELECTRIC INC. 05/06/2014 05/06/2014 ddress - 1638 W. HUNTINGTON DR., UNIT A hone - 9099315700, Fax - 9099315701, Email - matt@cmvelectric.net ONTECH CONCRETE TECHNIQUES, INC 05/06/2014 05/06/2014 ddress - 4687 E. CORTLAND AVENUE hone - 5592518818, Fax - 5593518821, Email - contechg@gmai►.com T CONCRETE CUTTING INC. 05/06/2014 05/06/2014 ddress - 26341 JEFFERSON AVE. UNIT B hone - 9516987745, Fax - 9516980795, Email - ct@ctconcretecutting.com USTOM QUALITY ELECTRIC, INC 05/06/2014 05/06/2014 ddress - 1722 S. GRAND AVE hone - 7145410404, Fax - 7145412080, Email - ryan@cqeoc.com M TRUCKING 05/06/2014 05/06/2014 ddress - 2872 W. KEYS LANE hone - 7143928688, Fax - 0000000000, Email - dfmcampos@aol.com AGLE ENGINEERING & DEVELOPMENT, INC. 05/06/2014 05/06/2014 ddress - 216 TOBY WAY hone - 9094445566, Fax - 9094448311, Email - bramirez@eagleengdev.com ORE ENGINEERING CONSTRUCTION, INC 05/06/2014 05/06/2014 ddress - 212 TECHNOLOGY DR. STE. W hone - 7142581100, Fax - 7142581158, Email - foreeng@earthlink.net & G ELECTRIC INC 05/06/2014 05/06/2014 ddress - 4229 GILES COURT hone - 9515720196, Fax - 9516892694, Email - chvz_glbrt@yahoo.com OLDEN ARROW ENGINEERING, INC 05/06/2014 05/06/2014 ddress - 1960 CHICAGO AVENUE, SUITE D-13 hone - 9517220845, Fax - 9516862473, Email - khays@goldenarrowengineering.com IYM ENGINEERING, INC 05/06/2014 05/06/2014 ,ddress - 6380 ROLAND STREET hone - 7145232372, Fax - 5622496609, Email - solee206@hymengineering.com FRANCIS COMPANY 05/06/2014 05/06/2014 ,ddress - 16197 KRAMERIA AVE 'hone - 9517769100, Fax - 9517769172, Email - diana@jfranciscompany.com .C.A. TRUCKING 05/06/2014 05/06/2014 ,ddress - 1600 EAST ARROW HIGHWAY 'hone - 6263579343, Fax - 6263576740, Email - beajca@aol.com OS ANGELES SIGNAL CONSTRUCTION, INC. 05/06/2014 05/06/2014 tJtsr. uooaiann lnc. uooa r aun 1 ransaction Eog JE TIME UTILITY SALES, INC 05/06/2014 05/06/2014 dress - 501 GARFIELD STREET one - 7149535700, Fax - 7148665059, Email - brian@onetimeutility.com ZTIZ ASPHALT PAVING, INC 05/06/2014 05/06/2014 dress - 382 EAST ORANGE SHOW ROAD one - 9519667060, Fax - 7609954443, Email - bruceatortiz@aol.com TO TRUCKING 05/06/2014 05/06/2014 dress - 665 FAIRMOUNT AVE., #3 one - 8183551098, Fax - 8182410729, Email - ottosilve@sbcglobal.net )BNETT ELECTRIC, INC. 05/06/2014 05/06/2014 dress - 6400 CRENSHAW BLVD. one - 3235652660, Fax - 3237784305, Email - david@robnett.com ). CAL TRAFFIC INC 05/06/2014 05/06/2014 dress - 1358 LA MIRADA DRIVE one - 8587200179, Fax - 8587924495, Email - cecilia@socaltraffic.net T B, INC 05/06/2014 05/06/2014 dress - 7093 W BELMONT lone - 5592751998, Fax - 5592751995, Email - deborah@wtbinc.org DBE Goodfaith Inc. Good Faith Transaction Log DBE Goodfaith Inc. Fax Confirmation Report for Unique Performance Construction, Inc Bid Number:CC1426 No. Company Name Type Ph. Number Fax Number Status Date/Time 1 ACTION ENTERPRISES DBE 5625918880 5622185637 Success 05/06/2014 17:10 2 AMERICA PACIFIC CONSTRUCTION DBE 5595779999 7143843988 Success 05/06/2014 17:17 3 APEX UNIVERSAL, INC DBE 5629448878 5629442298 Success 05/06/2014 17:39 4 CABLEMASTERS DBE 3107830081 3107830082 Success 05/06/2014 17:51 5 CALIFORNIA PROFESSIONAL ELECTRICAL ENGINEERING DBE 6268101338 6268101322 Success 05/06/2014 17:50 6 CD MONTGOMERY INC. DBE 5628262983 5622965125 Failed 05/06/2014 17:41 7 CMV ELECTRIC INC. DBE 9099315700 9099315701 Success 05/06/2014 17:48 8 COONTECH CONCRETE TECHNIQUES, INC DBE 5592518818 5593518821 Failed 05/06/2014 17:45 9 CT CONCRETE CUTTING INC. DBE 9516987745 9516980795 Success 05/06/2014 17:31 10 CUSTOM QUALITY ELECTRIC, INC DBE 7145410404 7145412080 Success 05/06/2014 17:52 11 DM TRUCKING DBE 7143928688 0000000000 Failed 05/05/2014 17:00 12 EAGLE ENGINEERING & DEVELOPMENT, INC. DBE 9094445566 9094448311 Success 05/06/2014 17:24 13 FORE ENGINEERING CONSTRUCTION, INC DBE 7142581100 7142581158 Failed 05/06/2014 18:00 14 G & G ELECTRIC INC DBE 9515720196 9516892694 Success 05/06/2014 17:41 15 GOLDEN ARROW ENGINEERING, INC DBE 9517220845 9516862473 Failed 05/06/2014 17:43 16 HYM