Loading...
HomeMy WebLinkAboutJ. RDMMAC Inc. - 2008-10-06RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to All City Clerk's Office 11� (Name) h after signing/datingL) (Date) We 'A., CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION 07" Allillillandw TO: S ha ri'Freiden rich, City Treasurer FROM: J , DATE: 41/ SUBJECT: Bond Acceptance I have received the bonds for (Company Name) 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. C/ MSC No. Approved A Agenda Item No. (Council Approval Date) City Clerk Vault No. #27 g1followup/bondlefter.doc ®�� City ofHuntington Beach INTER -DEPARTMENT COMMMUNICATION HUNTINGTON BEACH TO: THOSE LISTED HEREON FROM: David Verone, Contact Administrator DATE: April 20, 2009 SUBJECT: Retention Release Payment Company Name: J RDMmac, Inc Address: 14221 Whisperingsands City, State and Zip Code: Victorvile, CA 92392 Phone Number: (760) 955-8441 Business License Number: A 271876 Local Address: N/A Notice of Completion Date:3/11/09 Contract Purpose: Retention Release for Construction Contract 1244, Safe Routes to School Cycle IV The conformed copy of the Notice of Completion for the above contract has been filed The thirty-five (35) day waiting period has elapsed or will elapse before payment is made. Processing of the full retention ,payment is recommended so long as no stop notices or outstanding invoices are on file with the City. If any stop notices have not been cleared, then processing of partial retention is recommended with the retention of one hundred and fifty percent of the stop notice(s) amount and with no outstanding invoices on file with the City. I certify that are no notices are on file on the subject at this time. Date ravis rl/ opkins, Director of Public orks ny to ting I certify that there are no outstanding invoices on file. 2-? - 0 Date City Treasurer Freidbnrich, City Treasurer I certify that are no notices are on file on the subject contraG#, and that a guaranty bond has been filed with this office. { oan Fl"n, 00 Clerk 1244 retention release memo REV 2-2009 .doc l / 4/20/2009 1:59:00 PM Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: C,- C- V —a l } Project: Ca•-_CS�1yS --o <Z--- ;Y��_t The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VI[ 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 P 20 at ' California. , 3"CmA\ AK(- i r'1 L (7ype Contractor Alame) By: Name: [Type Name] M Title: [Type Title] TAORNEY 3.. up 2459t1.1 Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: C C l'��{ H Project: ^ G _ 1r ? - i�S A /U 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 udder the laws of the State of California that the foregoing is true and correct. Executed this day of , 20 . at V - , California. e , Sk "yo C (Type Contractor Name) By: cc-� C e�S' 'S t ► Name: [Type Name] Title: [Type Title] A `? =CMAR-MRN R EY 'TLY 03- ab • 01n 247542.1 CONTRACTOR'S CERTIFICATE I, C. P Qc—Ji PS , state and certify that: (Name of Declarant) is the general contractor to the City of Huntington Beach ("City') on Contract No. C C -- (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"): 0 C7u 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at yi, C_ ' I on APPROVED AS TO FORM By: S%i�%a —A.J 3• Zo•�� Name: [Type Name) Title: [Type Title) 20914.1 DEFECTIVE MATERIALS AND WORKMANSHIP (WARRANTY) BOND Bond No 43670605M Premium Included in Performance Bond KNOW ALL MEN BY THESE PRESENTS: That, J.RDMMAC, Inc., as Principal, and SureTec Insurance Company, a corporation organized under the laws of the State of Texas and authorized to do a surety business in the State of California, as Surety, are held and firmly bound unto the City of Huntington Beach in the sum of Forty -Seven Thousand Seven Hundred Fifty and 00/100, lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: WHEREAS, on October 29th, 2008, the said Principal, entered into an agreement (the "Agreement") for Public and On Site Improvements for:Safe Routes to School Cycle IV; CC-1244; for the sum of Forty -Seven Thousand Seven Hundred Fifty and 00/100 Dollars ($47,750.00); and, WHEREAS, under the terms of the specifications for said work, the said Principal is required to give a bond to protect the Obligee against defective work or labor done or defective materials furnished for a period of one year from and after the date of the completion and acceptance of same; to wit: one year from and after February 27th, 2009.. NOW, THEREFORE, if the said Principal shall for a period of one year from and after the date of the completion and acceptance of same by said Obligee pay the reasonable and necessary cost of repair of defective work or labor done or defective materials furnished in the performance of the Agreement, then the above obligation to be void; otherwise to remain in full force and effect; PROVIDED, HOWERVER, Surety and Principal shall be given reasonable notice and opportunity to cure any such defects as a condition precedent to Surety's liability hereunder. SEALED with our seals and dated this 3 I st day March, 2009. J.RI mm SureTec Insurance Company APP tS TO F RM JEN1NiF McGIRATH, City tt m y10-617 3033 Fifth Avenue ■ Suite 300 . San Diego, CA 92103 619-400-4100 . Toll Free 800-288-0351 a Fax 619-400-4101 Burchfiel, Attorney-in- 3033 Fifth Avenue ■ Suite 300 ■ San Diego, CA 92103 619-400-4100 e Toll Free 800-288-0351 . Fax 619-400-4101 ACKNOWLEDGMENT State of California County of Los Angeles March 31 st, 2009 On before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the personw whose nameod-57are subscribed to the within instrument and acknowledge o me that he/o/they executed the same in his"their authorized capacity), and that by hi /he /their signature on the instrument the perso'n, or the entity upon behalf of which the personal acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature 000440Q39•} 44 •b o¢i�ptl� ue'Q®iw¢?4YP91iP 446404+Yq S 6 0 i� a R T F 3 i C$. NIM 4 164.2285 P"h jI s r- GAS ORINA (i7 h1v Commission Expires Jan. 31, 2010 ooaoac�:ra;a•>o��aar.r��ax �e�. a,�-s�.�oagoo®4�,20� (Seal) POA #: 510026 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All 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 George Burchfiel, Shaunna Burchfiel of Corona, CA its true and lawful Attorney(s)-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 bonds were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the premises. Said appointment shall continue in force until 10/31/09 and is made under and by authority of the following resolutions of the Board of Directors of the Sure'Tec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with fitll 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: Attorney -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 Resolved, 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 seal 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 20"' 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 20th day of June, A.D. 2005. r VRETEC NCE COMPANY \_ B ua ; �y y B.J. Ki g, reside t State of Texas ss:�y z �� .