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Home My WebLink AboutGMC Engineering, Inc. - 2008-10-06,..U:-....��..?.i �-.• u"-� .ram.,..-,....,,-. ,..,...--...__ _ ,.,....-.,,,.,.;..,...v,;�., -... � - .,. `^. _ i.,r � �.. ✓ -., � ...... m -, . RECEIVED BY: nnrr/5[� (Name)' (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Shari Freidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance have received the bonds for (-:?Iyr. (Company Name) Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. y Maintenance Bond No. & - Guarantee and Warranty Bond No. Re: Tract No. CC No. !y� MSC No. Approved `(Council Approval Date) Agenda Item No. City Clerk Vault No #27 g1followup/bondlefter.doc FROM: David Verone, Contract Administrator Olwz DATE: March 12, 2009 SUBJECT: Retention Release Payment Company Name: GMC Engineering, Inc. Address: 1401 Warner Avenue Suite B City, State and Zip Code: Tustin, CA 92780 Phone Number: (714) 247-1040 Business License Number: A194832 Local Address: N/A Notice of Completion Date:3/02/09 Contract Purpose: Retention Release for Cash Contract 1243, Safe Routes to School Cycle IV 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. 1 certify that no stop notices are on file on the subject at this time. = _16 _0 G. Date Travis Xklopkins, Director Pub3odXftN9V Company PVP Appmvd as to edit! Rating 4 I certify that there are no outstanding invoices on file. S rl !:_FrneiUenrich, city Treas, 3 ,'02 f Date Shari Fl 'denrich, City Treasurer I certify that no stop notices are on file on the subject contract, and that a guaranty bond has been filed with this office. A Da a Joan Fly , City Clerk 1243 retention release memo .doc 3/12/2009 4:42:00 PM RECEIVED BY: (Name) (Date) TO: Sha i Freidenri h, City Treasurer FROM: DATE: /9 SUBJECT: Bond Acceptance have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved16 . (Conn I Approval Date) l (Company Name) w's L/ ► Agenda Item No. City Clerk Vault No CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating #27 g1tollowup/bondletter.doc MAINTENANCE BOND Bond No. 6469275 KNOW ALL MEN BY THESE PRESENTS, That we, GMC Engineering, Inc. (hereinafter called the Principal), and First National Insurance Company of America Premium: Inlcuded (hereinafter called the Surety), are held and firmly bound unto the City of Huntington Beach (hereinafter called the Obligee), in the full and just sum of One Hundred Seventy Thousand and 001100 Dollars ($ 170,000.00 ) Dollars, lawful money of the United States, for the payment of which, well and truly to be made, we bind ourselves, our heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, said Principal has entered into a certain contract with the Obligee dated September 23, 2008 , for Safe Routes to School, Cycle IV Cash Contract 1243 AND WHEREAS, as a condition of acceptance obligee requires that, GMC Engineering, Inc. should guarantee Safec Routes to School, Cycle IV, Cash Contract No. 1243 for a period of One (1) year(a), then this obligation shall be null and void; otherwise to remain in full force and effect. Signed, sealed and delivered February 4, 2009 Witness as to GMC Engineering, Inc. p Principal 1 BY: Gennady Chizhik - resident Gennady Chi z6ik - Secretary " VED AS�+'PO F McGkTH, City on e_y / First National Insurance Company of America B: effr y . Gryde, mt rney-in-Fact 5-3749/GFFF 3/01 FRP POWER First National Insurance Company of America t 1001 4th Avenue ,.....;._...Ma OF ATTORNEY Suite 1700 Seattle. WA 98154 KNOW ALL BY THESE PRESENTS: No, 9392 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint ****ax-x**•x************************�x-*JEFFREY R. GRYDE; Laguna Niguel, its true and lawful attorney(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 26th day of January , 2009 Dexter R. Legg, Secretary Timothy A. Mikolajewski, Vice President CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attomeysan-fact or under other appropriate files with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof. may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (I) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seat of the Company may be a facsimile thereof." I, Dexter R. Legg , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Aromey are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 4th s�AA �192$ S-10491DF V09 -%,�* 9 day of February 2009 �XR, k1l Dexter R. Legg, Secretary Sateco® and the Safeco logo are registered trademarks of Safeco Corporation. WEB PDF tz CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Ora On February 4, 2009 before me, personally appeared Jeffrey R. Gryde Kathy L. Burnum, Notary Public (Here insert name and title oft he officer) who proved to me on the basis of satisfactory evidence to be the person(X) whose name(X) is/" subscribed to the within instrument and acknowledged to me that he/� executed the same in his/XOtXM authorized capacity(W, and that by his/ wk signature%) on the instrument the person(k), or the entity upon behalf of which the person(x) 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. _ �� vC.. • .�� n mac ivr� Signature of blic KATHY L. SURNUM Commission # 1705358 . ~� Notary Public - California Orange County I MyCcmm.B00NOv142010 (Notary seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title of description of attached document) (Title or description of attached document continued) Number of Pages _ Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) -- D Partner(s) X1 Attomey-in-Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETNG THIS FORM Jay acknowledgment completed is California must contain verbiage ecactl} as appears above in the notary section or a separate acknoHdedgrnentfornr mnst be properly completed and attached to that docuruent. The only exception is if a docarrreut is to be recorded outside of California_ In .vrcb instances, arry altemadve acknowledgment rerbiage as nrtrp be printed on such a document so long as the verbiage does riot require the notary w do something that is illegal for a notart- in California (i.e. cenifiino the authorized capacity° af'the signer). Please che..ck the docrunent caretrdlp for proper notarial wording and attach this form if required. • State and County information must be the State and Comity where the document sip ,ner(s) personally appeared before the notary- public for acknowledgment. • Date of notarization must be the date that the signers) 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 siguer(s) who personally appear at the time of notarization. • Indicate the correct sumstilar or plwat fortes by crossing off incorrect forms (i.e. lre'she+may - is iafe- ) or circling the correct forms. Failure to correctly indicate this informatiou inav lead to rejection of document recording. • The notary seal impression most 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. • 5ignatitre of the notary public must match file signature on file with the office of the county clerk. Additional infonuation is riot required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached docwnent mmnber of pages and date. Indicate fire capacity claimed by the signer. If fire 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 vl_.10.0' 800-873-9865 www.NotaryClassmconl CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of ® f-a e- On Feb cuaeti y, ZCQ9 before me, (Here insert name and title ofthe offi personally appeared -(-,-eNry etdv Ch1,Z,fk1 K who proved to me on the basis of satisfactory evidence to be the person(g) whose name(,0 is/alfi' subscribed to the within instrument and acknowledged to me that he/s4e hey executed the same in his/4ve theif authorized capacity(,ies), and that by his/be lkctr signature(8t on the instrument the person(e), 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. KATHY L. BtlRNUM Commission # 170388 lb WITNESS my hand and official seal. _ -� Notary Public - California : Orange County % lCorrm 6 Iles Nov 16=10 Signature oGq:_ar blicv� (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT fY1 c.� 1vte�J �r\)fC,e_ R rrni d - CC4{2`{3 (Title or description of attached document) ski cLC\r- 0 'sJ6r,1 kiC_ ('I itle or description of attached document cont n— nued) Number of Pages �_ Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) Corporate Officer Ge Si c(e r�'i"lScc�e�� r . (Title)—�— / El 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 et document is to be recorded outside of California. In 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 thisform if required. • State and County information must be the State and County � here 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 offincorrect Iorms (i.e 4,te/she/0*e — is /are) or circling the correct forms. Failure to correctly indicate this information may lead to rejection ofdocument recording. • The notary seal impression must be clear and photographically reproducible Impression must not cover text or lines. If seal impression smudges" re -seal it 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 v 12.10.07 800-873-0865 www.NotaryClasses.cot L Gennady Chizhik (Name of Declarant) CONTRACTOR'S CERTIFICATE state and certify that: l GMC Engineering, Inc. is the general contractor to the City of Huntington Beach ("City'") on Contract No. 1243 (the "Contract") for the construction of the public work of improvement entitled: Safe Routes to School - CycleIV in the vicinity of Mesa View Middle School City of Huntington Beach (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 far 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 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"): NONE I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Tustin, CA APPROVED AS TO FORM on this ,5 4 day of PP_,k, 20 09 . V (Signature of I) larant) Name: Gennady Chizhik Title: President By: N 3 . Z"LP Name: [Type Name] Title: [Type Title) Certification of Compliance with Prevaftg Wage Laws To: City of Huntington Beach Departmeut of Public Works 2000 Main Street/P.O. Box 190 Huniiagtoa Beach, CA 92,648 Re: Certification of Compliance with Pmvai M Wage Laws Contract: Cash Contract No. 1243 Project: Safe Routes to School - Cycle IV in the Vicinity of Mesa View Middle School -ity of Huntington Beacfi The undersigned contractor on the above--refamcod project ("Project") hereby certifies that all W"rars, mechanics, apprentices, traismeos, watahmcn and guards employed by him or by any anbcontractor pu fomming work under the contact for the Project have bean paid pursuant to the nrinimuua wage and bona Ado fine benefit •requirements specified for each particular olassification of work, as set forth in time wage4ide determinations of the State of Califdrnia, Department of industrial Relations, and/or die Umted States Depaclment 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 a Tustin , California. GMC Engineering, Inc. (Type Contractor Name) By.-, r - Name: Gennady Chizhi Title: President CSCNO fqE o 7LS ols• 3b • tsta '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 194 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Cash Contract No.`1243- Project: Safe Routes to School - Cycle IV_ w in the Vicinity of Mesa View Middle School City of Iluntin tg on Beach ry _ The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VH 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 Sfl� -day of �e /, r u a 7 09 , 20 , at Tustin , California. GMC Engineering, Inc. (Type Contractor Name) By: Name: Gennady Chizhik Title: President TF It a- t-t A ORNEY 11.) 3'26'UP 2459SL1 GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 RESOLUTION AUTHORIZING EXECUTION OF ANY CONTRACT BY PRESIDENT GENNADY CHIZHIK At a Meeting of the Board of Directors of GMC Engineering Inc. (hereinafter sometimes called Corporation), a corporation organized and existing by virtue of the laws of the State of California, duly called and held on the 15t" of January, 2009, a quorum being present, consisting of the President and Secretary of the Corporation, Gennady Chizhik, the following Resolution was adopted: BE IT RESOLVED by the Board of Directors of this Corporation that its President, Gennady Chizhik, is hereby authorized, empowered, and directed to execute on behalf of this Corporation, and in its name, any contract. BE ITFURTHER RESOLVED, that any prior acts of said officer of the Corporation, -in connection with the execution of any contract on behalf of the Corporation, are hereby confirmed and ratified. I, Gennady Chizhik, hereby certify and declare that I am the regularly and duly acting President and Secretary of GMC Engineering, Inc., a Corporation; that the Resolution above set forth was ,duly and regularly adopted by the Board of Directors of said Corporation at a Special Meeting. of said Board of Directors, held at Tustin, California, on the 15th day of January, 2009; that the whole number of Board of Directors of said Corporation is one; that there were present at said meeting one Director; that all Directors present voted in favor of said Resolution, and that thereupon the Resolution was declared regularly adopted. Corporate Seal 14 ��' r Gennady Chizhik President & Secretary of GMC Engineering Inc. Notarization Attached 1401 Warner Avenue, Suite B, Tustin, California 92780 (714) 247-1040 • Fax (714) 247-1041 CALIFORNIA ALL-PURPOSE CERT'IFICAT'E OF ACKNOWLEDGMENT State of California County of () San`,we- On Fe. bfuav yam/ 20107 before me, personally appeared ___L-,-c4mNv d ,/ CM 2A,` K isC1TtiaM Nr, (Here insert name and title of the o who proved to me on the basis of satisfactory evidence to be the person(stwhose nameJ� is/subscribed to the within instrument and acknowledged to me that he/ ddl executed the same in his/%eet+ i-r authorized capacity(Jes), and that by his/her%theirsignatureoRton 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. KATHY L. BURRNUM Commis3lon # 1705358 WITNESS my hand and official seal. .m Notary Public - California ' Orange County - l WConvn, kesNov16,2010 �C (Notaryseal sw S1gnt1tur6 L7`yot r Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OFI/THE ATTACHED DOCUMENT fro/id,bN a' �AI!dAdtiZtA)Q EZecG6m) ol ((/^h^ (Title or description of alAched documentt)L Z/,/, /<' ('title o- on of attached document continued) Number of Pages ti Document Date N 4 (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) �pote Offi er ,)I_ �Secre�;rry (Title) ❑ Partner(s) 11 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 he properly completed and attached to that document. The only exception is if a document is -to be recorded outside of California. In such instances, any alternative 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 illegalfin- 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 pub] ic). • 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/Owis /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection ofdocrament recording. • The notary seal impression mrist 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 counfy,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. CE0. CPO.. Secretary). • Securely attach this document to the signed document 2008 Version CAPA v 12.10.07 800-873-9865 www.NotaryClasses.com CONSENT OF SURETY TO FINAL PAYMENT Conforms with the American Institute of Architects, AIA Document G707 TO OWNER: (Name and address) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 PROJECT: (Name and address) Safe Routes to School, Cycle IV Cash Contract 1243 OWNER ARCHITECT CONTRACTOR SURETY OTHER ARCHITECT'S PROJECT NO.: N/A CONTRACT FOR: Safe Routes to School CONTRACT DATED: September 23, 2009 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address cfSurety) First National Insurance Company of America 120 Vantis Aliso Viejo, CA 92656 ,SURETY, on bond of (Insert name and address of Contractor) GMC Engineering, Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 asset forth in said Surety's bond Bond No. 6469275 IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: February 9, 2009. (Insert in writing the month followed by the numeric date and year.) First National Insurance Company of America (surety) ( gn re o authorized)"preentative) Attest: (Seal): Jeffrey R. Gryde, Attorney -in -Fact (Printed name and title) S-21341GEEF 10/01 , OWNER, KNOW ALL BY THESE PRESENTS: First National Insurance Company of America POWER 1001 41h Avenue OF ATTORNEY Suite 1700 Seattle. WA 98154 No. 9392 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint x *****.".X * -*" .x.-xx. � -* "xz** *"• .X"JEFFREY R. GRYDE; Laguna Niguel, CaliforNaxx•*"**""************•x•***xx•*•-X. its true and lawful attorney(s} in -fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 26th day of January , 2009 � �i.•�1�-s-1„�k:.z-Graf-�'f�.� Dexter R. Legg, Secretary Timothy A. Mikolajewski, Vice President CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of Its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof. may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such Instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (I) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, Dexter R. Legg , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 9th dayof February 2009 ��RANCicp r „_- - Dexter R. Legg, Secretary S-1049/0F 1t09 4�10 Safeco@ and the Safeco logo are registered trademarks of Safeco Corporation. WEB PDF CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On February 9, 2009 before lie, Kathy L. Burnurn, Notary Public (Here insect name and title of the officer) personally appeared Jeffrey R. Gryde who proved. to me on the basis of satisfactory evidence to be the person(X) whose name( is/M subscribed to the within instrument and acknowledged to me that heA00" executed the same in his/)>)o authorized capacity(i , and that by histtkovd l signature(K) on the instrument the person(X), or the entity upon behalf of which the person(g) 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 nay hand and official seal. (Notary KATHY L. BURNUM Commission # 1708388 a llotary Public • California Orange County ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title of description of attached docuarcu ) (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) X1 Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM AY acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form +nest be properh, completed and attached to that document. The only exception is if a document is to be recorded ontside of Caiifornia. lit sttch instcmces, an alternative acknowledgment eerbiage as mat' be printed on such a document so long as the verbiage does not require the notan to do something that is illegal for a noton, is California (i.e. eenfirng the authoiIzed capacity of'the signer). Please check the doctnent carefrdly for proper notarial wording and attach this form if required. • State and County information must be the State and Comity where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) 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 names) of docuttltut sigtrer(s) who personally appear at the time of notarization. • Indicate the correct singular or phnal forms by crossing off incorrect foams (i.e. he/she%tK-),- is lafc-) or circling the correct forms. Failure to correctly indicate this hifonmatiou 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 penuits, otherwise complete a different acknowledgment form. • Signature of the norary public mast match file sigliattue au Tile with the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate tide or type of attached docnrnent number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer. indicate the title fi.e. CEO, CFO. Secretary). • Securely attach this document to the signed document ?008 Version CAPA G 1 _.10.07 800-873-9865 www.NotaryClasses.conl PLEASE COMPLETE THIS INFORMATION t RECORDING REQUESTED BY: Recorded in Official Records, Orange County Tom Daly, Clerk -Recorder AND WHEN RECORDED MAIL TO: IIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIII NO FEE 2009000095458 01:06pm 03/02/09 WHEN RECORDED MAIL TO: 100 200 N12 1 CITY OF HUNTINGTON BEACH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Attn: Robert A. Martinez P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT: NOTICE OF COMPLETION u 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 GMC Engineering Inc. who was the company thereon for doing the following work to -wit: SAFE ROUTES TO SCHOOL, CYCLE IV; CC #1243 That said work was completed January 29, 2009 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 November 12, 2008, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract First National Insurance Company of America 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 3, 2009. rector of ublic Works or City Engineer City of Hu tington 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 3, 2009. Dir2Etor of Pyr lic Works or City Engineer C' of Huni' gton Beach, California THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) 'P.059-TITLE PAGE (R7/95) FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND ame- FOR <;a..oe;- Ar. -AES -fv Sc4o v e-G /2 y3 TABLE OF CONTENTS Page No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 3 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 4 7. NOTICE TO PROCEED 5 8. BONDS 5 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 6 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 9 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 10 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 10 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT & TERMINATION 14 24. TERMINATION FOR CONVENIENCE 14 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 15 27. CITY EMPLOYEES AND OFFICIALS 15 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 15 29. NOTICES 16 30. SECTION HEADINGS 16 31. IMMIGRATION 16 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 34. INTERPRETATION OF THIS AGREEMENT 35. GOVERNING LAW 36. DUPLICATE ORIGINAL 37. CONSENT 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 39. CALIFORNIA PREVAILING WAGE LAW 40. CALIFORNIA EIGHT -HOUR LAW 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 42. EMPLOYMENT OF APPRENTICES 43. PAYROLL RECORDS 44. FEDERAL PARTICIPATION 45. ADDITIONAL FEDERAL REQUIREMENTS 46. DAVIS-BACON ACT 47. DISCRIMINATION, MINORITIES, ALIENS 48. EQUAL EMPLOYMENT OPPORTUNITY 49. COPELAND "ANTI -KICKBACK" ACT 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 52. ENERGY CONSERVATION 53. HOUSING AND URBAN DEVELOPMENT 54. SIGNATORIES 55. ENTIRETY 17 17 18 18 18 18 19 19 20 20 20 21 21 22 22 23 23 24 25 25 25 25 25 11 FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND f r uR 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 �i w1 C. C n o I •n OF Z& I'll g� a C" J , &nu �Q, wA A -W-Q �.or hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as 75� R Q*4-tz % +- S- 4a a L Cy C I E -X cc — 12 43 in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not g/agree/ surfnet/federal const 12-07 1 limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK, PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; g/agree/ surfnet/federal const 12-07 2 D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference), and the Federal Requirements from FHWA 1273 and additional requirements (which is attached hereto as Exhibit "B"); F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. g/agree/ surfnet/federal const 12-07 3 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 ),IF #i k.%4,rJ ) E V f,,�t TLC d Dollars ($ 1 'TO. M . �— ), 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 ,r4 (3 a ) consecutive Wor � 5'-04--4 5 from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/ swfnet/federal const 12-07 4 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/ surfnet/federal const 12-07 5 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/ surfnet/federal const 12-07 6 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 F %ge 9,v%Arc c Dollars ($ 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 12-07 7 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 12-07 8 (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/ swfnet/federal const 12-07 9 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, ten percent (10%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the Agreement price shall not be considered as a acceptance of any part of the work. g/agree/ surfnet/federal const 12-07 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTORs property, arising directly or indirectly out of the obligations or operations herein undertaken by g/agree/ surfnet/federal const 12-07 11 CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, g/agree/ surfnet/federal const 12-07 12 a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above -mentioned insurance contain a self -insured retention, or a "deductible" or any other similar form of limitation on the required coverage. 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: 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. g/agree/ surfnet/federal const 12-07 1 13 The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 23. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may g/agree/ surfnet/federal const 12-07 14 make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. g/agree/ surfnet/fedeml const 12-07 15 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES, RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: g/agree/ sw fnet/federal const 12-07 16 TO CITY: City of Huntington BeKgwv"'r- 2000 ATTN: � � (A Main Street Huntington Beach, CA 92648 30. SECTION HEADINGS TO CONTRACTOR: m The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. g/agree/ surfnet/federal const 12-07 17 33. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 34. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 35. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. g/agree/ surfnet/federal const 12-07 18 36. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 37. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 39. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of g/agree/ surfnet/federal const 12-07 19 Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 40. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty- five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is g/agree/ surfnet/federal const 12-07 20 required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 42. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 43. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 44. FEDERAL PARTICIPATION The PROJECT pursuant to which the work covered by this Agreement is being executed is being assisted by the United States of America. Several Agreement provisions embodied herein are included in this Agreement in accordance with the provisions applicable to such federal assistance. As federal funds are financing all or part of this work, all of the statutes, g/agree/ surfnet/federal const 12-07 21 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. Additionally, the CONTRACTOR shall insert in each subcontract all of the stipulations contained in the Required Contract Provisions of Form 1273, and further require their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. Certain sections of Form 1273 may not be applicable depending upon the project and will be crossed out. 45. ADDITIONAL FEDERAL REQUIREMENTS CONTRACTOR agrees to abide by the additional requirements necessary for federal- aid (see pgs. 12-14 of Exhibit `B"). The CONTRACTOR agrees to buy only steel and iron made in the United States for all federal -aid construction projects ("Buy America"). The CONTRACTOR also agrees to be subject to the legislative and regulatory Disadvantaged Business Enterprise (DBE) requirements (42 USC Section 2000d, et seq.). If the CONTRACT does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non -collusion certification. Select projects may also require "Federal Trainee" or "On -the -Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined by the Secretary of Labor in accordance with the Davis -Bacon Act (40 USC Section 176a, et seq.) g/agree/ surfnet/federal const 12-07 22 for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 46. DISCRIMINATION, MINORITIES, ALIENS CONTRACTOR shall not discriminate nor allow its employees, agents, principals, or subcontractors to discriminate against any employee or applicant for employment on the basis of race, religious creed, national origin or sex. CONTRACTOR shall take affirmative steps to hire local qualified minority individuals when job opportunities occur and utilize local business firms when possible. 47. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled 'Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit "B"). CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. 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 12-07 23 discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 48. COPELAND "ANTI -KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations, which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 49. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327 et seq.) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight (8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in 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 g/agree/ surfnet/federal const 12-07 24 dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 50. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 114 of the Clean Air Act and section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every 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 12-07 25 51. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 USC Section 6201, et seq.). 52. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 53. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 54. ENTIRETY The foregoing, and Exhibits "A" and `B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that parry'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 12-07 26 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 OM,8C--i 04O , 20DL. CONTRACT R - �A . ) & _I --- print name ITS: (circle one) Chairma esiden ice President AND By: V)J) It print -name ITS: (circle one cretary hief Financial Officer/Asst. Secretary - Treasure g/agree/ surfnet/federal const 12-07 27 CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California INITIATED AND APPROVED: APPROVED AS TO FORM: /% 0 fb b City ttorney i OGINEERIGIc GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 RESOLUTION AUTHORIZING EXECUTION OF ANY CONTRACT BY PRESIDENT GENNADY CHIZHIK At a Meeting of the Board of Directors of GMC Engineering Inc. (hereinafter sometimes called Corporation), a corporation organized and existing by virtue of the laws of the State of California, duly called and held on the 15th of January, 2008, a quorum being present, consisting of the President and Secretary of the Corporation, Gennady Chizhik, the following Resolution was adopted: BE IT RESOLVED by the Board of Directors of this Corporation that its President, Gennady Chizhik, is hereby authorized, empowered, and directed to execute on behalf of this Corporation, and in its name, any contract. BE IT FURTHER RESOLVED, that any prior acts of said officer of the Corporation, in connection with the execution of any contract on behalf of the Corporation, are hereby confirmed and ratified. I, Gennady Chizhik, hereby certify and declare that I am the regularly and duly acting President and Secretary of GMC Engineering, Inc., a Corporation; that the Resolution above set forth was duly and regularly adopted by the Board of Directors of said Corporation at a Special Meeting of said Board of Directors, held at Tustin, California, on the 15th day of January, 2008; that the whole number of Board of Directors of said Corporation is one; that there were present at said meeting one Director; that all Directors present voted in favor of said Resolution, and that thereupon the Resolution was declared regularly adopted. Corporate Seal Gennady Chizhik President & Secretary of GMC Engineering Inc. Notarization Attached 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 EM CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of 4\3 e On sep{ent6er^ 30 4 a20o$ before me, personally appeared &e.NNcLdV Chl-Zh1W (Here insert name and title of the who proved to me on the basis of satisfactory evidence to be the person(ga whose name(. is/ar—subscribed to the within instrument and acknowledged to me that he/s1:ieftjwy executed the same in his/� authorized capacity, and that by hisZher/their signature(R) on the instrument the person(, or the entity upon behalf of which the personal acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature AZo 'ubhc r KATHY L. BURNUM Commiuton # 1 TOaSiiR Notary Public - California Orange County MvC,anvy 8a MesNOv1&2010 (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT /yes Lt iow k+,A0rl'21"UG kiccU-66A) or (Title or description of attar document) o(NV Cpto 0.��iden1t Gy"dyck,-O I (Title or descriptio of -attached document continu ) Number of Pages 1 Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ,:V4 Corporate Officer (Title) / ❑ Partner(s) ❑ Attorney -in -Fact I- -1 Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly cts 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. In such instances. any alternative acknowledgment verbiage as may be printed on such a document so Iong as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifving the authorized capacity of the signer). Please check the document carefidlyJor proper r,olarial wording and attach this.1brrn if required • State and Counte 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 names) 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. 4/she/they- is /are ) 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 sutticient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the ol-tice of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different doctument. Indicate title or type ofattached 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 CAFA v12.10.07 800-873-9865 www.NotaryCIasses.com 7 SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 in the CITY OF HUNTINGTON BEACH AGMC Engineering Inc. U01 Warner Avenue, Suite B Tustin, CA 92780 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 therefore, 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 30 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 Bidders Bond in the amount of $ 10 which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed 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 B' der Is Si nature One 1 Se t. 3 2008 ft Wl&- � GMC Engineering Inc. U01 Wanner Avenue, Suite B Tustin, CA 92780 C-2 GMC Engineering Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 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, Cycle IV — CC 1243 September 2, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Mesa View Middle School) CC1243 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, dated September 2, 2008. GMC Engineering, Inc. Company Name By Gennady Chifiik September 11, 2008 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. GMG Engineering Inc. 1401 Wamer Avenue, Suite B Project Bid Schedule Tustin, CA 92780 Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 '.t��"�' L q { �' °�.�^i•�.'. kc " "c= -, ...y � j 9 �x � '4 k •�F :. � �� li.. � v+v'�" :�.�'`•.. iA?t.:iA.��'r�#6.. h- "� may' K � f ,�" _3 F J'.`ti.E ,� '. U v. ��; z«t. 1 1 L.S. Mobilizatio . 2 1 L.S. ye- er L.S. Furnish Project Traffic Control. @nNc $ �,850 $ /, Aso. ea 3 1 L.S. Per L.S. Furnish and Install Traffic Striping and igning. @ Apq vie Al 7w04s $ y/ . spo $ /y,s�0 • cgo 'vim Awt k 4 1 L.S. Per L. S. Modify Traffic Signal at Edwards Street and Slater Avenue �i Per L.S. $62WO- $62, fX • O'O 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and /� $ Z f O. W $ a, 9So. eo AC Paving Replacement. ZW 0 6 3 E.A. Per EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $/, 2� 60 X $ 3 MM 0 7 6 L.F. Poles are City Furnished). @ A oP ,-O;<!O o Per EA. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works Co� ectioiy,(A.P.Wandazd Plan 606-2. @ Per L.F. $ 1�• 00 $ 020. 00 8 100 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ 1S To $ 5-50 80 207. Sidewalk Locations as Determined by the City. / 4 /] L-- PerS.F. 7 Total Amount Bid in Figures: $ T Total Amount Bid in Words: $ 04%A- G�G�e a[ •�=� �`s '`� C-2.1 GMC Engineering Inc. $401 Wamer Avenue, Suite 6 Tustin, CA 92780 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. Contractor is to pick up the materials at the City Yard, 17371Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375-5015. C-2.2 GMC Engineering Inc. LIST OF SUBCONTRACTORS 1401 Warner Avenue, Suite 6 Tustin, CA 92780 In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion Name and Address of Subcontractor State License Number Class Work pof I --�0~ MARTINEZ CONCRETE INC. 920 West Foothill Blvd. Azuza, CA 91702 626-334-2979 Lic. # 394471 C8 CONCRETE FLATWORK T__ MACADEE ELECTRICAL 4755 Lanier Road Chino Hills, CA 91710 909-627-1336 Lic. # 583125 ELECTRICAL `7 IL & ORANGE COUNTY STRIPING SERVICE INC. 183 North Pixley Orange, CA 92668 714-639-4550 Lic. # 346095 C 32 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 GMC Engineering Inc. $401 Warner Avenue, Suite 6 NONCOLLUSION AFFIDAVIT Tustin, CA 92780 TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Gennady Chizhik , being first duly sworn, deposes and says that he or she is President of GMC Engineering, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone. interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. GMC Engineering, Inc. Name of Bidder Signature of Bidder Genlady Chizhik GMC Engineering Inc. U01 Warner Avenue, Suite B Tustin, CA 92780 Address of Bidder Subscribed and sworn to before me this day of , 20 SEE ATTACHED NOTARY SEAL C-4 Jurat State of California County of Oro-N e- Subscribed and sworn to (or affirmed) before me on this day of S epie-DN6 e- r, 20 0$ by �r'eNNo.-dV Chf"Z: 11l XIF proved to me on the basis of satisfactory evidence to be the person(g) who appeared before me. X a, � Signatur (Notary seal) rii4`r. KATHY L. BURNUM Commission # 1705356 IL Notary Public - California Orange County MCaCa n.d 1oesNov16.2010 OPTIONAL INFORMATION DESCRIPTION OF THEATTACHEDDOCUMENT ND�C-ai(s�t$i'oly l��7tvdO -f ('Title or description of attached document) (Title or description of attached document continued) Number of Pages f Document Date (Additional information) INSTRUCTIONS FOR COMPLETING THIS FORM The wording of all Jurats completed in California after January 1. 2008 must be in the form as set forth within this Jurat. There are no exceptions. 1f a Jurat to be completed does not follow this form, the notary must correct the verbiage by using a jurat stamp containing the correct wording or attaching a separate jurat form such as this one which does contain proper wording. In addition, the notary must require an oath or afftrmation from the document signer regarding the truthfulness of the contents of the document. The document must be signed AFTER the oath or affirmation. if the document was previously signed, it must be re -signed in front of the notate public during the jurat process. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the jurat process is completed. • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Signature of the notary public must match the signature on file with the office of the county clerk. • 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 jurat form. Additional information is not required but could help to ensure this jurat is not misused or attached to a different document. Indicate title or type of attached document, number of -pages and date. • Securely attach this document to the signed document 2008 Version CAPA v19.07 800-873-9865 www.NotaryC]asses.coni UTILITY AGREEMENT GMG Engineering Inc. U01 Warner Avenue, Suite B Tustin, CA 92780 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 Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: September 11 , 2008 GMC Engineering, Inc. Contractor By Gennady Chizhi President Title C-5 GMG Engineering Inc. 1401 Warner Avenue, Suite 6 DISQUALIFICATION QUESTIONNAIRE Tustin, CA 92780 In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes 9 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 GMe Engineering Inc. COMPENSATION INSURANCE CERTIFICATE 1401 Warner Avenue, Suite B Tustin, GA 92780 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: September 11 , 2008 GMC Engineering, Inc. Contractor By Gennady Chizhik President Title C-7 GMC Engineering Inc. UNDERGROUND SERVICE ALERT 14001 Warner Avenue, Suite B IDENTIFICATION NUMBER Tustin, CA 92780 (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: GMC Engineering, Inc. Contractor By Gennady Chizhik President Title Date: September 11 , 2008 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work Additional forms may be obtained from the AGENCY upon request. C-8 GMC Engineering Inc. BIDDER'S INFORMATION 1401 Warner Avenue, Suite 6 Tustin, CA 92780 BIDDER certifies that the following information is true and correct: GMC Engineering, Inc. Bidder Name 1401 Warner Avenue Business Address Tustin City, ( 71 4 ) 247-1 040 Telephone Number Suite B 739091 State Contractor's License No. and Class 8/11 /97 Original Date Issued 8/31 /09 Expiration Date CA 92780 State Zip The work site was inspected by Gennady chi zhikf our office on Sept. 2 32008 The following are persons, firms, and corporations having a principal interest in this proposal: GMC Engineering, Inc. Gennady Chizhik C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. AMC engineering Inc. GMC Engineering, Inc. 1401 Warner Avenue, Suite B .r__ �., ,,,, Company Name smn'Ag2780 Signature of Bidder Gennady Chizhik Printed or Typed Signature Subscribed and sworn to before me this , day of PUBLIC SEE ATTACHED NOTARYSEAL Listed below are the names, address and telephone numbers for three public agencies for wh' the bidder has performed similar work within the past two years: I SEE ATTACHED Name and Address of Public Agency ZZ Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public AgXMger: Name and Telephone No. of Pro Contract Amount Type of Work Date Completed 3.zx Na>andddres of Public Agency Nalephone No. of Project Manager: Xntract Amount Type of Work Date Completed C-10 Jurat State of California County of © M pi Q, Subscribed and sworn to (or affirmed) before me on this I I -b�l day of Ae-0fernLe-r _, 2003 by sZ f proved to me on the basis of satisfactory evidence to be the person( who appeared before me. Slgnatu (Notary seal) =KATHY L. BURNUM Aof�ommission #k 1705358 16 Notary Public • California 29 i a .Orange County QgrrM teuNov 16, 2010 OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT ('title or description of attached document) ('title or description of attached document continued) Number of Pages a Document Date (Additional information) INSTRUCTIONS FOR COMPLETING THIS FORM The wording of all Jurats completed in California after January 1. 