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Golden State Constructors, Inc. - 2010-05-17
RECEIVED BY: CITY CLERK RECEIPT COPY ' ) Return DUPLICATE to Dom':. i f <4te 1; City Clerk's Office (Name) - 1 after signing/dating (Date) %. CITY OF HUNTINGTON REACH INTERDEPARTMENTAL COMMUNICATION TO: Shari Freidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. 12/,, �)`- MSC No. Approved / >` 7 4)6110 (Council Approval Date) (Company Name) Agenda Item No. City Clerk Vault No #27 gAollowup/bondletter.doc FROM: Joseph Dale, Contact Administrato DATE: November 8, 2010 SUBJECT: Retention Release Payment Company Name: Golden State Constructors, Inc. Address: 6162 Galipean Dr. City, State and Zip Code: Huntington Beach, CA 92647 Phone Number: (714) 625-8758 Business License Number: A267675 Local Address: Same as above Notice of Completion Date: October 19, 2010 Contract Purpose: Retention Release for Construction Contract #1367, Safe Routes to School Spring View Middle School The conformed copy of the Notice of Completion for the above contract has been filed. The thirty-five (35) day waiting period will elapse on Monday, November 22, 2010. Processing of the full retention payment is recommended as no stop notices or outstanding invoices are on file with the City. I certify that no notices are on file on the subject project at this time. Date 1 certify that there are no outstanding invoi Z./ -! Date K opkins, Dire— ecTo—r ofPublic Works on file. Freidenrich, City Treasurer I certify that are 2 stop/no notices are on file on the subject contract, and that a guaranty bond has been filed with this office. /l - ?.;?- to Date Joanl'lynn; City Clerk RETEN. REL. FOR INTERNAL SIGN. 11/8/2010 12:16:00 PM This Document was electronically recorded by City of Huntington Beach PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH Attn: Joseph Dale, Public Works Dept. P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 Recorded in Official Records, Orange County Tom Daly, Clerk -Recorder 11111111111111111111111111111111111111111111111111111111111111111 NO FEE 2010000547663 01:37pm 10/19/10 66 406 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TITLE OF DOCUMENT: NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to Golden State Constructors, Inc. who was the company thereon for doing the following work to -wit: SAFE ROUTES TO SCHOOL — SPRING VIEW MIDDLE SCHOOL PROJECT; CC-1367 That said work was completed October 11, 2010 by said company according to plans and specifications and to the satisfaction of the City Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on October 18, 2010, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract North American Specialty Insurance Company was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. Dated at Huntington Beach, California, this October 18, 2010. �J 114 redfor of Pu is Works or City Engineer City of Hunti ton 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 Recor e f Orange County. Dated at Huntington Beach, California, this October 18, 2010. Director of P blic Works or City Engineer City of Huntington Beach, California THIS PAGE KIDDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) **.059-TITLE PAGE (R7I95) CONTRACTOR'S CERTIFICATE L tk3 - � � , state and certify that: (Name of Declarant} Cyr Y-71-u �S. It.)(- 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: -- k &-I L-- /Tr--JQ -,-) J- e n 5 C.A (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"): k) 011D 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"): A declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at e, on this q y of i 7r,� , 201. (Signature of Declarant) APPROVED AS TO FORM By:11� W�� S(t7% "li.J 3 • Zo•o� Name: [Type Name] Title: [Type Title] Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: C-C 126? Project: S04__ 44 �& The undersigned contractor on the above -referenced project CTroject) 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 mmimum wage and bona fide ffinge benefit -requirements specified for each particular classification of work, as set forth in the wage -rate, determinations of the State of Calif6rrda, 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 _T_,__ day of '_��166-?YZ 20to,ati-ioMDarO�3.9- fornia. (Type Contractor Name) By: Name: [Type Name] Y?-�,-O 16 r)) : � �wa-D Title: [Type Title] <Mels 9 ar-U99 Y4 Certification of Compliance with 'Title VU 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 VU of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: - tf -, 41e)L Z VLA--) i`� The undersigned contractor on the above -referenced project C"Projeef) hereby certifies that it has complied with Title VIT 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). T declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of S 09T-e"6 C,(L , 20 t 0 at k0,0 t *0d Ord( , California. (Type Contract acne} By: Name: [Type Name] -+ Title: [Type Title] A R ;RNEY ���� Coc f4fi RECEIVED BY: (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signineqfdating of, Vi Fit 11 Fiji"Ij y r TO: Sbhnm Freidenrich, City Treasurer FROM: DATE: %D 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. - (Company Name) a Approved // 7- Agenda Item No. (Council Approval Date) City Clerk Vault No. #27 g:/followuplbondletter.doc Bond No. 2097652-M Premium: 0.00 KNOW ALL MEN .BY THESE PRESENTS; That We, of Golden State Constructors (hereinafter called the "Principal'), as Principal, and North American Specialty Insurance Company, of Manchester, New Hampshire, as Surety, an New Hampshire corporation duly licensed to transact business in the State of California (hereinafter called the "Surety"), as Surety, are held and firmly bound unto City of Huntington Beach (hereinafter called the "Obligee" ), in the sum of One Hundred Sixty -Six Thousand Five Hundred Forty And 00/100 Dollars ($ 166,540.00 ), for the payment of which sum well and truly to be made, we, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Sealed with our seals and dated this 13th date of September A.D. 2010. WHEREAS, the said Principal has heretofore entered into a contract with said Obligee dated July 1st 2010 for Safe Routes To School In The Vicinity Of Spring View Middle School Cash Contract No. 1367. WHEREAS, the said Principal is required to guarantee the installed under said contract, against defects in materials or workmanship which may develop during the period beginning on the 8th day of _September 2010, and ending on the 8th day of September 2011 . In no event shall losses paid under this bond aggregate more than the amount of this bond. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that said Principal shall faithfully carry out and perform the said guarantee, and shall, on due notice, repair and make good at its own expense any and all defects in materials or workmanship in the said work which may develop during the period specified above or shall pay over, make good and reimburse to the said obligee all losses sustained by reason of failure or default of said Principal so to do, then this obligation shall be null and, void; otherwise shall remain in full force and effect. _ By: W `..� Am rican y Insurance Company AP VED TO F By: �Ifui z� -- Attorney -In -Fact _NNIF R McGRATH, ty Attomgy Matthew R. Dobyns NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SEVERALLY Its true and lawful 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 20 of March, 2000: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attotney'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." By Steven P. Anderson, President & Chief Executive Officer of Washington InteraationaI Insurance Company Sv'11_ =W :=l, I elu n & Senior Vice President of North American Specialty Insurance Company a Oi .pm a 4 �!y ♦ .�.0 - O ','64�Itt1 nti5 B Y David NL Layman, Senior Vice Presiden 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 2nd day of September 2010 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 2nd day of September 2010 , before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Senior 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 resnective companies. "OFFICIAL SEAT" DQNNA l). SMENS `�^� Notarf!'"c, State of Illalois Donna D. Sklens, Notary Public ft Com nisdov Expires 10%=I 1, 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 American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 13th day of September , 20 10 James A- Carpenter, Vice President & Assistant Secretary of Washington International Laurance Company & North American Specialty Laurance Company State of CALIFORNIA County of ORANGE On September 13. 2010 before nee, Erika Guido, NOTARY PUBLIC, personally appeared MATTHEW R. ®OBYNS ® 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 ERIKA WOO o COMM. # 1843731 g NOTARY PUBLIC CALIFORNL ORANGE COUNTY N �� My Comm. expires May 5, 2013 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. W TNESS nay hand and official seal. 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 ❑ INDIVI®UAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATToRNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAPE OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT State of California County of (9,1 95112 On q 2-0— /0 before me, personally appeared py/�i'!y/& 2C Ackmg who proved to me on the basis of satisfactory evidence to be the person(a) whose name(s) is/ -are subscribed to the within instrument and acknowledged to me that he/she/lhe executed the same in his n-rrz 4sir authorized capacity(ies), and that by his/her/#teir signature(R) on the instrument the person(&), 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. Signature of Notary Public 4&CLAUDIA COCHRAN COMM. #1722119 m Notary Publb-Csfforn e y ORANGE COUNTY a MVCWMExpAan30,2011 (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 aftached to that document. The only exception is if a document is to he recorded outside of Califorma In such instances; any alternative acknowledgmew 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 (_e. certifying the authorized capacity of the signer). Please check the document carefallyfor proper notariat worming and attach this fonn 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 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 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. WsheAhoy, is Iare ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seat impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permit% otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county cleric. . Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. .y 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 �,,,� ..,.-�,... ....�.�-r ,..-r ,u- .m,..... .F� -, w ...f-.,�-_.... .-...ram-�-� n,,.�`N...� ^`r�N'ti-�...-��-,.^,---.-...>*�.a.. .. :aR.., w..�.., ,.. „- ,,,.,,,�2 ... „ -4--�-••r v! -v,.. .,� .-,v.........Y ti. t RECEIVED BY flfl CITY CLERK RECEIPT COPY Return DUPLICATE to t City Clerk s Office (Name) u after signing/dating (Date) t t F� CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COI�'�l UNICATION TO Shari Freidenrich City Treasurer FROM DATE R9 A) r 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 ✓,36 MSC No Approved --/ / -,,— //0 (Council Approval Date) _S (Company Name) 9 76 s� Agenda Item No City Clerk Vault No i #27 g /followup/bondietter doc FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND FOR MCA4 IT TABLE OF CONTENTS 7 Page No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 4 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 5 7. NOTICE TO PROCEED 5 8. BONDS 6 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 7 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 11 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT & TERMINATION 14 24. TERMINATION FOR CONVENIENCE 15 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 16 27. CITY EMPLOYEES AND OFFICIALS 16 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 16 29. NOTICES 16 30. SECTION HEADINGS 17 31, IMMIGRATION 17 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 i FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 18 34. INTERPRETATION OF THIS AGREEMENT 18 35. GOVERNING LAW 18 36. DUPLICATE ORIGINAL 19 37. CONSENT 19 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 19 39. CALIFORNIA PREVAILING WAGE LAW 19 40. CALIFORNIA EIGHT -HOUR LAW 20 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 21 42. EMPLOYMENT OF APPRENTICES 21 43. PAYROLL RECORDS 21 44. FEDERAL PARTICIPATION 21 45. ADDITIONAL FEDERAL REQUIREMENTS 22 46. DAVIS-BACON ACT 22 47. DISCRIMINATION, MINORITIES, ALIENS 23 48. EQUAL EMPLOYMENT OPPORTUNITY 23 49. COPELAND "ANTI -KICKBACK" ACT 24 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 24 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 25 52. ENERGY CONSERVATION 26 53. HOUSING AND URBAN DEVELOPMENT 26 54. SIGNATORIES 26 55. ENTIRETY 26 ii 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_ __ .... a [type of entity and State] hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as - -- - --- -- - - --- _ 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 Page 1 of 27 5/10 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/ sur£netl£ederal const Page 2 of 27 5110 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/£ederal const Page 3 of 27 5/10 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 aNrk--N�:ni�.Slic� _. ),-as set forth in the N® 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 R*"_ 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 approlval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/ surfnet/federal const Page 4 of 27 5110 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/ surfnet/federal const Page 5 of 27 5110 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/ surfnet/federal const Page 6 of 27 5110 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 F1V5 Dollars ($ Fez->•CXD ) per day for each and every working day's delay in completing the work in excess of the number of working/calendar days set forth herein, which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. g/agree/ surfnet/federal const Page 7 of 27 5110 CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DIFFERING SITE CONDITIONS A. Notice: CONTRACTOR shall promptly, and before such conditions are disturbed, notify DPW in writing of: (1) Subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents; or g/agree/ surfnet/federal const Page 8 of 27 5110 (2) Unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the character to be performed under this Agreement. DPW shall promptly investigate the conditions and if it finds that such conditions do materially so differ and cause an increase or decrease in the time required for performance of any part of the work under this Agreement, whether or not changed as a result of such conditions, an equitable adjustment shall be made and the agreement modified in writing accordingly. B. Time Extension: No claim of CONTRACTOR under this Section shall be allowed unless CONTRACTOR has given the notice required hereunder provided, however, the time prescribed therefor may be extended by CITY. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an g/agree/ surfnet/federal const Page 9 of 27 5110 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 Page 10 of 27 5110 15. WITHHELD CONTRACT FUNDS SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by g/agree/ surfnet/federal const Page 11 of 27 5110 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 Page 12 of 27 5/10 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 CONTRACTORS insurance shall be primary. Under no circumstances shall said above -mentioned insurance contain a self -insured retention without the prior written consent of CITY; however an insurance "deductible" of $5,000.00 or less is permitted. 21. CERTIFICATES OF INSURANCE,• ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. g/agree/ surfnet/federal const Page 13 of 27 5/ 10 CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 23. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default g/agree/ surfnet/federal const Page 14 of 27 5110 by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. g/agree/ surfnet/federal const Page 15 of 27 5/ 10 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES: RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: g/agree/ surfnet/federal const Page 16 of 27 5110 TO CITY: City of Huntington Beach ATTN: 2000 Main Streets Huntington Beach, CA 92648 30. SECTION HEADINGS TO CONTRACTOR: 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 Page 17 of 27 5110 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 Page 18 of 27 5/10 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 Page 19 of 27 5/10 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 Page 20 of 27 5110 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 Page 21 of 27 5110 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 CONTRACTOR does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non -collusion certification. Select projects may also require "Federal Trainee" or "On -the -Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined g/agree/ surfnet/federal const Page 22 of 27 5110 by the Department of Labor (29 CFR part 5) in accordance with the Davis -Bacon Act (40 USC Section 276a to 276a-7) for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 47. DISCRIMINATION, MINORITIES, ALIENS The CONTRACTOR or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The CONTRACTOR shall carry out applicable requirements of 49 CFR, Part 26 in the award and administration of DOT -assisted contracts. Failure by the CONTRACTOR to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as recipient deems appropriate. 48. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled "Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit "B") CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. g/agree/ surfnet/federal const Page 23 of 27 5110 Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 (38 USC Section 219 et seq.) prohibits job discrimination and requires affirmative action to comply and advance in employment (1) qualified Vietnam veterans during the first four (4) years after their discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 49. COPELAND "ANTI -KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations (29 CFR part 3), which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight (8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in excess of eight (8) hours in any calendar day or g/agree/ surfnet/federal const Page 24 of 27 5110 forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 306 of the Clean Air Act and section 508 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. g/agree/ surfnet/federal const Page 25 of 27 5/10 52. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 USC Section 6201, et seq.). 53. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 54. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 55. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, g/agree/ surfnet/federal const Page 26 of 27 5110 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 �/��-� , 20�. CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California ,,A-FJ By: print name INITIATED AND APPROVED: ITS: (circle) Chairman resid ice PresidentAll -� / irector of I u is Works REVIF A D APPROVED: 1 /-% City ministrator >G'1� '•pri ITS: (circle on Secretary hief Financial Officer/Asst. Secretary - Treasur APPROVED AS TO FORM: City Attorney g/agree/ surfnet/federal const Page 27 of 27 5110 City ®, f Huntington Beach Business License Business Name / Service Address GOLDEN STATE CONSTRUCTORS INC 6162 GALIPEAN HUNTINGTON BEACH License Type Contractor Owner I Corporation GOLDEN STATE CONSTRUCTORS INC License Number A267675 Effective Date 10/01/2009 Expiration Date 09/30/2010 THIS LICENSE IS ONLY FOR THE BUSINESS AND Amount Paid $99.64 TYPE SHOWN. IT IS FOR THE PERSON TO WHOM ISSUED AND IS NON -TRANSFERABLE. RENEWAL IS SIC 8711 DUE ON OR BEFORE THE EXPIRATION DATE. POST IN PUBLIC VIEW Zf- SECTION C PROPOSAL, f7It �z�5 for the Safe Route to School In the vicinity of Spring View Middle School CC No. 1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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 644 in the amount of $ 0 . which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 I I L.S. Mobilization. U Per L.S. 4 I L.S. I L.S. 1 L.S. Monument Preservation. Per L.S. Furnish Project Traffic Control. Per L.S. Furnish and Install Traffic Striping and Signing. $ C. $ Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ 7� $ 7/, Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ 4 $ 12 ;?0 c.� Depression per City -Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $ 7 00 $ per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. Per S.F. C-2.1 Project Bid Schedule Safe Routes to School -- Spring View Middle School CC-1367 #em No Estimated Quanti Iteml Unit �'nce 4 ' Extended Amount 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City $ $ Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan $ No. A88A and AC Paving Replacement. 11 Per EA. 11 4 EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ $-® Per L.S. 12 11,000 S.F. Construct Type U Slurry Seal. Per S.F. $ o� $ Total Amount Bid in Figures: $ Total Amount Bid in Words: $ OTC r /7u•��i C r Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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 Name andAddess of,Subcontractor: State License ':Class_ 6f Worn Number 9'04�70 Gi.uc c/A-,' PAW if. 4 a 11r2d-6 10P Wurry 36-1044 0Ln,&G1 le " 3 CA , 90b7 d 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 State of California ss. Co un of Orange being �f st duly s rn, d poses and says that he or she is of G4 �J%rvgfjthe 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. iI-IAY �t e- Name of er Z�?i— Signature of Bidder /'wz Address of Bidder Subscribed and sworn to before me this Zq day of rZ-tC , 201. NOTARY PUBLIC CLJIUDIA COCHRAN �. COMM. #1722119 Notary Pub6c-CaNfornia �? •a ORANGE COUNrt r t NY Comm. E41� NOTARY SEAL C-4 State of California County of (n fffI/a�' On before me,�C/tt'tr� personally appeared �r7>1fz who proved to me on the basis of satisfactory evidence to be the person(s) whose name() is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his4win-~heir-authorized capacity(4es), and that by his/her/their signature(,) on the instrument the person(s), or the entity upon behalf of which the person(s-) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. W CIAUDW WITNES y hand ict Seal. comm, COCH Notary is ME�a f0� (Notary a W Comm. Exp. Jan 30, 2011 AIDIDITIONAL OPTIONAL. INFORMATION DESCRIPTION OF TIME ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAWED 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 oniv exception is if a dxument is to be recorded outside of California In such instances, atv 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 Cakfonea (r.e. cernfwng the authorized capacity of the signer). Please check the document carefuliv 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) personalty appeared before the notary public for acknowledgment, • Date of notarization must be the date that the signer(,) personally appeared which must also be the sense 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 phrral forms by crossing off incorrect forms (i.e, Wshe4ha5- is /eye) 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 team 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. nr Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. v indicate title or type of attached document. number of pages and date. -0� Indicae 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 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, in the vicinity of Spring View Middle School - CC1367, (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: q-2e)—I(-) �9o�L k��� Contractor ie-tjj By Title C-5 In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTI®NNAME Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? El Yes No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: q 26 to Contractor � e 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 1-8004224133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: W ' (9 4 d &` 4, A, 6 f ' r, , 14, Contractor By Pf"'S"'4,4- Title Date: q-?t - 10 Note: This form is required for every Dig Alert Identification Number issued by USA. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: Bidder Name t 6 L Cq Business Address �A,k 6,(J;1VUC4r-3 'j- d /— 14, (C) CA '?2z 5/ Z City, State Zip 71,V) l - f Telephone Number 70�© � State Contractor's License No. and Class Original Date Issued 3 -- ,2o// Expiration Date The work site was inspected by go, ��of our office on y- 40 , 20/0 The following are persons, firms, and corporations having a principal interest in this proposal: Pr-e-jrec,,J 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. 9[)f� "'-J k 6'J Iry e rs �.vuz� y zvcuzz Signature of Bidder Printed or Typed Signature Subscribed and sworn to before me this day of A49M L CLAUDIA COCHRAN COMM, i�1722119 mm OrobR 01", p�UryNfomi�a Ty AA! Comm. �xp. Jan 30, 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: ►9 Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of w '—A b Name and Address of Public Name and Telephone No. of Contract Amount 3. Name and Addrree, � Name and Te 1)b Contr ct Amount Type of Work Public Agency No. of Project Manager: Type of Work Date Completed Date Completed Date Completed C-10 State of California County of a--�/l On before me, 004' / m personally appeared Zm& 2C l/>4n'ao 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 the that he/shelthey executed the same in his. rilheir- authorized capacity(ies), and that by his/herAheir- signature(s) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. CLAUDIA COCHRAN r ° GOPiIM. #1722119 m 7W1TNE::my hand o ic' eal. w �o�cs a coucr +� My Gomm. EXp. Jett 30, 2011 Signature of Notary- Public (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 CLARVIED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FOR'%2 Any acb¢awtedgment completed in Cahfornia must contain verbiage exaetty as appears above in the notary section or a separate cnknowiedgment form must be property completed and attached to that document. The only excephon 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 tot require the notary to do something that is illegat for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the doeumew earef & for proper notarrat warding and attach dusform if required. . State and Cotmty information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. o Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. e 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). o Print the name(s) of document signer(s) who personally appear at the time of notarization. a Indicate the correct singular or plural forms by crossing off incorrect forts (i.e. Wshe/ihoy- is /4e) or circling the correct forts. Failure to correctly indicate this information may lead to rejection of document recording. o The notary seal impression must be clear and photographically reproducible. Impression must not cover tent or lines. If seal impression smudges. re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. m 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 (Le. CEO, CFO, Secretary). e Securely attadn this document to the signed document (For federally funded projects, use this following page) HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: gb(Aj Chmarudor"> Contact Person:��,�,��� Contact Phone: -7/y W s-- F 7' 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 EXHMIT 12-E PS&E Checklist instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) The bidder ( subcontractor proposed hereby certifies that he has, has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-12 Page 12-79 LFP 01-04 March 15, MI Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D t Noncmllusi®n Affidavit t. (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY I COUNTY of DEPART ffNT OF P OLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid t price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-13 Page 12-81 LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Cade Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stat9.1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has — , has not Ybeen convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder' is understood to include any partner, member, officer, director, responsible maaag7mg officer, or responsible mmagimg employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is pars of the Bid. Signing t1t3s Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal -prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interesf in the bidder, ever been . disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? yes — No If the answer is yes, explain the circumstances in the following space. C-1.3 Public Contract Code 10232 Statement In conformance with Public Contract Cade Section 10232, the Contractor, hereby states under penalty of penury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of federal court which orders the Contractor to comply with an order of the National tabor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXMIT 12-E PS&E Checklist Instructions Attachment E TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred; voluntarily excluded or determined ineligible by any federal agency within the past 3 years; ® Does not have a proposed debarment pending; and e Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Page 12-83 LPP O1-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) if any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15. Page12-55 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT' 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES UQMrL1;TE `THIS i'URNI'll) VISUL05b LU1313YINU At;11V F11;5 FV"UA.NT 1U J i U.S.t;. 1j:1 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract 91 a. bid/offer/application a initial b. grant b, initial award b, material change a 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, m Enter Name and Address of Prime: IM 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. I4a) (last name, first name, MI) 0 C"I 916Y'1 (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) $ 0 actual planned 12. Form of Payment (check all that apply): Qa. cash ® b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred LJ f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), empleyee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Shee 15. Continuation Sheet(s) attached: 'Yes ® Ni 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. I352. This information will be reported to Congress semiannually and will be available for public inspection, Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Signa Print Title: Telephone No.: 76rV I3ate: -t& "/ Authorized for Local Reproduction Standard Form - LLL Rev. C-16 Page 12-87 LPF 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Tnstructions INSTRUCTIONS .FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. S. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, { State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). if known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in E item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (Il{B) 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 C-17 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-B PS&lE Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include 01 preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev, 06.04-90((T NAIF» C-18 Page M89 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Nan DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. 'I tt ♦ 1 1 1 ! 1i}YF,.g •/ 1 1 1 1 1 1 ' 1 f i ! 1 1 1' 1 i :! C 'State, '' 1 "ice"Xi�c?o a{fit) r• iSCc:::icr..ltti`..ia,l S:i 'Q':i<;'j hi;:a!i'%'u•A} r. M r I4 111 ., K ♦ qq L ��♦ i 1 1 Ill+� .... .. r S a ■� 1 ♦ - ,--n--�y��'�,� f-^"-�- � p ,� ...ir v rA )),3 a 1 f \`.c-c hr^�a^�r �° ♦ r � ■IIIII�:J�:.0 , / R. 1 o-° UNIT(, G /I ,1cS�?62�.�rz.�t� '� � 1 ♦ �`J(��<7!Ii>.11�^,ii���.-Ji�.Jl�i�:l'.l'iF���..t��i<t�1s y'v -• S"S �"', ern rSI . ("b'.1' S'ar a i . �� Y} 4t, l� E r0, °)_i!7i1c3';:A:s;�:f�,t�LSrY !"' - •.�..i_...." .• u�..w' ,[. r.�. _: %F,,.k<kS.L:51iss"i�':nr<�� �s> '�"' ,.� :i� Distribution: !) Original - Loral Agency File Page 12-111 LPP 06-06 November 14,2006 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-Gl Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORK GENCY:ia�/n LOCATION: CGryj�,/_�1�/ R03ECT TDESCRIPTION: Liu f c.i OTAL CONTRACT AMOUNT: ID DATE: - .Z %C7 BIDDER'SNAME: - CONTRACT UDBE GOAL:,, Z ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED CerLNo,ofUDBS AND EXPIRATION(Must DATE NAME OF UDBEs be certified on the date bids aro opened - include UDBE address and phone number OAS DOLLAR AMOUNT ITEM NO, UDBE 74, zvd q5'i IiJ�✓J � iPur�G 1% - or Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number Federal Share: Total Claimed Participation $ [,r�, .3 - l[� ntract Award Date: cat Agency certifies that all information is complete and accurate. rintName Signature Date Local Agency Representative Ares Code Telephone Number Xpature S of Bidder �� - /V 6o? Zy JF Date (Area Code) Tel. No. 4", �-�i ��'•�_ __ For Caltrans Review: Print Name Signature Caltrans District Local Assistance Engineer Date Person to Contact (Please Type or Print) Local Agency Bidder - tMBE Commitment (Rev 3/09) Distribution: (1) Copy - Fax or scan a copy to the Caltrans District Local Assistance Engineer (OLAE) wain r 3 says or awara. ratmre m send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project (2) Copy -- Include in award package to Caltrans District Local Assistance Q) Original -Local agency files C-21 Page 15-31 LPP 09-xx March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) 'Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (if 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agenc>iCS should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 C-22 March 27, 2009 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE' REFER TO INSTRUCTIONS ON THE REVERSE'STDE OF THIS FORM AGENCY: •�5/ O r" �/+�iTie ,• LOCATION: ©,04"6r _e,,,r4K ROJECT DESCRIPTION: i=F �yt Jy� A�, OTAL CONTRACT AMOUNT- S BID DATE: y- 2,6 _ /p iDDEWS NAME: ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBE Cent. No. AND EXPIRATION DATE NAMB OF DBEs (Must be certified on the date bids()BE are opened - include DBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. Vr�e2,01 h'ovhe$rr_ or Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number. ederat Share: Contract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate Print Name Signature Dale Local Agency Representative Area Cock Telephone Number: Total Claimed Participation $ +� (r0 l Jdar &L 7C1 % Signature of Bidder el 2B �y 7`y Alj =f 4rf date (Area Code) Tel. No. �� �-- C%��✓ For Caltrans Review: Print Name Signature Caltrans District Local Assistance Engineer Date Pe on to Contact (Please Type or Print) Local Ageney Bidder DOE information (Rev 3M) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project (2) Copy — include in award package to Caltrans District Local Assistance (3) Original — Local agency files C-23 Page15-32a LPP Q9-xx March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSF UIL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. HAPORTANT: Identify all DBE firms participating in the project —including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b C-24 March 27, 2009 UP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort ]FOM 3IT 15-H UDBE INFORMATION --GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE C�.einmitment" of the Special Provisions: A. The names and dates of each publication in which a req t for UDBE participation for this project was placed by the bidder (please attach co es of advertisements or proofs of publication): Publications DateAertisement B, The names and dates of written and the dates and methods used whether the UDBEs werei int confirmations, etc.): Names of UDBEs sent to certified UDBEs soliciting bids for this project wing up initial solicitations to determine with certainty ase attach copies of solicitations, telephone records, fax Date of Initial Solicitation Follow Up Methods and Dates C. The itemsyf of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx C_25 March 4, 2009 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain- a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. _ e± JJ-1,4;o a Company Name By V-,, Z /) - /� 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. A. SSG f,r Golden State Constructors, Inc. 6162 Gaf!pean Dr. Huntington Beach, CA 92647 Phone:714-625-8758 Fax:714-625-8295 2009 Rc ire ces0 City Of Newport Beach Alfred Castanon 3300 Newport Blvd. Newport Beach, CA 92663 949-644-3314 Construction Dates: 9/14/09 to 1/31/2010 Project: Coastal Access — River Ave Bid Amount: $1,006,579.92 Project Total: $ N/A City of Anaheim Matt Card J 200 S. Anaheim Blvd. Suite 276 Anaheim, CA 92805 (714) 765-5176 Construction Dates: 7/20/09 to 8/7/09 Project: Bikeway/Pedway Bid Amount: $267,765.50 Project,Total: $.278,275.50 City of Irvine Kal Lambaz 1 Civic Center Plaza Irvine, CA 92606-5207 949-724-7555 Construction Dates: 7/20/09 to 8/7/09 Project: School Enhancement Project Bid Amount: $26,746.25 Project Total: $ 40,335.75 City of Monterey Park Vennie Bermudez 320 W. Newmark Ave. Monterey Park, CA 91754-2896 626-307-1325 Construction Dates: 5/12/09 to 5/29/09 Project: Driveway Entrance Modification Bid Amount: $36,702.20 Project Total: $36,702.20 City of Norwalk Randy Hillman 12700 Norwalk Blvd Rm 16 Norwalk, CA 90650 562-929-5719 Construction Dates: 5/4/09 to ongoing Project: Median Island and Striping Modification Bid Amount: $73,963 Project Total: $80,460.15 {;olden St a f, Coi) tructors, Inc. References Page 1_ Golden State Constructors, Inc. References 11acze I City of La Habra Chafik Mouradi 201 E. La Habra Blvd La Habra, CA 90631 562-905-9720x209 Construction Dates: 4/27/09 to 5/1/09 Project: Traffic Management — Traffic Calming Bid Amount: $48,568 City Of Newport Beach Alfred Castanon, Public Works Department 3300 Newport Blvd. Newport Beach, CA 92663 949-644-3314 Project Total: $ 52,000 Construction Dates: 3/9/09 to 4/28/09 Project: Balboa Village Alley Replacement Bid Amount: $128,606 Project Total: $142,000 City of Huntington Beach Villa Pacific Huntington Beach, CA Construction Dates: 2/27/09 to 3/6/09 Project: Villa Pacific ADA Ramps Bid Amount: $7,200 Project Total: $7,200 City of Tustin Jason Churchill, Public Works Dept. 1472 Service Road Tustin, CA 92780 714-573-3350 Project: Slope Repair Construction Dates: 2/4/09 to 2/4/09 Bid Amount: $4,100 Project Total: $4,100 Department of Public Works Public Works 3rd Floor N306 100 N. Garfield Ave, P.O. Box 7115 Pasadena, CA 91109-7215 626-744-7389 Construction Dates: 1/5/09 to 2/27/09 Project: Hamilton Park Drainage Improvements Phase II and III Bid Amount: $236,321 Project Total: $403,571 Golden State Constructors, Inc. References Page 2 \G.00(den State Constructors, Inc. 6162 Gafipean Dr. Huntington Beach, CA 92647 Phone: 714-625-8758 Far 714-625-8295 20081Ze_ ferences: City of Laguna Beach Steve May 505 Forest Ave. Laguna Beach, CA 92651 949-497-0351 Construction Dates: 11/18/08 to 11/25/08 Project: Curb and Gutter Replacement Bid Amount: $16,926 Project Total: $16,926 City of Santa Ana Terry Daugherty 20 Civic Center Plaza Santa Ana, Ca 92701 714-615-0891 Construction Dates: 10/27/08 to 11/26/08 Project: Plaza of the Sun Drainage Improvements Bid Amount: $42,214 Project Total: $52,750 City of Stanton Nick Guilliams 7800 Katella Ave Stanton, CA 90680-3162 714-379-9222 Construction Dates: 10/6/08 to 10/17/08 Project: PCC Rehabilitation — Bradford Place and College Drive Bid Amount: $61,340 Project Total: $67,473 City of Huntington Beach t Dereck Livermore 2000 Main Street Huntington Beach, CA 92648 714-392-4007 Construction Dates: 7/28/08 to 10/10/08 Project: Curb ramps in Various Locations Bid Amount: $167,123 Project Total: $183,600 Golden State Constructors, Inc. References Page 1 Moffatt & Nichol Gary Foster 3780 Kilroy Airport way Ste 700 Long Beach, CA 90806 562-426-9551 Construction Dates: 6/9/08 to 6/9/08 Project: Harbor Vopak Project Bid Amount: $4,538 Project Total: $5,503 City of Norwalk Randy Hillman 12700 Norwalk Blvd Rm 16 Norwalk, CA 90650 562-929-5719 Construction Dates: 7/15/08 to 7/25/08 Project: Senior Center ADA Improvements Bid Amount: $26,892 Project Total: $32,850 County of Orange Tony Nevarez 1143 E. Fruit St. Santa Ana, CA 92701 714-567-7799 Construction Dates: 5/22/08 to 5/24/08 Project: Court House Concrete Replacement Bid Amount: $14,713 Project Total: $14,713 Long Beach Water Dept. 1800 E. Wardlow Rd. Long Beach, CA 90807-4931 562-570-2300 Project: Water Line Replacement Construction Dates: 4/28/08 to 7/14/08 Bid Amount: $149,575 Project Total: $177,328 City of Rancho Santa Margarita 22112 El Paseo Rancho Santa Margarita, CA 92688-2824 949-63 5-1800 Project: E1Corazon Sidewalk Project Bid Amount: $54,130 Construction Dates: 3/17/08 to 4/21/08 Project Total: $61,081 Norwalk City Hall Randy Hillman 12700 Norwalk Blvd Rm 16 Norwalk, CA 90650 562-929-5723 Construction Dates: 2/7/08 to 5/4/08 Project: Pool Deck Concrete Repairs Bid Amount: $68,648 Project Total: $83,236 Golden State Constructors, Inc, References Page 2 City of Laguna Niguel Attn: Nick Renn 27791 La Paz Road Laguna Niguel, CA 92677 949-362-4337 1 Construction Dates: 1/8/08 to 2/9/08 Project: Crown Valley Restroom Project Bid Amount: $131,736 Project Total: $143,149 Norwalk City Hall Randy Hillman 12700 Norwalk Blvd Rm 16 Norwalk, CA 90650 562-929-5723 Project: New Doors at City Hall Construction Dates: 2/2/08 to 2/4/08 Bid Amount: $10,040 Project Total: $10,040 Golden Sete Constructors, Inc. References Page 3 'q 'M Go(den State Constructors, Inc. 6162 Gafiyean Dr. Huntington Beach, CA 92647 Phone:714-625-8758 Fax.714-625-8295 Department of Public Works Dale Torstenboe Public Works 3rd Floor N306, 100 N. Garfield Ave, P.O. Box 7115 Pasadena, CA '91109-7215 626-744-7389 Construction Dates: 11 /29/07 to 1 /2/08 Project: Hamilton Park Drainage Improvement Bid Amount: $89,176 Project Total: $95,696 California State Lands Commission Annabell Abeleda 100 Howe Ave. Ste 100 South Sacramento, CA 95825-8202 916-574-1871 Construction Dates: 10/8/07 to l/l/08 Project: Install Utilities for Wetlands Trailers Bid Amount: $99,993 Project Total: $133,413 City of Norwalk Randy Hillman 12700 Norwalk Blvd Rm 16 Norwalk, CA 90650 562-929-5723 Construction Dates: 9/17/07 to 7/29/07 Project: Concrete Courtyard Replacement Bid Amount: $38,733 Project Total: $38,733 City of Laguna Niguel Randy Trinkaus 27791 La Paz Road Laguna Niguel, CA 92677 949-362-4348 Construction Dates: 7/18/07 to 7/29/07 Project: George White Elementary Batting Cage Bid Amount: $55,367 Project Total: $57,787 Golden State Constructors. Inc. References Page 1 City of Laguna Niguel Randy Trinkaus 27791 La Paz Road Laguna Niguel, CA 92677 949-362-4348 Construction Dates: 7/18/07 to 7/29/07 Project: George White Elementary School Electrical Upgrade Bid Amount: $17,778 Project Total: $17,778 City of Laguna Niguel Randy Trinkaus 27791 La Paz Road Laguna Niguel, CA 92677 949-362-4348 Construction Dates: 7/16/07 to 7/29/07 Project: Sewer Repair at Crown Valley Elementary School Bid Amount: $14,375 Project Total: $30,749 Junipero Serra State Building Robert Langley 320 W. 4th Street, Los Angeles, CA 90013 949-362-4348 Construction Dates: 6/18/07 to 6/29/07 Project: Install hose bibs in Junipero Serra Building Bid Amount: $42,865 Project Total: $44,794 City of Huntington Beach Public Works 2000 Main Street Huntington Beach, CA 92648 To: Fronc c« GSG.L Fax 374 - /s 73 Fay %!¢ l2 S - S 2qS Date. 41Z7' Re: is oo Pages: 3 ❑ Urgent ❑ For Review ❑ Please Continent )d Please Reply ❑ Please Recycle m!/ 4 �r'r.q ; PA'f4'fie- a D8E'1 ('714) 536-S43/ fo scf Lp 4 t«e -fX> cue a.. Ccp" o4r, a 1'4 (So Local Assistance Procedures Manual Exhibit 15-G1 N. Local Agency Bidder UDBE Commitment (Construction Contracts) v Exhibit I5-Gi Local Agency Bidder UDBE Commitment (Construction Contracts) t NOTV�LEASE REFER �Q YTS iTCTIUI�TS ONTHE REVERSE SE3E fiETHIS FORKGENCYpp LOCATION: o r'+ Ca j xe !x PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT: $ S 8 ID DATE. - BIDDER'S NAME: 64 0 I - ONTRACT UDBE GOAL. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED rL No, of UDBE AND EXPIRATION DATE qAME OF UDBEs Must be certified on the date bids ut opened - include UDBE iddress and phone number CONTRACT DOLLAR AMOUNT TEEM NO. UDBE .ctL b eQds`$.S or Local Agency to Complete: Agency Contract Number: Federal Aid Project Number. edoral Share: Total Claimed Participation " 7/ 6 aty $ / , [f� Contract Award Date: Local Agency certifies that all information is complete and accurate. PrintName Signature Dale Local Agency Representative ArcaCode Tele howNumbcr: Agao ofBidder / q?� S®/ �ZQ — A' 0�-Zj -/VT F Date (Area Code) Tel. No. ,c/iC' ���'•-! For Ctlltx'ans Review: Print Name Signature Calf= District Local Assistance Engineer Date Person to contact (Please Type or Print) Loral Agency Bidder. UDBE Commiwmr (Rev 3M) k n h 0 M 71 Distrtbmtion: 43 coopy- Fax or scan a copy to the t:aurans uisma Local Assistanoc, tngmeer (uLAh) wnmm t a says or awam. raunre w I send a copy to the DLAE within 15 days of award may result in d"bligatico of funds for this projecL f (2) Copy -- include in award package to Caitrans district Local Assistance (3) Original -Local agency files M IY4 C-21 Page 157 LPP 09-xx March 27, 2009 Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder 138E Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE-S83E OF THIS FORM AGENCY: D LOCATION: e9,44"6F ��vr-TSB PROJECT DESCMPTION: :�A F-F -+�i f� .5 Vie � TOTAL CONTRACT AMOUNT: $ / �46 S¢ 7 tDDATE: ^Z6-10 L- BIDDER'S NAME' "I d ( 'i s �t�yS� �r U4..f ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS TO BE PROVIDED DBECOrLNo. AND EXPIRATION(Must DATE NAME OF DRES be certified on the date bids are opened - include DBE address and phone number NTRACT DOLLAR AMOUNT ITEM NO. D13B f1L e✓ f ? 6 cS 2S V s� A P PrZ65 - p6¢ ouiE Or Local Agency to Complete: Local Agency Contract Number. Federal Aid Project Number. Federal Share: Contract Award Date4 Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Te one Number Total Claimed Participation of 7 C•+' % Signature of Bidder -t�/ 1d 70 7eY ,�;'% -f7.J"F Date (A�r�e�a7�Code) Tel. No. i✓•'"/l e C .GC�'r'�`✓ For Caltirans Review: Print Name Signature Date Caltrens District Local Assistahce Engineer Pe n to Contact (Please Type or Print) LoW Agency Bidder DRE Womiadon (Rev 31") Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this prajc#. (2) C*py — Include in award package to Caltrans District Local Assistance �. (3) Original — Local agency files C-23 Page 15-32a LPP 09-xx March 27, 2009 APR-23-2010 14:00 LINCOLN PACIFIC 626 960 7739 P.01 L I N C 0 L N P AC I F I C 4501 LIT'I'LlijOHN ST , "RALDWIN CALIPORNIA W06 FACSlMlLU'fKANSMTYTAL SHEET is P A Y, NUMBER; DATS L4 Mom; FAX NUMBER; M-Alyll 67.0-%0-77,39 Tr7 VOTAL NUMPRR OFSHEKiS INU�.UUINC CL)Vr?,: VEE 4 C3 URGENT Effef.)J? kPVTFW ❑ PLBASECOMMEAT PLZARF P UPLY Fl P1 FASK Kp,(..YCLE J.h Y C 0 r)Tr) NOY RECM7E MIF- 12 4DICkTW PAGES, PL2AESE CAU 626.96W"! 3 S INMAMIATFELY CITY OF LYNWOOD 1.1 _NOTICE INVITING BIDS For Construction of STOCKWELL DR., BENWELL DR.,,CARSON DR., LILITA ST. & Le SAGE ST. IMPROVEMENT PROJECT 1.1.1 NOTICE IS HEREBY GIVEN that sealed bids for the STOCKWELL DR., BENWELL DR., CARSON DR., LILITA ST. & Le SAGE ST. IMPROVEMENT PROJECT will be received. at the City Clerk's Office of, the City of Lynwood, 11330 Bullis Road, Lynwood, California 90262 until 10:00 A.M. (Pacific Time), on THURSDAY, JANUARY 21, 2010, at which time they will be opened and read aloud. The form of the_ bids_ shall be in , accordance With the Instructions to Bidders, and any bids received after the time and date specified above will be returned unopened. 1.1.2 WITHDRAWAL OF BIDS. No Bidder shall withdraw its bid for a period of sixty 60 days after the Bids have been publicly opened, subject to the exceptions set forth in Section 5103 of the California Public Contract Code. This sixty (60) day review period may be extended upon the written request of the Engineer, and written approval of the affected Bidders. 1.1.3 DESCRIPTION OF THE WORK: The Work encompassed by the Project is more specifically defined in the Contract Documents, but in general consists of, but is not limited to, the following Work: Street improvements including asphalt concrete (A.C.) pavement grind & overlay; removal & reconstruction of portland cement concrete (P.C.C.) curbs & gutters, sidewalks, curb ramps & driveway approaches; installation of new fire hydrants & services; and street striping placement. Location of the Work is Stockwell Dr. (Imperial Hwy. to Martin Luther King, Jr. Blvd.), Benwell Dr. (Imperial Hwy. to Martin Luther King, Jr. Blvd.), Carson Dr. (Imperial Hwy. to Martin Luther King, Jr. Blvd.), Lilita St. (Stockwell Dr. to Bullis Rd.) and Le Sage St. (Stockwell Dr. to Bullis Rd.) in the city of Lynwood, CA. The Work is to be completed before the expiration of FORTY-FIVE (45) WORKING DAYS from the date specified in a written "Notice to Proceed" from the City. The Engineer's Cost Estimate for the entire project is approximately $706,000. 1.1.4 AWARD OF CONTRACT: (a) The City of Lynwood shall award the Contract to the lowest responsible Bidder submitting a responsive Bid. Whenever additive or deductive items are included in a bid, the lowest bid shall be the lowest Total Bid Price on the Base Bid without consideration of the bid prices on any additive or deductive items. The City of Lynwood reserves the right to reject any or all bids or to waive any. irregularities or informalities in any bids -or in the bidding process to the extent permitted by law. (b) As a condition of award, the successful bidder will be required to submit payment and performance bonds and proof of insurance and endorsements as specified in the Contract Documents. 1.1.5 BID SECURITY: Each bid shall be accompanied by a certified or cashier's check or Bid Bond in the amount of ten percent (10%) of the Total Bid Price, payable to the City of Lynwood. CITY OF LYNWOOD - 030 NOTICE INVITING BIDS (w/Calif. Wage Rates Only) 1.1-1 (Calif.) CALIFORNIA UNIMD CERTIFIC-AXION PROGRAM DISADVANTAGED BUSINESS ENTERPRISE CERTIFICATE LJ LlNCOff, V PACYYIC BUILDER& INC. m L;{l1 LrrrLEJOHM gn mET �J RALDIM PAM CA 91705 Owner: I,WOLN CSIAN m O gasrsms E-tractorea C*ltRl�i ,e1.'11€iN `11us mo i ieete actata lrxlgea ttwt card ftm Is apponed by the +CWrio ds Unified CertMeadon Progra®r (CUCri as a Dtsadvarrtaged Snadncu 13aterprtse (DRE) as icftsi ed b3 ft UA. Deparirreat at'1 tranVc tadinm(00T) CFU49 Pars 26, :as mW 4e xmrnded, fartha fllawing NAICS €odes: NA1CS Cak(s) ° Lidltatesprtmary AAIC9 mde * 23621t, Blmt.ad Ccctactxs Work Cabepey Codes) CS531 3"P-UBTJ3RJNG SYST M C931)1 E MT>rkG C4DWTFLUj ION uccaso A Creticra! Eryg,irtewug Cant wwl C.o Elactrtalecmactar Cs15Oi C8 20 C9810 p Geac"I13uildipg Car_tro dx He Ci-vil ftia ter tMS AGE SIGNS, LTGHn-40 & SIGN IUIUW4i ClV1L ffjKGiaWX-RWG SMALL STRLG LIKES C4; Lour 5 ottage Systems i:ortlaaaox CERi1PMNG i4 ItCY: UCF 1 innNumbcr : 35831 r— z to O r- z n DEAR" 14VTOF T"NSPOiffATJON 192314M S7 REr, US 74 nma, 4 SA CILM&WTO, CA 9$M 10000 � Tune 5, 2QL 9 016) 324.1700 cue , 1C-fiR. its 0) ltit Ct]Cr"e priloF dad o6ja4we93, pranate and ma€ndaia a kret Haying fieW for IMEe ft CA hrob an F[derd! ald ca Xtuva. Rcutsure 0 asadiceembleadtoft *wag anRsdrrllbf aeE4aofUE.TIOT&4dstodow(radablodutheVaudit -j _j W Lo :u Q fli 1.1.6 CONTRACTOR'S LICENSE CLASSIFICATION: The Contractor shall possess a valid, unexpired -Class A Contractor's license approved by the State of California Contractors State License Board at the time of submitting bids. 1.1.7 CALIFORNIA WAGE RATE REQUIREMENTS: The Contractor and all subcontractors shall,;' pay the general prevailing rate of per diem wages as determined by the Director of the Department of 'Industrial Relations of the State of California for the locality where the work is to be performed. A copy of said wage rates and the latest revisions thereto are on file at the City Engineer's Office of the 'City of Lynwood located at 11330 Bullis Road, Lynwood, California., 90262. The Contractor and any subcontractors shall pay not less than said specified rates and shall post -a copy of said wage rates at the project site. 1.1.8 RETAINAGE FROM PAYMENTS: The Contractor may elect to receive 100 percent- of. payments due under the Contract Documents from time to time, without retention of, any portion.-oV the payment by"the 'City by depositing securities of equivalent value with the City,lin accordance with the provisions of Section 22300 of the Public Contract Code. 1.1.9 PRE -BID VISIT TO WORK SITE: There is NO pre -bid walk-through (i.e., pre -bid visit):for' this street improvement project. However, prospective bidders are encouraged to inspect •the proposed street improvement site or sites on their own time. 1.1.10 OBTAINING OR INSPECTING CONTRACT DOCUMENTS: (a) Contract Documents may be inspected without charge at the Public Works.'' Department, Engineering Division, 11330 Bullis Road, Lynwood, California 90262. (b) Complete sets of said Contract Documents may be purchased for 50 dollars (60 dollars if mailed) per set and are obtainable from the Public Works Department, Engineering Division, 11330 Bullis Road, Lynwood, California 90262. No refund will be made of any charges, for sets of Contract Documents. 1.1.11 ADDRESS AND MARKING OF BIDS: The envelope enclosing the Bid shall be sealed and addressed to the City of Lynwood, Attention-, City Clerk, and shall be delivered or mailed to the City Clerk at 11330 Bullis Road, Lynwood, California 90262. The envelope shall be plainly marked in the upper left hand corner with the name and address of the Bidder and shall bear the words "Bid For..." followed by the title and number of the Project and the date and -hour of opening Bids. The certified or cashier's check or Bid Bond shall be enclosed in the same. envelope with the Bid. BY ORDER OF THE CITY COUNCIL, CITY OF LYNWOOD, CALIFORNIA MARIA QUINONEZ, CITY CLERK Date: TUESDAY, DECEMBER 15, 2009, City of Lynwood G. DANIEL OJEDA, P.E. Director of Public Works/City Engineer Department of Public Works CITY OF LYNWOOD- 030 NOTICE INVITING BIDS (w/Calif. Wage Rates Only) 1.1-2 (Calif.) APR-23-2010 14:00 LINCOLN PACIFIC 626 960 7739 P.03 AKK"!1) t Tv rwM Search Returned 1 Records Query Criteria Pirm/1)BA Name: iincobi pH6 is huildcrs Pirm'fype: FEE Firm ID E'irmiDBA Name Address Une1 Address Un22 city SWA Zip Codc1 z1p Cude2 Gertlticatton TYPE. Email Area CVde Phone NwhAr Fax Are a Code Fax Phone Number Agency Namp crountioc Districts r)BE NAIL$ ACURE NAILS U931 WNCOLN PACIFIC 13=ERS, WC 45011 M LkJOHN MEET bAi nWiN PARK CA 91700 OBE IeMnttRiInW, <<-kectrw,com (626 ) WO-Tr38 (M) DEPARTMENT UE TRAMPORTATION 1$;A=36; 0T; obt 12; 438210: 541.'5A ! mon dun 0115:+ 9 00 PDT 201M C86041, qTM; CA605 M✓LSWE 3My, L04TM & SIGN ILLI IMINAI t0K C801 I RAW NMi&r- WurkCodes SY''T� FMk�lil'20G11/LEN6lVEERING;C98018UILDNGCUN 7RttGTt�N:G9814GM�tLSTRt TtJRE�+; CUM Rf 80CIVTiAL CLtOTRI A1, Uoense3 AGrancral Enr7':nzcring Oorntraetor, B Gwe9r taaldtrq Wntrrn:tur; CIO ClecUioal CoMrPcMr; EC MR tn=er, A .ender M Ethnicity Firm Type ASNAi PACIFIC U17B BaCk To OuefV Fom I of 1 61112009 3:53 PM CITY OF LYNWOOD 1.2 INSTRUCTIONS TO BIDDERS 1.2.1 DEFINED TERMS - Terms used in these Instructions to Bidders and the Notice Inviting Bids and not defined herein shall have the meanings assigned to them in the General Provisions of the Standard Specifications for. Public Works Construction (the "Greenbook") Current Edition and the Special Provisions of the Contract Documents. The term , "Bidder" shall mean one who submits a Bid directly to the City of Lynwood as distinct from a sub -bidder, who; submits a. Bid to a Bidder. The term "Engineer" shall be as defined in the Special Provisions. "Bid Documents" shall consist of ; those documents listed in Section 1.3 hereof. 1.2.2 COMPETENCY OF BIDDERS - In selecting the Lowest Responsible Bidder under the procedure set forth in Subsection 1.2.18 of these Instructions, consideration will be given not only to the financial standing of the Bidder, but also to the general competency of the Bidder for the performance of the Work covered by the Bid. To this end, each Bid shall be supported by a statement of the Bidder's recent experience on the form entitled "Bidders General Information,". bound herein. Resumes of key construction personnel who will be assigned to the Work shall also be required. Except as otherwise provided under Public Contract Code §20103.5, no Bid for the Work will be accepted -from .ak_, contractor who does not hold a valid contractor's license in the State of California for the classifications named in the Notice Inviting Bids at the time of opening Bids. 1.2.3 DISQUALIFICATION OF BIDDERS - More than one Bid from an individual, firm, partnership, corporation, or association under the same or different names will not be considered. If the City believes that any Bidder is interested in more than one Bid for the Work contemplated, all Bids in which such Bidder is interested will be rejected. If the City believes that collusion exists among the Bidders, all Bids will be rejected. 1.2.4 BIDDER'S EXAMINATION OF CONTRACT DOCUMENTS AND THE'•SITE (a) It is the responsibility of each Bidder before submitting a Bid to . examine' the Contract Documents thoroughly; visit the site to become familiar with local conditions that may. affect cost, progress, or performance of the Work; consider federal, state, and local laws and regulations that may affect cost, progress, or performance of the Work; study and carefully correlate the Bidder's observations with the Contract Documents; and notify the. Engineer of all; conflicts, errors, or discrepancies noted in the Contract Documents. (b) Reference is made to the Special Provisions for identification of those reports of explorations and tests of subsurface conditions at the site which may have been utilized by the Engineer in the preparation of the Contract Documents. However, such reports are NOT a part of the Contract Documents. The interpretation of such technical. data, including any interpolation or extrapolation thereof, together with non -technical data, interpretations, and opinions contained therein or the completeness thereof is the responsibility of the Bidder. (c) Copies of such reports and drawings will be made available for inspection by the City to any Bidder upon request. Those reports and drawings are NOT part of the Contract Documents, but any technical data contained therein upon which the Bidder is entitled to rely is limited to that set forth in the Special Provisions. (d) Subject to the provisions of Section 4215 of the California Government Code, information and data reflected in the Contract Documents with respect to underground utilities at or contiguous to the site is based upon information and data furnished to the City and the Engineer by the owners of such underground utilities or others, and the City does not assume responsibility for the accuracy or completeness thereof unless it is expressly provided otherwise in the Special Provisions. (e) Provisions concerning responsibilities for the adequacy of data furnished to prospective Bidders on subsurface conditions, underground utilities and other physical conditions, and possible changes in the Contract Documents due to differing conditions appear in the Standard Specifications and Special Provisions. (f) Before submitting a Bid, each Bidder must, at Bidder's own expense, make or obtain any additional examinations and investigations which pertain to the physical conditions (surface, subsurface, and underground utilities) at or contiguous to the site or which otherwise may affect cost, progress, or performance of the Work and which the Bidder deems necessary to determine its Bid for performing the Work in accordance with the time, price, and other terms and conditions of the Contract Documents. (g) Where feasible, upon request in advance, the City will provide each Bidder access to the site to conduct such investigations and tests as each Bidder deems necessary for submittal of a Bid. The Bidder shall fill all exploration and test holes made by the Bidder and shall repair damage, clean up, and restore the site to its former condition upon completion of such exploration. FORMAT-F INSTRUCTIONS TO BIDDERS CITY OF LYNWOOD - 100 1.2-1 APR-23-2010 14:01 LINCOLN PACIFIC CALIFORNIA UNIFIED 626 960 ?739 JUN ` 9 2-009 0:5! =5.. snd��asaK CERTIFICATION PRO (CUM n1GP"I'MNI T OF 7'1R.ANS PDRT.NrION Cm RIGHTS 1823 -140MUMI, MS-79 SACMM"O, CAA 9$811 Phrma. (916) 3 24-1700 To11 kree! 066) 81ab340 r= (916) 324-1 M? TTY, 711 Dew Btlsinwe Owner, Thank you for your cantimed intcreat in the Disadvantaged Ma iness Enterpzi sc (DBE) Certification. progP+XT,. We are plt-dt, l to inform you that your Vasiness has been recerd.f e l for the next five years from the issumce date on thr. mcksed ))BE certificate. wt: wish you much success in your business sn4eavors. 5inceroly, ANXCE 5ALAIS Ullief certif►caliun Linit Enclos= WE TOTAL P.O4 1. (h) The lands upori which the Work is to be performed; the; rights -of -Way and, easements for access thereto, and other lands designated for use by the Contractor in. performing the Work are identified in the- Plans (Contract Drawings) of the Contract Documents. All additional ,lands and access thereto requiredjor temporary construction facilities or storage of materials and equipment are to be provided - by' the Contractor:_,, Easements -for permanent structures or permanent changes in existing structures will be obtained and ; paid for-: by. the, City Unless- otherwise specified in the Contract Documents. (i) The submittal of a Bid will constitute an incontrovertible representation by the Bidder that the' Bidder' has complied with every requirement of this Section; that without exception the Bid is premised upon performing, the. Work' required by the Contract Documents and such means, methods, techniques, sequences, or procedures .of construction as may be indicated in or required by the Contract Documents; and that the Contract Documents are sufficient in scope, and detail to indicate and convey understanding of all the terms and conditions for performance of the Work. 1.2.5 INTERPRETATIONS - All questions about the meaning or intent of the Contract Documents shall be in writing and hand -delivered or mailed to the Engineer at the City of Lynwood, Public Works Dept., 11330 Bullis Road, Lynwood, California 90262, Faxes and a -mails will not be accepted. Interpretations or clarifications considered necessary by the Engineer in response to such questions will be resolved by the issuance of Addenda mailed or hand -delivered to all parties recorded by the Engineer or the City as having received the Contract Documents. Questions received less than 7 days prior to the date of opening Bids may not be answered. Only questions that have been resolved by formal written Addenda will be binding. Oral and other interpretations or, clarifications will be without legal or contractual effect. 