° County of Barris On this 20th day o1'.lune, A.[). 2005 before me personally came B.J. King, to me known, who, being by me duly sworn, did depose and say, that he resides in. Houston, Texas, that he is President of SL'RF-1'I C INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal: that it was so affixed by order of the Board of Directors of said Company; and that lie signed his name thereto by like order. omoorroc�ommnm Michelle Denny Notary Public * ` State of Texas My Commission Expires 0f' August 27, 2008 Michelle Denny, Notary Pif lic My commission expires August 27, 2008 1, M. Brent Beaty, Assistant Secretary of SURE'fEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a titre 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 fulf force and effect. Given under my hand and the seal of said Company at Houston, Texas this 31 st day March 289 A.D. Brent W,ASsistantry Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. Company Profile Page 1 of 1 company 5earcn Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Financial Statements PDF's Annual Statements Quarterly Statements CA Supplements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer SURETEC INSURANCE COMPANY 952 ECHO LANE, SUITE 450 HOUSTON, TX 77024 Old Company Names Effective Date back to top Agent For Service )ERE KEPRIOS C/O CT CORPORATION SYSTEM 818 WEST SEVENTH STREET, 2ND FLOOR LOS ANGELES CA 90017 back to top Reference Information NAIC #: 10916 California Company ID #: 4914-8 Date Authorized in California: 10/24/2005 License Status: UNLIMITED -NORMAL Company Type: Property & Casualty State of Domicile: TEXAS back to top NAIC Group List NAIC Group #: 0000 back to top Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. SURETY back to top <c� 2008 California Department of Insurance http://interactive.web. insurance. ca. gov/companyprofile/companypro file?event=companyPr... 4/ 16/2009 RECEIVED BY: (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Sh reidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for (Company Name) 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. 14' /0 ,�ApprovedAgenda Item No. 141 (Council Approval Date) �� City Clerk Vault No. t�t�.� #27 gAollowup/bondletter.doc PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH Attn: Robert A. Martinez P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 TITLE OF DOCUMENT: Recorded in Official Records, Orange County Tom Daly, Clerk -Recorder Illllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll NO FEE 200900011335510:100 03/11109 100 200 N 12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 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 J. RDMMAC Inc. who was the company thereon for doing the following work to -wit: SAFE ROUTES TO SCHOOL CYCLE IV PROJECT, CC-1244 That said work was completed February 27, 2009 by said company according tol plans and specifications and to the satisfaction of the City Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on November 12, 2008, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract Suretec 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. I Dated at Huntington Beach, California, this March 3, 2009. Dir ctor of Vfiblic Works or City Engineer of Hu ington 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 Recordejof Orange County. Dated at Huntington Beach, California, this March 3, 2009. Director of Public Works or City Engineer hA —6ity of Huntington Beach, California THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) t°'*�.059-TITLE PAGE (R7/95) :...^..T^."�-"•r-t i,[-hi`�, - .u,.T _. i.,..,---^^.v,.._..-.-,,..—..rA.,�.,-..s-�i,�.......:--c.:-�.: .;. ., .t tea..+-w�,...v' n.; .' ..:,�,-i..:.7-,..`,r�v...... - �.—�-. -.... .,- .: _ . ..,ti _ 9:w,,; »,�„,�' _.<;.-v.�r`-^'�-wYr. RECEIVED BY- (Name), " I /1,0 0 � (Date) J i CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating 90' " TO: Shari Freidenrich, City Treasurer /� i/Or'FROM: ���� DATE: 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. i zf v MSC No. Approved (Council Approval Date) (Company Name) t Agenda Item No City Clerk Vault No #27 gAollowuplbondletter.doc FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN �-- THE CITY OF HUNTINGTON BEACH AND 1�. monp-r- Inc - FOR s +0 i cG,Z C- TABLE OF CONTENTS Page No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 3 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 4 7. NOTICE TO PROCEED 5 8. BONDS 5 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 6 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 9 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 10 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 10 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12• 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT & TERMINATION 14 24. TERMINATION FOR CONVENIENCE 14 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 15 27. CITY EMPLOYEES AND OFFICIALS 15 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 15 29. NOTICES 16 30. SECTION HEADINGS 16 31. IMMIGRATION 16 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 34. INTERPRETATION OF THIS AGREEMENT 35. GOVERNING LAW 36. DUPLICATE ORIGINAL 37. CONSENT 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 39. CALIFORNIA PREVAILING WAGE LAW 40. CALIFORNIA EIGHT -HOUR LAW 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 42. EMPLOYMENT OF APPRENTICES 43. PAYROLL RECORDS 44. FEDERAL PARTICIPATION 45. ADDITIONAL FEDERAL REQUIREMENTS 46. DAVIS-BACON ACT 47. DISCRIMINATION, MINORITIES, ALIENS 48. EQUAL EMPLOYMENT OPPORTUNITY 49. COPELAND "ANTI -KICKBACK" ACT 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 52. ENERGY CONSERVATION 53. HOUSING AND URBAN DEVELOPMENT 54. SIGNATORIES 55. ENTIRETY 17 17 18 18 18 18 19 19 20 20 20 21 21 22 22 23 23 24 25 25 25 25 25 ii FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTTON BEACH AND A 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 T(Z -D M d �� o�� , a hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as k V 4M `�e6—� in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not g/agree/ surfnet/federal const 12-07 1 limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK: PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; g/agree/ surfnet/federal const 12-07 2 D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference), and the Federal Requirements from FHWA 1273 and additional requirements (which is attached hereto as Exhibit "B"); F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. g/agree/ surfnet/fedeml const 12-07 3 Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed 'a:;'AVy gZ- .Vzo�d jiryeoj H'.nd re., -A-! Dollars ($ " ), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within �� htd'�`✓ ( �) consecutive oatkkv%c� �A)LS' from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/ surfnet/federal const 12-07 4 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/ surfnet/federal const 12-07 5 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/ surfnet/federal const 12-07 6 secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of Five �1.4ajdd-e cl Dollars ($ 5 oz:> . 