ENGINEERING, INC DBE 7145232372 5622496609 Success 05/06/2014 17:19 17 J FRANCIS COMPANY DBE 9517769100 9517769172 Failed 05/06/2014 17:36 18 J.C.A. TRUCKING DBE 6263579343 6263576740 Failed 05/06/2014 17:38 19 LOS ANGELES SIGNAL CONSTRUCTION, INC. DBE 9095992201 9095992722 Failed 05/06/2014 18:11 20 ONE TIME UTILITY SALES, INC DBE 7149535700 7148665059 Success 05/06/2014 17:53 Ljtsr, kjooarann inc. kjooa r ann i ransaction Log No. Company Name 21 ORTIZASPHALT PAVING, INC 22 OTTO TRUCKING 23 ROBNETT ELECTRIC, INC. Type Ph. Number Fax Number Status Date/Time DBE 9519667060 7609954443 Success 05/06/2014 17:21 DBE 8183551098 8182410729 Failed 05/06/201417:39 DBE 3235652660 3237784305 Success 05/06/2014 18:01 24 SO. CAL TRAFFIC INC DBE 8587200179 8587924495 Failed 05/06/2014 17:53 25 W T B,INC DBE 5592751998 5592751995 Success 05/06/2014 17:28 litsr, il000mann inc. uooa r ann i ransaction i og INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:ACTION ENTERPRISES CONTACT NAME Matt Kabany Phone Number :5625918880 ADDRESS 1321 N.Jefferson St. Fax Number: 5622185637 Anaheim, California, 92807 Date :05/06/2014 5:10PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY: Huntington Beach PROJECT STATE: California PROJECT DETAILS: Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at iinr, tioomann inc. uoou r aim i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:DM TRUCKING CONTACT NAME Matt Kabany Phone Number :7143928688 ADDRESS 1321 N.Jefferson St. Fax Number: 0000000000 Anaheim, California, 92807 Date :05/05/2014 5:OOPM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY: Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at mir, tioouiann inc. tioou r aiin i ransacuon Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction,lnc TO:AMERICA PACIFIC CONSTRUCTION CONTACT NAME Matt Kabany Phone Number :5595779999 ADDRESS 1321 N.Jefferson St. Fax Number :7143843988 Anaheim, California, 92807 Date :05/06/2014 5:17PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at iitsr, %rowiann inc. tjooa r aitn transaction i�og INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:HYM ENGINEERING, INC CONTACT NAME Matt Kabany Phone Number :7145232372 ADDRESS 1321 N.Jefferson St. Fax Number :5622496609 Anaheim, California, 92807 Date :05/06/2014 5:19PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http:/Iwww.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Requestlinterest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at "rsr, uooaiann iinc. uooa r ann 1 ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc CONTACT NAME Matt Kabany ADDRESS 1321 N.Jefferson St. Anaheim, California, 92807 Phone 714-528-2220 Fax 714-528-2225 TO:ORTIZ ASPHALT PAVING, INC Phone Number :9519667060 Fax Number :7609954443 Date :05/06/2014 5:21 PM This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://ww*.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at unr, kioomaim inc. kiooa r ann i ransaction i,og INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:EAGLE ENGINEERING & DEVELOPMENT, INC. CONTACT NAME Matt Kabany Phone Number :9094445566 ADDRESS 1321 N.Jefferson St. Fax Number: 9094448311 Anaheim, California, 92807 Date :05/06/2014 5:24PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC 1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE : California PROJECT DETAILS Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors& suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Lts� kjoomaitn inc. uvva r ann i ransactivn Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:W T B, INC CONTACT NAME Matt Kabany Phone Number :5592751998 ADDRESS 1321 N.Jefferson St. Fax Number: 5592751995 Anaheim, California, 92807 Date :0510612014 5:28PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at ijt5r. kroomann inc. uooa r ann i ransaction i,og INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc CONTACT NAME Matt Kabany ADDRESS 1321 N.Jefferson St. Anaheim, California, 92807 Phone 714-528-2220 Fax 714-528-2225 TO:CT CONCRETE CUTTING INC. Phone Number :9516987745 Fax Number :9516980795 