1.2.6 BID SECURITY, BONDS, AND INSURANCE - Each Bid shall be accompanied by a certified or cashier's check or approved Bid Bond in the amount stated in the Notice Inviting Bids. Said check or bond shall be made payable to the City of Lynwood and shall be given as a guarantee that the Bidder, if awarded the Contract to perform the Work will enter into an Agreement with the City in the form provided in the Contract Documents, and will furnish the necessary proof of insurance/certificates and. endorsements,., Payment Bond, and Performance Bond. Each bf said bonds and insurance certificates shall be in the amounts stated in'the Standard Specifications or Special Provisions. In case of refusal or failure of the successful Bidder to enter into said Agreement, the. check or Bid Bond, as the case may be, shall be forfeited to the City. If the Bidder elects to furnish a Bid Bond as its security, the Bidder shall use the Bid Bond form bound herein, or one conforming substantially to it in form. 1.2.7 RETURN OF BID SECURITY - Within 14 days after award of the Contract, the City will return all bid securities accompanying such of the Bids that are not considered in making the award. All other Bid securities will be held until the Agreement has been finally executed. They will then be returned to the respective Bidders whose Bids they accompanied. 1.2.8 BID FORM - The Bid shall be made on the Bid Schedule sheets bound herein and the pages shall not be removed from the bound volume. Unless otherwise provided in the Notice Inviting Bids, in the event there is more than one Bid Schedule, the Bidder may Bid on any individual schedule or on any combination of schedules.. All bid items shall be properly filled out. Where so indicated in the Bid Documents, Bid prices shall be shown in words and figures, and in the event of any conflict between the words and figures, the words shall govern. The envelope enclosing the sealed bids shall be plainly marked in the upper left-hand corner with the name and address of the Bidder and shall bear the words "BID FOR,""followed by the title and number of the Project and the date and hour of opening of bids. The Bid Security shall be enclosed in the same envelope with the Bid. 1.2.9 SUBMITTAL OF BIDS - The Bids shall be delivered by the time and to the place stipulated in the Notice Inviting Bids. It is the Bidder's sole responsibility to see that its Bid is received in proper time. Bids will not be accepted after the appointed time for opening of bids, no matter what the reason. 1.2.10 NON -RESPONSIVE BIDS — Non -responsive bids will be rejected. A bid shall be considered non -responsive for reasons including, but not limited to, the following: 1. The Bidder fails to furnish a price for all Bid Items in the Bid Schedule when there is more than one Bid Item in the Bid Schedule. 2. The Bidder attaches unauthorized modifications, conditions, limitations, or provisions to the Bid. 3. The Bidder fails to list the percentage of work to be performed by subcontractors. 4. The percentage of work to be performed by subcontractors exceeds 50% of the Total Bid Price. 5. The Bidder fails to attend a required pre -bid walk-through. 6. The Bidder fails to provide written acknowledgement of receipt of all Bid Addenda. 7 Other reasons as permitted by applicable law. FORMAT-F CITY OF LYNWOOD - 100 INSTRUCTIONS TO BIDDERS 1.2-2 rI, 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 SCHOOL, JOB/BID NO. 1367, 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 19TH day of APRIL, 2010. BY: NORTH RICAIK SPECIALTY INSURANCE COMPANY RANDY SPQHN, ATT(PRICEY-IN- GROUPNAS SURETY 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 duty organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Itasca, Illinois, each does hereby make, constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SEVERALLY Its true and lawful 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 24ih of March, 2000: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." naanlN By ,�4d4pPP0i d,'G i • 5�1. Stevrn P. Andersaq PreaWeat & ChhrF.xeenlive Onicer of waehfngton laterastional [nsaraace Company $ i SEAL v0v .�. sTi t973 ln;�s h Senior Vitt PmWeal or North American Specialty Insurance Company By David M. Laymsn, Senlor Vim Presides of warhmngton International Insurance Company & Vice President ofivorth 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 30th day of September 2008 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Du Page ss: On this 30th day of September 20 08 , before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Senior 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 comnanies. "OFFIOAL511 D. SKLENS Notary Pubti , Stater of nhwis my coaunisewn Eupires 19it UM11 Donna D. Sklens, Notary Public I, James A. Camenter , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies thisl9th day of April 2010 , Jam- A. Corpema, Vice PreAdont & Aasismta Scovtmy ar. WaQdngtm International Insurance Company& North AmeAc m Specialty Insurance Company State of CALIFORNIA County f ORANGE On before me, Erika Guido, NOTARY PUBLIC-, personally appeared RANDY SPOHN ® who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/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 QUIDU OC®MM. # 1843731 NOTARY CALIFORNIA RANG .Mv comm. expires Ma_ Y` 3 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my nd and official seal. s8nature of Poiffiv 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 State of California County of a'CJ,I5L,, On before me, C)1//? .f�'2%a personally appeared r: /J"/1 2 6(Ia�f?Y�' > who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/ -are subscribed to the within lmt umentt and acknowledged to me that he/sheAhey executed the same in hisfhmMaeir-authorized capacky(tes), and that by his/herAheif signatures-) on the instrument the person(&), 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. %�UDLACOCH RAN 4-MM. #1722119 m WI my ha d o WORANGE Cy Conan. Exp. Jan 30,201 1 of #66y Public Seat) DESCRIPTION OF THE ATTACHED DOCUMENT IS �� nQ (Title or description of Atarhed end) (Titk or description of attached docu nent continued) Number of Pages Document Date (Additional infommtimt) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attomey-in-Fact ❑ Tmstee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any ackAm►k4sumt c nnpleted in Calif— mast contain verbiage exactly as appears above in the notary section or a separate acknowledgment form mast be properly completed and attached to that docent. The only exception is if a document is to be recomW outside of C&Iforma in such mAi nces, any alternative acknowledgment verbiage as soy be printed on mach a document so long as the verbiage does not require the notary to do something that is tllegat for a notary in California (Le. Certtfyrng the aathor&od cqxwnyy of the signer). please Check the document cmefallyfor'propernotarial worming and attach d usform ifrrgaired. . State and Cotmty information must be the State and County where the document signer(s) personally appeared before the notary public for ado—ledgmant. . 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 commissimn followed by a comma and then you title (notary public). . Print the name(s) of doanttett signa(s) who personally appear at the Come of notarization. . Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. be/she/Vw)L,- is Iwo) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording- ® The notary seal impression must be clew and photographically reproducble. Impression must not cover text or lines If seal impression smudges. re -seal if a sufficient area permits, otherwise complete a dd%rent acmowledgment 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. 4 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 doamteat City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK June 29, 2010 Golden State Constructors 6162 Galipean Drive Huntington Beach, CA 92647 Re: Safe Routes to School — Spring View Middle School — CC-1367 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, J L. Flynn, CM 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 Citi fl%gj,KJ f}\caW,: 4Wftgr.g0JNew Zealand (Telephone: 714-536-5227 ) 1, 1 CONTRACTOWS CERTIFICATE state and certify that: (Name of Declarant) 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"): 1 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: f 0Cf Name: [Type Name] Title: [Type Title] 245914 1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above -referenced project ("Project') hereby certifies that it has complied with Title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20_, at , California. (Type Contractor Name) By: CI Name: [Type Name] Title: [Type Title] E , IF R c�RA �- t� - A 0RNEY 3--,)6-up 245911 1 Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit 'requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20 , at , California. (Type Contractor Name) By: Name: Title: [Type Name] [Type Title] -Tus o3 • ab • 0-1P 2475411 RECEIVED BY: (Name) (Date) TO: Shari Freidenrich, City Treasurer -�- �—� FROM: DATE:6A9116' 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. /.36 7- MSC No. Approved — //0 (Council Approval Date) ;r G (Company 423 0 S—A Agenda Item No. City Clerk Vault No N- CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating #27 g:/foilowup/bondletter.doc Bond No.2097652 KNOW ALL PERSONS BY THESE PRESENTS that WHEREAS, the City of Huntington Beach (hereinafter referred to as "City") has awarded to Golden State Constructors, 6162 Galipean Drive, Huntington Beach, CA 92647 (name and address of Contractor) (hereinafter referred to as "Principal"), a contract ("Contract") for the work described as follows: Safe Routes to School, Spring View Middle School, Cash Contract 1367 (project title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOWTHEREFORE, we, the undersigned Principal, and North American Specialty Insurance Company, 701 S. Parker Street, #3800, Orange, CA 92868 (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 Sixty —Six Thousand Five Hundred Forty and 00/100 dollars, ($166, 540.00 ), this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns; jointly and severally, firmly by these presents. THE CONDITION OF THiS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code ("Claimants") for all labor, materials or services used or reasonably required for use in performance of the work described in the Contract, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same,. in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be, null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. Surety stipulates and agrees, for value received, that no change, extension of time, alteration, addition or modification to the terms of the Contract, or any contract document or any work to be performed thereunder, whether made after notice or not, shall in any way affect, impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such change, 277599.1 PAYMENT BOND Page 1 of 2 Bond No. 2097652 extension of time, alteration, addition, or modification to the terms of the Contract, the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEROF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: June 22nd, 2010. ATTEST Golden State Constructors (Corporate Seat) (Princi ame) By: P'15' � Name: ,),j, Its: -g fz S ATTEST North American Specialty Insurance (Corporate Seal) Company (Surety Name) By Name: Matthew R. Dobyns (Signature of Attomey=in-Fact for Surety) 7( 14 } 550-7799 (Attach Attomey-in-Fact Certificate) (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH By �� ennifer Mc rath '*—City Attorney s�l 5 f 156 Note: This bond must be executed in duplicate and dated, all signatums must be notarized, and evidence of the authority of any person signing as attomey-in-tact must be attached. 277589-1 PAYMENT BOND Page 2 of 2 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL. POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Itasca, Illinois, each does hereby make, constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SEVERALLY Its true and lawful 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 20 of March. 2000: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and at] 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 shalt.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." srlrttpr rr kPy4 a�'��`g^na��u s ztoNgt r " tG By y ?. 5f:i4i. . n = Sievert P. Audem]4 PresMeat & Cblef P.:eeaave oflki of Wnhlurtaa Iettreatloni Imoranee Compsay '0 & Senior Vitt rmkime or North American Sp btty iomrasce Company 61 i Fo- himntt+� gy mays f ' is David M. Layman, Seolor Yiec rreddeoi M WmhlnQroa lotrroatienal Imaraa- Company & VI" rraidmi orNorth Aw icaa Sp-1-tty imurance C'empaay 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 30th day of September , 2008. North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Du Page as: On this 30th day of September 20J before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Senior Vice President of Washington International Insurance Company and Vice President ofNorth 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 comnanies. EMYE D. SIQ ENS sw6ommmDonnaD. Sklens,Notary Public mbrion PWiraa 10MMI 1, James A Caroenter , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 22 day of June 2010 i J. A. Cm vice President & Aumunt soaoury orweshiV- International IMu— Cmyway I North Amvimn SpeeAtty Inswam Cmwmy CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of CALIFORNIA County of ORANGE i On before me, Erika Guido, NOTARY PUBLIC, personally appea ed 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 P COMM. # 1843731 NOTARY PUBLIC CALIFORNIA o ORANGE COUNTY ^� My Comm. expires May 5, 2013 It I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. W TNESS alrtly hand and official seal. Though the data below is not required by taw, 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 a/a 5'P, On before me, 6L/,/,9,/,/,!' Adr/,!'Y/,. 9%;k9'7,1 personally appeared �OYOA.y/& � 1. , ar" , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(&) islwa subscribed to the within instrument and acknowledged to me that heAAwM ey executed the same in hisAterAheil<authorized capacity(-ies), and that by his/her heir 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. CLAUDIA COCHW COMM. #1722119 � m TNESS my h and ci eal. W %,Wn" �, F4 CWM Exp. Jan X 2011 of Notary Public (Notary Sean 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 Cahforma must contain verbiage exactly as appears above it the notary section or a separate achnowiedgment 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 aclorowledgmern 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 carefullyforp tper not —at wording and attach thisf— if regnued. • State and County information must be the State and County where the document signers) personally appeared before the notary public for admowledgment. • Date of notarization must be the date that the signers) personally appeared which must also be the same date the admowledgment 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 phwW forms by crossing off incorrect forms (i.e. Ws heMiey- is Iwo) 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 admowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk a Additional information is not required but could help to ensure this admowledgment is not misused or attached to a different document. • Indicate title or type of attached document, number of pages and date. �i 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 THE FINAL. PREMIUM IS PREDICATED ON THE FINAL CONTRACT PRICE KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 2097652 WHEREAS, City of Huntington Beach (hereinafter referred to as "City") has, by written agreement dated May 17th 12010 , entered into contract with Golden State Constructors, 6162 Galipean Drive, Huntington Beach, CA 92647 (name and address of Contractor) (hereinafter referred to as "Principal"), for performance of the work described as follows: Safe Routes to School, Spring View Middle School, Cash Contract 1367 (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract. NOW THEREFORE, we, the undersigned, as Principal, and North American Specialty Insurance Company, 701 S. Parker Street, #3800, Orange, CA 92868 (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, areheld and firmly bound unto City in the penal sum of One hundred Sixty —Six Thousand Five Hundred Forty and 00/100 Dollars ($166,540 -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 payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severalty, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the Principal shall promptly, fully and faithfully perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall indemnify and save harmless City and all of City's officers, agents and employees (hereinafter collectively referred to as "Obligees") from any and all losses, liability and damages, claims, judgments, stop notices, fees and costs of every description, whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract, Including all alterations, amendments and modifications thereto, and any warranties or guarantees required thereunder, then this obligation shall be void; otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees, for value received, that no adjustment of the time or price in the Contract or any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract time or contract price, and 277591.1 PERFORMANCE BOND Page 1 of 2 Bond No. 2097652 any other alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, and agrees to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations, changes, deletions, additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code §§ 2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: June 22nd, 2010. ATTEST Golden State Constru tors (Cvrpvra to vc�oi} ( nri ame) By. Name: ,Jn)tc Title: ATTEST North American Specialty Insurance Com an (Corporate Seal) L(Surety Name) e� By: �' _ Name: Matthew RKD�y ns (Signature of Attomey4n-Fact for Surety) (Attach Attorney -in -Fact Certificate) 7( 14) 550-7799 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY 0 UNTINGTOU BEACH 3Ye&nnifte!Lr c M ath s/js1g�ity Aorney 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 in4act must be attached. 277S91.1 PERFORMANCE BOND Page 2 of 2 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Itasca, Illinois, each does hereby make, constitute and appoint: RANDY SPOHN and MATTHEW R. DOBYNS JOINTLY OR SEVERALLY Its true and lawful 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 24d of March, 2000: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shalt 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." alnanplKr �1, IrY GUy4 BY Stereo P. Aaknoo, President & ChkrExeeoWc Onker of Washington bttraational Insurance Cwopany S s t9r3 & Senior Vitt President or Korth American Specialty Insurance Campany �! t Jnrnnn+� B r" ' David M. Layman, Senior Vier P_ m"eut orwashingroa international IrourancrCarnpony & Vice President or North Amerkao specialty laannnee Cont"ay 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 30th day of September , 2008 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Du Page as: On this 30th day of September . 20 08 , before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Senior 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. -OFFtt3At.StinC A S[Q M Mobw Public Suck of Mmm bey Commfaon Fxpi— t0A6 l; Donna D. Sklens, Notary Public 1, 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 American Specialty Insurance Company and Washington International insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 22 day of June 2010 James & Carpenter, Vice President & Atststenr socmtary of Washington intrnwhanal insurance company & North Ammicros Specially Insurance CW V—y f. , CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of CALIFORNIA County of ORANGE AN3 On before me, Erika Guido, NOTARY PUBLIC, 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 GUI C14l :... COMM. # 1843731 :E g NOTARY PUBLIC CALIFORNIA o r ORANGE COUNTY 2 My ccMn expires May 5, ^_✓Ii f? 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. Though the data below is not required bylaw, 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 b State of California County of on -22-to personally appeared PW,0 y/y/1p, 2C Qr,& y/ who proved to me on the basis of satisfactory evidence to be the person(s) whose name(-&) is/e&e subscribed to the within instrument and acknowledged to me that heMieAhey executed the same in his "- - 'rya- authorized capacity(ies), and that by his/hefAheir signature(s) 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. W17 tSmy:hand d offs i �sea Signature of Notary Public (Notary Seal) OADA COCHRM M#1722118 aPuWb o MNGE COUNTY Exp. d8r 30. 2011 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (111c or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAWED 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 mast contain verbiage exactly as appears above in the notary section or a separate acnowledgment form mast he properly completed and attached to that document The only exception is if a dacament is to be recorded outside of Qdtfor► a. In such instances, any afterrutive aacknowledgmew verbiage as mxey 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 Carhforwa (t.e. certifying the aathonfzed capacity of the signer). Please check the document carefallyforproper notarial wwdng and attach thisform 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. hen/sheMwir is /4o ) or circling the correct fours. 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. 3� Indicate the capacity claimers 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 ACM. C.'EI�TIFICA`TE OF LIA�ILITV IIVSUFZAIVC� OP ID DATE(MMIDD/YYYY) GOLDENS 06 16 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Huntington Pacific Ins. Agency 7901 Professional Circle HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Huntington Beach CA 92648 Phone: 714-841-6283 Fax: 714-842-2538 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Scottsdale Insurance Company INSURER B: Mercury Casualty Company 11908 Golden State Constructors, Inc 6162 Galipean Drive Huntington Beach CA 92647 INSURERC: Everest National Ins Co. 10120 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATEYM/D/YEFFECTIVE POLICYEXPIRATION M/DD YIY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 A X X COMMERCIAL GENERAL LIABILITY BCS0021352 01/31/10 01/31/11 PREM1 ES(Ea occurence) $ 100,000 CLAIMS MADE [;7'1 OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1 , 000 , 0 00 X POLICY PRO- LOC JECT B AUTOMOBILE X LIABILITY ANY AUTO CCA0006989 02/06/10 02/06/11 COMBINED SINGLE LIMIT (Ea accident) $ 1 000,000. BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS j D AS DAMAGE (Per accident) $ eA yePROPERTY GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO ` OTHER THAN EA ACC I $ $ AUTO ONLY: AGG EXCESSfUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ Is $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 7600004867101 02/06/10 02/06/11 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE. $ 1 , 000 , 000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT 1 $ 1 , Q 00 , 0O0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Huntington Beach it's Agents,Officers and Employees are named as Additional Insured in respects to the General Liability. This Insurance is Primary & Non Contributory. Waiver of Subrogation applies per written contract. ff9T*ar17ra3Oil r!ry;4gAe1111I[a]0 CI TYHUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Huntington Beach DATE THEREOF, THE ISSUING INSURER WILL $@(C AMMAIL 30 DAYS WRITTEN it's Agents , Officers and NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, l9 f Employees 2000 Main Street Huntington Beach CA 92648 AUTHOR_ DD REPRESENTATIVE !/ l eR ACORD 25 (2001/08) V© ACORD CORPORATION 1988 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. Policy # BCS0021352 -COMMERCIAL_ GENERAL LIABILITY CG 20 33 07 04 THIS -ENDORSEMENT CHANGES"'THE POLICY. PLEASE READ IT CAREFULLY.' The City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers 2000 Main Street Huntington Beach, Ca 92648 COMMERCIAL GENERAL LIABILITY COVERAGE PART A Section it — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing opera- tions when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with re- spect to liability for -"bodily -injury, "property dam- age",:or "personal .and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations far .that . additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any - - professional architectural; engineering or surveying services, including:. . a. The preparing, approving, or failing to pre- p�e -or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- mi , ► ejoter�r ox—r_ep-air-s)-to_be;pier-- formed by or on behalf of the additional in- ganA(s) - at- the " location of --the the covered operations has been. completed; -or .................... K. TK& portion of 'your -work" -out of which the injury or-¢amage:ar�ses-has been put -.to its rntendgO._usse. by. any -person. _or. -organization. other than another contractor or suboon- ttactor__engaged_ in --performing operations for a.orind p-aTas a part.af, the same project. CG 20 33 07 04 ® ISO PropertiesInc 3004_ .. _ Page 1 of.1 D- . Insured copy ..- --- -- --POLICY NUMBER: ECS00-2-1352 - COMMERCIAL: GENERAL LlAfNLITY- . CG 20 37.07 04 -THIS ENDORSEMENT -CHANGESTHE-POUCY.- PLEASE -READ -IT -CAREFULLY. ........... ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONR -- - - -------- This endorsement modifies insurance provided under the following: .... .... ...... .. 11I.I.. .. . ......... . . ...1._.........._ ..... .. .... COMMERCIAL GENERAL LIABILITY COVERAGE PART bCHEDULE Name Of Additional Insured Person(s) Or Organization(s); Location And Description Of Completed Operations ALL LOCATIONS The City of Huntington Beach its officers, elected or appointed officials,employees, agents & volunteers 200 Main Street Huntington -Beach, Ca 92648 the Section 11 - Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with ..respect Jo liability.. lor. - .."bodily ini P-erty damage" caused, in wholeorin part, by 'your work" ..at- the - location designated_.and--described -inthe_ schedule_, of this endorsement performed...joc..thot.. additional. -insured- - --''*and-included--, '----.-.:jnA-he, j"prod ucts-- completed-op-erabons-.hazard"..--- CG 20 37 07 04 ISUPropgqies, _tqq�_2004: -p-age ......... ....... ...... .... . ...... hmed Copy POLICY NUMBER BCS0021352 COMMERCIAL-GLNERAL--LfABIUTY— CG 24 04 05 09 WAIVER OF_TRANSFER OFRIGHTS OF RECOVERY- AGAJNST-OTHERS TO US This-.endorsemen.txnodifies_insurance-provided under the. -following - COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS( COMPLETED OPERATIONS LIABILITY COVERAGE PART -SCHEDULE 1 Norm Of Person Or Organization: The City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers 200 Main Street Huntington Beach, Ca 92648 ....... The following is added to_Paragraph 8 Transfer_O_ f Rights--f_Recoy! ry Against Others -To -Us -of Section - w=- :ordifiors: ---- _ ._ We wa�v_e,y .rlgY�f of recovery we have againsf, the person or.organ�zation shown m f. a Schedule above because -of payments we make for injury or damage arising out of your ongoing operations or "your-worW,done under a coritrect witWthat persor or:_orgaeize6on_and_inclu.ded_in:tbe_=. roducts--- cdiYlp# t =oper8tions h zarct":'fftis NaNer applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ® Insurance Services Office; Inca 2008 Insured COPY Council/Agency Meeting Held:_ / - ,�0/e) Deferred/Continued to: ] Appr edv ❑ Conditionally Approved ❑ Denied Ci y Clerfs Sign ft re Council Meeting Date: May 17, 2010 Department ID Number: PW 10-032 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Administrator PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Approve project plans and specifications, authorize execution, and award Construction Contract in the amount of $166,540 to Golden State Constructors, Inc. for the Safe Routes to School Project - Spring View Middle School, CC-1367; and, authorize 15% Change Order Statement of Issue: On April 20, 2010, bids were opened for the Safe Routes to School improvements in the vicinity of Spring View Middle School (CC-1367). City Council action is requested to award the contract to Golden State Constructors, Inc., the lowest responsive and responsible bidder. Financial Impact: Funds in the amount of $341,000 are appropriated for construction in Safe Routes to School, Traffic Improvements, Account No. 87890005.82700. Funding is $306,900 in grant funds from the state Safe Routes to School program with matching local Measure M funds of $34,100. The engineer's cost estimate for this project is $271,000. No additional appropriations are necessary. Recommended Action: Motion to: A) Approve the project plans and specifications for the Safe Routes to School improvements in the vicinity of Spring View Middle School (CC-1367); and, B) Accept the lowest responsive and responsible bid submitted by Golden State Constructors, Inc., in the amount of $ 166,540.00; and, C) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney; and, D) Authorize the Director of Public Works to execute change orders not to exceed a total of 15 percent of the contract construction costs. Alternative Action(s): Reject all bids and provide staff with alternative direction. -23- Item 3.. - Page 'I REQUEST FOR COUNCIL ACTION MEETING DATE: 5/17/2010 DEPARTMENT ID NUMBER: PW 10-32 Analysis: In April 2009, the City staff, working in conjunction with the Ocean View School District, applied for a grant for traffic safety improvements in the vicinity of Spring View Middle School under the Safe Routes to School program. The grant was approved and the State allocated funds in September 2009. The goals of the Safe Routes to School program include facilitating the planning, development and implementation of projects that improve safety in the vicinity of schools. This will enable and encourage children to walk and bicycle to school and make walking and bicycling, a safer and more appealing lifestyle choice. The project includes the installation of a traffic signal at the intersection of Heil Avenue and Trudy Lane, which is a major crossing point for students from Spring View Middle School. The traffic signal installation includes the modification of the island nose at the Heil Avenue frontage road to provide a pedestrian refuge area, along with minor drainage improvements. Also included are curb ramp installations along Trudy Lane, signing and striping improvements, and the removal of the flashing beacons along Heil Avenue that are no longer appropriate due to the installation of the traffic signal. A complete set of plans and specifications are available for review at the Public Works counter during normal business hours. Bids were opened publicly on April 20, 2010, and are listed in ascending order: Bidder Submitted Bid 1 Golden State Constructors, Inc. $166,540.00 2 PTM General Engineering Services, Inc. $188,088.00 3 Hillcrest Contracting $193,825.00 4 Southland Construction $195,200.00 5 Nobest, Inc. $210,000.00 6 Kormx, Inc. $211,325.00 7 All American Asphalt $216,620.00 8 Gass Construction Co., Inc. $230,000.00 9 EBS, Inc. $264,270.00 The engineer's estimate for the bid items was $265,000. The total estimated cost for this project is $271,000 which includes the City's direct purchase of all major equipment. This practice ensures consistency of equipment among the traffic signals and street lighting maintained by the City. Direct purchase also provides the added benefit of reduced costs to the City due to elimination of contractor mark-ups, typically in excess of 20 percent on this type of equipment. Staff is requesting that the Director of Public Works be given authorization to approve change orders on this project up to 15 percent of the construction cost rather than the standard 10 percent. The requested percentage equates to a 10 percent contingency based on the total of the construction contract and the materials purchased by the City. This authorization will Item 3. - Page 2 -24- REQUEST FOR COUNCIL ACTION MEETING DATE: 5/17/2010 DEPARTMENT ID NUMBER: PW 10-32 provide the added flexibility needed to complete a typical construction project yet still be consistent with the intent of the 10 percent limit. With the current condition of the pavement on Heil Avenue, there may be locations where small sections of pavement may need to be rehabilitated in order to properly install the traffic signal equipment. The reference check for Golden State Constructors, 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 Golden State Constructors, Inc. as the lowest responsive and responsible bidder. Public Works Commission Action: The Public Works Commission recommended this project on March 17, 2010, by a vote of 7-0. Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c). Strategic Plan Goal: Maintain, improve and obtain funding for infrastructure and equipment Attachment(s): -25- Item 3e - Page 3 ATTACHMENT #1 Item 3. - Page 4 -26- I[% PROJECT LOCATION MAP N.T.S. SAFE ROUTES TO SCHOOL —SPRING VIEW SCHOOL PROJECT AREA CITY OF HUNTINGTON BEACH f � ♦IiM 'Y DEPARTMENT OF PUBLIC WORKS TRAFFIC ENGINEERING M ATTACHMENT 1 Item 3e o Page 5 CITY OF HUNTINGTON BEACH Safe Routes to School in the Vicinity of Spring View Middle School CC-1367 BID OPENING: APRIL 20, 2010 @ 2:OOPM ENGINEER'S ESTIMATE: $235,000 BIDS SUBMITTED (AS READ AT OPENING) No. BIDDER'SNAME.F RANK APPARENT Bl®AMOUNT' 1 All American Asphalt 6, 2 BC Traffic Specialist 3 California Professional Engineering, Inc. 4 Christopher R. Morales 5 C. T. & F., Inc. 6 Dynaelectric 7 EBS, Inc. �Ll 5;�2v 8 El Camino Construction & Engineering 9 Excel Paving 10 G Coast Construction, Inc. 11 Gass Construction Co. Inc. 12 GSCI 13 Hillcrest Contracting 14 Kormx, Inc. a l 15 Lincoln Pacific Builders, Inc. 16 Macadee Electric 17 McCain, Inc. 18 Nobest, Inc. 19 Pavement Recycling Systems 20 1 PTM General Engineering Services, Inc. 21. R & M Electrical Contracting 22. Southland Construction gs� 23. Steiny & Company, Inc. 24. Traffic Loops Crackfilling, Inc. 25. Valley Slurry Seal 26. 27. co 01- C,4 2- 1. 0 ip /j� :7— V-2.0 - �,�� gin CITY OF HUNTINGTON 2000 Main Street P.O. Box 190 Huntington Beach, CA LETTER OF TRANSMITTAL Attention: Joan L. Flynn To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 92648 2 0.10 1-I'lli R 25 A£i 10: 58 Fax (714) 374-1573 Date: March 25, 2010 Project/C.C. No.: C.C. No. 1367 Regarding: Safe Routes to School, Spring View School ❑ 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 'Pa es t „ Descri `tion 1 1 1 Notice Inviting Sealed Bids for CC-1367, Safe Routes to School, in the vicinity of Spring View Middle School. 2 3 These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other: Remarks: Per Resolution 2009-50 (adopted on September 8, 2009), the City Council authorized the advertisement of the above Safe Routes to School, Project CC-1367. Please find attached the Notice Inviting Sealed Bids for advertisement on 4/1/10, 4/8/10 & 4/15/10. The bid opening is scheduled for 4/20/10. Please contact me at 374-1628 with any questions you may have. cc: file By: William F. Janusz, Rdncipal Civil Engi GACONSTRUCTION CONTRACTS (CCS)\CC1367 SR2SL CYCLE 8 SPRING VIEW\PRE-BID\NISB TRANSMITAL TO CLERK-CC-1367.DOC NOTICE INVITING SEALED BIDS for CC-1367 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 2:00 PM on April 20, 2010, at which time bids will be opened publicly and read aloud in the Council Chambers for the Safe Routes to School Project in the Vicinity of Spring View Middle School, CC-1367 in the City of Huntington Beach. A set of plans, specifications, and contract documents may be obtained starting April 1, 2010 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 on the 8th day of September 2009, by RESOLUTION 2009-50. Joan L. Flynn City Clerk of the City of Huntington Beach 2000 Main Street. (714) 536-5431 CC-1367 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 �{ NOTICE INVITING SEALED BIDS PUBLICATION (tfor` -136T Notice is hereby given that sealed bids will be received by the City of STATE OF CALIFORNIA) Huntington Beach at the office of the City Clerk at City Hall, 2000 Main ) SS. Street, Huntington, Beach, CA 92648, until' the hour of 2:00 ; TAT �T 7� �T l COUNTY OF ®l�t�l�lGE 0, at Appril 20, 2010, at 1 which time bids will be' opened '- publicly - and read aloud in the Coun-, am the Citizen of the United States and a cil Chambers for the ;Safe Routes to School 'the resident of the Count aforesaid; I am over y : orol'Iecf in vicinity of Sprin' View. Middle Schaal, in the the age of eighteen ears, and not a art g g y party f H'u67; city of Huntington to or interested in the below entitled matter. Beam_ am a principal clerk of the HUNTINGTON p p A set of:, plans; >pecifications; and con - BEACH INDEPENDENT, a newspaper of be tract ed starting April obtained startin Appril 1,.2010,'at general circulation, printed and published in .City Hall, Department of Public the City of Huntington Beach, County of Works upon receipt of a non-refundable fee of Orange, State of California, and the $40.00, sales tax in - , eluded, if'picked up or attached Notice is a true and complete copy $50.00 if mailed. ; Each "'bid •shall be as was printed and published on the ;made on the Proposal ;Form .provided -in 'the following date(s): contract document's' and shall be accompa- nied by a certified or cashier's check or a bid [bondfornot less'than 110% of the amount of ithe . bid, made payable ; ,to the City of Hunting- �ton'Beach..The Contrac- tor shall,; in the per- formance of .the work and improvements, con= form to the Labor Code April 1, 8, 15, 2010 lof 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= i suanf to which proceed- , declare under penaltyofperjury, that the ings hereunder are tak- en and, which have not Ibeen, foregoing is true and correct. superseded by the provisions of the Labor Code. Preference to la-. 'bor shall be given -only' in the manner provided by law. ` Executed on April 15, 2010 Nolbid shall be consid- ered unless it, is made! at Costa Mesa, California on a form furnished by the City';of Huntington; i Beach, Department of Public Works,. and is, made in "accordance I with the provisions of. the p'roposa`I' requirements. . 'Each .bidder must 6e licensed as required by raw. . Signature -The City,Council'of the I 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 on the 8th day of i [September - 2009, by ; RESOLUTION.2009.50. ' Joan L. Flynn- : I I City,Clerk of the.City of, Huntington Beach '2000 Main Street... (714) 536,5431 Published Huntington 6:Beach Independent April.? 1; 8, 15, 2010",,_ 041-5101 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); April 1, 8, 15, 2010 I declare, under penalty of perjury, that the foregoing is true and correct. Executed on April 15, 2010 at Costa Mesa, California Signature NOW INVITING , SEALED BIDS_ for t(-1367 Notice is hereby given that sealed bids will be received by the City of Huntington each at the office of the City Clerk at City all, 2000 Main Street,. Huntington Beach, CA 92648, until the hour of 2:00 PM on April 20,,'2010,: at which time bids will be opened publicly and read aloud in the Coun- 1 cil Chambers for., the Sole Routes to. School' Project in the Vicinity of Springg View Middle School, CC-1367 in the City of Huntington B_ea_cti A set of plans, specifications, and con- tract documentsmay be obtained starting `April 1, 2010, at City, Hall, Department .of Public Works upon receipt of a non-refundable- fee of ,$40.00,,'sales tax. in- I cluded, if picked up or i $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 t cashier's check or,a bid i bond for not less than 10% of the amount of i the bid, made •payable j to the City of Hunting- ton Beach. The Contrac- for shall, ,in the per- formance .of,the work and improvements, con- form to the Labor* Code of the State of Califor- ma,'and other -Laws of the State of California 1 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 t IT .p r o; p o.s a''I' requirements. Each bidder rfiust be licensed as required. by law. The City. Council of, the' City of. Huntington Beach reserves the right to reject any oe'all,bids. By order; .of the, City council of the City of Huntington .Beach, Cali- fornia on the'8th day of September 2009,. ,by. :RE SOLUTION-2009-50. ;Joan L: Flynn. City Clerk of the ;City of Huntington Beach .. 2000 Main Street. i (714)536-5431 ; Published Huntington ,Beach Independent April 11,8, 15, MO 041-510 UNSUCCESSFUL BIDS CC-13 67 Safe Routes to School in the Vicinity of Spring View Middle School CITY OF HUNTINGTON BEACH Safe Routes to School in the Vicinity of Spring View Middle School CC-1367 BID OPENING: APRIL 20, 2010 @ 2:OOPM ENGINEER'S ESTIMATE: $235,000 BIDS SUBMITTED (AS READ AT OPENING) No 8li)DER'S NAME'. RK �PARE,NT 131D AI�IOl3NT 1 All American Asphalt 2 BC Traffic Specialist 3 California Professional Engineering, Inc. 4 Christopher R. Morales 5 C. T. & F., Inc. 6 Dynaelectric 7 EBS, Inc. q Lbw 7,70 8 El Camino Construction & Engineering 9 Excel Paving 10 G Coast Construction, Inc. 11 Gass Construction Co. Inc. Z.30, 00D 12 GSCI 14 b, ro 13 Hillcrest Contracting 3 ti `l3, 0 z3" 14 Kormx, Inc. {� Z!!, 3z5 15 Lincoln Pacific Builders, Inc. 16 Macadee Electric 17 McCain, Inc. 18 rNobest, Inc. 5 2, 101000 19 Pavement Recycling Systems 20 PTM General Engineering Services, Inc. Z $1 B o0 0016 21. R & M Electrical Contracting 22. Southland Construction 1 QS"r 7-VD 23. Steiny & Company, Inc. 24. Traffic Loops Crackfilling, Inc. 25. Valley Slurry Seal 26. 27. City ®f Huntington Beach 2000 Main Street © Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERIC June 30, 2010 All American Asphalt P. O. Box 2229 Corona, CA 92878-2229 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe enclosure Sister Citiegsffj�U�e31b��b�New Zealand (Telephone: 714-536-5227) TO: I 2010 APR 20 PM 1: 50 ALL AMERICAN ASPHALT P.O. BOX 2229 CORONA, CA 92878-2229 RETURN REQUESTED SECTION C PROPOSAL, for the Safe Route to School In the vicinity of Spring View Middle School CC No. 1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THK" COUNCIL OF HUNTINGTON BEACH: � In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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. I D%. Accompanying this proposal of bid, find Ldl in the amount of $ ——�:rhich 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 shalt signify receipt of all Addenda here, if any: C-2 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 Item ` Estxgqmy•yated Item S t .. . . ....... `t.Jn�t Px�ce h L Extended Arnount�, 1 1 L.S. Mobilization. $1010C1-- T $ 10100.— Per L.S. 2 1 L.S. Monument Preservation. SWl-ib0•-' $ 3HOo• Per L.S. 3 1 L.S. Furnish Project Traffic Control, $12100 $ 1 -2-100. — Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $I O(D OQ• ' $ 1 a U O ®• — Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and TrudyLn, $80000•- $ 80000- Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $12,1 b 0 • _" $ 1-)-) 0 0- '- Depression per City Standard Plans 205, 311 and 315, (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A8813, Modified $-bj So • $ 5) 50- per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ q . — $ tU 300 • — Per S.F. C•-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-13 67 v Item F,stimated Item Ur3it Pry ee ` 'Extenided N..p ., vQuanti_ ,Amount 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan $ H D 00 • $ 5 (O 000 — No. A88A and AC Paving Replacement. Per EA, 11 4 EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ 00 • — -2 0 0 • — Per L.S. 12 11,000 S.F. Construct Type II Slurry Seal. $ 0. .r $ 19 C V-7 Per S.F. Total Amount Bid in Figures: $ 2-i �o `o 2 0 Elunt Bid in Words: $jyvp hUjociYwed S iX'JoLf) +)oU`aa hcl S -k- hU d eo( ± weh c4o)�o S. Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375- 5015. C-2.2 1 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. 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 State of California ss. County of Orange R_o tm+ Pb raA (i , being first duly sworn, deposes and says that he ewe is YU&P Prest dAAt of AJ) affleviAvo (92pUuj1+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. ' emu' i-• � •.�� Name of Bidder ell gnature of Bidder Address of Bidderl Subscribed and sworn to before me this day of , 20 ___ NOTARY PUBLIC NOTARY SEAL C-4 4- Sep Ruched Wjcria. J4vT,+ -qM CmjQekpr, CALIFORNIA JURAT State of California County of Riverside DEBBIE A. MATSEN - Commission # 1775685 Notary Public - California _ Riverside County MyComrn. Ex�lres Nov22, 2011 Place Notary Seal Above Subscribed and sworn to () before me on this 16th day of April, 2010, Date Month By (1) Robert Bradley Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) (,) (2) Name of Signer (and Proved to me on the basis of satisfactory evidence be the person who appeared before me.) Signature aLz:� Q 1 7'YlAt M&. 2 Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document Non -collusion Affidavit. City of Huntington Beach Document Date: April 16, 2010 Number of Pages: 1 Signer(&) Other Than Named Above: None UI`ILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGI'ON 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, in the vicinity of Spring View Middle School - CC1367, (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. By Roby►'+ C3r�dl� u 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 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. i * u.:Contractor _ V'i ce P�;, dr-A+ 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 V i « Pc,-5 ► aAg+ Title Note: This form is required for every Dig Alert Identification Number issued by U.SA. 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 U . -box - aq Business Address CvrOA!a rA- 01 a,87�3- as City, State Zip (q 51 ) -7 3 JQ- -7 LPDa Telephone Number :W- a&7D-23 14 C—ia State Contractor's License No. and Class Original Date Issued _ 1-31-a(91a Expiration Date The work site was inspected by: ), Q.e--��T of our office on J) a\ � E , 2010 'Pro�e�- Mctv��ev The following are persons, firms, and corporations having a principal interest in this proposal: I =YA-1 LL�W �11 C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. r�olnyl+ Company Name - of Bidder yolaP✓t �ra�l1��I�V(Icse P( 5icitn+- Printed or Typed Signature Subscribed and sworn to before me this _ day of , 200— NOTARY PUBLIC � Sse'e A4+aC W&'4 �Jo+o✓ia ( 3krct+ -Gturn &o Va6ov% 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 year . 5e,e pAtacha'd rooeS. 1. N 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 JURAT State of California County of Riverside Subscribed and sworn to () before me on this 16th day of April, 2010, Date Month By (1) Robert Bradley Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) (,) DEBBIE A. MATSEN (and Commission # 1775685 Notary Public - California z (2) z<: Riverside County (V�Cotnrn E�drzsNov22 2011 Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me.) Signature .QL&h d.,o Q 21�AA -2 Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document Bidder's Information, City of Huntington Beach Document Date: April 16, 2010 Number of Pages: 1 Signer(s) Other Than Named Above: None "2009" PAST WORK REFERENCES City of Costa Mesa 77 Fair Drive P.O. Box 1200 Costa Mesa, CA 92628-1200 Contact: Tom Banks, (714) 536-5431 City of Dana Point 33282 Golden Lantern Dana Point, CA 92628 Contact: Archie Rempher, (949) 248-3500 City of Beverly Hills 345 Foothill Road Beverly Hills, CA 90210 Contact: Juan Martinez, (310) 285-2521 County of San Bernardino 825 East Third Street San Bernardino, CA 92415-0835 Contact: Sri Srirajan, (909)387-7935 City of Redondo Beach 415 Diamond Street Redondo Beach, CA 90277 Contact: Javier Urista, (310) 318-0661 City of Westlake Village 31200 Oak Crest Drive Westlake Village, CA 91361 Contact: Roxanne Hughes, (805) 653-6597 Department of Transportation 12975 Culver Blvd. Los Angeles, CA 90066 Contact: Sixto Ramin, (213) 216-4406 City of Rialto 150 South Palm Avenue Rialto, CA 92376 Contact: Eddie Chan, (909) 820-2651 Prop 1 B Street Maintenance Contract Amount: $993,993.00 Start: 7/2009 On -going — not completed yet Annual Roadway Resurfacing Project Contract Amount: $3,982,982.00 Start: 4/2009 On -going — not completed yet 2008-09 Street Resurfacing Contract Amount: $4,085,000.00 Start: 1/2009 Completed: 8/2009 Arrow Route Contract Amount: $1,980,000.00 Start: 2/2009 Completed: 7/2009 . Public Improvement Package Contract Amount: $1,678,000.00 Start: 1 /2009 Completed: 9/2009 Joint Cities Pavement Rehab. Project Contract Amount: $1,242,241.11 Start: 6/2009 Completed: 9/2009 Route 27, Contract No. 07-2Y4904 Contract Amount: $915,511.00 Start: 6/2009 Completed: 9/2009 Route 210 Detour Contract Amount: $1,983,548.00 Start: 6/2009 Completed: 9/2009 "2008" PAST WORK REFERENCES City of Irvine One Civic Center Plaza P.O. Box 19575 Irvine, CA 92606-5268 Contract: Kal Lambaz, (949) 724-7555 City of Anaheim 200 South Anaheim Blvd. Anaheim, CA 92805 Contact: Sean Razmy, (714) 765-5069 City of Newport Beach 3300 Newport Blvd. Newport Beach, CA 92658 Contact: Andy Tran, (949) 644-3315 University Drive Rehabilitation Contract Amount: $3,445,289.40 Start: 1 /2008 Completed: 6/2008 Anaheim Blvd. Improvements Contract Amount: $278,391.00 Start: 4/2008 Completed: 6/2008 Superior Avenue Improvements Contract Amount: $862,862.00 Start: 1/2008 Completed: 6/2008 City of Westminster Citywide Street Improvements 8200 Westminster Blvd. Contract Amount: $1,118,383.00 Westminster, CA 92683 Start: 3/2008 Contact: Theresa Tran, (714) 898-3311 Ext. 282 Completed: 7/2008 City of Lake Forest 25550 Commercentre Drive, Suite 100 Lake Forest, CA 92630 Contact: Luis Estevez, (949) 461-3485 City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 Contact: Ed Torres, (714) 647-5018 Street Resurfacing & Slurry Seal Contract Amount: $1,638,523.00 Start: 2/2008 Completed: 4/2008 Santa Clara Avenue Improvements Contract Amount: $2,219,523.00 Start: 11/2007 Completed: 3/2008 (For federally funded projects, use this following page) HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): ME Will ensure that 10°l0 of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: 4' Contact Phone: „I• r Date: ilia a .` p *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&P Checklist Instructions Attachment C (!HE BIDDER'S EXECUTION ON THE SIGNAYME PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) The bidder sulxceRUW#QT- , hereby certifies that he has, Est__, 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. C-12 Page 12-79 LPP 01-04 March 1.5, 2001 Local Assistance Procedures Manual EXHIBIT 12-B PS&E Checklist Instructions Attachment D Noncollusioan Affidavit �. (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY l COUNTY of A i Ir�V i AI° DEPARTMENT OF PUBLIC WORKS: In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly col luded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-13 Page12-81 LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidders , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of; or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible maaagmg officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal•prosecudon. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall cample% under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? yes , No Yf the answer is yes, explain the circumstances in the following space. C-1.3 Public Contract Code 1OZ32 Statement In conformance with Public Contract Code Section I0232, the Contractor, hereby states wader penalty of penury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXH BIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: o Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; ® Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; s Does not have a proposed debarment pending; and o Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. _ N\A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal, Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Page 12-83 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLODBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Force-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15. Page 12-85 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist instructions DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G 1.:VMrLk 1L' Stilb t'VKM 1V UltSULVbb LUt3k$Y1NLi At;l'1YI11b5 YVFVNUAN't' "1'V 31 U.S.U. 1352 \Name Federal Action: 2. Statlas of Federal Action: 3. Report Type: ct ❑ a, bid/offer/appiicat:on a initial b. initial award b. Material change ative agreement c. post -award For Material Change Only: arantee year .�... quarter urance date of last report ddress of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime \ Q Subawardee "Pier , if known Congressional District, ' Congressional District, if known 6. Federal Departmei t �fknown y: 7. Federal Program NamODescription: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby En 'ty (If individual, last name, first ream (attach Coatinuati 11, Amount of Payment (check all that apply) $ 0 actual planned 12. Form of Payment (check all that apply): ❑ a. cash jk•�j+ b. in -kind; specify. nature value 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) Sheet(s) if necessary) 13. Type of Payment (check all that apply) a retainer b. one-time fee a commission contingent fee e Aelernrw f. o , specify 14, Brief Description of Services Performed or to be performed and Date(s) of ftrvice, including officer(s), employce(s), or member(s) contacted, for Payment Indicated in Item 1: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes No 16, Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure: of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: U.S.C. I352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: V I G� Pr�St �t?I/) person who fails to file the required disclosure shalt be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: �g5���b'lla�) _ Dater Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Form LLL Rev. 09-12-97 u C-16 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COIV.IPLETION OF SF-LLL, IDISCLOSURE 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 ding 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. l . 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 malting 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 E 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., 'IRFP-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. z 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. Mother, specify nature. r Page12-88 C-17 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04.90cM?IFN C-18 Page 12-89 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBrr 12-C Bidder's List of Subcontractors (DBE and Non -DUE) El1DDEWS LOST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (Moth DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Address/Firm Namet cityl'stlkt� ZIP 1 Description of Portion oWorkto be r F : ! : k�¢.n . „ pit+ . ■ t .t i�';3..� �ttb�uP �„�:rt•'�,Xr ■mF ■ a# j,5+�t1 E fEj����}' Fit: / R ■ R �� E��,� .S t �TI.� ENUM Distribution: 1) Original - i. W Agency File Page 12-111 LPP 06-06 November 1.4,2006 Exhibit G Local AssistancelProcedurea ...jnual Bidder's List of Subcontractors (DBE and Nan -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DEE and NON.DBE)m PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with. Title DWribution; 1) Original — Local Agency File Page 12-112 UP 06d16 November 14, 2006 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) L, NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SB3E OF TMS FORM AGENCY: CI'-}LIC{ Ujft4 !nr i Zf� LOCATION: PROJECT DESCRIPTION: S C EO c) OTAL CONTRACT AMOUNT: $ Z 1 2 0 - IDDATE: Aaril lib r%1pp — IDDER=s NAME : Ff 11 Owy-i nwi @;*V%d CONTRACT UDBE GOAL; rn . Hg I. OF WORK AND DESCRIPTION OR SERVICES TOO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED Cert No, of UDBE AND EXPIRATION DATE NAME OF UDBEs Must be certified on the date bids are opened - include UDBE address and 2hone number CONTRACTITEM DOLLAR AMOUNT ITEM NO. UDBE i -e c4 r i een 1 03` 11 cal Pro, eh y q© 0- (✓ 1 Irn ter• For Local Agency to Complete: Local Agency Contract Number: ederal Aid Project Number: Federal Share: Total Claimed Participation alp a 4/0 - -- ontract Award Date: Local Agency certifies that all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Telephone Number: " a e tj b tdder D�XQdlt°�vIL Date (Area Code) Tel. No. 1 � For Caltrans Renew: Print Name Signature Caltrans District Lora) Assistance Engineer Date Person to Contact ( e Type or Pri Local Agency Bidder � UDBE Commitment (Rev 3109) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAir) within i 5 nays of awam. suture to send a copy to the DLAE within 15 days o£award may result in de -obligation offends for this project• (2) Copy -- Include in award package to Caltrans District Local Assistance (3) Original—Localagenc files C-21 Page 15-31 LP? 09-xx March 27, 2009 Exhibit 15-Gl Local Assistance Procedures Manual Loc I Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised[ 03/09) PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers, Prime contractors shall indicate all work to be performed by UDBEs including, if the prince is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the, First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project, District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 C-22 March 27, 2009 L1PP 09-xx Local Assistance Procedures Manual Exhibit 115-G2 Local Agency .Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE'SIODE OF THIS FORM AGENCY- C_ '±-j G-f' HuLn1H'►no$oj4 FYa1!•aJn LOCATION: PROJECT DESCRIPTION: � 1 Y O �)1 (. fo -S C h ad i S TOTAL CONTRACT AMOUNT: S '2 LQ , D BIDDATE: Q r)rl � A (i, ti,f�.l h BIDDER'S NAME:A Ik AYY1W Cao A Obd 14- ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBECert.No. AND EXPIRATION DATE NAME OF DBEs (Must be certified on the date bids are opened - include DBE address and phone number ONTRACT DOLLAR AMOUNT ITEM NO. DBE I e eC• � 0 C . E qo 6 U-_ S• ) 2 6 — For Local Agency to Complete: cal Agency Contract Number: Federal Aid Project Number: Federal Share: Contract Award Date, Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Print Name Signature Date Local Agency Representative Area Code Tele hone Number: Total Claimed Participation $ 79 Q (g 0 • `— % SfgaffureBf Bider , I v� e O _ell Role+ r�dl� t {"'I �f I �'��� Date (Area Code) Tel. No. pekle=, �� For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to ContacE ase Type or Pri Local Agency Bidder DBE information (Rev 310) i Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days ofcontract execution may result in d"bligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files C-23 Page 15-32a LPP Q9-xx Ma reh 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the. Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (trust be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. DAPORTANT: Identify all DBE firms participating in the project including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15»day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page15-32b C-24 March 27, 2009 LPP 09-xx Local Assistance Procedures Manual Exhibit IS-H UDDE Information - Good Faith Effort E+ XHMIT 15-H UDBE INFORMATION --GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date The (City/County o established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B, The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations; etc.): Names of UDBEs Solicited Date of Initial Solicitation Follow Up Methods and Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page I5-33 LPP 09-xx C-25 March 4, 2009 ®® Fidelity and Deposit Company of Maryland Home Office: P.O. Box I227. Baltimore. MD 21203-1227 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ALL AMERICAN ASPHALT BOND NO.085 97 423 , as Principal, (hereinafter called the "Principal"), and FIDELITY AND DEPOSIT COMPANY OF MARYLAND P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto City of Huntington Beach as Obligee, (hereinafter called the "Obligee"), in the sum of TEN PERCENT OF THE TOTAL BID PRICE IN -------- Dollars ($ 10% OF TOTAL BID PRICE ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Construction of Safe Routes to School in the Vicinity of Spring View Middle School, CC No.1367 Bid Date: April 20, 2010 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 14th Witness . . . . . . . . . . . d Barbara J. Bender Witness of April A.D., 2010 ALL AMERICAN ASPHALT (SEAL) Pri ' at Title UILP Vlre5i FIDELITY AND DEPOSIT COMP NY OF MARYLAND Surety By �e Q �Dr� (SEAL) Rebecca Haas -Bates Attorney-in-Fccr Printed in cooperation with the American Institute of Architects (AIA) by Fidelity and Deposit Company of Maryland, Fidelity and Deposit Company of Maryland vouches that the language in the document conforms exactly to the language used in AIA Document A-310, February 1970 Edition. BID70000ZZ0701f ���..'a�•.��.s�>.: �q,: �.�%TN':�Yr. �sS.vAt TC; :.�t,.�>��..zii,i����.�T>;'�<i �n>..�aL':�5.%�;� caa,.=�: ..�.� .�..a�v�a�+��,.�N7.•.c�.¢,T>,.'