0M. ) 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/ag ee/ surfnet/federal const 12-07 7 CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DIFFERING SITE CONDITIONS A. Notice: CONTRACTOR shall promptly, and before such conditions are disturbed, notify DPW in writing of. (1) Subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents; or g/agree/ surfnet/federal const 12-07 8 (2) Unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the character to be performed under this Agreement. DPW shall promptly investigate the conditions and if it finds that such conditions do materially so differ and cause an increase or decrease in the time required for performance of any part of the work under this Agreement, whether or not changed as a result of such conditions, an equitable adjustment shall be made and the agreement modified in writing accordingly. B. Time Extension: No claim of CONTRACTOR under this Section shall be allowed unless CONTRACTOR has given the notice required hereunder provided, however, the time prescribed therefor may be extended by CITY. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an g/agree/ surfnet/federal const 12-07 9 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, ten percent (10%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the Agreement price shall not be considered as a acceptance of any part of the work. g/agree/ surfnet/federal const 12-07 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by g/agree/ surfnet/federal const 12-07 11 CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, g/agree/ surfnet/federal const 12-07 12 a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above -mentioned insurance contain a self -insured retention, or a "deductible" or any other similar form of limitation on the required coverage. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. g/agree/ surfnetlfederal const 12-07 13 The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 23. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may g/agree/ surfnet/federal const ] 2-07 14 make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. g/agree/ surfnet/federal const 12-07 15 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: g/agree/ surfnet/federal const 12-07 16 TO CITY: City of Huntington Beach ATTN: -J) .4-J 4'W kJ' d2Cry1 C 2000 Main Street Huntington Beach, CA 92648 30. SECTION HEADINGS TO CONTRACTOR: ' 2Z1 VVSFeIr S'knds A 92342 i r The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. g/agree/ surfnet/federal const 12-07 17 33. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 34. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 35. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. g/agree/ surfnetlfederal const 12-07 18 36. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 37. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 39. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of g/agree/ surfnet/federal const 12-07 19 Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 40. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty- five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is g/agree/ surfnet/federal const 12-07 20 required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 42. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 43. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 44. FEDERAL PARTICIPATION The PROJECT pursuant to which the work covered by this Agreement is being executed is being assisted by the United States of America. Several Agreement provisions embodied herein are included in this Agreement in accordance with the provisions applicable to such federal assistance. As federal funds are financing all or part of this work, all of the statutes, g/agree/ surfnet/federal const 12-07 21 rules and regulations promulgated by the Federal Government and applicable to the work will apply, and CONTRACTOR agrees to comply therewith. Attached is FHWA Form 1273, known as Exhibit "B", which describes required contract provisions for federal -aid construction contracts. Additionally, the CONTRACTOR shall insert in each subcontract all of the stipulations contained in the Required Contract Provisions of Form 1273, and further require their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. Certain sections of Form 1273 may not be applicable depending upon the project and will be crossed out. 45. ADDITIONAL FEDERAL REQUIREMENTS CONTRACTOR agrees to abide by the additional requirements necessary for federal- aid (see pgs. 12-14 of Exhibit "B"). The CONTRACTOR agrees to buy only steel and iron made in the United States for all federal -aid construction projects ("Buy America"). The CONTRACTOR also agrees to be subject to the legislative and regulatory Disadvantaged Business Enterprise (DBE) requirements (42 USC Section 2000d, et seq.). If the CONTRACT does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non -collusion certification. Select projects may also require "Federal Trainee" or "On -the -Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined by the Secretary of Labor in accordance with the Davis -Bacon Act (40 USC Section 176a, et seq.) g/agree/ surfnet/federal const 12-07 22 for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 46. DISCRIMINATION, MINORITIES, ALIENS CONTRACTOR shall not discriminate nor allow its employees, agents, principals, or subcontractors to discriminate against any employee or applicant for employment on the basis of race, religious creed, national origin or sex. CONTRACTOR shall take affirmative steps to hire local qualified minority individuals when job opportunities occur and utilize local business firms when possible. 47. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled "Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit "B"). CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 (38 USC Section 219 et seq.) prohibits job discrimination and requires affirmative action to comply and advance in employment (1) qualified Vietnam veterans during the first four (4) years after their g/agree/ surfnet/federal const 12-07 23 discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 48. COPELAND "ANTI -KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations, which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 49. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327 et seq.) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight (8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in excess of eight (8) hours in any calendar day or forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or g/agree/ surfnet/federal const 12-07 24 dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 50. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 114 of the Clean Air Act and section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. g/agree/ surfnet/federal const 12-07 25 51. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 USC Section 6201, et seq.). 52. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 53. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 54. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that 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 12-07 26 inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on ()CT O,6E)�— 06 , 20 0( CONTRACTOR �r By: print name ITS: (circle one) Chairman residen�✓Vice Presop AND LM Tint- e. ITS: (circle one -.Secreta Chief Financial Officer/Asst. Secretary - Treasurer —} g/agree/ surfnet/federal const 12-07 27 CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California INITIATED AND (APPROVED: A-- 1 irector ofPublic Works REVIEWk6A4 APPROVED: APPROVED AS TO FORM: t Z ®0 TX1, ( )M� ity Attorney SECTION C EX #���r PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bill 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. 0 C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 1 V15 I L.S. � Jg4✓' 3yyRM' MPml F°i Mobilization. @Sje\r ,evv ,y. ,C,ea $ " iN5y^ aiv&- $ 100 2 1 L.S. Per L.S. Monument Preservation.c3� @ O A, &) Nec� $ ��l)' $ 3 1 L.S. Per L.S. Furnish Project Traffic Control. @ QKN E XWQS,+5c� Glib' cro $���� — g $ 4 1 L.S. \rNee-fo Per L.S. Furnish and Install Traffic Striping and Signing. @ a)4 $I — $ 5 13 EA. Per L.S. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and $ $ 33 1. So AC Paving Replacement. 6 4 EA. � t er EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ �j S $ Q, 34 0 Poles are City Furnished) @ C\\119- 01��V E Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan O �O $ (_ $ 207. Sidewalk Locations as Determined by the City. 6641 AMZ��6-00 Per S.F. Total Amount Bid in Figures: $� s Total Amount Bid in Words: $��� ��llL�►�Tx`�ClAi �O �i��l� Obi ��`1 Note: The City will provide the radar feedback signs and Type 1 A poles (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-2.1 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 and Address of Subcontractor 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 CA-erodsmaP , being first duly sworn, deposes and says that he or she is PP -es t CNEX>fi of nj ' 0VVvwA-Prc `IJC 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. o MARYELLEN S. TOR . COMM 91779724 mnraRv QUgi_iC CAUFORNiA " ORANGE'COUNTY C; MY COMM Expires 0ea. 9.2011 tya1t �u1k�51P�.�N� Sb•N�S Address of Bidder Subscribed and sworn to before me this 168day of , 20 (IL. l toZ'6 -oe0 sej!dx3 uIw00 FW "NA00 30NVIdO W f-' ViN6lO311V0 onand AtlY1oN U 4ZLULi#'1 VY00 q m 38dol 'S N3'1-13,1M1AW NOTARY PUBLI y j, , ��Q NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: M - \a?rrCL - i,a Contractor 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. s C-7 Contractor Title UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER certifies that the following information is true and correct: �)- * CM Bidder Name qCfAa'5Ah4tS Business Address Qa3�ti City, State Zip �71�r ) q6S 1�, L w Telephone Number State Contractor's License No. and Class c g=-Xf LZ Original Date Issued %- Expiration Date The work site was inspected by C6"bf our office on Oq-%Q " , 20CI The following are persons, firms, and corporations having a principal interest in this proposal: C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name Signature of +q CA�kQlaWb.5 Printed or Typed Signature Subscribed and sworn to before me this I—Aay of , 200 o MARYELLEN S. TORR' COMM. #1779724 mNOTARY PUBLIC CALIFORNIA ORANGE COUNTY ray Comm. Expires Dec. 9, 2;>5 f NOTARY NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1 2 93 N Name and Address of Public Agency Name and Telephone No. of Project Manager: 1 f, �(W16j �1COU- C135 -moo" (- 4,5- Contract Amount Type of Work en• -a% Date Completed Name anh Address of Public Agency Name and Telephone No. of Project Manager: W%c,� R 6 AM-K3 0 Contract Amount Name an&Address of Public Agency Type of W ®g/ a I& Date Completed Name and Telephone No. of Project Manager: 1AV.,UV A" &—r1 c--, qsi - cp -- X43 7q.„_-mod F Contract Amount Type Date Completed C-10 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contact Phone: ng6,�� j Signed: _UA (']A Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C t i (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder,proposed subcontractor j.�(3> � , hereby certifies that he has W T has not V ,ctparticipated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering*agency,'"or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the .Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Pave 12-79 LPP 01-04 March 75, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G UUMPLbihikuzs1•UKM1UIJLJI.LVJr;LU13L3I1NUAl.,1lV1111~.JruAbUAN11V)1V.J.k, 1.17G 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: na. contract FT bid/offer/application ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year ' quarter_ f. loan insurance date of last report 4. Name and Address of Reporting Entity S. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: , 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11. 12. 14. Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. i 0a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee . b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation 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: _ W, iwL was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: l ( C o i� 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than hone NJL Date: () o.4 ' - SI00,000 for each'such failure. Telephone Authorized for Local Reproduction Federal Use Only: Standard Form - LLL IZ—A-1 F.— t_I1. Rev n9-17-97 LPP 01-04 Page 12-87 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I . Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action- (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev. 06-0440«ENDIF>? Page 12-89 LPP 01-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. 