2008 must be in the form as set forth within this Jurat. There are no exceptions. If a Jurat to be completed does not follow this ,form, the notary must correct the verbiage by using a jurat stamp containing the correct wording or attaching a separate jurat form such as this one which does contain proper wording. In addition, the notary must require an oath or affirmation from the document signer regarding the truthfulness of the contents of the document. The document must be signed AFTER the oath or affirmation. If the document was previously signed, it must be re -signed in front ofthe notary public during the jurat process. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the jurat process is completed. • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Signature ofthe notary public must match the signature on file with the office ofthe county clerk. • 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 jurat form. Additional information is not required but could help to ensure this jurat is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. • Securely attach this document to the signed document 2008 Version CAPA vl.9.07 800-873-9865 www.NotaryClasses.com GEC sIGINEERIGIC GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS. PROPOSAL REFERENCE LIST OWNER City of Anaheim ADDRESS 200 E. Anaheim Anaheim, CA 92807 OUR JOB# 194-05 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT State College Blvd. / Ball Road Intersection Improvements $ 1,377,713.00 OUR JOB# 202-06 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT Lincoln Avenue Street Improvements $ 1,678,026.00 OUR JOB# 203-06 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT Harbor Blvd. / Ball Road Intersection Improvements $ 394,010.00 OUR JOB# 204-06 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT Lincoln Ave. / Sunkist St. Intersection Improvements $ 421,003.00 OUR JOB# 206-06 CONTACT Keith Laster PHONE 714-231-8373 DESCRIPTION & CONTRACT AMOUNT State College Median & Landscape Improvements $ 1,687,843.50 OUR JOB# 209-07 CONTACT Keith Laster PHONE 714-231-8373 DESCRIPTION & CONTRACT AMOUNT. Harbor Blvd. Roadway and Parkway Improvements $ 331,785.56 OWNER City of Beaumont / F.J. Hanshaw Properties ADDRESS 10921 Westminster Avenue, Garden Grove, CA 92843 OUR JOB# 208-07 CONTACT Richard Borden PHONE 714-573-9644 DESCRIPTION & CONTRACT Realignment of Second Street at Highland Springs Avenue City of AMOUNT Beaumont for F.J Hanshaw Properties $ 3,500,000.00 OWNER City of Brea ADDRESS One Civic Center Circle, Brea, CA 92621 OUR JOB# 173-03 CONTACT Raul Lising PE PHONE (714) 671-4450 DESCRIPTION & CONTRACT State College Blvd./Lambert Rd Intersection Impts. & Brea Blvd. / AMOUNT Central Ave Intersection Impts. $ 1,220,294.48 OUR JOB# 189-05 CONTACT Raul Lising PE PHONE (714) 671-4450 DESCRIPTION & CONTRACT AMOUNT Lambert & Kraemer Intersection Improvemetns $ 287,506.00 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 gixEERIG I GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER Boeing Realty Corporation / The Moote Group ADDRESS 1516 Brookhollow Drive, Santa Ana, CA 92705 OUR JOB# 199-05 CONTACT Steve Morrow PHONE 714-751-5557 DESCRIPTION & CONTRACT Pacific Gateway OnSite Street Improvements Tract 16375 City of AMOUNT Seal Beach $ 1,197,453.38 OUR JOB# 200-06 CONTACT Steve Morrow PHONE 714-751-5557 DESCRIPTION & CONTRACT Pacific Gateway Off Site Street Improvements Tract 16375 City of AMOUNT Seal Beach $ 3,852,196.32 OUR JOB# 201-06 CONTACT Steve Morrow PHONE 714-751-5557 DESCRIPTION & CONTRACT Pacific Gateway Storm Drain Improvements Seal Beach Blvd. City AMOUNT of Seal Beach $ 1,491,235.76 OWNER City of Chino ADDRESS 13220 Central Avenue, Chnio CA 91710 OUR JOB# 165-03 CONTACT Naghmen Imani PHONE (909) 464-8367 DESCRIPTION & CONTRACT AMOUNT Mountain Ave Water Main $ 338,020.04 OWNER City of Colton ADDRESS 650 N. La Cadena Drive Colton, CA 92324-2897 OUR JOB# 157-02 CONTACT Amer Jakher, PE PHONE (909) 370-5067 DESCRIPTION & CONTRACT AMOUNT Santa Ana River Project Area - Washington Street Medians $ 617,569.71 OUR JOB# 172-03 CONTACT Victor Ortiz PHONE (909) 370-5065 DESCRIPTION & CONTRACT AMOUNT Valley Blvd. Median Improvements $ 351,437.60 OWNER City of Costa Mesa ADDRESS 77 Fair Drive, Costa Mesa, CA OUR JOB# 175-04 CONTACT Tom Banks PHONE (714) 754-5029 DESCRIPTION & CONTRACT Bike Trial @ OC Fairgroungs - Newport Blvd. South, Fair to AMOUNT Arlington $ 193,026.47 OWNER City of Cypress ADDRESS 5275 Orange Ave, Cypress CA 90603 OUR JOB# 164-02 CONTACT Kamran Dadbeh PE PHONE (714) 229-6756 DESCRIPTION & CONTRACT AMOUNT Ball Road Parkway Improvements $ 290,325.37 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 G GIc GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Downey ADDRESS 11111 Brookshire Ave Downey, CA 90241-7016 OUR JOB# 162-02 & 162A-02 CONTACT Anthony La PHONE (562) 904-7118 DESCRIPTION & CONTRACT AMOUNT Paramount Gateway Streetscape $ 1,132,265,62 OUR JOB# 205-06 CONTACT Jim Bautista PHONE (562) 904-7117 DESCRIPTION & CONTRACT AMOUNT Paramount Blvd. $ 394,771.00 OWNER City of Huntington Beach ADDRESS 2000 Main Street Huntington Beach, CA OUR JOB# 190-05 CONTACT Eric Charlonne PHONE (714) 536-5430 DESCRIPTION & CONTRACT AMOUNT Adams & Brookhurst Intersection Improvements $ 434,974.00 OUR JOB# 195-05 CONTACT Eric Charlonne PHONE (714) 536-5430 DESCRIPTION & CONTRACT AMOUNT Underhill Lane Improvements $ 577,577.50 OUR JOB# 212-08 CONTACT Eric Charionne PHONE (714) 536-5430 DESCRIPTION & CONTRACT AMOUNT Safe Routes to School, Cycle V - Sowers School $ 274,688.00 OWNER City of Irvine ADDRESS One Civic Center Plaza Irvine, CA 92623-9575 OUR JOB# 168-03 CONTACT Steve 011o PHONE (949) 724-7562 DESCRIPTION & CONTRACT AMOUNT Harvard Blvd. Bike Trail 329,030.31 OWNER City of Irvine ADDRESS One Civic Center Plaza Irvine, CA 92623-9575 OUR JOB# 210-07 CONTACT Louie Martinez PHONE (949) 724-7343 DESCRIPTION & CONTRACT AMOUNT Michelson Drive Improvements (From Royce to University Dr.) $ 497,710.50 OWNER City of Laguna Hills ADDRESS 24035 El Toro Road, Laguna Hills, CA 92653 OUR JOB# 196-05 CONTACT Kenneth Rosenfield PE PHONE 949-707-2655 DESCRIPTION & CONTRACT AMOUNT Intersect Wide/Pvmt Resurf & Median Impts Molton Pkwy $ 1,064,003.60 OWNER City of La Mirada ADDRESS 15515 Phoebe Ave La Mirada, CA 90638 OUR JOB# 155-02 CONTACT Gary Sanui PHONE (714) 522-6821 DESCRIPTION & CONTRACT Rosecrans Pavement & Median Reconstruction Valley View to AMOUNT Biola $ 525,467.27 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 INGINEERIGIC GENERAL ENGINEERING CONTRACTOR Uc. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Mission Viejo ADDRESS 200 Civic Center, Mission Viejo, CA 92691 Our Job # 160-02 CONTACT Marc Changon PHONE (949) 470-3091 DESCRIPTION & CONTRACT AMOUNT Improvement of El Paseo Roadway & Traffic Signal Impts $ 223,734.33 Our Job # 171-03 CONTACT Marc Chagnon PHONE (949) 470-3091 DESCRIPTION & CONTRACT Alicia Pkwy / Trabuco Cyn Intersection Traffic Signal Impts & Alicia AMOUNT Pkwy Median Landscaping $ 396,256.58 OWNER City of Newport Beach ADDRESS 3300 Newport Blvd., Newport Beach, CA 92663 Our Job # 179-04 CONTACT Robert Stein P.E. PHONE (949) 644-3322 DESCRIPTION & CONTRACT AMOUNT Newport Blvd. / Balboa Blvd. Merger (Mixmaster) $ 273,625.75 Our Job # 211-07 CONTACT Andy Tran P.E. PHONE (949) 644-3315 DESCRIPTION & CONTRACT AMOUNT Superior Avenue Median Improvements $ 634,118,50 OWNER City of Paramount ADDRESS 16400 Colorado Avenue, Paramount, CA 90723 OUR JOB# 167-03 CONTACT Robert French — Willdan & Associates PHONE 562-714-5599 DESCRIPTION & CONTRACT Street, Traffic & Landscape Impts on Paramount Blvd. & Harrison AMOUNT Streets $ 867,957.00 OWNER City of Riverside ADDRESS 3900 Main Street Riverside. CA 92522 OUR JOB# 174-04 CONTACT Juan Rojas PHONE (951) 826-5236 $ 330,076.68 DESCRIPTION & CONTRACT AMOUNT Central Ave to Chicago, Alleys, Fairmount from Strong to 60 Fwy OUR JOB# 176-04 CONTACT Juan Rojas PHONE (951) 826-5236 DESCRIPTION & CONTRACT AMOUNT Van Buren Blvd. Median Improvements $ 740,000.15 OWNER City of Torrance ADDRESS 3031 Torrance Blvd.; Torrance Ca 90503 Our Job # 166-03 CONTACT Sandy Cohen PHONE (310) 618-2824 DESCRIPTION & CONTRACT Hawthorne Blvd. / Del Amo Blvd. Traffic Signal and Interesection AMOUNT Improvements $ 336,841.11 1401 Warner Avenue, Suite B, Tustin, California 92780 (714) 247-1040 • Fax (714) 247-1041 LNG1XEERUiG It GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Upland ADDRESS 1370 N. Benson Ave Upland, CA 91786 OUR JOB# 177-04 CONTACT Alex Qishta PE PHONE (909) 931-4272 DESCRIPTION & CONTRACT AMOUNT Foothill Blvd. Medians $ 110,073.96 OWNER City of Wesminster ADDRESS 8200 Westminster Blvd. OUR JOB# 197-05 CONTACT Jake Ngo PHONE (714) 898-3311 x 217 DESCRIPTION & CONTRACT AMOUNT Westminster Blvd. Median Improvements from Beach to Edwards $ 2,100,000.00 OUR JOB# 198-05 CONTACT Jake Ngo PHONE (714) 898-3311 x 217 DESCRIPTION & CONTRACT AMOUNT City Hall North Parking Lot Improvements $ 287,287.00 ADDRESS 4845 Casa Loma Ave POBox 87014, Yorba Linda, CA OUR JOB# 169-03 CONTACT Fernando Saldivar PHONE (714) 961-7170 DESCRIPTION & CONTRACT AMOUNT Yorba Linda Blvd. Median Improvements $ 556,270.26 OUR JOB# 207-07 CONTACT Mark Stowell PHONE 714-961-7172 DESCRIPTION & CONTRACT AMOUNT Esperanza Road Mitigation Project $ 4,137,990.00 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 GMC Engineering Inc. (For federally funded projects, use this following page) 1401 Warner Avenue, Suite B Tustin, CA 92780 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: GMC Engineering, Inc. Contact Person: Gennady Chizhik Contact Phone: 71 4-247-1 040 Signed:' Date: September 1 1 , 2008 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 GMC Engineering Inc. Local Assistance Procedures Manual 1401 Warner Avenue, Suite B�tlStln, CA 92%$0 EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WIHCHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION .. The bidder GMC Engineering, Inc. , proposed subcontractor hereby certifies that he has X has not-, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the .Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions GMC Enginee'ng Inc. 1401 Wamer Avenue, Suite B Tustin, CA 92780 DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G UUMFLh l ,t I ti1J tUKM L V ll1Jl LV J1; LViSt3 T IN 11 Al I I Y 111b5 F U KS UAN I IU 31 U.b.u. 1. Type of Federal Action: 2. Status of Federal Action: /..alha*.ge Type: Ra. contract Fla. bid/offer/application Fla.al b. grant b. initial award erial change c. cooperative agreement c. post -award d loan rial C ageOnly: e. loan guarantee quarterf. loan insurance ast report4. Name and Address of Reporting Entity 5. If Reporting Enis Subawardee,Enter Name anPrime: Prime Subawardee Tier , if known i Congressional District, if known Con ssional District, if known - 6. Federal Department/Agency: 7. F eral Program Name/Description: A 1 pr CFDA Number, if applicable S. Federal Action Number, if known: N 9. Award Amount, if known: 10. a. Name and Address of Lobby Entit b. Individuals Performing Services (including (If individual, last name, first n , MI) address if different from No. I Oa) (last name, first name, MI) 11. 12. (attach Continuation Sheet(s) if necessary) /Formayment t (check all that apply) 13. Type of Payment (check all that apply) actual planned a. retainer b. one-time fee heck all that apply): c. commission d. contingent fee pecify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes NoLni 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 U.S.C. print Name: Gennady Chi Zh ik 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: president person who fails to file the required disclosure shall be subject to a civil penalty of not less than S 10,000 and not more than $100,000 for each such failure. Telephone No.: 71 4 - 2 4 7 -1 0 4 0 Date: 9 / 1 1 / Federal Use Only - Standard form LLL Rev. V9-I2-V7 Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Attachment G GMC Engineering Inc. 1404 Warner Avenue, Suite B Tustin, CA 92780 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 (IF$) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has .been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL Instructions Rcv.06-04-90u6NDMt Page 12-89 LPP O1-04 March 15, 2001 910 BOND KNOW ALL BY THESE PRESENTS, That we, GMC Engineering, Inc of 1401 Warner Avenue, Suite-B. Tustin, CA 92780 (here)nafter called the Principal), as Principal, and FIRST NATIONAL USUENCEE COMPANV OF AMFMCA, W , Ww&iagtos, a oarparstioe defy mgsnized ender the 1pws of the Stato of WW*Wgton 4e Surety, hereinafter called the Surety, ere )mid end fatly bound usto the City of Huntington Beach (bmIuftr taped 1he O>bHp) in tine p=1 fmm of Ten Percent of the Total Amount Bid ------------------ ------ ------------------- Rollers 0 ----- 10%------- - y for the payatadt of which the Prfiki-pil and the Surety bind themselres,their baits, o tars, iNiIiWiaitarsi suoceesars and assigns, jointly seed severally, firmly by theso preaante. THE CONDIT>hDN OF THIS OBLICA770M IS SUCH, That Whereas, the Arlmlpal has submitted or k about to anbWt a prWMI to tlhe Obligee o® a centr: far Safe Routes to School, Cycle IV in the vicinity of Mesa View Middle School C.C. No. 1243 NOW, THEREFORE, If the said Contraot be timely awarded to the Principal and the Priucipl shall, within such time as may be specified, cater into the contract in writing, hail give bond, if bond is required, with suety weepuble to the Obl`tgw for the faithful porfe maned of the said Omtraet, that this obligation shell be void, otherwise to remain in full (neon and effget. Signed and sealed this 10th day of September, 2008. GMC Engineering, Inc. (Seal) Principal J&/ , 11 . I . FIRST NATIONAL INSURANCE COMPANY OF AMERICA BY s44/zte a J r R. GrydLl' Attaraey-ia- act S-"WP 7Nf fi• POWER OF ATTORNEY No. 9392 KNOW ALL BY THESE PRESENTS - First National insurance Company of America Safeco Plaza Seattle. WA 98185 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint ***********************************JEFFREY R. GRYDE; Costa Mesa, its true and lawful attorneys) -in -fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 20th day of October STEPHANIE DALEY-WATSON, SECRETARY TIM MIKOLAJEWSKI, SENIOR VICE-PRESIDENT, SURETY CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment. the signatures may be affixed by facsimile. On any instrument conferring such authority of on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Secfion 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, Stephanie Daley -Watson , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 1Oth SEAL qze S-1049/DF 4/05 ; day of September . 2008 STEPHANIE DALEY-WATSON, SECRETARY SafecoOO and the Safeco logo are registered trademarks of Safeco Corporation. WEB PDF CALIFORNIA•ACKNOWLEDGMENT :�.,:�5.!�C�S��.5��3,a>fs�.�:!s�: y5�.,�4✓a�: y,�4.�.�,'S�.; .,�4�.s�'S ;� ��S;:�S�S�.-�.'.�>.�C�_c�.'.,�4,c�.;:�;�.,c�C%"'�'C,�,a:.�S,:�S...�S s� State of California County of On Septelnbex 10,E before me, CV)n bb-n e-Tbne_�'a+6�e�, at Date Here Insert Name and Title of the Officer `. J personally appeared e-,4 t`, Gc 6e— ame(s) of Signer(s) „. CHRIST►NE JANE THATCHER Commission # 1716548 Nofory Pubilc - Callfornia : It Los Angeles County t �'hrCorrfm. E"resJlOrI26.2011 1p Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person% whose nameW is/are subscribed to the within instrument and acknowledged to me that he/shiI executed the same in hislheft4liteir authorized capacity(ieo), and that by his/her,4141I signatureW on the instrument the person(W, or the entity upon behalf of which the personal 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. A WITNESS my hand and oJ49(al seal. Signature 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): — El Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT OF SIGNER .. of thumb here 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: RIGHTTHUMBPRINT OF SIGNER of thumb here 02WI National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orallo e- On �5embe_r 200E before me, personally appeared 0'- n1N0_0(y ck L. tBurNl�rn, /Uo�Zc! (Here insert name and title of the who proved to me on the basis of satisfactory evidence to be the person(.) whose name( is/im subscribed to the within instrument and acknowledged to me that he/.s#ethtjrexecuted the same in his/fir authorized capacity4i.esj, and that by hisilher4heif-signature(s) on the instrument the personk8- , or the entity upon behalf of which the person(gy 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. +� KATW L. BURNUM [ G;��7ornrnftdon * 1705356 L WITNESS my hand and official seal. : Notary Pub11C - Callrotrda orange County � v CW Nav16,2010 ' (Notary Seal Signatu o ary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (I itle or description of attached document continued) NumberoFPages i Document Date --- -----(Additional information) CAPACITY CLAIMED BY THE SIGNER Cl Individual (s) >47- Corporate Officer (Title) ❑ Partner(s) ❑ Attornev-in-Fact ❑ Trustee(s) CI Other INSTRUCTIONS FOR COMPLETING THIS FORM 4ny acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form rnusi be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances. any alternative 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,fol a nolorr 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 %,,here the dOCUmem signer(s) personally appeared before the notary public for acknowledgment_ • Date of notarization must be the date that the signer(s) personalh appeared %Ouch must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears %within hi, 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 oil incorrect limns (i c. he/she/diey- is /are ) or circling the correct forms. Failure to correctly indicate this nformation 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, ro-scal 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 counts 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 ofattached document_ number ofpages and date Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i c_ CF.0, C1 0- Secretary )_ • Securely attach this document to the signed document 2008VcrsionCAPAv1110,07800-873-9865 evww.NotaryClasses -corn GMC-En9lmWi"9 Inc- Mol Wow A"mie. Spa 6 Tusft CA 92780 2008 SEP 1 pp, 09 7 XI-1- s6lr a , REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS Page I. General................................................................... 1 II. Nondiscrimination.................................................... III. Nonsegregated Facilities ......................................... IV. Payment of Predetermined Minimum Wage ............. V. Statements and Payrolls .......................................... VI. Record of Materials, Supplies, and Labor ................ VI 1. Subletting or Assigning the Contract ........................ Vill. Safety: Accident Prevention .................................... IX. False Statements Concerning Highway Projects................................................................. X. Implementation of Clean Air Act and Federal Water Pollution Control Act ....................... XI. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion ...................... XII. Certification Regarding Use of Contract Funds for Lobbying ................................................ ATTACHMENTS a. discriminate against labor from any other State, possession, or territory of the United States (except for employment preference for Appalachian contracts, when applicable, as specified in Attachment A), or b. employ convict labor for any purpose within the limits of the project unless it is labor performed by convicts who are on parole, supervised release, or probation. II. NONDISCRIMINATION 8 (Applicable to all Federal -aid construction contracts and 8 to all related subcontracts of $10,000 or more.) 9 11 A. Employment Preference for Appalachian Contracts (included in Appalachian contracts only) I. GENERAL 1. These contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 2. Except as otherwise provided for in each section, the contractor shall insert in each subcontract all of the stipulations contained in these Required Contract Provisions, 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. 3. A breach of any of the stipulations contained in these Required Contract Provisions shall be sufficient grounds for termination of the contract. 4. A breach of the following clauses of the Required Contract Provisions may also be grounds for debarment as provided in 29 CFR 5.12: Section I, paragraph 2; Section IV, paragraphs 1, 2, 3, 4, and 7; Section V, paragraphs 1 and 2a through 2g 5. Disputes arising out of the labor standards provisions of Section IV (except paragraph 5) and Section V of these Required Contract Provisions shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the U.S. Department of Labor (DOL) as set forth in 29 CFR 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the DOL, or the contractor's employees or their representatives. 6. Selection of Labor: During the performance of this contract, the contractor shall not: Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 1. Equal Employment Opportunity: Equal employ- ment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 1630 and 41 CFR 60) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and 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 Equal Opportunity Construction Contract Specifications set forth under 41 CFR 60-4.3 and the provisions of the American Disabilities Act of 1990 (42 USC 12101 et seg.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract. In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO: a. The contractor will work with the State highway agency (SHA) and the Federal Government in carrying out EEO obligations and in their review of his/her activities under the contract. b. The contractor will accept as his operating policy the following statement: "It is the policy of this Company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, preapprenticeship, and/or on-the-job training." 2. EEO Officer: The contractor will designate and make known to the SHA contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active contractor program of EEO and who must be assigned adequate authority and responsibility to do so. 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action, or who are substantially involved in such action, will be made fully cognizant of, and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum: Page 1 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 minority group employees. d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees. e. The contractor's EEO policy and the procedures to 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 minority groups in the area from which the project work force would normally be derived. a. The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minority group applicants. To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority group applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, he is expected to observe the provisions of that agreement to the extent that the system permits the contractor's compliance with EEO contract provisions. (The DOL has held that where implementation of such agreements have the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Executive Order 11246, as amended.) c. The contractor will encourage his present employees to refer minority group applicants for employment. Information and procedures with regard to referring minority group applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without regard to race, color, religion, sex, national origin, age or disability. The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to insure that working conditions and employee Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 facilities do not indicate discriminatory treatment of project site personnel. b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage practices. c. The contractor will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is found, the contractor will promptly take corrective action. If the review indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly investigate all complaints of alleged discrimination made to the contractor in connection with his obligations under this contract, will attempt to resolve such complaints, and will take appropriate corrective action within a reasonable time. If the investigation indicates that the discrimination may affect persons other than the complainant, such corrective action shall include such other persons. Upon completion of each investigation, the contractor will inform every complainant of all of his avenues of appeal. 6. Training and Promotion: a. The contractor will assist in locating, qualifying, and increasing the skills of minority group and women employees, and applicants for employment. b. Consistent with the contractor's work force requirements and as permissible under Federal and State regulations, the contractor shall make full use of training programs, i.e., apprenticeship, and on-the-job training programs for the geographical area of contract performance. Where feasible, 25 percent of apprentices or trainees in each occupation shall be in their first year of apprenticeship or training. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of minority group and women employees and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use his/her best efforts to obtain the cooperation of such unions to increase opportunities for minority groups and women within the unions, and to effect referrals by such unions of minority and female employees. Actions by the contractor either directly or through a contractor's association acting as agent will include the procedures set forth below: a. The contractor will use best efforts to develop, in cooperation with the unions, joint training programs aimed toward qualifying more minority group members and women for membership in the unions and increasing the skills of minority group employees and women so that they may qualify for higher paying employment. b. The contractor will use best efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without Page 2 regard to their race, color, religion, sex, national origin, age or disability. c. The contractor is to obtain information as to the referral practices and policies of the labor union except that to the extent such information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the contractor, the contractor shall so certify to the SHA and shall set forth what efforts have been made to obtain such information. d. In the event the union is unable to provide the contractor with a reasonable flow of minority and women referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability; making full efforts to obtain qualified and/or qualifiable minority group persons and women. (The DOL has held that it shall be no excuse that the union with which the contractor has a collective bargaining agreement providing for exclusive referral failed to refer minority employees.) In the event the union referral 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 SHA. 8. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. a. The contractor shall notify all potential subcontractors and suppliers of his/her EEO obligations under this contract. b. Disadvantaged business enterprises (DBE), as defined in 49 CFR 23, shall have equal opportunity to compete for and perform subcontracts which the contractor enters into pursuant to this contract. The contractor will use his best efforts to solicit bids from and to utilize DBE subcontractors or subcontractors with meaningful minority group and female representation among their employees. Contractors shall obtain lists of DBE construction firms from SHA personnel. c. The contractor will use his best efforts to ensure subcontractor compliance with their EEO obligations. 9. 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 completion of the contract work and shall be available at reasonable times and places for inspection by authorized representatives of the SHA and the FHWA. a. The records kept by the contractor shall document the following: (1) The number of minority and non —minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment opportunities for minorities and women; Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 (3) The progress and efforts being made in locating, hiring, training, qualifying, and upgrading minority and female employees; and (4) The progress and efforts being made in securing the services of DBE subcontractors or subcontractors with meaningful minority and female representation among their employees. b. The contractors will submit an annual report to the SHA each July for the duration of the project, indicating the number of minority, women, and non -minority group employees currently engaged in each work classification required by the contract work. This information is to be reported on Form FHWA-1391. If on—the—job training is being required by special provision, the contractor will be required to collect and report training data. III. NONSEGREGATED FACILITIES (Applicable to all Federal -aid construction contracts and to all related subcontracts of $10,000 or more.) a. By submission of this bid, the execution of this contract or subcontract, or the consummation of this material supply agreement or purchase order, as appropriate, the bidder, Federal -aid construction contractor, subcontractor, material supplier, or vendor, as appropriate, certifies that the firm does not maintain or provide for its employees any segregated facilities at any of its establishments, and that the firm does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The firm agrees that a breach of this certification is a violation of the EEO provisions of this contract. The firm further certifies that no employee will be denied access to adequate facilities on the basis of sex or disability. b. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, timeclocks, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive, or are, in fact, segregated on the basis of race, color, religion, national origin, age or disability, because of habit, local custom, or otherwise. The only exception will be for the disabled when the demands for accessibility override (e.g. disabled parking). c. The contractor agrees that it has obtained or will obtain identical certification from proposed subcontractors or material suppliers prior to award of subcontracts or consummation of material supply agreements of $10,000 or more and that it will retain such certifications in its files. IV. PAYMENT OF PREDETERMINED MINIMUM WAGE (Applicable to all Federal -aid construction contracts exceeding $2,000 and to all related subcontracts, except for projects located on roadways classified as local roads or rural minor collectors, which are exempt.) 1. General: a. All mechanics and laborers employed or working upon the site of the work will be paid unconditionally and not less often than once a week and without subsequent deduction or rebate on any account [except such payroll deductions as are permitted by regulations (29 CFR 3) issued by the Secretary of Labor under the Copeland Act (40 U.S.C. 276c)] the full amounts of wages and bona fide fringe benefits (or Page 3 cash equivalents thereof) due at time of payment. The payment shall be computed at wage rates not less than those contained in the wage determination of the Secretary of Labor (hereinafter "the wage determination") which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor or its subcontractors and such laborers and mechanics. The wage determination (including any additional classifications and wage rates conformed under paragraph 2 of this Section IV and the DOL poster (WH-1321) or Form FHWA-1495) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. For the purpose of this Section, contributions made or costs reasonably anticipated for bona fide fringe benefits under Section 1(b)(2) of the Davis -Bacon Act (40 U.S.C. 276a) on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of Section IV, paragraph 3b, hereof. Also, for the purpose of this Section, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs, which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in paragraphs 4 and 5 of this Section IV. b. Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein, provided, that the employer's payroll records accurately set forth the time spent in each classification in which work is performed. c. All rulings and interpretations of the Davis -Bacon Act and related acts contained in 29 CFR 1, 3, and 5 are herein incorporated by reference in this contract. 2. Classification: a. The SHA contracting officer shall require that any class of laborers or mechanics employed under the contract, which is not listed in the wage determination, shall be classified in conformance with the wage determination. b. The contracting officer shall approve an additional classification, wage rate and fringe benefits only when the following criteria have been met: (1) the work to be performed by the additional classification requested is not performed by a classification in the wage determination; (2) the additional classification is utilized in the area by the construction industry; (3) the proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination; and (4) with respect to helpers, when such a classification prevails in the area in which the work is performed. c. If the contractor or subcontractors, as appropriate, the laborers and mechanics (if known) to be employed in the additional classification or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 contracting officer to the DOL, Administrator of the Wage and Hour Division, Employment Standards Administration, Washington, D.C. 20210. The Wage and Hour Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. d. In the event the contractor or subcontractors, as appropriate, the laborers or mechanics to be employed in the additional classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Wage and Hour Administrator for determination. Said Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary e. The wage rate (including fringe benefits where appropriate) determined pursuant to paragraph 2c or 2d of this Section IV shall be paid to all workers performing work in the additional classification from the first day on which work is performed in the classification. 3. Payment of Fringe Benefits: a. Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor or subcontractors, as appropriate, shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly case equivalent thereof. b. If the contractor or subcontractor, as appropriate, does not make payments to a trustee or other third person, he/she may consider as a part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, provided, that the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. 4. Apprentices and Trainees (Programs of the U.S. DOL) and Helpers: a. Apprentices: (1) Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the DOL, Employment and Training Administration, Bureau of Apprenticeship and Training, or with a State apprenticeship agency recognized by the Bureau, or if a person is employed in his/her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Bureau of Apprenticeship and Training or a State apprenticeship agency (where appropriate) to be eligible for probationary employment as an apprentice. (2) The allowable ratio of apprentices to journeyman - level employees on the job site in any craft classification shall Page 4 not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any employee listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate listed in the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor or subcontractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman —level hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. (3) Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeyman -level hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator for the Wage and Hour Division determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. (4) In the event the Bureau of Apprenticeship and Training, or a State apprenticeship agency recognized by the Bureau, withdraws approval of an apprenticeship program, the contractor or subcontractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the comparable work performed by regular employees until an acceptable program is approved. b. Trainees: (1) Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the DOL, Employment and Training Administration. (2) The ratio of trainees to journeyman -level employees on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable 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. (3) Every trainee must be paid at not less than the rate specified in the approved program for his/her level of progress, expressed as a percentage of the journeyman -level hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 corresponding journeymanlevel wage rate on the wage determination which provides for less than full fringe benefits for apprentices, in which case such trainees shall receive the same fringe benefits as apprentices. (4) In the event the Employment and Training Administration withdraws approval of a training program, the contractor or subcontractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. c. Helpers: Helpers will be permitted to work on a project if the helper classification is specified and defined on the applicable wage determination or is approved pursuant to the conformance procedure set forth in Section IV.2. Any worker listed on a payroll at a helper wage rate, who is not a helper under a approved definition, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. 5. Apprentices and Trainees (Programs of the U.S. DOT): Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal —aid highway construction programs are not subject to the requirements of paragraph 4 of this Section IV. The straight time hourly wage rates for apprentices and trainees under such programs will be established by the particular programs. The ratio of apprentices and trainees to journeymen shall not be greater than permitted by the terms of the particular program. 6. Withholding: The SHA shall upon its own action or upon written request of an authorized representative of the DOL withhold, or cause to be withheld, from the contractor or subcontractor under this contract or any other Federal contract with the same prime contractor, or any other Federally -assisted contract subject to Davis -Bacon prevailing wage requirements which is held by the same prime contractor, as much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the SHA contracting officer may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. 7. Overtime Requirements: No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers, mechanics, watchmen, or guards (including apprentices, trainees, and helpers described in paragraphs 4 and 5 above) shall require or permit any laborer, mechanic, watchman, or guard in any workweek in which he/she is employed on such work, to work in excess of 40 hours in such work week unless such laborer, mechanic, watchman, or guard receives compensation at a rate not less than one -and -one-half times his/her basic rate of pay for all hours worked in excess of 40 hours in such workweek. Page 5 8. Violation: Liability for Unpaid Wages; Liquidated Damages: In the event of any violation of the clause set forth in paragraph 7 above, the contractor and any subcontractor responsible thereof shall be liable to the affected employee for his/her unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory) for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer, mechanic, watchman, or guard employed in violation of the clause set forth in paragraph 7, in the sum of $10 for each calendar day on which such employee was required or permitted to work in excess of the standard work week of 40 hours without payment of the overtime wages required by the clause set forth in paragraph 7. 9. Withholding for Unpaid Wages and Liquidated Damages: The SHA shall upon its own action or upon written request of any authorized representative of the DOL withhold, or cause to be withheld, from any monies payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other Federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph 8 above. V. STATEMENTS AND PAYROLLS (Applicable to all Federal -aid construction contracts exceeding $2,000 and to all related subcontracts, except for projects located on roadways classified as local roads or rural collectors, which are exempt.) 1. Compliance with Copeland Regulations (29 CFR 3): The contractor shall comply with the Copeland Regulations of the Secretary of Labor which are herein incorporated by reference. 