�...:�3��71 State of California County of Orange On 4-14-10 before me, Barbara J. Bender, Notary Public Date Here Insert Name and Title of the Officer personally appeared Rebecca Haas -Bates Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(&) is/ere subscribed to the within instrument and acknowledged to me that i-pe/she/" executed the same in 44slher/their authorized capacity(iee), and that by his/herAheiF signatures} on the instrument the person(*, or the entity upon behalf of which the persons} acted, executed the instrument. BARggPAJ. BENDER Commission # 1801899 1 certify under PENALTY OF PERJURY under the laws z - f Notary Public - California Z of the State of California that the foregoing paragraph is Orange County ' true and correc My Comm. Expires Jul 13, 2012 WITNESS m d an icial eal. Signature Place Notary Seal Above Signature of N ry Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: 4-14-10 Number of Pages: One (1) Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas -Bates ❑ Individual Corporate Officer — Title(s): — El Partner — ❑ Limited ❑ General (] Attorney in Fact Ei Trustee Guardian or Conservator Other: Signer Is Representing: Fidelity and Deposit Company of Maryland Top of thumb here Signer's Name: Individual ❑ Corporate Officer — Title(s): _ D Partner — ❑ Limited ❑ General Attorney in Fact Trustee D Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here 02007 National Notary Association • 9350^De Soto Ave.. P.O. Box 2402 -Chatsworth, CA 91313-2402• www.NationaiNotaryorg Item #5907 Reorder: Cali Toll -Free 1.806-B76-6827 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Riverside on April 16, 2010 before me, Debbie A. Matsen, Notary Public Date Here Insert name and Title of the Officer personally appeared Robert Bradley Name�A of SignerA who proved to me on the basis of satisfactory evidence to be the person(A) whose names$) is/afee subscribed to the within instrument ORDEBBIE A. MATSEN and acknowledged to me that he/shefttrdy executed the same in Commission Public # 17756 California65 his/herfthe# authorized capacity(iea), and that by his/� 'r,vrr heir .a; Notary Riverside - County a signatureo on the instrument the person(,a'), or the entity upon behalf = Rlverslde County NyComm BomNov22,2011 of which the personal acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the forgoing paragraph is true and correct. WITNESS my hand and official seal. Signature jj_d.?� G . h-f-t10 :p Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Bid Bond, City of Huntington Beach Document Date: April 14, 2010 Number of Pages: 1 Page Signer(j) Other Than Named Above: Fidelily and Deposit Company of Maryland Capacity fts) Claimed by Signer(p) Signer's Name: Robert Bradley Signer's Name: ❑ Individual ❑ Individual �f Corporate Officer — Title(,): Vice President ❑ Partner— ❑Limited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Other: Signer is Representing: All American Asphalt ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Other: Signer is Representing: Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and GREGORY E. MURRAY, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said y, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the d ereby nominate, constitute and appoint William SYRKIN, Rebecca HAAS-BATES an f Irvine, California, EACH its true and lawful agent and Attorney -in -Fact, to mak a 'v r� ` behalf as surety, and as its act and deed: any and all bonds and undert o ecu ' or undertakings in pursuance of these presents, shall be as binding upon I d ► I ents and purposes, as if they had been duly executed and acknowled y ele ompany at its office in Baltimore, Md., in their own proper persons er rn e on behalf of William SYRKIN, Rebecca HAAS-BATES, Sergio D. BECHA and ed April 8, 2008. The said Assistant 0s eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, ofthe By- s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 25th day of September, A.D. 2009. ATTEST: 'gyp DEPps�i J rpr O W , 4 N.n� State of Maryland ss: City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND Gregory E. Murray Assistant Secretary By. r William J. Mills Vice President On. this 25th day of September, A.D. 2009, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J. MILLS, Vice President, and GREGORY E. MURRAY, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ��tf t111� Maria D. Adamski Notary Public My Commission Expires: July 8, 2011 POA-F 012-0033 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a .storm . drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any, fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe - construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010.. Company Name �Okx�r�►- 13�zd Ui�>° Re f) .ari l 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. City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK June 30, 2010 Elite Bobcat Service, Inc. 1320 E. Sixth, Suite 100 Corona, CA 92879 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citie4..�f&aWpil�gpi6LA,flr&AAdkM ao�Jew Zealand 1 Telephone: 714-536-5227 ) 2010 APR 20 PrI 1: 51 '7 r--:3 ELITEEBOBCAT SERVICE GENERAL ENGINEERING "- 1320 E. SIXTH, SUITE 100 9 CORONA, CA 92879 Tel: (951) 279-6869 * FAX: (951) 279-6832 City of Huntington Beach City Clerk 2000 Main Street, 2nd FL Huntington Beach, CA 92648 Safe Routes to School in the vicinity of Spring View Middle School Project No. 1367 DIL e: 04120110 @ 2:00 PM SECTION C PROPOSAL for the Safe Route to School In the vicinity of Spring View Middle School CC No.1367 in the CITE' OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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 $ 10% of amount bid 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: 04/08/2010 C-2 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 > of,P sRp � tSM� Cbt .^'�} f _'n -,,...� e. .;.ssT 4 _ d:SRuPlS•-r+. �i'-^.FM1�s...k �", E 1 z+.'-w.-'"%';>' 'd';Yq!'�a.G_• l"i_. ry..:_a 'yk{ f```:%b 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Monument Preservation. Per L.S. 3 1 L.S. Furnish Project Traffic Control. $ 3� $T Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $_ $ "7 Coo Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ 0 Soo $ f © , Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ ZOC Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $ $ L) per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk City Standard Plan 207. $ $ 340 per Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City $ :50 $ 14, Standard Plan 202, Including AC Pavingi2�Q Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan $ 3200 $ LI? 00c, No. A88A and AC Paving Replacement. Per EA. 11 4 EA, Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ 60& $ Per L.S. 12 11,000 S.F. 'Construct Type 11 Slurry Seal. Per S.F. Q, Total Amount Bid in Figures: $ SL4 170 Total Amount Bid in Words: $ I-y'/8%�I Lazo 11 1i\)(3 Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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. Por6n Name �crtdAddress of,5�tbconiractor State L%nse Class of Work 1V umber Pryi By submission of this proposal, the Bidder certifies: 37-Z-?919 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 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. Portionubco�airactor State L%erase Class o Work _ IVuriibev 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 Joseph Nanci being first duly sworn, deposes and says that he or she is President of Elite Bobcat Service, Inc. the party g makin 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. Joseph Nanci Name of 'dder Signature of Bidder 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 State of California County of Riverside On April 19, 2010 before me, Jeff Lee, a notary public, personally appeared Joseph Nanei, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my han and o ficial seal. ,aye \o Signature (Seal) ° G G °J�°y�L cc Q sN , �\a UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNfINGTON 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, in the vicinity of Spring View Middle School - CCI.3b7, (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: 4 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: 04/19/2010 C-5 Elite Bobcat Service, Inc. Contract r By Joseph 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 O(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: 04/19/2010 C-7 Elite Bobcat Service, Inc. Contractor By Joseph Nanci Title President 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 1-8004224133 a minimum of two worldng days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for every Dig Alert Identification Number issued by USA. 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: Elite Bobcat Service, Inc. Bidder Name 1320 E 6th St #100 Business Address Corona CA 92879 City, State Lip ( 951 ) 279-6869 Telephone Number 720016A State Contractor's License No, and Class 03/1994 Original Date Issued 03/31 /2012 Expiration Date The work site was inspected b- Joe Nanci of our office on April 9 2010 The following are persons, firms, and corporations having a principal interest in this proposal: Elite Bobcat Service, Inc. 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 Signature of Bidder Joseph Nanci, President Printed or Typed Signature Subscribed and sworn to before me this 19 day of April 20010 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 Corona 400 S Vicentia Ave Ste 125, Corona, CA 92882 Name and Address of Public Agency Name and Telephone No. of Project Manager: Clint Harrera (951) 739-4888 $801,178 Street Improvements 12/2009 Contract Amount Type of Work Date Completed 2 City of San Clemente 910 Calle Negocio, Suite 100, San Clemente, CA 92673 Name and Address of Public Agency Name and Telephone No. of Project Manager: Gary Voborsky (949) 361-6132 $419,459 Street Improvements 12/2009 Contract Amount Type of Work Date Completed 3, City of Fontana 16489 Orange Way, Fontana, CA 92335 Name and Address of Public Agency Name and Telephone No. of Project Manager: Bijan Salar (310) 989-2256 $537,762 Street Improvements 09/2009 Contract Amount Type of Work Date Completed C-10 State of California County of Riverside On April 19, 2010 before me, Jeff Lee, a notary public, personally appeared Joseph Nanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. -4. Witness my h d an official seal. Signature (Seal) CIP (For federally funded projects, use this following page) fa § S I -1 t 10 HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Elite Bobcat Service, Inc. Joseph Nanci Contact Phone: ( ) 279-6969 Signed: Date: April 19, 2010 *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 EXi:iJ Brr 12-E PS&E Checklist Instructions Attacbment C (THE BIDDER'S MCUTION ON THE SIGNATURE POR77ONOF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEAMNTAND EXECUT70N OF THOSE CERTIFICATIONS TfWCHA s A PART OF THIS PROPOSAL) The bidder Elite Bobcat Service, 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. Dote: 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 filled 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. C-12 Page 12-79 LFP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHOIT 12-E PS&E Checklist Instructions Attachment ID Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed perm, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above NoncoIlusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. -- C-13 Page 12-81 LPP 01-04 March is, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10295.1(Cbapter 376, Stats. 1985), the bidder bereby declares under penalty of perjury under the laws of the State of CalMmia that the bidder has _ , has not 2 been convicted within the preceding three years ofany offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act In violation of any state or Federal antitrust law in connection with the bidding upon, award of or performance of any public works contract', as defined in Public C ntruct Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of tho University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof; as referred to in Section 10295.1. Note: The bidder must place a check mark after "has" or "has not" is one ofthe blank spaces provided. the above Statement is part of the Hid. Signing d* Bid on the signature pottion d reoif shall also constitute sig uVm of this Statement. Btddera are cautioned that mating a false oartificaiion may subject the certifier to afinkalprosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shalt cowpldic, under penalty of pet jury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary iatet+sst in the bidder, ever been disqualified, removed, or offmvvise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the mover is yes, eVIain the circumstances in the following space. C-13 lPubUc Contract Code 10232 Statement In oonformartce with Public Contract Code Section 1023Z the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board Note: The above Statement and Questionnaire are part of the Bid Signing this Bid on the signature portion thereof shall also constitute sipature of this Statement and questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecudon. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS" Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: + Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shalt also constitute signature of this Certification. —�-- C-14 Page12-83 LPP 01-04 March 15, 2001 Local Assistance procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment )i The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract; the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any fiends outer than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15 Page 12-55 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EX M171712-E )PS&E Cheddist Instructions Attachment G (DISCLOSURE OF LOBBYING ACPIVrIUS 1e of Federal Action: FTcontract b. grant c. cooperative agreement d. loan a loan guarantee C loan Insurance 2. Staters of Federal Action: Fla. bid/ofer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime Q Subawardec Tier , if (mown Congressional District, If known 6. Federal Departweat/Agency: & Federal Action Number, ifknown: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, lull} 110i 3. Report Type; ® a. initial b. material change For Material Change Only: year ____ quarter date of lass report 5, If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime; Congressional Distrlet, If known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, If known: b. Individuals Performing Services (including ttddrm if different from No. I Oa) (last name, first name, Iv1I) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) S [] actual planned 12. Form of Payment (check all that apply): a. cash b. in -land; speoW. nature value 13. Type of Payment (check all that apply) a. retainer b. on"mo fee c. commission d. contingent fee e dafbnw f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, Including ofiieer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Shed(s) if necessary) 15. Continuation Sheets) attached; Yes ❑ No [] I6. laformation requested tiaough this form is authorized by 11t1e 31 U.S.G Saxton 13$2. This disclosure of lobbying reliance was placed by the der above when his transaction was made or entered into. This disclosure Is required pursuant to 31 U.S.0 1352. This information will be reported to Congress seanlannually and will be available for public f gwdon. Any person who fails to file the requirod disclosure shall be subject to a civil penalty of not less than $ 10,000 and not more than $100,000 for each such t`ailuse. Federal Use Only: Signature Print Name. Joseph Nanci Title: President Telephone No: (951) 279-6869 Dan: 04/19/10 Authorized for Local Reproduction Standard Form - LLL C-16 Page1247 LPP 01-04 March 15, 2001 EXHIBIT 12-.E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COWIPLETION 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 ofMauagement and Budget for additional information. l . Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of covered federal action. 2. Identify the status ofthe 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 ofthe prune 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 ofthe federal agency malting 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., '?FP-DB-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). I I. 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-S8 C-17 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual E)=IT 12-E PSE&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. include all preparatory and related activity not just time spent in actual contact with federal officials. identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheets) 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 (0349-0046), Washington, D.C. 20503. sF-ML-bWsUaim Rm 0&04-90«ENm1Pw C-18 Page 12-89 LPP 01-04 March 15, 2001 "cat Assistance -Procedures Manua! EXHIBIT J!" Bidder's List of Subcontractors (I)BE.and Non-DRE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -,DBE)- PART I The bidder shall list all subcontraam (both DBE and non-DDE) in accor&acc -,Nith Section 2-1.054 of the Standard Specifications and per Title 49, Seaion 26, 11 Of the Code of Federal . Reguladons. Tais listing is required in addition to listing DR E Subcontwtors elsewhere in the proposal. Photocopy this form for additional firms. Distribution. 10rigiva! - 1,=1,A,7eP4Y File, i- PaRe 12-111 ,LPP 06-06 November 14,2006 Loco) As5lstauce Procedures Manual EXHIBIT 112-C Biddim's List of Subcontractor& (I)BE and Non-DRE) SIDDER"S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractoni (both DBE and non-DDE) in actor nee v%ith Section 2-1.054 oft e Stanidwrd Specifications and per Thle 49, Section 26, 11 of the C.Qde of Federal Rcguledons. This listing is required in addition to listing DBE Subcontractors else -where in The proposal- Pbotot:opy fbis form for additional firmL DISHbutiow 1),Otigiral- Ag=-Y He page 12-111 Lpp 0016 Novcynber 14,2006 Exhibit --G, Local Assistance Procedure,,, Ann l idderls List of Subcontractors (DRE and Non- EE) BIDDER'S LIST OF SURCONTRACTORS (DBE an -: PART 11 The bidder shall list all subcontractors who provided a quote cr bid but were not selected to participate as a subcontractor on. t is grojecct� ThLs is required far comp anct with Tide :ijOd int-a RIJAttMyFite Page 12-f IZ November ber 14,'406 PP � bra City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders. - Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306.1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge Into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees In addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, ed Apol.8, 2010. Elite Bobcat Service, Inc. Company Name By Joseph anci, President April 19, 2010 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. State of California County of Riverside On April 19, 2010 before me, Jeff Lee, a notary public, personally appeared Joseph Nanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that, the foregoing is true and correct. Witness my hand and official seal. Signature �\V\'\ y 14y t�NO ay (Seal) d2 �5 iyy� Bond No.08739262 . ------------------------- Fidelity and Ike ositCompanyP�x POST OFFICE BOX 1222 OF MARYLAND KNOW ALL MEAT BY THERE PRESENTS: That we, -- Elite Bobcat Service, Inc BALTIMORE, MD 21203 as Principal, (hereinafter called the "Principal'), and She FIDELtTY AND DEPosrr COMPANY OF MARYLAND, P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of t3ae State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmfiy bound unto_- City -of Huntington Beach Obligee, (hereinafter called the "Obligee"), in the sun, of --Ten Percent of Amount Bid 10 0 ---- -------- -}, 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- SchoolAin the -Vicinity of S rin View Middle School No. 1367 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 failureof the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, .otherwise to remain in full force and effect. Signed and sealed this14 t h April 2U 10 g __.... of ------ __A_D Elite Bobcat Service, Inc '----(SEAL) ----- -- _-- --- --- --- -- ---- - - --- - Principal ---------- ----.._— Witness pp xns \ BY: _ T��S\_ �\ ----w`�hC Title FIDELITY AND DEPOSIT C P\\VVANY OF MARYLAND � Surety ------------------------- Y ----- - ---- - - - -- - -- - - ---- - ----- ---- - - -- 13 - Witness A RNEY-IN-FACT Title C775f-5 M.7-92 - Richard A. - Coon Conforms m Anlef 4 IMEitUte Of A,checM Doc.,"M- FcMwry 1970 Edition. ALL-PURPOSECALIFORNIA ACKNOWLEDGMENT �`�� d' d' "e7' d' d' e� d' .✓' dY"d aY d' di"d d d' tPi" - y STATE OF CALIFORNIA County of Orange } On 4-14-10 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 SHEIF11 1111111/o115 Comm. #1 It U) NOTARY PUBLIC ® CAUFORNIA ORANGE COI IiTY + Comm. Exp. JULY 27, 2013 who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 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 offi 'al seal. Signature Place Notary Seal Above Signature of Notary P6ffic 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.- 0 individual ❑ Corporate Officer — Title(s):_ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s) ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here 02007 National Notary Association - 9350 De Soto Ave., P.D. Sox 2402 -Chatsworth, CA 91313-2402 - y ,,w.NationalNotary.org Item N5907 Reorder: Call Toll -Free 1-800-876-6827 and appoint Richard A. COON, Charles L. FLAKE, David L. CULB QZtnrie S OOD all of Anaheim, California, EACH its true and >lawful =agent and a g ,° d deliver, for, and on its behalf as surety, and asits act and deed: any an n xecution of such bonds or rese 1 in , as fully and amply, to all intents and undertakings in pursuance of these p purposes, as if they had been d t a ularly elected officers of the Company at its office in Baltimore, Md., p er ` attorney revokes that issued on behalf of Richard A. COON, Charles L. FLAKE, ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005. The said Assistant " eby certify that the, extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By- ; s cid Company, and is now in force. IN WITNESS WHEREOF, ,the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said. FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of November, A.D. 2006. Fop 9fPps`i Eric D. Barnes Assistant Secretary State of Maryland ss: City of Baltimore By: 1' 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. 4D.. wnn.__- v - Constance A. Dunn Notary Public My Commission Expires: July 14, 2011, POA-F 012-4150H City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK June 30, 2010 Gass Construction Company, Inc. 1401 Warner Ave., Suite B Tustin, CA 92780 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe enclosure Sister Citi(y;.zfc 6"/dg~trfeWr ita-b�aa&toNew Zealand ( Telephone: 714-536-5227 ) UALED BY* SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRINGVIEW MIDDLE SCHOOL CC- 1367 Bid Date: 4/20/2010 Did Time: 2:OOPM OFFICE OF THE CITY CLERK SECOND FLOOR CITE' HALL, 2000 MAIN STREET HUNTINGTON BEACH, CA SEALED III) - D® of Open With Regular Mail GASS Construction Company Inc. 1401 Warnw Avenue, Suits S SECTION C Tustin, CA MO PROPOSAL for the Safe Route to School In the vicinity of Sparing View :Middle School CC No. 1367 in the CITY OF HUNTINGTON BEACH TO —V%E HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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 I 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. Bidd is Accompanying this proposal of bid, find 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). GASS Construction Company Inc. 1401 Warner Avenue, Suite B Bidder shall signify receipt of all Addenda here, if any: Tustin, CA 92780 Addenda No ; ' Date Received Bidd 's'' .i nature One (1)1 April 8, 2010 C-2 GASS Construction Company Inc. 1401 Warner Avenue, Suite B City of Huntington Beach Tustin,'CA92780 Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a storm drain which requires the contractor to obtain a. de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. Thecontractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. GASS Construction -Co., Inc. 1= 144W,Z --- Company Name gy Meeina. Chizhik April 8, 2010 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. GASS Construction Company Inc. 1401 Warner Avenue, Suite S Tustin, CA 92780 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 Item "Estimated item " TJ�st Pxiee Extended Amount 1 1 L.S. Mobilization. $30o. Go $ 30 000. 90 Per L.S. 2 1 L.S. Monument Preservation. Per L.S. 3 1 L.S. Furnish Project Traffic Control. Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. _ $ A5O 80 $ / ®. 00 Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $4'� $ ��6z� • 6U Per L.S. 1. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ 6� $ Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $Jf,, 4 00 $ Jam`, 50_ 8c� per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ /O.90 $ ��• SO Per S.F. C-2.1 GASS Construction Company Inc. 1401 Wanner Avenue, Suite B Tustin, CA 92M Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 Item Estimated Item Unit Price Extended Amount 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City $ ✓��• 8� $ Li, Z5-O• Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan $ 5o, OD $ 92, 569D• BO �^ No. A88A and AC Paving Replacement. 11 4 EA. Per EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ 2SO•'90 $ l O-Qp- go Per L.S. 12 11,000 S.F. Construct Type II Slurry Seal. Per S.F. Total Amount Bid in Figures: $ z� 0-0-0 •"t7 Total Amount Bid in Words: $ 7WO A-e Oa I w 414w-f l e Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375- 5015. C-2.2 GASS Construction Company Inc. LIST OF SUBCONTRACTORS 1401 Wamer Avenue, Suite B 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 .of Work .Name and Addtexs of Subcontractor State License Number : Class, . . MACADEE ELECTRICAL 4755 Lanier Road Chino Hills, CA 91710 909-627-1336 Lic. # 583125 ELECTRICAL 2 J i California Surveying Corp. 18200 W. McDermott #5 ' Irvine, CA 92614 949-981-0871 Lic# 5848 Doug Martin Contracting Co. Inc 220 E. Foundation Ave La Habra, CA 90631 (714) 441-0513 470131— LTC ORANGE COUNTY STRIPING SERVICE INC. 183 North Pixley Orange, CA 92668 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 LASS Construction Company Inc. 1401 Warner Avenue, Suite B I®1NONCOLLUSION AFFIDAVIT iustln, CA 92780 TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Marina Chizhik , being first duly sworn, deposes and says that he or she is CEO/V.P./secretary of GASS Construction Co.Inghe. 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. GASS Construction Co., Inc. Name of Bidder Signatur (Bidder Marina Chizhik 1401 Warner Avenue, Suite B Tustin, CA 92780 Address of Bidder Subscribed and sworn to before me this day of , 20 _ SEE ATTACHED NOTARY PUBLIC NOTARY SEAL C-4 Jurat State of California. County of (j Subscribed and sworn to (or affirmed) before me on this l qtb� dayof 20JQ_ by iY ora Na C � j z k k proved to me on the basis of satisfactory evidence to be the personfK7 who appeared before me. /I " .L . Slgnatll�� (Notary sea]) ttATNY L. euaNUiw # 17053s$re,09CornmisslonNotary Public - California y Orange County Gomm. i�tOvlb,20i0 OPTIONAL, INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT _i�._p�CO��US10N �'F�ipLtU�'" - Sa�P l�ou (I itle or description of attached document) fn_.-s—ko- l - iV+'c.I; of SWe ('Title or description of attached docul ant Conti ed) Number of Pages Document Date N ff (Additional information) INSTRUCTIONS FOR COMPLETING THIS FORM The wording of all Jurais completed in California afierdanuaiy 1, 3008 must be in the farm as set forth within this Jurat. There are no exceptions. Ifa 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 separatejuratform such as this one which does contain proper warding. In addition, the notary must require an oath or affirmation from the docwnem signer regarding the truthfulness of the contents of the document The document must be signed AF'TF.R the oath or affirmation. If the docutnent etas previously signed, it must be re -signed in front of the notcny public diming the jurat process. • State and County information must be the State and County where the document signer(s) personally appeared before the notary Put)] ic. • 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 most match the signature on file with the office of the county clerk. • The notary seal impression must be clear and photographically rcproducibic. Impression must not cover text or lines. If seal impression smudges, re -seal if u 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 diferent document. Indicate title or type of attached document., number of pages and date. • Securely attach this document to the signed document 2008 Version CAPA v1.9.07 800-873-9865 www.NotaryClasses.com GASS Construcdoon Company Inc. UTILITY AGREEMENT 1401 Warner Avenue, Suite B Tusfin, 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, in the vicinity of Spring View Middle School - CC13b7, (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 S, 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: April 19, 2010 GASS Construction Co., Inc. Contractor ,� -, Z - �/X,4/4 By Mar a Chizhik CFO/V.P./Secretary Title C-5 GASS Construction Company Inc. 1401 Warner Avenue, Suites S 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 0 No If the answer is yes, explain the circumstances in the space provided. MWr 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. GASS Construction Company Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 Date; April 19, 2010 GASS Construction Co.,,Inc. Contractor gy a na Chizhik CEo/V.P./Secretary Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER GASS Construction Company Inc. U01 Warner Avenue, Suite B Tusitn, 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: GASS Construction Co., Inc. Contractor By Marijg Chizhik CEO/V.P./Secretary Title Date: April 19, 2010 Note: 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 GASS Construction Company Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 BIDDER certifies that the following information is true and correct: GASS Construction Co.,Inc. Bidder Name 1401 Warner Avenue, Suite B Business Address Tustin, City, ( 71 4 ) 247-1 040 Telephone Number 816579 A, B State Contractor's License No. and Class 5/15/2002 Original Date Issued 1 /31 /201 1 Expiration Date CA 92780 State Zip The work site was inspected byGennady Chizhikof our office on April 8 , 201 Q The following are persons, firms, and corporations having a principal interest in this proposal: GASS Construction Co., Inc. Marina Chizhik - CEO/V.P./Secretary Gennadv Chizhik - 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. GASS Construction Co., Inc. Company Name GASS Construction Company Inc. Signature idder 1401 Warner Avenue, Suite B Tustin, CA 92780 Marina Chizhik Printed or Typed Signature Subscribed and sworn to before me this — day of , SEE ATTACHED Y PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1 SEE ATTACHED z. 0 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 ype of Work Date Completed Name and Address of lie Agency Name and Tel one No. of Project Manager: Amount IType of Work Date Completed C-1© Jurat State of California County of C) ra)jq e. Subscribed and sworn to (or affirmed) before me on this I9"5- day of 4PCJ, 20 I p by M ari nNA. Ck , 7z k, K proved to me on the basis of satisfactory evidence to be the person(4 who appeared before me. A S 1 gnatu C (Notary sea]) KAi A/lTHYTHY 4. BURNUM Commission # 17053s8 yes Notary Public • California Z Orange County MC Corrm Gci+esNov 16, 2010 OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT ('title or description ofattached document) S1-10101[-�N!__j' p- Keinu}o4 SpfiNG VielJ (Title or description of attached documeni conti ed) Number of Pages _2 Document Date N/fj (Additional information) INSTRUCTIONS FOR COMPLETING THIS FORM The wording of all Jurats completed in California after Janacary 1, 2008 intiv be in the jorm as set fords within this Jurar There are no exceptions. 1 f 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 separatejuratform such as this one which does contain proper wording. 1n addition, the notary must require an oath or Cffrmation from the document signer regarding the truthfulness of the contents of the docinnent. the document must be signed AFTER the oath or affirrnonon. if the document eras previously signed it must be re -signed in fironi of the notmy 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 oll'ice 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 iurat form. Additional information is not required but could help to cnsurc 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 v1.9.07 800-873-9865 www.NotaryClasses.com OAOO a, C000 9 0 ca MO 999� RE� GENERAL ENGINEERING CONTRACTOR GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Lic. No. 739091 A, 8 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Anaheim ADDRESS 200 E. Anaheim Anaheim, CA 92807 OUR JOB# 194-05 CONTACT Sean Razmy P.E. / Mike Wood PHONE (714) 765-5059 / 714-231-8372 DESCRIPTION & CONTRACT AMOUNT State College Blvd. / Ball Road Intersection Improvements $ 1,377,713.00 OUR JOB# 202-06 CONTACT Sean Razmy P.E. / Mike Wood PHONE (714) 765-5059 / 714-231-8372 DESCRIPTION & CONTRACT AMOUNT Lincoln Avenue Street Improvements $ 1,678,026.00 OUR JOB# 203-06 CONTACT Sean Razmy P.E. / Robert Luciano PHONE (714) 765-5059 / 714-765-5286 DESCRIPTION & CONTRACT AMOUNT Harbor Blvd. / Ball Road Intersection Improvements $ 394,010.00 OUR JOB# 204-06 CONTACT Sean Razmy P.E. / Robert Luciano PHONE (714) 765-5059 / 714-765-5286 DESCRIPTION & CONTRACT AMOUNT Lincoln Ave. / Sunkist St. Intersection Improvements $ 421,003.00 OUR JOB# 206-06 CONTACT Sean Razmy P.E. / Robert Luciano PHONE (714) 765-5059 / 714-765-5286 DESCRIPTION & CONTRACT AMOUNT State College Median & Landscape Improvements $ 1,687,843.50 OUR JOB# 209-07 CONTACT Sean Razmy P.E. / Robert Luciano PHONE (714) 765-5059 / 714-765-5286 DESCRIPTION & CONTRACT AMOUNT Harbor Blvd. Roadway and Parkway Improvements $ 331,785.56 OUR JOB# 214-08 CONTACT Carl Heimberger / Robert Luciano PHONE 714-765-4465 / 714-765-5286 DESCRIPTION & CONTRACT AMOUNT Miraloma Way Sidewalk and Landscape Project $ 207,187.00 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 o (714) 247-1040 0 Fax (714) 247-1041 0900 °C000a 0° ca Ro GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 LTG� IN] GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 A, 8 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Chino ADDRESS 13220 Central Avenue, Chnio CA 91710 OUR JOB# 165-03 CONTACT Naghmen Imani / Pete Reinheimer PHONE (909) 464-8367/ 909-464-8305 DESCRIPTION & CONTRACT AMOUNT Mountain Ave Water Main $ 338,020.04 OUR JOB# 219-09 CONTACT Naghmen Imani PHONE (909) 464-8367 DESCRIPTION & CONTRACT AMOUNT Traffic Signal Upgrades- Chino Ave. at Pipeline Ave. $ 164,164.00 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 a@ 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 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 1401 Warner Avenue, Suite B, Tustin, California 92780 o (714) 247-1040 o Fax (714) 247-1041 6900 CNO 3 0 ca MO GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 A, 8 CONTRACTORS PROPOSAL REFERENCE LIST 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 Charlonne PHONE (714) 536-5430 DESCRIPTION & CONTRACT AMOUNT Safe Routes to School, Cycle V - Sowers School $ 274,688.00 OUR JOB# 218-08 CONTACT Dave Verone PHONE 714-375-8471 DESCRIPTION & CONTRACT Safe Routes to School - Cycle IV in the vicinity of Mesa AMOUNT View Middle School $ 170,000.00 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 $ 329,03 •31 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 OWNER City of La Palma ADDRESS 7822 Walker Street, La Palma, CA 90623-1771 OUR JOB# 216-08 CONTACT Ismile H. Noorbaksh P.E. / Larry Baldwin PHONE 714-690-3310 ./ 714-292-2574 DESCRIPTION & CONTRACT Median Improvements for La Palma Avenue from Denni St. to AMOUNT 240 Feet West of Moody St. $ 380:380.65 1401 Warner Avenue, Suite B, Tustin, California 92780 o (714) 247-1040 o Fax (714) 247-1041 GENERAL ENGINEERING CONTRACTOR GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 I.ic. No. 739091 A, 0 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 & AMOUNT Alicia 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. / Marcus Puglisi PHONE (949) 644-3322 / 949-795-6942 DESCRIPTION & CONTRACT AMOUNT Newport Blvd. / Balboa Blvd. Merger (Mixmaster) $ 273,625.75 Our Job # 211-07 CONTACT Andy Tran P.E. / Marcus Puglisi PHONE (949) 644-3315 ! 949-795-6942 DESCRIPTION & CONTRACT AMOUNT Superior Avenue Median Improvements $ 634,118.50 OUR JOB# 217-08 CONTACT Iris Lee / Marcus Puglisi PHONE 949-644-3323 / 949-795-6942 DESCRIPTION & CONTRACT Pelican Hill Road North and Newport Coast Drive Southbound AMOUNT Right Turn Improvements $ 318,318.00 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 1401 Warner Avenue, Suite B, Tustin, California 92780 o (714) 247-1040 o Fax (714) 247-1041 8900 coot 9 sock MO GENERAL ENGINEERING CONTRACTOR Lic. No. S16579 GIC 99 coo GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 A, B CONTRACTORS PROPOSAL REFERENCE LIST 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 Arno Blvd. Traffic Signal and Interesection AMOUNT Improvements $ 336,841.11 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 OWNER City of Yorba Linda 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 o (714) 247-1040 m Fax (714) 247-1041 GASS Construction Company Inc. (For federally funded projects, use this following page) 1401 Warner Avenue, Sine BTustin, CA 92780 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED 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): P Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: Signed: Date: GASS Construction Co., Inc. Marina Chizhik 714-247-1040 April '9'9, 2010 *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 GASS Construction Company Inc. 1401 Warner Avenue, Suite B Local Assistance Procedures Manual Tustin, CA 92780 EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE KIDDER'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 GASS Construction Co., Inc. proposed subcontractor hereby certifies that he haste_, has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable 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. C-12 Page 12-79 LPP 01-04 March 15, 2001 GASS Construction Company Inc. 1401 darner Avenue, Suite B r Local Assistance Procedures Manual Tustin, CA 92780 EXHIBIT 12-B PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY/ COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or share; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-13 Page 12-81 LPP 01-04 March 15, 2001 GASS Construction Company Inc. 1401 Wamer Avenue, Suite B PUBLIC CONTRACT CODE Tustin, CA 92780 Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder hereby declares under penalty ofperjury under the laws of the State of California that the bidder has - , has not,„,X_been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award o� or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" is one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature ofthis Statement. Bidders are cautioned that making a false certification may subject the certifier to criminai•prosecadon. Public Contract Code Section 101.62 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest'in the bidder, ever been dis;qualifxed, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes — No I — of the answer is yes, explain the circumstances in the following space. C 13 GASS Construction Company Inc. 1401 Warner Avenue, Suite 9 Public Contract Code 10232 Statement Tustin, CA 92780 In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of penury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor`s failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 GASS Construction Company Inc. 1401 Warner Avenue, Suite B Local Assistance Procedures Manual Tustin, CA 92M EXHIBIT 12_E PS&E Checklist instructions Attachment E ]®E1SA1E2N NT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: s Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Page 12-83 LPP 41-04 March 15, 2001 GASS Construction Company Inc. 1401 Wanner Avenue, Suite 8 Local Assistance Procedures Manual Tustin, CA 92780 EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLO$BYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15 Page 12-85 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions COMPLETE THIS 1. Type of Federal Action: Qa. contract b, grant c, cooperative agreement d. loan e, loan guarantee E loan insurance GASS Construction Company Inc. 1401 Warner Avenue, Suite B Tustin, CA 02780 EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING AC�IES FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 2. Status of Federal Action: 3. Report Type: ® a. bid/offer/application a. initial b, initial award b. material change c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: N/A 8. Federal Action Number, if known: For Material Cha a Only: year mrharter date R —IaaQort 5. If Reporting Entity in No. 4 Enter Name and Address of Congressi I District, if known 7. Federa rogram Name/Description: FDA Number, if applicable Award Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, fast name, first name, MI) address if different from No. I Oa) (last name, first name, MI) attach Continuation Sheet(s) if necessary) 11. Amount of Payment (che 11 that apply) 13. Type of Payment (check all that apply) $ dual planned a. retainer b. one-time fee 12. Form of Paymen check all that apply): a commission 8 a. cas d. contingent fee b. ' -kind; specify, nature a deferred value f, other, specify 14, Brie escription of Services Performed or to be performed and Date(s) of Service, including o er(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 l::l 16. Information requested through this form is authorized by Title / 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Namga r i na C h i z h i k U.S.C. I352. This in€ennation will be reported to Congress semiannually and will be available for public inspection. Any Title: CEO/V.P./Secretary person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than 71 4 — 2 4 7 —1 0 4 0 4 / 19 / 1 Q $100,000 for each such failure. Telephone No.. Date: Federal Use Only: Authorized for Local Reproduction Standard Form - LLL C-16 Page 12-87 LPP 01-04 March 15, 2001 G am Construction Company Inc. 1401 Wamer Avenue, Sub B EXIiI I ' 12-E Twdn, CA 92780 Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. S. If the organization filing the report in Item 4 checks "subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. d. 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). Cheek 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. ! l Page 12-88 C-17 March 15, 2001 LPP 01-04 GASS Construction Company Inc. 1401 Warner Avenue, Suite B Local Assistance Procedures Manual Tustin, CA 92780 EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials, identify the federal offeer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached, 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev, 06-04 9UEMIR C-18 Page 12-89 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual LASS C®nstrueccdon Company Inc.1�'I Warner Avenue, Stli4s 8 EXHIBIT f2_G - Bidder's List of Subcontractors (DBE and Non -DUE) usnie9 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations., This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - WW Agency File LPP 06-06 Page 12-111 November 14,2006 GASS Construction Company Inc. Exhibit .--G 1401 Warier Avenue, Suite B Local Assistance Procedures ..-inual Bidder's List of Subcontractors (DBE and No!-IDBE) Tustin, CA 92780 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Firm Name/ Phone/ Arun al �� Address/ Fax Gross (Description of Portion of Work to be Performed City, State, ZIP Receipts MARTINEZ CONCRETE INC. BENZ= moo IN NM ddress 920 West Foothill Blvd. �rw626-334-2979 � z :: _1.I..`," ?JiAc=?' wk;-�s�.az,_d., Quality First Concrete cal • irM�ltiiili� {c `�laj Placentica, CA 1 , '32-3000 ♦-k- ' �a'�'�`���`=�;`"d,.'t • • -,a ICI • � • • . Name Sterndahl Enterprises, Inc. 11861 Branford Street Aa�ess Sun Valley, CA 91352-1032 (818) 834-8199 x118 city stare : Lic# 421823 STRIPING /SIGNING U < $I million 0<$s million <$lomillion 0<$15millian ©' $is mill M Name Phone U <$1 million MSL ELECTRIC, INC. © $5 million rlddressAnaheim, CA 92807 <$ltlmiilio 714-693-4837 Fax Q <$15 millio 01YStaki9P# 822450 C10 EI,ECTRi ;Al. 0>$15mililo Dis-Wbution:1) original — Local Agency File Page 12-112 November 14, 2006 -- — ` LPP 0b-06 0 GASS Conshuction Company Inc. Exhibit .--G 1401 Warner Avenue, Suite B Local Assistance Procedure, -inual Bidder's List of Subcontractors (DBE and Non -DBE) Tustin, CA.92780 _ BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution; 1) Original — Local Agency Fite Page 12-112 LPP 06-06 November 14, 2006 GARR Compaq t�g��p� Inc. Local Assistance Procedures Manual Tusk CA 92M Exhibit 15-G1 LOW NenEy Bidder UDBE Commitment (Construction Contracts} Exhibit 15-G I Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE RE TO INSTRUCTIONS ON THE REVERSE SE DE OF THIS FORM G�Nc�t: City of Huntington Beach LOCATION; Trudy Ln. - Sheilds Dr. to Heil Ave. ROJECTDESCRIPTION: Safe Routes to School - Spring View Middle School TOTAL CONTRACT AMOUNT: S In DATE: --,-April 20. 2Q10 - IDDER'SNAME: GASS Construction Co. Inc. CONTRACT UDBE GOAL: _,,,_3.55% T EM OF WORK AND DESCRIPTION SERVICES TO BE BCONTRACPED OR MATERIALSATE 0BE PROViDfiD No, of UDBB EXPIRATION OF UDDE8 e certified on the date bids ned - include UDBE and ph2Lq number V CONTRACT AMOUNT ITEM NO. E For Local Agency to Complete: Agency Contract Number: ederai Aid Project Number: edoral Share: Contract Award Date: cat Agency certifies that all information is complete and accurate- Print Name Signature Data Weal Agency Representative Are. Cod!a Telt hone Number: Total Claimed Participation sigrtat'"OfB Marina Chizhik 4/19/2010 714-247-1040 Date (Area Code) Tel. Na. Gennady Chizhik -President or Caltrans iteview: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Connukrneet (Rov W09) Distribution: (1) Copy — Pax or scan a copy to the Caltrans District Locat Assistance Engineer (DLAE) within 15 days of award. Failure to send a off to the DLAE within IS days of award may result in de -obligation of funds for this project. (2) Copy — Include In award package to Caltrans District Loral Assistance \ 3 Chi inal — Local agency f0es C-21 Page 15-31 LPP 09-xx March 27, 2009 GASS Construction Company Inc. 1401 Warner Avenue, Suite B TuOn, CA 82780 exhibit 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) Falls into one of the following groups in order to count towards the UDBE contract goal.: 1) Black American; 2) Asian -Pacific American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions, There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100°/a of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencIIes should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the I5-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 C-22 March 27, 2009 LPP 09-xx Local Assistance Procedures Manual 141 Wanes Amp Tuedn, CA Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Infonnation (Construction Contracts) (inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE'SiDE OF THIS FORM AGENCY: City of Huntington Beach LOCATION: Trudy Ln. - Sheilds Dr. to Heil Ave. ROJECTDFSCRrMON. � Safe Routes to School -Spring View Middle School OTAL CONTRACT AMOUNT: S BID DATE: April 20, 2010 BIDDER'S NAME: GASS Construction Co., Inc. rMM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS TO BE PROVIDED DBE Cert. No. AM EXPIRATION DATE NAME OF DBEs Must be certified on the date bids we opened • include DBE address and obonewumbo CONTRACT DOLLAR AMOUNT ITEM NO. DBE or Local Agency to Complete. Local Agency Contract Number: _ cdoral Aid Project Number. Federal Share: Contract Award Date: Local Agency certifies that the DBE certificatiort(s) has been verified and all information is complete and accurate. Tint Name Signatura Date. Local Agency Representative Area Codel Te eNumtxr. Total Clairrud Participation % Signature i Marina Chizhik 4/ 19 2010m 714-247-1040 Date (Area Codc) Tel, No. Gennad Chizhik " «President Person to Contact (PlemType or Print) 1=9 Age"y Bidder DBE Tr4nuati" (Rev 3109) For Caltrans Review: PrintNam Signature Daft Caltrans District Local Assistance Engineer Distribution: (I) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAB) within 15 days of contract execution. Failure to send a copy to the DLAE within IS days of contract execution may result in d"bligation of finds for this project. (z) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files C-23 Page 15-32a LPP 09-xx March 27, 2009 GASS Cons mdlon Company Inc. 1401 Wanes Avenue, Suite B CA 92780 Tuskjft ibli I5-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be. certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project —including all UDBEs listed on the UDBE Commitment form (Exhibit 1 SG(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid, There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 1 S-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the farm to the District Local Assistance Engineer within IS days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b C-24 March 27, 2009 LPP 09-xx GASS Con*MxIion Comer Inc, 1401 WWw Avg, Sure S Local Assistance Procedures Manual Tusdn,CA WN Exhibit 15-H UDBE Deformation - Good Faith Effort E)MBIT 15-H UDBE INFORMATioN—("OOD FAl'i'kl< EFFORTS CC No. 1367 Aril 20, 2010 Federal -aid Project Na. - Bid Opening Date p City of Huntington Beach The (Litt&/ ounty ob established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of 3_5,5 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder -- UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder - UDBE Commitment" forth may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement AGC's Good Faith Effort Advertising Reoort - 1 week startin 1 10 oodfaitheffort.com Mi orit Bidders B 41� ..�odtaiO.dr.cacta- - ' r3�1.0----- B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up UDBEs Initial Methods and Solicited Solicitation Dates See Contact Log and back-up paperwork attached. C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Surveying, Traffic Signal, Traffic Control. Stripin2 & Pavement Markin Slurry Seal Storm Drain Structures AC & PCC Paving Page 13-33 LPP 09-IX C-25 March 4, 2009 3 MCI GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 RESOLUTION AUTHORIZING EXECUTION OF ANY CONTRACT BY CEO/V.P./SECRETARY MARINA CHIZHIK AND/OR PRESIDENT GENNADY CHIZHIK At a Meeting of the Board of Directors of GASS Construction Co., 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 15r" of January, 2010, a quorum being present, consisting of the CEO/V.P./Secretary of the Corporation, Marina Chizhik, and President of the Corporation, Gennady Chizhik, the following Resolution was adopted: BE IT RESOLVED by the Board of Directors of this Corporation that its CEO/V.P./Secretary, Marina Chizhik, and/or President, Gennady Chizhik, are 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(s) of the Corporation, in connection with the execution of any contract on behalf of the Corporation, are hereby confirmed and ratified. I, Marina Chizhik, hereby certify and declare that I am the regularly and duly acting CEO/V.P./Secretary of GASS Construction Co., 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, 2010; 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 , r Marina C ' ik CEO/V.P./Secretary of GASS Construction Co., Inc. Notarization Attached 1401 Warner Avenue, Suite B, Tustin, California 92780 o (714) 247-1040 o Fax (714) 247-1041 A, r o n. t CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of QC'ar�a2 On �,,�j 1q.�,d1 before me, l�c>` �y ,L• St rA.)L k-1, m q & ,`c (Here insert name and title of e officer) personally appeared Mar, Na` C ki z k,s K who proved to me on the basis of satisfactory evidence to be the personO whose name(Al is/.aeesubscribed to the within instrument and acknowledged to me that 4e/she/executed the same in leis her/t4k-if authorized capacity(jves), and that by hi-fher/tDefisignature(,sl 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.�aws� KATHY Iss L. —F1705 tC NUM Commlaaton # 1708388 S WITNESS my hand and official seal. Notary Pubtto - Calitorria Orango County �f corraa=Navt 20t0� /[ r� u ���� (Notary Seal) Signature Qr Public ADDITIONAL OPTIONAL INFORMATION DESCRIP LION OF THE ATTACHED DOCUMENT ResQfu Q�v_�,sfl�vrtL,,v� 1E)reQ_uiisr) O�a6) L(Title or description taached document) I XCAI'Alk (Title or description ofattached do ument continued) Number of Pages l _ Document Date -1dip -�C,vo� ��c�es.�`deai_- Ge�^�a•cEv Cti � Zj� `k i (Additional inlonnat n) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) Corporate Officer ('rifle) Partner(s) CI Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in Cahfornia naisi contain verbiage exacily cis appears above in the notary section or a separate acknowledgment farm must he properly completed and attached to that document. The only exception is ,t a document is to be recorded outside of California. In such instances, an) alternative acknowledgment verbiage as may be printed on such a document so long as dre verbiage does not require the notary to do something that is illegal Jbr a notary ni California ti e. certifying the authorized capacity of the signet). please check the document carefully.for proper notarial wording and attach this,loan if required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowlcdgmenl, • 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 namc(s) of' document signer(s) who personally appear at the tinie of notarization • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. die/she/flwe -,- is /are ) or circling the correct forms. Failurc to concctly indicate this information may lead to relection 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 if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file svith the ol'fice of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to it different document Indicate title or type of attached document, numbei of pages and dale Indicate the capacity clanned by the signer If the claimed capacity is n corporate officer, indicate the title (i e CFO, CFO, Secretary) • Securely attach this document to the signed dOCnn1CM 2008 Version CAPA v 12 10 07 800-873-9865 www NotaryClasses. coin r Y 4 u GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 GOOD FAITH EFFORT SOLICITING DBE's 4/09/2010 - The following request for sub bids was faxed or e-mailed to twenty six (26) Sub -contractors who qualify as UDBE, DBE or VIBE. REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 jr 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 Attachments: Contact Log, Faxes/E-mails, Fax/E-mail Confirmations, Bids / Responses received. 1401 Warner Avenue, Suite B, Tustin, California 92780 o (714) 247-1040 o Fax (714) 247-1041 SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 - CITY OF HUNTINGTON BEACH COMPANY: GASS CONSTRUCTION CO., INC. UDBE COMPANIES CONTACT FAX / EMAIL DATE TIME CONF Accurate Striping Steve Richey 951-609-3370 4/9/10 2:45 PM OK MGD Enterprises Michael G. Dickens 760-772-6306 419/10 2:53 PM OK DCN Corporation Estimating Dept. 760-598-7226 4/9/10 2:55 PM OK Exbon Development, Inc. Estimating Dept. 562-777-1888 4/9/10 2:58 PM OK Gates Enterprises, Inc. Estimating Dept. 213-745-4597 4/9/10 3:01 PM OK Lincoln Pacific Builders, Inc. Lincoln Chan 626-960-7739 4/9/10 3:02 PM OK Loop Masters, Inc. Andrea North 714-630-1783 4/9/10 3:03 PM OK Rebel Concrete Breaking Service James E. Hines rebelconcretebreakingCavahoo.corn 4/9/10 3:04 PM OK Traffic Contol Engineering, Inc. David Kuan P.E. 714-447-6081 4/9/10 3:10 PM OK CD Montgomery, Inc. C. Montgomery 866-601-2695 4/9/10 3:12 PM OK G & F Concrete Cutting, Inc. Rita M. Vigil- Ferguson 714-550-0624 4/9/10 3:14 PM OK NCCI Inc. Estimating Dept. 562-220-1133 4/9/10 3:16 PM OK JMC-2 Estimating Dept. 310-320-8871 4/9/10 3:17 PM OK John C. Payne Dump Truck Service Barbara J. Payne 626-359-2899 4/9/10 3:18 PM OK Payco Specialties, Inc. Rebecca Lewellyn 619-427-1620 4/9/10 3:20 PM OK Full Traffic Maintenance Sammy Salgado 951-520-9980 4/9/10 3:29 PM OK Wagner Engineering & Survey Inc. Stephanie Wagner P.E. 818-892-6611 4/9/10 3:35 PM OK RESULTS No Response Submitted Bid 4/19/10 No Response No Response No Response No Response No Response No Response Not Bidding No Response No Response No Response No Response No Response No Response No Response No Response Triumph Geo-Synthetic Inc. Estimating Dept. 714-237-1549 4/15/10 8:03 AM OK No Response MBE / DBE COMPANIES CONTACT FAX / EMAIL DATE TIME CONF. RESULTS Advanced Civil Group Steve Austin steve(aadvancedmilgroup. com 4/9/10 3:37 PM OK No Response Buena Vista Landscape, Inc. Angel Gomez 714-779-1406 4/9/10 3:45 PM OK Not Bidding Cuscatlan Trucking LLC Luis Calderon 310-679-4616 4/9/10 3:48 PM OK Submitted Bid 4/12/10 Hardy Landscape Estimating Dept. 909-895-7314 4/9/10 3.49 PM OK Not Bidding Martinez Concrete Robert Martinez 626-334-3365 419110 3:51 PM OK Submitted Bid 4/12/10 Precision Engineering Fernando Padilla 909-862-6328 4/9110 3:53 PM OK No Response Rock Structures Tony Peredes 951-278-2802 4/9/10 3:54 PM OK Not Bidding Tribe Environmental Service Estimating Dept. 909-568-2488 4/9/10 3:55 PM OK No Response Ecologic Landscape Construction Estimating Dept. 951-461-2246 4/9/10 3:57 PM OK Not Bidding GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 Company: tic_c_uroLfe. S%j Contact: S+eVe Ri chev Fax#/Email JSI- bog -3370 Date: V91 a Time: "1: 1S Pm REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC c& PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 . (714) 247-1040 • Fax (714) 247-1041 04/09/2010 02:07 FAX 7142471041 GMC ENGINEERING 'F 7 �csx TX REPORT�a TRANSMISSION OK TX/RX NO 0664 CONNECTION TEL 19516093370 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:07 USAGE T 00'28 PGS. SENT 1 RESULT OK CONSTRUCT101 CQe lice GENERAL I=NGINEERINO CONTRACTOR Lie. No. 816579 Company: Acc LA -fie. Sidpi Na Contact:Ste& 91 r-hev F'ax#/Email 9 SI -bag - 3 3 Z Date: 1ly/, 2 Time: 2: g5Pm REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 (aD 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from Tben 1'';+x7 Roach GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: M GD EN 4-ef a6` 9e_ S Contact: Mtckoel G bj'C.Ken15 Fax#/Email 766 77,2 - 1.3 a(, Date: 16 Time: a '53 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 L& 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 9 (714) 247-1040 ® Fax (714) 247-1041 04/09/2010 02:15 FAX 7142471041 GMC ENGINEERING IM001 TX REPORT aKx� TRANSMISSION OK TX/RX NO 0667 CONNECTION TEL 17607726306 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:15 USAGE T 00'21 PGS. SENT 1 RESULT OK GASS colffRUCTIOICO,111109Nil GENERAL ENGaNgERING* CONTRACTOR Lic. No. 816570 Company: 01&b EK4erpp,'&g5 Contact: ftr-,ad ai'ckenlS __— Fax#/Emaii 760 - 772 - L 3 66 Date: y/qL_ Time-, a'S - REQUESTING SUB -BID :CBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN TIIE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 O VUNER: CITY OF HUNTINGTON BEACH BID DATE TUESDAY, APRII. 20, 2010 (oD 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, "traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from Thy C itv of Reach Hpr zu ,i u p.1 (Michael G. Dickens) Minority Contractor and Material Supplier UDBE (DBE) DVBE SEE Native American Owned Companies Please enter MGD Enterprises into your data base for all your minority needs in the future. To: Estimating Department Fax: Date:04/19/2010 Re: City of Huntington Beach —Safe Routes to School in the Vicinity of Spring View Middle School —Project No. CC1367 From: MGD Enterprises ( Mike Dickens } Fax: PH. 760-772-63C6 Phone: 760-535-5550 Comments: if you have any questions please call Michael G. Dickens at 760-535-5550. UDBE Certified (#12026)—Amerc Inc. Thank You. Urgent FX For Review Please Comment Pages: (including cover pg.) 8 Please Reply PO BOX 14223 Palm Desert, Ca 92255 Phone: 760-535-555C Fax: 76D-772-6306 Email: michaelgdickens@gmail.com Apr 20 10 11:35a p,2 FA Amerc Inc. (UDBE/DBE) 2:1437 Ahury live., Murrietd,011Z562 DBE Material Supply Unlimited U DBE/DBE #12026 Minoritv Contractor "Equipment rRentai General Engineering Material Supplier License # 630041 City of Huntington Beach Safe Routes to School in the Vicinity of Spring View Middle School Project No. CC1367 We propose the following services: o Rent caterpillar motor grader (model 140 H or M) @ $155.00 operated. o Rent 2000 Gallon water truck (BARE) @ $140.00 daily or $1600.00 monthly. o Rent 12,000 Gallon water tower @ $1,000 monthly. o (321 C) Caterpillar excavator with zero tail swing @ the rate of $162.00 per hour operated & maintained. o (321C) Caterpillar excavator with zero tail swing @ the rate of o $528.00 per day (Bare) % $2120.00 per week (BARE) / o $6600.00 per month (BARE) ® Mobilization and Demobilization $500.00 lump sum. o Hourly trucking $95.00 per hour end dumps & Transfers $85.00 per hour ten wheelers & bottom dumps. a Includes sales tax and environmental fees. • Call for any other prices on equipment you might be interested in. Amerc Inc. 23437 Abury Ave, Murrieta, Ca 92552 UDSE(DBE)#12026 Contact [Michael G. Dickens 7 60-5 35-5550 michaeledickens@ xmaii.coro Apr 20 10 11:36a a (UDBE/DBE) 23-13 7 Abu ry Ave.. Murrie la, c a925f.'2 DBE. Material Supply Unlimited UDBE/DBE #12026 Minority Contractor General Engineering License # 630041 City of Huntington Beach Safe Routes to School in the Vicinity of Spring View Middle School Project No. CC1367 o (Base on today's fuel prices) Equipment Rental Material Supplier *Also you may have us purchase any materials of the following materials and resale them to you @ 3.0% to utilize the UDBE (DBE) (SBE) (WBE) credits. (Concrete, Asphalt, Sand & Gravel, Base Material, Dirt etc.) Amerc Inc. 23437 Abury Ave. Murrieta, Ca 92562 UDBE (DBE) #12026 Contact Michael G. Dickens 760-535-5550 michaeledirko;;s wF,rnaii.eom Apr 20 10 11:36a v11 vo1 4U.LU lo. -/- 7Jl On Gl IrJI RMtKUiNU p.4 NAGE 0 1 / 0 4 April s, 20 1 0 CALIFORNIA UNIFIED CERTIFICATION PROGRAM (CUCP) Ms. Assuntaethel Murphey Amem Inc. dba Material Supply Unlimited 23437 Abury Ave. Murrieta; CA 92562 RE: DISADVANTAGE DIWOMEN BUSINESS ENTERPRISE (OBE/WBE) RECEIt'1CIMCA.TION APEROVAL F'il'e No. - 6601 _ .... _---•—_--• _ -- _ -_-- Dear Ms. Murphy: We are pleased to advise you that of tex careful review of your application and supporting documentation, the City of Los Angeles has detem>, aed that your fum meets the eligibility standards to be recertified as a Disadvantaged/Women Rusimess Enterprise .(DBE/WBE) as required under the U.S. Department of Transportation (U.S. DOT) Regulation 49 CFR Part 26, as amended. Your firm will be .listed in the CaCi_fornia Unified Certification Program (CUCP) database of certified DBEs and the City of Los Angeles DBE/MBEMBE directory. under the following. specific area(s) of expertise that you leave identified on the•business service form for contras dreg opportunities: NAICS Codes Descrintiav 237990 Other Heavy and Civil Engineering Construction 23.7310 Highway, Street, and Bridge Construction 238910 Site Preparation Contractors 423320 Brick, Stone, & Related Construction Material Merchant Wholesalers 4251.20 'Wholesale Trade Agents and Brokers Local _. 484220 Specialized Freight Trucking, Local 532412 Construction, Mining, And Forestry Machinery and Equipment Rental and Leasing Your DBE certification is good :Cor five years from the date of this letter and applies only for the above codes. You may review your finn's .Oformation in the CUCP DBE database which can be accessed at the California Department of Transportation's websitc at ww-w,dot.ca.Rov/4a/ben/ and the City of Los Angeles DT3Er'MBF/WBE database at http.