4i-c--Ik Company Namef By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. ,+�e i - Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, J.RDMMAC. Inc. as Principal, (hereinafter called the "Principal'), and SureTec Insurance Company , a corporation duly organized under the laws of the State of Texas , 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 Total Bid Amount Dollars ($10% of Total Bid Amount ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for C.C. No 1244 - Handicapped Ramps Construction 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 famished 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 9th day o Witness SureTaWnsurance Company S,lk, Surety , SEE ATTACHED ACKNOWLEDGEMENT By �A (SEAi) Witness Shaunna Burchfiel Attorney -in -Fact Printed in cooperation with the American Institute of Architects (AIA) by vouches that the language in the document conforms exactly to th s l;�nguage used in AIA Document A-310, February 1970 Edition. BID70000ZZ0701f ACKNOWLEDGMENT State of California County of Los Angeles September 9th, 2008 On before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person(,s'J whose nameoj I are subs abed to the within instrument and acknowledge o me that he/o/they executed the same in his"their authorized capacity), and that by hi"!their /their signature on the instrument the person, or the entity upon behalf of which the persono 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. 4444464444;44440i44400440444O400N44i4444 WITNESS my hand and official seal. r TRACT LARSOND W Comm # 1642285 m NOTARY PUBLIC - CALIFORNIA :1) Q LOS ANGELES COUNTY s Commission Expires Jan. 31, 2010 e ^ ,,t��..-----q` 040440040440444444f0p0400N40404040400000 Signature \Vf (Seal) ran #: 510026 a Know All 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 George Burchfiel, Shaunna Burchfiel of Corona, CA its .true and lawful. Attorneys) -in -fact, with full power and authority hereby conferred in its name, place and.stead, to execute, acknowledge and deriver 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 hind the Company thereby as fully and to. the same extent asifsuch bonds were signed by the President, sealed with the corporate seal of. the Company and duly attested by its Secretary; hereby ratifying and confirming all that the said Attorneys) - in -Fact may do in the premises. Said appointment shall continue in force until 10/31/09 and is made under and by authority of the following resolutions of the Board of Directors of SureTec Insurance Company: Be it Resolved, that the President, any Slice -President, any Assistant Bice -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 ofthe Company subject to the following provisions: Attorney -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; recognizanees, 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 Attomey-in-)*act shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, 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 seal 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 20 ojAprd, 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 20th day of June, A.D. 2005. inn VTECURANCE COMPANY c'`�ON By:M: de t State of Texas ss: `�; County of Harris On this 20th day of June, A.D. 2005 before me personally came B.J. King, to me known, who; being by.me duly sworn, did depose and say, that he resides in Houston; Texas, that he is. President of SURETEC INSURANCE COMPANY, instrument; that he knows the seal of said Company; that the seal affixed to said instrument i Board of Directors -of said Company; and that he signed his name thereto by like order. omarm Michelle Denny .to`�'Y i+bfcny Public State of Texas ;,ram VV Commission I xl W August 27, 2008 the company described in and which. executed the above s such corporate seal; that it was so affixed by order of the ` 1(m e" _ Michelle Denny, Notary P tic My commission expires August 27, 2008 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 Houston, Texas this day �S'� F , 20i� , A.D. Brent Bea , sistant See tary Any Instrument issued in excess of the penalty stater! above Is totaily void and without any validity. For verification of the authority of this power you may call (7 i 3t 812-0800 any business day between 8:00 am and 5:00 pm CST. City ®f Huntington Beach 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK December 9, 2008 J. RDMMAC, Inc. 14221 Whispering Sands Victorville, CA 92392 Attn: Javier Cardenas Re: Safe Routes to School, Cycle IV — CC-1244 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 Vil of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5437. JF:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid Bond (original) Sister CitVf -!'° dyd �calayoan�'c%s, VNi�aWeVe` New Zealand (Telephone: 714-536-5227 ) Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20_, at , California. (Type Contractor Name) By: _ Name Title: [Type Name] [Type Title] AS TIUOW 41 E: MQL%, CITY ATTORNEY -TLS US- ab - My 247542.1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20_, at , California. (Type Contractor Name) By: Name: [Type Name] Title: [Type Title] E , IF R A oRNEX -P-,) 3-2y(,)-up 24591 1.1 CONTRACTOR'S CERTIFICATE I, , state and certify that: (Name of Declarant) l • is the general contractor to the City of Huntington Beach ("City") on Contract No. (the "Contract") for the construction of the public work of improvement entitled: (the "Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3. Except for the claims listed.below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at APPROVED AS TO FORM on this day of 120 By: 2,o-0Le Name: [Type Name] Title: [Type Title] (Signature of Declarant) 1 245914 1 AC®R®TM CERTIFICATE OF LIABILITY INSURANCE NTE D10/27/2008YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CROSBY VV INS.AGENCY LIC #0767091 760 245 5225 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO BOX 2619 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VICTORVILLE, CA 92393-2619 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER ANAVIGATORS INSURANCE CO. J. RDMMAC, INC. INSURER BCENTURY NATIONAL INSURANCE CO. ATTN: JAVIER CARDENAS 14221 WHISPERING SANDS INSURER C: VICTORVILLE, CA 92393 INSURER D: INSURER E: CnVFRAGFS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO. WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRDOF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A X G'cidERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 04-10046613 5/16/2008 5/16/2009 1 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurence $ CJD O00 MED EXP (Any one person) $ 5,000 CLAIMS MADE �OCCUR PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 X1 POLICY 7PRO- LOC IECT B X AUTOMOBILE LIABILITY ANY AUTO BAP-161599 5/18/2008 5/18/2009 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ X ALL OWNED AUTOS SCHEDULED AUTOS - BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS � �-i VvD ASF PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY 4 (/ AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WC STATU- OTH- WORKERS COMPENSATION AND ITFIR E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPcZIETOPIPART14E[ZIEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS THE FOLLOWING ARE NAMED AS ADDITONAL INSUREDS PER ATTACHED ANF -ES 160 (5/06): CITY OF HUNTINGTON BEACH, ITS AGENTS, OFFICERS & EMPLYEES EXCEPT FOR 10 NOTICE FOR NON PAYMENT C:tK I IF CITY OF HUNTINGTON BEACH DEPT OF PUBLIC WORKS PO BOX 190 HUNTINGTON BEACH, CA 92648 ACORD 25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL' IMPOSE NO OBLIGATION LIABILITY OF ANY jf'INIp UPON THE INSURER, ITS AGENTS OR ©ACORD CORPO 2F�ATT�bN 1988 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.