Date :05/06/2014 5:31 PM This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE : 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Requestlinterest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at jitsr, uooaiann mc. uooa r ann 1 ransaction Eog INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:J FRANCIS COMPANY CONTACT NAME Matt Kabany Phone Number :9517769100 ADDRESS 1321 N.Jefferson St. Fax Number :9517769172 Anaheim, California, 92807 Date :05/06/2014 5:36PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY: Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at utsr, uooaiann inc. uooa r ann t ransaction i,og INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:J.C.A. TRUCKING CONTACT NAME Matt Kabany Phone Number :6263579343 ADDRESS 1321 N.Jefferson St. Fax Number :6263576740 Anaheim, California, 92807 Date :05/06/2014 5:38PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE : California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Ltsr tioomann inc. tiooa r aitn i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:OTTO TRUCKING CONTACT NAME Matt Kabany Phone Number :8183551098 ADDRESS 1321 N.Jefferson St. Fax Number :8182410729 Anaheim, California, 92807 Date :05/06/2014 5:39PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at tior, uoouiann inc. uoou r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:APEX UNIVERSAL, INC CONTACT NAME Matt Kabany Phone Number :5629448878 ADDRESS 1321 N.Jefferson St. Fax Number :5629442298 Anaheim, California, 92807 Date :05/06/2014 5:39PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at LtsL uwataim inc. t-ooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:CD MONTGOMERY INC. CONTACT NAME Matt Kabany Phone Number :5628262983 ADDRESS 1321 N.Jefferson St. Fax Number: 5622965125 Anaheim, California, 92807 Date :05/06/2014 5:41 PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construct! on,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Lnr. uooaiann inc. uooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:G & G ELECTRIC INC CONTACT NAME Matt Kabany Phone Number :9515720196 ADDRESS 1321 N.Jefferson St. Fax Number :9516892694 Anaheim, California, 92807 Date :05/06/2014 5:41 PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc Is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS: Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at vitir uooaiann inc. uooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc CONTACT NAME Matt Kabany ADDRESS 1321 N.Jefferson St. Anaheim, California, 92807 Phone 714-528-2220 Fax 714-528-2225 TO:GOLDEN ARROW ENGINEERING, INC Phone Number :9517220845 Fax Number :9516862473 Date :05/0612014 5:43PM This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Ltsr tioomann inc. kjooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:CONTECH CONCRETE TECHNIQUES, INC CONTACT NAME Matt Kabany Phone Number: 5592518818 ADDRESS 1321 N.Jefferson St. Fax Number: 5593518821 Anaheim, California, 92807 Date :05/06/2014 5:45PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc Is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS: Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at LtsL uooaiaitn inc. uooa r aitn transaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:CMV ELECTRIC INC. CONTACT NAME Matt Kabany Phone Number :9099315700 ADDRESS 1321 N.Jefferson St. Fax Number: 9099315701 Anaheim, California, 92807 Date :05/06/2014 5:48PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc Is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Lnr tioomaitn inc. tiooa r aitn i ransaction i,og INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc CONTACT NAME Matt Kabany ADDRESS 1321 N.Jefferson St. Anaheim, California, 92807 Phone 714-528-2220 Fax 714-528-2225 TO:CALIFORNIA PROFESSIONAL ELECTRICAL ENGINEERING Phone Number :6268101338 Fax Number :6268101322 Date :05/06/2014 5:50PM This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Requestlinterest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Lnr, uooaiann inc. uooa r ann i ransaction