2. Payrolls and Payroll Records: a. Payrolls and basic records relating thereto shall be maintained by the contractor and each subcontractor during the course of the work and preserved for a period of 3 years from the date of completion of the contract for all laborers, mechanics, apprentices, trainees, watchmen, helpers, and guards working at the site of the work. b. The payroll records shall contain the name, social security number, and address of each such employee; his or her correct classification; hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalent thereof the types described in Section 1(b)(2)(B) of the Davis Bacon Act); daily and weekly number of hours worked; deductions made; and actual wages paid. In addition, for Appalachian contracts, the payroll records shall contain a notation indicating whether the employee does, or does not, normally reside in the labor area as defined in Attachment A, paragraph 1. Whenever the Secretary of Labor, pursuant to Section IV, paragraph 3b, has found that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 benefits under a plan or program described in Section 1(b)(2)(B) of the Davis Bacon Act, the contractor and each subcontractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, that the plan or program has been communicated in writing to the laborers or mechanics affected, and show the cost anticipated or the actual cost incurred in providing benefits. Contractors or subcontractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprentices and trainees, and ratios and wage rates prescribed in the applicable programs. c. Each contractor and subcontractor shall furnish, each week in which any contract work is performed, to the SHA resident engineer a payroll of wages paid each of its employees (including apprentices, trainees, and helpers, described in Section IV, paragraphs 4 and 5, and watchmen and guards engaged on work during the preceding weekly payroll period). The payroll submitted shall set out accurately and completely all of the information required to be maintained under paragraph 2b of this Section V. This information may be submitted in any form desired. Optional Form WH-347 is available for this purpose and may be purchased from the Superintendent of Documents (Federal stock number 029-005- 0014-1), U.S. Government Printing Office, Washington, D.C. 20402. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. d. Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his/her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1) that the payroll for the payroll period contains the information required to be maintained under paragraph 2b of this Section V and that such information is correct and complete; (2) that such laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in the Regulations, 29 CFR 3; (3) that each laborer or mechanic has been paid not less than the applicable wage rate and fringe benefits or cash equivalent for the classification of worked performed, as specified in the applicable wage determination incorporated into the contract. e. The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH- 347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 2d of this Section V. f. The falsification of any of the above certifications may subject the contractor to civil or criminal prosecution under 18 U.S.C. 1001 and 31 U.S.C. 231. g. The contractor or subcontractor shall make the records required under paragraph 2b of this Section V available for inspection, copying, or transcription by authorized representatives of the SHA, the FHWA, or the DOL, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, Page 6 the SHA, the FHWA, the DOL, or all may, after written notice to the contractor, sponsor, applicant, or owner, take such actions as may be 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. VI. RECORD OF MATERIALS, SUPPLIES, AND LABOR 1. On all Federal -aid contracts on the National Highway System, except those which provide solely for the installation of protective devices at railroad grade crossings, those which are constructed on a force account or direct labor basis, highway beautification contracts, and contracts for which the total final construction cost for roadway and bridge is less than $1,000,000 (23 CFR 635) the contractor shall: a. Become familiar with the list of specific materials and supplies contained in Form FHWA-47, "Statement of Materials and Labor Used by Contractor of Highway Construction Involving Federal Funds," prior to the commencement of work under this contract. b. Maintain a record of the total cost of all materials and supplies purchased for and incorporated in the work, and also of the quantities of those specific materials and supplies listed on Form FHWA-47, and in the units shown on Form FHWA-47. c. Furnish, upon the completion of the contract, to the SHA resident engineer on Form FHWA-47 together with the data required in paragraph 1b relative to materials and supplies, a final labor summary of all contract work indicating the total hours worked and the total amount earned. 2. At the prime contractor's option, either a single report covering all contract work or separate reports for the contractor and for each subcontract shall be submitted. VII. SUBLETTING OR ASSIGNING THE CONTRACT 1. The contractor shall perform with its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the State. Specialty items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractor's own organization (23 CFR 635). a. "Its own organization" shall be construed to include only workers employed and paid directly by the prime contractor and equipment owned or rented by the prime contractor, with or without operators. Such terry does not include employees or equipment of a subcontractor, assignee, or agent of the prime contractor. b. "Specialty Items" shall be construed to be limited to work that requires highly specialized knowledge, abilities, or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid on the contract as a whole and in general are to be limited to minor components of the overall contract. 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. Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 3. The contractor shall furnish (a) a competent superintendent or supervisor who is employed by the firm, has full authority to direct performance of the work in accordance with the contract requirements, and is in charge of all construction operations (regardless of who performs the work) and (b) such other of its own organizational resources (supervision, management, and engineering services) as the SHA contracting officer determines is necessary to assure the performance of the contract. 4. No portion of the contract shall be sublet, assigned or otherwise disposed of except with the written consent of the SHA contracting officer, or authorized representative, and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the contract. Written consent will be given only after the SHA has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. Vill. SAFETY: ACCIDENT PREVENTION 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the SHA contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. 2. It is a condition of this contract, and shall be made a condition of 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. 333). 3. Pursuant to 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Secretary under Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S. C. 333). IX. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers, contractors, suppliers, and workers on Federal - aid highway projects, it is essential that all persons concerned with the project perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or 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, the following notice shall be posted on each Federal -aid highway project (23 CFR 635) in one or more places where it is readily available to all persons concerned with the project: Page 7 NOTICE TO ALL PERSONNEL ENGAGED ON FEDERAL -AID HIGHWAY PROJECTS 18 U.S.C. 1020 reads as follows: "Whoever, being an officer, agent, or employee of the United States, or 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 not more that $10,000 or imprisoned not more than 5 years or both. " X. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT (Applicable to all Federal -aid construction contracts and to all related subcontracts of $100,000 or more.) By submission of this bid or the execution of this contract, or subcontract, as appropriate, the bidder, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows: 1. That any facility that is or will be utilized in the performance of this contract, unless such contract is exempt under the Clean Air Act, as amended (42 U.S.C. 1857 et seq., as amended by Pub.L. 91-604), and under the Federal Water Pollution Control Act, as amended (33 U.S.C. 1251 et seq., as amended by Pub.L. 92-500), Executive Order 11738, and regulations in implementation thereof (40 CFR 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 firm shall promptly notify the SHA of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility that is or will be utilized for the contract is under consideration to be listed on the EPA List of Violating Facilities. 4. That the firm agrees to include or cause to be included the requirements of paragraph 1 through 4 of this Section X in every nonexempt subcontract, and further agrees Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 to take such action as the government may direct as a means of enforcing such requirements. XI. CERTIFICATION REGARDING DEBARMENT, SUS- PENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION 1. Instructions for Certification — Primary Covered Transactions: (Applicable to all Federal -aid contracts - 49 CFR 29) a. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause of default. d. The prospective primary participant shall provide immediate written notice to the department or agency to whom this proposal is submitted if any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. e. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal, and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is submitted for assistance in obtaining a copy of those regulations. f. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. g. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. Page 8 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 eligibility of its principals. Each participant may, but is not required to, check the nonprocurement portion of the "Lists of Parties Excluded From Federal Procurement or Nonprocurement Programs" (Nonprocurement List) which is compiled by the General Services Administration. i. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. j. Except for transactions authorized under paragraph f of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; b. Have not within a 3-year period preceding this proposal been convicted of or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph 1b of this certification; and d. Have not within a 3-year period preceding this applicaion/ proposal had one or more public transactions (Federal, State or local) terminated for cause or default. 2. Where the prospective primary'participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Covered Transactions: Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 (Applicable to all subcontracts, purchase orders and other lower tier transactions of $25,000 or more - 49CFR29) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d. The terms "covered transaction," "debarred," "suspended," "ineligible," "primary covered transaction," "participant," "person," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion, -Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph e 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 Page 9 may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions: 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 participation in this transaction by any Federal department or agency. 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. XII. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING (Applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 - 49 CFR 20) 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any funds other than Federal appropriated funds have been paid or will be 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 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 recipients shall certify and disclose accordingly. Form FHWA-1273 (Rev. 3-15-02) Q:\SPECIAL\CONTRACT PLANS\468 Page 10 Q::\SPECIAL\CONTRACT PLANS\470 Rev. 3-15-02 SPECIAL PROVISIONS EEO AFFIRMATIVE ACTION REQUIREMENTS ON FEDERAL & FEDERAL -AID CONSTRUCTION CONTRACTS Federal -aid contractors are hereby notified they are subject to the OFCCP goals and timetables for minority and female participation expressed below. Compliance with the goals and OFCCP affirmative action efforts for contracts and subcontracts consisting of $10,000 or more will be determined by OFCCP officials. APPENDIX A Notice of Requirement for Affirmative Action to Ensure Equal Employment Opportunity (Executive Order 11246) 1. The Offeror's or Bidder's attention is called to the Equal Opportunity Clause and "Standard Federal Equal Employment Opportunity Construction Contract Specifications" set forth herein. 2. The goals and timetables for minority and female participation, expressed in percentage terms for the Contractor's aggregate workforce in each trade on all construction work in the covered area, are as follows: GOALS FOR FEMALE PARTICIPATION EACH TRADE 6.9% TIMETABLES GOALS FOR MINORITY PARTICIPATION IN EACH TRADE 153 Great Falls, MT SMSA (Standard Metropolitan Statistical Area) Counties 3040 Great Falls, MT 3.2% Cascade County Non-SMSA Counties 4.1 % Blaine, Broadwater, Chouteau, Fergus, Glacier, Hill, Jefferson, Judith Basin, Lewis & Clark, Liberty, Meagher, Petroleum, Phillips, Pondera, Teton, Toole, Wheatland 154 Missoula, MT Non-SMSA Counties 2.7% Beaverhead, Deer Lodge, Flathead, Granite, Lincoln, Madison, Mineral, Lake Missoula, Powell, Ravalli, Sanders, Silver Bow 155 Billings, MT SMSA Counties 0880 Billings, MT Yellowstone County 3.3% Non-SMSA Counties 3.3% Big Horn, Carbon, Carter, Custer, Dawson, Fallon, Gallatin, Garfield, Golden Valley, McCone, Musselshell, Park, Powder River, Prairie, Rosebud, Stillwater, Sweet Grass, Treasure, Wibaux, Yellowstone Nat'l Park Non-SMSA Counties Valley, Daniels, Sheridan, Richland, Roosevelt 4.4% These goals are applicable to all the Contractor's construction work (whether or not it is Federal or federally assisted) performed in the covered area. If the contractor performs construction work in a geographical area located outside of the covered area, it shall apply the goals established for such geographical area where the work is actually performed. With regard to this second area, the contractor also is subject to the goals for both its federally involved and nonfederally involved construction. The Contractor's compliance with the Executive Order and the regulations in 41 CFR Part 60-4 shall be based on its implementation of the Equal Opportunity Clause, specific affirmative action obligations required by the specifications set forth in 41 CFR 60-4.3(a), and its efforts to meet the goals. The hours of minority and female employment and training must be substantially uniform throughout the length of the contract, and in each trade, and the contractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from Contractor to Contractor or from project to project for the sole purpose of meeting the Contractor's goals shall be a violation of the contract, the Executive Order and the regulations in 41 CFR Part 60-4. Compliance with the goals will be measured against the total work hours performed. 3. The Contractor shall provide written notification to the Director of the Office of Federal Contract Compliance Programs within 10 working days of award of any construction subcontract in excess of $10,000 at any tier for construction work under the contract resulting from this solicitation. The notification shall list the name, address and telephone number of the subcontractor; employer identification number of the subcontractor; estimated dollar amount of the subcontract; estimated starting and completion dates of the subcontract; and the geographical area in which the subcontract is to be performed. City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK October 8, 2008 GMC Engineering, Inc. 1401 Warner Avenue, Ste B Tustin, CA 92780 Attn: Gennady Chizhik Re: Safe Routes to School, Cycle IV — CC-1243 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 proiect is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5437. Sincerely, ?an*L.9FIynn, CMC City Clerk J F: pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid Bond (original) Sister Cit�eS.1oXnjo, apan . ai'ffte`re` New Zealand ( Telephone: 714-536-5227 ) Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above -referenced project ("Project') hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit 'requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of 20_, at (Type Contractor Name) By: Name: [Type Name) Title: [Type Title] California. f me TLS o3- a"b - 01P 247542-1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20, at , California. (Type Contractor Name) By: Name: [Type Name] PAL, ` Title: [Type Title] J"A EX jIF a- t� �7RN 1U3-2KI)-UP 1 245911 1 CONTRACTOR'S CERTIFICATE I, , state and certify that: (Name of Declarant) 1. is the general contractor to the City of Huntington Beach ("City") on Contract No. (the "Contract") for the construction of the public work of improvement entitled: (the "Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3. Except for the claims listed below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at on this day of 120 (Signature of Declarant) APPROVED AS TO FORM By: V1I-)/ts —U 3 zo oc� Name: [Type Name] Title: [Type Title] 245914.1 RECEIVED BY: (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: S ri Freidenrich, City Treasurer FROM: p DATE: 0 &4K SUBJECT: Bond Acceptance I have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. - MSC No. Approved lor (Count Approval Date) (Company Name) ��T -7f Agenda Item No. City Clerk Vault No. 6M #27 g1tollowup/bondletter.doc Bond No. 6469275 Premium: $1836.00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereinafter referred to as "City") has, written agreement dated September 23 2008 , entered I11t4 a contract with GMC Engineering, Inc. 1401 Warner Avenues Suite B, Tustin, CA 92780 (name and addre6o of Contractor) (hereinafter referred to as "Principar), for performance of the work described as follows: Safe Routes to School, Cycle IV Cash Contract 1243 (Project Tine) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a pat hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to fumish a bong guaranteeing the prompt, full and faithful performance of said Contract NOW 'THEREFORE, we, the undersigned, as Principal, and First National Insurance Company of America 120 Vantis, Aliso Viejo, CA 92656 (name and address of Surety) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of One Hundred Seventy Thousand and 00/100-------------------------------------------------------------- Dollars ($ 170,000.00 ), 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 paymentof 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 aii of the covenants, obligations and things to be done and performed bythe 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 shaft 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 Page j of 2 Bond No. 6469275 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 INS 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 duty 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: September 29, 2008 ATTEST GMC Engineering, Inc. 1401 Warner Avenue, Suite B, Tustin, CA 92780 (Corporate Seal) (Principal Name) By: Name:—Gennady Chizhik Title. President ATTEST First National Insurance Company of America 120 Vantis. Aliso Viejo, CA 92656 (Corporate Seal) (Surety Name) By: �te�� Na J*ffref R. Gtorney-in- act (Signature of Attorney -in -Fact for Surety) (Attach Attorney -in -Fact Certificate) (949) 860-6620 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY 0 UNTINGTON BEACH By- ennifer ath I5164ty Attorney 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. 277591.1 PERFORMANCE BOND Page 2 of 2 ' First National Insurance Company of America POWER 1?.r: g � �_ � Safeco Plaza t�:;•a OF ATTORNEY Seattle. WA 98185 No. 9392 KNOW ALL BY THESE PRESENTS: That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint ***********************************JEFFREY R. GRYDE, Costa Mesa, its true and lawful atiorney(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 20th day of October 2006 STEPHANIE DALEY-WATSON, SECRETARY TIM MIKOLAJEWSKI, SENIOR VICE-PRESIDENT, SURETY CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA; "Article V, Section 13. - FIDELITY AND SURETY BONDS .._ the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." 1, Stephanie Daley -Watson , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 29th day of September 2008 SEAL, STEPHANIE DALEY-WATSON, SECRETARY S-10491DF 4/05 r Sateco@ and the Safeco logo are registered trademarks of Safeco Corporation. WEB PDF CALIFORNIA•ACKNOWLEDGMENT aS,�S.9.3�.T.'z�,•,.',s>:.-.'5..5.��.,s�t�.-.'>,:.'.aA•>.,�.;'ac,s�S.,�Z,g;a�:e S.:>;5'�S,ea.•�!z�>,TSB.c�.'<�.'�`..,�t,.a,•aZ..�.,�c,:aS State of California County of I_Q l AnQ •, On September 29, 2008before me, Date personally appeared ------------------- CHRISTINE JANE THATCHER Commission # 1716548 Notary Public - California = z`�;'• Los, Angeles County My Comm. Wes Jan 26, 2011 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person whose name(4 is/are subscribed to the within instrument and acknowledged to me that he/sheMiey executed the same in his/hoWtheir authorized capacity0ee), and that by his/her4heir-signatureW on the instrument the person(W, or the entity upon behalf of which the person(00 acted, executed the instrument. 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 officAf seal. Signature PUNIC 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) Number of Pages: Signer's Name: Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General _ _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Attorney in Fact • El Trustee Top of thumb here El Trustee Top of thumb here ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 0 2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402+ www.NationalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of 0m tone On m% 30, �008 before me, X -f ky L r ✓n , N o-Ea f y Pub) i (Here insert name and title of the officer) personally appeared who proved to me on the basis of satisfactory evidence to be the person(*) whose names- is/Arirsubscribed to the within instrument and acknowledged to me that he/AY&I Bey executed the same in his/her/Iheir authorized capacity(les), and that by his/her/t1,&ir signature(g ' on the instrument the person(o, 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. Z. 6 Signature of Public KATHY L. SURNUM Commission * 1705358 16 Notary Public - California Orange County Comm Nar 16, 2010 ------------ (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description ofattached document) (Title or description of attached document continued) Number of Pages 1 ___ Document Date 9 6$ (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) Corporate Officer (litic) f 1 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 fnin must be properly completed and attached to that document. The only exception is 4 a document is to be recorded outside of California. In such instances, and alternative acknowledgment verbiage as may be printed on such a docronem 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 o/'the signer). Please check the document carefully for proper notarial wording and attach this form if required. • State and Countyinformation 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 Ibrms (i e. he/she/fl4ey, is /are ) 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. II the claimed capacity is a corporate officer, indicate the title (i e. CEO, CF0, Secretary). • Securely attach this document to the signed document 2008 Vci oon C-VPA v12 10-07 800-873-9865 www.NotarvClasses.com Bond No. 6469275 PAYMENT BOND Premium: Included (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS, the City of Huntington Beach (hereinafter referred to as "City') has awarded to GMC Engineering, Inc. 1401 Warner Avenue, Suite B, Tustin, CA 92780 (name and address of contractor) (hereinafter referred to as "Principar), a contract ("Contract") for the work described as follows: Safe Routes to School, Cycle IV Cash Contract 1243 (Project tipe) 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 First National Insurance Company of America 120 Vantis, Aliso Viejo, CA _ 92656 (name and address of Surety) (a duly admitted sarety insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of One Hundred Seventh+ Thousand and 00/100 ------------------------------------------------------------ do, (S 17Q000.00 ), this amount being not less than one hundW 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 Ca*mia 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 tabor performed under the Contract, Surety vAil pay for the same, in an amount not exceeding the pens! sum specified in this bond; otherwise, this obligafion 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 band, 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 ContfaA or any oontrat 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 cftVo, 277SIVA PAYMENT BOND rage 1 of 2 Bond No. 6469275 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 §§ 2846 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 property execute this bond. Dated: September 29, 2008 ATTEST GMC Engineering, Inc. (Corporate Seal) 1401 Warner Avenue, Suite B, Tustin, CA 92780 (Principal Name) �XAdo�l By: Name: cennady Chizhik Its: President ATTEST (Corporate Seal) (Attach Attorney -in -Fact Certificate) First National Insurance Company of America 120 Vantis, Aliso Viejo, CA 92656 (Surety Name) By: Nam J re --Gry,orney-in-Fact (Signature of Attorney-iri-Fact for Surety) ( 949) 860-6620 (Area Code & Telephone number of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH 011 By' ennifer Mc lath '—City Attorney 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 attomey-in-fact must be attached. zrssv_i PAYMENT GOND Page 2 of 2 r rl� First National Insurance Company of America POWER :„:,w` OF ATTORNEY Safeco Plaza Seattle, WA 98185 No. 9392 KNOW ALL BY THESE PRESENTS. That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint R. GRYDE; Costa Mesa, its true and lawful attorneys}in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duty executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 20th day of October 2006 STEPHANIE DALEY-WATSON, SECRETARY TIM MIKOLAJEWSKI, SENIOR VICE-PRESIDENT, SURETY CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ..- the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power-of-attomey appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seat of the Company may be a facsimile thereof." 1, Stephanie Daley -Watson , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto. are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 29th day of September 2008 SEAL e STEPHANIE DALEY-WATSON, SECRETARY S-104901' 4105 SafecoOO and the Safeco logo are registered trademarks of Safeco Corporation. WEB PDF CALIFORNIA•ACKNOWLEDGMENT ate-` ti�..c�S,c��.a:;'�S!�4,.�S,a>'.,�5!c�:.!.��Z,yaS=�5;,�..�_'4,�:.�••�'..�Z:3.'.•,_-•�.!•j.,pa3tia..:t.,.�i',�_a.'S,_ A:..ya State of California County of L S On September 29, 2008 before me, Date personally appeared CHRISTWE JANE THATCHER Commission _` • `� NoOr # 1716548 z , Y Public - California = Los Angeles County wCanm• esJdn26,2011 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person% whose name(4 is/ate subscribed to the within instrument and acknowledged to me that he/s49A4oy executed the same in hisAie#their authorized capacity(aes), and that by his/he4#4eif-signatureW on the instrument the person(W, or the entity upon behalf of which the personal acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the fo�ggoing paragraph is true and correct. / / WITNESS my hand and Signature OPTIONAL Public 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 • El Trustee Top of thumb here ❑ 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: RIGHTTHUMBPRINT OF SIGNER 02007 National Notary Association • 9350 De Soto Ave_, P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NabonaiNotaryorg Item Reorder. Call Toll -Free 1-800-876-6827 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Oram e_ On Se emb 2ao before me, /�a4"hv k, 8 ct wam , Nowt^ y Pu.l (Here insert name and title ofiffe officer) personally appeared V e-MA) PJ(( Ch i ZYti who proved to me on the basis of satisfactory evidence to be the person(,*) whose name(R) is/subscribed to the within instrument and acknowledged to me that he/sl rAhey executed the same in his/J ejtrauthorized capacityaasl, and that by hisZherftheir signature( on the instrument the person(e�,-or the entity upon behalf of which the person(efiacted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature o Public KATHY L. BURNUM Commission # 1705358 Notary Pubi1C - CollforMa Orange County i MuCmvrLaakwN0v16,2010 (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) ("Dille or description of attached document continued) Numher of Pages % Document Date 0� (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) -�d` Corporate /Officer (Title) ❑ Partner(s) C.i Attorney -in -Fact 11 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 roust be properly completed and attached to that document. The only exception is l/ a document is to be recorded outside of California. In 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, of California (i.e. certifying the authorized capacity of the signet). Please check the document carefully for proper notarial wording and attach this form i f requir ed. • 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 c, he/she/they- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection ofdocument recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. 11' 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 thu 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 v 12.10 07 800-873-9365 www_NotaryClasses_coin sU ityINSURANCE AND INDEMNIFICATION WAIVER Huntin � Beach MODIFICATION REQUEST AEA- C 2: �I%[2GV, 1. Requested by: David Veron x OCT 01 2008 2. Date: September 30, 2008 City of Huntington Beach 3. Name of contractor/permittee: GMC Engineering CityAttorney's office 4. Description of work to be performed: Traffic Signal and ADA Ramps 5. Value and length of contract: $170,000.00 and 30 working days 6. Waiver/modification request: $5000.00 insurance deductable 7. Reason for request and why it should be granted: non -impact to project 8. Identify the risks to the City in approving this waiver/modification: none 9/30/2008 Head Signature Date: APPROVALS Approvals must be obtained in the order listed onthis form. Two approvals are required for a request to be granted. Approval from e City Admini' trator's Office is only required if Risk Management a9d th City Attorney' is ree. 1. i k Management L14- 10 Approved ❑ Denied Signature bate 2. City Attorney's Office t Approved ❑ Denied �� Signature (" Date 3. City Administrator's Office ❑ Approved ❑ Denied Signature Date If approved, the completed waiver/modification request is to be submitted to the City Attorney's Office along with the contract for approval. Once the contract has been approved, this form is to be filed with the Risk Management Division of Administrative Services waiver form.doc 9/30/2008 3:00:00 PM DATE ACORD,. CERTIFICATE OF LIABILITY INSURANCE 09/26/08DnY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BB&T Insurance Svcs of CA Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 680 Lan sdorf Drive #100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 34009 Fullerton, CA 92834-9409 INSURERS AFFORDING COVERAGE INSURED — _ INSURER A: Travelers Property Casualty Co GMC ENGINEERING, INC. INSURER B: Northern Insurance Co of NY 1401 Warner Avenue #B INSURER C: Tustin, CA 92780-4116 INSURERD: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY DTEC05206C39ATIL0$ 06/25/08 06/25/09 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $300 000 X !, COM M ERCIAL GENERAL LIABILITY MED EXP (Any one person) $5 OOO CLAIMS MADE iX OCCUR PERSONAL & ADV INJURY $1,000,000 X PDDed:5,000 _ GENERAL AGGREGATE $2 00O OOO PRODUCTS -COMP/OPAGG $2 000,000 GEN'LAGGREGATE LIMITAPIPLIE�SPER: POLICY X JECOT ! LOC A AUTOMOBILE LIABILITY X ! ANY AUTO BA5206C39AO8CNS 06/25/08 06/25/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS P ED AS F PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ki q `'C'I /a O AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO — V $ A EXCESS LIABILITY DTSMCUP5206C39ATIL 06/25/08 06/25/09 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 X _I!, OCCUR L CLAIMS MADE $ $ DEDUCTIBLE $ X RETENTION $$10,000 B WORKERS COMPENSATION AND IWCO285895100 10/01/08 10/01/09 X TJRYLIMT C STATU-OER E.L. EACH ACCIDENT $1,000,000 EMPLOYERS' LIABILITY E.L. DISEASE -EA EMPLOYEE _ $1,000,000 E.L. DISEASE -POLICY LIMIT _ $1,000,000 A OTHER Equipment QT6606069C455TIL08 06/25/08 06/25/09 Deductible $1,000 Rented/Leased $150,000 Max per item DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Safe Routes to School, Cycle IV in the vicinity of Mesa View Middle School Cash Contract 1243 The City, its officers, elected or appointed officials, employees, agents and volunteers are named as additional insureds as respects general and auto liability and this insurance (See Attached Descriptions) TE HOLDER I I ADDITIONAL City of Huntington Beach PO Box 190 Huntington Beach, CA 92648 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, THE ISSUING INSURER WIW,1(X= TO MAIL 30DAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFTXX" AUTHORIZED REPRESENTATIVE II V _ _ ACORD 25-S (7/97) l of 3 #S458626/M447296 GAGAB 0 ACORD CORPORATION 19SS IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD25-S(7/97)2 of 3 #S458626/M447296 DESCRIPTIONS (Continued from Page 1) 1 is primary and noncontributory with any other insurance of the additional insured as required by written contract, per endorsement attached. Endorsement for waiver of subrogation as respects workers compenation applies as required by written contract. AMS 25.3 (07/97) 3 of 3 #S458626/M447296 POLICY NUMBER: DTEC05206C39ATIL08 COMMERCIAL GENERAL LIABILITY CG 20 3710 01 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 Person or Organization: City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers Location And Description of Completed Operations: Safe Routes to School, Cycle IV, in the vicinity of Mesa View Middle School, Cash Contract No. 1243 Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that insured and included in the "products -completed operations haz- ard". CG 20 3710 01 0 ISO Properties, Inc., 2000 Page 1 of 1 0 DTEC05206C39ATI L08 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 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 Person or Organization: City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A Section Il — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to i- ability arising cut of your ongoing operations per- formed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or "property damage" occurring after. (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional insured(s) at the site of the cov- ered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 © ISO Properties, Inc., 2000 Page 1 of 1 0 POLICY NUMBER: BA5206C39A08CNS COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: Countersigned By: C� • 6/25/08 Named Insured: GMC Engineering Inc. Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED TO INCLUDE AS AN ADDITIONAL INSURED ON THIS COVERAGE FORM IN A WRITTEN CONTRACT OR AGREEMENT THAT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS AND THAT IS IN EFFECT DURING THE POLICY PERIOD." (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement Is Issued subsequent to preparation of the policy.) This endorsement, effective on 10/01/2008 at 12:01 A.M. standard time, forms a part of (DATE) Policy No. WC 02858951 00 Endorsement No. of the Northern Insurance Company of NY (NAME OF INSURANCE C ANY) issued to GMC Engineering, Inc. �� ` • Premium (if any) $ Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The premium charge for this endorsement shall be 0.0 % of the California workers compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE BLANKET WAIVER OF SUBROGATION REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US WC 252 (4-84) WC 04 03 06 (Ed. 4-84) Page 1 of 1 -_. RECEIVED BY: ' CITY CLERK RECEIPT COPY ReWrr DUPLICATE to City Clerk's Ofte (Name) after signinghloftq oR (Date) F, CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: ri Freidenrich, City Treasurer FROM: OF DATE: 20l SUBJECT: Bond Acceptance 1 have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. _ MSC No. Approved 1()1�6 zz (C&mk4 Awmaf tare) Agenda item No. City Clerk Vault No, 0 #27 g:/foRowupAwdletter.doc Council/Agency Meeting Held: U 6 Deferred/Continued to: 1 Appr ve ❑ C ditiona ly pproved ❑Denied �rJT Ci a 's ignat r Council Meeting Date: 10/6/2008 Departme D Number: PW 08-69 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY COU CIL MEMBERS SUBMITTED BY: FRED A. WILSON, CITY ADMINIST PREPARED BY: TRAVIS K. HOPKINS, PE, DIRECTO F PU WO SUBJECT: Award Safe Routes to School Project - Mesa View Middle School Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The Safe Routes to School Project in the vicinity of Mesa View Middle School, CC 1243, was advertised and nine bids were received on September 11, 2008. The apparent low bid was deemed non -responsive and was disqualified. Staff requests the City Council award the project to the lowest responsive and responsible bidder, GMC Engineering, Inc. Funding Source: Grant funds in the amount of $130,050 are budgeted in the Safe Routes to School Fund Traffic Improvements, 87890001.82700. Matching funds of $130,000 are budgeted in the Gas Tax Fund 20790007.82700. The estimated cost of the project is $260,000, which includes the purchase of traffic signal equipment by the City. Recommended Action: Motion to: 1. Approve the project plans and specifications for the Safe Routes to School, Cycle IV Project in the vicinity of Mesa View Middle School, CC-1243; 2. Declare the apparent low bid from California Engineering & Contracting, Inc., as non- responsive; 3. Accept the lowest responsive and responsible bid submitted by GMC Engineering, Inc., in the amount of $170,000.00; and 4. Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids and direct staff to readvertise or abandon the project. REQUEST FOR CITY COUNCIL ACTION MEETING DATE: 10/6/2008 DEPARTMENT ID NUMBER: PW 08-69 Analysis: In May 2003, the City, working in conjunction with the Ocean View School District, applied for a grant for traffic safety improvements in the vicinity of Mesa View Middle School under the Safe Routes to School Program. The grant was approved and the State allocated funds in September 2005. State funds will be appropriated in the amount of $130,050. The balance of the funding is from Gas Tax Funds as indicated in the 2008/09 Capital Improvement Program. The required City match is a minimum of 10%. The City typically purchases all major components of the traffic signal and electrical equipment directly. This practice ensures consistency of equipment among the traffic signals, lighting, and radar feedback signs maintained by the City. Direct purchase provides the added benefit of reduced costs to the City due to elimination of contractor mark-up. The project includes the installation of east -west left turn arrows at the intersection of Slater Avenue and Edwards Street, the installation of curb ramps, damaged sidewalk replacement, the installation of radar feedback signs to display motorists' speed, and signing and striping improvements. A complete set of plans and specifications are available for review at the Public Works counter during normal working hours. Bids were opened publicly on September 11, 2008, and are listed in ascending order: Bidder Submitted Bid 1 California Engineering & Contracting, Inc. $160,420.00 2 GMC Engineering, Inc. $170,000.00 3 Steiny & Company, Inc. $175,359.00 4 Christopher Morales Inc. $178,897.00 5 Golden State Contractors, Inc. $183,325.00 6 California Professional Engineering, Inc. $188,417.00 7 Elite Bobcat Service, Inc. $205,205.00 8 Pacific Coast Infrastructure, Inc. $233,000.00 9 Damon Construction Company $258,757.00 The bid from California Engineering & Contracting, Inc. was non -responsive due to an apparently inaccurate response to a critical element contained in the bid package. This inaccuracy was deemed significant enough to warrant disqualification of the bid and the bidder was promptly notified of the decision. The reference check for GMC Engineering, Inc. provided acceptable responses from past clients. All other elements of the bid were found to be in compliance with bidding requirements. Therefore, staff recommends that the City Council accept the bid from GMC Engineering, Inc. as the lowest responsive and responsible bidder. Public Works Commission Action: The Public Works Commission recommended the project on August 20, 2008, by a vote of 6-0-1 (Siersema absent). -2- 9/18/2008 10:21 AM REQUEST FOR CITY COUNCIL ACTION MEETING DATE: 10/6/2008 DEPARTMENT ID NUMBER: PW 08-69 Strategic Plan Goal: (1-1) Improve the City's plan for funding and completing infrastructure needs, and develop strategies for resolving crucial infrastructure problems to preserve the physical foundation of the community and enable the community's value to grow. (C-1) Improve transportation through a variety of means including improving traffic flow, synchronizing traffic signals, traffic calming, and alternative transportation methods such as bike and walking paths. Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c). Attachment(s): -3- 9/18/2008 10:21 AM ATTACHMENT CITY OF HUNTINGTON BEACH * PUBLIC WORKS * TRAFFIC ENGINEERING ' LOCATION MAP ATTACHMENT SAFE ROUTES TO SCHOOL PROJECT - MESA VIEW MIDDLE SCHOOL 1 - - � _ � ■ - 9 �� __ PALMA CR. MONTOYA MESA VIEW MIDDLE SCHOOL CR CR. LEGEND � = SIGN F = RADAR SIGN x s = "SLOW SCHOOL XING" LEGEND ® = CURB RAMP IMPROVEMENT o = TRAFFIC SIGNAL MODIFICATION o ADD EAST -WEST LEFT -TURN ARROWS VIA z HUNTINGTON CENTRALPARK ST_ ) L CONSTRUCTION NOTES ' 0 REMOVE EXISTING SIGN O2 REPAINT EXISTING "SLOW SCHOOL XING" LEGEND (YELLOW) O REPAINT CROSSWALK (YELLOW) O INSTALL FLUORESCENT YELLOW GREEN W63 (36"X36") & W65 PER CALTRANS INSTALLATION "A" O INSTALL FLUORESCENT YELLOW GREEN W66 (36"X36") & W66A PER CALTRANS INSTALLATION "B" O INSTALL RADAR SIGN M: TRAFFIC DRAWINGS/SR2S/MESA VIEW — SIGNS CITY OF HUNTINGTON BEACH ATTACHMENT DEPARTMENT OF PUBLIC WORKS 2 MESA VIEW MIDDLE SCHOOL PROPOSED IMPROVEMENTS RCA ROUTING SHEET INITIATING DEPARTMENT: Public Works SUBJECT: Award Safe Routes to School Project - Mesa View Middle School COUNCIL MEETING DATE: October 6, 2008 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Tract Map, Location Map and/or other Exhibits Attached Not Applicable ❑ Contract/Agreement (w/exhibits if applicable) Attached ❑ (Signed in full by the City Attorney) Not Applicable Subleases, Third Party Agreements, etc. Attached ❑ (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Attached ❑ Not Applicable Fiscal Impact Statement (Unbudgeted, over $5,000) Attached ❑ Not Applicable Bonds (If applicable) Attached ❑ Not Applicable Staff Report (If applicable) Attached ❑ Not Applicable Commission, Board or Committee Report (If applicable) Attached ❑ Not Applicable Findings/Conditions for Approval and/or Denial Attached ❑ Not Applicable :EXPLANATj-- ON FOR UISSING ATTACHMENTS REVIEWED RETURNED. FORRDED Administrative Staff ( ) ) Deputy City Administrator (Initial) ( ) ( ) City Administrator (Initial) ( ) ( ) City Clerk ( ) EXPLANATION FOR RETURN OF ITEM: RCA Author: Janusz:jg City of Huntington Beach CC-1243 Safe Routes to School, Cycle IV Mesa View Middle School Bid Opening: September 11, 2008 @ 2:30 P.M. Engineer's Estimate: $200,000 Rank Bidder's Name Bid Amount Corrected Bid Amount ACR — Concrete & Asphalt Construction, Inc. All American Asphalt Andy Quiocho Concrete California Engineering & Contracting, Inc. California Professional Engineering, Inc. Za, Damon Construction Company EBS r% GMC Engineering, Inc. GSCI — Golden State Constructors, Inc. .1 JRD Mmac Los Angeles Signal Construction, Inc. McCain, Inc. Moore Electrical Contracting, Inc. PCI — Pacific Coast Infrastructure, Inc. o — ' Steiny & Company, Inc.�'— r ) f r �"o e I Okl-* :Z Hd 1 6 d3S CON RE NOTICE INVITING SEALED BIDS for CC-1243 Notice is hereby given that sealed bids will be received by the City of Huntington Beach at the office of the City Clerk at City Hall, 2000 Main Street, Huntington Beach, CA 92648, until the hour of 2:30 PM on September 11, 2008, at which time bids will be opened publicly and read aloud in the Council Chambers for the Safe Routes to School Program, Cycle 1V (in the vicinity of Mesa View Middle School) - CC-1243 in the City of Huntington Beach. A set of plans, specifications, and contract documents may be obtained starting August 21, 2008 at City Hall, Department of Public Works upon receipt of a non-refundable fee of $40.00, sales tax included, if picked up or $50.00 if mailed. Each bid shall be made on the Proposal Form provided in the contract documents, and shall be accompanied by a certified or cashier's check or a bid bond for not less than 10% of the amount of the bid, made payable to the City of Huntington Beach. The Contractor shall, in the performance of the work and improvements, conform to the Labor Code of the State of California and other Laws of the State of California applicable thereto, with the exception only of such variations that may be required under the special statutes pursuant to which proceedings hereunder are taken and which have not been superseded by the provisions of the Labor Code. Preference to labor shall be given only in the manner provided by law. No bid shall be considered unless it is made on a form furnished by the City of Huntington Beach, Department of Public Works, and is made in accordance with the provisions of the proposal requirements. Each bidder must be licensed as required by law. The City Council of the City of Huntington Beach reserves the right to reject any or all bids. By order of the City Council of the City of Huntington Beach, California the 4th day of September 2007, by RESOLUTION 2007-55. Joan L. Flynn City Clerk of the City of Huntington Beach 2000 Main Street. (714) 536-5431 CC-1251 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 92 64 8 Fax (714) 374-1573 Date: Auqust 14, 2008 Project/C.C. No.: C.C. No. 1243 Regarding:Safe Routes to School, Cycle IV - Mesa View ❑ We are sending you: ❑ By Mail ❑ By Fax Mail(Number of pages including this sheet:) ® We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other: Notice Inviting Sealed Bids Item # Co ies Pages Descri tion 1 1 1 Notice Inviting Sealed Bids for CC-1243 2 (Safe Routes to School Program, Cycle IV -In the vicinity of Mesa View Middle School 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 2007-55 (adopted on September 4, 2007), the City Council authorized the advertisement of the above Safe Routes to School Project. Please find attached the Notice Inviting Sealed Bids for advertisement on 8/21/08, 8/28/08, & 9/4/08. The bid opening is scheduled for 9/11/08. Please contact me at 374-1628 with any questions you may have. c: file By: 2 i liam F. Janusz, P al Civil Engin GACONSTRUCTION CONTRACTS (CCS)\CC1243\NISB TRANSMITAL To CLERK-CC-1243.DOC Huntington Beach Independent has been adjudged a newspaper of general circulation in Huntington Beach and Orange County by Decree of the Superior Court of Orange County, State of California, under date of Aug. 24, 1994, case A50479. STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) I am the Citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the below entitled matter. I am a principal clerk of the HUNTINGTON BEACH INDEPENDENT, a newspaper of general circulation, printed and published in the City of Huntington Beach, County of Orange, State of California, and the attached Notice is a true and complete copy as was printed and published on the following date(s): August 21, 28, 2008 September 4, 2008 I declare, under penalty of perjury, that the foregoing is true and correct. Executed on September 4, 2008 at Huntington Beach, California 1A 1/1 Signat NOTICE INVITING -SEALED BIDS , I r for CC-1243 Notice is hereby given that sealed bids"will be received by the City of Huntington. Beach at the office of the City Clerk at_City Hall, 2000 Main Street, Huntington; Beach,. -CA 92648, until thi hour of 2:30 PM'on September 11, 2008, at=which time, bids will beyopened publicly and', read aloud in the Coun- cff Chambers for I the Safe Routes to School Program; Cycle IV (In the vicinity of Mesa View Middle school). - „'CC-1243 in,the City of Huntington Beach. .Aset of plans„' specification's,`and con- tract documents,may be obtained starting Au- gust 21, 2008 at City Hall, Department, of Public Works.,upon 're,- . ceipt..;of .a non refundable fee, of,' f- tax in- cluded, if picked up or $50.00,if mailed.. Each bid shall be made on the Proposal. Form. provided in' Ahe contract .documents, and shall be accompa= nied. by a certified or cashier's. check or a,bid bond for not1ess than 10% of the amount of the bid, made 'payable to the City of Hunting- ton Beach. The Contrac- tor, shall, in- the per - and improvements, con- form to the Labor Code of the State. of Calif6r-, nia and other. Laws ;of the State of California applicable thereto, .with the exception. only of such variations that may be required under the special statutes 'pur- suant .to which proceed- ings' hereunder are tak- en and which have' not been superseded by the provisions of the, Labor Code. Preference to la- bor shall be given only in the manner provided bylaw. No bid shall be consid- ered unless'it is made on a form furnished by I the 'City of Huntington i Beach, Department of 1 Public Works, and is made in% accordance with the provisions of the pro'posaI requirements. .Each bidder must be licensed as required by,l law. 1 The,City,Council of the. City of. Huntington' Beach reserves the right to reject any or all bids. i By order of the City, Council of the City of Huntington Beach, Cali -I fornia the 4th day of 'September 2007, by RESOLUTION 2007-55. ` Joan L. Flynn City Clerk of the City of� Huntington Beach, I 2000 Main Street. i (714) 536-5431 Published Huntington Beach Independent Au- gust 21, 28, Septemberi 4, 2008 083-785i __J Huntington Beach Independent has been adjudged a newspaper of general circulation in Huntington Beach and Orange County by Decree of the Superior Court of Orange County, State of California, under date of Aug. 24, 1994, case A50479. PROOF OF PUBLICATION STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) I am the Citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the below entitled matter. am a principal clerk of the HUNTINGTON BEACH INDEPENDENT, a newspaper of general circulation, printed and published in the City of Huntington Beach, County of Orange, State of California, and the attached Notice is a true and complete copy as was printed and published on the following date(s): August 21, 28, 2008 September 4, 2008 I declare, under penalty of perjury, that the foregoing is true and correct. Executed on September 4, 2008 at Huntington Beach, California ��A Q - " Signat e -= NOTICEINVITING SEALED BIDS for CC-1243 Notice is hereby given that sealed bids will be received by the City of Huntington Beach at the office of the City, Clerk at: -City Hall, 2000 Main Street, Huntington Beach, CA 92648, until the hour of 2:30 PM on September 11, 2008, at which time bids will be. opened publicly and read aloud in the Coun- cil- Chambers f_or', the Safe Routes to School Program, Cycle IV (In The vicinity of :Mesa View Middle School) =. CC-1243 in the 'City of Huntington Beach. A. set of plans, specifications, and con- tract documents may be obtained starting Au- gust 21, 2008 at City 'Hall, Department, of Public Works upon re- ceipt of a non- refundable fee of $40.00, sales, tax in- cluded, if picked up or $50.00 if mailed. Each bid .shall be made on the Proposal Form .provided in the contract documents, and shall be accompa- nied by a certified or cashier's check or a. bid bond for not less than 10% of the amount of the bid, made payable to the City of Hunting- ton Beach, The Contrac- tor 'shall, in the per- formance of .the iwork and improvements, con- form to the Labor Code of the State of Califor- nia and other. Laws of the State of California applicable thereto, with the exception only of such variations that may be required under_ the special statutes pur suant'to which proceed- ings hereunder are.tak- en and which have not been superseded.by the provisions of the Labor Code. Preference to la- bor shall be, given only in the manner provided by law. No bid shall be consid- ered unless it is made on.a form furnished by the City of Huntington Beach, Department of Public Works, and is made in accordance with the provisions of. the pr.oposa11 requirements. Each bidder must be licensed as required by law. The City Council of the City of Huntington Beach reserves the right. to reject any or all bids. By order of the City Council of the . City of. Huntington •Beach, Cali- fornia the 4th day of September 2007, by RESOLUTION 2007-55. Joan L.Flynn. City Clerk of the City of Huntington Beach 2000 Main Street. (714) 536-5431 Published Huntington Beach Independent Au- gust 21, 28, September. 412008 083-785 1} W r City ®f Huntington Beat 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 Christopher R. Morales, Inc. 155 N. Eucla Ave. San Dimas, CA 91773 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, JF:pe Enclosure Sister Citiq.lfo64Wi,"iiupetl i� goNew Zealand ( Telephone: 714-536-5227 ) �ujxj� I UFHER R. MORALES, INC. 155 N. EUCLA AVE. SAN DIMAS, CA 91773 SEALED BID FOR SAFE ROUTES TO SCHOOL, CYCLE IV IN THE VICINITY OF MESA VIEW MIDDLE SCHOOL CC 1243 CITY OF HUNTINGTON BEACH- DO NOT OPEN WITH REGULAR MAIL CITY CLERK CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 BID DATE: SEPTEMBER 11, 2008 BID TIME: 2:30 PM C= 51 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, Cycle IV — CC 1243 September 2, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Mesa View Middle School) CC1243 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, dated September 2, 2008. Christopher R. IN®112, Its. Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. SECTION C PROPOSAL. for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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. ert- Accompanying this proposal of bid, find,0&-61 ZNd in the amount of $10o vf- IM ft"whi h said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received A M44er's Signature C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 Yea e. w el�nr1tw ften�1it1 - a ..w.�z ''.z4ti .�"+.^�'� �n�y2ixi- ��"`^{}a e.,,N �'•.�Y3t-y� s .Y>$`6 2 t}Q',P 1r.�.``'- 1 1 L.S. Mobilization. d u @ 5.R.e Per L.S. $ M— $ 7 000 2 1 L.S. Furnish Project Tr is Control. @ VAIO rmilyo 0'/r GU Per L.S. $ $ 2,�,: O'a 3 4 5 6 7 1 L.S. 1 L.S. 21 E.A. 3 E.A. 6 L.F. Furnish and I tall Traffi Striping and Signing. Per L.S. Modify Traffic Signal at Edwards Street and Slater Aven e. ` ©-n 0Rc7 1 �G �,/cn .Dr�lan Per L.S. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and AC Paving Replace ent. V.XAhJ 0 A D Per EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type I Poles are City Furnished). Per EA. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works Construction (A.P.W.A.) Slandarj Plan 60fi 2� Per L.F. -t3 q 0 $ — a $ $�3 0 $ o $ 1 3 i� �. DO $ $ �10�' $ 6 06,,E 8 100 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan 207. Sidewalk Locations as Determined by the @ty. 4:7-1 v $ 5,00 $ S;W' l� Per S.F. Total Amount Bid in Figures: $� �� d Total Amount Bid in Words:.$ h <_-e.— C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. 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) 375-5015. 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. Portion o Work Name and Address of Subcontractor State License Number r+e`n5 i 3A1. P-X le V S+- 0 tz N e. C e-If -3q 09 S rem 4rr7c, ,_ C Cp.,st�vcac"' 2-7i3 CA;cow /lw S— "0-73 �Jibiy By submission of this proposal, the Bidder certifies: Class C-3Z 1� 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 BIDDEN AND SUBMITTED WITH BID State of California ss. County of Orange \ \Q/� 4 , being first d sworn, deposes and says that he or she is 9 r i c� of �oly r �— 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. Chrldopher R. Momlee, Inc. Name of Bidder Signature of Bi der Y\,�-(A ag kV .,. A,A),OAS C A -13 Address of Bidder Subscribed and sworn to before me this �_ day of 20 . NOTARY PUBLIC NOTARY SEAL C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of 7�josAnaeies O'n J` lJ- b?fpr:-me. Tram_-n C. 7%rteaT4a a No-_ ui_s_ DaiF Here Inset Name anc Tti r,l the n,'nce� personally appeared Christopher R. Morales R ON CARTEAGA :. z Commission # 1655887 California z % Notary Public a Angeles County Ang fV1y Los Comm. Expires Apr 29, 2010 Place Notary Seal Above who proves to rrre on the basis of satista^tort; evidence tc )e the rpe'soni U4" D e "lame is4w subscribe -u 11-fe ,rv1thl instrument an' ackk"nowledge tG me tha he/ftnOW, executer tree same, ir; histaftaw authorized capacity ' and that by hisAmISINM signature(% on the instrument the person(*, or the entity upon, behal' 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. Vv17NESS my h `and afficai sea:. , Signature Signature of Notary Fublic 0PTIONAL Though the information below is not required by law, it may prove vaivable to persons reivinp on the document and could prevent traudulenf removal and reattachment of tPis form to another document Description of Attached Document Title or Type of Document: �� , (`y -, _ �( 6 J AV t Document Date: �l "y%� _ Number of Pages: Sianer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signers Name: C r i_q t ooh e r Mora 1 es Sianer's Name: Individual Individual Corporate Officer — Titie(s;: Pre s i dent Partner — Limited Eli General _] Attorney in Fact e Top ci thumb here ^7 Trustee Guardian or Conservator _ Other i �., Signer Is Representing: Chr� S+ni 41Pr 4 �rl� �es �nc I Corporate Officer — Title(s): Partner — Limited L i General Attornev in Fac Q Truste@ Top of thumb here Guardian or Conservator Other: i Signer Is Representing: 1 i i ©2007 National Notary Association 9350 De Soto Ave.. P.QBox 2402 -Chatsworth, CA 91313-2402• www.NationalNotarv.orc Item #5907 Reorder* Call Toll -Prep 1-800-876-6827 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: 6ti , Chrlstopher R. Momles, Inc. Contractor By yv, Q ti' e�1� Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ® Yes 4 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. DatA-tP4'1�, Christopher R. M omles, Inc. Contractor By Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: 19 0 Christopher R. Morales, Inc. Contractor By Title Date: 06 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: Christopher R. Morales, Inc. Bidder Name K5 A, eve Business Address � V,\ V City, ( �jk)15 ��-7-7-0r Telephone Number I V�Vl �1:3Yj r- - 10) State Contractor's License No. and Class \-'q - I- jz�� Original Date Issued \\-�)0_ LQ2J Expiration Date State Zip The work site was inspected by(-\r,r 0A. �Jour office on , 20U? The following are persons, firms, and corporations having a principal interest in this proposal: Christopher R. Morales h ri dapher R. Morales, Inc. C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements, in accordance with the plans and specifications set forth. Christopher R. Moraln, hm Company Name Signature of Printed or Typed Signature ff �� Subscribed and sworn to before me this I \ day of C uAt! ", , 2000 . 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: 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-10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of!,(Ds Ancreles — j Or; �` l?�� before me. _ Re.mor: C. krteaca. a No_aru tj-_.0 Dau. Here Insert Name aue T:hF of the 019ice� personally appeared. Christopher R.. Morales 1•,lamels; of Signeris; RAMON C. ARTEAGA Commission # 1655887 z Z... A Notary Public - California zy z ° r Los Angeles County My Comm. Eypires Apr 29, 2010 Place Notarq Seal Above who proved to me or, the basis of satistactory evidence tm be the person( whose nameit isAoW subscrlbec tr, the within instrumen` anc' acknowledge'd to me. tha he/vill executed the same: in, hisOmISMOr authorizes capacity( and that by his#j0jWM signature(*,� on the instrument the personill or the entity- upon behalf of which the person(*.; acted, executed the instrument. I certify under PENALTI Y OF PEPJURY under the laws of the State of California that the foregoing paragraph true and correct. WITNESS my h and official seal. Signature Signature of Notary Public OPTIONAL Though the information below is not required by law: it may prove valuable to persons reiving on the document and could prevent fraudulem removal and reattachment of this: form to another document. Description of attached Document Title or Type of Document: I �- �/ cv ( 1 A , _ Document Date: `� \ / �1� Number of Pages: , Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Christopher R. Morales Signer's Name: Individual ' Individual g Corporate Officer —Title(s): President Corporate Officer —Title(s): 7 Partner —D, Limited [J General ❑ Partner — Limited L-I General Attorney in Fact `i Trustee Guardian or Conservator Otner. Signer Is Representing: Chrn.:)he-- R f�� ales a Top of thumb here i �nc. I � Attorney in Fac Trustee --I Guardian or Conservator 01 Other: Signer Is Representing RIGfITTHUMBFRtNt oFBIGIJER 0,2007 National Notary Association • 9350 De Soto Ave.. P.O. Box 2402 • Chatsworth. C6, 91313-2402 • www.NationalNotary.orc Item #5907 Reorder Call Toli-Free 1-800-876-682 Christopher R. Mor les, Inc. 155 N. Eucla Ave., San Dimas, CA 91773. Phone (909)599-2201, Fax (909) 599-2722 RE: REFERENCES -COMPLETED PROJECTS ➢ City of Pasadena Lincoln Ave.- In -Fill Lighting C-10 117 E. Colorado Ave. Original Contract: $318,848 Final: $318,848 Pasadena, CA 91105 Contact: Reny Quijano (626) 744-4124 Date of Completion: February 2006 Percentage performed by our own forces: 100% Project Manager: Jennifer Alvarez ➢ City of Pasadena Raymond Ave. -Street Lighting C-10 117 E. Colorado Blvd. Original Contract: $58,888 Final $58,888 Pasadena, CA 91109 Contact: Reny Quijano (626)744-6741 Date of Completion: May 2007 Percentage performed by our own forces: 100% Project Manager: Araceli Nieto ➢ City of Pasadena Avenue 64-Street Lighting C-10 117 E. Colorado Blvd. Original Contract: $409,887 Final $427,887 Pasadena, CA 91109 Contact: Reny Quijano (626)744-6741 Date of Completion: May 2007 Percentage performed by our own forces: 100% Project Manager: Essen Menjivar ➢ City of Baldwin Park Los Angeles St. Traffic Signals 3 locations C-10 14403 E. Pacific Ave. Original Contract: $438,438 Final: $452,572 Baldwin Park, CA 91708 Contact: Arjan Idnani (626) 960-4011 Date of Completion: December 2006 Percentage performed by our own forces: 92% Project Manager: Araceli Nieto ➢ City of Pasadena Sunnyslope Crosswalk C-10 117 E. Colorado Ave. Original Contract:$229,989 Final: $229,989 Pasadena, CA 91105 Contact: Reny Quijano (626) 744-4124 Date of Completion: January 12, 2007 Percentage performed by our own forces: 100% Project Manager: Jennie Pittman ➢ County of Los Angeles San Bernardino @ Nora -Traffic Signal C-10 900 S. Fremont Ave. Original Contract: $79,255.50 Final $75,745 Alhambra, Ca 91803 Contact: Luke Miller (626) 458-3122 Date of Completion: December 12, 2005 Percentage performed by our own forces: 97.4% Project Manager: Jennie Pittman Christopher R. Morales, In - 155 N. Eucla Ave., San Dimas, CA 91773. Phone (909)599-2201, Fax (909) 599-2722 RE: REFERENCES -COMPLETED PROJECTS -page 2 ➢ City of Gardena Normandie Ave -Traffic Signal C-10 1700 W. 162"d St. Original Contract: $112,9000 Final $113,958 Gardena, Ca Contact: John Felix (310) 217-9643 Date of Completion: May 11, 2006 Percentage performed by our own forces: 91.5% Project Manager: Jennie Pittman ➢ City of La Mirada Rosecrans & Biola Ave. Traffic Signal C-10 13700 La Mirada Blvd Original Contract: $88, 780 Final $91,639 La Mirada, CA 90638 Contact: Gary Sanui (562) 902-2373 Date of Completion: December 2006 Percentage performed by our own forces: 100% Project Manager: Araceli Nieto ➢ City of Monrovia Royal Oaks Drive Traffic Signal C-10 415 South Ivy Ave. Original Contract: $129,218 Final $130,765 Monrovia, Ca 91016 Contact: Jed Rizk (626)932-5562 Date of Completion: May 2007 Percentage performed by our own forces: 95% Project Manager: Jennie Pittman ➢ City of Whittier Pickering Avenue Traffic Signal C-10 13230 Penn Street Original Contract: $189,738 Final $191,414 Whittier, CA 90602 Contact: James Keena (562)464-3523 Date of Completion: January 2007 Percentage performed by our own forces: 96% Project Manager: Jennie Pittman ➢ LA County Via Princessa Traffic Signal C-10 900 S. Fremont Ave. Original Contract: $373,516 Final $306,825 Alhambra, CA 91803 Contact: Robert Eisenhammer Date of Completion: September 2006 Percentage performed by our own forces: 90% Project Manager: Araceli Nieto ➢ City of Irvine Berkley & Cornell Traffic Signal C-10 6427 oak Canyon Original Contract: $297,997 Final: 270,865 Irvine, Ca 92623 Contact: Uyenly Buy (949)724-7559 Date of Completion: July 2007 Percentage performed by our own forces: 100% Project Manager: Araceli Nieto Christopher R. Morales, Inc® 155 N. Eucla Ave., San Dimas, CA 91773. Phone (909)599-2201, Fax (909) 599-2722 RE: REFERENCES -COMPLETED PROJECTS -page 3 ➢ City of Cypress Cypress Traffic Signal C-10 5275 Orange Ave. Original Contract: $149,870 Final $158,168 Cypress, Ca 90630 Contact: Keith Carter (714)229-6750 Date of Completion: April 23, 2007 Percentage performed by our own forces: 100% Project Manager: Jennie Pittman ➢ City of Santa Ana Adaptive Downtown Signal C-10 20 Civic Center Plaza Original Contract: $321,032 Final $343,097 Santa Ana, CA 92702 Contact Edgard Torres (714) 647-5058 Date of Completion: June 2008 Percentage performed by our own forces: 60% Project Manager: Araceli Nieto ➢ City of Diamond Bar Golden Springs Traffic Signal C-10 21825 Copley Drive Original Contract: $383,740 Final $420,707 Diamond Bar, CA 91765 Contact Rick Yee (909)839-7043 Date of Completion: June 2008 Percentage performed by our own forces: 85% Project Manager: Jennie Pittman ➢ County of Orange In roadway Flash Crosswalk Light Sys C-10 300 North Flower St. Original Contract: $128, 860 Final $137,912.22 Santa Ana, CA 92702 Contact: David Rocha (714) 834-2300 Date of Completion: June 2008 Percentage performed by our own forces: 95% Project Manager: Araceli Nieto ➢ City of Vernon Atlantic Blvd. and Bandini Traffic Signal C-10 4305 Santa Fe Ave. Original Contract: $226,689 Final $236,124.88 Vernon, CA 90058 Contact: Sherwood Natsuhara (323) 583-8811 Date of Completion: June 2008 Percentage of work performed by our own forces: 95% Project Manager: Jennie Pittman ➢ City of Pasadena CCTV Rosemont C-10 100 N. Garfield Original Contract: $205,000 Final $204,800 Pasadena, CA Contact: Reny Quijano (626) 744-6741 Date of Completion: July 2008 Percentage of work performed by our own forces: 75% Project Manager: Essen Menjivar (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: °t h 2Lfl Signed: Date: a el ✓ �. `�� *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION .. The bidder__ Chdstapher RMOOss ft, , proposed subcontractor , hereby certifies that he hae'\ 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. Pave 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual �Q �)�,44/�IrBIT'12-E PS&E Checklist Instructions G DISCLOSURE OF LOBBYING ACTIVITIES UUMYLhIt 1HIS 1`UKM 1U1JI61Wbr WtWT11NUA1..11Y111CJYU"UAN1 1U31 U.b.k; IJDZ 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: F1a. contract R a. bid/offer/application ❑ a. initial b. grant b. initial award b. material change c, cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter _ f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10, a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11. 12. 14. Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including offrcer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes n No 16. Information requested through this form is authorized by Title kj�, 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or pppp entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: C � 4�� / `r` 9 ct I 1352. This information will be reported to Congress semiannually and will be available for public inspection- Any i� -� de --, + person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than $I00,000 for each such failure. Telephone No.: �� GZ�� 1 Date: Federal Use Only: Form LI]_ Rev_ 09- Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00L" 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 awardfloan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 1 L Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the Iobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13_ Check the appropriate box(es). Check all boxes that apply_ If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXFIIBIT 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 Rcv.06-04-90uENDIFv. Page 12-89 LPP O1-04 March 15, 2001 c RECEIVE INSCO INSURANCE SERVICES, INC. 'ns '�® Underwriting Manager for: SLI Q 8 2008 �o I� Developers Insurance Company • Indemnity Company of California Developers Surety and Indemnity Company 17780 Fitch, Suite 200 • Irvine, California 92614 • (949) 263-3RJSTOPHER R. MORALES INC. BID BON® BOND NO. N/A ----------------- KNOW ALL MEN BY THESE PRESENTS, That we,_-__--CHRISTOPHER R. MORALES, INC. ------------------------------------------------------------------ --------------------------------------------------------------------------------------------- as Principal, and - DEVELOPERS SURETY AND INDEMNITY COMPANY ___a corporation ------------------------------------------------------ authorized to transact a general surety business in the State of -IOWA _ _ _ as Surety, are held and firmly bound unto ---- CITY OF HUNTINGTON -BEACH -------------------------------------------------------------------------------- _____________________________________________________________________(hereinaftercalled the Obligee) in the full and just sum of TEN -PERCENT -OF THE -AMOUNT -OF -THE -BID ------------------------------------------------------------------- Do!lars, ($- 10%_OF BID----) for the payment whereof in lawful money of the United States, we bind ourselves, our heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the said PRINCIPAL has submitted the accompanying bid for SAFE ROUTES TO SCHOOL, CYCLE IV IN THE VICINITY OF MESA VIEW MIDDLE SCHOOL, C.C. NO. 1243 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, or in the event of the failure of the Principal to enter such Contra ct, 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 5 ----- —_ day of - SEPTEMBER---------- - ----- -, 2008 -- ---- - - YEAR— CHRISTOPHER R. MORALES, INC. DEVELOPERS SURETY AND INDEMNITY COMPANY Surety By. sxAWN BLUME L k0-11 IaPl,Z: Mc)rrn le.s Principal Attorney -in -Fact ID-1198 (Bid Bond) (REV. 12100) CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of RIVERSIDE On, before me, R. CISNEROS "NOTARY PUBLIC" , (Here insert name and title of the officer) personally appeared SHAWN BLUME who proved to me on the basis of satisfactory evidence to be the personA whose nameW is/.at'e-subscribed to the within instrument and acknowledged to me that he/shetthey executed the same in his/hePk4t6r authorized capacitykieo, and that by his/heathei-r-signatureJ j on the instrument the personal; 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. �. ITNESS my hand and official seal. CISNEROSCc®MM. #1796916 9 'Q NOTARY PUBLIC - CALIFORNIA RIVERSIDE COUNTY My Comm. Expires June 7, 2012 (Notary Seal) Signature of Notary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attomey-in-Fact ❑ Trustee(s) ❑ Other 2CO8 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed In Ca1(%rnia must contain verbiage exacth, as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. 77re only exception is if a document Is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require tire notary to do something that is illegal for a notary in California (i.e. cerd&ng tire authodced capacity of the signer). Please check the document carefully for proper notarial wording and attach this fornt if required • State and County information must be the State and County where the document signers) 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 plum( forms by crossing off incorrect forms (i.e. he/she/theyr is /are ) 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 signatrm 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 tide (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263-3300 KNOW ALL MEN BY THESE PRESENTS, that as except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each, hereby make, constitute and appoint: ***Michael D. Stong, Rosemary Cisneros, Shawn Blume, Jeremy Pendergast, jointly or severally*** as their true and lawful Attorney(s)-in-Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of surety- ship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s)-in-Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 2008. RESOLVED, that the chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of Attorney, qualifying the attorneys) named in the Powers of Attorney to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship, and that the Secretary or any Assistant Secretary of the corporations be. and each of them hereby is, authorized to attest the execution of any such Power of Attorney; RESOLVED, FURTHER, that the signatures of such officers 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 shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective Vice President and attested by their respective Assistant Secretary this January 1st, 2008. By. `— — ; 4�ty .ANDPAN y po Stephen T. Pate, Senior Vice President�p,POR.gTbF�y sY �L OQPOq� =w OCT. 10OCT.5 By — o`: 1936 <a 1967 -Z Charles L. Day, Assistant Secretary State of California County of Orange On January 1 st 2008 before me, Christopher J. Roach Notary Public Date Here Insert Name and Title of the Officer personally appeared Stephen T. Pate and Charles L, Day Name(s) of Signer(s) 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 my hand and official seal. Signature �—��- Ch er J. Roach CERTIFICATE The undersigned, as Assistant Secretary, of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, the day of By: TJ Albert Hillebrand, Assistant ecretary I D-1380(Wet)(Rev.07/07) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles MM� or, ' 1i` �W_�� before me. FieTTlGri C. k r} ecCtn d NGt cry-- Pii_t)_ C rail He utsar Nam, am llu, r' r+,, Olhce personally appeared _ Christopher R. Morales _-------- --- - -- Nanefs� of Sionen,s RAMON C. ARTEAGA Commission # 1655887 „ m Notary Public -California z Los Angeles County My Comm. Expires Apr 29, 2010 Place Notary Seal Above who proved to me on the basis of satistactory evidence to I flip perSCn V�I I- I riamel ts/M :.: bscribe the withir mstrumen. an acknowledged tc me that heir exe used the same in hiss authorized capacity(ta►.. and that by his signature(*? on the instrument the person*. or the entity upon behalf of which the person(4a acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS m rid =X_A*1 Signature p� Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached document Title or Type of Document: 111 Document Date: �k \`�I_ , z7 , Number of Pages: / Signer(s) Other Than Named Above. _ Capacity(il Claimed by Signer(s) Signers Name: Christopher R . Morales Signer's Name: rl Individual D Individual Corporate Officer — Titie(s): President ` Corporate Officer — Title(s): Partner D Limited E General _ r! Partner — ❑Limited =1 General 101P.560111111_ _ 4121 Attorney in Fact D Attorney in Fac - `i Trustee Top of thumb here Trustee Top of thumb here Guardian or Conservator `i Guardian or Conservator Other: ❑ Other: i Signer Is Representing: Signer Is Representing: Chri stTnnher_ R Morales Inc. OO 2007 National Notary Association - 9350 De Soto Ave.. P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary.ore Item #5907 Reorder: Call Toll -Free 1-800-876-6827 City of Huntington Beach 2000 Main Street a Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 Golden State Constructors, Inc. 6162 Galipean Dr. Huntington Beach, CA 92647 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citig:Ifo&thi@i,ciali�a%retWgi&@kmrgocNew Zealand (Telephone: 714-536-5227 ) C00001, CL�iuc C h"� of 44. 71 T m 0- 4, SEP I I PH 2:. 20 SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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, find9,1 in the amount of $ D -c'e.-f 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 4qtftLs ' nature C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 :,Y1� 1 1 L.S. Mobilization. f'Uu-Art/t (ir,i14r1 Per L.S. 2 1 L.S. Furnish Project Traffic Control. @01r,q 71-'OU54" 71 6 $ 3a00 $ 3 a CA V l tar'_ Per L.S. 3 1 L.S. Furnish and Install Traffic Striping and Signing. @ ::5 r CIfe j, $ O U $ 1 . ©e 6 Per L.S. 4 1 L.S. Modify Traffic Signal at Edwards Street and Slater Avenue. , $ ! (� ® o o $ (qoo 0 (a-) ✓�.. �t1s 0.s+ _yi--A, cli (ir:l to 0 Per L.S. 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and $ 2- 15- q $ '5 1 'J 5 AC Paving Replacement. —Hs,-Wa'kJ `T�.c.�iy i�� all�•� Per EA. 6 3 E.A. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ Op $Soo Poles are City Furnished). @ Z oU t r"VLrC 11 Per EA. 7 6 L.F. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works $�� Construction (A.P.W.A.) Standard Plan 606-2. @ �2 xri 1�r raPl Q..iU-,- Per L.F. 8 100 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ OO $ Q 207. Sidewalk Locations as Determined by the City.< \ t Per S.F. r Total Amount Bid in Figures: $ a 3 a-'13 Total Amount Bid in Words: $ ® lie 1 r =r-A C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. Contractor is to pick up the materials at the City Yard, 17371Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375-5015. 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. Portion o Work Name and Address of Subcontractor State License Number Class bdd 3 ®�► �'��i t� (� 3 C- r'S®S? L.olu e. a 1 �c, APh A 0(om C.- r L) g� QC IN cln 2 o 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 State of California ss. County of Orange Qn o LY'% e- CGhrtabeing first duly sworn, deposes and says that he or she is of I- 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. �e6W""S Name Bidder Signature of Bidder d f: � cA C?160 Address of Bidder Subscribed and sworn to before me this \© day of 30 20 OV. cauow cocrPrw Nobu Pub000 le La ORANGE COUNTY -' Comm. Jen 30, 2011 NOTARY PUBLI g1 c,0 C44rLA-0� PJr1 <.NOTARY SEAL C-4 CERTIFICATE OF ACKNOWLEDGMENT State of California County of (Q) we On (5�— 10 -i before me, clau tia oAt%m, ,fl 1PLM 11>011'r , (Here insert name and title of the officer) personally appeared t®nnf a who proved to me on the basis of satisfactory evidence to be the person*whose name I arm -subscribed to the within instrument and acknowledged to me thatkkey executed the same in Is authorized capacity(i , and that by&her-/"r signature(,} on the instrument the person(( -or the entity upon behalf of which the person(b -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. Signature of Notary Public OCLAUDIA CocF+RAN COMM. #1722119 m Notary PubtloCalibmia y ORANGE COUNTY '• A4y Comm. Exp. Jan 30, 201 t (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage 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. In 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 autborf_ed capacity of the signer). Please check the documuent 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 /are ) 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 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 Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: q-10-08 v/I, Cont for 60cj a By Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes (ONO 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: 9-10- 0 Contractor By rre Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Ai W--k- 6 0 &"�-+r0C'LcS Contractor f- C L ra By PcJ, � Title Date: q —I 6- Note: This form is required for every Dig Alert Identfcation Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: N. Bidder Name �16L 6AQpaa dr. 14(b , Cal 'qd,(.0g9 Business Address �16 Y? City, State Zip M Telephone Number 3(a-? c)%0 l/ State Contractor's License No. and Class l�- as - Original Date Issued a 5 -1 v al Expiration Date The work site was inspected by 0-&,-J (��ta- of our office on / J6 , 206�? The following are persons, firms, and corporations having a principal interest in this proposal: eotj#, e— l".,j C-9 Z'he undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. r-3 Com Name I �-A a Signature of Bidder Jl Jl e- C-6cfte-qvl Printed or Typed Signature Subscribed and sworn to before me this AO day of 200p . CLAUm COC w • COMM. #1722119 m M Notary Pubilo C fomla LA W ORANGE COUNTY '' Comm. E . Jan 30 2011 NOTARY PUBLIC cca- COC4*4.,31 n» AA,`0 PL) f3LiC 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: I. Name and Address oMublic Agency Name and Telephone No. of Project Manager: i2.L (J Vermoorc— Contract Amount r a C?1 rwN� Type of Work ow � Date 49 2. (a 1 u� 11100 Mof-whlk 15LV-Q; A-M-leIk, CA qb(P 1 Name and Address of Public Agency Name and Telephone No. of Project Manager: - IPdNr� � c C o 'dej �t:) (.L') q2-q - 5 711 lot 000 r.Jrre. 0.-, r roiP 2 - 08 Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: dris P+ fSee-A i —1, o6y Lg. t' 20PA&i0F " Contract Amount Type of Work Date Completed C-10 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Q On <:R, —LQ —OP before me, Glulu od 1t2 I > �p �1i�f (Here insert name and title of the officer) personally appeared u0nuir X�. &(4= who proved to me on the basis of satisfactory evidence to be the person(O-whose name(&me-subscribed to the within instrument and acknowledged to me that MwAhey executed the same inLfft3hef4heir authorized capacity(, and that b�he- ke* signature(oon the instrument the person(*�,-or the entity upon behalf of which the person(Wacted, 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. .A.*.� WITNESS nnd an �� 1 s Signature of Notary Public CLAUow COCHRAN ;!7 f COMM. #1722119 m No Public-Calliomis LA ORANGE COUNT My Comm, Exp, Jan 30, 2011 (Notary Seal) ADDITIONAL OPTIONAL, INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage 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. In 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 authori=ed 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. lie/she/theme- is /are ) 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. h Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. d* Indicate title or type of attached document, number of pages and date. +3 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 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 13 5 * Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: CA)C_kra PJ Contact Phone: Signed:„ Date: C( — 10 - 0 7 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C t . (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS KHCH ARE APART OF THIS PROPOSAL) The EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION .. 11 proposed subcontractor S�r% Di ICI , , hereby certifies that he has has notparticipated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering'agency,.or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1,7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the .Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 11.. Type of Federal Action: Ka. contact b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: FAI—a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity V1Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11. 12. 14. 3. Report Type: FAT. initial b. material change For Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known - 7. Federal Program NameMescription: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission ea. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) iZnece) 15. Continuation Sheet(s) attached: YesEl No El 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 U.S.C. print Name: f/M/I tSc -4'"1 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: %��f to a civil penalty of not less than S 10,000 and not more than `� / rt �,2 r^ /� S100,000 for each such failure. Telephone No.: 4Z J late Q -®P Authorized for Local Reproduction Federal Use Only: Standard Form - LLL StanCard corm LLL Kev. 09-IZ-97 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment: Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IF$) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G s 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 Rcv.06-04-90,(ENDIFn Page 12-89 LPP O1-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Gain Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1243 September 2, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Mesa View Middle School) CC1243 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. ThZo o acknowledge receipt and review of Addendum Number One a d Septemb 008. 