//bca-lacitv.org. Any additions and revisions must be submitted to the City of Los Angeles for review and approval. After the five-year certification period, your entim .file will be reviewed in order to s4scertat`n continued DBE certification status. You will be notified of the pomdiag DBE status review and any documentation update necessary prior to the expiration date. C9tyoftos Angde9 - Deputment of Public Works - Humm of•ContmCt AdrtLmi5t a6an • otTiccafiCantract ComQiiance Centratiz t Certification Administration 1149 S. Breafwy, Suite 300, Los Angctcs. CA. 9001 i • Prone (213) R47.2684 - rnx (211) 947.2777 CALEFORNIA UNIFIED CFRTIFICATION PI IQG - r DISADVANTAGED BUSINESS ENTERPRISE C�RTTFJCA E �MTERB_AL SUPPLY o.Jl\JLJ$le'31 ED 23437 A13URY AVENTUE, MURWYA, CA 92562 I Dyer: ASSUNTA.KEHEL A11114F Y." ! Business Structure: CORPORATION I ' TM1 This certificate acknowledges that said t'irm is approved -by the Callfornis Unifled'C� ikicatioA Program (CUCP) as a Disadvantaged Business Enterprise (DBE) as defined by the U.S. Department of Tt axrsltoriafton (IlD'F) CNit 49 Part lti, as may be amended, fob Ate foW%Vng NAILS codes: NAILS Code(s) * Indicate-s primary- NAICS code * 237990 Other 1lca�y.and Ci�il &rginoering Canstnr�tion ,r 532412 Comtnietiun, Mining, and Faredry A4adtin¢cy and Equipment-Rebtii 237310 1Trgbway, St-*d, and Hridgc Coastruction 425120 Wholesale Teade Agents and Brokers ' 4 1' York Category Code(s) 42332Q Brick, Slobr<, and Related C ohstrnction Material Merehaut Wholesaler 484 Spe*lizied Freig, d (excepl dsed Goods) Truekirkq, Local 23891.0 Site i'lrtparation'Contraciors 484110 General Freight Tri gking, Local C9774 ?BUCKER f' I _ 09907 CO3�6'ItUCTJON EQUIPI#nrPRENTAL C9909 REAV3f EQUIPMEt,'T RENTAL "-' `•. i F5630 . Ui1 WPRAND WNSTRUCTION KATERIAL ... _ Licenses+... ,..' .. • .. A. . '._ _.j_,...... ;....- _..-_......__._...- _.._ ., . `.... _ ,._ .•..I AGeneral EngineeringContraetor :... J• CERTIMNG AGENCY: CTf Y OF LOS ANGELES t 149 SOUTH $ROADWAY STREET LOS ANGELES, CA 90015 0000 (2 €-3) 847- l 922 /1 i UCP Finn Number : 12026 April 5, 2010 MCP OFF•(CER, { I •t Apr 20 10 11:36a EquipmentDily a Rates Daily lWeekly Monthly Aerial Equipment 25' MANUFT, ELECTRIC $70 $210 $525 19'-20' SCISSORLIFT, ELECTRIC $70 $210 $525 26' SCISSORLIFT, ELECTRIC $90 $300 $625 32' SCISSORLIFT, ELECTRIC $125 $500 $1,000 26 SCISSORLIFT, RT, DUAL FUEL $110 $350 $800 32' SCISSORLIFT, RT, DUAL FUEL $125 $500 $1,000 30'40' BOOMLIFT, KNUCKLE ELECTRIC $175 $700 $2,100 40'-45' BOOMLIFT, TELE OR KNUCKLE DF $200 $650 $1,600 60'-65' BOOM LIFT, TELE OR KNUCKLE DF 1$300 $1,000 $2,500 85' TELESCOPIC BOOMLIFT, DIESEL 1 $600 $2,400 $6,300 Backhoes 420D $245 $980 $2,940 4301) $245 $980 $2,940 H90C HAMMER FOR 420D/430D $245 $980 $2,940 COMPACTION WHEEL (ALL SIZES) $80 $320 $960 446B/D $350 $1,400 $4,200 H100 HAMMER FOR 446B/D $350 $1,4D0 $4,200 PLATE COMPACTOR ATTACH $100 $4D0 $1,200 EXTRA BUCKET $30 $120 $300 Compaction Equipment DOUBLE DRUM SMOOTH RD11A 36" 1.5 TON (WACKER) $100 $400 $1,200 CB214E 39" 3-5 TON $150 $600 $1,800 CB224E 47" 3-5 TON $180 $720 $2,160 CB434 56" 7-9 TON $350 $1,400 $4,200 CB534 67" 10-18 TON $400 $1,600 $4,800 CB634 84" 11-22 TON $425 $1,700 $5,100 SINGLE DRUM PADDED CP323 54" 5TON $275 $1,100 $3,300 CP433 66" STON $375 $1,500 $4,500 CP563 84" 12TON $450 $1,800 $5,400 SINGLE DRUM SMOOTH CS433 66" STON $350 $1,400 $4,200 CS563 84" 12TON $425 $1,700 $5,100 Amerc Inc. Apr 20 10 11:37a m WHEEL ROLLER Daily Weekly Monthly P5200B/PS150C 9 WHEEL ROLLER $325 $1,300 $3,900 PS3607 WHEEL ROLLER $400 $1,600 $4,800 Dozers D4C / G $350 $1,400 $4,200 D5G _ $350 $1,400 $4,200 D5M / N $425 $1,700 $5,100 D6M / N $500 $2,000 $6,000 06R $700 $2,800 $8,400 D8R $1,300 $5,200 $15,600 SLOPEBOARD (DUAL SLOPE UPCHARGE) $75 $300 $900 Excavators 301.8 $160 $640 $1,920 302.5 $175 $700 $2,100 303.5 / 303CR $190 5760 $2,280 304CR $205 $820 $2,460 305CR $225 $900 $2,700 307 $300 $1,200 $3,600 312C $350 $1,400 $4,200 314C $400 $1,600 $4,800 315C $450 $1,800 $5,400 320CL $550 $2,200 $6,600 321CLCR $600 $2,400 $7,200 HAMMER FOR 320 $550 $2,200 $6,600 THUMB FOR 320 $100 $400 $1,200 M322 (WHEEL EXCAVATOR) $650 $2,600 $7,800 325 $750 $3,000 $9,000 HAMMER FOR 325 $750 $3,000 $9,000 330 $900 $3,600 $10,800 HAMMER FOR 330 $900 $3,600 $10,800 345 $995 $3,980 $11,940 ADDITIONAL BUCKET (315/320/330) $100 $40D $1,000 COMPACTION WHEEL $125 $500 $1,250 Elevating Scrapers 613C1 $650 1 $2,600 1 $7,800 623E 1 $1,200 1 $4,800.1. $14,400 Motor Graders 12H $500 $2,000 $6,000 140H $550 $2,200 $6,600 14H $750 $3,000 $9,D00 Amerc Inc. Apr 20 10 11:37a Telehandlers Daily Weekly Monthly TH210 17'4850# $175 $700 $2,100 TH360 44' 7000# $200 $800 $2,400 TH46044' 9000# $240 $960 $2,880 TH560 44' 11000# $320 $1,280 $3,840 TH580 54' 11000# $400 $1,600 $4,800 1.75YD BUCKET $20 $80 $240 TRUSS BOOM $20 $80 $240 Wrack Loaders 933C $350 $1,400 $4,200 939C $400 $2,600 $4,800 953C $500 $2,000 $6,000 963C $650 $2,600 $7,800 Trucks & Accessories DUMP TRUCK, 5YD $200 $800 $2,400 WATER TRUCK, 2000 GAL $225 $900 $2,700 WATER TRUCK, 4000 GAL $400 $1,600 $4,800 Water Towers 10K GALLON 1 $100 1 $400 1 $1,200 Wheel Loaders 9081YD $250 $1,000 $3,000 928G 2 1/2YD $325 $1,300 $3,900 93BG 3YD $400 $1,600 $4,800 95OG 4YD $525 $2,100 $6,300 966G 5YD $700 $2,800 $8,400 RAIL ROAD BOOM ATTACHMENT $100 $400 $1,200 QUICK CONNECT BUCKET ATTACHMENT $100 $400 $1,200 98OG 7 1/2YD $1,000 $4,000 $12,000 1% Environmental fee + Sales Tax Insurance Required Amerc Inc. GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: bCN Coco or&4-t°dN Contact: ES` ,NA ock,)!� llep Fax#/Email 7(Q0- 5_90 -7,22 (o Date: 919LIo Time: ; 5-3- REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marring, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 9 Fax (714) 247-1041 04/09/2010 02:17 FAX 7142471041 GMC ENGINEERING x�x TX REPORT xc 2100] TRANSMISSION OK TX/RX NO 0668 CONNECTION TEL 17605987226 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:17 USAGE T 00'17 PGS. SENT 1 RESULT OK WKSTRKTIOX Ca Iice GENERAL ENGINEERING CONTRACTOR LIc. No. 816579 Company: bCN Caro 0raL6p,) Contact:_ a+;,aA_ I+ ax#/Email 7 W - 5-3 8- -7.22 �O Date: 9 io Time- .2;53- REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: T'UESDAY, APR.IL 20, 2010 04 2:00 PM GASS Construction. Co., Inc. is requestiD,g bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC c& PCC Paving, Plans and Specifications are available from Tl,,� Oitxr n-FUiintinntrni Raar11 GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Exbn N ��Ve r�oI lnlc. Contact: Es+, rna,_EpjA Fax#/Email 5(a - 777—/&fft Date: 9 o Time: REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 0 Fax (714) 247-1041 04/09/2010 02:20 FAX 7142471041 GMC ENGINEERING [a 001 TRANSMISSION OK TX/RX NO CONNECTION TEL SUBADDRESS CONNECTION ID ST. TIME USAGE T PGS. SENT RESULT sc�c TX REPORT *xc s�a���c�cskaksk���k��N�sk�:�sksk�kxc 0669 15627771888 04/09 02:20 00'32 1 OK GENERAL ENGINEERING CONTRACTOR Lie. No. $16579 Company: Exbe,) by_Ve 1e)pme� C. Contact: Fs "ma � � Qcpa rd-m Fax#/Email $!*:L777-19W Date: y/ 9 Ito Time: REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER; CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 R 2:00 PM_ GASS Construction Co,, Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control., Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from Tho C"itx? of Piintinafnri RParh GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Go,1 Ewre w'; Ses ; INc. Contact: Es- m afii ,�U Q� Ao.t'�rnea1 Fax#/Email 213- 7IS- ySg7 Date: /p 'Time: 3`edL REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 04/09/2010 02:24 FAX 7142471041 GMC ENGINEERING TX REPORT x� Z001 TRANSMISSION OK TX/RX NO 0670 CONNECTION TEL 12137454597 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:24 USAGE T 00'15 PGS. SENT 1 RESULT OK ORNERAL ENGINEERING CONTRACTOR LIc. No. 816679 Company:-{-IJC- Contact: E3+;ffia_ti No 8,e±pQ1`�'rn� Fax#/Email 213- 7YS- y5y7 Datc:-1/26n Time: 3:odL REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN T14E VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUN'1 INGTON BEACH B.ID DATE: T'UESDAY. APRIL 20, 2010 n, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, 'Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The Citvv of T4untingttnn RP,gr.h GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: liocoiN Pat Sic. Qui ldcr , 200c- Contact: L.iNc61N C}knw Fax#/Email 69(p — 10 -7 739 Date: q a Time: �:o), REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 (cry, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marring, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 . (714) 247-1040 • Fax (714) 247-1041 04/09/2010 02:30 FAX 7142471041 GMC ENGINEERING a 001 xc�c�c TX REPORTxe �k�k��kxc�s&s�&sk���k�ksk�skskxs�� TRANSMISSION OK TX/RX NO 0671 CONNECTION TEL 16269607739 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:29 USAGE T 00'49 PGS. SENT 1 RESULT OK JwA GENERAL ENGINEERING CONTRACTOR Lin. No. 816979 company: lioic.olty Pa oRc. kw' Ide-rs, -Zvi c.. Contact: LitvcaI/o Y+ax#/Email l01(0 ~ 9 %D -7 739 . Date: yl� Time: 3, O 2 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades; Surveying, 'Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & IPCC Paving, Plans and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lic. No. 816979 Company: Loop (Aa_g{-erS, Tnjc, Contact: ANdpea 1\)O( k Fax#/Email -M - (, 3d-17 b Date: V191to Time: 3,'03 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 g 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 9 (714) 247-1040 • Fax (714) 247-1041 04/09/2010 02:31 FAX 7142471041 GMC ENGINEERING 9.1001 TX REPORT TRANSMISSION OK TX/RX NO 0672 CONNECTION TEL 17146301783 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:31 USAGE T 00'28 PGS. SENT 1 RESULT OK GENERAL ENGINEERING CONTRACTOR Llc. No. 816579 Company: Loop Me- rs..TAur. Contact:_ _k a j d (, jN) 6,4, , Fax#/E mail 71q - L 30 - [ 7 $3 Date: VA/gyp Time: 3� 03 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL, IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY APRIL 20 201 0 2 2:00 PM. GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & :PCC Paving, Plans and Specifications are available froi n Tl�o r%+Nr r,f'TTi1yi+inRtn» Raarrh GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: RP.bel Cmcre4e 8re.&Ki,A) Serv,°ce- Contact: .Te'ar\e-S F. 1+ rues Fax#/Email rebe,leorucsele.be c. K.j: Date: Y19110 Time: 3.09 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 0 (714) 247-1040 0 Fax (714) 247-1041 y Page l of 1 kat From: kat [kat@gassgmc.net] Sent: Friday, April 09, 2010 3:04 PM To:'rebelconcretebreaking@yahoo.com' Subject: Request for Sub -Bid Please see attached request for Sub -Bid for Safe Routes to School in the Vicinity of Spring Middle School — City of Huntington Beach 4/9/2010 kat From: Mail Delivery Subsystem [MAILER-DAEMON@mail.wilogic.com] Sent: Friday, April 09, 2010 3:07 PM To: kat@gassgmc.net Subject: Return receipt J :J details.txt (566 B) ATf00016.txt (1 019 B) The original message was received at Fri, 9 Apr 2010 1.5:06:41 -0700 from CSR348PCR-CaHaSe-SaAn-Or-Ca-c904-GMCEngineering.wilogic.com [69.44.67.109] ----- The following addresses had successful delivery notifications -----<rebelconcretebreakingnyahoo.com> (relayed to non-DSN-aware mailer) ----- Transcript of session follows -----<rebelconcretebreaking@yahoo.com>... relayed; expect no further notifications kat From: rebelconcretebreaking@yahoo.com Sent: Friday, April 09, 2010 3:07 PM To: kat Subject: Delivered: Request for Sub -Bid JIII"7___7_" details.txt (214 B) Your message was delivered to the recipient. GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: 77Q_};� �oafrc�l E�aPn�eer�nl5, lac. Contact: ba„yi'd KuaN P 1=, Fax#/Email 11q -4y 7 - 4o$! Date: y Time: °3; io REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC 8a PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 . (714) 247-1040 0 Fax (714) 247-1041 04/09/2010 02:34 FAX 7142471041 GMC ENGINEERING 000 �c TX REPORT �x x�s�sxxesa��xcsesxx�xe�cs�scx��x�c�ae� TRANSMISSION OK TX/RX NO 0673 CONNECTION TEL 17144476081 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:34 USAGE T 00'27 PGS. SENT 1 RESULT OK GA -SS COISTR.UCTIOI coo 1,10,11416 GENERAL ENGINEERING CONTRACTOR LIc. No, 816579 Company: 7'rnAr tp Aml &jga ,l eel j, zwc. Contact: bo vi od Cum P L ]FaxWErnail 'lly -4y7 - foo$! Date: y Time: 3: LC REQUESTING SUB -BID DEE Subcontractors and Suppliers for: SAFE .ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY. APRIL 20, 2010 (a, 2:00 PM G'ASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from Trt.� r;+..U-13clh GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 Company: C. D. Mo,J+Aame.r� . Contact: C. MoL,} omery Fax#/Email � - 01- 2 05_ Date: V /n Time: 3 : ,;- REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 9 (714) 247-1040 o Fax (714) 247-1041 04/09/2010 02:35 FAX 7142471041 GMC ENGINEERING 01001 sk�k�k�k�C�k�k�k%k�kk�S�kW��kkk��s xc TX REPORT xs xc TRANSMISSION OK TX/RX NO 0674 CONNECTION TEL 18666012695 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:35 USAGE T 00,18 PGS. SENT 1 RESULT OK cOISTRUCTIONC011111CL ®LNERAL ENGINEERING CONTRACTOR Lie. No. 816579 Contact: C. ►gbLAgpfrie�y Fax#/Email 96 � - �01-2645 __ Date: 1191io Time: --a, I .'L REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH 13ID :DATE: TUESDAY. APRIL 20,_2010_� 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available. from 11'. 04, niT4rr�t+rirrtnn T2aan1-i GENERAL ENGINEERING CONTRACTOR Llc. No. 816579 Company: G 2 F C'_otoc j,e4e CL, 4,� Air Fax#/Email 7 SSo - d6�y Contact: R� 111, j/i`u; ` Fea`Qus OA) Date: q 1JILo Time: 3 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 ® (714) 247-1040 o Fax (714) 247-1041 04/09/2010 02:36 FAX 7142471041 GMC ENGINEERING R nni x� TX REPORTxc TRANSMISSION OK TX/RX NO 0675 CONNECTION TEL 17145500624 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:36 USAGE T 00'16 PGS. SENT 1 RESULT OK GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 Company: G � F Cofoc.re4e C' �N� Fax0ri mail 7/2- 6:6-0 - 042.4 Contact: Kt4utA, Via; I ` F� dasQ�a IDate: y_(y fio Time: 3+ I REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTING"IRON ]BEACH BIDDATE: TUESDAY. APRI1, 20, 2010 a, 2:00 .PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control,, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lic. No. 516579 Company: N C,C.Z SNc.. Contact:�;lRen4{- Fax#/Email 5�,2 - 2 ;L(p - 1(3 3 Date: q1jjjo Time: v : [ 16 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 g 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control, Striping c& Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 (BASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 ® Fax (714) 247-1041 04/09/2010 02:37 FAX 7142471041 GMC ENGINEERING a 00] x�x TX REPORT TRANSMISSION OK TX/RX NO 0676 CONNECTION TEL 15622201133 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:37 USAGE T 00'15 PGS. SENT 1 RESULT OK CORSTRU.C7101 Coo love GENERAL ENGINEERING CONTRACTOR Lie. No. $16579 Company: N ccz xroc. Contact: Fax#/Email Date: to Time- 9 : ( 6 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCIIOOL IN T14F `V'ICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY. APRIL 20, 2010 0) 2:00 PM GASS Construction Co., Inc. is requesting bids - or, but not limited to the following trades: Surveying, ',Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plaits and Specifications are available From T1,� Ci+,(7 of "iintinrrtnn Rec arin I GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: 2-MC - 2 Contact: FS+i I q ti NG Q*-Dg_(tmen4 Fax#/Email 310 - 3;0 - W Date: q /p Time: ` i REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a,, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 0 Fax (714) 247-1041 04/09/2010 02:39 FAX 7142471041 GMC ENGINEERING R nnl TX REPORT xc�s ��kskxe�k�s&�:aexc:k�sksR��kNs��sk�k TRANSMISSION OK TX/RX NO 0677 CONNECTION TEL 13103208871 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:39 USAGE T 00,19 PGS. SENT 1 RESULT OK GASS cONSTRUCTION Ca lice GENERAL ENGINEERING CONTRACTOR Lie. No. 01$S79 Company:_ �-M C, -� _ Contact: ES►m0.Ii10a D�pal�me� Faxg/Fma;.l 310 - 3a0 - $t71 Date: bo Time: '6'.1 L REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. l 367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, .APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, 'but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Frain Structures, AC & PCC Paving, Plans and Specifications are available from 'M- r'',+,, n,r u17+%+1*1 rV+^." Dxmr3t4l GA COIST�RUC' TION coo lice GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 Company: TotiN C. PO -Vide— imfnp `Truck Sjtma Contact: S�rbara S, �'c.vNe Fax#/Email Date• y/� �p Time: 3;116 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 g 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 04/09/2010 02:40 FAX 7142471041 GMC ENGINEERING TX REPORT [a 001 TRANSMISSION OK TX/RX NO 0678 CONNECTION TEL 16263592899 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:40 USAGE T 00,18 PGS. SENT 1 RESULT OK GENERAL ENGINEERING CONTRACTOR Lit. Na. 816579 Company: Toklu C. PA,Ne_ bump Truck S Fax#/Email C:ont3Ct: 8a.r bars � &o J f c Date:/gl oTime: 2, I,r,)_ REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL :IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESD,AY APRI.L 20, 2010�2:�00 P_M G,A.SS Construction Co_, Inc. is regLiesting bids for, but not limited to the following trades: Surveying, Traffic Signal, "traffic Control, Striping & Pavement Marking, S.Iurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: ('p„yco Sper t ctj%je5, TNc Contact: Rel c�_cx a Lew r Fax#/Email Date• [p Time: 3 �0 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 e Fax (714) 247-1041 04/09/2010 02:41 FAX 7142471041 GMC ENGINEERING 0.1001 �x TX REPORT�cxc TRANSMISSION OK TX/RX NO 0679 CONNECTION TEL 16194271620 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:41 USAGE T 00'16 PGS. SENT 1 RESULT OK GENERAL ENGINEERING CONTRACTOR Llc. No. 896579 Company- P0.4'ya SAeci Contact: oi�l1 aLCr n LeyJ4.l_'TJI� Fax#/Emaul W2- W- I4ZO D11te:_4jjjgZ Time: 3 0 )-a REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction, Co., Inc. is requesting bids for, but not limited to the following trades; Surveying, Traffic Signal, Traffic Control., Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from Tl,o r;+%, rf'LTiIIg1•ir.1ntnn Roar+'h GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Fu.11 TM4r c A4 ; Nfen)aA)ce Contact: Sg-m my Sa q j o Fax#/Email 75I - 5?-0 _ J 9 $© Date: Time: 3 *,2. REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 0 Fax (714) 247-1041 04/09/2010 02:56 FAX 7142471041 GMC ENGINEERING 0 001 x TX REPORT �cxcx� TRANSMISSION OK TX/RX NO 0681 CONNECTION TEL 19515209980 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:55 USAGE T 00'15 PGS. SENT 1 RESULT OK G'401STR9C?101 Ca lice GEN9RAL ENGINSERING CONTRACTOR Llc. No. 816579 Company: 601 jCgAk- 04 "AAe+ Q [Ur- P Contact: So.rn rn.l./ %_J as d D Fax#/Elnail Q51- 5aD- '198.0 Date: N o Time: 510.1 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, ,APRIL 20,_2010_0), 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from ThP City of 14untinatrin Reach GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: WagA)c r &►4o"Ne.e.r1 f SurV!W TA)C, Fax#/Email $1$- 6 t2 Contact: Sfephagte_ Wczar)e.r L. Date: VAlto Time: '3,,SS' REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 ® (714) 247-1040 • Fax (714) 247-1041 04/09/2010 02:57 FAX 7142471041 GMC ENGINEERTNG R nni TX REPORT TRANSMISSION OK TX/RX NO 0682 CONNECTION TEL 18188926611 SUBADDRESS CONNECTION ID ST. TIME 04/09 02:57 USAGE T 00'17 PGS. SENT 1 RESULT OK COISTRUC110jua lee GENERAL ENGINEERING CONTRACTOR Lie. No. 616570 Company: W J,)C.e T,, Fax##/Email $Y Ct,retnct: 5'fepJ�aNi� WSA r P Date: y%9 (rD. Time: 3;35 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN TFIE `V'ICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNUNGTON .BEACH '.BID DATE: TUESDA.Y, APRIL 20, 201O�r. 2_00_PM GASS Construction Co., Inc. is requesting bids for, but not limited to the followiaig trades: Surveying, Traffic Signal, 'Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plates and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 Company: 7-ri`(AMAh Ge.c Svn� '���r"cS��o��, Fax#/Email �iy� �37- ISyS Contact: ES+, M a.+:�;g �e_omtf MEAJf Date: 5 to Time:_; 3 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 L 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, 'Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax: 714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 a (714) 247-1040 o Fax (714) 247-1041 04/14/2010 19:25 FAX 7142471041 GMC ENGINEERING lih001 a�skNc TX REPORT xcxcxc :k�sk�k�k�ksk��kskXs�k�ksk�k�sk�kxesk� TRANSMISSION OK TX/RX NO 0717 CONNECTION TEL 17142371549 SUBADDRESS CONNECTION ID ST. TIME 04/14 19:24 USAGE T 00'32 PGS. SENT 1 RESULT OK GASS COISTI INC GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: J"ChAmpk Geo -sv►U&e�,r �o��. Eax#/Email 7/y-.237- /5yI Contact: Esi~�n1 a-i�`fu� �e.�ar"�M Date: 5 to Time: $:03 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH. BID DATE: TUESDAY, APRIL 20, 2010 & 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control., Striping & Pavement Marking, Slurry Seal, Storm Drain. Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Aj VaA1 cej C;,y;/ Grp Contact: 3}e.de. husi-; Fax#/Email S+P_yz*Ay ca��c�aL� Date: y p Time: 3:3` REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 g 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, 'Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 0 (714) 247-1040 ® Fax (714) 247-1041 Page 1 of l kat From: kat [kat@gassgmc.net] Sent: Friday, April 09, 2010 3:42 PM To: 'steve@advancedcivilgroup.com' Subject: Request for Sub Bid Please see attached request for Sub -Bid for Safe Routes to School in the Vicinity of Spring Middle School — City of Huntington Beach 4/9/20l 0 kat From: Mail Delivery Subsystem [MAILER-DAEMON@mail.wilogic.com] Sent: Friday, April 09, 2010 3:44 PM To: kat@gassgmc.net Subject: Return receipt J detailsAxt (562 B) ATT00013.txt (1,013 B) The original message was received at Fri, 9 Apr 2010 15:44:08 -0700 from CSR348PCR-CaHaSe-SaAn-Or-Ca-c904-GMCEngineering.wilogic.com 169.44.67.1091 ----- The following addresses had successful delivery notifications ----- <steve@advancedcivilgroup.com> (relayed to non-DSN-aware mailer) ----- Transcript of session follows -----<steve@advancedcivilgroup.com>... relayed; expect no further notifications kat From: steve@advancedcivilgroup.com Sent: Friday, April 09, 2010 3:44 PM To: kat Subject: Delivered: Request for Sub Bid J", details.txt (211 B) Your message was delivered to the recipient. GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: 8ue.Na.Y,s L�Nc�sc t.�Ne Contact: ti Ael Game-7— Fax#/E,mail 71q- 275- jqo� Date: Time: T46_ REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 g 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC 8z PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 ® (714) 247-1040 o Fax (714) 247-1041 04/09/2010 03:08 FAX 7142471041 GMC ENGINEERING 0..1001 x� TX REPORT TRANSMISSION OK TX/RX NO 0683 CONNECTION TEL 17147791406 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:07 USAGE T 00'38 PGS. SENT 1 RESULT OK Company: Contact: AOAJ CIO MIZ-7- %J F'ax#/Email ?tY- Z 9- tyo% Bate: y�9 /�o Time: REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, .A.PRIL 20, 2010 @ 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, ,AC & PCC Paving, Plates and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Cuac jj" Trlxcl<juc LLC Contact: Luis Ca ld e w o Fax#/E mail Date: R o Time: 3 E 4Y REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM_ GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 9 Fax (714) 247-1041 04/09/2010 03:10 FAX 7142471041 GMC ENGINEERING �c TX REPORT Z001 TRANSMISSION OK TX/RX NO 0684 CONNECTION TEL 13106794616 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:09 USAGE T 00'33 PGS. SENT 1 RESULT OK cOISTRUCT101-Ct lice GENERAL ENGINEERING CONTRACTOR LIc. No. 818379 Company. Cuu'(Al" TrucK"lul LJ_-C. Contact: (, uiS CJd e w N Fax#/Email Date: 4 0 Tiwe: 3; yf REQUESTING SUB -BID D13E Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TU•ESDAY, APRIL 20, 2010 (u, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from Cuscatlan Trucking LLC P.O.Box 1349, Hawthorne, CA 90251 www.cuscatlantrucking.com Luis@cuscatlantrucking.com Cell (310) 906-6054 Cell (310)529-5218 Fax (310) 679-4616 To: Estimating Department From: Cuscatlan Trucking, LLC Company: Gass Construction CO. Inc Fax: (1714) 247-1040 Phone: (714) 247-1041 TO: Estimating Department Date: 04/12/10 Page# Sender Ref # Proposal Thank you for giving us the opportunity to quote on your Projects: Safe Routes to School in the vicinity of Spring Middle School: CC # 1367 I would like to Quote this project to you at $75.00. Per Hr. With the super ten dump truck to move the unwanted material away or deliver to the job site Be Advice that our company is Certified by the State of California and Caltrans: DBE/MBE/ SBE Caltrans Certification #37893 and Certification From the State: #1042605 Ins: $1,000,000: Conbined single limit, Hire auto Liab-to others, Employer Non -Owned auto Liab-to others. General Ins:$2,000,000.general Agg, $2,000,OOO.products-comp/op agg. $1,000,000. Personal+ Worker's Comp:$1,000,OOO.per occurrence . Note: This Qoute are for S/10 Dump Truck at $75.00. or End dumps at Rate of $85.00. Per Hr I think it is a very affordable price for you so we can work together let us know if you need any additional information. P.S. For over 6 years Cuscatlan Trucking, LLC has meant competitive rates, personal service and the kind of service that today's Engineering and Excavating Contractors want most. We look forward to work with you soon a Should you have any question, please feel free to call us. Thank you, Jose Henriquez, son Luis Calderon, owner GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Ro_rdj "tic) ScoLAe, Fax#/]Email 101- g15-- 731y Contact: C st ryv & -`,' pq be c ck f mA_,,A Date: 1111.o Time:.X,49 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 e (714) 247-1040 ® Fax (714) 247-1041 04/09/2010 03:11 FAX 7142471041 GMC ENGINEERING 00(11 TX REPORT x xcxc xc��xexcxesxxc�c:k��c�sk��xcsmxexcxc TRANSMISSION OK TX/RX NO 0685 CONNECTION TEL 19098957314 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:11 USAGE T 00'30 PGS. SENT 1 RESULT OK MM coiSTRUCT101 C06I e aF-N RAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: 4O.Clr �..o rj a e.qe Contact: Esl m )e'60L M, 4 Fax#/Emai1_J0 w t45 731Y Date: /o Time: REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SATE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1.367 OWNER: CYTY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., In.c. is requesting bids :for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marldug, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from . m1 /N". - .CTT__._.i___ ._L—__ GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: Mo-rfiNeZ C:ok)cmi-e. Contact: Es�'maJ-2,'NA �e,pa6men1�' Fax#/Email �), � - 334 - 3 31 S- Date: V I llo Time: 3 , 5 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEA BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 0 Fax (714) 247-1041 04/09/2010 03:13 FAX 7142471041 GMC ENGINEERING 01001 xc x TX REPORT ss* TRANSMISSION OK TX/RX NO 0686 CONNECTION TEL 16263343365 SUBADDRESS CONNECTION ID MARTINEZ CONCRET ST. TIME 04/09 03:13 USAGE T 00'16 PGS. SENT 1 RESULT OK t . a � 7 ' _ a GENERAL ENGUNEERI Q CONTRACTOR Lie. No. 816379 Company: l��'�'LNe2 Con�c.r�% Contact: E4 (ko&" N� Q e.�o0.c�m--I," Fax#1E+mafl jIL L3M- 35- Date: y14 /io Time: 33 SL REQUESTING SUB-BTD DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRJNG MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH_ BID DATE: TUESDAY APRIL 20, 2010 0), 2,00 .PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control, ,Striping & Pavement Marking9 Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from BID PROPOS,�\L . A Cc Crete inc. Stote License 4394471 Date: 4/8/.: 010 From, To: Martinez Concrete Inc. G:,na 920 W. r-oothil! Blvd, GMC Eng. nc. - 1401 WarnerAY.S,Ie,B Azusa, CA 91702 Tustin. CA 91 180 Phone 626-334-2979 Fox 626-334-3365 rmarfinez@mortinezconcrete,net Estimator Job �. Robert i luntin ion Beach -Safe Route to School-Springview Middle _ MidSchool I. . .... __.. Description Qty. Unit Price Unit Line Total 7) install modified Island passage woy per Colirans std 1 $4,350.00 ea ,3$0,01 plan A886. inci, curbs„gutter, 8) 4" Sidewalk per 9 td 207 700 $4.00 sf 2.800.0f' 9) 8" Curb with 2' Gutter. 85 $18.00 if 1,530,Ot 10) Curb Romp incl, C&G(domes nOl incl) 14 $1,675.00 ea 23,450.0['., Total $32,130,00 Quotation prepared by. This is a quotation on the goods named, subject to the conditions noted below: Exclusions: Inclusions: Precise grade by others, Mix: 560-c-3250 Traffic control. survey. Spoils removed from site and washout pit, Permits. To accept this quotation, sign here and return: rnnFRI 1WTWq'4NJT`)Kr4 Obj.! F OKI a,LaHOKOO ZHNIIHVI-i 29CEtiCC9Z9T YV3 T2tTT OTOZ/ZT%%0 GENERAL ENGINEERING CONTRACTOR L"ec. No. 816579 Company: N6 5i'QA) ENA i Neer-iM . Contact: Fe.rNQaydo Pad+ 11A Fax#/Email qoq - $ �Z - 6 3;29 Date: L yN Time: 3, 53 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 n, 2:00 PM GAS S Construction Co., Inc. ' is requesting bids for, but not limited to the following trades: Surveying, 'Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC L& PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 . (714) 247-1040 m Fax (714) 247-1041 04/09/2010 03:15 FAX 7142471041 GMC ENGINEERING a 001 TX REPORTNc TRANSMISSION OK TX/RX NO 0687 CONNECTION TEL 19098626328 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:15 USAGE T 00,15 PGS. SENT 1 RESULT OK INCWISTRUCTION Ca GENERAL ENGINEERING CONTRACTOR Lie. No. 816679 Company: PPCQi5 oA) Eiu4 i Nee.rW& Contact-. Ferfjamdo &djjjq F+ax#/Email 90- S0 - 4 329 Date: y I bD Time: 3 Sa RIE"Y. CESTING SUB -BID DBE Subcontractors and. Suppliers for: SAFE ROUTES TO SCHOOL IN T14E 'V'ICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER- CITY OF I- UNTINGTON BEACH BID DATE: TU'ESDAY, APRIL 20, 2010 @ 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: ROCK- S�(%tc+ures Contact: Totvy iPe f jeS Fax#/Email qS/ -)-7, -- a 80 2 Date: q /0 Time: 3: $ REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 al 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping c& Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:71.4-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite D, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 e (714) 247-1040 • Fax (714) 247-1041 04/09/2010 03:16 FAX 7142471041 GMC ENGINEERING aoni �x x TX REPORT x� TRANSMISSION OK TX/RX NO 0688 CONNECTION TEL 19512782802 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:16 USAGE T 00'17 PGS. SENT 1 RESULT OK Company: Rork Sl ruc,+Up s Contact: Tory Pkc� ales Fax#/Email qS/ - 27,�- a9oa .Date: 9 /D Time: 3 : S REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TU.ESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids .for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: j p; be, L N✓; P0nomeN+0j v;ce F ax#/Email Contact: Es+ mak'.0u Deparri ftA)� Date: Y19110 Time: REQUESTING SUB -BID DBE Subcontractors and. Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 e (714) 247-1040 ® Fax (714) 247-1041 04/09/2010 03:17 FAX 7142471041 GMC ENGINEERING a 001 TX REPORT x�xx TRANSMISSION OK TX/RX NO 0689 CONNECTION TEL 19095682488 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:17 USAGE T 00'28 PGS. SENT 1 RESULT OK CONSTRUCT101 Ca isc. GENERAL ENGINEERING CONTRACTOR Lie. No. 816579 Company: T(,E be, LA) ytoN(leN+qj Lgt ce- F'ax#/Email Contact: ES+; mah'k DePQ,f+A Wn}f' Date: Y19110 Time:. REQUESrTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE 'VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDA.Y, APRIL 20. 2010 a, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from I C0111ce GENERAL ENGINEERING CONTRACTOR Lic. No. 816579 Company: l E_c 1oc, LAscape Cc�n>.S�rurf�o(j Fax#/Email q51- Y61-a�yCo Contact: E }; Na �Rr '(►teat% Date: y /o Time: 35-7 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 WNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph: 714-536-5431 Fax: 714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 ® Fax (714) 247-1041 04/09/2010 03:19 FAX 7142471041 GMC ENGINEERING [?]001 �c TX REPORTxcxc TRANSMISSION OK TX/RX NO 0690 CONNECTION TEL 19514612246 SUBADDRESS CONNECTION ID ST. TIME 04/09 03:19 USAGE T 00'30 PGS. SENT 1 RESULT OK .GASS cONSTRUCT101 Ca l GENERAL ENGINEERING C0NTRACTOR Lie. No. 816579 Company: EcpIcn,c- Laiodsc pe CoN.sjr +onL Fax##/Email q51- Y61-;.14� ___ Contact: Date: y /0 Time: 36-7 REQUESTING SUB -BID DYKE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDA.Y, APRIL 20, 2010 cr, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain. Structures, AC & PCC Paving, Plaals and Specifications are available from o 0 0 0 GENERAL ENGINEERING CONTRACTOR 6ic. No. 816579 GOOD FAITH EFFORT 4/09/2010 - Faxed goodfaitheffort.com Ad Information form requesting Ad be run in Monday's Focus Publication, Monthly Bidder's Bulletin 4/12/10 and Thursday's 'trade Publication, Construction Update 4/15/10, and to be displayed on their website. 4/09/2010 - Faxed AGC's bequest for Sub -Bid Ad Placement Order Form Requesting Ad be run in the AGC Good Faith Advertising Report for one (1) week starting 4/12/10. 7 Attachments: Ad Placement Forms, Ads, Fax Confirmations and Proofs of Publication. 1401 Warner Avenue, Suite B, Tustin, California 92780 © (714) 247-1040 © Fax (714) 247-1041 r` REQUEST FOR ` UB-BI® A® PLACE EK d° ORDER FOR Report is distributed each Monday Company Name: GASS Construction Co., Inc. Contact Person: Mike LaVoie Address: City: Phone 1401 Warner Avenue, Suite B Tustin 714-247-1040 Email: mike@qassgmc.net State: CA Zip: _ 92780 Fax: 714-247-1041 AD REQUEST MUST BE FAXED TO 858-874-8569 OR EMAILED TO planroom@agcsd.org by FRIDAY AT 5:00 PM FOR PLACEMENT. Please contact Jessica Kovack at (858) 874-8560 ext. 11, Jessica@agcsd. org, or Lisa Lovelace at (858) 874-8560 ext. 13, lisa@agcsd. org, with questions. Please complete the following or attach a "sample ad. " If providing a sample ad please submit via email to planroom@agcsd. org. Project Name: Safe Routes to School in the Vicinity of Spring Middle School Project #: CC No. 1 367 Bid Date: 4/20/10 Bid Time: 4: 00 PM Project Location Project Owner: Citv of Huntinaton Beach City of Huntington Beach Phone #: 714-536-5431 Trades / Work Items to include in ad: see Sample Ad attached (or attach sample ad). Select Ad Size: IN 3.5" x 3.5" ($50) ® 3.5" x 5" ($100) Ad Run Dates - Please include the dates you'd like the ad to run (consecutive Mondays): C 01 4 /12 /2010 2. 3. a 9 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 g 2:00 P GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, 'Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 04/08/2010 21:32 FAX 7142471041 GMC ENGINEERING r 4 D z TX REPORT xcx N:�skxe��:�&�caexe���k�k�k�ksk��sksk TRANSMISSION OK TX/RX NO 0661 CONNECTION TEL 18588748569 SUBADDRESS CONNECTION ID ST. TIME 04/08 21:32 USAGE T 00'29 PGS. SENT 2 RESULT OK 'TEQUEST r M Report is distributed each Monday Company Name- GASS Construction Co. , Inc. Contact Person: Mike LaVoie Address: City: Phone: 1401 Warner Avenue, Suite H Tustin 714-247-1040 Email- mike@gassgmc.net State: cA ,Zip: 92780 Fax: 714-247-1041 AD REQUEST MUST BE FAXED TO 858-874-8569 OR EMAILED TO plan room(&agcsd.org by FRIDAY AT 6:00 PM FOR PLACEMENT Please contact Jessica Kovack at (858) 874-8560 ext. 11, jessica@agcsd, org, or Lisa Lovelace at (858) 874-8560 ext. 13, lisa@agcsd.org, with questions. Please complete the following or attach a "sample ad." If providing a sample ad please submit via email to planroom@' agcsd. org. Project Name: Safe Routes to School in the Vicinity of Spring Middle .School Project #: CC No. 1 367 Bid Date: 4/20/1 0 Bid Time: 4:00 PM Project Location: City of Huntington Beach Project Owner: City of Huntington Beach Phone #: 714-536-5431 Trades / Work Items to include in ad: See sample Ad attached Page 1 of 1 kat From: Lisa Lovelace [Iovelace@agcsd.org] Sent: Tuesday, April 13, 2010 3:20 PM To: kat@gassgmc.net Subject: AGC's Good Faith Advertising Report - Week of 04/12/2010 LOOK ON PAGE 4, YOUR AD IS IN THE LEFT COLUMN. I AM FAXING YOU A PROOF OF PUBLICATION NOW. HAVE A NICE EVENING. (LISA LOVELACE) AGC SAN IE O'S GOOD FAITH ADVERTISING REPORT Meet your firm's Disabled Veteran Business Enterprise (DVBE), "Good Faith Effort" requirements as well as your MBE, DBE, WBE and OBE "Good Faith Effort" requirements by advertising in AGC's Good Faith Advertising Report. To unsubscribe from this list, please forward this email with "Unsubscribe" in the subject line to planroom@agcsd. org. Associated General Contractors of America San Diego Chapter, Inc. AGC Main Office: 1 621 2 ferris square I san diego, California 1 921 21 AGC Plan Room: 1 4355 ruffin road I suite 103 1 san diego, California 1 921 23 �Tr W-Wwc..ag sd.org "Building Your Quality of Life" F_ru, I OI i rnii =his „-nn;J i1 yap ic:d1% nc'd its 4/13/2010 I Requesting bids - ALL TRADES Especially From CERTIFIED MBEIWBE/DVBE For The Following Project: Fairbanks Ranch Fire Station Rancho Santa Fe, CA Owner: Rancho Santa Fe Fire Protection District 10*1 Contact: Melanie Ziemniak 10805 Thommint Rd., #200 San Diego, CA 92127 Phone: (858) 592-6500 x1 20 / Fax: (858) 592-1410 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 Owner: City of Huntington Beach Bid Date: Tuesday April 20, 2010 (cD 2:00 PM GASS Construction Co., Inc, is requesting bids for, But not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving Plans and Specs are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph. 714-536-5431 Fax: 714-374-1573 GAS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 1 Ph: 7`14-247-11040 Fax: 714-247-1041 1 Requesting bids -ALL TRADES Especially From Certified DVBE/Ml3E/WI3E/DBE1UDI3E for the following: Street Resurfacing, Precast Concrete, Curb & Gutter, SWPPP, Traffic Control, Wet Utilities '''Vier Construction Corp. will Assist Any Qualified Subcontractor in obtaining Bonds, Lines of Credit or Insurance Project: Sewer Group 734 Project # K 1 04904C Owner: City of San Diego B I D QLELAVL2L221Q at 2:40 PM Wier Construction Corp. Contact: Alan Nicoles 2255 Barham Drive Escondido, CA 92029 Phone: (760) 743-6776 1 Fax: (760) 746-5224 Requesting Bids from Certified MBE / WBE I DBE and OBE Subcontractors & Suppliers fof-, Removal of the existing soccer field & preparation of the complete site iricludin".) grading; Installation of site drainage; Installation of the new synthetic turf soccer field and goals: Installation of surrounding landscape & In igabon: Cors'l uction of adjacent pad & walkways, Installation of player henches RKWggLIjqgLDelano Park Synthetic Soccer Field Project No: E170483F Owner; C :ty of Los Angeles Bid Date & Time: April 20, 2010 at 3:00 PM Plans and Specs: are available for review in our Office U00nyout 1equest Monday through Friday, from 8:00 AM to 5M PM Y&M Construction, Inc. will assist MBEMBEMBE and 013F in obtaining bonds, lines of credit and or insurance if necessary Y & M Construction, Inc. Contact: Magda Mina 17800S. in Street, #206 Gardena, CA 90248 Tel: (310) 516 - 9933 OR (310) 516-9997 Fax: (310) 516 - 9994 E-mail: ymco@sbcglobal.net Requesting bids -ALL TRADES Especially From Certified MBE / DBE / DVBE / OBE for the lollowina: Sidewalks, Curbs, Gutters, Driveways, Pedestrian Ramps, and Landscaping. Payment & Performance Bonds May Be Required, This job is subject to state prevailing wage rates. Plans available online at City of San Diego t,vebsite or for review in our office at 13684 Highway 8 Business, Lakeside, CA Project: East Village Streetscape Improvements Project# K1 05019RDA Owner: City of San Diego, (619) 533-5191 BID DATE: April 22 201-0 at M:0_0, PM El Cajon Grading & Eng. Contact: Tom Brown P.O. Box 967 Lakeside, CA 92040 Phone: (619) 561-9840 1 Fax: (619) 561-9908 t.brown@ecgrading.com Requesting bids - ALL TRADES Especially from Certified DVBE/MBE/WBE/DBEIUDBE for the following: A/C Paving, Sidewalk Removal/Replacement, Slurry Seal, Underground Utilities, SWPPP, Crack Sealnt, Curb & Gutter Wier Construction Corp. will Assist Any Qualified Subcontractor in obtaining Bonds, Lines of Credit or Insurance. Project: Water Group 909 Phase I & 11 Project # K1 04834C Owner: City of San Diego BID DATE: April 23, 2010 at 2:00 PM Wier Construction Corp. Contact: Alan Nicoles 2255 Barham Drive Escondido, CA 92029 Phone: (760) 743-6776 1 Fax: (760) 746-5224 Associated General Contractors of America, San Diego Chapter, Inc. AGC Flan Room 4355 Ruffin Rd, Ste.103, San Diego, CA 92123 (858) 874-8560 Fax (856) 874-8569 planroom@agcsd.org FAX TRANSMITTAL DATE: April 13, 2010 COMPANY: GASS Const ATTENTION- Kathy or Mike LaVoie FAX #: 71 4-2417-1041 i FROM: Lisa Lovelace PAGE #'S: 3 *xw�x*iewwww www�eww�*+t*wxwwwrrse*�x+�**f*xww,tw**w*r***x*+�-lr�rxwk**w*w**w+��#**www�e*�ewrW *w*+4,Mwe+rw�rrrw�rre�x*ir Proof of Publication attached regarding City of Huntington Beach , Safe Routes to School PROOF OF PUBLICATION (2016.6 C.C.P.) STATE OF CALIFORNIA County of Sari Diego I am a permanent resident 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 interestled in the above entitled matter. I am the publisher of AGC GOOD FAITH ADVERTISING REPORT (formerly DAILY CONSTRUCTION REPORTER), a publication of general Circulation, published weekly in the city of San Diego, County of San Diego, and which publication has been ADJUDGED A PUBLICATION OF GENERAL CIRCULATION by the Superior Court of the County of San Diego, State of California, under the bate of February 20, 1973, case number 337691, and a Trade and Focus publication approved by the California Department of General Services on May 3, 2004, that the notice of which the annexed is a printed copy (set in type not smaller than nonpareil) has been published in each regular and entire issue of said publication and not in any supplement thereof of the following dates to -wit: April 12, 2010 In the year of 2010 'Proof of publication is attached. I certify (or declare) under penalty of perjury that the foregoing is true and correct. Dated at: San Diego California, this 12th day of April, 2010 r LISA LOVELACE Editor JESSICA KOVACK Publisher In the year of 2010 REQUESTING SUB-BIID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 Owner: City of Huntington Beach Bid Date: Tuesday April 20, 2010 (2 2:00 PM GASS Construction Co., Inc, is requesting bids for, But not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving Plans and Specs are- available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714.536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph:714-247-1040 Fax.714-2474041 Printable Form Page 1 of 2 PRINT OUT THIS PAGE AND FAX IT TO: 858/487-3500 AD INFORMATION SUB BIDS REQUESTED FROM QUALIFIED M/W/DBE/DVBE SUBCONTRACTORS AND SUPPLIERS Project Safe Routes to School in the Vicinity of Spring Middle School Project Number CC No.!1376 Project Location City of Huntington Beach Bid Date and Time 2:00 PM Tuesday, April 20, 2010 Respond By 4:0o PM Monday,_Apri1119,_2010 Company Name GASS Construction, Co. Inc. Contact Name Mike LaVoie Address/City/State/Zip 1401 Warner Avenue, Suite B, Tustin, CA 92780 Phone 714-247-1040 Fax 714-247-1041 Additional Information See attached Request for Sub -Bid for Scope of Work and City Information. Run Ad On Following Dates Monday, April 12, 2010 and Thursday, April 15, 2010 Special Program Rate is only QQ f�ublishin _Dates & Advertising Deadlines $48.00 We publish every Monday and Thursday $24.00 each insertion - min 2 To place and ad in Monday's Minority Bidder's Bulletin the deadline is 4:00 P.M. on Friday To Place an ad in Thursday's Construction Update http://www.goodfaitheffort.com/placeads.htm 4/9/2010 REQUESTING SUB -BID DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY. APRIL 20.2010 n, 2:00 PM GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving, Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph:714-536-5431 Fax:714-374-1573 GASS CONSTRUCTION CO., INC. 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 Fax: 714-247-1041 04/08/2010 21:31 FAX 7142471041 GMC ENGINEERING TX REPORT �cxc�c [a 001 Printable Form TRANSMISSION OK TX/RX NO 0660 CONNECTION TEL 18584873500 SUBADDRESS CONNECTION ID ST. TIME 04/08 21:30 USAGE T 00'40 PGS. SENT 2 RESULT OK PRINT OUT THIS PAGE AND FAX _IT-- CO-: 858/487-3500 Page 1. of 2 AD INFORMATION SUB BIDS REQUESTED FROM QUALIFIED M/W/DBE/DVBE SUBCON'I"RACTORS AND SUPPLIERS Project Safe Routes to School in the Vicinity of Spring Middle School Project Number CC No. 1376 Project Location city of Huntington Beach Bid Date and Time 2:00 PM Tuesday, April 20, 2010 Respond By 4:0o PM Monday, Apti1:19, 2010 Company Name GASS Construction, Co. Inc. Contact Name Mike Lavoie Address/City/State/Zip 1401 Warner Avenue, Suite B, Tustin, CA 92780 Phone 714-247-1040 Fax 714-247-1041 Additional Information See attached Request for Sub -Bid for Scope of Work and City Information. _ _ FILE PUBLICATION ��'w 9 �� COPY L �; i'*� " DECLARATION OF PUBLICATION STATE OF CALIFORNIA Suzle Davidson /Art Director REQUESTING SUB-BJDS DBE Subconl.tractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING DIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUN'T'INGTON BEACH BID DATE: TUESDAY, APRIE 20, 2010 @ 2:00 PM Resnond bv: 4:00 ,vm, A GASS Construction Co., Inc. is requesting bids for, but not limited to th.e following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement: Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving Plans and Specifications are available from The City of Huntington. Beach. Office of the Director of Public Works 2000 T\4.ai.n Street, Huntington Beach, CA 92648 Ph: 714-536--5431, - Fax: 71.4-374-1573 GASS CONSTRUCTION CO., INC. - Mike LaVoie 1,401. Warner Avenue, Suite B, Tustin,, CA 92780 Ph: 714-247-1040 • Fax: 714-247-1041 The undersigned declares: I am over the age of 1, 8,years and a citizen of the United States. I am not a party to and have no interest in this matter. .I am principal clerk of the publisher of the Construction Up -Date, Inc, and Minority Bidders Bulletin, a trade/ focus publication in the City of San Diego, the County of San Diego, and the State of California. This notice, a true copy hereon, was published on the below dateW., I declare under penality of perjury that the foregoing is true and correct, //�� Executed at San Diego, Californiz _ ^',��'U�C�fr��t� -_ srgnauu•e 0" DATES PUBLISHEDUNST TNMINI � d �. � � a(� • yW1D TRADE PUBLICATION rt LOCUS PUBLICATION ALSO DISPLAYED ON WEB. SITE @ http://)vww,goodfaitheffort.coni 16885 W. Bernardo Dr., Suite 335, San Diego, CA 92127 Phone Dumber (858) 487-2600 Fax Number (858) 487-3500 CAI I BANS - ANTA BA.HAIRA CCJON-EY NEAR SANTA BARBARA F120M Mll nAS SFREFT 1-i—ERCROSSINC; TC) MARIA 1G1NA1iC1 C'rx—P HRIOC;E N n5-(ISR 1 (1.1 SANTA nARBARA, CA R 11) UA'1'G: APltlh 2 , 2010 Pla•.,sc . .sp�„d ASAP �' 91 _ _ it' s •� AI ( A iJ jF I_c„1 1, ,nil vcniuw.r. or nnl llrnl t�rcry rcn: Itnr. Y '�. coNr nos-,e4-lair aevIt42! Ina/ "RLQU LSI IN(: SU HCONI RAC'I OR/SUPPLIER QUO FITS ON ALL TRADLS" DlSE/MBh/Wllh/SHE/OBE/DVBE REQUIREMENTS knoor,• L:11•,l:lr.11 Conlr.irlln);, Inc m c,•klnl; ona lcl ppbcn f_0> or th,• Clly of 1A,,,,'Ic4 I t,•pnllr-:enf nl I'uhllc 11'o rk. 13ur,, uan{ St reel I I,,ghh,ig pmlect 1l t,d below. 11 you have .i n) IIu:.ho—,11I:I)1ano Cady, I'roicct C--fi rt,rr z t(y5l) 371-42(12 Thank you. PROJECT TITLE: SA17ETEA LU: VICTORY BLVD. - BELMAR AVE. TO RESEDA BLVD. PROJECT NUMBER: W.O. L0819647 PROJECT LOCATION: LOS ANGELES PROJECT OWNER: CITY OF LOS ANGELES BID DATE: MAY 12, 2010 AT 10:00 AM Please respond by: May 11, 2010 at 4:00 put Flec(riral M.,I—ial Suppliers PLANS AND SPFCS Altl;. AVAILABLE IN OUR OFFICF, FOR VIEWING & COPING. As —A-- will 1, gI v<... obt.11nlnl3 bonds, t -dr hu—, in ,u , e•qvipm. n1,'upph—, material. I ll r)','„ I'r1 /ul nlanlr nil It Prt4inrill M 1, 11,11 R, Requll rd 1'I rIIII „•III ):,III u)I rn 1 ,.: nI I4r:1d 111 rin...... Moor,• Flectlical Conhactmg, Tn - Diane Cody, Project Coordinator 163 North Sr-11 Ave, Coruna, CA 92980 `FWr- '•tl"• (9SU 371-4202 • Fax (951) 278-3406 A F.0 1. MATICH CORPORATION t F9F Harry Shoppard Blvd . San Bernardino, CA 92408 WE ARE RFQUESTING SUB -BIDS AND MATERIAL QUOTES FROM ALL QUALIFIED DVBE SUBCONTRACTORS AND/OR SUPPLIERS FOR THE FOLLOWING STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION ROUTE 18 (PARK TO HIGHWAY 395) APPLE VALLEY & VICTORVILLE #08-ON7004 BID DATE: MAY 13, 2010 - 2:00 P.M. Please respond by: May 13, 2010 Mauch Corporation I, e.questing quotes from qualified DVBE subcontraclors & suppliers for the following trades Site Managernenl, SWPPP, Area Signs, Traffic Control, PCMS, Cold Plane, Asphalt (Emulsion, RHMA, Replace Surfacing), Slurry Seal, Data Core, Striping & Marking, Pavement Markers, Loops. Plant. a he reviewed at Agency o office. WeawilI provide necessary assistance MATICH CORPORATION - GENE BOISVERT (909) 382-7400 - Fax (909) 382-0113 w/= nit r= n1v r_oun/_ oo-1 cI (alunrl/r con rcorerz .._.--------------- .-------- .---------- ___ ......... .------------ ......____.____-"'-_.,-_..___---------- T.,._ bob-It1ds R,equestcd for any portion of work from certified DBE/UnBE/SIIE/MBE/WBF/DVBE Subcontractors & Suppliers Fur: UJDBF. includes: Black Aln eri can, Native American, Asian -Pacific Anteri—n and Worrell Owned Businesses) OWNER: COUNTY OF SAN BERNARDINO; H14318 FEDERAL. AID ESI'L-5954(115) AMBOY ROAD OVERLAY RIDDI N(:: A1'f2ll. 29 2010 TIME: 10:00 AM. t1/oIh CIr 1<;7nr r,•> Bi<hlmy /'d,/rn(cnf Maikrngs, Sr,tr - A—,; SWI'l'1', 'I'rro%l+r Coatr(>l. (,r.in Ile C o. tit ruction Company (CA Liccn,. 89) Is a (•yual 1111 ag to sly , ;ottof, ad t1 I ubcontiocior ` ,ci/„ uppicle rl eded Any item of - ark, prl rllon of . item,, _ mhlnatlo�n thcrcol v.il he Id,•rcd Joint part check;: i, iiloblu whc•i, e,lu,•stcd. I', Ilclrmnn:, a:lna,nt 13ond, I oy be rcquired.r Bonding . [o n,:: 1 iila hll•. 1'lon4 ndaa�peci ti ca lion~ ar,, a\ailoblu I„r Ie,le (a ll iC:ranile•'n 1�,1 C-entaro offler•n Pl— 1_)1—:1 Qu,, I,, and Incluiren 'I'o: GRANI'LH CONS'I' RUC'I'fON COMPANY 3N000 MON RCIF, S'I-121:I.'I INIJ1C), CA 92203-9500 PIiUNI.: 760/77.5-7500 - FAX 760/775-8229 C [)IN-VC:F: SAXA VAN PAFTliN REQUESTING SUB -BIDS DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 01 20 PM Respond by: 4:00 pm, April 19, 2010 GASS Construction Co., Inc i, rc,11-11ng bid, for, hul n01 limit(•d to the tollow'ing U-ade . Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving Plans and Specification~ ale avoilable from The City of Huntington Bvach Office of the Director of Public Works 2000 Maul Stroct, Huntington Brach, CA 92648 Ph: 714-536-5431 • 17ax: 714-374-1573 GASS CONSTRUCTION CO., INC. • Mike LaVoie 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 • pa_r: 714-247-1041 REQUESFING SUB-131DS DBE Subcontractors and Suppliers for: CAMINO CAPISTRANO LANDSCAPE AND STREET IMPROVEMENT PROJECT RE -BID CASH CONTRACT NO. 08-40 OWNER: CITY OF LAGUNA NIGUEL BID DATE: TUESDAY APRIL 27, 2010 W2:00 P_M Respond by: 4:00 Urn, MondayL_pril 26-2-0-10 - GASS Cnn s truction Co., Inc i cqu—tu- b,dc for, but nni Iii—h-'d to the following bade, Surveying, Traffic Control, Fencing, AC Cold Plane, AC & PC( Paving, Slurry Seal, Storm Drain Structure„ Signing & Slriping, Landscaping & Irrigation Plans and Spccification, ar(' availab]v Ilona The City of Laguna Niguel - Public Works/ krip, Inccnng 27791 La Paz R2 d, Laguna Niguel, CA 92677 Ph: 949-362-4337 • lox. 949- 362-43N GASS CONSTRUCTION CO., INC. • Mike La Vote 1401 Warner Avenue, Suite B, 'Tustin, CA 92790 Ph: 714-247-1040 a Fix— 714-247-1041 Floyd Johnson Construction Co., Inc. requests sub -bids from qualified UDBE subcontractors and/or suppliers for: MAIN STREET RECONSTRUCTION FROM ARIZONA TO PLACER AVENUES (BUY AMERICAN) PROJECT # ESPLSTP-5245 (009) CITY OF SAN JOAQUIN BID DATE: APRIL 27, 2010 Please Respond: ASAP BONDS MAY BE REQUIRED Please send copy of certification with quotes Sub's and Supplier's for Pipeline, Grading, Agg Banc, Asphalt Concrete, Surveying, Striping, Fog Seal, Manholes. Floyd Johnston Construction Co., Inc Contact: Steve Little 2301 Herndon Ave. Clovis, CA 93612 (559) 299-7373 - Fax (559) 298-3452 DA:UEY n'1'1 ()N I'(l Ii1D n p1t F•,a i I :::• ana a.�nl: ,:. 1,,,, fn:. p kO.)E:C1' 1111,F: GRIND PoRI1.AND C'L:MI•. F C'ONC RI- F, AND()VF.I LAV S11()lI1.D 1•:RS I-RoJEC:1' N()- II-2M1171/4 OWNFIt: DEPAlt'1'MF;N'1'()1 " FRANSPORIAI'ION - I, A1.1'ItANS I'a, I::1 \'.:I::, a. I'i•I.,I„a1 :� I �I I:»::I.a 1., h.• ai.ran.nnn - I>iti ttlnl "1'::. WHIDAI-E: APRI1,23,2010-2:noPM WI I I Ultt, l IN,; RF i it Its QIIII11 III I I n�1 I,,rA Ivl Ynurt unNuI'll rnnlna Itnl I. —1n rnl e wen; IINI:, c -1 I I ANi 1 AREA '(IN(. Ix -I \ IV(., n (, 1, '.ti .l m ARnr. -t'r1. t:ie M OI'In Ll uli(I� N(( DN rRo1. 11to( 11AII II RAI 1�i( c ON I uol ltl <)f llitl_� ILtiN al nl t I. I`121� \\'n nlirll ax Lti <,I h1 Itn1 , caN l>I I ION~ i 113 rnI Ni N,; i,1 I nuc, I, IiI�II,N nc,I.I I nII Nip ui r NIk(aci nnti I. NI ni II It c,n 1, I>I ANnnl NIIN I I All Y<)II I I()h� , c,N, I. I.IN,� I III~ 112t III < All I,:1 \III III I(i ( nl I. (IIJ It (,i I I( I 5 -V2— PUBLICATION AFFIDAVIT DECLARATION OF PUBLICATION STATE OF CALIFORNIA Suzie Davidson /Art Director REQUESTING SUB -BIDS DBE Subcontractors and Suppliers for: SAFE ROUTES TO SCHOOL IN THE VICINITY OF SPRING MIDDLE SCHOOL CC No. 1367 OWNER: CITY OF HUNTINGTON BEACH BID DATE: TUESDAY, APRIL 20, 2010 C& 2:00 PM Respond by: 4:00 pm, April 19, 2010 GASS Construction Co., Inc. is requesting bids for, but not limited to the following trades: Surveying, Traffic Signal, Traffic Control, Striping & Pavement Marking, Slurry Seal, Storm Drain Structures, AC & PCC Paving Plans and Specifications are available from The City of Huntington Beach Office of the Director of Public Works 2000 Main Street, Huntington Beach, CA 92648 Ph: 714-536-5431 ® Fax: 714-374-1573 GASS CONSTRUCTION CO., INC. ® Mike LaVoie 1401 Warner Avenue, Suite B, Tustin, CA 92780 Ph: 714-247-1040 ® Fax: 714-247-1041 The undersigned declares: I am over the age of 18,years and a citizen of the United States. I am not a party to and have no interest in this matter. I am principal clerk of the publisher of the Construction Up -Date, Inc, and Minority Bidders Bulletin, a trade/ focus publication in the City of San Diego, the County of San Diego, and the State of California. This notice, a true copy hereon, was published on the below date(s): I declare under penality of perjury that the foregoing is true and correct. Aq�t'6 Executed at San Diego, California signature DATES PUBLISHED TRADE PUBLICATION FOCUS PUBLICATION ALSO DISPLAYED ON WEB SITE @ http://www.goo(lfaitheffoi-t.cont 16885 W. Bernardo Dr., Suite 335, San Diego, CA 92127 Phone Number (858) 487-2600 Fax Number (858) 487-3500 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we GASS CONSTRUCTION COMPANY, INC. as Principal, hereinafter called the Principal, and Western Surety Company a corporation duly organized under. the laws of the State of low as Surety, hereinafter called the Surety, are held and firmly bound unto the City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of the Total Amount Bid Dollars (S 10% for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted bid for Safe Routes to School - Spring View Middle School (CC No. 1367) NOW, THEREFORE, 9 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 Documentswith good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished ire 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 performthe Work covered by said b�d, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 16th day of April 2010 GASS CONSTRUCTION COMPANY, INC. ri "pal) (Seal) By, Marina zhik (Title) CEO/V.P/Sece Western Surety Company (Surety) (Seal) By: �a ee —T-TiUe) Jeffrey R. Gryde, Attorney -in -Fact Printed in cooperation withthe American Institute ofArchitects (AIA) by the CNA Insurance Companies. The language in this document conforms exactly to the language used in AIA Document A310- Bid Bout -February 1970 Edition. G-10BO41-A 'T.,""Vestern Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Jeffrey R Gayde, Individually of Laguna Niguel, CA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereor, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to be hereto affixed on this 17th day of June, 2009. RET WESTERN SURETY COMPANY ?."-"" .fk�f oni`S Paul 4rBruflat, Senior Vice President State of South Dakota County of Minnehaha I ss On this 17th day of June, 2009, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires 44444444444444444444444h } r D. KRELL i November 30, 2012 us : NOTARY PUBLIC st2at f sSOUTH DAKOTA r f44444444444444444444444 � D. Krell, No ry Public CERTIFICATE I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 16th _ day of April 2010 * WESTERN SURETY COMPANY �q-}v CAv�pi &LLMSZ • L. Nelson, Assistant Secretary Form F4280-09-0b State of California County of Orange April 16, 2010 _ Kathy L. Bu_r_n_u_ m, Notary Public On before rue. _ _ _ (Here insert name and rile of the officer) personally appeared Jeffrey R. G who proved to me on the basis of satisfactory evidence to be the person(X) whose name(X) is/M subscribed to the within instrument and acknowledged to me that he)OVXK t executed the same in his/Xk)" authorized capacity(W, and that by his/kovdak signature(K) 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. Signature of N blic ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title of desaiptiou of attached doctunclio (Title or description of attached document contioned) Number of Pages Document Date (Addttiona! infoanation} CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) D Partner(s) Xl Attorney -in -Fact D Trustee(s) D Other INSTRUCTIONS FOR COMPLETING THIS FORM _.ant. acknoidedginent completed in California must contain verbiage eracd} as appears above in the notory secrion or a separate acknoirledgnfet form mast be properly' completed and atiariW to rhat document. The only exception is if a document is to be recorded outside of California. In such instances, an "V altemative ncknowledgment verbiage as mar be printed oft such a document so long as the verbiage does itot require the notary to do something that is illegal for a noran. in California (t.e- ceilifi- ig the aurhonred capacty- of'rhe signer). Please check die document caret dhv far proper notarial wording and attach this form if required • State and County intormauon must be the State and Comity where the document siener(s) personally appealed before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personalh• appeared which must also be the same date the acknowledgment is completed. • The notary public must mint his or her name as it appears within his or her commission followed by a cormna and then your title (notary public). • Print the name(s) of doculnerrt siper(s) wbo personally appear at the time of notarization. • Indicate the correct singtdai or plural forms by crossing off incorrect forms (i.e. k'shelilwy;- is /ate ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seat impression must be clear and photographically reproducible. Impression must not cover text or lines- If seal impression smudges. it -seal if a sttfticient area permits. otherwise complete a different acknowledgment form • Sinature of the notary public mast match the .vgnatt e on file with the office of the county clerk. Additional uifomration is not required but could help to ensure this acknowledgment is not misused or attached to a different doctment. Indicate title or type of attached docmment, munber 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 ?008 Version CAPA eI2.10.0'• 800-873-9865 www.NotaryClasses.cont CALIFORNIAALL—PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of _ Ora rN o 2 On !Ta(sl'i 1 qbefore me, Kc,,+hU ,,t! t-00,m r Md-cLpy—Pul r (Here insert name and title of p6e officer) personally appeared 1 'riNa Chi Vlr K who proved to me on the basis of satisfactory evidence to be the person(( whose name(k' ism subscribed to the within instrument and acknowledged to me that .kdshe/tj ey executed the same in li�s/her/�h7r authorized capacity(ies), and that by>is/her/tom signatureks) on the instrument the personkKa , or the entity upon behalf of which the person(8) 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. (Notary Seal) Signature c �ublie ADDITIONAL OPTIONAL. INFORMATION DESCRIPTION OF THE ATTTACHED DOCUMENT Q( (Title or description of attached document) iN�'{�e_y� i N►'E�r off- Spr►"lua �� c� 111,`dc�Ie, �� (Title or descril tion of atta hed do ument continued) Number of Pages Document Date t/ / aot0 Cc Nm. t 3G7 (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) iod: 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 Donn must he properly completed and attached to that document The only exception is if a document is to be recorded outside of California. bn 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 utording and attach this form i/ 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 olT incorrect forms (i.c 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 lorm • Signature ofthe 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 attacbed 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 vl2.10.07 800-873-9865 www.NotaryC)asses.com City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK June 30, 2010 Hillcrest Contracting, Inc. P. O. Box 1898 Corona, CA 92878-1898 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, JF:pe Enclosure Sister Citiq�s�fy��d,�C4?,t1Fe,rjbNew Zealand (Telephone: 714-536-5227) SECTION C PROPOSAL for the Safe Route to School In the vicinity of i Spring View Middle School CC No.1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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. BIDDER'S Accompanying this proposal of bid, find BOND in the amount of $ 10% OF BID which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-Z Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 K' 'p d M I L.S.[M :obili lion. P erLT .S. I L.S. I L.S. Monument Preservation. Per L.S. Furnish Project Traffic Control. [ I$ I 1 $390( ]P er L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $ /(2 CV Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ s0c), L-1:0 Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ �UO Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $ CA) $ Cyr), Cam? per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ $ Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC- 13 67 . Ite-" =Fstiiia e�iA-� t vt�:r t� trni Psi c' xt un �E .: eride_`� �Amo. .... a..R.: .