Eog INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:CABLEMASTERS CONTACT NAME Matt Kabany Phone Number :3107830081 ADDRESS 1321 N.Jefferson St. Fax Number :3107830082 Anaheim, California, 92807 Date :05/06/2014 5:51 PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at unr, uooaiann mc. kjooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc CONTACT NAME Matt Kabany ADDRESS 1321 N.Jefferson St. Anaheim, California, 92807 Phone 714-528-2220 Fax 714-528-2225 TO:CUSTOM QUALITY ELECTRIC, INC Phone Number :7145410404 Fax Number :7145412080 Date :05/06/2014 5:52PM This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE : California PROJECT DETAILS Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at ijtsrJ uoourann inc. uoou r alm i ransaction -Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc CONTACT NAME Matt Kabany ADDRESS 1321 N.Jefferson St. Anaheim, California, 92807 Phone 714-528-2220 Fax 714-528-2225 TO:ONE TIME UTILITY SALES, INC Phone Number :7149535700 Fax Number :7148665059 Date :05/06/2014 5:53PM This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit hftp://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY: Huntington Beach PROJECT STATE : California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping, trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at unr tioomann mc. tiooa r ann 1 ransaciion Eog INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:SO. CAL TRAFFIC INC CONTACT NAME Matt Kabany Phone Number :8587200179 ADDRESS 1321 N.Jefferson St. Fax Number :8587924495 Anaheim, California, 92807 Date :05/06/2014 5:53PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction,lnc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Requestlinterest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Lnr. uomiann inc. uom r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:FORE ENGINEERING CONSTRUCTION, INC CONTACT NAME Matt Kabany Phone Number :7142581100 ADDRESS 1321 N.Jefferson St. Fax Number: 7142581158 Anaheim, California, 92807 Date :05/06/2014 6:OOPM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at jinr uoomann inc. uooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:ROBNETT ELECTRIC, INC. CONTACT NAME Matt Kabany Phone Number :3235652660 ADDRESS 1321 N.Jefferson St. Fax Number :3237784305 Anaheim, California, 92807 Date :05/06/2014 6:01 PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction, Inc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE: California PROJECT DETAILS : Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping,trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at vor. tioomann inc. uooa r ann i ransaction Log INVITATION TO BID Good Faith Solicitation Fax From Unique Performance Construction, Inc TO:LOS ANGELES SIGNAL CONSTRUCTION, INC. CONTACT NAME Matt Kabany Phone Number :9095992201 ADDRESS 1321 N.Jefferson St. Fax Number :9095992722 Anaheim, California, 92807 Date :05/06/2014 6:11 PM Phone 714-528-2220 Fax 714-528-2225 This is a Fax solicitation for projects by DBE Goodfaith Inc. on behalf of our client Unique Performance Construction, Inc For additional information about minority participation projects, visit http://www.dbegoodfaith.com Focus Ad Unique Performance Construction,lnc is Seeking Qualified DBE BID DUE DATE: 05/20/2014 at 2:00 P.M BID No: CC1426 PROJECT NAME: Safe Rout to School- In the vicinity of Stacey Middle School Clegg Elementary school AGENCY NAME: city of Huntington Beach PROJECT CITY/COUNTY : Huntington Beach PROJECT STATE : California PROJECT DETAIL Unique Performance construction is bidding this project as a Prime General Contractor. We are seeking Sub Bids from Qualified certified DBE subcontractors & suppliers with 10.28% DBE participation. The plans and specs are available for your review at our office or you can Email us/Fax us your Request/interest in this project and we will send you a copy of the Plans and Spec to your email address. Your quote should be sent to our office prior to the bid date/time. We are looking for DBE certified Subcontractors & Suppliers FOR THE FOLLOWING items: Traffic Control, Hauling & Dumping, trucking, Asphalt contractors & suppliers, concrete contractors & suppliers, stripping, Loops, Electrical contractors & suppliers, metal railings. Unique Performance Construction (UPC, Inc.) will provide DBE firms with required assistance in Bonding, Insurance, Equipment, Supplies and Material if necessary. Plans and specifications are available at our UPC office Address provided with this Ad. Please call our office phone number to set an appointment to view the plans. You can also contact us to send you the plans and specs to your email address. Subcontractors must possess a current contractor's license, insurance and worker's compensation coverage and will be required to sign the standard Subcontract Agreement with Unique Performance Construction. 100% payment bond and performance bond may be required for the full amount of the subcontract price. Subcontractor scope & Quote (including any conditions or exceptions) is required 24 hours prior to bid deadline to allow proper evaluation. Quotes are required to be in accordance with the plans and specifications and good for the contract duration as specified in the bid documents. If you need any assistance, please do not hesitate to call our office. Items of work may be broken down into economically feasible packages to encourage participation. We do not discriminate against any qualified employee, applicants for employment, subcontractors or vendors regardless of age, race color, creed, religion, sex, marital status, national origin, military service disabilities, disable veterans or Vietnam era veteran status. Please Fax your quotes to our office Fax number and show your interest to bid with us by replying to this Ad. 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: 714-528-2225 [ ]Yes, we will send a fax quote by bid date. [ ]No, we are not interested. [ ]Interested. Would like more information. Please contact us at Unique Performance Construction Good Faith Effort 1 WTB, INC DBE ASPHALT (Work Code) 5592751995 Success 5592751998 5/9/2014 Jeremy 2 AMERICA PACIFIC CONSTRUCTION DBE ASPHALT CONCRETE (Work Code) 7143943988 Success 5595779999 5/9/2014 Ashish 3 EAGLE ENGINEERING & DEVELOPMENT, INC. DBE ASPHALT CONCRETE (Work Code) 9094448311 Success 9094445566 5/9/2014 Free 4 HYM ENGINEERING, INC DBE ASPHALT CONCRETE (Work Code) 56224966D9 Success 7145232372 5/9/2D34 Voice mail 5 ORTIZ ASPHALT PAVING, INC DBE ASPHALT CONCRETE (Work Code) 7609954443 Success 9519667060 5/9/2014 Voicemail 6 CD MONTGDMERY INC. DBE CONCRETE CURB &51DEWALK-MISC(Work Code) 5622965125 Failed 5628262983 5/9/2D14 Hailee 7 CONTECH CONCRETE TECHNIQUES, INC DBE CONCRETE CURB&SIDEWALK- MISC(Work Code) 5593518821 Failed 55925IB818 5/9/2014 Voicemail 8 CT CONCRETE CUTTING INC. DBE CONCRETE CURB&SIDEWALK- MISC(Work Code) 9516980795 Success 9516987745 5/9/2014 Deana 9 GOLDEN ARROW ENGINEERING, INC DBE CONCRETE SURFACE FINISH (Work Code) 9516862473 Failed 951722D845 5/9/2D14 Kurby 101 FRANCIS COMPANY OBE CONCRETE SURFACE FINISH (Work Code) 9517769172 Failed 9517769100 5/9/2014 Voicemail 11 LOS ANGELES SIGNAL CONSTRUCTION, INC. DBE ELECTRICAL& SIGNALS (Work Code) 9095992722 Failed 9095992201 5/9/2014 lose 12 ONETIME UTILITY SALES, INC DBE ELECTRICAL & SIGNALS (Work Code) 714B665059 Success 714953570D 5/9/2014 Voice mail 13 CABLEMASTERS DBE Electrical Contractors 31D7B3DDB2 Success 3107830DB1 5/9/2014 Voice mail 14 CALIFORNIA PROFESSIONAL ELECTRICAL ENGIN (prime) DBE Electrical Contractors 6268101322 Success 6268101338 5/9/2014 Secretary 15 CMV ELECTRIC INC. DBE Electrical Contractors 9099315701 Success 9D993157D0 5/9/2014 Bow 16 CUSTOM QUALITY ELECTRIC, INC DBE Electrical Contractors 71454120BO Success 7145410404 5/9/2014 Voice mail 17 ROBNETT ELECTRIC, INC. DBE Electrical Contractors 3237794305 Success 3235652660 5/9/2014 Chariet 18 FORE ENGINEERING CONSTRUCTION, INC DBE SIGNAL& LIGHTING (Work Code) 714258115B Failed 71425B110D 5/9/2014 Voice mail 19G&G ELECTRIC INC DBE SIGNAL& LIGHTING (Work