14d Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. NORTH AMERICAN SPECIALTY INSURANCE COMPANY BOND NO.: GOLST-048 KNOW ALL MEN BY THESE PRESENTS: That we, GOLDEN STATE CONSTRUCTORS, (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 SCHOOLS CYCLE IV AT MESA VIEW MIDDLE SCHOOL JOB/BID NO. 1243, 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 9TH day of SEPTEMBER, 2008. G0LDEX9TAM CON 57 ER,UCT0RS NORTH AMERICAN SPECIALTY INSURANCE COMPANY BY: �. MA-1 THEW R. DOBYNS, ATTORNE -IN-F CT 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 Arizona and having its principal office in the City.of Itasca, Illinois, each does hereby make, constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-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: TWENTY-FIVE MILLION ($25,000,000.00) 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 24'h of March, 2000: "RESOLVED, that any two of the President, any Executive 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." .`mpuuutnprrr ,,,aatu,,,.:,,. y GO¢POq,IT.G 1 —._ rCJGPy'S _ BV l�n 1 SEAI- c m _ Steven P. Anderson, President & Chief Executive Officer of Washington International lasuraoceCompany & cs p ea W4� is%s tu: q } Vice President of North American Specialty Insurance Company " yy S li Il 1. ? p q 1. '/',b� JI 11111N��,�i 'a�'o>'�vt.'a'c✓y. . _ 'dam-`"„"._", � 10� Ev David NI. Layman, Vice President of Washington 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 this 16th day of June 2008 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Du Page SS: On this 16th day of June , 20 08 , before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and 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. "OFFICIAL SEW DONNA D. SKL.EAIS Notary Public, State of IDinois My Commission RKpires 101060011 Donna D. Sklens, Notary Public I, James A. Carpenter , 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 Arraerican Specialty Insurance Company and Washington International Insurance Company, which is still it, full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 9th day of September 20 08 . James A. Carpenter, Vice President & Assistant Secretary of Washington International Insurance Company & North American Specialty insurance Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of CALIFORNIA County of ORANGE v On14before me, Erika Guido, NOTARY PUBLIC061 , ()�,( personally appeared MATTHEW R. DOBYNS ® 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. ERIKA GUIDO I certify under PENALTY OF PERJURY under the laws of the State of COdU M. # 1576135 � California that the foregoing paragraph is true and correct. Flou.conn. ayW pUBW CAUFMI ► ORANGE COUNTY 13 nay s, 2aoe WITNESS my hand and official seal. 4 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 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of ©iL• = C3 On before me, c t,� k9 C%c C-WL*� ('tl 8 Ld L , (Here insert name and title of the officer) personally appeared C _-_�A-D , who proved to me on the basis of satisfactory evidence to be the person(cTwhose name/are subscribed to the within instrument and acknowledged to me thatSshekher executed the same in ii)Awkh& authorized capacityCKsj; and that by OherAheirsignatureKon the instrument the person(sf, or the entity upon behalf of which the person(sfacted, 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. CLAUDIA COCHRAN COMM. #1722119 m Notary Pubk-CaNlomia WITNESS my h o 1 401hy°RAN°ECOUNTY Comm. Exp. Jan 30, 2011 Signature of Notary Public (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT 3 &�� (Title or description of atilached document) (Title or description of attached document continued) Number of Pages Document DateA-0- 92 (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2008 Version CAPA 02.10.07 800-873-9865 www.NotaryClasses.com 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. In 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 earefudlyfor 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/shekhe}L is /are ) 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. 46 Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. o'+ Indicate title or type of attached document, number of pages and date. dr 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 City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92.648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK April 3, 2009 Steiny and Company, Inc. 12907 East Garvey Ave. P. O. Box 8100 Baldwin Park, CA 91706-0993 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, 4vwj Joan L. Flynn, CMC City Clerk J F: pe Enclosure Sister Citi6�yol o� giclgWWrf;tWg r& New Zealand ( Telephone: 714-536-5227 ) WID C, i . .. .�r c� City Clerk Second Floor 2000 Main Street Huntington Beach, California 92648 SAFE ROUTES TO SCHOOL, CYCLE IV C.C. No. 1243 Bid Time: 2:30 P.M. Bid Date: Thursday September 11, 2008 SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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, findsblcjd LV n bWJDi the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature 9 Z o.V C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 -.lYa+.6 �' 1 j� `V� _.vYx...:. �•/" 1 L.S. '1CYiicY x 0i'Fiy�,.W'k '� ��£E+Tw.3 t-fs'.5.d 'rY%+ Mobilization. &K Pf 51E"::._.I i A ._.ro.. NAM L 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. @ $ p aoo — $ 10I BOO.— Per L.S. 4 1 L.S. Modify Traffic Signal at Edwards Street and Slater Avenue. $ (9-6rLl $ Of �1 39.' @ r Per L.S. 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and $ H i 10D. " $ 361 1 AC Paving Replacement. @ Per EA. 6 3 E.A. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ 9q 0 $ 2 & n Poles are City Furnished). @ Per EA. 7 6 L.F. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works $ 2-m $ i Ecm ,'-' Construction (A.P.W.A.) Standard Plan 606-2. @ Per L.F. 8 100 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ 1 O - 207. Sidewalk Locations as Determined by the City. @ l J1 Per S.F. 2 q Total Amount Bid in Figures: $ Tota Amount Bid in Words: $ V ✓�Q u J6ei 5e&-an ;V`e. 4NI on ok 'N"rejQ,, A'M i rLL of v I tw5 c-n ct zero C.¢r,4s , C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. Contractor is to pick up the materials at the City Yard, 17371Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375-5015. 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. Portion of Work Name and Address of Subcontractor State License Number Class �--L48/ -- was �n cpaa �-1- D.C. 4,' CA 3q95 C- 32 1( � �A z2 U� By submission of this proposal, the Bidder certifies: L 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 State of California ss. County of Orange Richard Tesoriero , being first duly sworn, deposes and says that he or she is dace President of STEINY AND COMPANY, INC the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. SHAWN R. BRADFIELD Commission # 1738049 :.� Notary Public - California Z Z% Riverside County '- My Comm. Expires May 9, 2011 STEINY AND COMPANY, INC. Name of Bidder Signature ,op, fcagl#CAND COMPANY, INIC, . 12907 East Garvey Avenue P.O.13ox 8100 Baldydn Park, CA 91706-mri.l Address of Bidder Subscribed and swornto before methiA-6K day of' 20 A . NOTARY PUBLIC NOTARY SEAL C-4 1KNIA UJE K'll'lJHUA'1'E Q_iI ' AUKiN V W LL+'lUtrME1N I State of California County of Los Angeles ss. On September 10, 2008 before me, Shawn R. Bradfield, Notary Public Date Name and Title of Officer (e.g. "Jane Doe, Notary Public") personally appeared Richard Tesoriero , Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(4) whose name(s) is/afe subscribed to the within instrument and acknowledged to me that he/she4hey executed the same in his/hen4he4 authorized capacity(•ies), and that by hiss 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. 1 .. �L _ �. 1 SHAWN R. BRADFIELD Commission # 1738049 :..�; Notary Public - California = Riverside County My Comm. Expires May 9, 2011 (Seal) OPTIONAL Though the information below is not required bylaw, 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: Bidder's Information and Certification Document Date: September 10, 2008 Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: Richard Tesoriero ❑ Individual X1 Corporate Officer - Title(s): ❑ Partner(s) - ❑ Limited ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ General Vice President Signer is Representing: STEINY AND COMPANY, INC. None Top of thumb here M:\SHAWN\Notary\Copy of 2008 Notary Forms 1 9/11/2008 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 Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 2 M Contractor Title STEINY AND COMPANY, INC. Mcha, d Tesoftr®, Vice Pras';&'A C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes )'a' 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. Contractor 12 Title STEINY AND COMPANY, INC. C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor 0 Title 1 STEINY AND COMPANY, INC. f ,!ehsrd Tesorjero, Vice -it Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name STStPY AND COMPANY, iNG, 12907 East Garvey Avenue P.O. Roy 8100 Business Address Baldwin Park, CA 91706-0993 City, State Zip (Wla) 33�- Got' Telephone Number State License No.161273 Class A, B, C-7 & C-10 State Contractor's License No. and Class LU l aSCv Original Date Issi; d M at , ZCD9 Expiration Date The work site was inspected by MI k L 444--WU W of our office on 0 , 200 The following are persons, firms, and corporations having a principal interest in this proposal: Chairman J.O. Steiny President Susan Steiny Vim President Richard Tesodero Secretary Gayle C. Kappelman C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Nam Signature of Bidder STEINY AND COMPANY, INC Rle,hard Tesodero, Vice Preeldel Printed or Typed Signature Subscribed and sworn to before me this JMday of , 2001. ,fi SHAWN R. BRADFIELD Commission # 1738049 '< .® Notary Public - California z Z �� • Riverside County ' My Comm. Expires May 9, 2011 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. �) LL [)-#a Cf� Q_& Name and Address of Public Agency 2. 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: Date Completed Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 Owner Project Location Valuation Contact Person Telephone No. Owner Project Location Valuation Contact Person Telephone No. Major construction projects in progress as of this date: City of Santa Monica FY 2005 Street and Park Liqhtinq Proiect (SP1970) $2,089,527.00 Gene Higginbotham (310) 458-8721 Owner Los Angeles County Metropolitan Transportation Authority Project Location Goldline Valuation $44,423,656.00 Contact Person John Yen Telephone No. (323) 980-2504 Owner Project Location Valuation Contact Person Telephone No. Owner Project Location Valuation Contact Person Telephone No. Owner Project Location Valuation Contact Person Telephone No. Construction projects completed as of this date: Countv of Los Angeles Inglewood Avenue, ET AL TSM0010152 $662,222.00 Cliff Craig (626) 458-5100 City of Beverly Hills Phase III Residential Street Lighting Improvements $7,059,977.00 Chris Theisen (310) 285-2504 City of Pasadena Fair Oaks Corridor Transportation (626) 744-4312 More Available upon Request (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or unction with new employees in conj Will hire no� 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: STEINY AND COMPANY, INC Contact Person: Richard Tesoriero Contact Phone: - q Signed: Date: a *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C .% (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS l3'HICHARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION ._ STEINY AND COMPANY, INC' The bidder ,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. Pave 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVTMIES EXHIBIT 12-E Attachment G WKF1,.t I t 1HIJ rVKM IU ULJl -"br J-U00Y1NU AL:11VII LtZiVUKJUANI LV SI U.S.L:. IS2)l 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract ❑ a. bid/offer/application Fla. initial b. grant b. initial award b. material change C. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter_ f. loan insurance date of last report 4. Name and Address ofTteporting Entity FJ Prime , 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 Subawardee, Enter Name and Address of Prime: Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable Award Amount, if known: b. Indi ' uals Performing Services (including address ' different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (c eck all that apply) S actual planned a. retainer b, one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee _ b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: YesEl No El 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 U.S.C. print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than S 100,000 for each such failure. Telephone No.: Date: Federal Use Only: Sundard Form LLL Rev_ 09- Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 March 15, 2001 l 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 ffl$) 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-90-00L" 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the Iobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G a 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 Rcv.06-04-90uENDTF+� Page 12-89 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send continents 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 Rcv.06-04-90aENDffir Page 12-89 LPP O1-04 March 15, 2001 THE AMERICAN INSTITUTE OF ARCHITECTS El AIA Document A310 KNOW ALL MEN BY THESE PRESENTS, that we STEINY AND COMPANY, INC. 12907 E. Garvey Avenue tHere insert full name and address or legal tide of Contractor) Baldwin Park, CA 91706 as Principal, hereinafter called the Principal, and SAFECO INSURANCE COMPANY OF AMERICA SAFECO Plaza (Here insert full name and address or legal title of Surety) Seattle, WA 98185 a corporation duly organized under the laws of the State of WA as Surety, hereinafter called the Surety, are held and firmly bound unto (Here insert full name and address or legal title of Owner) CITY OF HUNTINGTON BEACH 2000 Main Street, Huntington Beach, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of 10% of Amount Ten percent of amount bid. Dollars ($ Bid ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for (Here insert full name, address and description of project) Safe Routes to School, Cycle IV, in the vicinity of Mesa View Middle School CC 1243 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 10th day of September 2008 INC. aQ 111n CLI f ( incipaf) (Seal) (Witness) / T asoriar% Vice PNs; j`� A (Tide) n SAFECO INSURANCE COMPANY OF AMERICA (\ (Surety) (Seat) Rhonda-C. Abel (Witness) GM Jeri po ac`(TitleA A rney-in-Fact AIA DOCUMENT A310 • BID BOND • AIA ® • FEBRUARY 1970 ED • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D. C. 20006 CALIFORNIA CERTIFICATE OF ACKNOWLEDGMENT State of California County of Los Angeles ss. On September 11, 2008 before me, Shawn R. Bradfield, Notary Public Date Name and Title of Officer (e,g. ")ane Doe, Notary Public") personally appeared Richard Tesoriero Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/afe subscribed to the within instrument and acknowledged to me that he/Aw4hey executed the same in his/he4theif authorized capacity(ies), and that by hishen/n�T 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. SHAWN R. BRADFlELD Commission * 1738049 ~ Notary Public -California Riverside County My Corrvn. Expires May 9, 2011 (Seal) OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document: Title or Type of Document: Bid Bond Document Date: September 10, 2008 Number of Pages: Signer(s) Other Than Named Above: Jeri Apodaca, Safeco Insurance Co. of America Capacity(ies) Claimed by Signer Signer's Name: Richard Tesoriero ❑ Individual x❑ Corporate Officer - Title(s): ❑ Partner(s) - ❑ Limited ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ General Vice President Signer is Representing: STEINY AND COMPANY, INC. M:\SHAWN\Notary\Copy of 2008 Notary Forms 1 9/11/2008 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On SEP 10 2008 before me, personally appeared Jeri Apodaca K. Luu, Notary Public (Here insert name and title of the officer) who proved to me on the basis of satisfactory evidence to be the person(j) whose name(a) is/Rw subscribed to the within instrument and acknowledged to me that 1%e(she/1b3xy executed the same in his/her/theix authorized capacityoW, and that by W/her/jWr signature(s) on the instrument the person(i), 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- K. l,U U WITNESS my hand d official seal. S."� Commission # 1778641 Z -� Notary Public - California Z s • Orange County (Notary Seal) Niy Comm. Expires Nov 6, 2011 Signature of Notary Public ADDITIONAL OIPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ® Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage 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. In 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 carefullyfor proper notarial wording and attach this form ifrequired. • 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 /are) 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 POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS: No. 9675 Safeco Insurance Company of America General Insurance Company of America Safeco Plaza Seattle, WA 98185 That SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA, each a Washington corporation, does each hereby appoint *****RHONDA C. ABEL; JERI APODACA; LISA K. CRAIL; LINDA ENRIGHT; JANE KEPNER; NANETTE MARIELLA-MYERS; MIKE PARIDNO; RACHELLE RHEAULT; JAMES A. SCHALLER; Irvine, California*********************************************************************** its true and lawful attorney(s)-in-fact, with full authority to execute on its behalf fidelity and surety bonds or undertakings and other documents of a similar character issued in the course of its business, and to bind the respective company thereby. IN WITNESS WHEREOF, SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA have each executed and attested these presents this 31 st day of March 1 2008 STEPHANIE DALEY-WATSON.SECRETARY TIM MIKOLAJEWSKI. SENIOR VICE-PRESIDENT, SURETY CERTIFICATE Extract from the By -Laws of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attomeys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking," Extract from a Resolution of the Board of Directors of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power-of-attomey appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." t, Stephanie Daley -Watson Secretary of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of these corporations, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation SOP 102008 this day of S-0974/DS 4/05 S EA L tis. STEPHANIE DALEY-WATSON, SECRETARY SafecoO and the Safeco logo are registered trademarks of Safeco Corporation. WEB PDF City ®f Huntington Beach 2000 Main Street o Huntington Beach, CA 92.648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK April 3, 2009 California Engineering & Contracting 16027 Brookhurst St., Ste. G-240 Fountain Valley, CA 92708 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citi�o��j��(�retrgfl�New Zealand (Telephone: 714-536-5227 ) 1008 SEP I I pli 2: 13 cn-f c t 1-I SUBMITTED BY: 42 CALIFORNIA ENGINEERING & CONTRACTING, INC. OFFICIAL BID 16027 Brookhurst St. Suite G # 240 (DO NOT OPEN) Founiain Valley, CA 92708 "OFFICIAL BID" ATE: A OPENING D DELIVERTO: PROJECT NO: Ai4S i& vw:b PROJECT NAME: �t� 0 o in AAL V1'bh1+U Lf M�so, vi-ew �o Back, qd-6o9� ® V��dIQ �chooC- 11 111 r7ii ip!I !!.�11 117111111 r r ,X� YW Y-4M.— X XVI r7y'U" SECTION C PROPOSAL, for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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 "� iaJ�� pe� in the amount of $1 T-, , 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. Received Bidder's Signature ®Date C-2 Project Bid Schedule Safe. Routes to School — Cycle IV (Mesa View Middle School) CC-1243 temp,;#�ahens� 1 1 L.S. *�v' Y "��' �,y ;2,a � Mobilization. @ On,- Y'daous-J F 1 V.- 3�w�i _ $ 1 S Oof - ge 0 $ 1 S-0 o, Jyt A. - Per L.S. 2 1 L.S. Furnish Project Traffic Control. $ \5'001.- $ \S-OOI— Per L.S. 3 1 L.S. Furnish and Install Traffic Striping and Signing. Per L. S. 4 1 L.S. Modify Traffic Signal at Edwards Street and Slater Avenue. $ �' o� Per L.S. 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and $ 26'W $ 5Z, S d0., AC Paving Replacemen .� @ ?wn 7-118v )C;'✓--. Per EA. 6 3 E.A. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ \ S-00 $ A7 ; Gq, Poles are City Furnished). @ c2v e 'Tkujs-J �--�Ve� Per EA. 7 6 L.F. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works Construction (A.P.W.A.) Standard Plan 606-2. $ Per L.F. 8 100 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ 1 C�, _ $ OOO, 207. Sidewalk Locations as Determined by the City. @Per S.F. Total Amount Bid in Figures: $_ _ f° 6 Cq -2-0� ---"' Total Amount Bid in Words: $ O in,e� FbLY C-2.1 Mote: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. Contractor is to pick up the materials at the City Yard, 17371Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375-5015. 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. Portion of Work Name and Address of Subcontractor State License Number Class 14 0 0V11 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 State of California ss. County of Orange fAlfA ��ez h , being first duly sworn, deposes and says that he or she is Y` —S,a f JJ of CA FNy Q)A`a& , I N(- •the parry making the foregoing bid that the bid is not made in the i rest 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, fii ther, 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. Lot Ni6� Fival . wp Iva & roofraC , Inr� Name of Bidder Signature of Bidder �11 6roW-1,,u6f Sk sue: clk awo VnAx l0 'ViWfUc C11 q1_0 Address of Bidder Subscribed and sworn to before me this day of , 2006. TIFFANY VAISANEN 4 NOTA Pu LIC - CALIFOANIA - 2 7Pn` C M! ON # 1669354 wt.. td�.E CCIUNTY M'jNOTARY PUBLIC < , p My 23, 20+a NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: ;�)ep.11 61a �Nqj'NO�NO Y (Oy*(A Contractor By FrP5 rm Title C-s DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes LA 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: 6f p 20 I — C U MA I 0�1�'fU(iN �,Nfi Contractor f ?f �S O Title C-7 (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: All A PA on I►�G . Contractor By Nsdeo Title Date: 6ep . � � , 2061 Dote: This form is required for every Dig Alert Identification Number issued by US A. during the course of the Work Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: ('RUMTNI(A Bidder Name WAD o raoK4U4 I Sint 69a40 Business Address &fthfo VON CA q94 City, I State Zip ( .714 ) ?by- Telephone Number �Ygf91 A , 6-11) State Contractor's License No. and Class 1- zz - A62 Original Date Issued I 3l— -100q Expiration Date The work site was inspected by 668e V 20 6° of our office on , The following are persons, firms, and corporations having a principal interest in this proposal: FLA Ta c F, . PrQsicl C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. C'aLi F rN i a E� in1¢e�i nr chi Company Name Signature of Bidder Printed or laadl Signature Subscribed and sworn to before me this 1� day of , 200 b . NOTARY PUBLIC A H-C'4 M et'V NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. 6ee, atta ctmd . FA 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-10 JURAT State of California County of Orange Subscribed and sworn to (or affirmed) before me Hansa A. Saysani (Notary Public) on this �(_ day of S z-1 20081, by �,�� , proved to me on the basis of satisfactory evidence to be the person(,) who appeared before me. HANSA ARVIND SAVSANI <3; NOTARY PUBLIC • CALIFORNIA -' COMMISSION # 1771634 ORANGE COUNTY My Comm. Exp. Oct. 4, 2041 Signature (Seal) (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: AM(0, kwew,ftfo � Wwfim INU Contact Person:A Contact Phone: Signed: Date: `fir �i , 20A *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 J 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) EQUAL ENYIPLOYMENT OPPORTUNITY CERTIFICATION The bidder r e�C- i .C+�� , proposed subcontractor Ca.\n,� �tr, �' e� , 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. Pave 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTPaTIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 I. Type of Federal Action: ® a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: n1p,a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11. 12. 14. 3. Report Type: Fla. initial b. material change For Material Change Only: year quarter_ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee . b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheets) if necessary) 15. Continuation Sheet(s) attached: YesEl No - 16. Information requested through this form is authorized by Title Z:L 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signa was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. print Name: ��ilCr�— 0,499-A /)�7' 1352. This information will be reported to Congress — semiannually and will be available for public inspection_ Any �� / Q person who fails to file the required disclosure shall be subject Title: y-& to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: Date: 0010q Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Sundard torn LLL Rev. 09-12-97 - Pace 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rcv.06-04-90aENDIF+r Page 12-89 LPP O1-04 March 15, 2001 = 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, Cycle IV — CC 1243 September 2, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Mesa View Middle School) CC1243 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, dated September 2, 2008. Company Name 7 hot o� . Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Project Completed O.L. Development Omer Levin Signal & Street lighting $350,000 2007/08 818-402-0600 Interconnect and Fiber optic LH Engineering Paul Lee Signal Modification $400,000 2007/08 714-758-8035 Brookhurst / 91 freeway 714-758-8036 Interconnect and Fiber optic Caltrans Moussa Elessly Signal Modification $160,000 2008 949-279-8816 interconnect Caltrans Mohamed Elsayed Traffic Signal $115,000 2008 949-279-8806 interconnect 16027 Brookhurst St, Suite G #240, Fountain Valley, CA 92708 Phone (714)708-3544. Fax (714)708-3581. Email caengcont@gmail.com License #88988 ----- �_ x�fWtstminoftr CIVIC CENTER MARGIE L. RICE 8200 WESTMINSTER BOULEVARD MAYOR WESTMINSTER, CALIFORNIA .92683 ANDY QUACH (7 ] 4) 898-33 t 1 MAYOR PRO TEM FRANK G. FRY August 6, 2008 COUNCIL MEMBER KERMIT D. MARSH COUNCIL MEMBER TRI TA Fayek Daaifi COUNCIL MEMBER California Engineering & Contracting, Inc. 16027 Brookhurst Street, Suite G #240 RAMON SILVER Fountain Valley, CA 92708 CITY MANAGER SUBJECT: Traffic Signal Control System, Controller Upgrades, CCTV Camera, Video Detection System, and Fiber Optic Cable — Project No. 55031-063100 Dear Mr. Daaifi: The City of Westminster has reviewed your company's bid proposal dated July 8, 2008 for the subject project. As you are aware, your company was the low bidder with a bid of $698,118.70. The Public Works Department performs an analysis to determine whether the low bidder is a responsible bidder as part of the City's consideration of the bid on all projects to be awarded. The term "responsible bidder" is legally defined as a bidder who has demonstrated the attribute of trustworthiness, as well as quality, fitness, capacity, and experience to satisfactorily perform the public works contract. In conducting our analysis, the Public Works Department found substantial evidence that supports a determination that your company is not a responsible bidder as defined by law. Initially, page GP-14 of the Contractor's Proposal contains the following question: In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of law or a safety regulation? Your company answered "no" to the preceding question. As part of the City's analysis we contacted all of the references your company included in its bid submittal. Six out of the seven references clearly stated that the project manager and/or the primary point of contact for each California Engineering & Contracting' Inc. project was a Mr. Jamal Deaifi. This is significant, since Jamal Deaifi has been debarred from doing work in the County of Los Angeles. Furthermore, we have in our possession evidence which clearly indicates that the person debarred by Los Angeles county is the same person who is now doing business under the name of California Engineering & Contracting, Inc. Thus, your company's response to the abovementioned question is untrue. In addition, our staff reviewed our own contract files related to a previous project performed by Jamal Deaifi for the City of Westminster under the name of Inspection Engineering Construction. Our records indicate that project was performed unsatisfactorily., with poor workmanship and safety issues. Finally, reference checks were made with other public agencies, including the City of Newport Beach and the City of Anaheim. Both cases revealed unsatisfactory work on .projects involving Jamal Deaifi. Based upon the preceding, the Public Works Department intends to reject your bid as submitted July 16, 2008, and to award the contract to the second lowest responsible bidder. i am sending this letter to inform you of the City's intent. If you would like to meet with staff to discuss the decision and provide us with any relevant information, please contact Jake Ngo at (714) 898- 3311, ext. 217, by no later than August 18, 2008. Sincere) Christian L. Bettenhausen, Esq. Assistant City Attorney Cc: R- Silver M. Youssef To: Mayor and City Council From: Marwan Youssef, Public Works Director/City Engineer Thru: Ray Silver, City Manager SUBJECT: Item No. 6.1 of City Council Agenda dated August 27, 2008 Attached please find a copy of the.foliowing: 1) City Attorney letter dated August 6, 2008, to CEC. 2) Muzi & Associates letter dated August 14, 2008, to the City. 3) Muzi & Associates letter dated August 25, 2008, to the City. 4) Five emails showing that Jamal Deaifi was the main contact for CEC projects. 5) CEC letter to the City of Pasadena signed by Jamal Deaifi, and a sign in sheet for a pre -construction meeting. 08/14/2008 16:24 19495539288 MUZI ASSOCIATES PAGE 02/03 LA N'Yb'RS Xerox Centre 1351 Eats F7rn S7rm SUW 72S7 Santa A ita, Chrijarnto 92705-4077 Thane (949) 353-9277 Factintik 049) 533-92R8 August 14, 2009 Sent via Facsimile (71.4)446-1448 and U.S. Mail Christian L. Bettenhausen, Esq. Jones & Mayer ' 3777 N. Harbor Blvd. Fullerton, California 92835 Re: California Engineering & Contraetfng, Inc./City of Westminster Traffic Signal Control System, Controller Upgrades, CCTV Camera, Video Project No. 555031-063100 Dear Mr. Bettenhausen: PIease allow me to introduce myself as counsel for California Engineering & Contracting, Inc. ("CEC"). We are in receipt of your letter, dated August 6, 2008 regarding the above -referenced Project. The purpose of dais letter is to provide an explanation and response to your concerns regarding CEC's bid proposal for the above -referenced Project. We have reviewed the bid, application and conducted an extensive interview with CEC regarding their company personnel, corapany project history and bid applicatiou. First of all, CEC is very well qualified to perform the necessary work to complete their, contract with the City of Westminster, As you can see from their list of project references, CEC is a licensed general engineering contractor who specializes in the exact scope of work the City of. Westminster requires on this Project. They have successfully completed many similar projects for Caltrans, the City of Pasadena and many others. They have never encountered any disputes on prior projects nor have they been engaged in any litigation in their entire company history, Your letter states that certain evidence was discovered that may indicate that a misrepresentation, was made in their bid proposal regarding a Mr. Jamal Daaifi. As stated, we conducted a detailed inquiry into your concerns and our review of this matter has concluded that CEC did not misrepresent their company personnel on their bid application. CIVIC CENTER MARGIE L. RICE 8200 WESTMINSTER BOULEVARD MAYOR WESTMINSTER, CALIFORNIA 92683 ANDY QUACH (7 t 4) 898-33 i t MAYOR PRO TEM FRANK G. FRY August 6, 2008 y COUNCIL MEMBER KERMIT D. MARSH COUNCIL MEMBER TRI TA Fayek Daaifi COUNCIL MEMBER California Engineering & Contracting, Inc. 16027 Brookhurst Street, Suite G #240 RAMON SILVER Fountain Valley, CA 92708 CITY MANAGER SUBJECT: Traffic Signal Control System, Controller Upgrades, CCTV Camera, Video Detection System, and Fiber Optic Cable — Project No, 55031-063100 Dear Mr. Daaifi: The City of Westminster has reviewed your company's bid proposal dated July 8, 2008 for the subject project. As you are aware, your company was the low bidder with a bid of $698,118.70. The Public Works Department performs an analysis to determine whether the low bidder is a responsible bidder as part of the City's consideration of the bid on all projects to be awarded. The term "responsible bidder" is legally defined as a bidder who has demonstrated the attribute of trustworthiness, as well as quality, fitness, capacity, and experience to satisfactorily perform the public works contract. In conducting our analysis, the Public Works Department found substantial evidence that supports a determination that your company is not a responsible bidder as defined by law. Initially, page GP-14 of the Contractor's Proposal contains the following question: In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of law or a safety regulation? Your company answered "no" to the preceding question. As part of the City's analysis we contacted all of the references your company included in its bid submittal. Six out of the seven references clearly stated that the project manager and/or the primary point of contact for each California Engineering & ContractingInc. project was a Mr. Jamal Deaitt. This is significant, To: Mayor and City Council From: Marwan Youssef, Public Works Director/City Engineer ' Thru: Ray Silver, City Manager SUBJECT: Item No. 6.1 of City Council Agenda dated August 27, 2008 Attached please find a copy of the,following: 1) City Attorney letter dated August 6, 2008, to CEC. 2) Muzi & Associates letter dated August 14, 2008, to the City. 3) Muzi & Associates letter dated August 25, 2008, to the City. 4) Five emails showing that Jamal Deaifi was the main contact for CEC projects. 5) GEC letter to the City of Pasadena signed by Jamal Deaiia, and a sign in sheet for a pre -construction meeting. since Jamal Deaifi has been debarred from doing work in the County of Los Angeles. Furthermore, we have in our possession evidence which clearly indicates that the person debarred by Los Angeles county is the same person who is now doing business under the name of California Engineering & Contracting, Inc. Thus, your company's response to the abovementioned question is untrue. In addition, our staff reviewed our own contract fifes related to a previous project performed by Jamal Deaifi for the City of Westminster under the name of Inspection Engineering Construction. Our records indicate that project was performed unsatisfactorily., with poor workmanship and safety issues. Finally, reference checks were made with other public agencies, including the City of Newport Beach and the City of Anaheim. Both cases revealed unsatisfactory work on projects involving Jamal Deaifi. Based upon the preceding, the Public Works Department intends to reject your bid as submitted July 16, 2008, and to award the contract to the second lowest responsible bidder. I am sending this letter to inform you of the City's intent. If you would like to meet with staff to discuss the decision and provide us with any relevant information, please contact Jake Ngo at (714) 898- 3311, ext. 217, by no later than August 18, 2008, Sincerei Christian L. Bettenhausen, Esq. Assistant City Attorney Cc: R- Silver M. Youssef 08/14/2008 16:24 15495539288 MUZI ASSOCIATES PAGE 02/03l MUZI m ASS0%C It,, TES L l WYI~'RS Xd X Cenht 1351 East nfn Area Suite 11S7 Santa A nn, Chrifanda 9270i a017 relephane (949) S53-9177 Fadt;nd d (949) 553-9288 August 14, 2008 Sent via Facsimile (71.4) 446-1448 and U.S. Mail Christian L. Bettenhausen, Esq. Jones & Mayer 3777 N. Harbor Blvd. Fullerton, California 92835 Re: California Engineering & Contracting, Inc./City of Westminster Traffic Signal Control System, Controller Upgrades, CCTV Camera, Video Project No. 55031-063100 Dear Mr, Bettenhausen: Please allow me to introduce myself as counsel for Caizforma, Engineering & Contracting, Inc. C'CEC"). We are in receipt of your letter, dated August 6, 2008 regarding the above -referenced Project. The purpose of this letter is to provide an explanation and response to your concerns regarding CEC's bid proposal for the above -referenced Project. We have reviewed the bid application and conducted an extensive interview with CEC regarding their company personnel, company project history and bid application, First of. all, CEC is very well qualified to perform the necessary work to complete their, contract with the City of Westminster, As you can see from their list of project references, CEC is a licensed general engineering contractor who specializes in the exact scope of work the City of. Westminster requires on this Project. They have successfully completed many similar projects for Caltrans, the City of Pasadena and many others. They have never encountered any disputes on prior projects nor have they been engaged in any litigation in their entire company history. Your Letter states that certain evidence was discovered that may indicate that a misrepresentation was made in their bid proposal regarding a Mr. Jamal Daaifi. As stated, we conducted a detailed inquiry into your concerns and our review of this matter has concluded that CEC did not misrepresent their company personnel on their bid application. County of Los Angeles CONTRACTOR HEARING BOARD 713 KENNETH HAHN HALL OF ADMINISTRATION • LOS ANGELES, CALIFORNIA 90012 June 13, 2006 The Honorable Board of Supervisors County of Los Angeles 383 Kenneth Hahn Hall of Administration 500 West Temple Street Los Angeles, CA 90012 Dear Supervisors: Member Departments: Chief Administrative Office Office of Affirmative Action Compliance Internal Services Department Department of Public Works Alternate Member Departments: Department of Health Services Department of Parks and Recreation Department of Public Social Services DEBARMENT OF JAMAL DEAIFI AND INSPECTION ENGINEERING CONSTRUCTION, INC. (ALL DISTRICTS AFFECTED) (3 VOTES) IT IS RECOMMENDED THAT YOUR BOARD: 1. Adopt the proposed findings, decision, and recommendations of the Contractor Hearing Board to accept the proposed settlement to debar Jamal Deaifi and Inspection Engineering Construction, Inc. from bidding on, being awarded, and/or performing work on any contracts for the County of Los Angeles for a period of 10 years from the date of your Board's approval. 2. Instruct the Executive Officer, Board of Supervisors, to send notice to Jamal Deaifi and Inspection Engineering Construction, Inc., advising of the debarment action taken by your Board. 