•lt. '•£,ill..:="':'.:-. -T. .:.:..y aa'r„. ...>-..-....;..... {., - uan ..:: _• :ice :' ^. ..... - - -" _ _ _ - - - .r> - - 9 85 L.F. Remove Existing Curb and Gutter and %� �� CID Q Construct New Curb and Gutter per City $ $ Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard PIan q $// 76,13(3 $ No. A88A and AC Paving Replacement. Per EA. 11 11 4 EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ 1;�60rw $'6'01�0• Per L.S. 12 11,000 S.F. struct Type H Slurry Seal. FPCeorl S.F. Total Amount Bid in Figures: $ Total Amoun#Bid in Words: $ N "� c, Gl/G6?�®' .Gh &A'11V � 'Tuh�'� & ej Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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 Ndme and Address of Subcontractor Stafe License Number Class w ��'• � `Ill /0 / 7��e ���� � b� c5` f c 4UC'yer:;Fro d - yPe' co 03 �(2 167 seU ��-� ► i 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 State of California ss. County of Orange GLENN J. SALSBURY , being first duly sworn, deposes and says that he or she is PRESIDENT Of HILLCREST CONTRACTING 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. HILLCREST CONTRACTING ,INC. Name of Bidder Signature oftidider GLENN J. SALSBURY-PRESIDENT 1467 CIRCLE CITY DR. CORONA, CA 92879 Address of Bidder Subscribed and sworn to before me this day of , 20 ___. NOTARY PUBLIC NOTARY SEAL C-4 JURAT State of California County of Riverside Subscribed and sworn to (or affirmed) before me This 9th Day of April 2010 by, Glenn J. S Is proved to me on the basis of satisfactory eT idence to be t person(s) who appeared before me. , //� MICHELLE�RlktO COMM. # 1703618 r Z z ' �_ NOTARY PUBLIC - CALIFORNIA Z i� RIVERSIDE COUNTY My Comm. Expires Nov. 6, 2010 C Michelle Santiago, ry Publ 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 of this form to another document. Description of Attached Document: Non -Collusion Affidavit Document Date: Pages: Signer(s) Other Than Named Above None UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CrrY OF HUNTING1 ON LEACH, 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, in the vicinity of Spring View Middle School - CC13b7, (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: 4/9/10 IIILLCREST C®NTRA!CTING; INC. Contractor By GLENN J. SALSBURY-PRESIDENT Title C-5 In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation.? ® Yes iNo 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. CG6 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: 4/9/10 HILLCREST CONTRACTING, INC. Contractor By 6 GLENN J. SALSBURY-PRESIDENT 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 1-8004224133 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 USA. 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: IIILLCREST CONTRACTING. INC. Bidder Name 1467 CIRCLE CITY DR. Business Address CORONA CA 92879 City, State Zip ( 951 ) 273-9600 Telephone Number 471664 A HAZ State Contractor's License No. and Class 04/1985 Original Date Issued 04/30/2011 Expiration Date The work site was inspected by JUSTIN PARSONS of our office on 4/15 2010 The following are persons, firms, and corporations having a principal interest in this proposal: GLENN J. SALSBURY-PRESIDENT EINER G. LINDHOLM-VP/SECRETARY C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. HILLCREST CONTRACTING, INC. Company Name s Signature GLENN J. SALSBURY-PRESIDENT Printed or Typed Signature Subscribed and sworn to before me this /5day of pri• , MICHELLE SANTIAGO _ COMM, # 1703618 z - NOTARY PUBLIC - CALIFORNIA�; RIVFRMOF COUNTY NOTARY PUBLIC /,11"4 ,�� NOTARY SEAS, Listed below are=the names, addre�s'and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. CITY OF CORONA 400 S. VICENTIA CORONA, CA 92882 Name and Address of Public Agency Name and Telephone No. of Project Manager: LINDA BAZMI 951-739-4960 $660,482 MEDIAN WORK 12/2009 Contract Amount Type of Work Date Completed 2. IVDA 294 S. LELAND NORTON WAY SAN BERNARDINO, CA 92408 Name and Address of Public Agency Name and Telephone No. of Project Manager: NICK MANCHEV 909-382-2084 $1,068,698 STREET IMPROVEMENTS 3/2010 Contract Amount Type of Work Date Completed 3. CITY OF RIVERSIDE 3133 MISSION INN AVE RIVERSIDE, CA 92507 Name and Address of Public Agency Name and Telephone No. of Project Manager: JASON PLOTKIN 951-224-3221 $1,092,827 GRADING, UTILITIES, CONCRETE & PAVING 1/2009 Contract Amount Type of Work Date Completed C-10 (For federally funded projects, use this following page) HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or i 1 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: HILLCREST CONTRACTING, INC. Contact Person: JUSTIN PARSONS Contact Phone: (951) 2 -9600 Signed: GLENN J. SALSBURY-PRESIDENT Date: 4/15/10 *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 EXISPI' 12-E PS&E Checklist Instructions Attachment C ('THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTH7UTEANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder HILLCREST CONTRACTING . 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. C-12 Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual 9XMIT 12-E PS&Z Checklist Instructions Attachment D Noneolinsion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of HUNTINGTON BEACH DE`PARTA&W OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that malting a false certification may subject the certifier to criminal prosecution. C-13 Page 12-81 LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Cade Section 10285.1 Statement in conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has - . , has not ✓ been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the ` California State University. The term "bidders' is understood to include any partner, member, officer, director, responsible tnarraging officer, or responsible managing employee thereof as referred to in Section 10295.1. Note: The bidder must place a check marls after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid Signing this Bid on the signatures portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire in conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? yes - No If the answer is yes, explain the circumstances in the following space. C-1.3 Public Contract Code 10232 Statement in conformance with Public Contract Goole Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court, which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questiot maire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. - C-14 Page 12-83 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&Z Checklist Instructions Attachment F NONLOBBYINO CERTIFICATION FOR FEDERAL -AU) CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15 Page 12-55 %PP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions LVDdrLh L b I fil5 ri 1. Type of Federal Action: 0 a. contract b. grant c. cooperative agreement d. loan e, loan guarantee E loan insurance DISCLOSURE OF LOBBYING ACTIVrMS EXHIBIT 12-E Attachment G 11J U15GLVbb LV13kf11INU AU11y1111;5 rVKSUANT 1V 31 U.S.U. 135Z 2. Status of Federal Action: 3. Report Type: Fla. bid/offer/application ® a, initial b. initial award b. material change c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known ®A 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, MT) 11. 12. 14. 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) $ actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in -land; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer($), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheets) attached: lies No 16. 1nfbirmition 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 GLENN J. SAL.SBU RX or entered into. This disclosure is required pursuant to 31 print Name: U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: PRESIDENT person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: 951-273-9600 Date: � J�_ Federal Use Only: Authorized for Local Reproduction Standard Form - LLL _. C-16_ Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 124 Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks " Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 C-17 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXMIT 1Z-B PS&E Checklist instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-UL-kanw Eons Rev. 0"-9Q«ENAIFu C-18 Page 12-89 LPP 01-04 March 1s, 2001 Loch istance Procedures Manual BX)Hl 12-G - Bidder's List of Subcontractors (DBE and i,,vn-DBE) lSf3 �32 BIDDER'S LOST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. 'Photocopy this form for additional firms. 1 1 I .t'' / 11 i' ,1� 1 Portion o1 .1 1Work�� I �t.. .11 :1 1G5. _t �..l `.b ` �-�' S—�' t ¢,! cr s ri zp^f\ A P G.f jyUf' jj{,' MUM _ y ' WMMI Rrs.: WTI / y i r • � i .:� � t Er�f}3�'�P��\t/��"ii�:hv1�C"ui 'i` t�� Distribution: t) Original - i o W Agency File Page 12-111 LPP 06-06 November 14,2006 Loch istance Procedures Manual EXH 12-G Bidder's List of Subcontractors (DBE and ivn-DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. f.l 1i •I 11 f 1 �.,t,r$;I���1�X.rG Lz� }��,�}`�� " Description 1 Portion 1Work1' be Per& f 1 . 1i,MS IS i `r. act 'Z' ;}b)• � �� � � � { ������•7Z}Jl�,?'liej� y� y' �u 47 ic:_0VOINf'C]t7a`r��7 • f ) ✓ f ,ark . 1:.! :.�r,...x�' ;1'�'� y { C . - ■ � 1 1 �%�����,..��` 4 �����f'{ ��Sf �4� �� ,Grp � �i M. .:=r- «s r�-a k`5�i_ J, M,-(�(.+; _ ii}�I.�34t'J y\if<:".'{�i �_ 15�'�}•`.l ,�•�1 R�ti'.. vNi .. FM Distribution: t) Original - Local Agency File Page 12-111 LPP 06-06 November 14,2006 Locs istance Procedures Manual EXH 12-G - Bidder's List of Subcontractors (DBE and ivvn-DBE) BIDDER'S Ugr OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. 'Photocopy this form for additional firms. Nil -39 Description 1 Portion 1Work1. be Petfd 00 1 p..S..L..,.. t'��Lfs 1 � � f. y�Gr F c �r�'``��•��� `r��a�� L1� �i♦ ,y'EtryA LNW=�i" I. ...1'„ ♦ �I u ,; S �i Mum== RE jyx.Z(� 7 i air Off , Ef I ®® ,1 A 1 �� �`3�e � `t�i �'r� fAfst7.• � : s * t,i t Zw 2r�V�}���yf i♦ 1 Distribution: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14,2006 Exhibit --G Local Assistance Procedures ...-inual Bidder's List of Subcontractors (DBE and Non -DBE} WDDER'S UST OF SUBCONTRACTORS (®SE and NON -DBE)- PART !i The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Firm Name/ 1 1 1 Description 1 Portion ofWorkt.1 1 1! r.l�C`,s'6°t/g state, ZIP •� I a. ittL�� ,%I ' �ryw�� 1 ,fit T ! ray'•"' �' n a"�".:'� � �MtUr7F111111 �i...,.. liff.(7i ] Vi. S ��.�.is_,.,�S.h ..]..��V .(t '•9 f�. �_ � // ( (jr^i^ �(f�l���.' t^✓S1rr,, � ♦1rFl ! r RR rr • �� J �i �rfn Sr%°1`4s�Lyn � 3�3 Distribution. i) Original — Local Agency Fite Page 12-112 November 14, 2006 UP 06-06 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT State of California County of Riverside ON April 19,2010 before me, Michelle Santiago, Notary Public, personally appeared Date Here Insert Name and title of the Officer Glenn J. Salsbury, who proved to me on the basis of satisfactory evidence to be the Name(s) of Signer(s) person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person or entity upon behalf of which the person acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the state of California that the foregoing is true and correct. Witmess m hand n icial seal MICHELLE SANTIAGO g ; � COMM. # 1703618 NO'* Z n A` Y ' B _IC - CALIFORNIAE k1VkR1IbE COUNTY Signature of N aryPu Ic n6y COMM, Expires Nov: 6,,2©19 Michelle Santa o, Nofa Public OPTIONAL Though law does not require the information below, it may prove valuable to persons relying on the document and could prevent fraudulent removal of this form to another document. Description of Attached Document: Bid Bond Document Date: Number of Pages: Signer(s) Other Than Named Above Capacity(ies) Claimed by Signer Signer's Name: Glenn J. Salsbury ❑ Individual Corporate Officer — Title(s): President ❑ Partner - ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑- Other: Signer is Representing: HILLCREST CONTRACTING, INC. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinityof Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. IHILLCREST CONTRACTING Company Name APR 0 9 2010 Date By Glenn . Salsbury -President 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. i i 08560235 Bond Tidelity p and Deposit ®sit Com"p"any POST OFFICE BOX 1227 OF MARYLAND BALTWORE, MD 2120.3 BID BOND KNOW ALL MEN BY THESE PRESENTS: Hillcrest Contracting, Inc. That we, --- ----- - -- - - - - -- __ -------- _-.---- __-_—_, as Principal, (hereinafter called the "Principal"), and !the FIDELITY AND DEPOSrr COMPANY OF MARYLAND, P.O. Box 1227, Baltimore, Maryland 21203, a corporation duty torganized under the laws of tfIe 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_----_------___--- _ -._.-------------____--Dollars ($_.._.____-----___—), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for_ Safe Route -to School -in the Vicint_r_____ of Spring View Middle School CC No. 1367 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. 14 t h -_-_da of __ April i 1 ____----- _A. D. , 2010 Signed and sealed this-_----._.- y—_---___--- Hillcrest Contracting, Inc. (SEAL) P opal Witness —_ Glenn I S /Sb!uiry_P=resient � Tuk FIDELITY AND DEPOSIT C PANY OF MARYLAND Surety --------- ---------------- By-- - (SEAL) --------------------- - Witness ATT N -IN-FACT Tt1e c~.zsr-saes. 7-92 Richard A., Coon coatoma a Aawiina lnstitaw of AccWw a the W A310. F;C wcy 19M 5ditioa. CALIFORNIA e1" o �' ar e7 c -a' a' a' e� r7- s'r' ar �' :rr a' a'i"ri a - iY�a/i� • STATE OF CALIFORNIA County of Orange } On 4-14-10 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) .;w • LEXIE SHERWOOD P COMM. #1856389 NOTARY PUBLIC • CALIFORNIA 2 ORANGE COUNTY Comm. Exp. JULY 27 201 Z 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 offi ial seal. Signature Place Notary Seal Above Signature of Notary FTjbhc 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: 0 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 ARID 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 authwity.granted by. Article Vl, Section 2; :ofthe 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 e y nominate, constitute and appoint Richard A. COONS Charles L. FLAKE, David L. CULB In e OOD, all of Anaheim, California, EACH its true and lawful agent and deliver, for, and on its behalf as surety, and as its act and deed: any an n xecution of such bonds or undertakings in pursuance of these prese 1 in , as fully and amply, to all intents and purposes, as if they had been d t a ularly elected officers of the Company at its office in Baltimore, Md., p er p. attorney revokes that issued on behalf of Richard A. COON, Charles L. FLAKE, ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005. t� The said Assistant, ` eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By- s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of November, A.D. 2006. ATTEST: 'gyp 9fips�i J wry ; W � State of Maryland I ss: City of Baltimore FIDELITY -ARID DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary f, l� By. r 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 pity of Huntington Beach 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK June 30, 2010 KORMX, Inc. P. O. Box 688 Walnut, CA 91789 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, Joan L. Flynn, CMC City Clerk J F: pe Enclosure Sister CitiW/to"6btd&VaotheW�OfS.qoNew Zealand (Telephone: 714-536-5227 ) luluAl 4% 6-1j k c Ff Y r HUNIT;:,`,iG T CIA K;%CH SECTION C PROPOSAL for the Safe Route to School In the vicinity of Spring View Middle School CC No.1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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 Cs in the amount of $ t` which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Seated Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shalt signify receipt of all Addenda here, if any: Addendd Na.'_ Bate Received Bidder's Si nat e ko- C-2 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 ......... . I L.S. Mobilization. $ Per L.S. ETI L.S. Monument Preservation. Per L.S. I L.S. Furnish Project Traffic Control. Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. Cal - $ J-3. Oco- $ t 154 0,oa®, Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ Q $ Sa/ 060- Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ a7, oco-'— Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $5,9M.— per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated I Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 A - m 'A 9 85 L.F. Remove Existing Curb and Gutter and as C). Construct New Curb and Gutter per City $ '5C). $ Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan z $ a '3c-t5- No. A88A and AC Paving Replacement. Per EA. 11 12 4 EA. 11,000 S.F. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. Per L.S. Construct Type 11 Slurry Seal, $296,, D Per S.F. $ $ Total Amount Bid in Figures: Total Amount Bid in Words: $ Pw /Z> 11, 0 Ock red - I b UAd reot �11�e"ilz rive &�J Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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 vf Work Name an"ddress of.Subconiraetor : ` State License Number:- . Class G OL i G 4,00P c f- , r rti 41 6 1771 _ er p r� 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-3 166, W. , mm State of California ss. County of Orange :To 1�_ 11 E C j�c v-_tA 1 , being first duly sworn, deposes and says that he or she is 3 of 1tea, IIIIIII � ,tz, 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, finther, 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. Tom Name of Bidder Si tore of Bidder _917PC) 4VI)��� Address of Bidder Subscribed and sworn to before me this day of i , 20 l V . NOTARY PUBLIC =-California ENAS 2533 a c alifornia oountyMy ar.13, 2014 NOTARY SEAL C-4 HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNICINGTON 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, in the vicinity of Spring View Middle School - CCI3b7, 0)(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: A"1 1 I_ I() CO r a Contractor By N i leAf 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 XNo 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. G6 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:to wocnx, 'Ta L, Contractor 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 1-800-4224133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor By �� C25 Title Date:` 1� Note: This form is required for every Dig Alert Identification Number issued by U.SA. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 g i� ;�_ 11111.,,r BIDDER certifies that the following information is true and correct: Bidder Name FO 130K 609 Business Address WCLI(f- A q 1-7R9 City, State Zip (gci )771-7079 15qS-- G169 Telephone Number 917L4.3n A State jj Contractor's License No. and Class Original Date Issued 1�- )-11 Expiration Date r� t , b The work site was inspected by l� CGS V p ite, of our office on � Z 1 7 20`10 The following are persons, firms, and corporations having a principal interest in this proposal: J cue , C:�r CA CAr I 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. J-G- M�" Company Name Sign re of Bidder 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. <�iy CF 5&ALo'- 14VAC'- ';�D Cam, V� Name and Address of Public Agency 2, 3. r;z Name and Telephone No. of Project Manager: �c �S� j7" - %� �D_1, q Amount Name'and Address of Public Agency Type of Work /v Date Completed Name and Telephone No. of Project Manager: S T e� L J, JJ 1 %3 I f Work and Address of Public Date Completed c� R1 Name and Telephone No. of Project Manager: ger+ &.r ; cex+, 7-54! b 155, 0*�9. 77 5 k"- Contract Amount Type of Work 10ZIg/©-1 Date Completed C-10 State of California Countyof Los .&�des CALIFORNIA JURAT Subscribed and sworn to (or affirmed) before me on this 1 q fi � day of A , f ' 20 io by C�rCi ekLe, s e,5i�eA proved to me on the basis of satisfactory evidence to be the person() who appeared before me. Signature OPTIONAL INFORMATION LOSER CAMNAMS µ comm. #1882533 Notary Public California Los Angeles Coun�r T . Comm. Mar.1 2014 Seal Although the information in this section Js not required bylaw, it could prevent fraudulent removal and reattachment of this jurat to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document This certificate is attached to a document titled/for the purpose of containing pages, and dated Method of Affiant Identification Proved to me on the basis of satisfactory evidence: L o form(s) of identification O credible witness(es) Notarial event is detailed in notary journal on: Page # Entry # Notary contact Other Afflant(s)Thumbiormt(s) ❑ Describe: © Copyright 2007-2009 Notary Rotary, Inc PO Box 41400, Des Moines, IA 50311-0507 All Rights Reserved Form JUROI 12107 Please contact your Authorized Reseller to purchase copies or this rorm (For federally funded projects, use this following page) li. `lr 1 ' i ,, HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: Signed: Date: �T�� *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&L Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) The bidder subcontractor proposed hereby certifies that he has_Z1 , 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-L5. (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_ C-12 Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHO[BIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY I COUNTY of �Vi� �i flcic L3"--C-k DEPARTMENT OF P£IB IC y oms. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-13 Page 12-81 LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Slats. 1985), the bidder hereby declares under penalty of penury under the laws of the State of California that the bidder has - , has not Xbeen convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of; or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereon as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one ofthe blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute s'ugaature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? yes - No 4- If the answer is yes, explain the etwumstances in the following space. C 1.3 Public Contract Cade 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Madonws Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checldlst Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; e Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; s Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Page 12-83 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment F NONLORBYING CERTIFICATION { FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall com* plete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15 Page 12-85; UP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES S1 WSAC:. 13 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ElU. contract R a. bid/offer/application ® a, initial b. grant b, initi ward b. material change c. cooperative agreement past ward d. loan For Material Change Only: e. loan guarantee year _,w, quarter E loan insurance date of last report 4. Name and Address of Reporting Enti S. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee i ter , if 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) (attach Col 11. Amount of Payment (check all that apply) $ 0 actual plan 12. Form of Payment (check all that apply): a. cash b. in -kind; specify: nature value 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. 14a) (last name, first name, MI) Sheet(s) if necessary) 13. Type of Payment (check all that apply) EL retainer b. one-time fee c. commission d. contingent fee e deferred rl f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including ofticer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: 'lies 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352, This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: No Signature: CJ Print Name: Tide: ,A / Telephone No.9'l -7.7/ ,77D7 J Dater Rev Authorized for Local Reproduction Standard Form - LLL --------.___ C-16 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-LLLL, DISCLOSURE OF LOBBYING ACTIMIES 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 F 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 i 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 C-17 March 15, 2061 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LU-Instructions Rev. 0644 WEMIPa C-18 Page M89 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Nan -DBE) BIDDER'S LIST OF GUSC®dl TRACTORS (DBE and NON -DICE)- PART N The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1 A54 of the Standard Specifications and per Title 44, Section 26.11 of the Code of Federal Regulations. 'This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. _Photocopy this form for additional firms. Firm Name/ Address/ :P - 1%+�-u'33kFfiu: a scIR7X,r 1 , ..ii.':" _`x MINE. idai�c. ISSUE. ♦ � � r `St 1? tom:% � `��,,�i-cl� �� r r �a �yi. • 4 II"� II ■ f.rlBs�U^"il�D�z'?�i�;K'i+zot�ir%yl ■ �' a��)r trsit� YxL^ Distribution: 1) Original -Local AgencY File Page 12-111 Epp 06-06 November 14,2006 Local Assistance Procedures Manual Exhibit 15-GI Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-GI Local Agency Bidder UDBE Commitment (Construction Contracts) N€DTE,: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM GENCY:6& Nu4nibix 15 " LOCAnowNo-JivAna A 9 PROJECT DESCRIPTION: iDtJ"1 ��' f Z5 S 6V 4 _.fie/ ;. S wint OTAL CONTRACT AMOUNT: $ a ID DATE: L) I C) P/'p� IDDEWS NAME:ffD (—tVk , CONTRACT UDBE GOAL: ;, -5 %Es ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED Cort No. of UDBE qAME OF UDBEs DOLLAR AMOUNT AND EXPIRATION Must be certified on the date bids UDBE DATE im opened - include UDBE gdtess and phone number CONTRACT ITEM NO. For Local Agency to Complete: Local Agency Contract Number: Federal Aid Project Number Federal Share: Total Claimed Participation s 7-6, fco —a—='�rr Contract Award Date: Local Agency certifies that all information is complete and accurate. Print Name Signature Date/�/iq Local Ageney Representative Area Code Tele hone Number('G�II ature of idder y l(J l•f/ 7 70_7 Date —_— Area Code) Tel. No. K ur 1Ix \r9 0r For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder • UDBE Commkment (Rev 30) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. rarture to , send a copy to the DLAE within 15 days of award may result in d"bligation of funds for this project (2) Copy -- Include in award package to Caltrans District Local Assistance Q) Original —Local agency files C-21 Page 15-31 LPP 09-xx March 27, 2009 Exhibit 15-Gl Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian -.Pack American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be, consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agenc1es should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within I5 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 C-22 March 27, 2009 LPP 09-xi Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DRE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ONTHE REVERSYSIDDE OF TMS FORM ENCY_ AI i IM . �,J LOCATION: +I I V ✓4 E` G: lei \,j OJECTDESCRIPTION. sek -�fo fo a f✓U�b vRe'V' - S TOTAL CONTRACT /A'MOUNT-. S BID DATE: I / ZI 0 iDDER'$ NAME: ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DEE Cert. No, EXPIRATION DATE NAME OF DBEs (Must be certified on the date bids are opened - include DBE address and one number CONTRACT DOLLARAMOUNT_ LIEN NO Bg For Local Agency to Complete: Local Agency Contract Number. Federal Aid Project Number: Federal Share: Total Claimed Participation s — / Contract Award Date: Local Agency certifies that the DBE certifications) has been verified and all information is complete and accurate. Tint Name Signature Date Local Agency Representative Area Code Tel hone Number: -'Signature of Bidder 1 i o M09 � 1 — r 0-79 ^/ Date / (Area Code) Tel. No. iCc �ik+ P, ��l Person to C�oniac—t� (Please Type or Print) Local Agency Bidder DRE Information (Rev 310) For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Distribution: (I) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within €5 days of contract execution. Failure to 1 send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files C-23 Page 15-32a LPP 09-xx March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15.32b C-24 March 27, Z009 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION --GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up UDBEs Initial Methods and Solicited Solicitation Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx C-25 March 4, 2009 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity c S yr K: ✓ Vtl --v. Notice To All Bidders: Please note the following clarification to the Project Pw::-s, 1) SPECIAL PROVISIONS SECTION 306-1A.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 - RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of S. 3) SHEET 4 - TRAFFIC SIGNAL. PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of S. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. Company Name I y L1- q 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. State of California • Department of General Services • Arnold Schwarzeneg-ger, Goventor PROCUREMENT DIVISION Office of Small Business and DVBE Services 707 Third Street, 1st Floor, Room 400 - PO Box 989052 D(,Js West Sacramento, California 95798-9052 ' (800) 559-5529 Mar 3, 2010 DVBE APP Supplier #1167000 Kormx, Inc. PO Box 688 WALNUT CA 91789 Dear Business Person: Congratulations on your certified Disabled "Veteran Business Enterprise--(DVBE) status with -the State of California. Your certification entitles you to benefits under the state's DVBE Participation Program within state contracting, including the three percent DVBE participation goal for overall state contract dollars. Certification Period From Mar 3, 2010 to Mar 31, 2011 Business 'Types Construction Classification's 301115 - Concrete and mortars 721410 - Highway and road construction services 721527 - Concrete installation and repair services Proof of Certification Status To verify your firm's small business certification status go to littp://www.eiDrocure.dgs.ca.goov/de_fault.htm and select "SB/DVBE Search." Annual Submission Requirement All DVBEs must submit to the Office of Small Business and DVBE Services (OSDS) each post certification tax year, a complete copy of the business' federal income tax return, including extensions, within 90 days of the tax return's filing due date. If your business is a partnership, each partner must also submit a complete copy of his or her individual tax return. Additionally, if you are a DVBE that is not a sole proprietorship and your firm rents equipment to the state, you must include in your submittal a complete copy of the personal federal income tax returns for each of your disabled veteran owners, including extensions, and within 90 days of the individual's tax return filing due date. Failure THE AMERICAN INSTITUTE OF ARCHITECTS Bond No. 20-SBA-300346 Premium Included in BBSU. KNOW ALL MEN BY THESE PRESENTS, that we KORMX, Inc. 19314 Avenida del Sol Walnut, CA 91789 i Here insert full name and address or legal title of Contractor) as Principal, hereinafter called the Principal, and American Safety Casualty Insurance Company - SBA 444 Ocean Blvd., 18th Floor Long Beach, CA 90802 a corporation duly organized under the laws of the State of Oklahoma as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 (Here msert full name and address or legal title ofOwner) as Obligee. hereinafter called the Obligee, in the sum of Twenty Three Thousand Five Hundred Dollars ($ 23,500.00) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS. the Principal has submitted a bid for Curb and Gutter, Curb and Gutter, located in Huntington Beach, CA (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 Live 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 food faith contract with another party to perform the Work covered by said bid then this obli-ation shall be null and void. otherwise to remain in full force and effect. Sinned and sealed thJ9th day of April, 2010. ( 'itnes -� - ( Witness) KORMX, In ex- Orincipal) (Seal) Joseph Uribe Cardenas, Arnefican Safety Casualty Insurance Company - SBA (Sur eal) Y) A Pietro Micciche , Atforne7--in-Fact XIA DOCUMENT A310 BID BOND AlA V FEBRUARY 1970 ED THE A.VIERIC.AN INS- iTU FE OF ARCHITECTS. 1735 N Y AVE_ N.W WASHINGTON, DC. 20006 WARNING: Unlicensed photocopying violates U.S copyzight laws and is subject to legal prosecution. State of California County of Los Angeles On April 19, 2010 before me, Me Se Rodriguez, Notary Public Date Here Insert Name and Title of the Officer personally appeared PIETRO MICCICHE Names) of Signer(s) M. S. ROORIOUEl NOTARY PUBLIC - CALIFORNIA LOS ANGELES COUNTY COMMISSION a 1872651 W COMM. EXPIRES 3AN. 2,10114 14 who proved to me on the basis of satisfactory evidence to be the person(.9) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/sl k►e}rexecuted the same in his/la�authorized capacity(1eg1; and that by his/twTAheim signature(Sj on the instrument the person(.0, or the entity upon behalf of which the person(Aj 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 sea]. Signature _ EAV" Place Notary Seal Above Signature of Notary f u cOPTIONAL 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 l I Corporate Officer — Title(s): U Partner — ❑ Limited IJ General -_- FX Attorney in Fact C! Trustee Top of thumb here i j Guardian or Conservator iJ Other: Signer Is Representing: Number of Pages: Signer's Name: f_J Individual E Corporate Officer — Title(s): E Partner — U Limited i il General l Attorney in Fact u Trustee Guardian or Conservator !' Other: Signer Is Representing: sRIGHTTHUM-BFRINT' ___ QF SIGNER - Top of thumb here C��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 NUMBER POWER OF ATTORNEY zi,.SEBA 1;0,346 KNOW ALL bIEri BY THESE PRESENTS, that American Safety Casualty Insurance Company has made, constituted and appointed, and by these presents does make, -constitute and appoints Pietro Micciche its true and lawful attorney -in -fact, for it and its name, place, and stead. to execute on behalf of the said Company, as surety, bonds, undertaking and contracts of suretyship to be given to ALL OBLIGEES, provided that no bond or underaking or contract of suretyship executed under this authority shall exceed in amount the sum of **ONE MILLION DOLLARS ($1, 000, 000.00) * * This Powe hf Attaraey is grante€iard is signed and steed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company tui the Eighth day of 5epternlier, 2003. RESOLVED, that the President in conjunction with the Secretary or any Assistant Secretary may appoint attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the Company, to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may remove any such attorney -in -fact or agent and revoke any power of attorney previously granted to such persons. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company: (i) when signed by the President or any Vice -President and attested and sealed (if a seal be required) by any Secretary or Assistant Secretary or (ii) when signed by the President or any Vice -President or Secretary or Assistant Secretary, and countersigned and sealed (if a seat be required) by a duly authorized attomey-in-fact or agent; or (iii) when duly executed and sealed (if a seal be required) by one or more arromey-in-fact or agents pursuant to and within the limits of the authority evidenced by the power of attorney issued by the Company to such person or persons. AESMVED, FURTHEX-ftt-pie signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification tEiereof- au3hniiiing theC)"tion a-n"livery of any band "r,ndcrtskiog recognizance, or other suretyship obligations of the Company. and such signature and seal when so used shall have the same force and affects as though manuaily aitixed. IN WnMSS WHEREOF, American Safety Casualty insurance Company has caused its official seal to be hereunto affixed, and these presents to be signed by its President and attested by its Secretary this Eighth day of September, 2003- i,,,,,,w„tt Altesl- �r "`— ''?-.-:,�=(�•: :o Stephen R. Crim, President Randolph L. Hutto, Seastary STATE OFGEORGLI - wwnuu - COUNTY OF COBB On this Eighth day of September, 2003, before me personally came Stephen R. Crim, to me known, who, being by me duty sworn, did depose and say that be is the President of American Safety Casualty Insurance Company, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the sent affixed to the said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order n,w,ny c��',.••b 't0 FSJO w"„7"-Z �hDan, Notary Public Ssor0� .o, amav 1, the undersigned, Secretary of American Safety Casualty Insurance Company, an okiahonn, corporation, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney retrains in full force and has not been revoked; and furthermore that the Resolution of the Board of Directors, set fonh in the said Power of Anomey, is now in force. Signed and Sealed at the City of Atlanta, in the State of Georgia. o .titiSU Dated the 19 th day of April, 20 tU . si ti: - L7 Y Y }Noun • RA h L Hutto, Secretary City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOA►N L. FLYNN CITY CLERK June 30, 2010 Nobest, Inc. P. O. Box 874 Westminster, CA 92684-0874 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, .i r Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citijif"pp/jM@AtPreWAi"W6q0,New Zealand (Telephone: 714536-5227 ) SECTION C PROPOSAL., for the Safe Route to School In the vicinity of Spring View Middle School CC No. 1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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 properly 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 7 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: C-2 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 R-1�-, J _4 I L.S. Mobilization.Per L.S. 2 1 L.S. Monument Preservation. $ lam02!o- _ $ /SO, 1 Per L.S. 3 1 L.S.Furnish Project Traffic Control. $ $ ow Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $ Oep ll bTV Per L.S. 1$ 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ 7 Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ 7- Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Q5? Caltrans Standard Plan A8813, Modified $ el tv. per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 "Oel-7 t 7, 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City $ $ -q4 Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan 0 $ $ No. A88A and AC Paving Replacement. Per EA, 11 4 EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ $d. Per L.S. F 72 7 1,000 S.F. F T Construct Type H Slurry Seal. Per S.F. 00 $ WO, Total Amount Bid in Figures:$ Total Amount Bid in Words: $ / W9 Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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. 14 Portion of Fork Name and Address of Subcontractor State ncense : Number . . Class �(ggal 1�G�f C/t X 6X Strip%ny fYi �� �r�h 3�1�©�`S' 3� O(q/0 Gill°k 5wt rre f rhu G 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 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange / ! - afi^ l 4 �1l'rG9 , being first duly sworn, deposes and says that he or she is erC-5 4en of /V©be5 f TA ,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. Laf ry Andl Name o Bidder U00 A�t-4 "Ave Address of Bidder &Lj"ed6'4 �s/�VP� v fw Subscribed and sworn to before me this Q h day of Ai , 20 /8 . NOTARY PUBLIC M E. ANOERSON comm. #1852452 NOTARY PUBLIC-MIFORIM A -4 ORANGE COUNTY . MV Comm. bohn June 13, 2013 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, in the vicinity of Spring View Middle School - CC13b7, (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: 4 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—V © _ 10 A,e�-�- Contractor rl-e 9 iA 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 ®No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: -1 ` 1$10 `V NohPs+- Znc. 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 1-8004224133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Date: q-w- %© q hm l r �vvh A wa *We5'f Znc. Title Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: ( es -� er Name -700 A c t! cia Ale. Business Address 6ardpo v e , 6 q # 2 City, State Zip R�� sS83 Telephone Number SO Paz A State Contractor's License No. and Class 7— 71 Original Date Issued -12-3T-1 Expiration Date The work site was inspected by A* L eW4 of our office on d % 20i0. The following are persons, firms, and corporations having a principal interest in this proposal: i.arr PmP ewt, ,ecre �� v 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. Nohe�t f� - C'mmnnnv NarnP V— Subscribed and sworn to before me this day of A-F2) L— , l � KAYEANOERSON I�Ac COMM. #1652452 tMmyaua�c-MiFOFMA-4 ORAOMOUNW c Mvc .2a19 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. ' Cee 'q-fiqCAV FQ 3. Name and Address of Public Agency Name and Telephone No, of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 REFERENCE LIST Page 1 No. 1 Project Name/Number. Maintenance Service Agreement Project Description: Remove and Replace Concrete at Various Locations Approximate Construction Dates: From: 10/2008 To: In Progress Agency Name: City of Westminster Contact Person: Todd Miller Original Contract Amount: $610,550 Telephone: (714) 681-3020 Final Contract Amount: In Progress No. 2 Project Name/Number.. Neighborhood Presidential St Imp. Various Locations 08-003 Project Description: Concrete R & R Street Imp. Cold Planing, and Overlay Approximate Construction Dates: From: 10/2008 To: 3/2009 Agency Name: City of Huntington Park Contact Person: Pat Fu Original Contract Amount: $646,000 Telephone: (323) 584-6253 Final Contract Amount: $770,000 Page 2 No. 3 Project Name/Number. ARRA Street Improvements Project Description: Concrete Construction, Coldraill, and Overlay Approximate Construction Dates: From: 312010 To: In Progress Agency Name: City of Huntington Park Contact Person: Pat Fu Original Contract Amount: $1,599,981 No. 4 Telephone: (323) 584-6253 Final Contract Amount: $ In Progress Project Name/Number. California Avenue Rehabilitation ESPL-5108(096) Project Description: Concrete Construction, Striping, Overlay, Tree Pruning Approximate Construction Dates: From: 1/2010 To: 4/2010 Agency Name: City of Long Beach Contact Person: Dan La France Telephone: (562) 577-8339 Original Contract Amount: $421,000 Final Contract Amount: In Progress N®BEST REFERENCE LIST Page 3 No. 5 Project Name/Number. Annual Sidewalk Curb & Gutter Improvements Project Description: R & R Concrete Sidewalks, Curb & Gutter and Alleys Approximate Construction Dates: From: 10/2008 To: 12/2009 Agency Name: City of Long Beach Contact Person: John Dela Cruz Telephone: (949) 521-9847 Original Contract Amount: $8,000,000 Final Contract Amount: $6,216,268 R.. Project Name/Number. Improvements of Alleys @ Various Locations Project Description: Remove and Replace Concrete Alleys Approximate Construction Dates: From: 3/2008 To: 6/2008 Agency Name: City of Huntington Park Contact Person: Pat Fu Telephone: (323) 584-6253 Original Contract Amount: $354,019 Final Contract Amount: $ 354,019 NOBEST REFERENCE LIST Page 4 No. 7 Project Name/Number: Annual Sidewalk Repair at Various Locations Project Description: Remove and Replace Concrete Approximate Construction Dates: From: 6/2008 To: 12/2009 Agency Name: City of Anaheim Contact Person: Dennis Vasquez Original Contract Amount: $1,260, 600 No. 8 Telephone: (714) 765-6936 Final Contract Amount: $ 1,000,000 Project Name/Number: Annual Cross Gutter Repair at Various Locations Project Description: Remove and Replace Concrete Approximate Construction Dates: From: 6/2008 To: 12/2009 Agency Name: City of Anaheim Contact Person: Dennis Vasquez Telephone: (714) 765-6936 Original Contract Amount: $1,101,688 Final Contract Amount: $ 1,101,688 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): / Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: Signed: Date: P,J ® n ,je-;._- k/ , t 4f4 ')�> A *Note: The above certification is $equired by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist instructions Attachment C ('THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTEANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS MCHARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTMCA IONS The bidder �' J �1 a-L-f�%� , proposed r 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_ C-12 Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncoiinsion Affidavit; t (Title 23 United States Code Section 112 and Public Contract Code Sec aon 7106) To the CITY l-TY of 4UL:�' I DB'PARTt ANT OF PUBLI WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly col luded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid { price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-13 ]Page 12-81. LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats.1985), the bidder hereby declares under penalty of penury under the laws of the State of California that the bidder has - , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing emrployee thereof: as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution, Public Contract Cade Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: alas the bidder, any oifioer 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 taw or a safety regulation? Yes,,,,,,,,,_,_, No If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 1OZ32 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Now. The above Statement and Questionnaire are part of the Bid Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager. 9 Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; ® Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and 4 Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. p') C>/Je Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Page 12-83 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15 Page 12-85 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C.1352 1. Type of Federal Action: Ea. contract b, grant c. cooperative agreement d. loan e. loan guarantee C loan insurance 2. Status of Federal Action: a. bid/offer/application b, initial award c. post -award 3. Report Type: ® a. initial b. material change For Material Change Only: year quarter date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Q Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. I Oa) (last name, first name, MI) NO Lor-,5i�!ivI)v6 (attach Continuation Sheet(s) if n ssary) 11. Amount of Payment (check all that apply) $ 0 actual planned 12. For of Payment (check all that apply): a. cash b. in -hind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including offleer(s), employee(s), or member(s) contacted, for Payment Indicated in Item Ii: (attach Continuation Sheet(s) if necessary) IS. Continuation Sheets) attached: Yes No 16, Information requested through this fonts is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. I352. This information will be reported to Congress semiannually and will be available €or public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $I00,000 for each such failure. Federal Use Only: Print Name: Title: i IC--c -� I by C.1 V J I Telephone No �/�9 2 " mate:. Authorized for Local Reproduction Standard Form - LLL Form LLL Rev. C-16 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 124 Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-L J,, DISCLOSURE OF LOBBYING ACT1iVITiIES 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 awardlloan 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. r Page12-88 C-17 March 15, 2001 LPP 01-04 Local Assistance procedures Manual EXE9BIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials, Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Inmcdons Rev. OG-04-M NDIN C-18 Page M84 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHMrr 12-G , Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART N The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. "Photocopy this form for additional firms. ------- _. Firm Namet t 1 1 Deseri1.tion of Portion 1Work 1 'i 1 f : t t!m,•z,y.+6�.'i tl' Wif5 A UP _ _ _ - . , -, - ■ . • I. F',F �� � `i C i �y'3`1� it C 1;� 11S5.e j ■v■�'�iii�itll�i� p3��� r� � 4�,yL�, 1Lskrdvt_..h" S na,L�,s�x d4�i�i�� ■ Mgggzg r l � � � � � � r r �■��� ���;�r� t� �} � �iy`t`\i, t�'.a;�+ie�'�:� ��) 1':� ■ •�NO zy.R j1kti tY� ktrY�S �LL ♦ y Distribution: 1) Odginai - Local Agency File Page 12-111 LPP 06-06 November 14,2006 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-GI Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SSE OF TffiS FORM GENCy.City of Huntington Beach LOCATION: Spring View Middle School ROlECTDESCRiPTl0N.. Safe Route to School TAL CONTRACT AMOUNT: S 196.000.00 Approx. ID DATE: 4-20-10 IDDER'SNAME: Nobest, Inc. CONTRACT UDBE GOAL: 3.55Z ITEM OF WORK AND DESCRIPTION DR SERVICES TO BE SUBCONTRACTED OR MATERIALS 110 BE PROVIDED CerL No, of UDBE AM EXPIRATION DATE qAUE OF UDBEs Mug be certified on the date bids ire opened - include UDBE dress and hone number CONTRACT DQUAR AMOUNT ITEM NO, UDBE 8,9 TruckinR 2037 Ra 's Trucking 6.000.00 2-1-15 P.O. Box 6553 Torrance. --- Toilets 37540 United Site Servi 1,500.00 4511 N. Rowland E1 Monte CA. 91731 626 698-3119 For Local Agency to Complete: Agency ContractNumber: Federal Aid Pmject Number Federal Shan Contract Award Date: Loral Agency certifies that all information is complete and accurate. Prima Name Signature Date Local Agency Representative AreaCode: Lckjbow Number. Total Claimed Participation $ 7,500, 3.83.% Signature of Bidder 4-20-10 . 714/892-5583 Date {Area Code} Tel. No. Kay E. Anderson For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder - UDBE Commitmeat (Rev 3/0) Distribution: (1) Copy— Fax or scaa a copy to the Caltrans District Local Assistance Engineer (DEAF) within 15 days of award. I "= to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance \ 23 Original — Local agency files C-21 Page 15-31 LPP 09-xx March 27, 2009 Local Assistance Procedums Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE'SIDE OF THIS FORM C,gNCy; City of Huntington Beach LoCATION: Spring View Middle School OJECTDESCRiPMM Safe Route to School TAL CONTRACT AMOUNT: S— 196,000.00 Approx. ID DATE: 4-20-10 IDDEWSNAME: Nobest, Inc. OF WORK AND DESCRIPTION OR SERVICES TO BE UBCONTRACTED OR MATERL41S TO BE PROVIDED DBECerLNo. AND EXPIRATION DATE OF DBEs (Must be unified on the date bids are opened - include DBE address and obone number CONTRACT DOLLARAMOUNT IT EM NO. DBE 8,9. Trucking 2037 Ra 's Trucking 6,000.00 2-1-15 P.O. Box 6553 Torrance CA. T 37540 -United Site Ser, 1.500.00 or Local Agency to Complete: cal Agency Contract Number. ederal Aid Project Number ederal Share: Contract Award Date - Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate. Tint Name Signature Date Local Agency Representative Area 2# jtSk= Number. Total claimed Participation $ 7 , 500.00 3.83 gnature Bidder 4-20-10 (714) 892-558 Date (Arta Code) Tel. No. Kay E. Anderson .1 Or Caltrans Review: Print Name Signature Caltrans District Local Assistance Enouz= Date Person to Contact (Please Type or Print) Local Ageaay Bidder DBE D&rr atioa (Rev 3109) Distribution: (I) Copy— Fax or sear a copy to the Caltrans District Local Assistance Engineer (DL.AE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project (2) Copy — Include in award package to Caltrms District Local Assistance �. (3) Original — Local agency files C-23 Page 15-32a UP 0.9-XX Marcb 27, 2009 Local Assistance Procedures Manual Exhibit 15-H UDDE Information - Good Faith Effort EXI3IBIT 15-H UDBE FORMATION --GOOD FAI'M EFFORTS Federal -aid Project No. Safe Route to School Bid Opening Date 4-20-10 City o untington Beach The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of 3. 55% for this project. The information provided therein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder - UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder - UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are fisted in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement SCCA 2009-10'Various Dates Green Sheets 2009-10 Various Dates PLEASE SEE ATTACHED B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up UDBEs initial Methods and Solicited Solicitation Dates Ray's Trucking 4-15-10 phone 4-19-10 United Site Services 4-15-10 phone 4-19-10 Calif. Traffic Maintenance 4-15-10 phone 4-20-10 Savala 4-16-10 phone_4-20-10 LA Signal 4-16-10 phone 4-10-10 C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx C-25 March 4, 2009 fig CONSTRUCTIONNEWS • REQUEST FOR BIDS Pbm Van Ovmra a Ti5 cnarpe f65 a mwbtl a.- IROM .eeao puen. a Coaannes Ire.ww4 D o9Aoewn+�ir�Ur A �ew G Dea~numn ox sw amo Oa-1S?1D 1 1-Ie��ava'en'eas Wd W15 f58T�aW%7 �1 LANC dda-.act-FaodaM Ec.lffi Fin f5R7•tlde•42511 LA Y STAGE -PM D RaoLAYATIAC rlTo6lT@ . Lmarwa bxw A • 1aD � PLY iTrnDE 6 • PM D6-1 c.) O lAa ' ;M o �r'P1O1K eioY m wishraa la,r,r ur C/r jIbIM, Lx C Y DN tM5 W e eon ecr rap Tit YUDYc Cermrer EI (51 Aw rBOeH2aa .a:wdon 120k Mott Mi oe erps .w rn . .-a aaruaaT +e AT ole r ivcT1 xaxo"' ,Iwwa,swmm. ten ooux nvAaor:T c r waLrr Twapuaw au a aT I -re 1oAx AT r (Continued an Page 4) +oca w eve a uxeaeres • sus ( PAID ADVERTISEMENTS REQUEST FORBIDS 1 1 PUBUCiMPROVEMENT SYLMAR STREETSCAPE TRAFFIC ISLANDS IFS NP-11557 INVITATION FOR BIDS The, CommurtllY Re lmr6kiprxm Agency Of the City of Lea Angeles, California pxrein rehalnd to n the TRAr LA-) hMte" aested bdd for hnniahoc sit avperwion. "Mary cords mom trdatml persmnel. labor. neaeNe. agWPmmo, loft and other sarvlon waded M pederm and mmprto eM ma-1 d e"pho4 tamale Pommanl end an mating bee. and uM e-in"- a rear mnrate pe irp. landerapaq wbdn b Yudee Pees. ahnAa and gnuM tart, sea hripW. wMr, act rds.eg b.0 W a"- burled m the rmracodm of can Fernando Road and mumri AverMe b act Silver ReamMopnam Puna Area wkW he Esgabe Way Replan of the City of tat Angeles. The obalrool worn Inaadne bW 1. nor earned M are tow." IL -- I . obtain and oomDM with all poaslu a rewired by he centred Pwrlona and by law. CRAM are Pay br 0. Pwaft. ublic waClear Ir Prime 2. Re reva ae cdeft aNagd -Wm, p••l,V walen Itq bur (4) ealsltW ma fsn 3. Rranevnl d axe (1) exlahn91rea mlNn ore (1) nit 1-. 4. Cwrgnla run 000 m, mlrnb P•veW emend act pe-, r oM pour (4) node- S. lived d_I go" YM.m for kmesoprg b bur(4)rr odor-hdir6ng he eoordnedon or he tgapaeon of run Maw remains by DWPW 6 Cwrdnabek win DWPW for rgabeaon of water narem CRAAA win pay DWPW for ideesllon al wart mole. 7. pwAOe torlaemybur (24) naM pant egobathmgd and lerdscaae marrrle ve S. hove in bur (4) mederat run tract, ahrube and ground raver e" bdlGlad m approved e.lnnullon doNmege. 6 arrive rm6 a Conhd pr reque-r DOW en •poured -arrndien daemiavt 14 Coordinate N baby won with IYponeble utter mmpoavv� 11. Dhm rimmed won that may be regrdfnd by he Cmuaen P-vW- THE DEADLINE FOR SUBLIrMNO SIDS IS 1ra0 A.M. WEDNESDAY, DECEMBER 30, taw BIN aWB be geog- he it. CRAILA a gained Cooper on it. Fifth Floor b it. en eo e On CRAM headed at 354 South Spring shop, Loa Angers, Contends 9on3. Bra we be and alone, rewieed ween otempnd In by the Records Oemr an the Feth Fleas Camara We Now sum arm gins In trove! ter their BIN M be amoebas to an time, Such Bras area be Brea tly sand pWtlkly opened, read cord and tat dead In ConWmw Roam 70 bit the Savant,, Floor a ate are as of ur CRARA lmmadrrty ao9orabg the 14.01) Daa sea ehal angina on December 30. 20B. Centred end Doc M. nth lnalruCnelr fo Sides- are on fi M m "a offs m d the CRAAA and ever may be obNMd hra rtx CRAM'a Engineering Depamnere en he ,unea l 0 ear al the ubew Andrea Them r no e L howavei, 9M marParVe none. addree, letep: na"War fax number and tamed peraen rwne no be pMwded whin facong up fed dmarwmL A bnfficcs oat tar, nd bbnrMden r noonvabl•. Nor@ CONTRACT Bra DOCUMENf9 W01 NOF SE MALLED, THEY MUST BE PICKED U►. A bid guaranly Intltrmdatoffnddmawbanedm4.pMbrMthemWcrgar •ComuM-y ReOeveopmer Agency of 0x Cny ar L. Ar.0oa Mamfabr LL S. OinemmoM Brdc, r e albb.ry Ntl Brad dernnd by Ibe eldNr and en e"mpedr W-y, m an .mount not be" hen ten P-1(10%) of are bW Bid shell be aubnlaw Mth lid, Bit The auo_,.I BhN, rate he rewired M rumen en4 pay tar enllarclory Faithful Pa%nomie and Labor and Matoriil Payment Botha se wen se Generel Uabllmy Au-d)IW Liabmy. and Worker. Campenmfon h--mare b adduM 9M Remeud Camo eWd be pmmot inaaoodde allwith Section 4500 of din Gavornnxm Cora,bdep l win the ORA" or win a Sint or Fedenew dM,Mms bank semtbes "Wwrnf b 0 rap inn Wove (10%) r be rommel pd. or a rmanute for monks wehbeb by he CRAM - Pa,l•mu•na• aatranm were wan hes ner been compiled were he me-qured, gar Cmirdr we be rare red b pay expatiated dglf as. wter form ei he-." Pnorim." and TeWd®I goads came. The genral pm an" she of wage" b each reA duo calbn. or tine of wonmee for, on wen M be p ulonved under ode armed rear been dalandwd purnam i eve pew alone of Some Lath P-voenS'en9a'take haw abe been dvrmbed by ha Serne"y r Leber p he _go reed N-mdr ed pmen- le air Law deter beta he wag. rer deter, vaned pugMm M Fail" Lev. br -4. drams mods of her, are Chorealpir act his gahmrrs huts, We pay rot be" don gin epber weer, ndA Prop" hldmr-d -PP- dens any be ampoynd In the peNrmeres d work under dtla mrand 0 thin are employed h emkmanm win are p,-Wr- d do. and Fretla-1 Law. Pursus e b eve unlyines d SDaperbneal of Labor regudbd an Labor Standard. W Radaral Asprmlao and T.9- re Jeunxymen anFa mine actN FamMonsrMd eon- gredoar aim bra, In Me Federal Lou. Sunderds Paxbbnk se emended. (Continua Aftaeheerd No Z. A prime Cumwcer or adimaladr shall hire and proYlN far sooner, Meer and trainee" pumam b said gand.m6 Th. Cora -del And ant- Cud ampgssa and app omits to, employment ere nr discs - .sued eased beeelre d hek tam• read mbr, ax. national .01 pursuant M Evecdre Order 11246 a emeraMa, regarding AS rmMa AWMn w Equal ErnoWma- OpprMdy and "iAndone timed purvon, me im, bentainere or Federally asedad e.katmcam mnevica are -gWred b Wte Am -0. Action lowrN "us] enlpbynuern oppommly, and to conity pet hey haw adopted 8111 amine aNen soar. hwuae" and cup. I. rgrremems A1r such of mWlw ndlon prm and he k,ne W oft oaNn am aim bin In dw rdmom to Sudden. pamuanl M he prwdm of gin Sur of CNbmb Pulik Cord= Cede. Sadie. M00. and me SMr of Cei armila Butlnae" and "Whom Coda, Sadlcn 7gaLIS, der CRM.A had doe mnod dd he Comparain shall PPLUM 1121111 Cla.a_•a•_ t�Mr a die ihw FeIK to sosome and indeed the ewran ad neenee" M M BM da Ms bell led tbe ere nape Nab• A C•27 Newnan taw aociablible, IN the --- r We he medlan MIIr' N h gel ereMEe ant godqm:.d •the 0.:w:re1 ranerender M the Ile Rbmaf•Ww a Mo CM ei Lw Ankelen ter a mhtlmc:.. d n w f61 em7acn wlMr Me rat flow war_a Tbe CRAM reserve" the dole to reps arty ar N BMe or M -W say bdormM he the bideMg A Pse•eM el.atln9 are be Wb b CmrrerM Room 79. an gre 71h Flova d gre CRAM baited 0 354 9 Spring 91- 11 Lee Angeles. Delffomb a 10:00 tan. an Tuesday, December 15. 20M. AtWM- at the fe"Id meer9 bq Me Cam -tiara wmWny raprate,natlw M rent mand"M „amoral •h wrwemlr Ind •dl Prevenhn Waew gpgg( Ogggr(knMv egB,Tedin MIr�Pm�,rldona d Me Gemnd MII M dreua�d For TechNml atg4lgMe ranted Lem 1LorrMt al (2t3) 977.1971, ftmm.erla reMem lea Crnp6arc .a.- Jamus Larun ar (213) grr - 19.4. flak" a.frdNam and hr Pi.abdo.n' Lau Bid Reaulr were. word. Starks .I (213) 977-1820. w,mwdrere rdNere. Dand: Novrmber23 2009 By Sandra L Sendec Senior CW Ergbleer November 30.20M Dodge ConeWdirl Neva Green Shea' Deeembe, 7, moce Dodge Crdraalk. News •GnweSneer Decembr, 3. 2009 Lin AngWe" Sond,d Noweeb.21', 200111 La opinion N-arbor 27. 2txe Lin Angeles Daay Novae DODGE GREENSHEET CHU1746234 bxgatiW@0✓e�lersW fiefawlaDnie�fianls/Qlbelolssu6pVl� Fog, IF 358.000 to MP 373.400 b=W m Quay County CN D4057 owner. NMDOr BIDS DUE December 19, 2009 N "MAM (MDT) I.. Request for Supplies and Sen'ke5inc ade, but not framed to Excavation, Milling, Muich Sock, MEW Barrels, Rtanbte Strlps,TlBtiic Control ManagemenWevllxs, Pavement Mathhlgs, Sunmy75WMg, Qua* Cditrd, Trucking and other related Items. FNF CONSTRUCTION, INC 115 S. 46M 6L,Tsmpa. AZ 85261 Cadet Law almwww I = (480) 968.7reBO w isha ne: 1480) 784.2910 D'llos INCORPORATED General Engineering Contractor Specializing in Public Works Projects The Company seeks sub -bids from certified UDBEIDBFJMBENVBE contractors along with SECTION 3 BUSINESS CONCERNS. Please contact estimating for details. P.O. Box 874 Westminster, CA. 926B4 Phone: (714) 892-5583 Fstc (714) 373-0039 Ucense S 359622 blaglesdrBtgN®fer'aiF� ®IdasdDetbmllst� Bellflewlr9N0Yeca US 64V, IF 406.13Dto W 418.5110Iocaled in Union County CN ES412M ONW..NMDOT BIDS DUE December 18. 2009 Al I IMAM (MDT) Qumtes Request tar Supplies and Sarvi =includs, bid not kmW IN Mlning,Traft Commit Mangg =nvDeykes, Pavement MarMm}a, Survey, asa ft Cddml,Tmddng End other related hems FNF CONSTRUCTION, INC 115 S. 43M 51, Tempe, AZ 85281 Ornbd Laub 6omDr F.. (480) 968.76BO w Phone: (4801 784-MID hem*.