\ BLANKET ADDITIONAL INSURED ENDORSEMENT (EXCLUDING RESIDENTIAL) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) CG 20 10 11 85 SCHEDULE Name of Person or Organization: CITY OF HUNTINGTON BEACH, *ITS OFFICERS, Any person or organization that the named insured is obligated by virtue of a written contract or agreement to provide insurance such as is afforded by this policy. AGENTS, & employees WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. The following additional provisions apply to any entity that is an insured by the terms of this endorsement: Prima Wording If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-insurance maintained by the above additional insured(s) shall be excess of the insurance afforded to the named insured and shall not contribute to it. 2. Waiver of Subrogation If required by written contract or agreement: We waive any right of recovery we may have against an entity that is an additional insured per the terms of this endorsement because of payments we make for injury or damage arising out of "your work" done under a contract with that person or organization. 3. Neither the coverages provided by this insurance policy nor the provisions of this endorsement shall apply to any claim arising out of the sole negligence of any additional insured or any of their agents/employees. 4. This endorsement does not apply to any work involving or related to properties intended for permanent residential or habifational occupancy (other than apartments). The words "you" and "your" refer to the Named Insured shown in the Declarations. "Your work" means work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. ANF-ES 160 (5/2006) RECEIVED BY: (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Shari Frei enric , City Treasurer FROM:Cl or DATE: SUBJECT: Bond Acceptance I have received the bonds for (Company Name) 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. L MSC No. Approved f/ (i Agenda Item No. (Counc'Approval Date) City Clerk Vault No. o� . DIVA �6 #27 g1followup/bondletter.doc Premium for contract term and is subject to adjustment based on final contract price Bond No, 46370605 Premium: $1,194.00 PERFORMANCE BOND Issued in one original counterpart KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereinafter referred to as "Citn No, by written agreement dated October 6th , 20 Og • entered Into a Contract with J.RDMMAC, Inc. PO Box 1481, Victorville, CA 92393 (name sad address of contractor) (hereinafter referred to as "Prindpar), for performance of the work described as follows: Safe Routes to School, Cycle IV Cash Contract 1244 (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract. NOW THEREFORE, we, the undersigned, as Principal, and SureTec Insurance Company 3033 5th Avenue, Suite 300, San Diego, CA 92103 - (name and address of Surety) (a duly admitted "Surety"), as Insurer under the laws of the State of Califomis and hereinafter referred to as are held and finny bound unto City in the penal sum of arty Seven Thousand Seven Hundred Fifty and 00/100 Dollars ($ 47, 750.00 1, this amount being not less than one hundred percent of the price set forth in the Contract, in lawful money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents, THE CONDITION OF THIS OBUGA11ON IS SUCH THAT if the Principal shag promptly, fully and faithfully perform each and an 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") fmm any and all losses, liability and damages, claims, judgments, stop notices, tees 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 fierce 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, restrlat, impair or release the obligations of the Surety under this Bond. Surety weaves notice of any adjustment of contract time or contract Rrtce, and 377321.1 PERFORMANCE BOND Page 1 of 2 Bond No, 4370605 any other alteration, change, deletion, additionor other modification to the Contract, or the work to be performed thereunder, and agrees to automatically adjust the penal sure of this Bond to reflect such adjustments, alterations, chess, 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 parry'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. Wed: October 29th, 2008 ATTEST J.RDMMAC, Inc. (Corporate Seal) (Prl pal Name) By. i Name b\�► ��fy, Cbfi Title:?1? ATTEST SureTec Insurance Company (Corporate Seal) (Surety Nam) BY: J�� A (� Name: aunna Burchfe1, Attorney -In -Fact (Signature of Attorney -in -Fact for Surety) %Attach Attorney -in -Fact Certiircate) 8( 00,288-0351 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY O UNTINGTON BEACH $y. Tra�� ennifer Mc ath '�l��lgt ily Attomay Nate: 771/s bond most be executed in dunGoste and dated, aD sWWures must be notarized, and evidence of the authority of anyperaon st nft as attomajo in -fad must be etfadmd- 27MIA PERFORMANCE BOND Page 2 of 2 ACKNOWLEDGMENT State of California County of Los Angeles On October 29th, 2008 Traci Larson before me, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the persWhIthey whose name I are subs abed to the within instrument and acknowledge o me that he executed the same in his"their authorized capacity), and that by hi /he /their signatureA on the instrument the person, or the entity upon behalf of which the person(O 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. 44944$4.4stA4641R4+Pti4444O44iO4P4444444444 TRACI LARSON D WITNESS my hand and official seal. . COMM # 1642285 W NOTARY PUBLIC - CALIFORNIA LOS ANGELES COUNTY My Commission Expires Jan. 31, 2010 0 444444?A44?444444444444400944444444444444 Signature (Seal) Premium for contract term and is subject to adjustment based on final contract price Bond No. 4370605 Premium Included in Performance Bond PAYMENT BOND Issued in one original counterpart KNOW ALL PERSONS BY THESE PRESENTS that; WHEREAS, the City of Huntington Mach (hereinafter referred to as "City") has awarded to J.RDMMAC, Inc. PO Box 1481, Victorville, CA 92393 (name and addms of Cor►trWWl (hereinafter referred to as "Principar), a contract ("Contract") for the work described as follows - Safe Routes to School, Cycle IV Cash Contract 1244 (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, materialman, and other persons as provided by law. NOW THEREFORE, we, the undersigned Principal, and SureTec Insurance Company 3033 5th Avenue, Suite 300, San Diego, CA 92103 (name and address of surety) (a duty admitted surety insurer under the laws of the State of Caliifomia and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of Fortv Seven Thousand Seven Hundred Fiftv and 00/100 dollars, ($47,750.00 1, this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the united States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, sucoessors 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 worts 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 Califomia 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 reoeived, 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, r nas.1 PAYMENT BOND Page 1 of 2 Bond N0,4370605 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 VATNESS MEROF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each Corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duty authorized pursuant to the authority of its governing body. Surety, by execution of this hand, 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: October 29th, 2008 ATTEST J.RDMMAC, Inc. (Corporate Sean (PrincipalMarne) By: ��A � �!, � , Dame: �e Its: 3V- I ATTEST (Corporate Seal) ( Bch Attorney -ins -Fact Certificate) 8f OO) 288-0351 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OF HUN11NGTON BEACH By nnifer Meth ity Attorney s h/bb Mote: This bond must be executed in duprxvta and dated, aN sigrratums must be nofa*ad, end awdenco of the auth"y Of anyP*fW siOmng as at y-Wad gust be aftaChed. 2M".1 PAYMENT BOND Page 2 of 2 State of California County Of Los Angeles On October 29th, 2008 before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person whose name are subs ribed to the within instrument and acknowledge o me that he/ h /they executed the same in his"their authorized capacity), and that by hi /he /their signature on the instrument the person; or the entity upon behalf of which the personal acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. 9aooaoaoaa00000aaoaaaeaoa000aaaae+oaoaoao TRACI LARSON D WITNESS my hand and official seal. COMM # 1642285 m UJ NOTARY PUBLIC - CALIFORNIA to Q LOS ANGELES COUNTY My Commission Expires Jan. 31, 2010 e �aaaoao�ra000aaae000eaesoaaoaooa000aaaaaoo Signature (Seal) POA #: 510026 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All 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 hlouston, Harris County, Texas, does by these presents make, constitute and appoint George Burchfiel, Shaunna Burchfiel of Corona, CA its true and lawful Attorney(s)-in-fact, with fall 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 bonds were signed by the President, sealed with the corporate seal of the Company and duly attested by its. Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the premises. Said appointment shall continue in force until 10/31 /09 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved that the President, any 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: Attornev-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 Resolved, 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 seal 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 20`h 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 20th day of June, A.D. 2005. RETEC NCE COMPANY Lt.�saf t� _:.tea t%• �•.•. .o s: '• :.aa B.J. Kng,Yrisidet CL i C3 State of Texas ss: °•, x County of Ifarris >` On this 20th day of June, A.D. 2005 before me personally came B.J. King, to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURI EIC INSURANCE COMPANY, the company described in and which executed the above instrument. that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that lie signed his name thereto by like order. -------------- Michelle Denny F'c",D Notary PLU10State of TexasMyComminion Expires Michelle Denny, Notary P` lic August 27. 2008 My commission expires August 27, 2008 1, M. Brent Beaty, Assistant Secretary of SURETEC IN''SURANCE COMPANY, do hereby certi fy 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 Houston, Texas this 29th day t October 1008 A.D. Brent Bea , sistant Sec tary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. id Council/Agency Meeting Held: 6 Z b� Deferred/Continued to: Ap roved ❑ Conditionally A roved ❑ Denied Ci CI rk's Ignature' tyu Council Meeting Date: 10/6/2008 Department ID Number: PW 08-70 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY COUNC L MEMBERS SUBMITTED BY: FRED A. WILSON, CITY ADMINISTRAT PREPARED BY: TRAVIS K. HOPKINS, PE, DIRECTOR O U �'-IC SUBJECT: Award Safe Routes to School Project - Marine View Middle School Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environmental Status, Attachment(s) Statement of Issue: The Safe Routes to School Project, CC 1244, was advertised and twelve bids were received on September 15, 2008. Staff requests the City Council award the project to the lowest responsive and responsible bidder, J. RDMMAC Inc. Funding Source: Grant funds in the amount of $76,860 are budgeted in the Safe Routes to School Fund Traffic Improvements, 87890002.82700. Matching funds in the amount of $36,140 are budgeted in the Gas Tax Fund 20790007.82700. The estimated cost of the project is $95,000, which includes the purchase of equipment by the City. Recommended Action: Motion to: 1. Approve the project plans and specifications for the Safe Routes to School, Cycle IV Project in the vicinity of Marine View Middle School, CC-1244; 2. Accept the lowest responsive and responsible bid submitted by J. RDMMAC Inc., in the amount of $47,750.00; and 3. Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids and direct staff to readvertise or abandon the project. _�P REQUEST FOR CITY COUNCIL ACTION MEETING DATE: 10/6/2008 DEPARTMENT ID NUMBER: PW 08-70 Analysis: In May 2003, the City, working in conjunction with the Ocean View School District, applied for a grant for traffic safety improvements in the vicinity of Marine View Middle School under the Safe Routes to School Program. The grant was approved and the State allocated funds in September 2005. The estimated cost for this project is $95,000. State funds will be appropriated in the amount of $76,860. The balance of the funding is from Gas Tax Funds as indicated in the 2008/09 Capital Improvement Program. The City typically purchases all major components of the electrical equipment directly. This practice ensures consistency of equipment among the traffic signals, lighting, and radar feedback signs maintained by the City. Direct purchase also provides the added benefit of reduced costs to the City due to elimination of contractor mark-ups. The project includes installation of curb ramps, damaged sidewalk replacement, the installation of radar feedback signs to display motorists' speed, and signing and striping improvements. A complete set of plans and specifications are available for review at the Public