Code) 95168926945uccess 9515720196 5/9/2014 Voicemail 2050. CALTRAFFIC INC DBE Traffic Management/ Operations (Work Code) B5B7924495 Failed 85B720D379 5/9/2014 Voicemail 21 APEX UNIVERSAL, INC OBE Traffic Striping, Marking and Traffic Control Materials Supplier 562944229B Success 5629448878 5/9/2014 Melody 22 ACTION ENTERPRISES DBE TRUCKER (Work Code) 56221B5637 Success 562591BB80 5/9/2014 Voice mail 23 DMTRUCKING OBE TRUCKER (Work Code) 0 Failed 714392B6BB 5/9/2014 Rick 241.C.A. TRUCKING DBE TRUCKER (Work Code) 6263576740 Failed 6263579343 5/9/2014 Voicemail 25 OTTOTRUCKING DBE TRUCKER (Work Code) 8182410729 Failed 81B3551098 5/9/2014 Rep No Not bidding No Not bidding No Not bidding Not sure Left a voice mail with project and bid details Not sure Left a voice mail with project and bid details No Not bidding Not sure Not bidding No Not bidding No Not bidding Not sure Left a voice mail with project and bid details Require more info/help, Prime contractor to send Not sure shortiv Not sure Left a voice mail with project and bid details Not sure Left a voice mail with project and bid details Yes Might be bidding as a prime No Not bidding Not sure Left a voice mail with project and bid details No Not bidding Not sure Left a voice mail with project and bid details Not sure Left a voice mail with project and bid details Not sure Left a voice mail with project and bid details No Not bidding Not sure Left a voice mail with project and bid details Not sure They are not sure if they are bidding or not Not sure Left a voice mail with project and bid details No Not bidding 5/16/2014 Jeremy No Not bidding 5/16/2014 Voicemail Not sure Left a voice mail with project and bid details 5/16/2D14 Sri No Not bidding 5/16/2D34 Voicemail Not sure Left a voice mail with project and bid details 5/16/2D14 Voicemail Not sure Left a voice mail with project and bid details 5/16/2014 Voicemail Not sure Left a voice mall with project and bid details 5/16/2014 Voicemail Not sure Left a voice mail with project and bid details 5/16/2014 Deana No Not bidding 5/16/2014 Voicemail Not sure Left a voice mail with project and bid details 5/16/2014 Diana Not sure They are not sure if they are bidding or not 5/16/2014 Chris No Not bidding 5/16/2014 Caudia Not sure They are not sure if they are bidding or not 5/16/2014 Rocky No Not bidding 5/16/2014 Cathy Yes Might be bidding as a prime 5/16/2D34 Matt No Not bidding 5/16/2014 Voicemail Not sure Left a voice mail with project and bid details 5/16/2014 Charlet No Not bidding 5/16/2D34 Voicemail Not sure Left a voice mall with project and bid details 5/16/2014 Gilbert Not sure They are not sure if they are bidding or not 5/16/2D34 Crystal Yes will send Quote 5/16/2014 Amanda No Not bidding 5/16/2014 Voicemail Not sure Left a voice mail with project and bid details 5/16/2014 Rick Yes will send Quote 5/16/2014 Juan No Not bidding 5/16/2014 Voicemail Not sure Left a voice mail with project and bid details Local Assist Procedures Manual Ems' 'T 12-G Bidder's List of Subcontractors (DBE anu :on -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- FART 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. JuMN ame State;.ZIP. Name Phone/ = Phone —_ `Annual::=. Gross-.-,--,.' ::Rece>< is 'p LJ <,;1 million ...: Description'of Portion of'Work to be Performed ��"' •,. If YES list DBE #: $S million ❑ < $10 million Address ! 90 5 !. Fax 09 0 - ❑<$15million ❑> $15 million Age of Firm (Yrs.) City State ZIP ,i Name �,Aa -�,, �� iL / v� S `-'�Y'�/la � Phone 4 � 5 2 a V 2 6 LJ <$Imillion Ci i L± 311y $5million Address 614 ` S S ❑< $l O million IfYES list DBE #• CJ !T i Fax y /�j ,® (,f O2� ❑ < $15 million City /State Z J 4ri�"`►M'I 4 � O) 2 ij Q Lf• ❑> $15 million Age offirm (Yrs.) - _ .�. .k`�'i Name � to ✓A r d"�v V Phone S u G `Y S Le<$1 million C �� cl i-Y ryk?q w u. ; If YES list DBE #: ❑ < $5 million Address ►�1rv,V-0 I,f ❑ < $10 million Fax Phone 4 �� 2 �� 4 $ ❑<$15million City/"yState Z!P //�M is Name > million Age of Firm (Yrs.) j$,�1t5} <$1 million �y7 rr 7�ri ❑ < $5 million Address ❑<$10million IfYES list DBE #; Fax ❑ < $15 million ❑ > 15 $ million 1 1 City state ZIP Distribution: 1) Original - Local Agency File it o �G✓L` v C.