* 0tpuessita.spfesanddeiaas0rnicaesforOP/cDovABRoig& Not M MP 41.140 to MP S85M totaled in Roosevelt CMMW CN ES2136D Owner. NMDOr BIDS DUE December 18, 2009 Al 1190AM (MDT) Quotes Request for Supplies and Services include, but not lusted to: Excavated, MM%Tndit Cont al Management. Signing, Barricades Paver mt Markings, survey)SWd1Ig, Quality Conbol,Thegng and other related Hems. FNF CONSTRUCTION, INC 115 S. 46M SL,Tempe. AZ 8=1 CeenrlarwSo- Pax: 1400) 968.7680 Celaone: 1480) 769.2910 ®AB I.R.T. Beres Asphaff, Inim Is Requesting Bids From Oualffied DVBE Subcontractors Project Name: Green Gate Improvements at The OC Fair 8 Event Center City of Costa Mesa Bid Date: November 17, 2009 Contact Andy King 0 714-640.1700 We are Equal Opportunity Employer ADVERTISEMENT FOR BIDS UC Irvh- imites sealed Bids for a Lump Sum Contract for UC Irvine Medical Center Building 1A Root Replacement Project him 997513 at UCI Medical Center. Orange, CA pESCRIPTION OF WORK: installation of adhered PVC thermoplastic roofing membrane to the existing 22.000 sq. it mual-level roof on Building 1A. Work starts appmx. January 2010 with a 45 day schedule from start to Substantial completion Eat Cost: S220,000 Bid Does MIL ZPM, 11130)09 at Conso9tlaled Reproomphles, Costa Mess. CA (714) 751.2680. Plenrodrfts F.W. Dodge (s26T OW-6120 or Reed (800) 424.3986. SIppEg QUALIFICATIONS: Must haw completed a minimum of three (3) projects which were each at least Mag,000 in construction coal a which had (2) ward completed projects built in Cellh mid: one (1) was a roof mplacement project involving installation of adhered PVC Ihermoplastie rooting mem• brand; one (1) was a roof replacement hwWving a hospltat healthcare ladler,, '.. and one (1) was a mot replacement Proles constructed in a fitly opera. sonalloccupted facility. Bidders not meeting the quals in the Contract Does w10 not be eligible for award I ICENgg p Q IIR 6' 11T- Curren and active fleeting Contractor "C-3s" CA contractors ficens- BID 5VAMITTAL REQS: Seated Bids due 21IM, 12/16109. R.CV and opened only at UCI DeCS, 5201 California An, Std, 250. Irvine, CA 92697. Contrad will be Branded to lowest responsive bidder. MANpAMpy ppE• 1p CONF: 1ZgM lone -Bid Conf and Site Visit promptly at 11AM at UCI Medical Carder, Building 22A, Rooms 2103 5 2104, at 101 The City Dr, Orange, CA 9286a. ONLY GC's attending Can Submit Sids. B0D:0 BID SECUBEL 10% bid security. Surety Issuing bid bond shall be an admitted surety insurer (as defined in the CA Code of CNE Procedure Section 995.720) at bid deadline. Successful GC and subs owed follow nondiscrimination req'6 in Bid Dow and pay prevaigng wages al location of Work Contact Lynn Javier (948) 824-7D08, `M•^^NAWd,%W or David Donovan (949) 824.6582, ddonovanAuc.edu For other opportunities. -.'i^a ..erdematmntion Lim=.edit FNF Cals4+xbor4 InC Is requesting quotes for supplies and services from Dan for the following Project 1.10, 1.19 to Valencia Road ARRA-010•D(206)A Owner. ADOT BIDS DUE December 11, 2009 At 11:ODAM (MDT) Quotes Request for Supplies and Services include, bud not funned to: Signing and Lightirig, Concrete Barriers, Barricades. Temporary impact AOenuators, Flagging, Electrical, Seeding, Erosion Control, Surveying and other related hams. FNF Construction, Inc 115 S. 461h SL Tempe, AZ B5281 Contact Laurie Billings-SChoornover Fax: (480) 958-7580 Phone: (480) 294-7734 b rwPrategrpMYsta aNflesmAa®IicasOmn�storliglmoai6Pasiarh US 491, MP 77.00010 W BBbM bleated M San Jam County CN ES51260 Ownar. NMDOT BIDS DUE December 18, 2G09 At 11:MAM (Men Quotes Regwsl fin supplies and Sarvkes inchei ed rlm6dted to: Excavation, MURM9,Tmft Control Management, Signing, Barricades pavement Markings, Survay)51e1dng, Quality Cm6mtTnuddrig and other related Items. FNF CONSTRUCTION, INC 116 6.4am SI. Tempe, AZ SS2a1 Cam¢ Lane ad - I = (40M 968.7580 Phone: (Oao) 784-2g10 is regeesthe queen for supplied bed services Min DBE% far if. fattening "act 140, MP 2132M to MP 232400 bleated n TmOnce County CN 3972 owner. NMDOr BIDS DUE December 19, 2009 At 110)OAM (MDT) Quotes Request Jar Supplies and Services include, bid net kdtad to: MMng. Metal awder.%TFNOc Control DsvkeslMarM96menC Slgrift pavemgnt Markings, Quality Cantrd,71nici g and other related Itam6 FNF CONSTRUCTION, INC 1165. 48M SL,TampgAZ OM Cared lain, adawe,a Faxs (4e0)868.7580 Minn (480)784.2910 Cheryl Noland ............................................ (310) 830-6450 Bob Hill Hydraulic Crane Rentals, LLC Karen Patin ............................................... (323) 875-1342 Alcom Fence Company Craig Phillips .............................................. (818)456-4560 Sunstate Equipment Sylvia Pizarroso.......................................... (949) 616-9165 TCF Equipment Finance Dean Fultz ................................................. (805) 527-9330 C.A. Rasmussen, Inc Tom Walsh ................................................. (714) 578-9600 Sully -Miller Contracting, Co. Steven Young ............................................. (800) 995-9170 Allen Lawrence & Associates, Inc. Scholarship Committee Mike Meier, Chair ....................................... (714) 245-1500 Standard Concrete Products Inc. John J. Clarke ............................................ (310) 542-7724 Clarke Contracting Corp. Lonnie Clausen .......................................... (714) 578-9508 Sully -Miller Contracting Scott Macintosh ......................................... (562) 692-1203 A. L. Macintosh Company Sam Meyer ................................................ (619) 938-8080 Marco Crane & Rigging Pat Poss..................................................... (323) 726-3511 Transportation Committee Daniel Ugalde, Chair....................................(714) 282-8012 Ugalde Trucking Co., Inc. Chris Bragg ................................................ (562) 984-2400 Heavy Transport Greg Dineen ............................................... (760) 249-4376 Greg Dineen & Associates Bob McVay ................................................. (714) 554-5930 Marco Rentals Rob Woods ................................................. (818) 834-0481 Homer Mann Trucking WBE/MBE Committee Anna Camo................................................ (949) 540-0320 Carno & Peters, LLP Rita Ferguson ............................................. (714) 648-0397 G & F Concrete Cutting, Inc. INDUSTRY COMMITTEES American Road & Transportation Builders Association (ARTBA) Board of Directors Doyle Powell ............................................. (909) 356-8880 Powell Constructors (term expires 2009) Paul Von Berg ........................................... (909) 350-3535 Brutoco Engineering & Construction (term expires 2008) Construction Industry Air Quality Coalition Mike Ortiz .................................................. (714) 540-5351 Sukut Construction Co., Inc. Steve Altfillisch.......................................... (951) 736-2811 ACI Don Macintosh .......................................... (562) 692-1203 A. L. Macintosh Bob Shepherd ............................................ (562) 463-4000 Quinn Shepherd Machinery Co. Construction Industry Coalition on Water Quality Michael Crawford........................................(714) 540-5351 Sukut Construction Inc. Chuck Poss................................................ (714) 897-4326 Earth Construction & Mining Paul Von Berg ............................................ (909) 350-3535 Brutoco Eng. & Const.,Inc. Construction Industry Crime Prevention Program Board of Directors Member Greg Dineen, President .............................. (760) 249-4376 Greg Dineen & Assoc. Construction Industry Research Board (CIRB) John J. Clarke ............................................ (310) 542-7724 Clarke Contracting Corp. James Halverson ....................................... (951) 682-1091 Pavement Recycling Systems Construction Industry Advancement Fund of Southern California John J. Clarke ............................................ (310) 542-7724 Clarke Contracting Corp. Les Farrow ................................................. (714) 887-0788 Les Farrow Excavating & Grading Chuck Poss................................................ (714) 897-4326 Earth Construction & Mining Fund for Construction Industry Advancement Michael Crawford........................................(714) 540-5351 Sukut Construction Inc. Les Farrow ................................................. (714) 887-0788 Les Farrow Excavating & Grading Charles W. Poss......................................... (323) 726-3511 Past President Public Works Standards Inc. Board of Directors Greg Erickson . ........................................... (323) 875-1342 Alcom Fence Company Green Book Committee Paul Von Berg ............................................ (909) 350-3535 Brutoco Engineering & Construction Paul Zolezzi................................................ (909) 356-8880 Powell Constructors Southern California Contractors Negotiating Committee (SCCNC) John J. Clarke ............................................ (310) 542-7724 Clarke Contracting Corp. Les Farrow .................................................. (714) 887-0788 Les Farrow Excavating & Grading H �o SPECIALIZING IN PUBLIC WORKS PROJECTS The company seeks sub -bids from certified DBE/MBE/WBE contractors along with SECTION 3 BUSINESS CONCERNS. Contact estimating for details. P.O. Box 374 0 Westminster, CA 92684 Phone: (714) 892-5583 ® FAX: (714) 373-0039 License #359622 2009 SCCA Directory 13 04/19/2010 07:16 FAX 714 373 0039 NOBEST [aool x� ACTIVITY REPORT�x ST. TIME CONNECTION TEL/ID SENDER NAME NO. MODE PGS. RESULT *04/16 08:16 8443 AUTO RX ECM 3 OK 00'52 *04/16 08:50 5624643345 8444 AUTO RX ECM 2 OK 00'32 *04/16 08:51 LINDA COATS 3972 TRANSMIT ECM 2 OK 00'56 19494571070 *04/16 08:55 +5628027499 8445 AUTO RX ECM 2 OK 00'36 *04/16 09:06 17144659424 8446 AUTO RX ECM 1 OK 00'18 *04/16 09:16 LINDA COATS 3973 TRANSMIT ECM 3 OK O1'21 19494571070 *04/16 09:27 ROY ALLAN 3974 B'CAST ECM 3 OK 02'39 15628646612 *04/16 09:30 STEVE DORECK 3975 B'CAST ECM 3 OK O1'19 15624318878 *04/16 09:32 CA TRAFFIC MAINT 3976 B'CAST G3 3 OK 07'22 18189514093 *04/16 09:40 HIGHLIGHT 3977 B'CAST ECM 3 OK 01'19 19513522921 *04/16 09:41 DOUG MARTIN 3974 B'CAST ECM 3 OK 02'39 17144410541 *04/16 09:44 VALVERDE 3975 B'CAST ECM 3 OK O1'49 15629061918 *04/16 09:47 CHRISP CO 3976 B'CAST ECM 3 OK 01'33 19097460354 *04/16 09:49 CT&F 3977 B'CAST ECM 3 OK 02'45 15629274171 *04116 09:52 PVMT.COATINGS 3974 B'CAST ECM 3 OK 01'22 17148263129 *04/16 09:54 SRD 3975 B'CAST ECM 3 OK 02'38 17146302484 *04/16 09:58 SUPERIOR PVMNT 3976 B'CAST ECM 3 OK 02'47 17145629400 *04/16 10:02 3975 B'CAST 0 NG 00'00 0 #022 *04/16 10:02 OC STRIPING 3976 B'CAST ECM 3 OK 02'40 17146396353 *04/16 10:05 MOORE ELECTRIC 3977 B'CAST ECM 3 OK O1'24 19512783406 *04/16 10:07 SAVALA 3975 B'CAST ECM 3 OK O1'22 19495528597 :04/16 10:09 J&S 3976 B'CAST ECM 3 OK 02'40 15627772499 *04/16 10:12 STEINY 3977 B'CAST ECM 3 OK 02'54 16263388343 *04/16 10:17 MOORE SIGNALS 3977 B'CAST ECM 3 NG 02'19 17146934838 3 ##765 *04/16 10:21 DYNALECTRIC 3977 B'CAST ECM 3 OK 02'39 17144842389 *04/16 10:24 PCI 3976 B'CAST ECM 3 OK 02'58 15622180634 *04/16 10:27 LA SIGNAL 3977 B'CAST 0 NG 00'00 16269685720 0 #018 *04/16 10:29 STERNDAHL 3976 B'CAST ECM 3 OK O1'21 18188348618 *04/16 10:31 WORKS 3976 B'CAST 0 NG 00'35 16268142805 0 #018 04/19/2010 07:16 FAX 714 373 0039 NOBEST Ia002 *04/1B 10:32 SUDHAKAR 3976 B'CAST 0 NG 00'38 19098792939 0 #018 :�04/16 10:33 5629061918 8447 AUTO RX ECM 2 OK 00'23 *04/16 10:37 8448 AUTO RX ECM 2 OK 00'55 *04/16 11:14 8449 AUTO RX G3 1 OK 00'47 *04/16 13:24 17146288905 8450 AUTO RX ECM 11 OK 04'35 *04/16 13:39 5992614 8451 AUTO RX ECM 14 OK 02'09 *04/16 13:42 951 682 1094 8452 AUTO RX ECM 1 OK 00'23 *04/17 20:27 714 569 1901 8453 AUTO RX ECM 1 OK 00'19 04/19 05:59 7144410541 8454 AUTO RX ECM 1 OK 00'38 04/19 06:43 8585657348 8455 AUTO RX ECM 1 OK 00'29 04/19 06:49 +5628027499 8456 AUTO RX ECM 2 OK 00'29 N®BEST INC. P.O.BOX 874 WESTMINSTER,CA. 92684 TEL.#(714)892-5583 FAX# (714)373-0039 LIC.# 359622 A FACSIMILE TRANSMITTAL SHEET TO: FROM: Estimating MIKE LEWIS DATE: 4/16/2010 FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER: 3 PHONE NUMBER: SENDER'S REFERENCE NUMBER -- RE: YOUR REFERENCE NUMBER: Huntington Beach- Safe Route to School ❑ URGENT ❑ FOR REVIEW ❑ PLEASE COMMENT Q PLEASE REPLY ❑ PLEASE RECYCLE Bids: April 20, 2010 @ 2:00 p.m. Nobest Incorporated seeks sub -bids from certified UDBE/DBE/MBE/WBE contractors along with Section 3 Business Concerns. Please attach certification number with quote. If you have any questions feel free to call Thanks NOBEST INC. MIKE LEWIS P.O.BOx 874 WESTMINSTER,CA.92684 Project Bid Schedule Safe Routes to School — Spring View Middle School f'l 1" 1 114 17 pgy. I I L.S. Mobilization. Per L.S. 2 1 L,S. Monument Preservation. Per L.S. 3 1 L.S. Furnish Project Traffic Control. Per L.S. 4 1 L.S. Furnish. and Install Traffic Striping and Signing. $ $ Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ $ Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement] to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $ per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 ME- NO, 'Uhl-t is - 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City $ $ Standard Plan 202, Including AC Paving Replacement. Per L.F. 10 14 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans. Standard Plan $ $ No. A88A and AC Paving Replacement. Per EA. 11 4 EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ $ Per L.S. 12 1,000 S.F. Construct Type II Slurry Seal. Per TotalAmount Bid in Figures: Total Amount Bid in Words: $ Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 375- 5015. C-2.2 Exhibit 15-H Local Assistance Procedures Manual UDBE Information - Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract Trucking Y 8,9 62000.00 3.06Z Toilets N --- 1,500.00 .77Z Striping N 4.8 12.000.00 16.3Z D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: California Traffic Maintenance - No Rid Names, addresses and phone numbers of firms selected for the work above: Ray's Trucking Torrance United_.Site Services E1 Monte E, Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: No.Assistance Needed F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: No Assistance Needed G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Page 15-34 March 4, 2009 C-26 UP 09-XX Back To Query Form Search Returned 1 Records Mon Apr 19 09.47:55 PDT 2010 Query Criteria Firm ID: 2037 Firm Type: DBE Firm ID 2037 Firm/DBA Name RAY'S TRUCKING Address Line1 17103 S HASS AVENUE Address Line2 City TORRANCE State CA Zip Code1 90504 Zip Code2 Mailing Address Line1 P.O. BOX 6553 Mailing Address Line2 Mailing City TORRANCE Mailing State CA Mailing Zip Code1 90504 Mailing Zip Code2 Certification Type DBE EMail luckylady5555@sbcglobal.net Area Code (310 ) Phone Number 538-9891 Fax Area Code (310 ) Fax Phone Number 327-6922 Agency Name DEPARTMENT OF TRANSPORTATION Counties 19; 30; 36; 56; Districts 07; 08; 12; DBE NAICS 425120; 484110; ACDBE NAICS Work Codes C9602 BOTTOM DUMP TRUCKING; C9771 TRUCK BROKER; C9774 TRUCKER; Licenses Gender F Ethnicity CAUCASIAN Firm Type DBE Back To Ouery Form Back To query Form Search Returned f Records Mon Apr 19 09:51:37 PDT 2010 Query Criteria Firm ID: 37540 Firm Type: DBE Firm ID 37540 Firm/DBA Name SUDHA DHANDAPANI CONSULTING Address Linel 509 SONORA DRIVE Address Line2 City SAN MATEO State CA Zip Codel 94402 Zip Code2 Mailing Address Linel Mailing Address Line2 Mailing City Mailing State Mailing Zip Codel Mailing Zip Code2 Certification Type DBE EMail sudhadh@yahoo.com Area Code (650 ) Phone Number 906-9444 Fax Area Code (650 ) Fax Phone Number 685-9444 Agency Name SAN MATEO COUNTY TRANSIT DISTRICT (SAMTRANS)/JPB Counties 00; Districts 00; DBE NAICS 541611; ACDBE NAICS Work Codes C8700 CONSULTANT; C9999 BROKER (FOR FEE ONLY); Licenses Gender F Ethnicity ASIAN SUBCONTINENT Finn Type DBE Back To Qum_ Form Local Assistance Procedures Manual Exhibit 15-H LIDBE Information - Good Faith Effort Name of Method/Date Results i Agency/Organization of Contact SCCA Southern Calif. Contractors Association by Internet G & F Concrete Cut] H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-xx C-27 March 4, 2009 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for -obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. �- Company Name By q/Z_V()fl 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. Bid Bond BID BOND The American Institute of Architects, AIA Document No. A310 (February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS, that we Nobest Incorporated as Principal hereinafter called the Principal, and ULLICO Casualty Company a corporation duly organized under the laws of the state of Delaware as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten percent of the total amount 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 Route to 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 16th day of April , 2010 Witness Witness ORSC 21328 (5/97) Nobest Incorporated Surety ; (Seal) By:. Matth . Coats homey -in -I acc ,q. State of California County of orange On q —� ®-` 2,o)C) before me, Ray E. Anderson/Notary Public , (Here insert name and fide of the officer) personally appeared Larry Nodland who proved tome on the basis of satisfactory evidence to be the personal whose nameis/subscribed to the within instrument and acknowledged to me that he/ffiy executed the same in his/r/fJ�e>F'authorized capacity, and that by his/ eflt�Ie�r signature ,Won 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. KAY E. AWERSORf`�� comm. #1852452 n V NOTARY�t�-CaiFo�A „� and and official seal. O ORANGE COUNTY j Mycomm. E1pm=hma 13. 2013 (Notary Seal) re of Notary Public ADDITIONAL OPTIONAL INF'OIZh'IA'TION DESCRIPTION OF THE ATTACHED DOCUMENT ,,(Tide 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 President: (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 outslde 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 #.e_ cerrtfying the authorized capacity of the signer). Please check the document carefidlyfar proper notarial wording and attach this form 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 namels) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (Le_ WshelMay- is lace) 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 tide or type of attached documel number of pages and date. Indicate the capacity claimed by the signer. if the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com rt' •: 70-Mi'aft .'MR1,111 State of California County of Orange On APR 16 2010 before me Adelaide C. Hunter, Notary Public (insert name and title of the officer) personally appeared Matthew J. Coats 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 "- -rr�ezAheir authorized capacity(ies), and that by hisfherftheir signatures) 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 _ A &'Vy� ADELAIDE C. HUNTER Commission # 1808793 <� Notary Public - California Orange County My Comm. Expires Aug 8, 2012 • ULLICO Casualty Company 1625 Eye Street, N.W. Washington D.C. 20006 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS: That ULLICO CASUALTY COMPANY (the Company), a corporation organized and existing under the laws of the State of Delaware, does hereby constitute and appoint: Linda D. Coats , Matthew J. Coats , Douglas A. Rapp , & Timothy D. Rapp of Lind a D. Coats Surety Insurance Services, Inc. Its true and lawful Attorney (s) in fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed $5,000,000.00. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of ULLICO Casualty Company at a meeting duly called the 15th day of July, 2009. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company to: (1) Appoint Attomey(s) in Fact and authorize the Attomey(s) in Fact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attomey-in-Fact and revoke the authority given. And, be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile, and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and biding upon the Company in the future with the respect to any bond or undertaking to which it is attached. IN TESTIMONY WH REOk ULLICOCASUALTY COMPANY has caused this instrument to be signed and its corporate seal to be affixed by its authorized office this day of (�i ( 20_10. ti )QRKSIDENT Daniel Aronowitz President ULLICO Casualty Company, a Delaware Corporation. On this 16th day of July 2009, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said that he is the therein described and authorized officer of the ULLICO CASUALTY COMPANY; that the seal affixed to said instrument is the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed. Notary Public CATHERINE M. OBRIEN NOTARY PUBLIC STATE OF MARYLAND MONTGOMERY COUNTY MY COMMISSION EXPIRES JANUARY 21, 2012 CERTIFICATE I, Teresa E. Valentine, Senior Vice President, General Counsel and Secretary of ULLICO Casualty Company, do herby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto on this 16th day of July 2009 are true and correct and are still in full force and effect. I do further certify that that Daniel Aronowitz, who executed the Power of Attorney as President, was on the date of execution of the attached Power of Attorney the duly elected President of ULLICO Casualty Company, In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 16ih day of July 2009. Teresa E. Valentine Senior Vice President, General Counsel & Secretary ULLICO Casualty Company City ®f Huntington Beach 2000 Main Street . Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK June 30, 2010 PTM General Engineering Services, Inc. 5942 Acorn Street Riverside, CA 92504 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sincerely, ?Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Zealand (Telephone: 714-536-5227 ) �L� % �� �/ ..��"16 � . SECTION C PROPOSAL for the Safe Route to School In the vicinity of Spring View Middle School CC No.1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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-t 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 bid bond in the amount of $ io o total bidwhich 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::;:.:;. C-z Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 gg s" N OU gg t aO -�M= 1 1 L.S. Mobilization. Per L.S. I L.S. Monument Preservation. UOO— Per L.S. I L.S. Furnish Project Traffic Control. $ UO I/UO Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $ $ 1010te'7— Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. $ -rb 00 Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local $ 1U5CO— w5oo Depression per City Standard Plans 205, 311 and 315. (Including AC Replacement to Finished Surface) Per L.S. 11 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified $ t1500 $ W500 per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.P. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ $ Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 t..n,..1„fc�ya*ew. t _P. ,•5 ,^* Bill- ey_-, _.M-r,;. �.. {.. >.E '^: y,,..I :�:SZVIT •,L^f;'^' 'r K t � .. � li •ate � ,����i�����;���.n t�..� � � �� �:�. _ w4�- .. .n .U::t _ 4�•'�:'. _ .r�n '7�i, .a• •.!. lt�1x �; l.aia;��rdj�.lti" �. ! vi'. r e+:� C.t, ..: 4• .iµ� .t.'• �!i�c.�:=� _. �u,�.j yB`��=✓� Ur_^�%n:•:,M�.�«.. �1�..�r' .15,.�.3'w �_3 �nAk��%i� :•di',.. . :yaw.: .'_�. �.: t� ��.e4 .r �.s�::YS R.S � d' � 3i� _.i$�`'SvF iF."%:5'; x• , E," 9 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City Standard Plan 202, Including AC Paving Replacement. Per L.F. , $ ��% $ `L (0 i g 10 11 12 14 EA. 4 EA. 11,000 S.F. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and AC Paving Replacement. Per EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. Per L.S. Construct Type II Slurry Seat. Per S.F. $ �j�'�0 ' $ 500 — $ 52�J6�� $ 2D00 nn Total Amount Bid in Figures: $ Total Amount Bid in Words: $ bpt� ku Oved ko[4 4,104 iNbugawt g(1(qqkt'J'5- Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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. PoSame..an.ii�dr7ress.o o . °work f . `.` Nutiili�r. tn.B/I #5 Freeway Electric 684572 A;C10;C31 5942 Acorn St. Riverside, CA 92504 Portion of electrical install. aip� , a- . 9aos? 4WU HAC Construction 57/n47 Lucretia Avenue, �/PMira Loma, CA 91752 , Cia!55�;A WZ ; bSr;59 U_ —0 0 C6111U[C PUt x�CS loll 0 1 CT & T Construction Inc. 324 S. Diamond Bar Blvd., PMB 275 Diamond Bar, CA 91765 CT & T Construction Inc. jp3 �' Licenses No. 868434, Class C12 & C8 Tel: 909-396-8453 �� lv �- j C �Z -�(✓ �V1 a �. fir, l`iOlt'1GI,5[ �CWa1��Gurloi��li11�. Orange County Striping Service 183 N. Pixlev Street, Orange, CA 92868yC�2 Orange County Striping Service Licenses No. 346095, Class C31 & C32 Tel : (714) 639-4550 By submission of this proposal,, tue tsiaaer-eer noes: - — 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 fiunished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of tft* Riverside Brian Mendoza , being first duly sworn, deposes and says that he or she is Vice President/Secretary of PTM General Eng. Svcs, 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 sharp 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. PTM General Engineering Services, Inc. Name of Bidder Brian Mendoza Vice President/Secretary Signature of Bidder 5942 Acorn St. Riverside, CA 92504 Address of Bidder Subscribed and sworn to before me this 19 t h day of Ap r i 1 20 10 EtlZA111 III TM�CRAE CO�4m, # 16768 tn m_ at NOTARY PUBLIC. CALIFORNIA UI e RIVERSIDE COU?,,Ty Poly CC'VM. EXP, AUu". 7, 2010 °b NOTARY PUBLIC NOTARY SEAL C4 ACKNOWLEDGMENT State of California County of Riverside On before Me, Elizabeth H.- M. McRae, Notary Public (insert name and title of the officer) personally appeared Brian Mendoza who proved to me on the basis of satisfactory evidence to be the person(x) whose name(4 is/apex subscribed to the within instrument and acknowledged to me thatl"heAfxy executed the same in hishiwAkeir authorized capacity(tm* and that by his/kw*Wr signature(a) on the instrument the person(, 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 ha and official seal. ELIZAGE'rH I RAE !-N! A k,UUICT My Com.m. Exp. kr,. 7, 20101 Signature (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, in the vicinity of Spring View Middle School - CCI367, (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: 04/19/10 C-5 PTM General Engineering Services, Inc. Contractor Brian Mendoza By Vice President/Secretary 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 ® 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: 04/19/10 C-7 PTM General Engineering Services, Inc. Contractor / llz'.-'-) Brian Mendoza By Vice resident/Se�etajzy Title (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: PTM General Engineering Services, Inc. Contractor Brian Mendoza By Vice President/Secret Title Date: 04/19/10 Note: 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: PTM General Engineering Services, Inc. Bidder Name 5942 Acorn St. Business Address Riverside, CA 92504 City, State Zip e51. ) 710.1000 Telephone Number 891265 Class A; C10; C31 State Contractor's License No. and Class 02/2007 Original Date Issued 02/2011 Expiration Date The work site was inspected by Brian Mendoza of our office on04 / 19 ,201.0 The following are persons, firms, and corporations having a principal interest in this proposal: PTM General Engineering Services, Inc. Elizabeth H. Mendoza de McRae, President/CFO Brian Mendoza, Vice President/ Secretary C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. PTM General Engineering Services, Inc. Company Name Signature of Bidder Brian Mendoza, Vice President/Secretary Printed or Typed Signature Subscribed and sworn to before me this 19 t&y o f April ,200 10 NOTARY PUBLIC ELlZABETH H.M. MCRAE # 1686768 rrflp ( I° NOL4RY PUBLIC-CALIFORNIA U! RIVERSIDE COUNTY PAY (;calm Fzo AUG. 7 2010 NOTARY SE. 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. Dept. of Transportation 1727 30th St. Sacramento, CA 95816 Name and Address of Public Agency Mr. Mike Bergiven, 951.232.3739 Name and Telephone No. of Project Manager: 489,489.00 Hwy. Ltg at Rte 10 & 66 07/09 Contract Amount Type of Work Date Completed 2 Dept. of Transportation 1727 30th St. Sacramento, CA 95816 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr . Mike Obadike 951.830.6821 492 1 55 00 In a 1 emergency electrical system. 06 /09 , Contract Amount Type of Work Date Completed 3, City of Diamond Bar 21825 Copley Dr. Diamond Bar, CA 91765 Name and Address of Public Agency Mr. John Huie 951.205.2856 Name and Telephone No. of Project Manager: 436,000.00 T/S Interconnect Ph. #1 05/08 Contract Amount Type of Work Date Completed C-1© Brian Mendoza P.O. Box 7745 Riverside, CA 92513-7745 Email; brian@ptm-eng.com a Cell 951.722.5755 Chief Estimator and Supervisor of Outside Operations Supervisor of outside operations with over 18 years of experience. Electrician with over 20 years of experience. An effective communicator and team leader; experienced in coordinating and executing large and fast -paced projects. CAREER EXPERIENCE Freeway Electric/PTM General Engineering Services, Inc. Riverside, CA 06/2006 to Date Chief Estimator/Supervisor of Outside Operations In charge of managing the estimating department and finalizing bid packages; coordinating the beginning phase of an awarded project between the company and agency. Project submittals, contract review. Coordinated and managed crews California region; handled various sized projects ranging in size from $1,000 to $4.5 million dealing with dry utilities, wet utilities, traffic signals, and road improvements. Maintained coordination Freeway Electric/PTM General Engineering and subcontractor, and project owners. In charge of handling project's administrative work; monthly gross estimates, project progress schedule, materials requisitions, contract change order negotiations and equipment purchase and rentals. High Light Electric Inc./Pete & Sons Construction Inc. Riverside, CA 10/96 to 06/2006 Chief Estimator In charge of managing the estimating department and finalizing bid packages. Coordinating the beginning phase of an awarded project between the company and agency or prime contractor; project submittals, contract review. Successfully bid on projects totaling $12 million with an average spread 6%. Area Supervisor Coordinated and managed 10 crews consisting of 6 members per team in the southern California region; handled various sized projects ranging in size from $1,000 to $4.5 million dealing with dry utilities, wet utilities, traffic signals, and road improvements. Maintained coordination between High Light Electric Inc and subcontractor, general contractor and project owners. In charge of handling project's administrative work; monthly gross estimates, project progress schedule, materials requisitions, contract change order negotiations and equipment purchase and rentals. Continued... BRIAN MENDOZA • Page 2 CAREER EXPERIENCE CONTINUED MIRE Electric Inc. in Riverside, CA 10/1998-10/1996 Vice President and Head of Outside Operations Managed outside operations for all projects ranging in size from $1 to $2.5 million. Headed an around the clock electric crew and coordinated with CC Meyes to repair the I-10 Santa Monica Freeway after it collapsed during the 1994 Northridge Earthquake to complete the fast paced project in 66 days. Maintain coordination between MBE Electric and subcontractors, general contractor and project owners; implemented and enforced safety guidelines. Handled administrative work; monthly progress estimates, material requisitions, contract change order negotiations. Vasco Corporation in San Fernando, CA 10/1987-0611998 Foreman (Part Time) Managed day to day operations of work crews and various projects ranging in size from $1,000 to $5,000 in Eastern Los Angeles County; traffic signals, street lighting, signal interconnect. Raymor Electric in Rosemead, CA 06/1986-10/1987 Crew Leader (Part Time) In charge of work crew on projects ranging from $25,000 to $250,000 through out Los Angeles County. s Capable of operating heavy equipment such as skip loaders, cranes, and backhoes; ® Hands-on experience with hand tools and power tools; a Capable of overseeing fast -paced and high profile projects; e An effective communicator and leader; EDUCATION ® International Brotherhood of Electrical Workers Completed training course (1988-1989) in'street lighting and traffic signal installations, code enforcement and blue print reading. ® South Gate High School Received High School diploma in 1988 BRIAN MENDOZA • Page 3 CAREER EXPERIENCE CONTINUED PROFESSIONAL MEMBERSHIPS • International Brotherhood of Electrical Workers (IBEW) • National Electrical Contractors Association (NECA) ACCREDITATION • IBEW-Journeyman Wireman; CSLB-Electrical Contractors; Certified Trench Safety Coordinator. • English (Native) • Spanish (Fluent) LANGUAGES AWARD RECEIVED • Recipient of the U.S. Small Business "Young Entrepreneur of the Year" Award in 1996, nationally. • Recipient of the Certificate of Recognition by the City of Los Angeles for "Small Business" in 1997. • Recipient of the Certificate of Recognition by the City of Riverside for "Small Business" in 1997. • Recipient of the Certificate of Recognition by the State Assembly,' Assemblyman Mr. Rod Pacheco, for the "top 506 Inland Empire Small Business" in 1997. • Ranked among the "Top 500 Inland Empire Hispanic Owned Companies" since 1997. • Certification of Appreciation for our participation and maximization in the "Century Freeway Affirmative Action" by CFAAC. PROFESSIONAL AND PERSONAL REFERENCES Caltrans project #07-1.224U4 (Electrical contract amount $4.5 million) Project completed in 2005 Description of project: Installation of traffic signals, ramps metering, sign illumination, Highway lighting, fiber optic communication, and electrical irrigation along the I-10 Freeway in Los Angeles County. • Doug Dwason-Project Manager for prime contractor, Balfour Beatty Cell (949)232-3276 and Office (909)397-8040 • Patty Galvan- Resident Engineer. Office (909)594-4270 9 Veronica Ross -Electrical Inspector. Cell (714)606-6311 BRIAN MENDOZA ® Page 4 CAREER EXPERIENCE CONTINUED City of Redlands Contract #208300-72304/41008 (Electrical contract amount is $218,800) Project completed in 2003 Description of project: Installation of traffic signals, modification of ramp metering, lighting and sign illumination, Bill Hensley -Senior Civil Engineer- Office (909)798-7586 ext 2 Juan Olvera-Project Manager for general contractor, H&H Construction- Cell (951)453-7712 and Office (909)473 -73 3 1. Caltrans project#08-4567V4) Electrical contract amount is $938,238) Project completed in 2005 Description of project: Installation of lighting system along the I-5 Freeway in San Bernardino County. ® Gary Vogel -Project Manager form prime contractor, Granite Construction Cell: (661)549-3953 and Office (661)726-4447 Sanbag Projects, Segment 1, 2, 3, early segment 9, segment 9, and alder Ave. (Total electrical contract amount was $3.2 million) Project completed in 2004. Description of projects: Installation of traffic signals, ramp metering, .sign illumination,' highway lighting, fiber optic communication, and electrical irrigation along the I-10 Freeway in San Bernardino County. Harold Lantis-Sanbag Contract Manager- Cell (760)802-7730 and Office (909)875-8029 ext 213. Tim Hanable-Caltrans Inspector- Cell (951)712-0021 Al Ortega- Project Manager for prime contractor, Yeager Shanska- Cell (714)240- 5333. City of Indio Project #ST'0137 (Electrical contract amount was $1.4 million) Project completed in 2005 Description of project: Installation of street lighting system, traffic signals, electrical irrigation, and dry utilities. • Gary Baxter -Area Manager for prime contractor, Yeager Shanska Construction - Cell (909)721-9749 and Office (760)343-5472 9 Tommy Young -Project Manager for prime contractor- Cell (951)232-6618 and Office (760)343-5472 ® Mehran Sepehri-City Engineer- Cell (760)250-2201 Additional Professional References: • ZaleHarris-Caltrans Inspector- Cell (951)289-0047 • Ray Robles-Caltrans area supervisor- Cell (909)799-0646 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: PTM General Engineering Services, Inc. Contact Person: Brian Mendoza, Vice President/Secretary Contact Phone: 951.710.1000 Signed: Date: 704Z112Z10 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THISPROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEWNTAND EXECUTION OF 77I0SE CER777CATIONS WHICHAREA PART OF TB7S PROPOSAL) PTM General Engineering Services, 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. C-12 rage 12.79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIIDff 12-E PS&E Checklist Instructions Attachment 1D Noncoitusion Affidavit l (Title 23 United States Code Section 112 and i Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach/Orange County DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. - Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C C-13 Page 12-81 LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1. Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats.1985), the bidder hereby declares under penalty ofpetjury under the laws of the State of California that the bidder has ; . , has not X been convicted within the preceding three years of any offenses referred to in thdt section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection With the bidding upon, award oft or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10295.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid Signing this Bid on the signature portion thereof shall also constitute signaiure of this Siatement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questiomtairc_ Has the bidder, any officer of the bidder, or any employee of the bidder wbo has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local goverment project because of a violation of law or a safety regulation? Yes No x If the answer is yes, explain the crrcumstances in the following space. C-13 Public Conitmet Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractoes failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National labor Relations Board Note: The above Statement and Questionnaire are, part of the Bid, Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that malting a false certification may subject the certiSer to criminal prosecution. C-14 Local Assistance Procedures Manual EXI>tIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty ofpedury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: i Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; z o Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; o Does not have a proposed debarment pending; and o Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years, If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Page 12-83 LPP 01-04 March 15, 2001 I,oeal Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NO.NLOBBYING CERTIFICATION FOR FEDERAL. -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 0) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant; loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission ofthis certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. C-15 Page 12-85 LPP 01-04 March 15, 2001 N/A = Not Applicable Local Assistance Procedures Manual EXIT 12-E PS&E Checklist Instructlons Attachment G DISCLOSURE OF LOBBYING ACTIVrMS 1. Type of Federal Action: a contract b. grant N/A C. cooperative agreement d. Ioan e. loan guarantee fi Joan insurance 2. Status of Federal Action: a. bid/offer/application b. initial award N/A c. post -award 4. Name and Address of Reporting Entity Prime [-1 Subawardee N/A Tier , if known Congressional District, if known 6. Federal Department/Agency: N/A $. Federal Action Number, if known: N/A 10, a. Name and Address of Lobby Entity (If individual, last name, first name, MI) N/A 3i 3. Report Type; F1. initial b. material change N/A For Material Change Only: year _ quarter date of last report S. If Reporting Entity in No. 4 is Sabawardee, Enter Name and Address of Prime: N/A Congressional District, if known 9. Federal Program Name/Description: N/A CFDA Number, if applicable 9. Award Amount, if known: N/A b. Individuals Performing Services (including address if different from No. 10a) Oast name, first name, MI) N/A (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. 'Type of Payment (check all that apply) $ N/A actual planned a. retainer N/A b, one -tune fee 12, Form of Payment (check a)` that apply). c. commission Ba. cash N / A d. contingent fee b. in -kind; specify: nature a deferred value LJ f. other, spec* 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: N/A (attach Continuation Sheets) if necessary) 15. Continuation Sheet(s) attached: Yes [] No K Information requested through this farm is authorized by Title 31U.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 inquired pursuant to 31 Print Name: Brian Mendoza U.S.C.1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: Vice President /Secretary person who fails to file the required disclosure shall be subject to a civil penalty of= less than $10,000 and not more than 951.710.1000 0 4 / 19 / 1 $100,000 for each such failure. `.telephone No.: Date: Federal Use LLL Authorized for Local Reproduction Standard Form - LLL C-16 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 124 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 Iast, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. S. if the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 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 individuals) 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 . C-17 March 1S, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information, Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-W anod= Fxv. 0604-90((FM1F)) C-18 Page 12-89 LPP 01-04 March 15, 2001 Lora istance ]Procedures Alanual 1EXH 12-G Bidder's List of Subcontractors (DBE and iron -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 44, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposaL Photocopy this form for additional firms. Firm Name/ Photlel Address) I Fax NOW Phone Freeway Electric 951.710.1000 5942 Acorn St. Riverside, CA 92504 1 951.710.1006 Vage 4ddress _i6 5'rta' gV-46 dn, SKA of/0 Fos HAC Construction 5747 Lucretia Avenue, Mira Loma, CA 91752 NAG Construction Licenses No. 883826, Class A Tel: 951-360-4726 CT & T Construction Inc. _ 324 S. Diamond Bar Blvd., PMB 275 Diamond Bar, CA 91765 CT & T Construction Inc. Licenses No. 868434, Class C12 & C8 Tel: 909-396-8453 Annual . '. .° ' ' .: Gross Description of Portion of Work to be Pekvr�e Etecei is <slmiliion portion of electrical install. <$5 million (inn —A Lv. < $15 million > $15 million <$1 million <$5 million (, <$10 million <$15 million > $15 million <$1 million b < $5 million < $10 million <$15 million > $15 million EMEM <$1 million La 0i < $5 million r <$10 million <$15 million & n b I I la AZ(( ; Rage 12-111 LPP 06-06 November 14,2006 �� n Exhib. -G Local Assistance 1Procedur, Anual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DOE)- PART If The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Titl( 49, Section 26 of the Code of Federal Kegutattons. Photocopy this form for additional firms. FirmName/' 1 1 II. li I 7f'3 j�troF�y,�''}�,�ii�l jair`�4vcii ir`� Address/ t Description 1Portion 1 1 1 he 1 11 0 1.r^-v city, State, [ , r i` a Rr M I ' / UMN 2=381 tTf t V !.'range County• • Service■ �� ��<h,�1. r , �:}i,�; �.� - ter: ,83 N. Pixley Street, Orange, CA 92868 • County• • C 1 .-ic. No. 346095, ' 1 qW State ZIP iv 0 Name Address City State ZIP Name Address CfryState ZIP >$1S < $i r Disk ibution: l) Od ival —Local Agenoy Fite Page 12-112 November 14, 2006 LPP 06-06 Local Assistance Procedures Manual Exhibit 15-GI Local Agency Bidder UDBE Commitment (Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) TE: PLEASE REFER TO INSTRUCTIONS ON TOE REVERSE SIDE OF TWS FORM : City of Huntington Beach LOCATIONHuntington Beach,•CA DESCRIPTION• Safe Routes to School in Vicinity of Spring View Middle School F TOTAL CONTRACT AMOUNT: a I D b O b IDDATE: �a/�Qfin IDDER'SNAME: PTM General Engineering Services, Inc. (DBE) goal is 5.29% (UDBE [Race Conscious]: 3.55% and DBE [Race Neutral]: 1.74% CONTRACT UDBE GOAL - ITEM OF WORK AND DESCRIPTION R SERVICES TO BE UBCONTRACTED OR MATERIALS O BE PROVIDED CwtNo.ofUDBE EXPIRATION ATE AMP OF UDBEs be certified on the date bids ned - include UDBE L ddand PhAw nuinbcd CONTRACT DOLLAR AMOUNT ITEM NO. BE ! ? 1Ss i� RV O � For Local Agency to Complete: Local Agency Contract Number. _ edmal Aid Project Number ederal Share.• Contract Award Date: Agency certifies that all information is complete and accurate. tint Name Signature Date Local Agency Representative Area 22d61 Telephone Number Total claimed Participation $� ff [VBrian Mendoza idder 0 4 / 19 / 10 951.710.1000 Date (Area Code) TeL No. Elizabeth McRae ForCaltransiteview: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agway Bidder . UDBE Commitment (Rev 3/09) C Distribution: (1) Copy - Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award mayresult in de -obligation offunds for this project, l (2) Copy -- Include in award package to Caltrans District Local Assistance ^�(3) Original -Local agency files C-21 Page 15-31 LPP 09-xx March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) Black American; 2) Asian Pacific, American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a farm meeting the definition of a DBE as specified in 49 CPR and is one of the following groups: 1. Black American 2. Asian -Pacific American 3. Native American 4. Women The foam requires specific information regarding the construction contract. -Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide it certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of tune to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-0 (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact Local agencies should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate fort within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page15-32 C-22 March 27, 2009 LPP 09-roc Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) ' (inclusive of all D13Es including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE' SWE OF THIS FORM GENCY• City of Huntington Beach LOCAII:Huntington Beach, CA ROJECTDESCRiPTION: Safe Routes to School in Vicinity ofSpring View Middle School TOTAL CONTRACT AMOUNT:�- m DATE: 04/20/10 MOMISNAMR: PTM General Engineering Services, Inc. (DBE) goal is 5.29% (UDBE [Race Conscious]: 3.55% and DBE [Race Neutral]: 1.74%). IM OF WORK AND DESCRHMON OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBE Cart. No. AND EXPIRATION(Must DATE NAME OF DBEs be certified on the date bids =opened - include DBE address and Done number COMACT DOLLAR AMOUNT ITEM NO. gE Q d aOE�r-/o JIF' t9' For Local Agency to Complete: al Agency Contract Number, ederal Aid Project Number: Federal Share: Contract Award Date.• Local Agency certifies that the DBE cortification(s) has been verified and all information is complete and accurate. tint Name Signature Date Agency Representative Area Code Telephone Number Total Claimed Participation $ 99 170 Brian Mendoza Signature of Bidder 4 / 2 0 / 10 951.710.1000 _0 Date (Area Code) Tel. No. Elizabeth McRae For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE Information (Rev 3/09) Distribution: (t) Copy - Fax or scan a copy to the Coltrane District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of cottttaa execution may result in de -obligation of funds for this project (2) Copy - include in award package to Coltrane District Local Assistance (3) Original - Local agency files C-23 Page 15.32a LPP 0,9-xx March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESS BIDDER; The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project —including all UDBEs listed on the UDBE Commitment form (Exhibit I5G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid, There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and ,percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (7f 100% of item �s not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b C-24 March 27, 2009 UP 09-XX Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort E IBiT 15•H UDBE INFORMiATION--GOOD FAITS EFFORTS Safe Routes to School Federal -aid Project Non vicinity of Spring View miadlid Vpen°ngDate 04/20/10 Huntington Beach OC The &LountX o established an Under-utilized Disadvantaged Business Ente ;Crprise (UDBE) goal of * % for this project. The information provided herein shows that a good faith effort was made. *(DBE) goal is 5.29% (UDBE [Race Conscious]: 3.55°s and DBE [Race Neutral]: 1.74%). Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder -- UDBE Commitrnent" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up _ UDBEs lraitiat Methods and Solicited Solicitation Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 18-33 LPP 09-xx C-25 March 4, 2009 C Exhibit 15-H Local Assistance Procedures Manual UIDBE Information - Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of items Amount Percentage Performs Item ($) Of (Y" Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Names, addresses and phone numbers of firm selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Page 15-34 March 4, 2009 C-26 LPP 09-xx Local Assistance Procedures Manual Eabibit 15-H UDRE Information - Good Faith Effort Name of Method/Date Results Ageney/Organization of Contact H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-xx C-27 March 4, 2009 APPENDIX I FEDERAL, & STATE REQUIREMENTS FOR FEDERAL, -AID CONSTUCTION PROJECTS IMPORTANT DISCLAIMER THE ATTACHED WAGE RATES ARE FOR REFERENCE ONLY. THE CONTRACTOR IS SOLELY RESPONSIBLE FOR PAYING THE ACTUAL AND CURRENT WAGES REQUIRED BY THE LAWS APPLICABLE FOR THIS PROJECT Local Assistance Procedures Manual EXWBIT 12-E PS&E Checklist Instructions Attachment A SECTION 14. FEDERAL REQUIREMENTS FOR FEDERAL -AID CONSTRUCTION PROJECTS GENERAL. —The work herein proposed will be financed in whole or in part with Federal funds, and therefore all of the statutes, rules and regulations promulgated by the Federal Gov- ernment and applicable to work financed in whole or in part with Federal funds will apply to such work. The 'Required Contract Provisions, Federal -Aid Construction Contracts, "Form FHWA 1273, are included in this Section 14. Whenever in said required contract provisions references are made to "SHA contracting oiiieer," "SHA resident engineer," or "authorized representative of the SHA," such references shall be construed to mean "Engineer" as defined in Section 1-1.18 ofthe Standard Specifications. _ PERFORMANCE OF PREVIOUS CONTRACT —In ad- dition to the provisions in Section II, "Nondiscrimination," and Section VII, "Subletting or Assigning the Contract," of the re- quired contract provisions, the Contractor shalt comply with the following: The bidder shall execute the CERTIFICATION WITH RE- GARD TO THE PERFORMANCE OF PREVIOUS CON- TRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND TIIE FILING OF REQUIRED REPORTS located in the proposal. No request for subletting or assigning any portion of the contract in excess of $10,000 will be considered under the provisions of Section VII of the required contract provisions unless such request is accompanied by the CERTIFICATION referred to above, executed by the proposed subcontractor. NON -COLLUSION PROVISION. —The provisions in this section are applicable to all contracts except contracts for Federal Aid Secondary projects. Title 23, United States Code, Section 112, requires as a condi- tion precedent to approval by the Federal Highway Administrator of the contract for this work that each bidder file a swom statement executed by, or on behalf of the person, firm, association, or corporation to whom such contract is to be awarded, certifying that such person, firm, association, or corporation has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the submitted bid. A form to make the non -collusion affidavit statement required by Section 112 as a certification under penalty of perjury rather than as a sworn statement as permitted by 28, USC, Sec. 1746, is included in the proposal. PARTICIPATION BY DISADVANTAGED BUSINESS EN- TERPRISES IN SUBCONTRACTING. —Part 26, Title 49, Code of Federal Regulations applies to this Federal -aid project. Pertinent sections of said Code are incorporated in part or in its entirety within other sections of time special provisions. Schedule B--lnformation for Determining Joint Venture Eli- gibility 11.1w] (This form need not be filled in if all joint venture ftrrrts are DBE owned.) 1. Name of joint venture 2. Address of joint venture 3. Phone number of joint venture 4. identify the firms which comprise the joint venture. (The DBE partner must complete Schedule A.) a. Describe the role ofthe DBE firm in the joint venture. b. Describe very briefly the experience and business qualifications of each non -DBE joint venturer. 5. Nature of the joint venture's business 6. Provide a copy of the joint venture agreement. 7. What is the claimed percentage of DBE ownership? — 8. Ownership of joint venture, (This need not be filled in if described in the joint venture agreement, provided by question 6.). Revised 3-95 OW-95 Page 12-65 LPP 01-04 March 15, 2001 ExHmri 12-E Local Assistance Procedures Manual Attachment A PS&E Checklist Instructions a. Profit and loss sharing. b. Capital contributions, including equipment. c. Other applicable ownership interests. 9. Control of and participation in this contract Identify b name, race, sex, and "firm" those individuals (and their titles who are responsible for day-to-day management and policy decision making, including, but not limited to, those with prime responsibility for. a. Financial decisions b. Management decisions, such as: 1. Estimating 2. Marketing and sales 3. hiring and firing of management personnel 4. Purchasing ofmajor items or supplies c. Supervision of field operations Note. --It; after filing this Schedule B and before the comple- tion of the joint venture's work on the contract covered by this regulation, there is any significant change in the information submitted, the joint venture must inform the grantee, either di- rectly or through the prime contractor if the joint venture is a subcontractor. Affidavit "the undersigned swear that the foregoing statements are cor- rect and include all material information necessary to identify and explain the terns and operation of our joint venture and the itttended participation by each joint venturer in the undertaking. Further, the undersigned covenant and agree to provide to grantee current, complete and accurate information regarding ac- tual joint venture work and the payment therefor and any pro- posed changes in any of the joint venture arrangements and to permit the audit and examination of the books, records and files of the joint venture, or those of each joint venturer relevant to the joint venture, by authorized representatives of the grantee or the Federal funding agency. Any material misrepresentation will be grounds for terminating any contract which may be awarded and for initiating action under Federal or State laws concerning false statements." Revised 3-95 0&07 95 ." W Name of Firm . Name of Firm Si.".................................................. .............. .................... ..................... Name ."................................... Name ............................... ...»............... 'title "............ ..................................... Title ..........".".._.............. Date .......................�.. ................ D Date State of County of On this + day of . 19 _ , before me appeared (Name) to me personally known, who, being duty sworn, did execute the foregoing affi- davit, and did state that he or she was properly authorized by (Name of rum) to execute the affidavit and did so as his or her free act and deed. Notary Public Commission expires [seal] Date State of County of On this _,_, day of , 19 _, before me appeared (Name) to me personally known, who, being duly sworn, did execute the foregoing affidavit, and did state that he or she was properly authorized by (Name of firm) to execute the affidavit and did so as his or her free act and deed. Notary Public Commission expires [Seal] I_. LW This form not applicable since PTM is not bidding as a joint venture. Page 12-66 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHMBIT 12-E ME Checklist Instructions Attachment B REQUIRM CONTRACT PROVISIONS 1FEDERA-1,-AIID CONSTRUCTION CONTRACTS (Exclusive of Appalachian Contracts) Page 1. General........................................................ I............. 3 If. Nondiscrimination..................................................... 3 III. Nonsegregated Facilities ..... ..................... ............. 5 IV, Payment ofPredeternuned Minimum Wage .............. 6 V. Statements and Payrolls .................. I.- .... ................... 8 VI. Record of Materials, Supplies, and Labor ................. 9 VIL Subletting or Assigning the Contract ......................... 9 VIII, Safety: Accident Prevention ._ .................................. 10 IX False Statements Concerning Highway Project.......... 10 X. Implementation ofClem Air Act and Federal Water Pollution Control Act ................................................. 10 XI. Certification Regarding Debarment, Suspension, Incligibility, and Voluntary Exclusion ..................... 11 XIL Certification Regarding Use of Contract Funds for Lobbying.................................................................. 12 ATTACHMENTS A. Employment Preference for Appalachian Contracts (included in Appalachian contracts only) IffK 71" 1. These contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 2. Except as otherwise provided for in each section, the con tractor shall insert in each subcontract all of the stipulations contained in these Required Contract Provisions, and further re- quire their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in arty case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. 3. A breach of any of the stipulations contained in these Re- quired Contract Provisions shall be sufficient grounds for temti- nation of the contract. 4. A breach of the following clauses of the Required Contract Provisions may also be grounds for debarment as provided in 29 CFR 5,12: Section I, paragraph 2; Section 1V, paragraphs 1, 2, 3, 4, and 7; Section V, paragraphs I and 2a through 2g. 5. Disputes arising out of the labor standards provisions of Section IV (except paragraph 5) and 'Section V of these Required Contract Provisions shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accor- dance with the procedures of the U.S. Department of Labor (DOL) FR-3 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 DO" or the contractor's employees or their representatives. 6. Selection of (Labor: During the performance of this contract, the contractor shall not: a. discriminate against labor from any other State, possession, or territory of the United States (except for employment preference for Appalachian contracts, when applicable, as specified in Attachment A� or b. employ convict labor for any purpose within the Iimits of the project unless it is labor performed by convicts who are on parole, supervised release, or probation. II. NONDISCRIMINATION (Applicable to all Federal -aid construction conhacts and to all related subcontracts of $10.000 or more.) 1. Equal Employment Opportunity: Equal employment oopppportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, roles, regulations (28 CFR 35, 29 CFR 1630, and 41 CFR 60) and 'orders of the Secretary of Labor as modified by the provisions prescribed herein, and im- posed pursuant to 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The Equal Oppportunity Construction Contract Specifications set forth under 41 CFR 60-4.3 and the provisions of the American Disabilities Act of 1990 (42 U.S.C.12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract. In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO: s. The contractor will work with the State highway agency (SHA) and the Federal Govemrnemt in earring out EEO obli- gations and in their review of his/her activities under the con- tract b. The contractor will accept as his operating policy the following statement: I'll is the policy of this Company to assure that applicants arc employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment upgrading, demotion, or transfer; recruitment or recruitment ad- vertising; layoff or termination; rates of pay or other forms of eompensatton; and selection for training, including apprentice- ship, preapprentieeship, 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 Pam I —Revised 3-95 0847-95 Page i2-67 LPP 09-xx April 10, 2009 F,XETB1T 1-24 Local Assistance Procedures Manual Attachment B PS&E Checklist instructions administering and promoting an active contractor program of EEO and who must be assigned adequate authority and responsibility to do so. 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action, or who are substantially involved in such action, will be made fully cognizant of, and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met; the following actions will be taken as a minimum: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and Its implementation will be re- viewed and explained. The meetings will be conducted by the EEO Officer. b. 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 im- plement such policy will be brought to the attention of em- playees by means of meetings, employee handbooks, or other appropriate means. 4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees the notation: "An Equal Opportunity Employer." All such adver- tisements will be placed in publications having a large circulation among minority groups in the area from which the project work force would normally be derived. a. The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee reftrral 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 EFA contract provisions. (The DOL has held that where implementation of such agreements have the effect of discriminating against minorities or women, or obligates the contractor to do the same, such Implementation violates Executive Order 11246, as amended C. The contractor will encourage his present employees to Form 1273 —Revised 3-95 08-07.95 refer minority group applicants for employment. Information and procedures with regard to referring minority group applicants will be discussed with employees. S. 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 p%jea sites to ensure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage practices. c. The contractor will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is found, the contractor will promptly take corrective action. If the review indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly investigate all complaints of al legcd 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 of led 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 Side regulations, the contractor shall make fWI use of training programs, i.e., apprenticeship, and on-the-job training programs for the ge- ographical area of contract performance. Where feasibie, 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 program and entrance re- quirements for each. d. The contractor will periodically review the training and promotion potential of minority group and women employees and will encourage eligible employees to apply for such training and promotion. FR4 Page 12-68 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EX1iii1BIT 12-E PS&E Checklist Instructions Attachment B 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees; the contractor will use his/her best efforts to obtain the cooperation of such unions to increase opportunities for minority groups and women within the unions, and to effect referrals by such unions of minority and female employees. Actions by the contractor either directly or through a contractor's association acting as agent will include the procedures set forth below: a. The contractor will use best efforts to develop, in coop eration with the unions, joint training programs aimed toward qualifying more minority group members and women for membership in the unions and increasing the skills of minority group employees and women so that they may qualify for higher paying employment. b. The contractor will use best efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. a 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 famish 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 race without regard to , color, religion, sex, national origin, age or disability; malting full efforts to obtain qualiiu d and/or gnai1fiabl0 minority group persons and women. (The DOL has held that it shall be no excuse that the union with which the contractor has a collective bargaining agreement providing for exclusive referral failed to refer minority employees.) In the event the union referral prac- tice prevents the contractor from meeting the obligations pursuant to Executive Order 11246, as amended, and these p Aal provisions, such contractor shall immediately notify the $. 