3. Instruct the Director of Internal Services to enter this determination to debar Jamal Deaifi and Inspection Engineering Construction, Inc. into the Contract Data Base. 4. Instruct the Director of Public Works, or his designee, to execute the voluntary Debarment Agreement on behalf of his Department. PURPOSE/JUSTIFICATION OF RECOMMENDED ACTION The purpose of the recommended debarment action against the contractor, Jamal Deaifi and Inspection Engineering Construction, Inc, is to ensure the County of Los Angeles (County) contracts only with responsible contractors who comply with the terms and conditions of their County contracts, and with any relevant Federal, State, and local laws. Implementation of Strategic Plan Goals The recommended actions are consistent with the County's Vision which supports shared values of integrity, professionalism, and accountability, and envisions the County as the premier organization for those working in the public's interest with a pledge to always work to earn the public trust. SpedW proiectsNvsc\2006\debamienl_Jamal dealli_brd 11r (061306) The Honorable Board of Supervisors June 13, 2006 Page 2 FISCAL IMPACT/FINANCING Not applicable. FACTS AND PROVISIONS/LEGAL REQUIREMENTS The Contractor Non -Responsibility and Debarment Ordinance The Contractor Non -Responsibility and Debarment Ordinance, County Code Chapter 2.202, provides the County with the authority to terminate contracts and debar contractors when the County finds, in its discretion, that the contractor has done any of the following: • Violated a term of a contract with the County or a nonprofit corporation created by the County; • Committed an act or omission which negatively reflects on the contractor's quality, fitness or capacity to perform a contract with the County, any other public entity, or a nonprofit corporation created by the County, or engaged in a pattern or practice which negatively reflects on the same; • Committed an act or omission which indicates a lack of business integrity or business honesty; • Made or submitted a false claim against the County or any other public entity. In considering debarment, the County may consider the seriousness and extent of the contractor's acts, omissions, patterns, or practices and any relevant mitigating factors. Contractor Hearing Board (CHB) Responsibilities County Code Chapter 2.202, the Contractor Non -Responsibility and Debarment Ordinance, established the CHB to provide an independent review of the contracting department's recommendation to debar a contractor. The CHB is chaired by a representative from the Chief Administrative Office (CAO) and includes one representative from the Office of Affirmative Action Compliance (OAAC) and the Departments of Internal Services (ISD) and Public Works (DPW), respectively. The Departments of Health Services (DHS), Parks and Recreation (Parks), and Public Social Services (DPSS) serve as alternate members of the CHB. The CAO is a nonvoting member except in the event the debarment action is initiated by the OAAC, ISD, or DPW. In such instances, the CAO exercises its vote and the CHB member from the department bringing the debarment action must recuse himself/herself from any participation in the hearing. In this particular debarment hearing, the representative from DPW did not sit on the CHB because of a potential conflict of interest arising from DPW's prior contractual relationship with Jamal Deaifi and Inspection Engineering Construction, Inc. Therefore, the CAO representative voted. On March 15, 2006, DPW requested the CAO to convene the CHB to recommend to your Board that Jamal Deaifi and Inspection Engineering Construction, Inc. be voluntarily debarred for a period of 10 years for the commission of an act or omission which negatively reflects on the contractor's quality, fitness, or capacity to perform a contract with the County and the commission of an act or offense which indicated a lack of business integrity or business special projectsvosd2006taebarmeni-jamal dealll_brd Itr (061306) The Honorable Board of Supervisors June 13, 2006 Page 3 honesty; and submission of false claims against the County. These acts were discovered when a felony complaint was filed against Jamal Deaifi by the District Attorney for one count of Forgery, two counts of Commercial Burglary, and another count for Attempting to File a False or Forged Instrument. Mr. Deaifi subsequently plead no contest to Penal Code Section 470(D): forgery. On February 23, 2006, DPW sent a certified letter to Jamal Deaifi notifying him of the Department's intent to initiate debarment proceedings against him and Inspection Engineering Construction, Inc. at a hearing scheduled for April 12, 2006 at 1:30 p.m., in the Kenneth Hahn Hall of Administration, Assessment Appeals Board Room B-28, Room E (Attachment 1). In lieu of undergoing the formal debarment proceedings before the CHB and subsequent public hearing by your Board, Mr. Deaifi was given the opportunity to sign a voluntary Debarment Agreement (Attachment II), to voluntary debar him and Inspection Engineering Construction, Inc. for a period of 10 years from the date of your Board's approval. Per his signature on the proposed agreement, Jamal Deaifi has accepted the terms of this voluntary Debarment Agreement upon approval by your Board. Jamal Deaifi and his attorney, Daniel D. White, were provided notices of the proposed debarment action and hearing before the CHB. The hearing concluded on April 12, 2006, at which time the CHB voted to recommend volunteer contractor debarment for the period of 10 years. The proceedings were recorded and an audiotape is available upon request, as well as all documents entered into the record as exhibits during the hearing. ■ Attachment III is a listing of the exhibits that were entered into the record. • Attachment IV is a listing of CHB members and the participating attorney. SUMMARY OF EVIDENCE AND ARGUMENT On behalf of DPW, County Counsel submitted a legal brief outlining the following: This matter developed out of a contract between DPW and Jamal Deaifi as owner of Inspection Engineering Construction, Inc. for Prairie Avenue traffic synchronization, in project I.D. No. RDC0013300. Jamal Deaifi's conduct in securing payment from DPW resulted in a felony complaint being filed by the District Attorney for one count of Forgery, two counts of Commercial Burglary, and another county for Attempting to File a False or Forged Instrument. Mr. Deaifi subsequently plead no contest to Penal Code Section 470(D): forgery. • ProTech Engineering, a subcontractor working on the Prairie Avenue project, filed a stop notice with DPW because Jamal Deaifi had failed to pay ProTech Engineering as contracted. • Thereafter, Jamal Deaifi forged ProTech Engineering's owner Mike Niknafs' signature, and also forged notary public Rosemary Standley's signature and her notary seal. • Jamal Deaifi presented the forged release document to DPW to release his subcontractor, ProTech Engineering's first stop notice. special proje tsVrisc12006)debarmem_,jamal dsaifl_4ro lir (061306) The Honorable Board of Supervisors June 13, 2006 Page 4 ® As a result of the submission, Mr. Deaifi personally received a payment of $31,335.85 from DPW to which he was not entitled. • ProTech Engineering filed a send stop notice after learning of the forged release of stop notice. ProTech Engineering was eventually paid. • On December 7, 2004, Jamal Deaifi and Inspection Engineering Construction, Inc. submitted a low bid on a County Public Works project, the Marina del Rey Bicycle Path, Project RDC0013732. • On December 29, 2004, Jamal Deaifi pled no contest to one count of Forgery, a felony. • On December 30, 2004, DPW recommended that your Board find Mr. Deaifi not responsible on the Marina del Rey Project. FINDINGS AND RECOMMENDED DECISION After considering the evidence presented by the DPW and County Counsel, the CHB found that: • Jamal Deaifi and Inspection Engineering Construction, Inc. committed an act or omission which negatively reflects on the contractor's quality, fitness, or capacity to perform a contract with the County by utilizing a forged document to improperly receive payment from DPW to which it was not entitled. • Jamal Deaifi and Inspection Engineering Construction, Inc. committed acts or omissions which indicated a lack of business integrity or business honesty by defrauding the County, failing to pay a subcontractor, and then committing additional acts to cover up its initial dishonest actions. The 2005 amendment to the County's Non -Responsibility and Debarment Ordinance (Title 2, chapter 2.202 of the County code), allowing for longer periods of debarment (including permanent debarment), was not in effect at the time the criminal act was committed by Jamal Deaifi and Inspection Engineering Construction, Inc. in this matter and it is uncertain whether the provisions would apply if a contested hearing was held. CHB deliberations focused on the fact that the voluntary debarment allowed the County to avoid this uncertainty and be assured that this contractor would not be able to contract with the County for a very significant period of time — 10 years — and that by listing this contractor on the County's list of debarred vendors, the wider community would have notice of and access to information on the nature of his actions as well. The aggravating factors committed by Jamal Deaifi and Inspection Engineering Construction, Inc. in this matter, such as the actual or potential harm or impact that resulted from the wrongdoing, the intentional nature of the acts, and the failure to disclose the acts to the County in a timely manner justified the period of voluntary debarment agreed upon by DPW and the vendor. special proieCtsvdsc}2D061debamiantJamal deaifi_brd hr (061306) The Honorable Board of Supervisors June 13, 2006 Page 5 Therefore, by majority vote, the CHB decided to recommend that your Board accept the proposed settlement and that Jamal Deaifi and Inspection Engineering Construction, Inc. be voluntarily debarred for a period of 10 years. In making this recommendation, the CHB considered the blatant criminal act committed by Jamal Deaifi and Inspection Engineering Construction, Inc. which negatively reflected on the contractor's quality, fitness or capacity to perform a contract with the County and which indicated a lack of business integrity or business honesty. IMPACT ON CURRENT PROJECTS Not applicable. CONCLUSION The Contractor Non -Responsibility and Debarment process is working as your Board intended to help assure that the County contracts only with responsible contractors who comply with all relevant laws, as well as the terms and conditions of their contracts. The process has also identified potential areas for County contracting program improvements to promote a better understanding of contracting requirements. Respectfully submitted, MARTIN K. ZIMMER AN Chair, Contractor ` ea ing Board Assistant Administr e Officer, Chief Administrative Office MKZ:VLA:ib Attachments (4) c: David E. Janssen, Chief Administrative Officer Dennis A. Tafoya, Affirmative Action Compliance Officer J. Tyler McCauley, Auditor -Controller Raymond G. Fortner, Jr., County Counsel Dave Lambertson, Director of Internal Services Donald L. Wolfe, Director of Public Works Jamal Deaifi, President/Owner, Inspection Engineering Construction, Inc. Daniel D. White, Attorney for Jamal Deaifi special projects'Msc\2006Webarrrent-jamal de0i brd Itr (061306) ATTACHMENT 1 DONALD L. NVOLFE, Director CV UNTY OF LOS ANGELv S DEPARTNIENT OF PUBLIC WORKS "To Enrich lives Through Effective and Caring Service' 900 SOUTH FREMONT AVENUE ALHAMDRA, CALIFORNIA 91803-1331 Tckphonc:(626)458.5100 www_ladpw.org SENT VIA FACSIMILE TO (949) 660-8930 ORIGINAL SENT CERTIFIED U.S. MAIL February 23, 2006 Mr. Jamal F. Deaifi Inspection Engineering Construction, Inc. 2973 Harbor Boulevard, No. 516 Costa Mesa, CA 92626 Dear Mr. Deaifi: DEBARMENT AGREEMENT ADDRESS ALL CORRESPONDENCE TO: P.0.13OX 1460 ALHAMDRA, CALIFORNIA 91802-1460 IN REPLY PLEASE REFER TO FILE_ C- .} 1 The County of Los Angeles Department of Public Works intends to initiate debarment proceedings against you and Inspection Engineering Construction, Inc. (collectively DEAIFI). A formal debarment may result in your firm being permanently barred from bidding on any contract with the County and its subsidiaries. PUBLIC_ WORKS INTENDS TO SEEK PERMANENT DEBARMENT IN THIS PROCEEDING. You are hereby notified that the Debarment Hearing with the Contractor's Hearing Board will be held on: DATE: Wednesday, April 12, 2006 TIME: 1:30 to 5 p.m. LOCATION: Kenneth Hahn Hall of Administration Room TBA 500 West Temple Street Los Angeles, CA 90012 Our action is based on your conduct in the Prairie Avenue traffic signal synchronization work, Project ID No. RDC0013300, which resulted in a felony complaint being filed against you by the District Attorney for Forgery and Burglary, among other things. We confirmed that you plead guilty to Penal Code Section 470(D): forgery. While we are aware that the subcontractor who had filed the stop notice was ultimately paid, we are Mr. Jamal F. Deaift February 23, 2006 Page 2 also aware that you authored a letter for the subcontractor to sign and submitted it to the District Attorney in seeking leniency. However, those additional facts do not mitigate your act of submitting a falsified document to the County for payment of funds to which you were not entitled. That act was a violation of Section 2.202.040 of the Los Angeles County Code. The County Code is available online at the County website www.lacounty.info. If you would prefer to avoid the formal debarment hearing and potential subsequent debarment during a public hearing by the Board of Supervisors, you may sign the enclosed proposed Debarment Agreement voluntarily debarring DEAIFI as set forth in the Agreement. If you opt to participate in a formal debarment hearing, which is your right, a full debarment proceeding will consist of all the acts that violated the terms of the contract, which indicate a lack of business integrity and business. For example, DEAIFI's submission of inflated prices to the County, failure to pay the City of Inglewood for use of their property, and failure to clean up Inglewood's lot, among other things. At the Contractor Hearing Board hearing, you are entitled to appear and/or be represented by an attorney or other authorized representative to present evidence against a finding of debarment. At the hearing, your representative may offer documentary evidence, present witnesses, and offer rebuttal evidence as authorized by the County Code. After the debarment hearing, the Contractor Hearing Board will prepare a proposed decision. This decision will contain a recommendation to the County of Los Angeles Board of Supervisors as to whether or not DEAIFI should be debarred and, if so, the appropriate length of time for debarment. The Board of Supervisors may, in its discretion, limit any further hearing to the presentation of evidence not previously presented. The Board of Supervisors has the right to modify, deny, or adopt the Contractor Hearing Board's proposed decision and recommendation. Any debarment finding shall become final upon the approval of the Board of Supervisors. You must confirm with Ms. Jolene Guerrero of Public Works in writing whether you and/or your representative intend to be present at the hearing. Your response must be sent by United States Mail and/or via facsimile to the above -identified address and be received no later than 5 p.m. on March 9, 2006. Failure to confirm the hearing date or otherwise respond may result in waiving all rights to a hearing before the Contractor Hearing Board. Mr. Jamal F. Deaifi February 23, 2006 Page 3 If you choose to contest the proposed debarment, the County will provide you with a list of prospective witnesses and copies of all documentary evidence at least five days prior to the scheduled hearing. If you intend to present evidence against the proposed debarment, you must provide Public Works with a list of prospective witnesses and copies of any documentary evidence at least five working days prior to the hearing. Each party must also provide the Contractor Hearing Board five copies of each item they provided in the exchange. The deadline for exchange of the list and documents is April 5, 2006. Conversely, if you choose voluntary debarment, please review the enclosed Debarment Agreement. If it meets your satisfaction, please sign it, and have your signature notarized by a notary public and return to our office within ten days of your receipt of this notice. Please be advised that Public Works' offer to DEAIFI for a voluntary debarment expires on March 9, 2006, at 5 p.m. If the original signed Debarment Agreement has not been received by Ms. Guerrero, or her designee, by that date and time, Public Works will proceed with the full debarment proceeding. If you have any questions, please contact our attorney, Mr. Michael L. Moore, Deputy County Counsel, at (213) 974-0807. Very truly yours, DONALD L. WOLFE Director of Public Works THOMAS W. HOAGLAND Assistant Deputy Director Construction Division JFG:er O;\projects\Froerams - Road%TratficTrairieAve (RQC0013300)\Board%debarmenl letter-DOC Enc. cc: County Counsel (Michael L. Moore) Chief Administrative Office (Contractor Hearing Board - Vincent Amerson) ATTAC13MENT 11 JAMAL DEAIFI INSPECTION ENGINEERING CONSTRUCTION DEBARMENT AGREEMENT The parties to this DEBARMENT AGREEMENT (hereinafter referred to as "AGREEMENT") are (hereinafter referred to as "COUNTY") and JAMAL ENGINEERING CONSTRUCTION, INC., a Sole collectively referred to as "DEAIFI"). RECITALS dated LOS ANGELES COUNTY, DEAIFI, and INSPECTION Proprietorship (hereinafter A. The parties entered into a contract (hereinafter referred to as "CONTRACT") on October 7, 2002, for the Prairie Avenue traffic light synchronization project under Project ID No. RDC0013300 (hereinafter referred to as "PROJECT"). This project was accepted by the Board of Supervisors on December 16, 2003. B_ In order to obtain funds legally being held by the COUNTY to honor a valid stop notice, DEAIFI submitted a forged Release of Stop Notice. DEAIFI was charged with several criminal counts and pled no contest to one count of Felony Forgery pursuant to Penal Code section 470(d), which has the same legal effect as a guilty plea. C. The COUNTY contends that the DEAIFI'S admitted criminal activity is an "act .. . which indicated a lack of business integrity or business honesty" in accordance with the County of Los Angeles Procedures for Determinations of Contractor Non -Responsibility and Contractor Debarment. The COUNTY intends to pursue formal debarment of DEAIFI, which could result in a permanent debarment as provided by Los Angeles County Code, Title 2, section 2.202.010, et. seq. NOW, THEREFORE, in order to protect the citizens of Los Angeles County, to save both parties the expense of formal debarment proceedings, and from DEAIFI'S perspective, prevent a potential permanent debarment, the parties agree to a voluntary debarment of JAMAL DEAIFI and INSPECTION ENGINEERING CONSTRUCTION INC., from bidding, seeking, obtaining, or performing on any contract, as defined by Title 2, section 2.202.020(B) of the County Code, with the County of Los Angeles, and any public entities for which the board of supervisors is the governing body, and any joint powers authorities of which the County of Los Angeles is a member that have adopted county contracting procedures as set forth in Title 2, section 2.202.020(E) of the County Code. As a compromise and settlement between these parties for the acts of dishonesty on the part of DEAIFI, as stated in the recitals above, these parties hereby agree, waive and release as follows: 1. JAMAL DEAIFI, acting individually or as an owner, partner, officer or employee of any company, including but not limited to INSPECTION ENGINEERING CONSTRUCTION, INC., and INSPECTION ENGINEERING CONSTRUCTION, INC., individually, and pursuant to the definition of Contractor as provided by Title 2 of the County Code, agrees not to bid, seek, obtain, or perform on any contract with COUNTY OF LOS ANGELES, as defined by Title 2 of the County Code, for 10 years from the date of this AGREEMENT. 2. Upon mutual signing this AGREEMENT, COUNTY OF LOS ANGELES agrees that it will not seek permanent debarment against JAMAL DEAFI and/or INSPECTION ENGINEERING CONSTRUCTION, INC., based on any recital set forth above or facts or circumstances relating to the CONTRACT or PROJECT. The COUNTY OF LOS ANGELES further agrees not to file an action for False Claims in this matter; except that the COUNTY reserves its contractual rights for indemnification by DEAIFI in the event of a third party claim, wherein the County's defense may involve a cross claim against JAMAL DEAIFI and/or INSPECTION ENGINEERING CONSTRUCTION, INC., for false claims or otherwise. 3. JAMAL DEAIFI acting individually or as an owner, partner, officer or employee of any company, including but not limited to INSPECTION ENGINEERING CONSTRUCTION, INC., and INSPECTION ENGINEERING CONSTRUCTION, INC., individually, its officers, employees and agents, hereby agrees to forever relieve, release and discharge the COUNTY OF LOS ANGELES, and their respective officers, agents, and employees, from any and all claims, debts, liabilities, demands, obligations, promises, acts, agreements, costs, interest, expenses (including but not limited to experts' and attorneys' fees), damages, actions and causes of action, of whatsoever kind or nature, whether known or unknown, suspected or unsuspected, present or potential, foreseen or unforeseen, based on, arising out of, or in any way connected with CONTRACT and PROJECT and/or with any of the recitals set forth above. 4. The foregoing release is intended to extend to all potential claims that may arise of the CONTRACT and PROJECT, and/or the recitals set forth above, known or unknown, suspected or unsuspected, and JAMAL DEAIFI acting individually or as an owner, partner, officer or employee of any company, including but not limited to INSPECTION ENGINEERING CONSTRUCTION, INC., and INSPECTION ENGINEERING CONSTRUCTION, INC., individually, its officers, employees and agents, expressly waive all rights that it/they may have under California Civil Code Section 1542, which provides as follows: "A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor." 3450131 5. This AGREEMENT is binding upon and inures to the benefit of the parties hereto and their respective successors, assigns, and legal representatives. JAMAL DEAIFI and INSPECTION ENGINEERING CONSTRUCTION, INC., individually and collectively, represent and warrant that they have not heretofore assigned or transferred any claim, demand, liability, or cause of action which is the subject of this AGREEMENT. 6. Each party hereto represents and warrants that it is authorized to enter into this AGREEMENT. 7. Each party hereto acknowledges that this AGREEMENT effects the settlement of claims, which have been or may be made, and are denied and contested, and nothing herein is intended to constitute an admission of liability to any party hereto. 8. Each party hereto acknowledges having read this AGREEMENT and fully understood its provisions, and that no other representation or promise has been made to induce said party to enter into this AGREEMENT. g. This AGREEMENT embodies the entire agreement and understanding between the parties hereto relating to the subject matter contained herein and supersedes all prior agreements and understandings between them with respect thereto. There are no agreements, representations, warranties, or statements, whether oral or in writing, with respect to the subject matter of this AGREEMENT, except as expressly set forth herein. 10. This AGREEMENT maybe amended or modified only by a writing signed by the party against whom enforcement is sought. 11. This AGREEMENT may be executed in counterparts, all of which taken together shall constitute one agreement binding on all the parties hereto. 12. This AGREEMENT is made and entered into in the State of California and shall be interpreted and enforced under the laws of the State of California. Whenever possible, each provision of this AGREEMENT shall be interpreted in such a manner as to be effective and valid under applicable law, but if any provision of this AGREEMENT shall be prohibited or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, without invalidating the remainder of such provision or the remaining provisions of this AGREEMENT. 3450131 3 DANIEL D. WHITE 949 729 9174 03/24 '06 11.38 N0.583 03/03 DATED: 3/3 , 2006 By JAMAL DEA(Fl An Individual, DATED: 310 .2006 DATED: APPROVED AS TO FORM: !11 JAMAL F. DEAIFI INSPECTION ENGINEERING CONSTRUCTION, INC. Tie y!ad LOS ANGELES COUNTY, DEPARTMENT OF PUBLIC WORKS 2006 By Deputy Director of Public Works DATED: 2006 JFG: 3450131 4 LOS ANGELES COUNTY, OFFICE OF THE COUNTY COUNSEL By Deputy_ County Counsel DATED: �Z DATED: 2006 By DATED: , 2006 By APPROVED AS TO FORM: DATED: 3-1(- a(, 2006 JFG: 345013_1 4 JAMAL DEAIFI An Individual, JAMAL F. DEAIFI INSPECTION ENGINEERING CONSTRUCTION, INC. Title LOS ANGELES COUNTY, DEPARTMENT OF PUBLIC WORKS Deputy Director of Public Works LOS ANGELES COUNTY, OFF�FE!\ OF THE COUNTY COUNSEL By Deputy County Counsel ATTACHMENT III EXHIBITS ENTERED INTO THE RECORD OF THE DEBARMENT HEARING OF JAMAL DEAIFI AND INSPECTION ENGINEERING CONSTRUCTION, INC. County of Los Angeles. Department of Public Works: Hearing Brief, prepared by Michael L. Moore, Deputy County Counsel, consisting of: 12 Exhibits, including Proposed Debarment Agreement, Public Works' letter dated 2/23/06; Jamal Deaifi letter dated 3/8/06; Contract No. RDC0013300; Criminal Complaint case No. GA057929; Pro Tech Engineering 1st Stop notice dated 3/20/03; Pro Engineering letter 8/13/03; Forged release documents dated 4/17/03 and 4/18/03; Los Angeles County check number G7836875 dated 4/28/03; Pro Tech Engineering 2nd Stop Notice dated 8/13/03; Los Angeles Superior Court Docket, Case Number GA057929; and Board of Supervisors' letter dared 12/30/04. DPW debarment_ ATTACHMENT III ATTACHMENT IV PARTICIPANTS IN THE CONTRACTOR HEARING BOARD DEPARTMENT PROCEEDINGS FOR JAMAL DEAIFI AND INSPECTION ENGINEERING CONSTRUCTION, INC. APRIL72, 2006 1:30 P.M. KENNETH HAHN HALL OF ADMINISTRATION ASSESSMENT APPEALS BOARD ROOM B -28, ROOM E 500 WEST TEMPLE STREET Los ANGELES, CA 90012 CONTRACTOR HEARING BOARD MARTIN ZIMMERMAN, CHAIR, ASSISTANT ADMINISTRATIVE OFFICER, CHIEF ADMINISTRATIVE OFFICE OZIE L. SMITH, SENIOR DEPUTY COMPLIANCE OFFICER, OFFICE OF AFFIRMATIVE ACTION COMPLIANCE KATHY HANKS, DIVISION MANAGER, INTERNAL SERVICES NANCY TAKADE, LEGAL ADVISOR TO THE CHB, SENIOR DEPUTY COUNTY COUNSEL VINCENT AMERSON, -CAO, STAFF TO THE CHB PUBLIC WORKS DEPARTMENT JOLENE GUERRERO, CIVIL ENGINEER, PUBLIC WORKS DEPARTMENT OFFICE OF THE COUNTY COUNSEL MICHAEL L. MOORE, COUNSEL FOR PUBLIC WORKS, DEPUTY COUNTY COUNSEL DPW debarment ATTACHMENT IV Los Angeles County Page 1 of 1 Enter a search term Vendor Name: ARROWHEAD EMANUF'AI ION F'RU(3KAM Alias: Debarment Start Date: 7/8/2008 Debarment End Date: Permanently Debarred Principal Owners and/or Affiliates: Irma F. Reed And Charlene Williams Vendor Name: G COAST CONSTRUCTION INC. Alias: Debarment Start Date: 9/11/2007 Debarment End Date: 9/10/2012 Principal Owners and/or Affiliates: Ezra Levi Vendor Name: INSPECTION ENGINEERING CONSTR Alias: Inspection Engineering Construction Debarment Start Date: 6/13/2006 Debarment End Date: 6/12/2016 Principal Owners and/or Affiliates: Jamal Deaifi http://lacounty.info/doing_business/debarmentList.htm 9/11/2008 vmw INSCO INSURANCE SERVICES, INC. ins��® Underwriting Manager for: �pO�p Developers Surety and Indemnity Company Indemnity Company of California 17780 Fitch, Suite 200 • Irvine, California 92614 • (949) 263-3300 Bond No.: 11-428-075 KNOW ALL MEN BY THESE PRESENTS, that we California Engineering & Contracting Inc as Principal, and Developers Surety and Indemnity Company a corporation duly organized'under the laws of the State of Iowa as Surety, are held and firmly bound unto City Of Hunington Beach as Obligee, in the Sum of Twenty Thousand Dollars ($20,000.00) for payment of which sum well and truly to be made, Principal and 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 Cycle IV @ Mesa View Middle School 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 11th day of September 520 08 PRINCIPAL: SURETY: California Engineering & Contracting Inc Developers S e and Indemnity Company Blake faster, Attorney -in -Fact ID-1118 (REV. 1/01) CONFORMS TO AIA DOCUMENT A310 2/70 ED. CALIFORNIA i..f ALL-PURPOSE ,Pi rPO- ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On September ?s, Date 2008beforeme, Lianne Nahina, Notary Public Here Insert Name and Title of the Officer personally appeared Blake A. Pfister a toLIANNE NAHINA Commission # 1767633 '< -m Notary Public - California • Orange County MyComm. Exlaires Sep 14, 2011 Name(s) who proved to me on the basis of satisfactory evidence to be the personf) whose name) is/A& subscribed to the within instrument and acknowledged to me that he/alvollokley executed the same in his/ authorized capacity(Aft), and that by his/ signature(#) on the instrument the personp), 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 a doff icial seal. Signatur Place Notary Seal Above Sign re of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond No. 11-428-075 Document Date: September 11, 2008 Signer(s) Other Than Named Above: None Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual Blake A. Pfister ❑ Corporate Officer —Title (s): ❑ Partner— ❑ Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Developers Surety an Indemnity Company 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: 1 920,07 National Notary Association • 9350 De Soto Ave., P.O. Sox 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org item #5907 Reorder: Cali Toll -Free 1-800-876-6827 POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263-3300 Attached to Bid Bond No. 11-428-075 KNOW ALL MEN BY THESE PRESENTS, that as except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each, hereby make, constitute and appoint: ***Blake A. Pfister*** as their true and lawful Attorney(s)-in-Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of surety- ship giving and granting unto said Attomey(s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s)-in-Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 2008. RESOLVED, that the chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of Attorney, qualifying the attorney(s) named in the Powers of Attorney to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship; and that the Secretary or anyAssistant Secretary of the corporations be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney; RESOLVED, FURTHER, that the signatures of such officers 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 shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severalty caused these presents to be signed by their respective Vice President and attested by their respective Assistant Secretary this January 1st, 2008 By: siitsisuyl rss . j ARID f'v©+'a Stephen T. Pate, Senior Vice President ' yJQ �ttPOJQq� �; , "°." t7GT'� O�FAN% G gP0 r'C. w10 By' z°d a I V 3.6. c �, y► to 1887 Charles L. Day, Assistant Secretary 4rowix fir. v o State of California County of Orange On January 1st, 2008 before me, Christopher J. Roach, Notary Public Date Here Insert Name and Title of the Officer personall;, appeared Stephen T. Pate and Charles L. Da Name(s) of Signer(s) Place Notary Seal Above 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 Alai seal. Signature-•'�� Ch er J. Roach CERTIFICATE The undersigned, as Assistant Secretary, of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, the 11 ta4of S ep t eImbe r , 2008 By: Albert Hill brand, Assistant ecretary ID-1 380(Wet)(Rev.07/07) City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 Elite Bobcat Service, Inc. 1320 E. Sixth, Ste. 100 Corona, CA 92879 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, JF:pe Enclosure Sister Citi§�.go600/,cl Wr%tWgijr&,New Zealand ( Telephone: 714-536-5227) INC. ELITE BOBCAT SERVICE GENERAL ENGINEERING 1320 E. SIXTH, SUITE 100 • CORONA, CA 92879 Tel: (951) 279-6869 • FAX: (951) 279-6832 City of Huntington Beach City Clerk 2000 Fain St Huntington Beach, CA 92646 SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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 Bidder's Bond in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bi - er's Si nature 1 09/08/2008 C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 igp'P. At'F' '#a e ie 7i!T'll' :x.�m� ISO --l" s d�,.4M. f�� ..... I I L.S. Mo, b�,lization. � 44 Per L.S. 2 3 1 L.S. I L.S. Furnish Project Traffic Control. @4 M %2Ad A -, $ 000 Per L.S. Furnish and Install Traffic Striping and Signing. Mn .4 Boo Per L.S. 4 1 L.S. Modify Traffic Signal at Edwards Street and t.;c }3 Slater Avenue. Teo --t7 $ 7 4 c.�4.FI,�.g� $ btA Per L.S. Ffup �+worn�Mn+ 5 21 E.A. Construct Curb Ramp per Caltrans Sta dard Plan No. A88A, Including Adjacent Gutter Plate and AC Paving Replac ment. @_� A $ yQOag-- 60 $ Bi000— y 0 Per EA. IL 6 3 E.A. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA Poles are City Furnished). o $ 1 5AD $ Soo Per EA. 7 6 L.F. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works Construction (A.P.W.A.) Standard Plan 606-2. $ z3i $ Per L.F. 8 100 S.F. Existing Sidewalk and Construct llaneous Sidewalk per City Standard Plan $ 35 $ 35CO idewalk Locations as Determined by the FReve F. Total Amount Bid in Figures: Total Amount Bid in Words: $ � U- i w o uyv�jZm� e. Nn w C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. 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) 375-5015. 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. Portion of Work Name and Address of Subcontractor State License Number Class S-1 ?I.)() OQArJG� ��c .�i¢'rP�,JI. �JC 2>46095 m �;�� i a• e o.6v ld,, P; C /6 / 0 7 3 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOI.,I.,USION AFFIDAVIT TO BE EXECUTED BY BIDDEN AND SUBMITTED WITH DID State of California ss. County of Orange Joseph Nanci , being first duly sworn, deposes and says that he or she is President of Elite Bobcat Service, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged 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. Elite Bobcat Service, Inc. Name of Bidder Signature ofi0tidder Joseph Nanci, President 1320 E 6th St #100, Corona, CA 92879 Address of Bidder Subscribed and sworn to before me this day of , 20 _ . NOTARY PUBLIC C-4 NOTARY SEAL UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: 09/08/2008 C-5 Elite Bobcat Service, Inc. Contractor By J seph Nanci President Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ® Yes M No If the answer is yes, explain the circumstances in the space provided. 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: 09/08/2008 C-7 Elite Bobcat Service, Inc. Contractor By Joseph Nanci, President Title UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Elite Bobcat Service, Inc. Bidder Name 1320 E 6th St #100 Business Address Corona city, � 951 ) 279-6869 Telephone Number 720016A State Contractor's License No. and Class 03/1994 Original Date Issued 03/31/2010 Expiration Date CA 92879 State Zip The work site was inspected by Joe Nanci of our office on September s , 20 os The following are persons, firms, and corporations having a principal interest in this proposal: Joseph Nanci, President C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Elite Bobcat Service, Inc. Company Name Signature of Bidd Joseph Nanci Printed or Typed Signature Subscribed and sworn to before me this _ day of , 200_. . NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. City of Vernon 4305 Santa Fe Ave, Vernon, CA 90058 Name and Address of Public Agency Name and Telephone No. of Project Manager: Vince Rodriguez (323) 855-2292 $289,000 Contract Amount Concrete Improvements 07/2008 Type of Work Date Completed 2. City of Temecula 43200 Business Park Dr, Temecula, CA 92590 Name and Address of Public Agency Name and Telephone No. of Project Manager: Jon Salazar (951) 694-6444 $2 296 618 _ _ Concrete & Asphalt 03/2008 Contract Amount Type of Work Date Completed 3. City of Anaheim Name and Address of Public Agency 200 S. Anaheim Blvd, Anaheim, CA 92805 Name and Telephone No. of Project Manager: Carl Heimberger (714) 765-5176 $775 890 Street Improvements 03/2008 Contract Amount Type of Work Date Completed C-10 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Elite Bobcat Service, Inc. Contact Person: Joseph Nanci Contact Phone: (9SI) 279-6 9 Signed: ' Cate: Septe er 8, 2008 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C f (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMTLOYMENT OPPORTUNITY CERTIFICATION . Elite Bobcat Service, Inc The bidder 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.S. (Generally only contracts or subcontracts of V 0,000 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. J Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTNTTIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. ❑ pe of Federal Action: a. con t 2. Status of Federal Action: Fla. bid/offedapplication 3. Report Type: l b. grant b. initial award rial c ge C. cooperative cement C. post -award d loan al Change Only: ZPrime: e. loan guarantee quarter_ f loan insurance f last report _4. Name and Address of Repo 'ng Entity 5. If Reporting is Subawarde,,Enter NarnePrime: El Prime Subatz Tier, if known Congressional District, if known 6. Federal Department/Agency: 8_ Federal Action Number, if known: 10. a. Name and Address oj2obby Entity (If individual, last Udmc, first name, MI) Congressional District, if known - 7. Federal Program Name/Descriptioh: , CFDA Number, if applicable 9. and Amount; if known: b. Individua Performing Services (including address if di rent from No. 10a) (last name, firs name, MI) (attach Continuation Sheet(s) if necessary) 11. Amou of Payment (check all that apply) 13. Type of Payment (chec all that apply) 5 � actual planned a. retainer b. one-time fee 12. orm of Payment (check all that apply): C. commission 8 a. cash d contingent fee b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including ofiicer(s), employee(s), or member(s) contacted, for Payment Indicated in Item I I: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: YesEl No El 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 U.S.C. Print Name: Joseph Nane i 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any president person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than 510,000 and not more than S 100.000 for each such failure. Telephone No.: (951) 279-6869 Date: 09/08/08 l Federal Use Only: / Sundard Fonn LLL Rey. 09-12.97 LPP 01-04 Authorized for Local Reproduction Standard Form - LLL Page 12-87 March 15, 200I 1 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVIT ES 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. 9. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev, 06-04AOuENDIF,. Page 12-89 LPP 01-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1243 September 2, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Mesa View Middle School) CC1243 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, dated September 2, 2008. Elite Bobcat Service, Inc. Company Name By September 8, 2008 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. Bond No-_---08739262. ----------------- NIL Fidelity and Deposit. Company POST OFFICE BOX 1227 OF MARYLAND KNOW ALL MEAT BY TUESE PRESENTS: Inc. That we, -- -------- -- Elite ---------- Bobcat Service------ - BAL77MORE, MD 21203 , as Principal, (hereinafter called the "Principal"), and .the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, P.O- Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto__ City of Huntington Beach —------ —_-__ ----____as Obligee, (hereinafter called the "Obligee"), ten percent of amount bid 10% in the sum of_ - - -- --------- for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for _—S a f e Routes to School, Cycle IV, in the vicinity of Mesa View Middle School Project No. 1243 NOW, THEREFORE, if the Obligee shall accept the bidof 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. 08 Signed and sealed this---____-- 8th day of ----September— ------------------------- A_D.,2fl __ Witness C325f--30K 7.92 Conforms a Anxricsll 1nstim of Amhif,= 130cawcx A-310. - Fcb ry 1970 Edition. Elite Bobcat Service, Inc. (SEAL) ...... ---- ----- — — - ..._--- — -- --- - -- - Principal Witness � BY: `' ------- -------``------------------------ • �OS�h \V�'��\ Title FIDELITY AND DEPOSIT COMPANY OF MARYLAND — Surety----- By-- --- -- -.-(SEAL) A EY-IN_FACT Title Richard A. Coon CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On 9 / 8 / 08 before me, Lexie Sherwood Notary Public Date Here Insert Name and Title of the Officer personally appeared Richard A. Coon Name(s) of Signer(s) LEXIE CHE WR OOD v COW,s. #1593951 0 " NOTARY PL-3UC *CALIFORNIA ORANGE COUNTY 0 Comm. Exp. JULY 27, 2009 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. 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 fficial sea Signature Place Notary Seal Above Signature y Pu is OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s):_ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 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: © 2007 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary, in pursuance of authority granted by Article Vl, Section 2, of the By -Laws of said Company, are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date h e�Os by nominate, constitute and appoint Richard A. COON, Charles L. FLAKE, David L. CULB n '94e OOD, all of Anaheim, California, EACH its true and lawful agent and ma a p d deliver, for, and on its behalf as surety, and as its act and deed: any anal -a 4 n xecution of such bonds or undertakings in pursuance of these presen 1�, in arty, as fully and amply, to all intents and purposes, as if they had been d VP t �acicn Q h gularly elected officers of the Company at its office in Baltimore, Md., iet s attorney revokes that issued on behalf of Richard A. COON, P Charles L. FLAKE, C a ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005. The said Assistant ° e e eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By-L s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Sea] of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of November, A.D. 2006. ATTEST: �p DUO, r � n o State of Maryland ss: City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary By: William J. Mills Vice President On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn Notary Public My Commission Expires: July 14, 2011 POA-F 012-4150H State of California County of St On efore me, ,��_ �2� , a notary public, personally appeared \_cs� Nv�`� ,who proved to me on the basis of satisfactory evidence to be the personK whose name�"i af-g subscribed to the within instrument and acknowledged to me t toe executed the same in is authorized capacity(j*, and that by is signatureN on the instrument the personN, or the entity upon behalf of which the personN acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my hand Vd o facial seal. 1-0-00 'A c� 1Go�J�%A Signature (Se ,0°,ICI 4� Z R, Vt- C F". a ice.T) 2008 SEP I I PM 2: 28 CITY I I fil T .) �,N G7 SEALED BID.for: Safe 'Rouges to School, Cycle IV. In the vicinity of Mesa View Middle School CC No 1243 The.City of Huntington Beach office of the City Clerk Second, Floor, 2000 Main St. Huntington, I Beach, CA 92648 SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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. Z7� 000. o'C Accompanying this proposal of bid, find Cert . Checkin the amount of $z; , hich 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 Wddg#Ts Sin ure 1. 9/2/08 C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 � _'"4A..."� •5 Ttern} 1 £ � t€,r,r .+u't „PM �sedI1�'ilett 1 L.S. ,a4 ,.sT -., c"S` �, T.r ;e'" ti X e J` AC,y^ q3`i �� Mobilization. @ , "Cite."" `I'�.a'tiSovvdl PN PM ',* .�r Y ;a"' %%%�� $ ,y" :.. a.`�`wt. u"e. ` 1^4` S ' $ LI�2w, oo Per L.S. 2 1 L.S. Furnish Project Tra ntrol. @ S_ $ 71%0 $ -71 0. &0 1QM 1w1 Per L.S. 3 1 L.S. Furnish and Install Traffic Stri ing and Signing. @ �-%d'4� +kDs= e,ay. $ IS1000.80 $ I Z)OD. 00 Per L.S. 4 1 L.S. Modify Traffic Signal at Edwards Street and Slater Avenues. A"� T @ v W e--I'1^.a ws any ai $ g O_ $ �� 000, 00 �a J" Per L.S. 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and $ o,0a $ 1001$0 D• 0d AC Paving Replacement. @� ' W¢nn Per EA. 6 3 E.A. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ KZo• 0d $ 4, Z(o O-N Poles are City Furnished). �n,nnal�f�Q.p�-iti�.1Pr11�-N •.QNeM Per EA. 7 6 L.F, Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works $ 7 3 0 •O0 $ 'I Construction (A.P.W.pA.) Standard Plan 606-2. @ SQ.++aM (NyyMC C" Jjki r" AAJC4A Per L.F. 8 100 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ j'%. OD $ 1 700• co 207. Sidewalk Locations as Determined by the City. Per S.F. Total Amount Bid in Figures: $ CCO- 00 Total Amount Bid in Words: $ C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. Contractor is to pick up the materials at the City Yard, 17371Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375-5015. 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. Portion of Work Name and Address of Subcontractor State License Number Class StY1�i (�G.S-t-r� a LPc 06W G-.