��o 6�-a LPP 06-06 Glb1_-- G Lf 7-9(173 Page 12-111 November 14, 2006 EXHIBIT I Local Assistance Proced Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DOE)- 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 11C1C 9•y OGUL1U11 GO Ul Ulc L.VUG Vl 1'cucial tw Firm Name /_ _ .:.. ..... .. ..... .... . • . Address/ •..,.::: ,, Ci State, ZIP Name uaauvua. i uvwv.J Phone � ��'� Phone Annual _�Gross Receipts < $lmillion" escripWeFDti Performed,: �. �'dr��• .: - _ ; M.... ,.. r.. t..y - t ❑<$5million Address ❑ <$10 million If YES list DBE #: Fax ❑ < $15 milIion ❑ > $15 million City State ZIP "Age Name Phone LJ < $1 Milliont . ,. ., es ❑<$5million Address ❑ < $10 million - --- If YES list DBE #: i }ke Ofy um N 1w Y 04 x�„^^,i -.mx,_sw,�'�=2r��;�•r^,fii,�2 yi?F:�J;�^�u;:•t',: Fax Phone ❑ < $15 million ❑ > $i s million City State ZIP Name 0 <$1 million ❑ < $5 m11110Il Address ❑ < $10 million If YES list DBE #: Fax ❑ < $15 million ❑ > $15 million r NM�s WA AkNONE g yrri; City State ZIP NamePhone ❑ < $ l million $5 million Address ❑ < $10 million If YES list DBE #: Fax ❑ < $15 million w. State City Ste ZIP ty ❑ > $15 million — �°� IN I OR�' , ---- --'--- Distributional) Original —Local Agency File Page 12-112 November 14, 2006 LPP 06-06 a Y I :J I CI I 111 ti "I C; i ICJ ki I ; ! "U . I I lJVll P. , Bid/Proposal From: Greg Campos/ DI[Trucking Re: Project for Stacy Middle School and Clegg School in Huntington Beach. J have 3 Super Ten Trucks available at an houriv rate of $80AI. 1 haul concrete, dirt, ;?6phalt, and trash. Trucks have electric mi-p§. Please contact me at 714-392-9688. Thank you, CFTC,;! Campos DM Trucking, "S' 05 1i1: 2014 I.�: 6 F :l' 17145204027 TRAFFIC:' LOOPS CRA(AKFiLI_i :�_. 001'' i01 Dzte: Attn: Owner: Project: Traffic Loops Crackfilling, Inc. 946 S. Emerald Strett, Anahcirn CA 52804 + Ter: 1714) 520 4` Fax, (7114) 520 402" State Liceasc # 6r29,56 - Class C-I (r & C-32 • DBE # 38033 Email: %4aiiam ticlnc-ca'XM 511 &42014 - Quotation Estimator City, of Huntington .Beac i Safe Routes to Scliool, in the Vicinity, o;'Starey M;Jdlt, Schc�6 & (Aegg Elennentery School CC No. 1426 - SR71,;I.-5181(1 73 ) Bid Batc, 05(202014 `r�'2;Ot? F[vf BICtTERA DESCRIPTION QTY. UiT NtTPftl('F _ITEMTOIAL Sheet No 3: Traffic Signai Plan - Springdale Street & C'roupie)- Drive instail Bicycle detector Loop Type D (Square;:• 2 tA, d 285.+00 570.00 Install Detector Lccp Type 0 (Clrt;uiar) t EA 285.00 1,995.000� Instaii !Detector Loop Type E � _ T t 3 EA 240,00 ._ 3,120.00 TOTAf.. VBiC) AMOUNT: $ 5,685.OU -Quote is good for 180 days from the ;late of tlbs proposal. -10 days notice required for scheduling- -Site must be ready with cat -track or permanent striping ;prior To loop installation. -Additional charges may incur f-3r extra move-or,s. Our quote includes: i - Lay out, saw cut, wash., blow. dry. seal, and rriegg ? Loop saw cut shall be filled with Hot Me;h Sealant 3- (n4ara.rce coverage up to $1 million, Ae.neral a_�glel-ate UT) W Sx million, rr:r,brelia up to $5 million 4- (fie move -on 5- �r:tYf:ccontrnl Our quote excludes: 1-Bond fee, permit fee, utiities fee, advance sign, posting OfaJ',y 13rtd, ,-r notifying residents 2- Traffic control 3- Weekend wwk, 4- Condtait, sub -out, splice All inclusion, and exclusio s are to be into 't7orated (fac) Our :XMITUt. if either party btcu nts involved in litigation or arbitration arising out of this contract, the court or arbitration panel shall: award attorney's fees wid coni to the prevailing, party. Plea: e. call if ynci tiave any questions or need more irfunna ion. Siricere ly. Mai -Lan Nguyen Page 1 of 1 NORTH AMERICAN SPECIALTY INSURANCE COMPANY BOND NO.: UNIPE-523 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, UNIQUE PERFORMANCE CONSTRUCTION, INC., (hereinafter called the Principal), and NORTH AMERICAN SPECIALTY INSURANCE COMPANY, a corporation organized and doing business under and by