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 CPR 26, shall have equal opportunity to compete for and perform subcontracts which the contractor enters into pursuant to this contract. The contractor will use his best efforts to solicit bids from and to utilize DBE subcontractors or subcontractors with meaningfu) minority group and female representation among their employees. Contractors shall obtain lists of DBE construction firms from SHA personnel. o. The contractor will use his best efforts to ensure subcon- tractor comp] lance 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 au- thorized representatives of the SHA and the FHWA. a. The records kept by the contractor shall document the following: (1)The number of minorit)r and non -minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment op- portunities for minorities and women; (3) The pro4ress 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 meaninglirl 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 member of minority, women, and non -minority group employees currently engaged in each work classification required by the contract work. 'Ibis 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, M NONSEGREGATED FACILnus (Applicable to all Federal -aid construction contracts and to all Mat subcontracts of$10 000 or more.) FR 5 a. By submission of this bid, the execution of this contract or subcontracg or the consummation of this material supply agreement or purchase order, as appropriate. the bidder, Federa]- 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 Sim does not permit Its employees to perform their services at any location, under its control, where segregated facilities arc 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 tern "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms, and other storage or dressing areas, Parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive, or are, in fact, seg- regated on the basis of rase, 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), Forst 1273 — Revised 345 08-07.95 Page 12-69 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment B PS&E Checklist Instructions c. The contractor agrees that it has obtained or will obtain identical certifieatlon 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 rumor collectors, which are exempt.) 1. General: a. All mechanici and laborers employed or working upon the she of the work will be paid unconditionally and not less often than once a week and without subsequent deduction or rebate on any account [ex such payroll deductions as are permitted by regulations (29 M 3)1 issued by the Secretary of Labor under the Copeland. Act (40 U.S.C. 276c) the full amounts of wages and bona fide Ainge benefits (or cash equivalents thereof) due at time of payment. The payment shall be computed at wage rates not less than those contained in the wage determination of the Secretary ofiabor. (hereinafter "the wage determination") which is attached hereto and made a part her+e4 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 m 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 l(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 tirade 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 paid, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage deter- mination for the classification of work actually performed, without regard to skill, except as provided in paragraphs 4 and 5 of this Section 1V, 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 llrth 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. Fonn 1273 — rtevised 3.95 09-07-9$ FR-6 2. Classification: a The SHA contracting officer shall require that any class of laborers or mechanics employed under the contract, which is not listed in the wage determination, shall be classified in conformance with the wage determination. b. The contracting officer shall approve an additional classification, wage rate and fringe benefits only when the following criteria have been met: (1) the work to be performed by the additional classifi- cation requested is not performed by a classification in the wage determination; (2) the additional classification is utilized in the area by the construction industry; (3) the roposed wage rate, including any bona fide fringe benefits, bears a reasonable relationshi to the wage rates contained in the wage detem nation; and p (4) with respect to helpers, when such a classification prevails in the area in which the work Is performed. c. If the contractor or subcontractors, as appropriate, the laborers and mechanics (if known) to be employed in the addi- tional classification or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the DOL, Administrator of the Wage and Hour Division, Employment Standards Administration, Washington, D.C. 20210. The Wage and Hour Administrator, or an authorized representative, wilt approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. d. In the event the contractor or subcontractors, as appro- priate, the laborers or mechanics to be employed in the addi- tional classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested - parties and the recommendation of the contracting officer, to the Wage and Hour Administrator far determination. Said Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary e. The wage rate (including fringe benefits where appropriate) determined pursuant to paragraph 2c or 2d of this Section IV shall be paid to all workers performing work in the additional classification from the first day on which work is performed in the classification. 3. Payment of Fringe Benefits: a. Whenever the minimum wage rate prescribed in the con- tract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor or subcontractors, as appropriate, shall either pay the benefit Page 12-70 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXI MIT 12-B ME Checklist Instructions Attachment B as stated in the wage determination or shall pay another bona fide finge 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 amourrt 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. IDOL) and Helpers: a. Apprentices: (!)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 Nona fide apprenticeship program registered with the DOL, Employment and IF iriing 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 ap , tice in such an apprenticeship program, who is not in vidually registered in the program, but who has been certified by the Bureau of Apprenticeship and Training or a State apprenticeship agency (where appropriate) to Mole for probationary employment as an apprentice. (2) The allowable ratio of apprentices to )OUrneyman-level employees on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any employee listed on apw u 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 joumeyrnan-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 fail 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. FR 7 (4) In the event the Bureau of Apprenticeship and Training, or a State apprenticeship agency recognized by the Bureau, withdraws approval of an apprenticedtip program, the contractor or subcontractor will no longer be permitted to udilm 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 rrccived 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 sball be paid not less than the applicable wage rate on the wage determination for the work actually performed. (3� Ever} 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 hinge benefits, trainees shall bepaid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman -level wage rate on the wage determination which provides for less than fail fringe benefits for apprentices, in which case such trainees shall re- ceive the same fringe benefits as apprentices. (4) In the event the Employment and Training Adminis- tration withdraws approval of a training program, the con- tractor or subcontractor w1I no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. e. Helpers: Helpers will be permitted to work on a project if the helper classification is specified and defined on the applicable wage determination or is approved pursuant to the conformance procedure set forth in Section iV.2. Any worker listed on a payroll at a helper wage rate, who is not a helper under an approved definition, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. Fort 1273 — Revisal 3.95 OW 95 Page 12-71 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment B PS&E Checklist Instructions 5. Apprentices and Trainees (Programs of the U.S. DOT): Apprentices and trainees working under apprenticeship and skill training programs which have been cctdfiled 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 e rates for apprentices and trainees under such programs wile 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 regwrements 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, inctudlnl 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, mechani% watchmai>s or guard in any workweek In which he/she is employed on such wod; to work in excess of 40 hours in such workweeks unless such laborer, mechanic, watchman, or guard receives compensation at a rate not less than one•and-one-half times hastier basic rate of pay for all hours worked in excess of 40 hours in such workweek. 8. Violation: Liability for Unpaid Wages; Liquidated Damages: In the event of any violation of the clause set forth In paragraph 7 above. the contractor and any subcontractorresponsible 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 we week of 40 hours without payment of the overtime wages required by the clause set forth in paragraph 7. F=1273—Revised 3-95 08-0795 9. Withholding for Unpaid Wages and Liquidated Damages: The SHA shall upon its own action or upon written request of any authorized representative of the DOL withhold, or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph 8 above. STATEMENTS AND PAYROLLS (Applicable to all Federal -aid construction contracts exceeding $2,000 and to all related subcontracts, ex t 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: FR 8 a. Payrolls and basic records relating thereto shall be maintained by the contractor and each subcontractor during the course of the work and preserved for a period of 3 years from the date of completion of the contract for all laborers, mechanics, apprentices, trainees, watchmen, helpers, and guards working at the site of the work. b. The payroll records shall contain the name, social security number, and address of each such employee; his or her correct classification; hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalent thereof the types described in Section I(bx2)(B) of the Davis Bacon Act); daily and weekly number o€� hours worked; deductions made; and actual wages paid. In addition, for Appalachian contracts, the payroll records shall contain a notation indicating whether the employee does, or does not normally reside in the labor area as defined in Attachment A, Para graph 1. Whenever the Secretary of Labor, pursuant to Sec- t►on , paragraph 3b, has found that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in Section 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 aftted, 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. Page 12-72 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXMBff 12-E PS&E Checklist Instructions Attachment B c. Each contractor and subcontractor shall famish, each week in which any contract work is performed, to this SHA resident engineer it payroll of wages paid each of its employees (including apprentices, trainees, and helpers, described in Section fir, paragraphs 4 and 5, and watchmen and guards en- gaged on work during the preceding weekly payroll perlod). 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.G 20402. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. d. Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or sub- contractor or his/her agent who pays or supervises the payment Of the persons employed under the contract and shall certify the foilowmg: (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 fulTwages earned, other than permissible deductions as set forth in the Regulations, 29 CFR 3; (3) that each laborer or mechanic has been paid not less that the applicable wage rate and fringe benefits or cash equivalent for the classification of worked performed, as specified in the applicable wage determination Incorporated into the contract. e. The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 2d of this Section V. f: The falsification of any of the above certifications may subject the contractor to civil or criminal prosecution under 18 U.S.C.1001 and 31 U.S.C. 231. g. The contractor or subcontractor shall make the records re- quired under paragraph 2b of this Section V available for in- spection, copying, or transcription by authoriwd representatives of the SHA, the FHWA, or the DOL, and shall permit such representatives to interview employees during worsting hours on the job. If the contractor or subcontractor fails to submit the re- quired records or to make them available, the SHA, the FHWA, the DOL, or all may, after written notice to the contractor, sponsor, applicant, or -owner, take such actions as may be nec- essary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may he grounds for debarment action pursuant to 29 CFR 5.12. VL RECORD OF MATERIALS, SUPPLIES, AND )LABOR L On all Federal-ald 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 anif 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. Famish, upon the completion of the contract, to the SHA resident engineer on Form FHWA 47 together with the data required in paragraph lb relative to materials and supplies, a final labor summary of all contract work indicating the total hours worked and rite total amount earned. 2. At the prima contractor's option, either a single report covering all contract work or separate reports for the contractor and for each subcontract Shall be submitted. VIL SUBLETTING OR ASSIGNING THE CONTRACT 1. The contractor shall perform with its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the State. Specialty items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractor's own organization (23 CFR 635). a. "Its own organization" shall be construed to include only workers employed and paid directly by the prime contractor and equipment owned or rented by the prime contractor, with or without operators. Such term does not include employees or equipment of a subcontractor, assignee, or agent of the prime contractor. FR 9 b. "Specialty Items" shall be construed to be limited to work that requires highly specialized knowledge, abilities,or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid on the contract as a whole and in general are to be limited to minor components of the overall contract. Form 1273 — Revised 3-95 0"7-95 Page 12-73 LPP 08-04 December 31, 2008 EXHIBIT 12-E Local Assistance Procedures Manual Attachment B PS&E Checklist Instructions 2. The contract amount upon which the requirements set forth In garding the seriousness of these and similar acts, the following paragraph I of Section VII is computed includes the cost of notice shall be posted an each Federal -aid highway project (23 material and manufactured products which are to be purchased or CFR 635) in one or more places where it is readily available to all produced by the contractor under the contract provisions. persons concerned with the project: 3. The contractor shall fivaish (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 far the fulfillment of the contract. Written consent wrl1 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. VUI. SAFETY: ACCIDENT PREVENTION 1.In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the SHA contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. 2. It is a condition of this contract, and shall be made a con- dition of each subcontrac k which the contractor enters into pur- suant to this contact, that the contractor and any subcontractor shall not peamit 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 nSht 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 catry out the duties of the Secretary under Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 333). IM FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS In order to assure high quality and durable consttuctim in conformity with approved plans and specifications and a hi degree of reliability an statements and representations made ley engineers, contractors, suppliers, and workers on Federal -aid highway projects, it Is essential that all persons concerned with the projectperform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or mis- representation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding re - Form im—Rmised3-95 08-07 95 NOTICE TO ALL PERSONNEL ENGAGED ON FEDERAL-AxD HIGHWAY PROJECTS 18 U.S.C.1020 reads as follows: "Whoever being an oO�eicer, agent, or employee of the United States or any State or f'erritory, or whoever, whether a person, assoctah'on, 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 cast thereof in connection with the submission ofppllaans, maps specifications, contracts, or costs of construction on arty highway or related project submitted for approval to the Secretary of Transportation. or Whoever knowingly makes any false statement false repre- sentation, false report or false claim with respect to the character, quality, quantity, or cost of any work performed or to be per - famed, or materials furnlsiied or to be furnished in connection with the construction of any highway or related project approved by the Secretary of Transportation; or Whoever knowingly makes any false statement or false repre- sentation as to material fact in any statement, certi icate, or report submitted psanant to provisions of the Federal -aid Roads Act approved July 4 1916, (39 Slat. 355), as amended and sup- plemented Shall be fined not more that $10,000 or imprisoned not more than S years or both.' X. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT (Applicable to all Federal -aid construction contracts and to all related subcontracts of$100,000 or more.) By submission of this bid or the execution of this contract, or subcontract, as appropriate, the bidder, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows; 1. That any facility that is or will be utilized in the performance Of this contract, unless such contract is exempt under the Clean Air Act, as amended (42 U.S.C. 1857 et seq., as amended by Pub. L. 91-604), and under the Federal Water Pollution Control Act, as amended (33 U.S.C.1251 et seq., as amended by Pub. L. 92.500), Executive Order 11738, and regulations in implementation thereof (40 CFR IS) is not listed, on the date of contract award, on the U.S. Environmental Protection Agency (EPA) List of Violating Facilities pursuant to 40 CFR 15 20. 2. That the firm agrees to comply and remain in compliance with all the requirements of Section 114 of the Clean Air Act and Section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. 3. That the firm shall promptly notify the SHA of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility that is or will be utilized FR 10 Page 12-74 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attacbment R 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 to take such action as the government may direct as a means of enforcing such re- quirements. XL CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION 1. lustructions 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 wilt 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 die 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 primmy participant shall provide im- mediate written notice to the department or agency to whom this proposal is submitted if any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by 'reason of changed circumstances. e. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," „proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is submitted for assistance in obtaining a copy ofthose regulations. f. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. Fit-11 g. The prospective prlmwy participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. h. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it [mows that the certification is erroneous. A participant may decide the method and frequency by which it determines the el- igibility of its principals. Each participant may, but is not required to, check the nonprocurement portion of the "Lists of Parties Excluded From Federal Procurement or Nonprocurement Programs" (Nonprocurement List) which is compiled by the General Services Administration. 1. 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 ofbusiness dealings. J. Except for transactions authorized under paragraph f of these instructions, if apartcipant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from pudoi ation in this transaction, in addition to other remedies available to the Federal GovernmeM the de- partment or agency may terminate this transaction for cause or default_ d kti*k Certifrcaden Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; b. have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated In paragraph lb of this certification; and Form 1273 — Revised "S 08-07.95 Page 17,75 LPP 01-04 March IS, 2001 EXEI[BIT 12-E Local Assistance Procedures Manual Attachment B PS&E Checklist Instructions d. Have not within a 3-year period preceding this sp- plfcation/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Covered Transactions: (Applicable to all subcontracts, purchase orders and other lower tier transactions of $25,000 or more - 49 CPR 29) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant leanis 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 Orft 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a ropy of those regulations. e. The prospective lower tier participant agrees by submitting this proposal drat, 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 tided Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in- ail lower der covered transactions and in all solicitations for lower der covered transactions. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, Ineligible, or voluntarily excluded from the covered transaction, unless It knows that the certification Is erroneous. A participant may decide the method and frequency by which it determines the el- igibility of its principals. Each participant may, but is not required to, check the Nonproauement List. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and Information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph a of these instructions, If a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the de- partment or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment Certification RegardingDebarment, Suspension, ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions 1. The ve lower tier participant certifies, by submission off its •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 Iower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Proposal. a###� 2M 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 si ing and submittin 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 sny Federal contract, the making of any Federal grant, the making of any Federal loan, tie 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 d to any person for influencing or attempting to Influence an of�cer 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, Form 1273 —Revised 3 95 08.07-95 FR-12 Page 12-76 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment B grant, loan, or cooperative agreement, the undersigned shall be su§ject to a civil penalty of not less than $10,000 and not more complete and submit Standard Form-LU , "Disclosure Form to than $100,000 for each such failure. Report Lobbying," in accordance with its instructions 3. The prospective participant also agrees by submitting his or 2. This certification is a material representation of fact upon her bid or proposal that he or she shall require that the language of which reliance was placed when this transaction was made or en- this certification be included in all lower tier subcontracts; which Wed imo. Submission of this certification is a prerequisite for exceed $100,000 and that all such recipients shall certify and making or entering Into this transaction Imposed by 31 U.S.C. disclose accordingly. 1352. Any person who fails to file the required certification shall FEDERAL -AID FEMALE AND MINORITY GOALS In accordance with Section II, "Nondiscrimination," of 177 Sacramento, CA: "Required Contract Provisions Federal -aid Construction Contracts" the following are the goals for female utilization: SMSA Counties: Goal for Women (applies nationwide)..............(percent) ......... 6.9 Tlc following am goals for minority utilization-. CALIFORNIA ECONOMIC AREA 174 Redding, CA: Non-SMSA Counties .............. CA Lassen; CA Modoo; CA Plumes; CA Shasta; CA Siskiyou; CA Tehama. 175 Eureka, CA: Non-SMSA Counties .................................... CA Del Norte; CA Humboldt; CA Trinity. 176 San Francisco -Oakland -San lose, CA: SMSA Counties: 7120 Salinas-Seadde- Monterey, CA ........................................... CA Monterey. 7360 San Ytancisco-Oakland, CA ................. CA. Alameda; CA Contra Costa; CA Merin; CA San Francisco; CA San Mateo, 7400 San lose, CA ........................................ CA Santa Clara. 7485 Santa Cruz, CA ..................................... CA Santa Cruz 7500 Santa Rosa, CA .................................... CA Sonoma, 9720 Valtejo-Fairfield- Napa, CA ................. CA Napa; CA Solano Non-SMSA Counties ........................................ CA Lake; CA Mendocino; CA San Benito. Goal (Percent) 6920 Sacramento, CA. ................................. 16.1 CA Placer; CA Sacramento; CA Yolo. Non-SMSA Counties ........................................ .14.3 CA Butto; CA Colusa; CA El Dorado; CA Glenn; CA Nevada; CA Sierra; CA Sumer; CA Yuba. 178 Stockton -Modesto, CA: SMSA Counties: 6.8 5170 Modesto, CA ....................................... 12.3 CA Stanislaus. 8120 Stockton, CA ...................................... 24.3 CA San Joaquin. Non-SMSA Counties ............................ ........... 19.9 CA Alpine; CA Amador, 6.6 CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne. 179 Fresno-Bakersficid, CA: SMSA Counties: 0680 Bakersfield, CA ................................... 19.1 CA Kern. - 28.9 2840 Fresno, CA ........................................ 26.1 CA Fresno. 25.6 Non-SMSA Counties ........................................ 23.6 CA -Y{ings- CA Madera; CA Tulare. 19.6 180 Los Angeles CA: 14.9 SMSA Counties 0360 Anaheim -Santa Ana -Garden 9.l Grove-, , C................................................ 11.9 CA Orange. 4480 Los Angeles -Long 17. i Beach, CA ... ........................................ 28.3 CA Los Angeles, 6000 Oxnard -Simi Valley- 23.2 Ventura, CA .............................................. 21.5 CA Ventura. FR.-13 Form 1273—Revised 3-IS 08-07-95 Page 12-77 LPP 09-xx April 10, 2009 EXHIBIT 12•E ]Local Assistance Procedures Manual Attachment B PUE Checklist Instructions 6780 Riverside -San Bernardino- Ontario, CA.' * ........ ...... A............................................... 19.0 CA Riverside; CA San Bemardino. 7480 Santa BarbamSanta Maria. Lompoc, CA ................................... 19.7 CA Santa Barbara Non-SMSA Counties ........................................ 24.6 CA Inyo; CA Mono; j CA San Luis Obispo. 181 San Diego, CA: SMSA Counties 7320 San Diego, CA .................................... 16.9 j CA San Diego. i Non-SMSA Counties ........................................ 18.2 CA Imperial. In addition to the reporting requirements set forth elsewhere in this contract the Contractor and subcontractors holding subcontracts, not including material suppliers, of $10,000 or more, shall submit for every month of July during which work is perfomrcd, employment data as contained under Form FHWA PR 1391(Appendix C to 23 CFR, Part 230), and in accordance with the instructions included thereon. Fo m 1273— Revised 3-95 OW-95 FR 14 Page 1248 April 10, 2009 UP 09-XX Local Assistance Procedures Manual EXWBIT ME PS&E Checklist Instructions Attachment H SECTION 2. ]PROPOSAL REQUIREMENTS AND CONDITIONS 2-1.04 GENERAL The bidder's attention is directed to the provisions in Section 2, "Proposal Requirements and Conditions," of the Standard Specifications and these special provisions for the requirements and conditions which the bidder must observe in the preparation of and the submission of the bid. The bidder's bond shall conform to the bond form in the Bid book for the project and shall be properly filled out and executed. The bidder's bond form included in that book may be used. In conformance with Public Contract Code Section 7106, a Noncollusion Affidavit is included in the Bid book. Signing the Bid book shall also constitute signature of the Noncollusion Affidavit. The contractor, sub recipient or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of Title 49 CFR (Code of Federal Regulations) part 26 in the award and administration.of US DOT assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as the recipient deems appropriate. Each subcontract signed by the bidder must include this assurance. Failure of the bidder to fulfill the requirements of the Special Provisions for submittals required to be furnished after bid opening, including but not limited to escrowed bid documents, where applicable, may subject the bidder to a determination of the bidder's responsibility in the event it is the apparent low bidder on a future public works contracts. (Use this Section for projects with Federal funds over $100,000) 2-1.015--FE DERAL LOBBYING RESTRICTIONS. —Section 1352, Title 31, United States Code prohibits Federal fiords from being expended by the recipient or any lower tier sub recipient of a Federal -aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal -aid contract, the making of any Federal grant or loan, or the entering into of any cooperafive agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal -aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal -aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Bid book. Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Bid book. 'Signing the Bid book shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower -tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower -tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower -tier contractors. An event that materially affects the accuracy of the information reported includes: (1) A cumulative increase if $25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or (2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or (3) A change in the offcer(s), emptoyees(s), or Member(s) contacted to influence or attempt to influence it covered Federal Action. Page 12-91 LPP 09-Oxx April 14, 2009 EXHIBIT 12-E Local Assistance Procedures Manual Attachment H PS&E Checklist Instructions 2-1.02 DISADVANTAGED BUSINESS ENTERPRISE (DBE). —This project is subject to Title 49 CFR 26.13(b): The contractor, sub recipient or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR part 26 in the award and administration of DOT-assist6d contracts. Failure by the contractor to carry out these -requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy as the recipient deems appropriate. Take necessary and reasonable steps to ensure that DBEs have opportunity to participate in the contract (49 CFR 26). To ensure there is equal participation of the DBE groups specified in 49 CFR 26.5, the Agency specifies a goal for Underutilized Disadvantaged Business Enterprises (IJDBEs). UDBE is a firm that meets the definition of DBE and is a member of one of the following groups: 1. Black Americans 2. Native Americans 3. Asian -Pacific Americans 4. Women References to DBEs include UDBEs, but references to UDBEs do not include all DBEs. Make work available to UDBEs and select_ work parts consistent with available UDBE subcontractors and suppliers. Meet the UDBE goal shown in the Notice to Bidders or demonstrate that you made adequate good faith efforts to meet this goal. It is your responsibility to verify that the UDBE firm is certified as DBE at date of bid opening. For a list of DBEs certified by the California Unified Certification Program, go to: bttp://www.dot.mgovAiq/bep/fin4_certified.htm Only UDBE participation will count towards the UDBE goal. DBE participation will count towards the Agency's Annual Anticipated DBE Participation Level and the California statewide goal, Credit for materials or supplies you purchase- from UDBEs counts towards the goal in the following manner. 1. 100 percent counts if the materials or supplies are obtained from a UDBE manufacturer. 2. 60 percent counts if the materials or supplies arc obtained from a UDBE regular dealer. 3. Only fees, commissions, and charges for assistance In the procurement and delivery of materials or supplies count if obtained from a UDBE that is neither a manufacturer or regular dealer. 49 CFR 26.55 defines "manufacturer" and "regular dealer." You receive credit towards the goal if you employ a UDBE trucking company that performs a commercially useful function as defined in 49 CFR 26.55. UDBE Commitment Submittal Submit UDBE information on the "Local Agency Bidder-UDBE Commitment (Construction Contracts)," Exhibit 15-G(1), form included in the Bid book. If the forth is not submitted with the bid, remove the form from the Bid book before submitting your bid. Page 12-92 April 14, 2009 LPP 0-xx Local Assistance Procedures Manual EXHUIT 12-E PS&E Checklist Instructions Attachment H If the UDBE Commitment form is not submitted with the bid, the apparent low bidder, the 2nd low bidder, and the 3rd low bidder must complete and submit the UDBE Commitment form to the Agency. UDBE Commitment form must be received by the Agency no later than 4:00 pm. on the 4th business day after bid opening. Other bidders do not need to submit the UDBE Commitment form unless the Agency requests it. If the Agency requests you to submit a UDBE Commitment form, submit the completed form within 4 business days of the request. Submit written confirmation from each UDBE stating that it is participating in the contract. Include confirmation with the UDBE Commitment form. A copy of a UDBEs quote will serve as written confirmation that the UDBE is participating in the contract. If you do not submit the UD13E Commitment form within the specified time, the Agency finds your bid nonresponsive. Good Faith Efforts Submittal If you have not met the UDBE goal, complete and submit the "UDBE Information - Good Faith Efforts," Exhibit 15-II, form with the bid showing that you made adequate good faith efforts to meet the goal. Only good faith efforts directed towards obtaining participation by UDBEs will be considered. If good faith efforts documentation is not submitted with the bid, it must be received by the Agency no later than 4:00 p.m. on the 4th business day after bid opening. If your UDBE Commitment form shows that you have met the UDBE goal or if you are required to submit the UDBE Commitment form, you must also submit good faith efforts documentation within the specified time to protect your eligibility for award of the contract in the event the Agency finds that the UDBE goal has not been met. Good faith efforts documentation must include the following information and supporting documents, as necessary: l . Items of work you have made available to UDBE firms. Identify those items of work you might otherwise perform with its own forces and those items that have been broken down into economically feasible units to facilitate 1UI7BE participation. For each item listed, show the dollar value and percentage of the total contract. It is your responsibility to demonstrate that sufficient work to meet the goal was made available to UDBE firms. 2. Names of certified UDBEs and dates on which they were solicited to bid on the project. Include the items of work offered. Describe the methods used for following up initial solicitations to determine with certainty if the UDBBs were interested, and the dates ofthe follow-up. Attach supporting documents such as copies of letters, memos, facsimiles sent, telephone logs, telephone billing statements, and other evidence of solicitation. You are reminded to solicit certified UDBEs through all reasonable and available means and provide sufficient time to allow UDBEs to respond. 3. Name of selected firm and its status as a UDBE for each item of work made available. include name, address, and telephone number of each UDBE that provided a quote and their price quote. If the firm selected for the item is not a UDBE, provide the reasons for the selection. 4. Name and date of each publication in which you requested UDBE participation for the project. Attach copies of the published advertisements. S. Names of agencies and dates on which they were contacted to provide assistance in contacting, recruiting, and using UDBE firms. If the agencies were contacted in writing, provide copies of supporting documents. b. List of efforts made to provide interested UDBEs with adequate information about the plans, specifications, and requirements of the contract to assist them in responding to a solicitation. If you have provided information, identify the name of the UDBE assisted, the nature of the information provided, and date of contact. Provide copies of supporting documents, as appropriate. Page 12.93 ]LPP 09-Oxx April 14, 2009 EXHIBIT 12-E Local Assistance Procedures Manual Attachment H PS&E Checklist Instructions 7. List of efforts made to assist interested UDBEs in obtaining bonding, lines of credit, insurance, necessary equipment, supplies, and materials, excluding supplies and equipment that the UDBE subcontractor purchases or leases from the prune contractor or its affiliate. If such assistance is provided by you, identify the name ofthe UDBE assisted, nature of the assistance offered, and date. Provide copies of supporting documents, as appropriate. S. Any additional data to support demonstration of good faith efforts. Page 12-94 ... . April I4, 2009 LPP 09-xx Local Assistance Procedures Manual KXKfflrr 12-E PS&E Checklist Instructions Attachment I SECTION 3. AWARD AND EXECUTION OF CONTRACT The bidder's attention is directed to the provisions in Section 3, "Award and Execution of Contract," of the Standard Specifications and these special provisions for the requirements and conditions concerning award and execution of contract. The award of the contract, if it be awarded, will be to the lowest responsible bidder whose bid complies with all the requirements prescribed. The contract shall be executed by the successful bidder and shall be returned, together with the contract bonds, to the Agency so that it is received within 10 days, not including Saturdays, Sundays and legal holidays, after the bidder has received the contract for execution. Failure to do so shad be just cause for forfeiture of the proposal guaranty. The executed contract documents shall be delivered to the following address: (Agency to provide detailed information if this paragraph is used) A "Local Agency Bidder -DBE information (Construction Contracts), Exhibit 15-0(2)" form is included in the - Bid book to be executed by the successful bidder. The purpose of the form is to collect data required under 49 CFR 26. Even if no DBE participation will be reported, the successful bidder must execute and return the form. The successful bidder's "Local Agency Bidder- Information (Construction Contracts), Exhibit 15-G(2)" form should include the names, addresses and phone numbers of DBE firms that will participate, with a complete description of work or supplies to be provided by each, and the dollar value of each DBE transaction. When 100 percent of a contract item of work is not to be performed or furnished by a DBE, a description of the exact portion of that work to be performed or furnished by that DBE should be included in the DBE information, including the planned location of that work. A successful bidder certified as a DBE should describe the work it has committed to performing with its own forces as well as any other work that it has committed to be performed by DBE subcontractors, suppliers and trucking companies. The successful bidder is encouraged to provide written confirmation from each DBE that the DBE is participating in the contract. A copy of a DBE's quote will serve as written confirmation that the DBE is participating in the contract. If a DBE is participating as a joint venture partner, the successful bidder is encouraged to submit a copy of the joint venture agreement. The "Local Agency Bidder -DBE Information (Construction Contracts), Exhibit 15-G(2)" form shall be completed and returned to the Agency by the successful bidder with the executed contract and contract bonds. SECTION 4. BEGINNING OF WOM TIME OF COMPLETION AND L2<Q>(I DATED )DAMAGES Attention is directed to the provisions in Section 8-1.03, "Beginning of Work," in Section 8-1.06, "Tune of Completion," and in Section 8-1.07, "Liquidated Damages," of the Standard Specifications and these special provisions. The Contractor shall begin work within _ calendar days after the contract has been approved by the City/County ofiuntinaton Beach/OC 40 This work shall be diligently prosecuted to completion before the expiration of WORKING DAYS beginning on the _ calendar day after approval of the contract. (INSERT AMOUNT or LIQUIDATE) DAMAGES) Huntington Beach/OC 500.00 The Contractor shall pay to the City/County of the sum of $ per day, for each and every calendar day's delay in finishing the work in excess of the number of working days prescribed above. Page 12-95 LPP 09-xx April 10, 2009 XEIIBIT 12-E Local Assistance Procedures -Manual Attachment X PS&E Checklist Instrnctlons LIQUIDATED DAMAGES TABLE (L%) (OPTIONAL FOR,NON-NITS PROJECTS) Project Estimate Project pe Resurfacing*/Rehab New Highway Realignment/ Widening Landscaping Soundwall Others Over $30 million 10 % 10 % 13% 15% 15% 15% $10million to $30 million 10% 12% 15% 15% 15% 15% $5 million to $10 million 10 % 15 % $750k to $5 million 15% 15% 15% 18 % 18 % 15 % Less Than $750k 15% 20 % 20 % 18 % 20 % 15 * Resurfacing projects include AC Surfacing, seal coats, slurry seals, and so on. The calculated liquidated damages should be rounded up in $100 increments to determine the amount to be specified. Page 12-96 April 10, 2009 LPP 09-xx Local Assistance Procedures Manual EXMIT 12-E FS&E Checklist Instructions Attachment J l 5-1 . SUBCONTRACTOR AND DBE RECORDS The Contractor shall maintain records showing the name and business address of each first tier subcontractor. The records shall also show the name and business address of every DBE subcontractor, DBE vendor of materials and DBE trucking company, regardless of tier. The records shall show the date of payment and the total dollar figure paid to all of these firms. DBE prime contractors shall also show the date of work performed by their own forces along with the corresponding dollar value of the work. Upon completion of the contract, a summary of these records shall be prepared on "Final Report -- Utilization of Disadvantaged Business Enterprises - (DBE), First Tier Subcontractors" (Exhibit 17-F/Form CEM 2402) and certified correct by the Contractor or his authorized representative, and shall be furnished to the Engineer. The form shall be furnished to the Engineer within 90 days from the date of contract acceptance. The amount of $10,000 will be withheld from payment until a satisfactory form is submitted. Prior to the fifteenth of each month, the Contractor shall submit documentation to the Engineer showing the amount paid to DBE trucking companies. The Contractor shall also obtain and submit documentation to the Engineer showing the amount paid by DBE trucking companies to all firms, including owner -operators, for the leasing of trucks. If the DBE leases trucks from a non -DBE, the Contactor may count only the fee or commission the DBE receives as a result of the lease arrangement. The Contractor shall also obtain and submit documentation to the Engineer showing the truck number, owner's name, California Highway Patrol CA number, and if applicable, the DBE certification number of the owner of the truck for all trucks used during that month. This documentation shall be submitted on "Monthly DBE Trucking Verification" Form CEM-2404(F). 5-1. DBE CERTMCATION STATUS If a DBE subcontractor is decertified during the life of the project, the decertified subcontractor shall notify the Contractor in writing with the date of decertification. If a subcontractor becomes a certified DBE during the life of the project, the subcontractor shall notify the Contractor in writing with the date of certification. The Contractor shall famish the written documentation to the Engineer. Upon completion of the contract, "Disadvantaged Business Enterprises (DBE) Certification Status Change" Form CEM-2403(F) indicating the DBEs existing certification status shall be signed and certified correct by the Contractor. The certified form shall be furnished to the Engineer within 90 days from the date of contract acceptance, Page 12-97 LIT 09-xx April 10, 2009 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment K 5-1., , - PERFORMANCE OF SUBCONTRACTORS The subcontractors listed by you in Bid book shall list therein the name and address of each subcontractor to whom the bidder proposes to subcontract portions of the work in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, in accordance with the Subletting and Subcontracting Fair Practices Act, commencing with Section 4100 of the Public Contract Code. The bidder's attention is invited to outer provisions of the Act related to the imposition of penalties for a failure to observe its provisions by using unauthorized subcontractors or by making unauthorized substitutions. UDBEs must perform work or supply materials as listed in the `q ocal Agency Bidder - UDBE Commitment' form specified under Section 2, "Bidding," of these special provisions. Do not terminate a UDBE listed subcontractor for convenience and perform the work with your own forces or obtain materials from other sources without prior written authorization from the Agency. The Agency grants authorization to use other forces or sources of materials for requests that show any of the following justifications: 1. Listed UDBE fails or refuses to execute a written contract based on plans and specifications for the project. 2. You stipulate a bond is a condition of executing the subcontract and the listed UDBE fails to meet your bond requirements. 3. Work requires a contractors license and listed UDBE does not have a valid license under Contractors License Law. 4. Listed UDBE fails or refuses to perform the work or furnish the listed materials. 5. Listed UDBVs work is unsatisfactory and not in compliance with the contract. 6. Listed UDBE delays or disrupts the progress of the work, 7. Listed UDBE becomes bankrupt or insolvent. If a listed UDBE subcontractor is terminated, you must make good faith efforts to find another UDBE subcontractor to substitute for the original UDBE. The substitute UDBE must perform at least the same amount of work as the original UDBE under the contract to the extent needed to meet the UDBE goal. The substitute UDBE must be certified as a DBE at the time of request for substitution. The Agency does not pay for work or material unless it is performed or supplied by the listed UDBE, unless the UDBE is terminated in accordance with this section. Page 12-99 LPP 09-XX April 10, 2009 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment L 5-1. SUBCONTRACTING No subcontract releases the Contractor from the contract or relieves the Contractor of their responsibility for a subcontractor`s work. If the Contractor violates Pub Cont Code § 4100 et seq., the City/County of * may exercise the remedies provided under Pub Cont Code § 4110. The City/County of * may refer the violation to the Contractors State License Board as provided under Pub Cont Code § 4111. The Contractor shall perform work equaling at least 30 percent of the value of the original total bid with the Contractor's own employees and equipment, owned or rented, with or without operators. Each subcontract must comply with the contract. Each subcontractor must have an active and valid State contractor's license with a classification appropriate for the work to be performed (Bus & Prof Code, § 7000 et seq.). Submit copies of subcontracts upon request by the Engineer. Before subcontracted work starts, submit a Subcontracting Request form. Do not use a debarred contractor, a current list of debarred contractors is available at the Department of Industrial Relations' Web site. Upon request by the Engineer, immediately remove and not again use a subcontractor who fails to prosecute the work satisfactorily. Each subcontract and any lower tier subcontract that may in turn be made shall include the "Required Contract Provisions Federal -Aid Construction Contracts" in Section 14 of these special provisions. Noncompliance shall be corrected. Payment for subcontracted work involved will be withheld from progress payments due, or to become due, until correction is made. Failure to comply may result in termination of the contract. 5.1. PROMPT PROGRESS PAYMENT TO SUBCONTRACTORS A prime contractor or subcontractor shall pay any subcontractor not later than 10 days of receipt of each progress payment in accordance with the provision in Section 7108.5 of the California Business and Professions Code concerning prompt payment to subcontractors. The 10 days is applicable unless a longer period is agreed to in writing. Any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of Section 7108.5 shall subject the violating contractor or subcontractor to the penalties, sanction and other remedies of that section. This requirement shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the contractor or subcontractor in the event of it dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance, or noncompliance by a subcontractor. 5-1._ PROMPT PAYMENT OF FUNDS WITMULD TO SUBCONTRACTORS (The local agency must include one of the following three provisions (if using Caltrans Standard Specification, modify or delete paragraphs 9-1.06 and 9-1,065) to ensure prompt and full payment of any retainage from the prime contractor, or subcontractor, to a subcontractor. (EITHER) No retainage will be withheld by the agency from progress payments due the prime contractor. Retainage by the prime contractor or subcontractors is prohibited and no retainage will be held by the prime contractor from progress due subcontractors. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the California Business and Professions Code. This requirement shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime Contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor or deficient subcontract performance, or noncompliance by a subcontractor. (OR) No retainage will be held by the agency from progress payments due the prime contractor. Any retainage held by the prime contractors or subcontractors from progress payments due subcontractors shall be promptly paid in full to subcontractors within 30 days after the subcontractor's work is satisfactorily completed. Federal law (49CFR26.29) requires that any delay or postponement of payment over the 30 days may take place only for good cause and with the agency's prior written Page 12-101 LPP 09-xx April 15, 2009 *Huntington Beach/OC EXIT 12-E Local Assistance Procedures Manuel Attachment L ' PS&E Checklist Instructions approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime Contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance, or noncompliance by a subcontractor. (OR) The agency shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the agency, of the contract work, and pay retainage to the prime contractor based on these acceptances. The prime contractor, or subcontractor, shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49CFR2&29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance, or noncompliance by a subcontractor. Page 12-102 May 1, 2006 UP 06-01 Local Assistance Procedures Manual 'EXHIBIT 12-E PS&E Checklist Instructions Attachment M Required for ALL construction contracts administered under the Caltrans Standard Specifications 5-1— BUY AMERICA REQUIREMENTS.-- Attention is directed to the "Buy America" requirements of the Surface Transportation Assistance Act of 1982 (Section 165) and the Intermodal Surface Transportation Efficiency Act of 1991(ISTEA) Sections 1041(a) and 1048(a), and the regulations adopted pursuant thereto. In conformance with the law and regulations, all manufacturing processes for steel and iron materials furnished for incorporation into the work on this project shall occur in the United States; with the exception that pig iron and processed, pelletized and reduced iron ore manufactured outside of the United Sta m may be- used in the domestic manufacturing process for such steel and iron materials. The application of coatings, such as epoxy coating, galvanizing, painting, and other coating that protects or enhances the value of steel or iron materials shall be considered a manufacturing process subject to the "Buy America" requirements. A Certificate of Compliance, conforming to the provisions in Section 6-1.07, "Certificates of Compliance," of the Standard Specifications, shall be furnished for steel and iron materials. The certificates, in addition to certifying that the materials comply with the specifications, shall specifically certify that all manufacturing processes for the materials occurred in the United States, except for the above exceptions. The requirements imposed by the law and regulations do not prevent a minimal use of foreign steel and iron materials if the total combined cost of the materials used does not exceed one -tenth of one percent (0.1 percent) of the total contract cost or $2,500, whichever is greater. The Contractor shall furnish the Engineer acceptable documentation of the quantity and value of the foreign steel and iron prior to incorporating the materials into the work. Page 12-103 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-B PS&E Checklist Instructions Attachment N (To be used, when applicable, in Federal -aid projects) *Insert number of trainees. FEDERAL REQUIREMENT TRAINING SPECIAL PROVISIONS This section applies if a number of trainees or apprentices are specified in the special provisions. As part of your equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types oftrades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract part, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their lstyear of apprenticeship or training. Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of journeymen in the various classifications within a reasonable recruitment area. Before starting work, submit to the Agency: 1. Number of apprentices or trainees to be trained for each classification 2. Training program to be used 3. Training starting date for each classification Obtain the Agency's approval for this submitted information before you start work. The Agency credits you for each apprentice or trainee you employ on the work who is currently enrolled or becomes enrolled in an approved program. The primary objective of this section, "Training," is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources lilcely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area, Show that you have made the efforts. In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status or in which the employee has been employed as a journeyman 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training Ask the employee if the employee has successfully completed a training course leading to journeyman status or has been employed as a journeyman. Your records must show the employee's answers to the questions. In your training program, establish the minimum length and training type for each classification, The Agency and FHWA approves a program if one of the following is met: 1. It is calculated to: 1.1. Meet the your equal employment opportunity responsibilities 1.2. Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the twining period Page 12485 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment N PS&E Checklist Instructions FR-15 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training and it is administered In a way consistent with the equal employment responsibilities of federal -aid highway construction contracts Obtain the Agency's approval for your training program before you start work involving the classification covered by the program. Provide training in the construction crafts, not in elerk typist or secretarial -type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers ifthe training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved by the division office. Off -site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. The Agency reimburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on -site training 2. For off -site training if the apprentice or trainee is currently employed on a federal -aid project and you do at least one of the following: 2, 1, Contribute to the cost of the training 2.2. Provide the instruction to the apprentice or trainee 2.3. Pay the apprentice's or trainee's wages during the off -site training period 3. If you comply with this section, "Training" Each apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's sldll 2. Remain on the project as long as training opportunities exist in the apprentices or trainee's work classification or until the apprentice or trainee has completed the training program Furnish the apprentice or trainee: 1. Copy of the program you will comply with in providing the training 2. Certification showing the type and length of training satisfactorily completed Maintain records and submit reports documenting your performance under this section, "Training." FR.-16 Page 12-106 May 1, 2006 UP 06-01 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment O 5-1.- FEDERAL REQUIREMENTS (AMERICAN RECOVERY AND REINVESTMENT ACT) Under the American Reeovery and Reinvestment Act (ARRA) of 2009, 9 USC § 902: SEC. 902. ACCESS OF GOVERNMENT ACCOUNTABILITY OFFICE. (a) AccEss.--Each contract awarded using funds made available in this Act shall provide that the Comptroller General and his representatives are authorized— (1) to examine any records of the contractor or any of its subcontractors, or any State or local agency administering such contract, that directly pertain to, and involve transactions relating to, the contract or subcontract; and (2) to interview any officer or employee of the contractor or any of its. subcontractors, or of any State or local government agency administering the contract, regarding such transactions. (b) RELATIONSHIP TO EXISTING AUTHORITY. —Nothing in this section shall be interpreted to limit or restrict in any way any existing authority of the Comptroller General. Under ARRA of 2009, 9 USC § 1515(a): SEC.1515. ACCESS OF OFFICES OF INSPECTOR GENERAL TO CERTAIN RECORDS AND EMPLOYEES. (a) ACCESS. --With respect to each contract or grant awarded using covered firads, any representative of an appropriate inspector general appointed under section 3 or 80 of the inspector General Act of 1978 (5 U.S,C. App.), is authorized— (1) to examine any records of the contractor or grantee, any of its subcontractors or subgrantees, or any State or local agency administering such contract, that pertain to, and involve transactions relating to, the contract, subcontract, grant, or subgrant; and (2) to interview any officer or employee of the contractor, grantee, subgrantee, or agency regarding such transactions. (b) RELATIONSHIP TO EXISTING AUTHORITY. —Nothing in this section shall be interpreted to limit or restrict in any way any existing authority of an inspector general. Immediately notify the Engineer if you have been contacted by the U.S. Comptroller, Inspector General, or their representatives. Page 12-107 LPP 01-04 March 15, 2001 Exhibit 12-E Attachment O '•TATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION UONTHLY EMPLOYMWNT REPORT :EM-1204 (NEW 05/2009) DLA Modified Local Assistance Procedure's Manual PSU Checklist Instructions AMERICAN RECOVERY AND REINVESTMENT ACT (ARRA) MONTHLY EMPLOYMENT REPORT 70B:'STAMP, seeftMC wnsAratlbttow 1. CONTRACT NO. 2. FEDERAL -AID PROJECT NUMBER (From speew pmvisroms) 3. FIRST DAY OF REPORTING PERIOD (MnVddtyy): 4. REPORT MONTH (MM/yy) S. CONTRACTING AGENCY 6. CONTRACTOR NAME AND ADDRESS 7. EMPLOYMENT DATA EMPLOYEES HOURS PAYROLL NFwImtFS MIM E MOYM rlEwliQ�S MORM PRIME CONTRACTOR DIRECT, ON -PROJECT JOBS SUBCONTRACTOR DIRECT, ON -PROJECT JOBS SUBCONTRACTOR NAME(S): DBE 1-3 Q PRIME AND SUBCONTRACTOR SUBTOTALS PRIME AND SUBCONTRACTOR TOTALS (NEW + EXISTING) 8. CERTIFIED BY CONTRACTOR: (Signature and Title) DATE TO BE COMPLETED BX AGENCY OR AUTHORIZED REPRESENTATWE -- ....._.. _ ....._ .._ ......_...-- H-...._.. 9. REVIEWED BY CONTRACT ADMINISTRATOR: (Signature and 7 <tle) DATE I DiSTRiAU-hom, Orwaal- ltesident&tgEmeer Copy -Contractor Copy —CalumDWctIoealAssiaWnEngatear %DA Notice For individuals witb sensory disabilities, ff& document is aWablc in alternate formats. For Wormadon cell (916) 654-6410 or TDD (916) 654-3880 or write Records and Fomu Management. 