�Z s, nil Los S 1 Cis SA'"' D� CA qS g'1'7 4 C _ 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 O- O OAFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Thomas Jessop , being first duly sworn, deposes and says that he or she is Secretary of Pacif is Coast Inf rastructhe 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. PacifiC Coast Infrastructure, Inc. Name of Bidder Si nature of Ifidder 22343 La Palma Ave. Ste. 114 Yorba Linda, CA 92887 Address of Bidder Subscribed and sworn to before me this l day of , 20 . KIM DACUE fl Commission �# 1532739 q rtu4�F+f",^ Z Notary Public - California z �E _ Orange County \° 3` My Comm. Expires Dec 9, 2008 NOTARY PUBLIC NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COiJNCIL CITY OF HUNI'INGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: 9/11 /08 Pacific Coast Infrastructure, Inc. Contractor By Secretary Title C-5 In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ® Yes X No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 9/11 /08 Pacific Coast Infrastructure, I Contractor Secretary Title C-7 4 UNDERGROUND ND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Pacific Coast Infrastructure, inc Contractor By Secretary Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: Pacific Coast Infrastructure, Inc. Bidder Name 22343 La Palma Avenue, Suite 114 Business Address YOrba Linda, CA 92887 City, State Zip ( 71 4 ) 970-7822 Telephone Number 915351, Class A - General Engineering State Contractor's License No. and Class 5/8/08 Original Date Issued 5/31 /1 0 Expiration Date The work site was inspected by Tom Martinez of our office on Sept. 9 5 2008 The following are persons, firms, and corporations having a principal interest in this proposal: Pacific Coast Infrastructure, Inc. and itsprincipals:_ Criiag Westmann and Thomas Jessop V-U' y C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Pacific Coast Infrastructure, Inc. Company Name Signature of Thomas Jessop Printed or Typed Signature Subscribed and sworn to before me this 11 day of September, 2008 , 800Z '6 ae(3 s9a1dx3 'uawo:) AN A4unoo a5mo w = z Is)auaoJito:) - oalgnd Ago;oN 6£LZ£5l uoissivawoa 3nova wig 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: 2. 3. Please see attached statemmnt of qualifications and resumes/ Name and Address of Public Agency references Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): X Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or X Will hire no new employees in conjunction, with this project. x Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: pacific Coast Infrastructure, Inc. Contact Person: Craig Westmann Contact Phone: (71 4) 970-7 22 Signed: 0 2(=_� Date: 9/11 /08 *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 disgualif cation. C-11 J Local Assistance Procedures Manual PS&E Checklist Instructions (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSI SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF TIIIS PROPOSAL) EQUAL EMTLOYMENT OPPORTUNITY CERTIFICATION .. . The bidder Pacific Coast Infrastructure, Inc , propc subcontractor TBD — will be furnished , hereby certifies that he h 12-E .nt C has not x , 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 administeringagency, 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. Pave 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACT=IES UUMPLETL IkUS 11UKM W U1b —Mt LU13dY INU I. Type of Federal Action: n/ a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action P y bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity �X Prime El Subawardee Tier , if known acific Coast infrastructure, 2343 La RR1ma Ave. Ste 114 orba Linda !2A 9�887 Congressional District, t own 6. Federal Department/Agency: n/a 8. Federal Action Number, if known: n/a EXHIBIT 12-E Attachment G 5 PUKSUAN I lu 31 U.S.U, 13-1)G 3. Report Type: F/Ja a. initial b. material change For Material Change Only: year quarter_ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Inc. Congressional District, if known - 7. Federal Program Name/Description: n/a CFDA Number, if applicable 9. Award Amount, if known: n/a 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. I Oa) (last name, first name, MI) n/a n/a (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Thomas J sop 1352_ This information will be reported to Congress Print Name: semiannually and will be available for public inspection. Any Secretary person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than $10,000 and not more than 71 4 - 9 7 0 - 7 8 2 2 9/11 S100,000 for each such failure. Telephone No.: Date-,-,~ Federal Use Only: Forth LLL Rev_ 09-12-97 Authorized for Local Reproduction Standard Form - LLL Pave 12-87 LPP 01-04 March 15, 2001 l 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. I. 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 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 0 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 Rcv.06-04-90uENDIF» Page 12-89 LPP O1-04 March 15, 2001 STATEMENT OF TECHNICAL ABILITY AND EXPERIENCE Safe Routes to School, Cycle IV, Mesa View Middle School, CC No. 1243 Pacific Coast Infrastructure (PCI) is a startup company specializing in heavy civil construction. As such, the company has no similar projects to reference. However, the principals of PCI have extensive experience in mass grading projects, highway projects, water works projects, and other assorted infrastructure related construction projects. We have included the work histories of our superintendent for this project (Tom Martinez), our project engineer (Fred Susoeff), and our president (Craig Westmann) for your use and information. Each work history provides projects and experience information for these key personnel that will be involved with the construction of the Safe Routes to School. We are also pleased to inform you that PCI is signatory to the Operating Engineers union, the Carpenters union, the Laborers union, and the Cement Masons union. These memberships will ensure that your project will not only have quality project management, but also that our craft personnel will be of the highest caliber. At this time none of the personnel at PCI are involved in litigation of any kind. Furthermore, our company has not had any litigation or disputes of any kind. We have provided a list of references for your use, and we encourage you to contact them or us with any questions you may have regarding our company. PCI also has approximately one million dollars in working capital. Statements can be provided to demonstrate our financial capability to complete this project. PCI is fully insured and bonded at this time, and we have confirmed complete compliance from our providers with your contract documents. Thus there should not be any difficulties with insurance certifications or performance/payment bonds once a contract is awarded. In the event that PCI is the low bidder on September 11 `", then we would encourage you to meet with us as soon as possible thereafter to discuss our plan to construct your project. We will gladly show the City of Huntington Beach our means, methods, and resources planned for the construction of this project. We are looking forward to doing business with the City of Huntington Beach. Sincerely, Pacific Coast frastructure Thomas Jessop Vice President Page 1 of 2 PACIFIC COAST INFRASTRUCTURE 22343 La Palma Ave, Suite 114 Bob Schneider Area Manager, C.C. Myers Inc. 1822 South Lewis Street Anaheim, CA. 85302 (714) 412-3882 (cell) Brad Spies President, SEMA Construction 7353 S Eagle Street Centennial, CO 80112 (303) 638-8207 (cell) Bruce Mimes President, Western Waterworks, Inc. 5831 Pine Avenue Chino Hills, CA. 91709 (909)597-7000 Ashok Dhingra Vice President, Metcalf & Eddy 999 Town & Country Road Orange, CA. 92868 (909) 224-3160 Matt Tice Vice President, Century Reinforcing Steel 10840 Norwalk Blvd. Santa Fe Springs, CA. 90670 (714)692-7082 Ivan Benavidez Senior Project Manager, TCM Group 8676 Wheeler Avenue Fontana, CA. 92336 Cell: (909) 203-3589 Yorba Linda, CA. 92887 Phone (714) 970-7822 Fax (714) 970-7899 License No. 915351 ►.. ptlpl Page 2 of 2 4 .0 EXPERIENCE PROFILE Craig Westmann is the President of Pacific Coast Infrastructure. He has over 20 years of experience in the construction industry. Craig has worked across California and held positions as Project Manager, Project Engineer, Estimator, and Area Manager. His expertise lies in the areas of heavy civil construction including DOT work, local highways and bridges, and reservoirs. Education: B.S., Engineering/Construction Mgmt 1992 California State University - Long Beach Years of Experience: 20 years While at SEMA, Craig was involved in project management, claims resolution, business development, and engineering roles for heavy civil construction. He managed SEMA's general operations and coordinated between the office and field. Craig directed the support of the office with the field to assure projects met schedules, were properly manned, and subcontractors were performing work. He also aided in new project bidding and job set-up. Craig was also instrumental in claims resolution for SEMA. Craig's project resume includes numerous projects with both project management and supervisory roles, with his more notable projects listed as follows: • Coldwater Reservoir, City of Beverly Hills, CA — $22 million • Hillcrest Park 5 MG Prestressed Reservoir, Fullerton, CA - $7.6 million • Secondary Effluent & Recycled Water Storage Tanks, Escondido, CA - $6.3 million • Santa Anita Reservoir No. 4 for City of Arcadia, Sierra Madre, CA - $5.3 million • Highway 60 Moreno Valley, Riverside County, CA - $24 million • St. Joseph Rerservoir #1, Arcadia, CA - $3 million • Two-8 MG Reservoirs and Pump Station, Westminster, CA - $7.7 million • Overcrossing for Route 30, La Verne, CA - $11 million • New Main Street Bridge Overcrossing, San Jacinto, CA - $5 million • Crown Valley Parkway at Ladera Ranch, CA - $4 million • Imperial Highway Grade Separation, Los Angeles, CA - $11 million • Pier J Grade Separation, Port of Long Beach, CA - $10 million • Widening of Route 110 at Rosecrans, Los Angeles, CA - $18 million • Route 241 in South Orange County #F5, Orange County, CA - $12 million • Route 241 in South Orange Conty #F9, Orange County, CA - $20.5 million • Widening of 1-5 at Main Street, Orange County, CA - $38 million • Widening of Route 110 from 37th Street to 181h Street, Los Angeles, CA - $17 million RELEVANT EXPERIENCE SEMA Construction, Inc. As Area Manager, Craig was responsible for managing the general operations of the California Division. He also coordinated between the office and the field. Pacific Hydrotech As an Estimator / Project Manager, Craig was responsible for providing project supervision, CPM scheduling, change order negotiations and processing, cost control, dispute resolution, and technical assistance for other project supervisors, as well as assisting the estimating team. MCM Construction Craig was the Project Manager on several highway projects for this firm. He provided project supervision, cost control, and technical assistance for supervisors in the field. CC Myers As the Chief Engineer for Southern California, Craig was responsible for project management on several multi -million dollar projects in Southern California. Pacific Coast Infrastructure, Inc. 22343 La Palma Ave, Suite 114 Yorba Linda, CA. 92887 IN, 4 , K Torn Martinez General Superintendent Experience Profile Tom Martinez is a General Superintendent with proven success in project building. His experience spans more than 17 years beginning in 1991. Primarily working in Southern California, he has held positions as General Superintendent, Project Superintendent, General Foreman, and Project Foreman. Tom's multi faceted carrier in heavy civil construction has included, international airports, military airports, regional highway interchanges, bridges, underground, general roadwork and street improvements. In performing the aforementioned duties, Tom has coordinated material resources and jobsite logistics. That coordination involves procurement of site specific materials, proper employment and set up of equipment, and the management of manpower involving various trades. This experienced leadership provides essential elements to scheduling subcontractors, inspection and partnering with government agencies at the local, state and federal level. Tom also manages the liaison the corporate office and the field offices. A list of his most notable projects is as follows: * Ontario Airport 26R / 8L Rehabilitation, Ontario, Ca - $49.5 Million * Long Beach Airport 12R / 30L Rehabilitation, Long Beach, Ca - $39.8 Million * Jackson Street Bridge, Riverside, Ca - $8 Million * Warner Street Rehabilitation, Costa Mesa, Ca - $2.8 Million * Whittier Narrows Dam, Pico Rivera, Ca - $2.5 Million * Crown Valley Parkway, Ladera Ranch, Ca - $4 Million * 1-5 / 91 Interchange, Fullerton, Ca - $6 Million * 71 Fwy Segments 2 & 3, Chino Hills, Ca - $7.3 Million * 1-5 / 22 / 57 Orange Crush Interchange, Orange, Ca - $4.9 Million * Grand Avenue Realignment Music Center, Los Angeles, Ca - $14.8 Million Relevant Experience Beador Construction As Superintendent, Tom is overseeing two bridge widenings and one on / off ramp widening. He is responsible for the planning and execution of the field operations. Griffith Company As Project Superintendent, Tom was responsible for the scheduling, coordinating of subcontractors, cost control, problem solving and partnering. California Engineering and Grading As General Foreman, Tom supervised multiple operations, multiple crews and multiple shifts. Fred F. Sus®eff III FSUSOEFF@PCINFRASTRUCTURE.COM Education California State Polytechnic University Pomona Bachelor of Science Degree in Construction Engineering Recipient of the Vinnel Foundation Scholarship Relevant Experience June 2008 — Present June 2007 to June 2008 March 2007 to June 2007 September 2006 to March 2007 September 2005 to September 2006 June 2005 to September 2005 November 2004 to June 2005 Construction Projects Senior Project Engineer/Pacific Coast Infrastructure Project Engineer/Field Engineer, SEMA Construction Superintendent, Tilden -Coil Constructors Asst. Superintendent, Tilden -Coil Constructors Project Engineer, Tilden -Coil Constructors Project Intern/Field Engineer, Kiewit Pacific Co. Project Intern, Tilden -Coil Constructors SEMA Construction Chevy Chase Reservoir and Pump Station Replacement — Project/Field Engineer December 2007 to Present Valley Blvd. Grade Separation — Project/Field Engineer June 2007 to December 2007 Responsibilities with SEMA consisted of a working knowledge of the entire project including original estimate comprehension, plan interpretation, project specifications, project cost code knowledge, and the overall construction schedule. Provided technical support for the held operations, including formwork design and the procurement of materials. Tilden -Coil Constructors La Sierra University — Superintendent (Phase 2 and 3) March 2007 to June 2007 The General Contractor of a college university commons. Construction consists of a new chiller, steel canopy structures, and kitchen/cafe. Patricia Beatty Elementary School — Assistant Superintendent September 2006 to March 2007 Construction Manager of a 51,000 square foot wood framed elementary school. The Grove Community Church Worship Center — Project Engineer September 2005 to September 2006 General contractor of a 161,000 square foot church and school facility consisting of four tilt -up buildings and 3 wood framed buildings. The facility is held on a 37 acre site with sport activity accommodations. The site required extensive grading and blasting of 31,000 yards of rock. Kiewit Pacific Co. Joseph Jensen Treatment Plant — Field Engineer June 2005 to September 2005 A $120 million dollar water treatment facility constructed for the Metropolitan Water District. Duties consisted of managing and coordinating piping penetrations in poured in place concrete contactor basins. Estimating small bore yard piping for Robert A. Skinner Treatment Plant. Provide layout drawings and cut sheets of new and existing utilities for field use. City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK April 3, 2009 Damon Construction Co. 8851 Watson Street Cypress, CA 90630 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, J n L. Flynn, CMC City Clerk JF:pe enclosure Sister CitigsfoAow o/AaIRAht/retWoida r&cNew Zealand ( Telephone: 714-536-5227 2808 SEP f i Phi 1: 4 3 ' L HUN' 14i4V I m u:.Nvi'1 W tTK SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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. Q ®W Accompanying this proposal of bid, find 8tncer-%in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's ! nature C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel, (714) 536-5431, Fax (714) 374-1573 Safe Routes to School, IV — CC 1243 SePw"dwz2= Notice To Al BWem. • �r r+ PE, i- - AA bbders must acknw ledge the receipt of this addendum with your bid propowL Show you have any questions regarding this Adderdum, pieaw cal Wdriam F. Janusz at (714) 536-U31. Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 1�a it ,Mee�� +.z::. ?: ' NO nre �' ° en��d k Ot�"'k. 2`.E.. .d:�*1�«s"I i..<R�� _...�v:i•�''�'t�?:.i�:ii, ., 6k x:. i..}:3"� �i�s^kf�^.u�1E"f1}h-�2.`� tl .recv,�+„CA.aa,Ya.Fi.: v��i .r i. � i ��r"�.... 3�' Ss. 1 1 L.S. Mobilization. @ r1g6 T ftOOSA" 0 $ Ott 00 $ ,S Cj00, o Per L.S. 2 1 L.S. Furnish Project Traffic Control. o @FOue 'rmousAob Fibgr $ W; 8tx1 O° $ y, god, 140ULRIED Per L.S. 3 1 L.S. Furnish and Install Traffic Striping and Signing. @ -W E i V E THOOAL) D Okle $j L /• O $ Id.,10 3. Oo uuuo�e,� rHR� Per L.S. 4 1 L.S. Modify Traffic Signal at Edwards Street and Slater Avenue. $8%649,0 $g9, 64 8 @EIGOTY'-M'TNC iHOtsSAUD SIX HUuoRGO FORTY E1Qf+-r Per L.S. 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and $ 6, t aji , °O $ 6, 6At D O AC Paving Replacement. @3=xT1100SAUD STX N�uDRED TWe►.]?Y-00E Per EA. 6 3 E.A. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ I, S5 . 120 b $ 9 6s' o a Poles are City Furnished). @ ON6 TNousAUD STX NUNt)REQ PTy-r't -FrVE Per EA. 7 6 L.F. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works $ SSO. n $ �,, 100. va Construction (A.P.W.A.) Standard Plan 606-2. @'THQey Ovurm2ED F'IFt� Per L.F. 8 100 S.F. Remove Existing Sidewalk and Construct Q a p a Miscellaneous Sidewalk per City Standard Plan $ It $ I C3 207. Sidewalk Locations as Determined by the City. @ ELEVEN.! Per S.F. 00 Total Amount Bid in Figures: $ o'ZS $ %� 7 . Total Amount Bid in Words: $` wo Vkk)o1DRfsA FTFTY EIGW TgowAtj6 St3 VEN HUuDP'G D FSVI-y SC-VtO DOLLA2S C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. 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) 375-5015. 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. Portion of Work Name and Address of Subcontractor State License Number Class - ALS y lI ORAOGG COO JT Y S i R.T Pit 45 C.'T, rz, i r0a 7,2,98 s u-T AVe., BELL RDEAus ao I 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 NONCOI. LUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange tAA-R&oo- Aram i2 3L-L-cp , being first duly sworn, deposes and says that he or she is '} l Lbe*X -- of (Zmtty. C© . 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. l Amni-1 Cr�N�ST Cn. Name of Bidder Signatur o 'cjder�--��,_�� emas I ularsc�a Sr cyPRESS, QA-- oc-�3o Address of Bidder Subscribed and sworn to before me this day of J tm , 20 D% . oo®000es0000000e0000�*e000s00000eoeooeo NOTARY PUBLIC °e oy MARIA MARCELINA A. GODINHO ® COMM. #1550552 �•.�; NOTARY PUBLIC - CALIFORNIA o " ORANGE COUNTY My Comm. Expires Feb, 6, 9009 0 ee000e000aoa0000eeoeae00000eooeeeooeeo NOTARY SEAL C-a 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 Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: 9--11-08 7NOAQ0 QCDIAS7: C-D o Contractor W"I VA M-F WIR I 'I, 14a �Wm %- 11� h�RE51�EhTT— Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? EJ Yes �KNo If the answer is yes, explain the circumstances in the space provided. Nate: 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: 9 —11—©S :b AM<t.1 cj=* S - C� . Contractor �st�E.tST" Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S IloTFORMATION BIDDER certifies that the following information is true and correct: BAN Ic*.) Bidder Name fps 1 W.TSoN ST. Business Address GYM► � CA- 9v4=1aC) City, State Zip (-7N-) 99S-S4-90 Telephone Number aeos g8 � State Contractor's License No. and Class 19 G9 Original Date Issued APRU- SO 00101 CQ Expiration Date The work site was inspected by W lS 4<u of our office on uG&)5'r)-7 200.8 The following are persons, firms, and corporations having a principal interest in this proposal: C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. MAM,=w Company Name Printed or Typed Signature Subscribed and sworn to before me this -L[�day of S44m o MARIA MARCELINA A. GODINHO ® COMM. #1550552 NOTARY PUBLIC - CALIFORNIA o ORANGE COUNTY • My Comm. Expires Feb. 6, 2009 v NOTARY PUBLIC+��►a��a�.�oso+oo®o�oos®oo�s®o®soo NOTARYSEAL 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: FA 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: Date Completed Date Completed Contract Amount Type of Work Date Completed C-10 8851 WATSON STREET • CYPRESS, CA 90630-2243 (714) 995-5490 • FAX (714) 995-5707 PROJECT REFERENCES PUBLIC_ AGENCIES City of Alhambra Frances Moore (626) 570-5090 City of Arcadia Mark Rynkiewicz (626) 256-6552 City of Bell. Carlos Alvarado (626) 960-1889 City of Brea Brian Ingallinera (714) 990-7600 City of Cerritos Mary Ann Wozniak (562) 860-0311 City of Commerce Martha Gomez . (323) 722-4805 City of Costa Mesa Carlos Castellanos (714) 754-5343 City of Cudahy Carlos Alvarado (626) 960-1889 City of Cypress Jim Gorin (714) 229-6748 City of Downey Jim Bautista (562) 904-7117 City of El Segundo Paul Bowen _ (310) 524-2356 City of Hermosa Beach Tristan Malabanan (310) 318-0229 City of Huntington Beach David Verone (714) 375-8471 City of Inglewood Teresa. Kneedler (310) 412-5333 City of Irvine Judy Morse (949) 724-7664 City of Long Beach Sadie Tuaa (562) 570-6537 City of Lynwood Antonio Perez (310) 603-0220 City of Maywood Lissette Calleros (323) 562-5700 City of Montebello Robert King (323) 887-1200 City of Newport Beach Frank Tran (949) 644-3311 City of Orange Alan Truong (714) 744-5568 . City of Pasadena . David Ortega (626) 744-6912 City of Pico Rivera Romeo Ligason (562) 801-4421 City of Santa Ana William Albright (714) 647-5029 City of Santa Monica Monica Diaz (310)458-2205 City of Thousand Oaks Jocelyn Bylsma (805)449-2456 City of Torrance Sue Herbers (310) 781-7532 City of Vernon - Max (323) 583-8811 ex. 221 City of Whittier David Mochizuki (562) 464-3510 City of Yorba Linda Mark Stowell (714) 961-7170 City of Whittier David Mochizuki (562) 464-3510 City of Yorba Linda Mark Stowell . (714) 961-7110 County of Orange Lori Hanson (714) 567-6257 Dept of Parks & Recreation Robert Scholfiel_d (949) 496-1866 L.A. Unified School Dist. Maria Martinez (213) 241-2702 O. C. T. A. Sarah Strader (714) 560-5633 Palos Verdes Peninsula USD Lora Dodell (310) 378-9966 ex.227 PRIVATE FIRMS Amoroso Construction Valerie Frahm (714)433-2326 ARB Structures Debbie Esparza (949) 598-9242 Archstone — Smith CJ Wiemann (949) 4554500 Bernards Bros. Paul Richardson (949) 461-3650 Bomel Construction Elizabeth Marin (714) 279-3224 Robert Castognia Don Perea , (562) 803-3328 CT&F Manny Rosales (562) 927-2339 R.J. Daum Const. Mark Perong (714) 894-4300 Del Amo Construction Roy Northup (310) 378-6203 Dynalectric Therese Jelnick (714) 484-2305 Excel Paving Co. Curt Brown (562) 599-5841 Eastside LRT Const. Al Guerrero (323) 980-2544 J. Fletcher Creamer & Son, Inc. Patty Padilla (818) 367-9748 GCI Construction, Inc. Janet Russell (714) 957-0233 Hathaway Dinwiddie Kip Drabeck (213) 236-0500 Henzel-Phelps Construction Ken Ketchum (949) 852-0111 Imperial Paving Co. Irene Gomez (562) 944-0975 Kemp Bros., Inc. Pegi Early (562) 236-5000 Keiter Corporation Bonch Nagata (323) 266-6302 Laird Construction Terri Duval (909) 989-5595 H. A. Lewis Inc. Herbert Lewis (310) 478-1511 McCarthy James Metoyer (949) 851-8383 Majich Bros. Paul Majich (626) 398-9992 John T. Malloy Inc. Justin Malloy (323) 780-9942 John S. Meek Company Bill Gomory (714) 830-6323 C.C. Myers Tracey Carlson (916) 635-9370 R.J. Noble Co. Jennifer De Iongb (714) 637-1550 W.E. O'Neil Construction Jim Surdyk (310) 643-7900 PCL Construction Services Paulin Cook (213) 614-0481 Peck/Jones Construction Dan Dagert (310) 423-3964 T. T. Polich Associates Donald Kral (714) 835-4612 Powell Constructors Paul Zolezzi (909) 356-8880 Hensel Phelps Construction Clint Squire (714) 938-3300 Premier Stamp Concrete Dominick Ingraffic (909) 965-3362 Mike Prlich & Sons, Inc. Pete Serdarusich (323) 283-7852 Ryco Construction Tycanne Arceri (310) 324-1151 Sema Construction Micaiah Revero (949) 470-0500 Shawnan Corporation Jenifer Soliz (562) 803-9977 J.F. Shea Const. Jack Herrington (909) 595-4397 St. Cornelius Church Ted Brodeur (562) 425-7813 Steiny and Co. Robert Hernandez (626) 338-9923 Swinerton Builder. Kevin Hermreck (949 )622-7000 TG Construction Ed Wright (310) 640-0220 Taisei Corp. Carolyn Carpenter (714) 886-1530 Thomsen Landscape Merle Thomsen (818 )344-0158 Ken Thompson Schalk Opperman (714) 995-1371 Trade Mark Concrete Yelena Westerfield (714) 970-8200 Trammel — Crow Bill Gertsner (310) 229-8919 Valleycrest Landscape Michelle Duran (818) 834-1000 Valverde Construction Chris Valverde (568) 906-1826 Weeger Bros. Inc. Mark Weeger (714) 536-3854 Western Paving Bill Miller (626) 338-7889 Howard S. Wright Construction Linda Madrigal (949) 567-1909 Woodcliff Corporation Omead Tabrizi (818) 784-8444 2 CONTRACT COMPLETION CONTRACTORIAGENCY PROJECT AMOUNT DATE CITY OF ORANGE ROLLING GREEN LANE -QUEENS GATEWAY 68,150.00 01/05 PALOS VERDES PENINSULA USD ASPHALT & CONCRETE REPAIT (PH 1) 260,000.00 02105 AMELCO CO. ADDITIONS TO BELL GARDENS, H.S. 643,000.00 04105 CITY OF LONG BEACH ANNUAL CONTRACT R65-95 4,481,300.00 05/05 CITY OF INGLEWOOD ALLEY CONST. PROG 04-79 277,420.00 07105 KAJIMA BONNIE AVE PARKING STRUCTURE 425,390.00 11/05 LAIRD CONSTRUCTION SIDEWALK RAMPS -RIVERSIDE 128,142.50 11/05 SWINERTON BUILDERS OCTA BUS PARKING STRUCTURE 410,825.00 11/05 WOODCLIFF BELMONT NEW PRIM CTR. 146,433.00 11/05 CITY OF HERMOSA BEACH CONCRETE IMPROVEMENTS 87,920.00 11105 CITY OF WHITTIER CONCRETE IMPROVEMENTS 189,510.00 12/05 KEMP BROS. HUNTINGTON PARK E.S. 05-04 394,000.00 12/05 R.J. NOBLE CO. RESIDENTIAL ST.-FULLERTON 356,479.00 12105 CITY OF PASADENA WASHINGTON POP -OUTS 570,752.50 12105 R.J. DAUM CONST. LA SOUTWEST COLLEGE 256,138.00 12105 EXCEL PAVING SOUTH ST.-ANAHEIM 114,730.00 01/06 TAISEI CONSTRUCTION DEL MAR STATION-PASADENA 153,320.00 01/06 DEL AMO CONSTRUCTION PACIFIC CHARTER-CRENSHAW, L.A. 140,232.00 02/06 CITY OF YORBA LINDA ACCESS RAMP IMPROVEMENTS 115,996.25 02106 CITY OF SANTA ANA OMNIBUS CONCRETE REPLACEMENT 403,835.00 03106 CITY OF MONTEBELLO SAFE ROUTE TO SCHOOL(SR2S) 229,688.00 03/06 CITY OF ALHAMBRA 2005 HUD CONCRETES/W REPAIR PROJECT 148,960.00 03/06 ROBERT CASTOGNIA STREET IMPROVEMENTS-TORRANCE 110,111.50 04/06 BERNARD BROS. SUNRISE ASSISTED LIVING -PLAYA VISTA 62,979.00 05106 CITY OF TORRANCE CURB & GUTTER REPLACEMENT 1,082,441.00 05106 CITY OF LYNWOOD S/W CURB & RAMP IMPROVEMENTS 247,240.00 05/06 BOMEL CONSTRUCTION CAL STATE FULLERTON PKG STRUCTURE II 154,710.00 05106 R.J. DAUM CONST. ORANGE COUNTY JUVY HALL 233,067.50 05/06 DYNALECTRIC (35030) AZUSA AVE. / SAN GABRIEL RD. - COVINA & AZUSA 12,785.00 05/06 CITY OF CUDAHY CURB RAMPS -VARIOUS LOCATIONS 37,600.00 05/06 EXCEL PAVING CO. (4307) NEWPORT SHORES REHAB 322,510.00 06/06 CITY OF PICO RIVERA PROJECT 2007 WASHINGTON BLVD. 343,379.90 06/06 MAJICH BROS, INC. SEWER IMPROVEMENT -GARDEN GROVE 294,350.00 07/06 EXCEL PAVING (4205,4206 & 4207) CHARLES DREW MIDDLE SCHOOL 172,829.00 08/06 CITY OF LONG BEACH R-6666 THE ANNUAL CONTRACT 1,500,000.00 12/06 ARB STRUCTURES, INC. POINT NORTH ENTRY, WEST HILLS 105,304.00 11/06 CITY OF ARCADIA 05206 ANNUAL CONCRTE REPAIR 291,998.50 11/06 CITY OF CYPRESS CONCRETE IMPROVEMENTS 176,006.00 11/06 R.J. NOBLE CO.(91029) REHAB. OF ARTESIA BLVD.-BUENA PARK 64,860.00 11/06 CITY OF CUDAHY S/W REPLACEMENT - VARIOUS LOCATIONS 47,276.00 11/06 TG CONSTRUCTION 2120 AUTO CENTER DRIVE - GLENDORA 67,765.15 11/06 CITY OF MAYWOOD SIDEWALK RECONSTRUCTION 171,626.00 11/06 JOHN T. MALLOY, INC. MISC. PCC WORK- NEWPORT BEACH 51,693.00 11/06 CITY OF EL SEGUNDO ANNUAL CONTRACTO FOR CURB & SIDE WALK 92,386.00 11/06 STONY & COMPANY LACO-PACIFIC, LONG BEACH VAR CITIES LA COUNTY 25,000.00 12/05 SWINERTON BUILDERS CHOC PARKING STRUCTURE- ORANGE, CA 94.448.00 08/06 EXCEL PAVING (4314) MARQUEE TOWER-MICHELSON, IRVINE 130,719.00 06/07 GCI CONSTRUCTION INC. 226TH ST. EXT. & STORM DRAIN - HAWAIIAN GARDENS 161,150.00 10/06 T. T. POUCH ASSOCIATES CORBIN & MASON BRIDGES - LOS ANGELES 38,926.00 IN PROGRESS HATHAWAY DINWIDDIE AVENUE OF THE STARS - LOS ANGELES 879,523.00 09/07 COUNTY OF ORANGE ANNUAL PCC MAINTENANCE REPAIR 100,000.00 06/07 EXCEL PAVING CO. (4339) CITYWIDE LOCAL STREET PROGRAM - LONG BEACH 520,284.00 10/06 GCI CONSTRUCTION INC. ORANGE -OLIVE ROAD & HEIM - C/O ORANGE 45,675.00 11/06 ROBERT G. CASTONGIA, INC. 1-37 DOWNTOWN SEWER REPLACEMENT - TORRANCE 67,967.50 01/06 EXCEL PAVING CO. (4340) SLAUSON AVE.IMPROVEMENTS - PLAYA VISTA 201,482.00 12/06 EASTSIDE LRT CONSTRUCTION METRO GOLD LINE EXT. PROJECT - LOS ANGELES 1,225,751.50 IN PROGRESS CITY OF LYNWOOD 2005-2006 SIDEWALK IMPROVEMENTS 41,210.00 07/06 CITY OF VERNON CITY WIDE CONRETE REPAIR 125,200.00 IN PROGRESS OCTA CONCRETE PVMT. GARDEN GROVE & ANAHEIM BUS BASES 989,000.00 01/07 CITY OF IRVINE ANNUAL CONCRETE MAINTENANCE 208,702.00 06/07 TRAMMEL - CROW CHEVIOT HILLS MEDIAN ISLANDS - LOS ANGELES 380,885.00 06/07 EXCEL PAVING CO. (4354) LA BREA AVE. STREET IMPROVEMENTS - HOLLYWOOD 18,900.00 07/06 Page 1 of 2 CONTRACT COMPLETION CONTRACTOR/AGENCY PROJECT AMOUNT DATE SWINERTON BUILDERS KAISER MEDICAL OFFICE EXPANSION - GARDEN GROVE 125,782.00 07/07 R. J. NOBLE DALE STREET REHABILITATION - BUENA PARK 9,881.25 09/06 EXCEL PAVING CO. (4329) SUNSET BLV. MANDEVILLE CYN. RD - LOS ANGELES 104,379.50 10/07 PCL CONSTRUCTION THE MARKET @ 9TH & FLOWER - LOS ANGELES 289,498.00 06/07 MAJICH BROS, INC. GLENDALE 83,083.63 11/06 R. J. NOBLE COMPANY HARBOR BLVD. IMPROVEMENTS - ANAHEIM 38,020.00 04/07 ARB STRUCTURES, INC. 636 MAPLE AVE. MULTI -MODAL - LOS ANGELES 44,537.00 01/07 CITY OF LONG BEACH SECOND AMENDMENT SIDEWALK REPAIRS 2,500,000.00 IN PROGRESS R. J. NOBLE COMPANY BREA BLVD. IMPROVEMENTS 89,966.00 02/07 ARB STRUCTURES, INC. W. HILLS CORP POINT PARKING - WEST HILLS 70,015.00 06107 CITY OF BELL SIDEWALK REPLACEMENT FY 2006-2007 60,428.50 04/07 ARCHSTONE - SMITH DEL MAR STATION OFF SIDE WORK - PASADENA 280,089.20 08/07 EXCEL PAVING CO. (4416) STIMSON AVE. ST. IMPROVEMENT - LA PUENTE 91,403.00 04/07 MIKE PRLICH & SONS, INC. STORM DRAIN IMPROVEMENT - ORANGE 19,717.50 03/07 EXCEL PAVING CO. (4419) PARKING STRUCTURE #2 - IRVINE 46,827.00 04/07 ARB STRUCTURES, INC. OLIVE STREET PARKING STRUCTURE - LOS ANGELES 50,111.00 07/07 CITY OF BREA CORSICAN VILLAS CURB ACCESS RAMPS 55,765.00 03/07 MCCARTHY VERMONT - MANCHESTER OFFICE BLDG. C/O LA 239,667.00 08/07 SWINERTON BUILDERS KAISER PALM COURT 1 C/O FONTANA 59,946.20 05/07 DYNALECTRIC ATSAC & TRAFFIC SIGNAL MOD. - SANTA MONICA 66,250.00 IN PROGRESS C.T. & F. , INC. LA COUNTY DEPT. OF PUBLIC WORK - ARTESIA 65,088.85 12/07 CITY OF INGLEWOOD 06-07 SIDEWALK, PREDESTRIAN RAMP & INTERSECTION 821,612.00 10/07 THOMSEN LANDSCAPE TRIANGLE ISLAND C/O LOS ANGELES 6,270.00 06/07 SWINERTON BUILDERS 505 CHAPMAN AVE. @ CHOC C/O ORANGE 89,807.00 09/07 KEITER CORPORATION SHERIDAN ELEMENTARY SCHOOL - LOS ANGLELES 36,000.00 IN PROGRESS SHAWNAN CORPORATION 2006/2007 SITE IMPROVEMENTS PORT OF L.A. 96,000.00 07/07 POWELL CONSTRUCTORS SUSAN ST. EXIT RAMP (07-06) - COSTA MESA 42,550.00 12/07 AMOROSO CONSTRUCTION EMERGENCY/POLICE & FIRE STA. OP. CTR: LOS ANGLES 472,875.00 IN PROGRESS MIKE PRLICH & SONS, INC. WASHINGTON SIDEWALK @ HOPE ST. -LOS ANGELES 15,957.85 08/07 R.J. NOBLE COMPANY HARBOR BLVD., LA HARBA HEIGHT COUNTY OF L.A. 35,429.15 10/07 JOHN S. MEEK COMPANY TUJUNGA AVE. CITY OF LOS ANGELES 143,413,50 IN PROGRESS IMPERIAL PAVING CO. PHILADELPHIA ST. IMPROVEMENT C/O ONTARIO 33,502.50 07/07 EXCEL PAVING CO. (4370) ALAMEDA ST. N. SPRING ST. - LOS ANGELES 96,779.50 02/08 TRADEMARK CONCRETE FULLERTON COMMUNITY COLLEGE 33,828.00 09/07 WEEGER BROS. INC. MULTI - BLDG. ALISO & LINDA VISTA SCHOOLS 10,414.00 11/07 J. FLETCHER CREAMER & SON, INC. WATER REPLACEMENT - BEVERLY HILLS 32,835.00 12/07 CITY OF HUNTINGTON BEACH EDINGER AVE. PARKWAY IMPROVEMENTS 137,606.00 12/07 TRADEMARK CONCRETE CALIF. STATE UNIVERSITY - LOS ANGLES 17,420.00 10107 COUNTY OF ORANGE PORTLAND CEMENT CONCRETE MAINTENANCE 100,000.00 IN PROGRESS EXCEL PAVING CO. (4486) LINCOLN WATERLINE @ BLUFF CREEK DRIVE 46,750.00 12/07 MIKE PRLICH & SONS, INC. JEFFERSON BLVD. & RODEO DR. - LOS ANGELES 14,005.75 10/07 CITY OF LOS ANGELES HOLLYWOOD MEDIA DISTRICT BUS STOP IMPROVEMENT 353,268.00 IN PROGRESS THOMSEN LANDSCAPE HIGHLAND MEDIAN ISLANDS C/O HOLLYWOOD 17,860.00 12/07 SHAWNAN CORPORATION PORT OF LOS ANGELES - T & M WORK AS NEEDED 30,000.00 IN PROGRESS R.J. DAUM CONST. DOWNTOWN PARKING STRUCTUURE C/O COVINA 32,122.00 IN PROGRESS WESTERN PAVING DOLLY PAD IN DOWNTOWN - C/O LOS ANGELES 61,640.00 01/08 MIKE PRLICH & SONS, INC. 06-07 SANITARY SEWER UPGRADE C/O FULLERTON 17,250.00 IN PROGRESS TOMOVICH MEDIAN CURB ON FIGUEROA ST. - LOS ANGELES 4,345.00 01/08 CEDRO CONSTRUCTION, INC. BLOOMFIELD & ORANGE C/O HAWAIIAN GARDENS 15,311.50 02/08 CITY OF LAWNDALE CONCRETE IMPROVEMENTS PROJECT AREA III 464,259.50 IN PROGRESS Page 2 of 2 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or x 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: t"'n,o" C.C:>W!S7 C® . Contact Person: MAt— 4&Aca—!RL_3 Contact Phone: 9 9S Signed: Date: --- --0 8 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C } (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMIPLOYMTENT OPPORTUNITY CERTIFICATION ._ . The bidder �/�.cw► Ca�ST. CCU. , 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 the the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the .Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Loca sistance Procedures Manual PS&E C cklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES LETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 I. Type of Fe at Action: 2. Status of Federal Action: 3. Report Type: F] a. contract Fla. bid/offer/application ❑ a. initial b. grant b. initial award b. material change C. cooperative agreement c. post -award d. loan For Material Cha ge Only: e. loan guarantee year uarter f. loan insurance date of 1 report 4. Name and Address of Reporting E 'ty 5. If Reporting Entity in No. 4 i ubawardee, Enter Name and Address o rime: Prime F] Subawardee Tier , i own �) , - Congressional District, if known Congressional D strict, if known 6. Federal Department/Agency: Federal Prog in Name/Description: DA mber, if applicable 8. Federal Action Number, if known: 9. Awa Amount, if known: 10. a. Name and Address of Lobby Entity b. ndaddividuals P forming Services (including (If individual, last name, first name, MI) ress if differ t from No. I Oa) (last name, first n e, MI) (attach Continuati Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check that apply) S actual planne a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission ea. cash d. contingent fee . b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Perfo med or to be performed and Date(s) of Service, including officer(s), employee(s), or membe (s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) \ 15. Continuation Sheet(s) attac ed: Yes No El 16. Information requested through th' form is authorized by Title 31 U.S.C. Section 1352. This d' closure of lobbying reliance Signature: was placed by the tier above w en his transaction was made or entered into. This disclosure ' required pursuant to 31 U.S.C. print Name: 1352_ This information will a reported to Congress semiannually and will be a ailable for public inspection. Any person who fails to file required disclosure shall be subject Title: to a civil penalty of not ss than S 10,000 and not more than S I00,000 for each such failure. Telephone No.: Date: Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Form LLL Rev. 09-12-97 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5_ 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rcv.06-04-90aENDIF» Page 12-89 LPP O1-04 March 15, 2001 Compliance Nevus Monthly Trade Journal Publication Affidavit -Declaration of Publication -- State of California Damon Const. Co. is seeking certified and qualified DBE subs and/or suppliers to provide 1) Trucking 2) Engineering 3) Traffic Striping/Signing 4) Traffic Signal Modification 5) Signs 6) Hand Railing Installation 7) Mobilization 8) AC Pavement Replacement 9) Electrical for CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE TV,IN THE VACINTTY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 in Huntington Beach,CA We are an Equal Opportunity Employer. We will require that all participating companies carry Workers' Compensation & Liability Insurance and be bonded. We will assist with obtaining insurance, bonds or lines of credit. Plans & specifications are available for viewing at our offices. Contact: Andy Fife 8851 Watson St. Cypress,CA,90630 Phone:(714) 995-5490 Fax:(714) 995-5707 Email:damonconstco@sbcglobal.net Bid Due on:09/11/2008 at 02:30 PM Solicitation Number: C.C. No. 1243 The Damon Const. Co. Good Faith Effort ad has been published in both the Compliance News Internet and Hard -Copy publications. Located Online at: http://www.compliancenews.com/classifieCmonthly The undersigned declares: I am over the age of 18 years and a citizen of the United States. I am the principal publisher of the Compliance News Monthly Trade Journal in the City of Long Beach, County of Los Angeles, and the State of California. The notice, a true copy of which is attached was published on Fri Aug 29 10:43:22 -0700 2008 I declare under penalty of perjury that the foregoing is true and correct. Executed at Long Beach, California Henry Sprague III Copyright 2005 Compliance News DVBE #0018455 All Rights Reserved Damon Const. Co. LOG Good Faith Effort for Bid Solicitation C.C. No. 1243 Project: CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Important Instructions 1.) Read and complete Section A. 2.) We have completed Section B for you. 3.) Complete Section C by making follow-up phone calls to the firms listed below. ->For DVBE firms, call at least 3 firms. ->For DBE, MBE, & WBE firms, call all of them. A. Awarding Department Contact Instructions Many California Good -Faith Efforts may require the bidding contractor to CALL the awarding department or owner and talk with their Good -Faith representative. SEE YOUR CONTRACT DOCUMENTS FOR THIS TELEPHONE NO. Call it and record the result below. Awarding Department Contact Action Damon Const. Co. contacted the awarding department issuing this contract at (tel number) at (time) on (date) and discussed Good -Faith Effort with (Awarding Department Contact) Remarks:(left message, etc.) Phone call was made by (Prime Rep's do —Signature) B. Federal, State, & Local Agencies Contacted On 08/29/08, Damon Const. Co. contacted: 1. Federal Agency: Central Contractor Registration (CCR) / PRO -Net at http://www.bpn.gov/CCRSearch/Search.aspx at 10:43AM on 08/29/2008 2. State Agency: Office of Small Business & DVBE Certification (OSDC) http://www.pd.dgs.ca.gov/smbus at 10:38AM on 08/29/2008 3. Local referral organization: DBE/DVBE Resource Center (www.dvbe.net) at 10:33AM on 08/29/2008 C. Summary of Firms Sent Bid Invitations 63 total firms were sent invitations. Company Name: Loop Masters Inc. Address: 4740 E Bryson St Anaheim,CA, 92807 Phone: (714) 630-8894, Fax: (714) 630-1783 Work Categories: Highway, Street, and Bridge Construction,Roadside Sign, Signal,Detector,Traffic Count Station Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Global Road Sealing, Inc Address: 6341 Klamath Dr. Westminster,CA, 92683 Phone: (714) 893-0845, Fax: (714) 893-0945 Work Categories: Site Preparation Contractors,Highway, Street, and Bridge Construction,Electrical Contractors,Traffic Control System,Clearing & Grubbing,Roadway Excavation,Structure Excavation,Structure Backfill,Ditches Excavation,Pavement Subsealing & Jacking,Residential Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Alameda Construction Services Inc. Address: 2528 East 125th Street Compton,CA, 90222 Phone: (310) 635-3277, Fax: (310) 635-0562 Work Categories: Site Preparation Contractors,Finish Carpentry Contractors,General Freight Trucking, Local,All Other Pipeline Transportation,Masonry Contractors,Industrial Building Construction,All Other Specialty Trade Contractors,Clearing & Grubbing,Roadway Excavation,S Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Direct Trucking Address: 11411 Westminster Garden Grove,CA, 92843 Phone: (714) 879-1995, Fax: (714) 636-0967 Work Categories: Truck, Utility Trailer, and RV (Recreational Vehicle) Rental and Leasing,General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Truck Rental,Truck Broker,Trucker Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Global Transloading, Llc Address: 1651 E. Edinger Ave Suite 206 Santa Ana,CA, 92705 Phone: (949) 307-4148, Fax: (714) 817-9703 Work Categories: Other Support Activities for Road Transportation,Other Nonhazardous Waste Treatment and Disposal,Hazardous Waste Treatment and Disposal,Freight Transportation Arrangement,Bus Terminal & Service Facilities,Trucking Terminal Facilities,Freight Transportatio Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Payco Specialties, Incorporated Address: 120 North Second Ave. Chula Vista,CA, 91910 Phone: (619) 422-9204, Fax: (619) 427-1620 Work Categories: Highway, Street, and Bridge Construction,A11 Other Specialty Trade Contractors,Traffic Control System,Sign Structure,Roadside Sign,Object Marker,Thermoplastic Traffic Stripe & Marking,Painted Traffic Stripe & Marking,Pavement Marking, Sandblasting Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Parada Trucking Address: 2010 Alona Street Santa Ana,CA, 92706 Phone: (714) 542-6412, Fax: (714) 342-1294 Work Categories: Specialized Freight (except Used Goods) Trucking, Local Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Tri-star Transportation Address: 1918 W. 169th Street Gardena,CA, 90247 Phone: (310) 538-9100, Fax: (310) 538-9625 Work Categories: General Freight Trucking, Local,Specialized Freight (except Used Goods) Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Bjv3 Trucking Address: 2323 West 78th Street Inglewood,CA, 90305 Phone: (323) 751-7473, Fax: (323) 759-9034 Work Categories: Couriers,General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker,Trucking & Courier Services, Ex. Air Phone Solicitation Information. Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: R. C. Dixon Trucking Address: 1264 West 132nd Street Gardena,CA, 90047 Phone: (310) 532-6897, Fax: (310) 532-6260 Work Categories: General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: V S A And Associates, Inc. Address: 12525 Lambert Road Whittier,CA, 90606 Phone: (562) 698-2468, Fax: (562) 698-2339 Work Categories: All Other Professional, Scientific, and Technical Services,Electrical Engineers Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Weaver Electric, Inc Address: 4210 E La Palma Ave Anaheim,CA, 92807 Phone: (714) 917-1165, Fax: (714) 917-3011 Work Categories: Electrical Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Apex Universal, Inc Address: 11033 Forest Place Santa Fe Springs,CA, 90670 Phone: (562) 944-8878, Fax: (562) 944-2298 Work Categories: Marking Device Manufacturing,Misc Suppliers Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINI TY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Globalrents.com Address: 3160 E. La Palma Ave, Suite A Anaheim,CA, 92806 Phone: (714) 237-9980, Fax: (714) 237-9983 Work Categories: Consumer Electronics Repair and Maintenance,General Rental Centers,Misc Equipment Rental & Leasing,Electrical Repair Shops Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINTTY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Hard Hat Communications Address: 8565 Fallbrook Cir. Unit 715c Hungtinton Beach,CA, 92646 Phone: (714) 960-6198, Fax: (714) 536-6961 Work Categories: All Other Professional, Scientific, and Technical Services,Public Relations Agencies,Marketing Consulting Services,Computer,Electrical Engineers Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Triumph Geo-synthetics,inc. Address: 2941 E. Miraloma Avenue, Unit 3 Anaheim,CA, 92806 Phone: (714) 237-1550, Fax: (714) 237-1549 Work Categories: Other Building Material Dealers,Other Construction Material Merchant Wholesalers,Other Direct Selling Establishments,All Other Transportation Equipment Manufacturing,Misc Suppliers,Lumber,Guard Railings & Barriers,Pavement Markers,Building Material,Tools, Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Pacific Electronics Address: 1136 Santa Delphina Avenue Chula Vista,CA, 91913 Phone: (619) 248-2543, Fax: (760) 757-4838 Work Categories: Wired Telecommunications Carriers,Cable and Other Subscription Programming,All Other Professional, Scientific, and Technical Services,Other Electric Power Generation,Electrical Contractors,All Other Specialty Trade Contractors,Other Communications Equipme Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,1N THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Callum Trucking Address: 357 E. Carson Street, Suite 213 Carson,CA, 90745 Phone: (310) 835-5279, Fax: (310) 835-5903 Work Categories: General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,1N THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: P W Trucking, Co. Address: P O Box 4512 Carson,CA, 90749 Phone: (310) 505-1263, Fax: (310) 715-1221 Work Categories: General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Express Energy Services, Inc Address: 15310 Studebacker Rd Norwalk,CA, 90650 Phone: (562) 936-1968, Fax: (562) 936-1969 Work Categories: Electrical Contractors,Electrical Apparatus and Equipment, Wiring Supplies, and Related Equipment Merchant Wholesalers,Electrical & Signals,Traffic Control System,Residential Electrical,Electrical Goods Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Ctekk Address: 7231 Garden Grove Boulevard, Suite K Garden Grove,CA, 92841 Phone: (714) 899-2259, Fax: (714) 899-2279 Work Categories: Other Telecommunications,Motor and Generator Manufacturing,Electrical,Communications Services, Nec Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: R. Davis Edm Address: 1121 N.cosby Way Unit 1 Anaheim,CA, 92806 Phone: (714) 630-8360, Fax: (714) 630-0492 Work Categories: All Other Miscellaneous Fabricated Metal Product Manufacturing,Other Scientific and Technical Consulting Services,Other Specialized Design Services,Drafting Services,All Other Miscellaneous Electrical Equipment and Component Manufacturing,Nonferrous (exce Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Sol Telecommunications Services Inc Address: 11822 East Washington Blvd Whittier,CA, 90606 Phone: (562) 907-4367, Fax: (562) 907-4369 Work Categories: Telephone Apparatus Manufacturing,Other Telecommunications,Electrical Apparatus and Equipment, Wiring Supplies, and Related Equipment Merchant Wholesalers,Electrical & Signals,Communications Services, Nec,Electrical Goods Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: S P Yu Inc. Address: 1935 Walnut Leaf Drive Walnut,CA, 91789 Phone: (909) 595-3329, Fax: (909) 594-1876 Work Categories: Electrical Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Date/s-Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Jada Rubber Stamps Address: 8749 La Mesa Blvd. La Mesa,CA, 91941 Phone: (619) 461-3245, Fax: (619) 461-1494 Work Categories: Communication Equipment Repair and Maintenance,Office Machinery and Equipment Rental and Leasing,Commercial Flexographic Printing,Metal Coating, Engraving (except Jewelry and Silverware), and Allied Services to Manufacturers,Marking Device Manufacturing,S Phone Solicitation Information Datels-Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Luna Trucking Address: 7102 Cortland Street Paramount,CA, 90723 Phone: (562) 762-5552, Fax: (310) 991-5862 Work Categories: General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: David Bravo Trucking Address: 9232 Cord Avenue Downey,CA, 90240 Phone: (562) 293-5187, Fax: (562) 869-0636 Work Categories: General Freight Trucking, Local,Trucker Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,1N THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Collins Trucking Address: 11104 Spinning Avenue Inglewood,CA, 90303 Phone: (323) 777-2617, Fax: (323) 777-2617 Work Categories: Specialized Freight (except Used Goods) Trucking, Local Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Convergence Services Inc Address: 1920 East Warner, Suite G Santa Ana,CA, 92705 Phone: (949) 955-2545, Fax: (707) 922-8378 Work Categories: Electrical Contractors,Telecommunications Resellers,Communication Equipment Repair and Maintenance,Traffic Control System,Residential Electrical Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: J P Construction & Electric Address: 14618 S. Corlett Ave. Compton,CA, 90220 Phone: (310) 639-6834, Fax: (310) 763-1876 Work Categories: Electrical Contractors,Other Lighting Equipment Manufacturing,Highway, Street, and Bridge Construction,Traffic Control System,Residential Electrical,Electric Lighting & Wiring Equipment Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Morales Trucking Address: 315 S. Tracy Lane Orange,CA, 92869 Phone: (714) 538-5339, Fax: (909) 822-8452 Work Categories: Truck, Utility Trailer, and RV (Recreational Vehicle) Rental and Leasing,General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Truck Rental,Truck Broker,Trucker Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: L & B Electric, Incorporated Address: 8219 Garfield Avenue Bell Gardens,CA, 90201 Phone: (562) 928-9792, Fax: (562) 928-8146 Work Categories: Electrical Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: A & P Construction Address: 3555 Voyager Street, #b Torrance,CA, 90503 Phone: (310) 793-2310, Fax: (310) 793-2312 Work Categories: Other Foundation, Structure, and Building Exterior Contractors,Electrical Contractors,Other Building Equipment Contractors,Drywall and Insulation Contractors,Painting and Wall Covering Contractors,Flooring Contractors,Tile and Terrazzo Contractors,Finish Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE TV,IN THE VACINTTY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Murthy Transportation Address: 2832 Alderberry Ct Fullerton,CA, 92835 Phone: (714) 350-5542, Fax: (714) 774-4620 Work Categories: Engineering Services,Mixed Mode Transit Systems,Process, Physical Distribution, and Logistics Consulting Services, Signal,Consultant,Traffic Engineer Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Universal Computer Technologies Address: 4926 Firestone Blvd. South Gate,CA, 90280 Phone: (323) 357-1190, Fax: (323) 357-1191 Work Categories: Electronic Computer Manufacturing,Computer Systems Design Services,Computer Terminal Manufacturing,Other Computer Peripheral Equipment Manufacturing,Software Reproducing,Office Equipment Merchant Wholesalers,Computer and Computer Peripheral Equipment and Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: E S P Aerospace Fasteners, Inc. Address: 4120 W. Valley Blvd. Walnut,CA, 91789 Phone: (909) 839-2595, Fax: (909) 839-2596 Work Categories: Other Electronic Parts and Equipment Merchant Wholesalers,Electrical Apparatus and Equipment, Wiring Supplies, and Related Equipment Merchant Wholesalers,Metal Service Centers and Other Metal Merchant Wholesalers,Hardware Merchant Wholesalers,Industrial Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Premier West Contractors, Inc. Address: 740 W. Grove Avenue Orange,CA, 92865 Phone: (714) 279-0903, Fax: (714) 279-0856 Work Categories: Poured Concrete Foundation and Structure Contractors,Motor and Generator Manufacturing,All Other Specialty Trade Contractors,Site Preparation Contractors,Structural Steel and Precast Concrete Contractors,Masonry Contractors,Painting and Wall Covering Cont Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Marin Bravo Electric, Inc. Address: 1248 South Lyon Street Santa Ana,CA, 92705 Phone: (714) 245-2450, Fax: (714) 245-2451 Work Categories: Electrical Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Mammoth Electric Address: 1582 No. Batavia St. Ste 3 Orange,CA, 92867 Phone: (714) 978-0807, Fax: (714) 978-8944 Work Categories: Electrical Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Super Seal & Stripe, Inc Address: 310 A Street Fillmore,CA, 93016 Phone: (805) 524-7345, Fax: (805) 524-7428 Work Categories: Poured Concrete Foundation and Structure Contractors,Highway, Street, and Bridge Construction,Structural Steel and Precast Concrete Contractors,All Other Specialty Trade Contractors,Seal Coat,Sign Structure,Roadside Sign,Object Marker,Painted Traffic Stri Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Southern California Fuse Co., Inc. Address: 23011 Moulton Parkwau #i-11 Laguna Hills,CA, 92653 Phone: (949) 458-3873, Fax: (949) 458-3790 Work Categories: Other Electronic Component Manufacturing,All Other Miscellaneous Electrical Equipment and Component Manufacturing,Motor and Generator Manufacturing,Power, Distribution, and Specialty Transformer Manufacturing,Electrical,Electric Distribution Equipment,Ele Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: A & S Cement Contractors, Inc Address: 8140 Monroe Avenue Stanton,CA, 90680 Phone: (714) 220-2694, Fax: (714) 220-0571 Work Categories: Poured Concrete Foundation and Structure Contractors,Masonry Contractors, Structural Steel and Precast Concrete Contractors,Highway, Street, and Bridge Construction,Concrete & Cement,Concrete Base,Portland Cement & Concrete Pavement,Steel Structures, Steel Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Consultants For Environmental Sys Techn Address: 10 Damara Street Irvine,CA, 92614 Phone: (714) 474-4558, Fax: (714) 474-4558 Work Categories: Electrical Contractors,Other Computer Related Services,Traffic Control System,Residential Electrical Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Marinex Inc Address: 1440 N Harbor Blvd, Suite 601 Fullerton,CA, 92835 Phone: (714) 578-1600, Fax: (714) 578-1606 Work Categories: Dimension Stone Mining and Quarrying,Rolled Steel Shape Manufacturing,Ornamental and Architectural Metal Work Manufacturing,Fabricated Pipe and Pipe Fitting Manufacturing,All Other Transportation Equipment Manufacturing,Lumber, Plywood, Millwork, and Wood Phone Solicitation Information Date/s-Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Golden Sun Construction, Inc Address: 25371 Mustang Drive Laguna Hills,CA, 92653 Phone: (949) 380-9797, Fax: (949) 380-9707 Work Categories: Structural Steel and Precast Concrete Contractors,Highway, Street, and Bridge Construction,Poured Concrete Foundation and Structure Contractors,All Other Specialty Trade Contractors,Guard Railings & Barriers,Pavement Markers,Tools,Steel Structures, Steel C Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Nova Electric, Inc. Address: 335 E Street, Suite B Chula Vista,CA, 91910 Phone: (619) 425-0513, Fax: (619) 425-0675 Work Categories: Other Telecommunications,Industrial Building Construction,Electrical Contractors,Site Preparation Contractors,Traffic Control System,Clearing & Grubbing,Roadway Excavation, Structure Excavation, Structure Backfill,Ditches Excavation,Signal & Lighting,Signal Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: J.w. Young Trucking, Inc. Address: 2504 West 79th Street Inglewood,CA, 90305 Phone: (323) 752-8570, Fax: (323) 756-2291 Work Categories: Specialized Freight (except Used Goods) Trucking, Local,General Freight Trucking, Local,Trucker Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE TV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Cmm Trucking, Llc Address: 548 West Tichenor St Compton,CA, 90220 Phone: (310) 886-0360, Fax: (310) 608-2210 Work Categories: Specialized Freight (except Used Goods) Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Carob Valley Electric, Inc. Address: 8531 Wellsford Place, Suite "a" Santa Fe Springs,CA, 90670 Phone: (562) 407-2105, Fax: (562) 407-2106 Work Categories: Electric Power Distribution,Electrical Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Power Engineering Industries Address: 1117 E. Janis Street Carson,CA, 90272 Phone: (310) 763-1524, Fax: (310) 763-8954 Work Categories: All Other Miscellaneous Electrical Equipment and Component Manufacturing,Power, Distribution, and Specialty Transformer Manufacturing,Electronic Coil, Transformer, and Other Inductor Manufacturing,Motor and Generator Manufacturing,Current-Carrying Wiring Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Epic Consulting Engineers Address: 3242 West Canyon Avenue San Diego,CA, 92123 Phone: (858) 565-4185, Fax: (858) 565-3845 Work Categories: All Other Professional, Scientific, and Technical Services,Other Management Consulting Services,Engineering Services,Electrical Apparatus and Equipment, Wiring Supplies, and Related Equipment Merchant Wholesalers,All Other Specialty Trade Contractors,Ele Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Southbay Edc, Inc. Address: 4050 Acacia Ave Bonita,CA, 91902 Phone: (619) 267-6881, Fax: (619) 267-6850 Work Categories: Electrical Contractors,Other Electric Power Generation,Electrical Apparatus and Equipment, Wiring Supplies, and Related Equipment Merchant Wholesalers,Electrical & Signals,Traffic Control System,Residential Electrical,Electric Services,Combination Utilit Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Total Healthcare Management, Inc Address: 17310 Redhill Ave., Suite 300 Irvine,CA, 92614 Phone: (949) 757-0075, Fax: (949) 757-0076 Work Categories: All Other Professional, Scientific, and Technical Services,All Other Insurance Related Activities, Electrical Engineers Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: P S Services Address: 316 Dyer Rd. # B Santa Ana,CA, 92707 Phone: (714) 513-1870, Fax: (714) 513-1871 Work Categories: Electrical Contractors,Consumer Electronics Repair and Maintenance,Other Services to Buildings and Dwellings,Janitorial Services,All Other Specialty Trade Contractors,Traffic Control System,Residential Electrical, Services To Buildings,Janitorial Services, Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Signs Portal Address: 425 S. Alexandria Ave. #22 Los Angeles,CA, 90020 Phone: (213) 880-8112, Fax: (213) 389-9404 Work Categories: All Other Specialty Trade Contractors,Other Services Related to Advertising,Graphic Design Services,Sign Structure,Message Signs, Lighting & Sign Illumination,Advertising,Commerical Art And Graphic Design Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Manuel D. Tejeda, Trucking Address: Lynwood Lynwood,CA, 90262 Phone: (310) 604-9604, Fax: (310) 604-4142 Work Categories: Specialized Freight (except Used Goods) Trucking, Local,Trucking & Courier Services, Ex. Air Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Anytime Dumping, Inc. Address: 22838 Morro Drive Carson,CA, 90745 Phone: (800) 793-6057, Fax: (310) 847-7002 Work Categories: General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Lincoln Pacific Builders, Inc. Address: 4501 Littlejohn Street Baldwin Park,CA, 91706 Phone: (626) 960-7738, Fax: (626) 960-7739 Work Categories: Electrical Contractors,Engineering Services,Lighting,Message Signs, Lighting & Sign Elumination,Ramp Metering System,Civil Engineering,Building Construction,Small Structures,Residential Electrical Phone Solicitation Information Dates -Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE MIN THE VACINTTY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Executive Lighting Services Address: 1141 North Cosby Way, Ste. A Anaheim,CA, 92806 Phone: (714) 632-5353, Fax: (714) 632-5093 Work Categories: Electrical Contractors,All Other Specialty Trade Contractors,Traffic Control System,Residential Electrical Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Mccants Trucking Address: 755 Loyola Avenue Carson,CA, 90746 Phone: (310) 323-7109, Fax: (310) 768-2827 Work Categories: General Freight Trucking, Local,Bottom Dump Trucking,Flat Bed Trucking,Trucker Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Co's Traffic Control, Inc Address: 2201 San Dieguito Drive Del Mar,CA, 92014 Phone: (858) 259-0300, Fax: (858) 259-0357 Work Categories: All Other Specialty Trade Contractors,Construction, Mining, and Forestry Machinery and Equipment Rental and Leasing,Electrical & Signals,Construction Area Signs,Traffic Control System,Message Signs, Lighting & Sign Illumination Phone Solicitation Information Date/s-Times Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. CA: 1243 CITY OF HUNTINGTON BEACH, SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Ajk Communications Address: 1215 E. Glenwood Place Santa Ana,CA, 92707 Phone: (714) 444-0946, Fax: (714) 444-0957 Work Categories: Other Communication and Energy Wire Manufacturing,Fiber Optic Cable Manufacturing,Traffic Control System,Signal & Lighting,Management Information Systems,Railroads,Telephone Communications Phone Solicitation Information Date/s-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Company Name: Rokel Electric, Inc Address: 1507 E Del Amo Blvd Carson,CA, 90746 Phone: (310) 608-2608, Fax: (310) 608-2619 Work Categories: Electrical Apparatus and Equipment, Wiring Supplies, and Related Equipment Merchant Wholesalers,Electrical Contractors,Other Electric Power Generation,Electrical & Signals,Traffic Control System,Residential Electrical,Electric Services,Combination Utilit Phone Solicitation Information Dates-Time/s Solicited by Phone: Person Contacted and Commments for Solicitation: C.C. No. 1243 CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Affidavit of Fax Solicitation The undersigned employee of Compliance News Publishing, located in the City of Long Beach, County of Los Angeles, and the State of California, declares that bid solicitation letters have been faxed to the following 63 firms listed below at 10:43AM on 08/29/2008. I am over the age of 18 years and a citizen of the United States. I declare under penalty of perjury that the foregoing is true and correct. Executed at Long Beach, California. Henry Sprague III Damon Const. Co. 8851 Watson St. Cypress,CA 90630 Telephone: (714) 995-5490 Fax: (714) 995-5707 INVITATION TO BED August 29, 2008 Loop Masters Inc. 4740 E Bryson St Anaheim,CA,92807 We are seeking certified and qualified DBE subcontractors and/or suppliers for: Project: CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Location: Huntington Beach,CA Bid Due Date: 09/11/08 at 02:30 PM PST Solicitation Number: C.C. No. 1243 Contact: Andy Fife Quotes are needed for: 1) Trucking 2) Engineering 3) Traffic Striping/Signing 4) Traffic Signal Modification 5) Signs 6) Hand Railing Installation 7) Mobilization 8) AC Pavement Replacement 9) Electrical. Contractors will be required to enter into our standard contract. No modifications to the contract are permitted. All sub- contractors/vendors awarded work on this project must be prepared to furnish sub -contract performance and payment bonds, for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion, reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: O We cannot participate in the contract Print Name of Business Owner Signature Date Please fax return this form by Sep 8, 2008 with a copy of your certification to Andy Fife at (714) 995-5707 Damson Const. Co. 8851 Watson St. Cypress,CA 90630 Telephone: (714) 995-5490 Fax: (714) 995-5707 INVITATION TO BED August 29, 2008 Global Road Sealing, Inc 6341 Klamath Dr. Westminster,CA,92683 We are seeking certified and qualified DBE subcontractors and/or suppliers for: Project: CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Location: Huntington Beach,CA Bid Due Date: 09/11/08 at 02:30 PM PST Solicitation Number: C.C. No. 1243 Contact: Andy Fife Quotes are needed for: 1) Trucking 2) Engineering 3) Traffic Striping/Signing 4) Traffic Signal Modification 5) Signs 6) Hand Railing Installation 7) Mobilization 8) AC Pavement Replacement 9) Electrical. Contractors will be required to enter into our standard contract. No modifications to the contract are permitted. All sub- contractors/vendors awarded work on this project must he prepared to furnish sub -contract performance and payment bonds, for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion, reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address. If you have any questions please do not hesitate to contact us. Participation Response Form () We can participate in this contract TYPE OF SERVICE OR SUPPLIES: () We cannot participate in the contract Print Name of Business Owner Signature Date Please fax return this form by Sep 8, 2008 with a copy of your certification to Andy Fife at (714) 995-5707 Damon Const. Co. 8851 Watson St. Cypress,CA 90630 Telephone: (714) 995-5490 Fax: (714) 995-5707 INVITATION TO BED August 29, 2008 Alameda Construction Services Inc. 2528 East 125th Street Compton,CA,90222 We are seeking certified and qualified DBE subcontractors and/or suppliers for: Project: CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Location: Huntington Beach,CA Bid Due Date: 09/11/08 at 02:30 PM PST Solicitation Number: C.C. No. 1243 Contact: Andy Fife Quotes are needed for: 1) Trucking 2) Engineering 3) Traffic Striping/Signing 4) Traffic Signal Modification 5) Signs 6) Hand Railing Installation 7) Mobilization 8) AC Pavement Replacement 9) Electrical. Contractors will be required to enter into our standard contract. No modifications to the contract are permitted. All sub- contractors/vendors awarded work on this project must be prepared to furnish sub -contract performance and payment bonds, for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion, reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: () We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Sep 8, 2008 with a copy of your certification to Andy Fife at (714) 995-5707 Damon Const. Co. 8851 Watson St. Cypress,CA 90630 Telephone: (714) 995-5490 Fax: (714) 995-5707 August 29, 2008 Direct Trucking 11411 Westminster Garden Grove,CA,92843 We are seeking certified and qualified DBE subcontractors and/or suppliers for: Project: CITY OF HUNTINGTON BEACH, CA: SAFE ROUTES TO SCHOOL,CYCLE IV,IN THE VACINITY OF MESA VIEW MIDDLE SCHOOL: C.C. NO. 1243 Location: Huntington Beach,CA Bid Due Date: 09/11/08 at 02:30 PM PST Solicitation Number: C.C. No. 1243 Contact: Andy Fife Quotes are needed for: 1) Trucking 2) Engineering 3) Traffic Striping/Signing 4) Traffic Signal Mortification 5) Signs 6) Hand Railing Installation 7) Mobilization 8) AC Pavement Replacement 9) Electrical. Contractors will be required to enter into our standard contract. No modifications to the contract are permitted. All sub- contractors/vendors awarded work on this project must be prepared to furnish sub -contract performance and payment bonds, for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion, reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address. If you have any questions please do not hesitate to contact us. Participation Response Form O We can participate in this contract TYPE OF SERVICE OR SUPPLIES: () We cannot participate in the contract Print Name of Business Owner Signature Date: Please fax return this form by Sep 8, 2008 with a copy of your certification to Andy Fife at (714) 995-5707 Sur6Tec KNOW ALL MEN BY THESE PRESENTS, that we DAMON CONST. CO. as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 3033 Fifth Avenue Suite 300, San Diego, CA 92103, 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 (10%) of the Amount Bid by Principal 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, CYCLE IV, IN THE VICINITY OF MESA VIEW MIDDLE SCHOOL, C.C. NO.1243 BID DATE: SEPTEMBER 11, 2008 NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, 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. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 60 days of the date hereof. SIGNED, sealed and dated this 3RD day of SEPTEMBER, 2008. DAMON CONST. CO. (Principal) TITLE: 1x--- r.1't SURETEC INSURANCE COMPANY BY: fiurls-t BROOKS ENZ, ttomey-in-Fact Sure'rec Bid Bond Rev 1.1.06 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT i®®®are��w��e®e�se��ec�er®e�se�e�o��mer�me®�®e�seee�e�m��e�emoe�ee®e State of California County of ORANGE A.SS. On September 3, 2008, before me, Maria Marcelina A. Godinho, Notary Public, personally appeared MARGARET ANN RULLO, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her 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. sees®eeeoesea�eaaaassaeeseseeeoeeeses WITNESS my hand and official seal. ; MARIAMARCELINAA.GODINHOs COMM. #1550552 • a' NOTARY PUBLIC - CALIFORNIA f < ORANGE COUNTY s • My Con)m, Expires Feb. 6, 2009 ° 06ee0.Oe0ee00®Pee�e•••'®'®•e�'e•e4A®®�a® Signatu (seal) i�eos��rw��owe�oo®■eea��e��e�r��ee�rosaeoeoe�■®s�se�aeee®�ame■®�o OPTIONAL INFORMATION Date of Document Type or Title of Document Number of Pages in Document Document in a Foreign Language Type of Satisfactory Evidence: Personally Known with Paper Identification Paper Identification Credible Witness(es) Capacity of Signer: Trustee Power of Attorney CEO/CFO/COO President / Vice -President / Secretary / Treasurer Other: Other Information: Thumbprint of Signer Check here if no thumbprint or fingerprint is available. 2 Ailstate Notary Preparation, nc;. - (800) 689-8456 - , 'V4a stateno ars-.c ;�m POA #; 510034 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know AU Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation .duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Lary D. Cogdill, Michael W. Thomas, Brooke Lafrenz, Jeanette Seidl, Colette Chisholm of La Jolla, CA its true and lawful Attotney(s)-in-fact, with frill power and authority hereby conferred in its name, place and stead, to execute, acknowledge and .deliver any and all bonds, recoguizanees, undertakings. or :other instruments or .contracts of suretyship to include waivers to: the conditions of contracts and consents of surety, providing the bond penalty does not exceed Five Million Dollars and no/100 ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary; hereby ratifying and confirming all that the said Attorneys) -in -Fact may do in the premises. Said appointment shall continue in force until 10/31/09 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Slice -President, any Assistant Vice -President; any Secretaryor any Assistant Secretary shall be and is hereby vested with full power and .authority to appointany one:ormore suitable persons as Attorneys) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact, ay be'given full power and authority for and in the name of and of behalf of the Company, to execute;: acknowledge and deliver, any and all bonds recognizances, contracts, agreements or indemnity and other condkiotid or obligatory undertakings and any and all notices and .documents canceling or terminating the Company's liability `thereunder; and.: any such instruments so executed by any such Attorney -in -Fact shall be binding upor►'the Company ?s if signed by the President and. sealed aril aftected:i>y theCorporate Secretary. BeIt_Resolved; that: the signature of any authorized officer and seal of the: Company heretofore orhereafter affixed, to any power of attorney or any certificate relating thereto by facsimile; and any, power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at meeting held on 20 qfAprij, 1999) In Witness 'N'hereof, SURETEC .INSURANCE COMPANY has caused these: presents to be signed by its President, and its corporate seal to be hereto affixed this 2.0'th day_ of June; A.D. 2005. uo rnRIETEC INSRANGE COMPANY By tel: a+ 3 B.T. g, :reside t State of Texas ss: { County of Harris �•: On this 20th day of June, A.D. 2005 before'me personally came B.J. King, to me known, •who;, being by.me duly sworn, did depose and say, that he. resides in Houston; Texas, that he is President of SUIZETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said'Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directorsofsaid Company; and that he signed his.name thereto by like order. OW MichWei Denny aotP�" Notary" •jkfto1Texas 11111f Coatttiisston WiN Atigust 27, 2= Nim?Ay=:� �� Niiichelle Denny, Notary Pi lic My cortitnission expires August 27, 2008 I, M. Brent:Beaty, Assistant, Secretary of SURETI✓C IIVSTJRANCE COMFAN , do'herebycertify that theabove and foregoing is a'true and correct copy of a Power of Attorney, executed by said Company, whieh.is still in full :force and effect and furthermore, the resolufions of the Board of Directors; set. out in the .Power of Attorney are lin'full force and. effect.. Given under my hand and the seal of said Company at Houston, Texas this 3RD day SEPT MBER 20 08 , A.D. l 14L Brent $ea sistant See to t ry Any instrument issued in excess of the penalty stated -above is totally void and without any validity: For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of San Diego On 03 September 2008 before me, Gladys D. Rogers, Notary Public personally appeared Brooke Lafrenz . GLADYS D. ROGERS \` Commission # 1537880 ,o-�Kr7my `' Notary Public -California San Diego County Comm. E>pires Dec 24, 2008 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her 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 al. Signature OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying an 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 1XI Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Surety Company Number of Pages: City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 California Professional Engineering 9316 Mabel Ave. South El Monte, CA 91733 RE: CC-1243 — Safe Routes to School (Mesa View) Enclosed please find your original bid bond for CC-1243. Sincerely, JFlynn, CMC City Clerk JF:pe enclosure Sister Citi6. ioilA LLB/cl�?c4Pt/,et,%iAdW.9ocNew Zealand (Telephone: 714-536-5227 ) II1 r 1� nti�'1 oil 1, S�\q b�K k��W\OQX �\ I mQ� ( a 30 ?t-A n IN I d3s goof r_ a J II City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1243 September 2, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Mesa View Middle School) CC1243 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number OnVtdtember 2, 2008. California Professional Engineering Company Name B q 1 U3 1DS 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. SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Mesa View Middle School C.C. No. 1243 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 therefore, 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 30 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 j; CO in the amount of $ �� which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date ReceivedBidder's Sigqature C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Mesa View Middle School) CC-1243 2 1 L.S. 1 L.S. 11 MA P� UN A -Old Ime 02 NUM W'--R, 000 0-11 Mobilization. Go Per L.S. Furnish Project Traffic Control. C1 \0iS Per L.S. $ $ $ $ I 3 1 L.S. Furnish and Install Traffic Striping and Signing. tWINQ-11). -Mqs'oy�O \%imi-ed VA-0m Per L.S. $ V, AN $ 4 1 L.S. Modify Traffic Signal at Edwards Street and Slater Avenudlk�"A f @C ' —YNCh-QO M -Nmv Per L.S. $ qCO V, $ 9'2� , quo 5 21 E.A. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Including Adjacent Gutter Plate and A. PavingReplacement. a V Ow nd -fi Y 0 Per EA. $ 3,06 0, OV $ 6 7 3 E.A. 6 L.F. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type 1 A Poles are City FuTished). 61W Ws-(im Alm hoy\cA1)) rVt-4 - 0 ved Nag 4 CM - Per EA. Furnish and Install Metal Hand Railing (Type B) per Standard Plans For Public Works Construction (A.P.W.A.) Standard Plan 606-2. �1060 Wi -h fi-vl 11 Ci Per L.F. $ iCfM VU $ $ ferry $ lot - 8 100 S.F. Remove Existing Sidewalk- and Construct Miscellaneous Sidewalk per City Standard Plan 207. Sidewalk Locations as Determined by the City. do[I(an $ $ I Per S.F. Total Amount Bid in Figures: $ 444FIV*N%S Total Amount Bid in Words:$ kmXW-XVeZk C-2.1 Note: The City will provide the radar feedback signs, traffic signal service cabinet, traffic signal poles (including anchor bolts), mast arms, luminaries, vehicle heads, pedestrian heads, push buttons, internally illuminated street name signs, emergency vehicle preemption sensors, block information signs, and fittings at no cost to the contractor. Contractor is to pick up the materials at the City Yard, 17371Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375-5015. 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. Portion of Work Name and Address of Subcontractor State License Number Class 3 oYOro,Cj 1�3 Pill\e 6 0, C q �s10� oq5 C �t 5 six s co�Qs\a, c au s-a ?_n of 3 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 0 State of California ss. County of Orange � M\ H beinR first dul sworn deposes and says that he or she is 10 MK "X of California rofessionalpEngin"dnQhe 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. California Professional Engineering Name of Bidder Signature'of Bidder 9316 Mabel Air Sold El Montk 91738 Address of Bidder Subscribed and sworn to before me this _ day of Se % , 20 c . NOTARY PUBLIC --------------- TRACY SOOC COMM. # 18"Ok N rrot�tY Puauc•C41FO u �) LOS Ap�LES COUlRY MY CO►w. W. 0 28 2012 NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Mesa View Middle School, CC 1243, (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: ` C H California Professional Engineering Contractor C a\ V\CMQ9K Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes l( No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. Date: 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. California Professional Engineering Contractor By Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: California Professional Engineering Contractor r� By (�rwa\ Title Date: (% Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: California Professional Engineering Bidder Name Business Address 13 Moifto CA 91 City, (U*) 4-5a - W09 Telephone Number -ICI'M 61 , C-10 , A - State Contractor's License No. and Class A- 11W 10\ Original Date Issued 4- 30 10q Expiration Date State Zip �e The work site was inspected by V 0 R/o/ f our office on , 20 The following are persons, firms, and corporations having a principal interest in this proposal: 4 4\ \A W 1 WA Q\ u C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. California Professional Engineering Company Signature of Bidder u \A Printed or Typed Signature Subscribed and sworn to before me this l� day of , 200&' IRACY SOOC� COMM. # 1804694 1A W NOTARY PUOLIC•CALIFORNU N Los AmEE Comy Mr Cowl. ExP. h►rE 28, 20/2 '� NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed` s(i)m��ilar work (within th"-�- Kq e past two years: 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-10 9316 Mabel Avenue South El Monte, CA 91733 Ph: (626) 452-8658 Fax: (626) 448-0470 JOB REIFE E CES: Beach Ave. & Caminita Blvd. Traffic Signal Installation Amount: $300, 000 Owner: City of Cerritos Project Manager: Rash Syed Contact phone #: (562)916-1221 Orange Grove & Garfield Ave. Traffic Signal Installation Amount: $196, 000 Owner: City of Pasadena Project Manager: Elvin Jiang Contact phone#: (626)744-6912 Lincoln Ave. Intelligent Transportation System Amount: $485, 000 Owner: City of Anaheim Project Manager: Robert Palaeologus Contact phone #: (714)765-5100 x5711 Seal Beach Blvd. Street Rehabilitation Amount: $250, 000 Owner: City of Seal Beach Project Manager: Karim Contact phone #: (714)412-2772 Additional information will be available upon your request. (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: California Professional Engineering Contact Person: Nab �A\Hlv, Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C } J (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WINCH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder California Professional Engineering , proposed subcontractor , hereby certifies that he has has not—, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, -or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G UUMYLI;I1; IkMi rUKM I WbU V6r, L-MIOrINV AUIIYIIIhZi YU"UANI I 31 U.b.U. 13�1 I. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: F] a. contract ❑ a. bid/offer/application Fla. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter_ f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if ne 15. Continuation Sheet(s) attached: Yes nNo El 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 U.S.C. print Name: 1352. This information will be reported to Congress (� /1 semiannually and will be available for public inspection_ Any ��`CJfa "oc person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than (r\2 �(�%� fj S 100,000 for each such failure. Telephone No.: tV ) Q 1�) a Date: Federal Use Only: �9w\ Authorized for Local Reproduction Standard Form - LLL Standard Form LLL Rev. 09-12-97 Page 12-87 LPP 01-04 March IS, 2001 i EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTTVTTIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment 13. Check the appropriate box(es). Check all boxes that apply_ If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G e 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 Rcv.06.04-90aENDIF» Page 12-89 LPP O1-04 March 15, 2001 THE AMERICAN INSTITUTE OF ARCHITECTS AlA Document A310 Bid Bond BOND # N/A KNOW ALL MEN BY THESE PRESENTS, that we CALIFORNIA PROFESSIONAL ENGINEERING, INC. DBA CALIFORNIA PROFESSIONAL ELECTRICAL 9316 MABEL AVE. S. EL MONTE, CA 91733 ENGINEERING (Here insert full name ,and address or legal title of Contractor) as Principal, hereinafter called the Principal, and NORTH AMERICAN SPECIALTY INSURANCE COMPANY 701 SOUTH PARKER STREET SUITE 3800 ORANGE, CA 92868 (Here insert full name ,and address or legal title of Surety) a corporation duly organized under the laws of the State of NEW HAMPSHIRE 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 AND 00/100 PERCENT of attached 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, CYCLE IV; INVITATION NO. 1243 (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 September 2008 CALIFORNIA PROFESSIONAL ENGINEERTNG, INC. DBA T SSIONALELECTRICAL7a1)7(Seal) ENGINEERING (Witness) (Title) n (Seal) (Witness) YUNG T. AIA DOCUMENT A310 BID BOND AIA ® FEBRUARY 1970 ED THE AMERIC INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W. WASHINGTON, D.C. 20006 ACKNOWLEDGMENT State of California County of Orange ) On September 8, 2008 before me, Peter Austin Neff, 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(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 .. OuL A:�kh::�t F PETER AUSTIN NEFF N o' '� COMM, # 1�799�/38899� X Z T NOTA PWLt�F0 WA X ORANGE COUNTY My Cam► E%0M IIAY Ih, 2QIT (Seal) 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 Arizona and having its principal office in the City of Itasca, Illinois, each does hereby make, constitute and appoint: JENNIFER C. GIBONEY, JAMES W. MOILANEN. and YUNG T. MULLICK JOINTLY OR SEVERALLY Its true and lawfiil Attomey(s)-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: TWENTY-FIVE MILLION ($25,000,000.00) 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 24"' of March, 2000: "RESOLVED, that any two of the President, any Executive 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." �onluuuttkq/r t1gwE. "Ini e ONNgttounurr,IV/i. �39; GaNPaRgZFG�v By 4Z 1973 Steven P. Ande-n Presderet & Chief Executive Officer of Washington Int—lional Insurance Company & Vice President of North American specialty Insurance Company 'lt`C�iRAfE a is [ y �J Gk yt t Qwoq` 6� y13,q�ittGNlt By David M. Layman, Vice President of washingtm�tematianalrnsurance Cmnpany & V lce President of North American Spectalty Insurance Cmpany 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 this 1st day of May , 20 08 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Du Page ss. On this I st day of May 20 08 before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and 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 dully 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. "vFFIciAL SE.A1:' SUSAN ? N$r!L f �e� t+€>I"Ptftc, Staleof!34*9 Susan Ansel, Notary Public M Eoff,misaialr Ex irO ; irafZ{DD9 1, James A. Carpenter , the dully 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 Ameaican 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 g day of SEPTEMBER , 20 08 . lames A. Carpenter, Vice President &Assistant Secretary of Washington International Insurance Cm9my & North American Specialty Insurmnce Company