virtue of the laws of the State of NEW HAMPSHIRE, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of CALIFORNIA, as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH, (hereinafter called the obligee) in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of TEN PERCENT OF THE TOTAL AMOUNT BID Dollars (10% OF BID AMOUNT), for the payment of which, well and truly to be made, we hereby bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the above bounden Principal as aforesaid, is about to hand in and submit to the obligee a bid for SAFE ROUTES TO SCHOOL — IN THE VICINITY OF STACEY MIDDLE SCHOOL AND CLEGG ELEMENTARY SCHOOL, in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefore. NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said obligee, and said principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 15t' day of MAY, 2014. CE CtONSTRUCTION. INC. ff-W Im ru,,.o::,.>,�3..u. 4�c.�...,.r ;.n..,.s A�:���.an�,r.�..��N"��,.'.�'s�.�s4r�1"�`�'•eW'::'F�4;�`�E'sFi •#"....,-i_..._.�,y a'r_*�'""".� ,LL "`�i:—'�rt"`r ,*..'�t.'.��:�rrs .�i ,.::�,r � -' `1� .�_'-`o*;xs�r?NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SEVERALLY Its true and lawful Attorneys) -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9th of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." .r,&llnmuu/1",i. GPO Y,G sg O �fT�.•..g B `t�: GORPORgjtiG ~,?• Si:aL m Steven P. Anderson, Senim• Vice President of Washington International Insurance Company 2' SEAL'i 3ty_:Z 1973 `Pry;On` & Senior Vice President of North American Specialty Insurance Company sg O: �m JiMnnuul�ld» By David M. Layman, Vice Presidenttshington International Insurance Company & Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers thiS26th day of June 2012 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook Ss: On this 26th day of June 2012 before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. "OPFIQAiSFr1I;"yta DONNAD.SI{IiENS Notary Public; Stale Of Illinois Donna D. Sklens, Notary Public My Comlaiu'ionHx :10Nf12015 I, Jeffrey Goldberg . the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington. International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 15 day of �Mjayy 120 14 Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company & North American Specialty Insurance Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of CALIFORNIA County of ORANGE On May 15th, 2014 before me, ERIKA GUIDO, NOTARY PUBLIC, personally appeared RANDY SPOHN , ® 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/theii- authorized capacity fk-*, and that by his/her/t-heif 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. WITNESS my(a d and -al. seal. ERIKA GUIDO It COMM. # 20221671 NOTARY PC BLIC CALIFORNIA N OSANGE COUNTY Al MV Comm, explr®®M»y re 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 ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING:. NAME OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT ® Complete items 1, 2, and 3. Also complete item 4 If Restricted Delivery is desired. Is Print your name and address on the reverse so that we can return the card to you. ® Attach this card to the back of the mailpiece, or on the front if space permits. 1: Article Addressed to: j�lrt?. �tou�y rq Z K/-� B�wY l/Nl4v6 /�E12Fc/Lr`'IAtiCE G'cyNSrQ NC, A. Signature X ❑ Agent ❑ Addressee Received by ( Printed Name) C. Date of Delivery D. Is delivery address different from Item 17 ❑ Yes If YES, enter delivery address below: ❑ No 1391, N• �/CFFE/Z SaN STi�EE"T 3. Service Type 1231 Certfffed Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number ransfer from service label)----_ _ PS Form 3811, February' 7 012 1010 D o o 1 0539 4569 —Velpt 102595-02-M-1540 A Erw h m Lrl Postage $ O Certified Fee ri C3 Return Receipt Fee Postmark C3 (Endorsement Required) Here C3 Restricted Delivery Fee C3 ',(.Endorsement Required) ri C3 Total Postage & Fees ri Sent To M2 ots.eT-;�Z . q f11----- E Cl�o44ii--HCTrp.v /.s.� 0 Street Apt. No.; C3 or'PO Box No. / S Z / N. City, State, ZIP+4 ,4A.Aq,Ve►✓-1 Crq ZBo%