1120 N Street, MS-89, Sacramento, CA 95814. Page 12-108 April 15, 2009 LPP 09-xx Local Assistance Procedures Manual EDIT 12-E PS&E Checklist Instructions Attachment O STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION MONTHLY EMPLOYMENT REPORT CEM-1204 MW WOW) DLA Modified INSTRUCTIONS FOR COMPLETING ARRA MONTHLY EMPLOYMENT REPORT FORM BOX]. Contract Number. The date -assigned project number or 1D: district and expenditure authorization (EA). BOX 2. Federal -aid Project Number. The state -assigned federal -aid project number. BOX 3. First Day of Reporting Period. The first day of reporting period is the first day of the first payroll period of the month. If the beginning of the month splits the payroll period, then the report will include dates from the prior month as necessary to complete the payroll period. BOX 4. Report Month. The month and year covered by the report. Reported as `mmry)r' (e.g. May 2009 would be coded as "05109."). BOX S. Contracting Agency. The name of the contracting agency. For state projects, enter Caltrans. For non -state projects, enter the name of the contracting agency (federal agency. tribe. WO, cit)4 county, etc.). BOX 6. Contractor Name and Address. The name and address of the contractor shall include the firm name, street address, city, state, and rip code. BOX 7. Employment Data. Subcontractor Name(s). The name of each subcontractor that was active on the project for the reporting month. Employees. The number of new hires and existing employees on the contractor's workforce that month, and the number of new hires mid existing employees for each of the active subcontractors that month. Do not include material suppliers. Reported as a whole number. Hours. The total hours on d►e specified project for the new hires and existing employees on the contractor's workforce that month, and the total hours for the new hires and existing employees for each of the active subcontractors that month. Reported as a whole number. Payroll. The total dollar amount of wages paid by the contractor that month for employees on the specified project, and the total dollar amount of wages paid by each of the active subcontractors that month. Rounded to the nearest whole dollar and reported as a whole number. Refer to Section 9-1.03A(l), "Labor," of the Standard Specifications. Prime and Subcontractor Subtotals. The subtotal for number of employees, hours and payroll for new hires and existing employees for the contractor and listed subcontractor(s). Prime and Subcontractor Totals (New + Existing). The total number of employees, hours and payroll for the contractor and Hated subcontracwr(s). BOX 8. Certified by Contractor. Name. Contractor representative or person responsible for certification of the information included on the form. By completing the form, the authorized representative certifies that they are knowledgeable of the hours worked and employment status for all employees. Contractors we responsible to maintain data to support the employment form and make it available to the state should it request supporting materials. Date. The daft that the contractor completed the employment form. Reported as "mm/ddlyy." BOX 9. Reviewed by Contract Administrator. (To be completed by the local agency or authorized representative.) Name. Local agency representative, such as the resident engineer or contract manager, or authorized project representative responsible for reviewing the submitted form. Date. The date that the state representative reviewed the form, Reported as "mmI&O y." Page 12-109 / LPP 01.04 March 15, 2001 j I. STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION FINAL REPORT - UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE), FIRST -TIER SUBCONTRACTORS CEM,2402F (REV 0=008) ADA Notice For Individuals with sensory disabliltles, this document is availe6la in aNemete forrmsts. For Inkxr Won call (916) 654-6410 or TDD (916) 664 MBO or valte Records and Fomes ManagemenL 1120 N Street, MS49, Sacramento, CA 95614. CONTRACT NUMBER COUNTY ROUTS POST MILES PEDERALAIOPROJECTNUMBER rMINISTERINGAGENGY CONTRACT COMPLETION DATE PRIME CONTRACTOR BUSINESS ADDRESS ESTIMATED CONTRACT AMOUNT S DESCRIPTION OF DBE CONTRACT PAYMENTS ITEM WORK PERFORMED COMPANYNAME ER T. NO. AND ANDBUSINESSADDRESS NUMBER NON -ME OBE BA APA NA W DATE WORK DATEOF FNNAt MATERIALS PROVIDED UDBE UDBE UDBE UDBE COMPLETE PAYMENT S $ $ $ $ $ E S $ $ $ $ $ S $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ ORIGINAL COMMITMENT TOTAL $ $ $ $ $ $ BA- Black Amerfean APA-Asian-Pacific Islander NA - Native Amen to UDBE W-Woman tistallFirstTlerSubcontractors,DisadvantagedBusinessEnterprises(Doft)andunder MbxdDBEs {UDSEs) regardless oftlerwhetherornatthefirmewereodginailyAstedforgoafcreditIfaetIldUDBEutilization (or room ofwork) was different than thatapproved at time of award, provide comments on back of form. List actual amount paid to each entigr. i caRmry rwA"rTNE ARovE INFORMATION IS COMPLETE AND CORRECT COPY DISTRIBUTION -CaltmnsoDrAnwts: Original- DlstrictConstcucdon Copy -SusitteaEnterphsePft)9mu Copy-Contraclor copy- Realdentenglneer COPY DISTRIBUTION - Local Agencyoomracts, Original -Distrid Local Assistance Engineer Copy -Distrtd Local Assistance Engineer Copy - Local Agency file (suhrr&W with the Reportof Expenditum) 6X4,taIr vI..I" STATE OF CALIFORNIA • DEPARTMENT OP TRANSPORTATION FINAL REPORT - UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE), FiRST-TIER SUBCONTRACTORS CEM-2402F (kW 0=008) _ The form requires specific information regarding the construction project: Contract Number, County, Route, Post Miles, Federal Aid Project number, the Administering Agency, the Contract Completion Date and the Estimated ContractAmount. It requires the prime contractor name and business address. The focus of the form is to describe who did what by contract item numbers and descriptions, asking for -specific dollar values of item work completed broken down by subcontractors who performed the work, both DBE and non -DBE work forces. DBE prime contractors are required to show the date of work performed by their own forces along with the corresponding dollar value of work The form has. a column to enter the Contract Item No. (or Item No's) and description of work -performed or materials provided, as well as a column for the subcontractor name and business address. For those firms who are DBE, there is a column to enter their DBE Certification Number. The DBE should provide their certification number to the contractor and notify the contractor in writing with the date of the decertification if their -status should change during the course of the project The form has six columns for the dollar value to be entered for the item work perforated by the subcontractor. The Non -DBE column Is used to enter the dollar value of work performed for firms who are not certified DBE. The. decision of which column to, be used for entering the DBE dollar value Is based on what program(s) status the firm Is certified. This program status is determined by the California Unified Certification Program by ethnicity, gender, ownership and control issues at time of certification. To confirm the certification status and program status, access the Department of Transportation Civil Rights website at http://www.dot.ca.gov1hq/bep or by tailing (916) 324-1700 or the toll free number at (888) 810-6346. Based on this DBE Program status, the following table depicts which column to be used: DBE Program Status Column to be used if program status shows DBE orgy with no other programs listed. DBE If program status shows DBE, Black American BA UDBE If program status shows DBE, Asian -Pacific islander APA UDBE If program status shows DBE, Native American NA UDBE if program status shows DBE, Woman JWLIDBE If a contractor performing work as a DBE on the project becomes decertified and still performs work after their decertification date, enter the total value performed by this contractor under the appropriate DBE identification column. if a contractor performing work as a non -DBE on the project becomes certified as a DBE, enter the dollar value of all work performed after certification as a DBE under the appropriate Identification column. Enter the total of each of the six columns on Form CEM-2402(F). Any changes to DBE certification must also be submitted on Form CEM-2403(F). Enter the Date Work Completed as well as the Date of FInal Payment (the date when the prime contractor made the "final payment" to the subcontractor for the portion of work listed as being completed). The contractor and the resident engineer sign and date the form indicating that the information provided Is complete and correct. PROOF COPY RETURN TO HQ FORMS OK X Date Locai ,.stance Procedures Manual EX , . 17-0 Disadvantaged Business Enterprises (DBE) Certification Status STATE OF CALUORNIA — DEPARTMENT OF TRANSPORTATION DISADVANTAGED BUSINESS ENTERPRISES (DBE) CERTIFICATION STATUS CHANGE CP-CEM 2403(F) (Now.10/99) Prime Contractor. List all DBEs with changes In certifFcaBon stales {cerl(JieWdecerAfied) while Inyanr employ, whether ornot firms were origina7(listed forgood credit Attach DBE 4w0caHonMecen0kaden Idler =aeeoidanee with the Special Pra*1bns CONTRACT ITEM NO. SUBCONTRACTNAMEAND BUSINESS ADDRESS BUSINESS PRONE CERTIFICATIONNUMBER AMOUNT PAIDVIKLE CERTIFIED CERTIFICATION! DECERTIFICATION DATE • Letter attached $ $ Comm(nts: I CERTIFY THAT THE ABOVE WORIYIATION IS COMPLETE AND CORRECT CONTRACTOR REPRESENTATIVE SIGNATURE TI 6 BUSINESS PHONENUMBER DATE TO THE DEST OF MY KNOWLEDGE THE ABOVE INFORMATION IS COWLETE AND CORRECT RESiAENT ENCiITTEER BUSINESS PHONENUMBER DATE DISTRIBUTION Original copy -DLAE Copy -1) Business Enterprise Program 2) Prime Contactor 3) Local Agency 4) Resident Engineer Page 17-43 LPP 06-03 July 21, 2006 EXIMI.T 17-0 Local Assistance Procedures Manual Disadvantaged Business Enterprises (ABE) Certification Status Change Form CP CEM 2403M (New 10/99) DISADVANTAGED BUSINESS ENTERPRISES (DBE) CHANGE IN CERTIFICATION STATUS REPORT The top of the form requires specific information regarding the construction project: Contract Number, County, Route, Post Mites, the Administering Agency, the Contract Completion Date, and the Estimated Contract Amount. It requires the Prime Contractor's name and Business Address. The focus of the form is to substantiate and verify the actual DBE dollar amount paid to contractors on federally funded projects that had a changed in Certification status during the course of the completion of the contract. The two situations that are being addressed by CP-CEM 2403(F) are, if a firm certified as a DBE and doing work on the contract during the course of the project becomes Decertified, and if a non -DBE firm doing work on the contract during the course of the project becomes Certified as a DBE. The form has a column to enter the Contract Item No (or Item Nos,) as well as a column for the Subcontractor's Name, Business Address, Business Phone, and contractor's Certification Number. The column entitled Amount Paid While Certified will be used to enter the actual dollar value of the work performed by those contractors who meet the conditions as outlined above during the time period they are Certified as a DBE. This column on the CP-CEM-2403(F) should only reflect the dollar value of work performed while the firm was Certified as a DBE. The column called Certification/Decertification Date (better attached) will reflect either the date of the Decertification better sent out by the Civil Rights Program or the date of the Certification Certificate mailed out by the Civil Rights Program. There is a box to check that support documentation is attached to the CP-CEM-2403 (F) form. There is a Comments section for any additional information that may need to be provided regarding any of the above transactions. The CEM-2403(F) has an area at the bottom where the Contractor and the Resident Engineer sign and date that the information provided is complete and correct. There is a Comments section for any additional information that may need to be provided regarding any of the above transactions. The CEM-2403(F) has an area at the bottom where the Contractor and the Resident Engineer sign and date that the information provided is complete and correct. Page 17-44 July 21, 2006 LPP 06-03 Federal Labor Standards Provisions U.S. Department of Housing and Urban Devetopmerrt Office of Labor Relations Applibabiiity The Projecl or Program to which the conslruclion work covered by this contract pertains Is being assisted by the United States of America and the following Federal Labor Slandards Provisions are included in this Contract pursuam to the provisions applicable to such Federal assistance, A. 1. (1) Minimum Wages. All laborers and mechanics em- ployed or working upon the site of the work wig be paid uncondt- Ifonally and not less often than once a week, and without subse- quent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secre- tary of Labor under the Copeland Act (29 CFR Part 3), the full amount of wages and bona tide Iringe benefits (or cash equiva- lents theroot) due at time of payment computed at Was riot less than those contained in the wage determination of the Secretary of Labor which Is attached hereto and made a part hereof, re- gardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or costs reasonably anticipated for bona tide fringe benefits under Section I(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of 29 GFR 5.5(a)(1)(tv); also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs, which cover the particularweekly period, are deemed to be constructively made or incurred during such woolly period. Such laborersand mechanics shag be paid the appropriate wage rate and fringe benefits on the wage determination for the classi- fication of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics per- forming work In more than one classification may be compensated at the rate specified for each classification for the lima actually worked therein: Provided, That the employer's payroll records accurately set forth the lime spent in each classification in which work Is performed. The wage determination (including any addi- tional classification and wage rates conformed under 29 CFR 5.5(a)(1)(i) and the Davis -Bacon poster (WH4321) shag be posted al all times by the contractor and its subcontractors at the site of the work in a prorninerd and accessible, place where it can be easily seen by the workers. (11) (a) Arry class of laborers or mechanics which is not listed in the wage determinallon and which is to be employed under the contract shall be classified in conformance with the wage deter- mination. HUD shag approve an additional classification and wage rate and fringe benefits therefor only when the tollowing criteria have bean met: (1) The work to be performed by the classification requested is not performed by a ckmilicallon in the wage determination; and (2) The classification is utilized in the area by the construction industry; and (3) The proposed wage rate, including any bona fide fringe ben- efits, bearsa reasonable relationship to the wage rates contained In the wage determination. (b) 1f the contractor and the laborers and mechanics to be em- ployed In the classification (f known), or their representatives, and HUD or its designee 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 HUD or Its designee to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of La- bor, Washington, D.C.20210. The Administrator, or an authorized representative, wig approve, modify, or disapprove everyadditionai classification action within 30 days of receipt and so advise HUD or its designee orwill notify HUD or its designee within the 30-day period that additional time is necessary. (Approved by the Office of Management and Budget under OMB control number 1215- 0140.) (0) In the event the contractor, the laborers or mechanics to be employed In the classification or their represantalIves, and HUD or its designee do not agree on the proposed classification and wage We (Including the amount designated for fringe benefits, where appropriate), HUD or Its designee shag reler the questions, including the viewsof all Interested parties and the recommanda- lion of HUD or its designee, to the Administrator for determina- tion. The Administrator, or an authorized representative, will is- sue a determination within 30 days of receipt and so advise HUD or its designee orwill notify HUD or itsdesignee within the 30-day period that additional time Is necessary (Approved by the Office of Management and Budget under OMB Control Number 1215- 0140.) (d) The wage rate (including fringe benefits where appropriate) determined pursuant tosubparagraphs (1)(11)(b) or (c) of this para- graph, shag be paid to all workers pedorming work in the classifi- cation under Ittis contract from the first day on which work is per- formed in the classification. Q&) Whenever the minimum wage rate prescribed in the contract fora class of laborers or mechanics includes a frnge benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as staled in the wage determination or shall pay an- other bona tide fringe benefit or an hourly cash equivalent thereof. Qv) it the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any taborer or mechanic the amount of any costs rea- sonably anticipated in providing bona tide fringe benefits under a plan or program, Provfdad. That the Secretary of Labor haslound, upon the written request of the contractor, that the applicable stan- dards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside In a separate ac- count assets for the meeting of obligations under the plan or pro- gram. (Approved by the Office of Management and Budget under OMB Control Number 1215.0140.) 2 Withholding. HUD or its designee shag upon its own action or upon written request of an authorized representative of the De- partment of Labor withhold or cause to be withheld from the con- Iraclor under this contract or any other Federal contract with the same prime contractor, or any other Federally -assisted contract subject to Davis -Bacon prevailing wage requirements, which is held by the same prime contractor so much of the accrued pay- ments or advances as may be considered necessary to pay la- borers and mechanics, Including apprentices, traineas and help- ers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of faifuro to pay any laborer or mechanic, including any apprentice, trainee or helper, employed or working on the site of the work, all or part Min HUD4010 (OV2003) Previous edition Is obsolete Page I of 4 of the wages required by the contract, HUD or its designee may, alter written notice to the contractor, sponsor, applicant, or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violailons have ceased. HUD or Its designee may, after written notice to the contractor, disburse such amounts withheld for and on account of the contractor or subcontractor to the respective employeestowhom they are duo. The Comptroller General shall make such disbursements In the case of direct Davis -Bacon Act contracts. 3. (1) Payrolls and pasta records. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work preserved for a period of three years thereaf- ter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social secu- rity number of each such worker, his or her correct classification, hourly rates of wages pakt (including ratesof contributtonsor costs anticipated for do nallde fringe benefitsor cash equfvalentsthereol of the types described in Section I(b)(2)(8) of the Davis -bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5 (a)(1)(iv) that the wagesol any laborer or mechanic Include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in Sac - lion I(b}(2)(8) of the Davis -Bacon Act, The contractor shall main - lain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially re- sponsible, and that the plan or program has been comet micaf ed in wriling to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost Incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of The apprentices and trainees, and the ratios and wage rates prescribed In the applicable programs. (Approved by the Office of Management and Budget under OMB Control Numbers 1215-0140 and 1215-0017.) (ilia (a) The conlraclorsteit subrnil weekly for each week in which any contract work is performed a copy of all payrolls to HUD or its designee if the agency is a party to the contract, but if the agency is not such a party, the contractor will submit the payrolls to the applicant sponsor, or owner, as the case may be, for t ransmisslon to HUD or its designee. The payrolls submitted shall set out ac- curalely and completely all of the information required to be main- tairned under 29 CFR 5.5(a)(3)(i). This information may be sub rrdt- led in any form desired. Optional Form WVI-347 Is available for this purpose and may be purchased from the Superintendent of Documents (Federal Stock Number 029-005.00014-1), U.S. Gov- ernment Printing Office, Washington, DC 20402. The prime con- tractor is responsible for the submission of copies of payrolls by all subcontractors. (Approved by the Office of Management and Budget under OMB Control Number 1215.0149.) (b) Each payroll submitted shall be accompanied by a "State- ment of Compliance,' signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the per- sons 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 20 CFR 5.5 (a)(3)(f) and that such information is correct and complete; (2) That each taborer or mechanic (including each helper, ap- prentice, and trainee) employed on the contract during the payroll period has been paid the lull weekly wages earned, without re- bate, either dlrecliyor indirectly, and that nodeductions have been made either directly or Indirectly from the full wages earn 90.other than permissible deductions as set forth In 29 CFR Part 3; (3) That each taborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equhrafents for tine classification of work performed, as specified In the appll- cable wage determination incorporated Into the contract. (o) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form Wi-f-347 shall sat- isfy the requirement for submission of the "Statement of Compli- ance` required by subparagraph A.3.(10(b). (d) The falsificallon of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecullan tmder Section 1001 of Title 18 and Section 231 of Title 31 of the United Slates Code. (ill) The contractor or subcontractor shall make the records re- quired under subparagraph A.3.(i) available for inspection, copy- ing, or transcription by authorized representatives of HUD or its designee, or the Department of Labor, and shall permit such rep- resentatives to Interview employees during working hours on the job. If the cordracloror subcontractor tails to subrndi the required recordsor to make them available,14UD or its designee may, after written notice to the Contractor, sponsor, applicant or owner, lake such acllon as may be necessary to cause the suspenslon of any further payment, advance, or guarantee of funds. Furthermore, failure to subrrdt the required records upon request or to make such records available may be grounds for debarment action pur- suant to 29 CFR 5.12- 4. Apprentices and Trainees. p) Apprentices. Apprentices will be permitted to work all less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. De- partment of Labor, Employment and Training Administration, Of- fice of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or d a person is employed in his or her first 90 days of probationary employment asap apprentice In such an apprenticeship program, who is not Individually registered in the program, but who has been coddled by the Office of Apprenticeship Training, Employer and labor Services or a State Apprenticeship Agency (where appropriate) to be eligible for probatonary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the Contractor as to the entire workforce under Me registered program. Any worker listed on a payroll at an ap= prentfce wage rate, who Is not registered or otherwise employed as staled above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actu- ally performed. In addition, any apprentice pettorrdng work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor Is perforindng construction on a project In a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be pail a1 not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the form HU 0 Mrz003) Previous edition is obsolete Page 2 of 4 Journeymen hourly rate specified in the applicable wage determi- nation. Apprentices shall be paid fringe benefits In accordance with the provisions of the apprenticeship program. if the appren- lice" programdoes not spochy fringe benefits, apprentices must be paid the full amount of fringe benefits hied on the wage deter- mination for the applicable classification, if the Admklistralor de- termines that a different practice prevails for the applicable ap- prenike classification, fringes shall be pail In accordance with that determination. In the event the office of Apprenticeship Train- ing, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an ap- preni reship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is ap- proved. (IQ Trainees. Except as provided in 29 CFR 6-16, 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 ap- proval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to journeymen on the job age shag not be greater than permitted under the plan approvers by the Employment and Train- ing Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate speCdied 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 pare] the full amount or fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprentice- ship programassociated with the corresponding journeyman wage rate on the wage determination which provides for less than lull fringe benefits for apprentices. Any employee listed on the pay- roll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Adminis- tration shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. in addition, any trainee performing work on the job silo in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Adr intetration withdraws approval of a training program, the con- tractor will no longer be permitted to utilize Iralness at less than the applicable predetermined rate forthe work performed until an acceptable program is approved. ON) Equal empfoynent opportunity. The utilization of appren- tices, trainees and journeymen under 29 CFR Part 5 shall be in condomity, with the equal employment opportunity requirements of Executive Order 11240, as amended, and 29 CFR Part 30. 5. Compliance with Copeland Act requirements- The cord rac- for shag comply with the requirements of 29 CFR Part 3 which are Incorporated by reference in this contract 6. Subcontracts, The contractor or subcontractor win Insert in any subcontracts the clauses contained in subparagraphs 1 through 11 of this paragraph A and such other clauses as HUD or its designee may by appropriate Instructions require, and a copy of the applicable prevailing wage decision, and also a clause re- quiring the subcontractors to include these clauses in any lower T. Contract termination; debarment. A breach of the contract clauses in 29 CFR 6.5 may be grounds for termination of the con- tract and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. S. Compliancewith Davis -Bacon and Ralated Act Requirement-. Allrulings and Interpretations of the Davis -Bacon and Related Acts contained in 29 CFR Parts 1, 3, and 5 are herein Incorpo- rated by reference in this contract 9. Disputes concerning labor standards. Disputes arising out of the laborstandards provisions of this contract shall not be sub - loci tothe general dispulesclause oflids cord ract. Suchdfspufes shalt be resolved In accordance with the procedures of the De- parfinenl of Labor set forth In 29 CFR Parts 5, 6, and 7. Disputes within the meaning of this clause Include disputes between the contractor (or any of Its subcontractors) and HUD or its designee, the U.S. Department of Labor, or the employees or their repre- sentatives, 10. (I) Certification of Eligibility. By entering into this contract the contractor certifies that neither it (nor he or she) nor any per- son or limn who has an interest In the conlractort firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) al the Davis -Bacon Act or 29 CPR S.12(a)(1) or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR Part 24. (ill No part of this contract shall be subcontracted to any person or firm Ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5,12(a)(1) or to be awarded HUD conlractsor participate in 14UD programs pursuant to 24 CFR Part 24, (blob) The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001. Additionally, U.S. Criminal Code, Section 1 01 0, Title 18, U.S.C., "Federal Housing Adminis- tration transactions", provides in part: "Whoever, for the purpose of ...Influencing in any way the action of such Adminisirafion..._ makes, utters or publishes any statement knowing the same to be false..... shall be lined not more than $5,000 or imprisoned not more than two years, or both" 11. Complafrrts, Proceedings, or Testhntony by Employees. No laborer or mechanic to whom the wage, salary, or other labor standards provisions of this Contract are applicable shall be dis- charged or In anyolher manner discriminated against by the Con- tractor or any subcontractor because such employee has filed any complaint or instituted or caused to be instituted any proceeding or has testified or is about to testify in any proceeding under or relating to the tabor standards applicable udder this Contract to his employer. s. Contract work Hours and safely standards Act. The provi- sions of Ihis paragraph B are applicable only where the amount of the prime contract wmeeds$100,000. As used in this paragraph, the terms laborere and "mechanic' include watchman and guards. (1) Overtime requirements. No contractor or subcontractor con- Micting for any part of the contract work which may require or involve the employment of laborersor mechanics shag require or permit any such Laborer or mechanic in any workweek in which he or site is employed on such work towork in excess of 40 hours in such work- week urdess such taborer or recharim receives compensation at a rate trot less than one and one -hag times the basic rate of pay for all hours worked in excess of 40 hours in such workweek. tier subcontracts, The prime contractor shag be responsible for the compliance by arty subcontractor or lower tier subcontractor (2) Violation; liability for unpaid wages; liquidated damages. with all the contract clauses in this paragraph. in the event of any violation of the clause sal forth in subpara- iorm liUD.4010 (07i20tt3) Previous edition is obsolete Page 3 014 rel. Handbook 1344.1 graph (1) of [his paragraph, the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addi- tion, such contractorand subcontractor shall be liable to the United Slates (n the case of work done under contract for The Dislricl of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shah be computed with respect to each Individual laborer or mechanic, including watchmen and guards, employed In violation of the clause set forth in subparagraph (1) of this paragraph, in the sum of $1D for each calendar day on which such Individual was required or permft- led to work in excess of the standard workweek of 40 hours without payment of the overtime wages required by the clause set forth in sub paragraph (1) of this paragraph. (3) Whhholdtng for unpaid wages and liquidated damages. HUD or its designee shall upon its own action or upon written request of an authorized representative of the Department of La- bor withhold or cause to be withheld, from arty rr*neys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contract, or any other Federally -assisted contract subject to the Contract Work Hours and Safety Standards Act which is hold by The same prime contractor such sums as may be determined to be necessary to satisfy any liabilities of such corl- tractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set lorth In subparagraph (2) of this paragraph. (4) Subcontract& The contractor or suboordraotor shall insert In any subcontracts the clauses set forth In subparagraph (1) through (4) of this paragraph and also a clause requiring the sub- contractors to Include these clauses In any lAwer her subcontracts. The prune contractor shall be responsible for compliance by arry subcontractor orlower tier subcontractor with The clauses set forth in subparagraphs (1) Through (4) of this paragraph. C. Health and Safety. The provisions of this paragraph Care ap- plicable only where The amount of the prime contract exceeds $100,000, (1) No taborer or mechanic shall be required to work in surround- ings or under working conditions which are unsanitary, hazard- ous, or dangerous to his health and safety as determined under construction safety and heallh standards promulgaled by the Sec- retary of Labor by regulatlon. (2) The Contractor shall comply with all regulations issued by the Secretary of Labor pursuant to Title 29 Part 1926 and failure to comply may result in imposition of sanctions pursuant to the Con- tract Work Fours and Safely Standards Act, 40 USC 3701 of sea. (3) The Contractor shall include the provisions of this para- graph in every subcontract so that such provisions will be binding on each subcontractor. The Contractor shah lake such action with respect to any subcontract as the Secretary of dousing and Urban Development or the Secretary of Labor shall direct as a means of enforcing such provisions. lorm HUO-4010 (074003) Previous edition Is obsolele Page 4 of 4 ref. Handbook 1344.1 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewateriing include discharge into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of S. 3) SHEET 4 — TRAFFIC SIGNAL. PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. �/ Company Name V 4`r-flty 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. Unified Certification Program Back To Query Form Page 1 of 1 Search Returned I Records Fri Aug 2111:36:63 PDT 2009 Query Criteria Firm/DBA Name: grand electric supply Firm Type: DBE Firm ID 9994 Firm/DBA Name GRAND ELECTRIC SUPPLY, INC. Address Line1 2430 SOUTH SANTA FE AVENUE, #510 Address Line2 City VISTA State CA Zip Code1 92084 Zip Code2 Certification Type DBE EMa i I Isims@grandelectdcsupply.com Area Code (760 ) Phone Number 744-5981 Fax Area Code (760 ) Fax Phone Number 744-5982 Agency Name DEPARTMENT OF TRANSPORTATION Counties 00: Districts 00; DBE NAICS 423610; ACDBE NAICS Work Codes CO600 MISC SUPPLIERS; C0686 ELECTRICAL & SIGNALS; F5060 ELECTRICAL GOODS; Licenses Gender F Ethnicity HISPANIC Firm .Type DBE BUSINESS ENTERPRISE CERTIFICATE GRAND ELECTRIC SUPPLY, INC. 2450 LA MIMA DIME VISTA, CA 92083 LAURADASILVASMW Business Structure: CORPORATION Pragatuncs STATE MMURITY RUSUMS ENTE"R1911 ills certificate acknowledges that said firm Is approved by the rtdi Oeyp—r6ifit:bf Tkan"HA" i State MinoritkBasiness: Enterprise or State Women Business Enterprise (or in some cases both) In accordance with As!-9mMy' W-MnMer 48C IkO CL i& it"i", Public Code, Chapter 2.6 (commenclog Iq with Section 2M), for the following NAICS oD" ra M111 # 423610 Efectric2l Apparatus and Equipmed g Supplies, and Related Equipment Mor I Indicates primary NAICS code CERTIFYING AGENCY: DEPARTMENT OF TRANSPORTATION 1823 14TH STREET, M5 79 SACRAMMO, CA 95814 0000 (916) 324-1700 Firm IAQ0 %�. — "9EAor'90 p 0 January 4,2006 RITA A. NELSON, CMWMG AGENCY REPRESENTATIVE - ,ID BONG ,NOW ALL BY THESE PRESENTS, That we, PTM General Engineering Services Inc. of 5942 Acorn Street, Riverside, Ca 92504 (hereinafter called the Principal), as Principal, and Berkely Regional Insurance Company (hereinafter called the Surety), as Surety are held and furnly bound unto City of Huntington Beach (hereinafter called the Obligee) in the penal sum of Ten Percent of Amount Bid Dollars ($ 10% ) for the payment of which the Principal and the Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents, THE CONDITION OF THIS OBLIGATION IS SUCH,That WHEREAS, the Principal has submitted or is about to submit a proposal to the Obligee on a contract for Safe Routes to Schhol in Vicinity of Spring View Middle School NOW, THEREFORE, If the said Contract be timely awarded to the Principal and the Principal shall, within such time as may be specified, enter into the Contract in writing, and give bond, if bond is required, with surety acceptable to the Obligee for the faithful performance of the said Contract, then this obligation shall be void; otherwise to remain in full force and effect. Signed and sealed this 12th day of April , 2010 PTM General Engineering Services Inc. (Seal) Principal Witness5�p ��:� ACW497i _ f1g�F/ Title Witness No. 7916a POWER OF ATTORNEY BERKLEY REGIONAL INSURANCE COMPANY WILMINGTON, DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY REGIONAL INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware, having its principal office in Urbandale, Iowa, has made, constituted and appointed, and does by these presents make, constitute and appoint: Philip Vega, Frank Morones or Jadon H. Smith of C & D Bonding & Insurance Services, Inc. of Covina, CA its true and lawful Attorney -in -Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 Dollars ($50,000,000.00), to the same extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on August 21, 2000: "RESOLVED, that the proper officers of the Company are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal of the Company to powers of attorney executed pursuant hereto; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the manner and to the extent therein stated; and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attomey-in-fact named; and further RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have ceased to be such at the time when such instruments shall be issued." IN WITNESS WHEREOF, the Company has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this j day of 2010. Attest: Berkley nal Insurance Company (Seal) By ' By ra S. Le erman Robert P. Cole Senior Vice President & Secretary Senior Vice President WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE "BERKLEY" SECURITY PAPER. STATE OF CONNECTICUT ) ' ) ss: COUNTY OF FAIRFIELD ) Sworn to before me, a Notary Public in the State of Connecticut, this ) day of /1 , 2010, by Robert P. Cole and Ira S. Lederman who are sworn to me to be the Senior Vice President, and the Senior Vice President and Secretary, respectively, of Berkley Regional Insurance Company. EILEE ' ,q�j ' 30, g?l> Notary Public, State.of Connecticut b 1 -- f7tn-q Gc,T�v�_..'YLW�a---r`� ,S2n1�1-,-✓'._o � � 2 CERTIFICATE (Jy I, the undersigned, Assistant Secretary of BERKLEY REGIONAL INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded and that the authority of the Attomey-in-Fact set forth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in full force and effect as of this date. Given under my hand and seal of the Company, this 12 th day of April 2010 (Seal) Steven Coward ACKNOWLEDGMENT State of California County of Riverside On efl1q l ° before me, Elizabeth H. M. McRae, Notary Public (insert name and title of the officer) personally appeared Brian Mendoza who proved to me on the basis of satisfactory evidence to be the person(x) whose name(O is/Aw subscribed to the within instrument and acknowledged to me thathe/y executed the same In hisbiwAWr authorized capacityoas , and that by his/kenUmIr signature(a) on the instrument the persons), 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 han and official seal. 1-rut, 3_e Signature (Seal) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles On 0 4 / 1 2 / 2 01 0 before me, Monica Blaisdell, Notary rate Here Insert Name and TtV of the Officer personally appeared PhilipyPga Nam a of nerjs MONICA BLAISDELL Commission # 1794078 Notary Public - California orange County W Comm. E Mar26, 2012 who proved to me on the basis of satisfactory evidence to be the person{,) whose name() is4W subscribed to the within instrument and acknowledged to me that he/offlftexecuted the same in hisW4hftauthorized capacity{tom and that by hisl}ta signature(*on the instrument the personf ), or the entity upon behalf of which the person(k) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Place Notary Seal Abm a a gnalure W Notary Public City ®f Huntington Beach 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK June 30, 2010 Southland Construction 3943 Irvine Blvd., #40 Irvine, CA 92602 RE: CC-1367 Safe Routes to School in the vicinity of Spring View Middle School Enclosed please find your original bid bond for CC-1367. Sister Citi .ifA64 pidapaotrteWr6t ,u(4o,lew Zealand ( Telephone: 714-536-5227 ) (0 N SECTION C PROPOSAL for the Safe Route to School In the vicinity of Spring View Middle School CC No. 1367 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR. AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 40 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. Accompanyingthis proposal of bid, find �'�'� 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: Bate Received Bidder's signature: KQ k,5c 2- ` C-2 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 I L.S. Mobilization. Per L.S. I L.S. Monument MO numo Preservation. L.S. I L.S. Furnish Project Traffic Control. Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. 7 9-c'O $ Per L.S. 5 1 L.S. Install Traffic Signal at Heil Ave. and Trudy Ln. Per L.S. 6 1 L.S. Install H.D.P.E Pipe, Junction Structure, Cross Gutter, Catch Basin and Local 0 00 $ Depression per City Standard Plans 205, 311 and 315, (Including AC Replacement to Finished Surface) Per L.S. 7 1 L.S. Install Modified Island Passage Way per Caltrans Standard Plan A88B, Modified C)O $ -/000 per the Project Plans. Including Island, Curbs, Retaining Curbs, Truncated Domes, Gutter, Concrete, and Asphalt Concrete Removal and Replacement. Per L.S. 8 700 S.F. Remove Existing Sidewalk and Construct Sidewalk per City Standard Plan 207. $ $ 2— Per S.F. C-2.1 Project Bid Schedule Safe Routes to School — Spring View Middle School CC-1367 Estimatecl Item hif"P 85 L.F. Remove Existing Curb and Gutter and Construct New Curb and Gutter per City $ $ 3((0 Standard Plan 202, Including AC Paving Replacement. 10 14 EA. Per L.F. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan $ $ No. A88A and AC Paving Replacement. J1 Per EA, 11 4 EA. Remove and Salvage Existing Flashing Beacons Including Foundation Removal. $ 2-S C) C) / Per L.S. 12 11,000 S.F. Construct Type 11 Slurry Seal, Per S.F. Total Amount Bid in Figures: $ 2— Total Amount Bid in Words: $ e7^4 H4V' CA- '-s- Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 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 Name and Address, of SuBcontraelor State `License Class. of Work Number. 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 e,- Lk -la, MIA- being first duly sworn, des qnd,says that he or she is 7j of C�7 [ dA- the party making the foregoing bid that the bid is not made in he 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. 3 a L" r6' I,,,- '� (- �' T" Name of Bidder Signature of Bidder Address of Bidder Subscribed and sworn to before me this �� day of��-- , 20 G-t:? NOTARY PUBLIC R{FRIG AN m �0 Commission # 1802949 a : ^�i er, �, Notary Public - California Z ' Orange County Poly Comm. Expires Jun 21, 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, in the vicinity of Spring View Middle School - CCI3b7, (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. -4, (�-2-0(,--, Date: Contractor 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 Q�10 If the answer is yes, explain the circumstances in the space provided. J 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. Contractor [A-0 (, G{�_ By Title C-7 UNDERGROUND SERVICE ALERT IDENTIJF'ICATION 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: U o-j Contractor By Title (�- Lo (� Date: q - ate -' e- Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: Bidder Name Business Address City, C�1- '� )-- C 0 2-- State Zip Telephone Number ) (-� J %6 o State Contractor's License No. and Class Original Date Issued 2—� K--:;� Expiration Date The work site was inspected by of our office on 111�r' c (- ' 20(,0 The following are persons, firms, and corporations having a principal interest in this proposal: �`�-2� �-�, Gj� cam, � C� �-�✓ / 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. 5� C" ,` Y' c--c_ C, Company Name Signature of Bidder Printed or Typed Signature Subscribed and sworn to before me this f Iday of14- e /' C , 200 (4� NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: Name and Address of Public Agency Name and Telephone No. of Project Manager:2-7 rpl-;f-k ea o 9 " 1 Contract Amount Type of Work Date 2. % O�-- C- ( 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: J k Contract Amount Type of Work EC).D Date Completed C-10 (For federally funded projects, use this following page) HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 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 requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: �- f -z — Contact Phone: °:zf `� `f K S 2--'mot / Signed:6, Date: V-(- *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et ao 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 EXHrBIT 12-E PS&E Checklist instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) ��' s1 yr (..-, ��t�C� �'1 S ✓ u C_ (1 � � ' / The bidder proposed subcontractor , hereby certifies that he has , has not_,Kparticipateti 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. C-12 Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY I COUNTY of DEPARTMENT OF PUBLIC WORKS: In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-13 ]Page 12-81 LPP 01-04 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has ` _ , has not _been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or federal antitrust law in connection with the bidding upon, award of� or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof as referred to in Section 10295.1. Note: The bidder must place a check mark aft "has' or "has not" in one of the blank spaces provided. The above Statewa nt is part of the Bid Signing this Bid on the signature portion thereof shall. also constif ite signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal -prosecution, Public Contract Cade Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest • in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? yesNo If the answer is yes, explain the circumstances in the following space. C-13 Public Contract Code 1OZ32 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states tinder penalty of perjury, that no more than one final unappealable funding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractoes failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: * Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; * Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; * Does not have a proposed debarment pending; and * Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility, For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-14 Paige 12-83 LPP 01-04 March 1.5, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&lE Checklist Instructions Attachment 1F jj 'IzMA, � 11 � a tl 4 ,14 v The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) if any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Farm-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission ofthis certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. I C-15 . Page 12-55# LPP 01-04 March 15, 2001 Local Assistance Procedures Manual E=BIT 12-E PS&E Checklist instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING A(;I1Yi1'1E5 PU"UAN'i' I V 3 i U.S.I:. 13J1 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a, initial b, grant b, initial award b. material change e, 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 Q Subawardee "Fier , if known Congressional District, if known 6. Federal Department/Agency; /A $. 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. I0a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (cheek all that apply) $ actual planned a. retainer b. one-time fee 12. For of Payment (cheek all that apply): e. commission a. cash d. contingent fee b. in -kind; specify: nature a deferred value U is 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 I1: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: 'ties ® No 16. information requested through this form is authorized by Title 31 U.S.C. Section 13S2. This disclosure of lobbying reliance Signature: !!! was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any t� C ✓�� vV 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 7 t i $100,000 for each such failure. Telephone No.: �' Date: --- Federal Use Only: Form Authorized for Local Reproduction Standard Form - LLL L'_ 1 6 Page 12-87 LPP 01-04 March 15, 2001 EXHMIT ME Local Assistance Procedures Manual Attachment G PS&>E Checklist Instructions INSTRUCTIONS FOR C01V% LETION OF SF-LLL, (DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. l . 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 prune is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. S. If the organization filing the report in Item 4 checks "subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item l (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00 1. " 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full naives of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). I L Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. 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-SS C-17 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the off ocr(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503, SF-LLL-Instructions Rev.06.04-90AM3IN C-18 Page M89 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LOST OF SUBCONTRACTORS (®BE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Namet ` t Y { Description L Portion ofWork to bePerfdiii6d ✓CYIF • 7I� J NEK&J14 "I, IBM t � :XS:1Z: 1 �Y�•CtSie ba "t..s.;c.�:. Fsl Name Phone Ll < $1 million Q $$S million Address ❑ <$10 million Fax ❑ c $15 million rite State ZIP n > S15 million Distribution: 1) Original - Local .Agency File LPP 06-06 Page 12-111 November 14,2006 Exhibit }r-G Local Assistance Procedurea anual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LISP" OF SUBCONTRACTORS (®SE and NON -DBE)- CART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution; 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency bidder UDBE Commitment (Construction Contracts) Exhibit 15-G l Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF TMS FORM AGENCY- ^^ ��� LOCATION: PROJECT DESCRIPTION: /`"'�/—e ✓�`' ® f j G v TOTAL CONTRACT AMOUNT: $ BID DATE: / — 2 Z G IDDER'S NAME: �.t2 t'G 1 [ �' "t t �c t �'1 CONTRACT UDBE GOAL: ITEM OF WORK AND DESCRIPTION R SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED CcrL No, of UDBE AND EXPIRATION DATE NAME OF UDBEs Must be certified on the date bids aro opened - include UDBE address and phone num or) CONTRACT DOLLAR AMOUNT ITEM NO. UDBE v� v �. For Local Agency to Complete: Local Agency Contract Numbet: federal Aid Project Dumber: Federal Share: Total Claimed Participation 9 ontract Award Date: Loral Agency certifies that all information is complete and accurate, Print Name Signature Bate Local Agency Representative AreaCade Tele bone Number: Sigbature of Bidder / --I f , 2� 1 41 Date ^7 { , a[Code}p'-i'ei. N�oi. - /1 For Caltrans Review: NintNarne Signature Caltrans District Local Assistance Engineer Date Person t0 Contact (Please, Type or Print) Local Agency Bidder - UDBE Commitment (Rev 3109) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in de -obligation of funds for this project. (2) Copy -- Include in award package to Caltrans District Local Assistance 3 Original — Local agenqy files C-21 Page 15-31 LPP 09-xx March 27, 2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE; It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal; 1) Black American; 2) Asian -Pack American; 3) Native American; 4) Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American x. Asian -Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The farm has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces. IMPORTANT: identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. Provide copies of the UDBEs' quotes, and if applicable, a copy of joint venture agreements pursuant to the Subcontractors Listing Law' and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of UDBE firms. Exhibit 15-G (1) must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agendas should complete the Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate €orris within the 1 S-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32 C-22 March 27, 2009 LPP 09-xx Local Assistance Procedures Manual Exhibit I5-G2 Local Agency Bidder DRE Information (Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE information (Construction Contracts) (Inclusive of all DBEs including the [TDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON TIME REVERSE'SII?E OF THIS FORM AGENCY -—LOCATION: PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT: S J BID DATE: 2 ' 2 ` Q IDDEWS NAME: S t^ tti P_CJ - S ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED DBE Cert. No. AND EXPIRATION DATE NAME OF DBEs (Must be certified on the date was are opened - include DBE address and phone number CONTRACT DOLLAR AMOUNT ITEM NO. DBE 1 v or Local Agency to Complete; Local Agency Contract Number: ederal Aid Project Number: Federal Share:lo Contract Award Date: Local Agency certifies that the DBE certification(s) has been verified and all information is complete and accurate.�— Print Name Signature Date Local Agency Representative Area Code Telephone Number: Total Claimed Participation 1 �� Signature of Bidder I,c,I 9 C nAOd. J' Date �rs ZdAr'e^a1 Code) Tel. No. / Or Caltrans Review: PrintName Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DRE Information (Roy 310) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within €5 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files C-23 Page15-32a LPP 0,9-xx March 27, 2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION ION (CONSTRUCTION CONTRACTS) (Revised 03109) The form requires specific information regarding the construction contract: Agency, Location, Project Description, Federal Aid Project Number (assigned by Caltrans-Local Assistance), Total Contract Amount, Bid Date, Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number (or Item No's) and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be. certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. HvTORTANT; identify all DBE firms participating in the project including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)), regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the total DBE dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts); to determine how to count the participation of DBE firms. Exhibit 15-G (2) must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date, Federal Share, Contract and Project Number fields, and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15»day time period may result in the de -obligation of funds on this project. District ABBE Coordinator should verify that all information is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b C-24 March 27, 2009 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDDE Information - Good Faith Effort Federal -aid Project No. Bid Opening Date The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder — UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder trade a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up UDBEs Initial Methods and Solicited Solicitation Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx C-25 March 4, 2009 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 011 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The following shall be added to Section 306-1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: Options for dewatering include discharge into a storm drain which requires the contractor to obtain a de- minimus discharge permit. The water can also be discharged into a sewer which requires the contractor to obtain a Special Discharge Permit from the Orange County Sanitation District. The contractor shall be responsible for any permit fees in addition to any fees or charges which may be assessed. Full compensation for obtaining and conforming with the requirements of this section shall be included in the cost of the pipe construction and no additional compensation will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: t Install curb ramp improvement per Caltrans Standard Plan A88A and the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. 3) SHEET 4 — TRAFFIC SIGNAL PLAN HEIL AVENUE AND TRUDY LANE The following shall be added to construction note 10: Refer to the "Typical Section at New Curbs and Ramps Adjacent to AC Paving" detail on sheet 5 of 5. This is to acknowledge receipt and review of Addendum Number One, dated April 8, 2010. W00'I0V@WVZ38UVZ3k!-IIVVY3 �- L c� Ivy_. 9931-G59-6b6 :XV-d Company Name 30926 VO °3NIr,81 By 0V# *10 3NIA81 CV6£ NOlion i1SNOO CNVIHi-nos SOUTHLAAND CONSTRUCTION 12 �- �� (ti' 3943 IRVINE BL. #40 Date IRVINE, GA 92602 TEL: 714-488-2891 FAX: 949-661-1265 REd7AM ®AOL.COM All bidders must acknowledge the receipt of this Addend&M*KRVRi.P bI proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. U RECEIVED 04/00/2010 10:15 City of Iffu 0 Beach PubUc Works 2OW PL-Ain Street AAM" on Beach, CA 92648 0 A rwm �„i�!il!''�'�r►!''IpII Fmw —�ot r-L--rlA 9, 0 Mfff,. an 6� / 3 6 7 Pamm a UMM& plll� R&Vmw 0 nemse CommmM El Meese Reor 0 ftmm MOCYC& SOUTHLAND CONSTRUCTION 3943 IRVINE El 440 JRVINE CA 92602. TEL: -,j4-488.289i FAX: 4 51-1265 9 R 86AM@A0L.CjOM EMAIL RE-7AR I RECEIVED 04/08/2010 18:15 CRY of Huntington Bead? Public Works Department 2000 Main Strut Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School in the Vicinity of Spring View Middle School CC 1367 April 8, 2010 Notice To All Bidders: Plea note the fdkmfng clarification to the Project Plans, moons, and Technical Provisions: 1) SPECIAL PROVISIONS SECTION 306-1.1.1 The fottowring shall be added to Section 30&1.1.1 of the special provisions. This paragraph shall be inserted after the first paragraph: OPOOM foe dewate:ring include discharge Into a stone drain which mqulres the contractor to obtain a de- minimus discharge pent' The center can also be diWarged Into a sewer which nequbms on contractor to obtain a Special Discharge Permit front the Chareoe County SanlhWwn plsOWL The contractor shall be responsible for any pew fees in addition to any flees or charges which may be assessed. Full conepensation for obtaining and conkwnft with the mquirerments of this sermon shall be included in the cart of tie pipe cordon and no additional comimmotion will be allowed therefore. 2) SHEET 2 — RAMP INSTALLATIONS AND SIGNING & STRIPING PLAN The first note in the legend shall be revised to read: Install curb ramp lnprovement per Calbans Standard Plan ASSA and the "Typical Section at New Curbs and Ranepe Adjacent to AC Paving" detail 4m sheet 5 of 5. 3) SHEET 4 -•- TRAFFIC SIGNAL PLAN HE]L AVENUE AND TRUDY LATHE The folowing shall be added to cor ebmcuon note 1o: Refer to the "Typical Section at New Curbs and Ramps Adlcent to AC Paving" deW on sheet 5 of & This is to ackmmledoe receipt and review of Addendum Number One, dated Aid 8, 2010. '( �-6 (.'el 60,VL Company Name- ..— By AN bidders must 8d4owtKlge the nice of this Addendum with your bid proposal. Steodd you haiae any questions regarding this Addendum, please cell wi iiam F. Janusz at (714) 5M-5431. 0 RECEIVED 04/08/2010 18:19 EODBOARD 4/8/2010 2:20:45 PM PAGE 1/001 Fax Server Date: 4/8/2010 9:46:58 AM From: City of Huntington Beach RE: Safe Routes to School in the vicinity of Spring View Middle School - Addendum posted To: Rez Zarrezam - Southland Construction Fax: (949) 651-1265 Phone: (714) 488-2891 Project Imo 'on• Project Name: Safe Routes to School in the vicinity of Spring View Middle School Contract #: CC 1367 Location: You are receiving this message because you are a plan holder for the referenced project. An addendum has been issued and posted for this project; the Contractor is responsible to include all addendums into the contract documents. Project Information: Project Na Powero By Construction Bid tanager :.` r SureTec Insurance Company BOND NO. 436 KNOW ALL MEN BY THESE PRESENTS, That we, Southland -Construction as Principal, and SureTec Insurance Company a corporation authorized to transact a general surety business in the State of CA as Surety, are held and firmly bound unto City of Huntington Beach (hereinafter called the Obligee) in the full and just sum of TEN PERCENT OF THE AMOUNT OF THE BID Dollars, $ 10�********* ( )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 Route to School in the Vicinity of Spring View Middle School — #1367 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 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. Signed and Sealed this 9th Southland Construction Reza Mohamedi — Owner Principal day of April 2010 YEAR SureTec Insurance Companyz_ Surety By:� Les M. Mantle Attorney .n-raci CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Oranges On ��4© before me, Mary Martignoni — Notary Public Date Here Insert Name and Tifle of the officer personally appeared Les M. Mantle Name(s) of Skyw(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 official steal. Signatucg�'�" OPTIONAL p/ signatV Notary 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: Les M. Mantle ❑ Individual ❑ Corporate Officer — Title(s): __ ❑ Partner — ❑ Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: SureTec Insurance Compan 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: 02007 National Notary Association • 9350 De Soto Ave., PO. Box 2402 -Chatsworth. CA 91313-2402 • www.NationalNotaryorg Item A5907 Reorder: Call ToM.lzree 1-800-876-6827 POA #: 510036 i Know Aft 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 Les M. Mantle, Ryan S. Mantle its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, 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 bond 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 10/31/12 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Nesolvect that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Auornev-in-Fact may 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 conditional 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 upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resohed, that the signature of any authorized officer and seal of the Company heretofore or hereafter 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 seat shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 2e of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 28th day of October, A.D. 2008. SURETEC INS CE COMPANY ,,. By, B.J. ids resident State of Texas ss: % County of Harris On this 28h day of October, 2008 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 SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seat affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. MichelleNoState of Um L j14A 41U� 1 Michelle Denny, Notary P Iic lYly commission expires August 27, 2012 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at liouston, Texas this 9th day of April , 2010 , A.D M, Brent aty, Assistant Secretary Any instrument issued in excess of the penalty stated above is tcially 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.