Works counter during normal working hours. Bids were opened publicly on September 15, 2008, and are listed in ascending order: Bidder Submitted Bid 1 J. RDMMAC Inc. $47,750.00 2 California Engineering & Contracting, Inc. $47,850.00 3 Golden State Constructors, Inc. $56,700.00 4 International Paving Solutions, Inc. $60,273.00 5 GMC Engineering, Inc. $64,000.00 6 Nobest Incorporated $69,000.00 7 Elite Bobcat Service, Inc. $75,000.00 8 Pacific Coast Infrastructure, Inc. $77,300.00 9 CJ Construction, Inc. $88,700.00 10 HYM Engineering, Inc. $92,500.00 11 Damon Construction Company $106,972.00 12 ACR Concrete & Asphalt Construction, Inc. $128,200.00 The reference check for J. RDMMAC 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 J. RDMMAC Inc. as the lowest responsive and responsible bidder. Public Works Commission Action: The Public Works Commission recommended the project on August 20, 2008, by a vote of 6-0-1 (Siersema absent). -2- 9/18/2008 10:30 AM REQUEST FOR CITY COUNCIL ACTION MEETING ®ATE: 10/6/2008 DEPARTMENT I® NUMBER: PW 08-70 Strategic Plan Goal: (1-1) Improve the City's plan for funding and completing infrastructure needs, and develop strategies for resolving crucial infrastructure problems to preserve the physical foundation of the community and enable the community's value to grow. (C-1) Improve transportation through a variety of means including improving traffic flow, synchronizing traffic signals, traffic calming, and alternative transportation methods such as bike and walking paths. Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c). Attachment(s): -3- 9/18/2008 10:30 AAA ATTACHMENT #1 CITY OF HUNTINGTON BEACH * PUBLIC WORKS * TRAFFIC ENGINEERING ® LOCATION MAP ATTACHMENT SAFE ROUTES TO SCHOOL PROJECT - MARINE VIEW MIDDLE SCHOOL 1 ATTACHMENT WARNER J l / / AVE. l z 0 r z z `9 ROGERS z DR. Ix i z JFl Z WHISTLER CR. r w m w RENOIR x CR. a Gy BRANNEN DR. GERSHWIN LL DR. r F � 3' LL LIEGE DR. C. 4 IN i m 9 G SLATER F TILBURG MARINE VIEW MIDDLE SCHOOL LEGEND F = SIGN = RADAR SIGN x s = "SLOW SCHOOL XING" LEGEND • = CURB RAMP IMPROVEMENT DR. CHANNEL DORITA DR. CONSTRUCTION NOTES 1O REPAINT EXISTING "SLOW SCHOOL XING" LEGEND (YELLOW) O REPAINT CROSSWALK (YELLOW) O INSTALL FLUORESCENT YELLOW GREEN W63 (36"X36") & W65 PER CALTRANS INSTALLATION "A" O INSTALL RADAR SIGN M: TRAFFIC DRAWINGS/SR2S/MARINE VIEW — RAMPS CITY OF HUNTINGTON BEACH low DEPARTMENT OF PUBLIC WORKS MARINE VIEW MIDDLE SCHOOL PROPOSED IMPROVEMENTS ATTACHMENT 2 INITIATING DEPARTMENT: Public Works SUBJECT: Award Safe Routes to School Project - Marine View Middle School COUNCIL MEETING DATE: October 6, 2008 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable El Resolution (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Tract Map, Location Map and/or other Exhibits Attached Not Applicable ❑ Contract/Agreement (w/exhibits if applicable) Attached ❑ (Signed in full by the City Attorney) Not Applicable Subleases, Third Party Agreements, etc. Attached ❑ (Approved as to form by City Attorney) Not Applicable Certificates of Insurance (Approved by the City Attorney) Attached ❑ Not Applicable Fiscal Impact Statement (Unbudgeted, over $5,000) Attached ❑ Not Applicable Bonds (if applicable) Attached ❑ Not Applicable Staff Report (If applicable) Attached ❑ Not Applicable Commission, Board or Committee Report (If applicable) Attached ❑ Not Applicable Findings/Conditions for Approval and/or Denial Attached ❑ Not Applicable ATTACHMENTSEXPLANATION FOR MISSING REVIEWED � �RETURNED, FOR A DE°D� Administrative Staff ( ) ) Deputy City Administrator (Initial) City Administrator (Initial) ( ) ) City Clerk ( ) I EXPLANATION FOR RETURN OF ITEM: RCA Author: Janusz:jg City of Huntington Beach CC-I244 Safe Routes to School, Cycle IV Marine View Middle School Bid Opening: September 15, 2008 @ 2:30 P.M. Engineer's Estimate: $113,000 Rank Bidder's Name Bid Amount Corrected Bid Amount 4 7CO (CR — Concrete & Asphalt Construction, Inc. 1)j� lJl1 Andy Quiocho Concrete California Engineering & Contracting, Inc. C.J. Construction, Inc. U 0—70o C.S. Legacy Construction, Inc. // ✓ Damon Construction Company . a EBS ow `dMC Engineering, Inc. / Dd© �4 3 GSCI — Golden State Constructors, Inc./ s (o/ Hym Engineering, Inc. �_ 9 / IPS / D -� ( ''� Mmac °�° Los Angeles Signal Construction, Inc. Moore Electrical Contracting, Inc. Nobest Incorporated Pacific Construction Co. �X, PCI — Pacific Coast Infrastructure, Inc. .�j�y�l✓ �C./ PTM Engineering i Steiny & Company, Inc. 20g3 ,�Fr -p ., 15 Pll 2: I e :2 I I Jjs cool NOTICE INVITING SEALED BIDS for CC-1244 Notice is hereby given that sealed bids will be received by the City of Huntington Beach at the office of the City Clerk at City Hall, 2000 Main Street, Huntington Beach, CA 92648, until the hour of 2:30 PM on September 11, 2008, at which time bids will be opened publicly and read aloud in the Council Chambers for the Safe Routes to School Program, Cycle IV (In the vicinity of Marine View Middle School) - CC-1244 in the City of Huntington Beach. A set of plans, specifications, and contract documents may be obtained starting August 21, 2008 at City Hall, Department of Public Works upon receipt of a non-refundable fee of $40.00, sales tax included, if picked up or $50.00 if mailed. Each bid shall be made on the Proposal Form provided in the contract documents, and shall be accompanied by a certified or cashier's check or a bid bond for not less than 10% of the amount of the bid, made payable to the City of Huntington Beach. The Contractor shall, in the performance of the work and improvements, conform to the Labor Code of the State of California and other Laws of the State of California applicable thereto, with the exception only of such variations that may be required under the special statutes pursuant to which proceedings hereunder are taken and which have not been superseded by the provisions of the Labor Code. Preference to labor shall be given only in the manner provided by law. No bid shall be considered unless it is made on a form furnished by the City of Huntington Beach, Department of Public Works, and is made in accordance with the provisions of the proposal requirements. Each bidder must be licensed as required by law. The City Council of the City of Huntington Beach reserves the right to reject any or all bids. By order of the City Council of the City of Huntington Beach, California the 4th day of September 2007, by RESOLUTION 2007-55. Joan L. Flynn City Clerk of the City of Huntington Beach 2000 Main Street. (714) 536-5431 CC-1251 CITY OF HUNTINGTON 2000 Main Street P.O. Box 190 Huntington Beach, CA LETTER OF TRANSMITTAL Attention: Joan L. Flynn To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 ]BEACH 92 64 8 Fax (714) 374-1573 Date: August 14, 2008 Project/C.C. No.: C.C. No. 1244 Regarding:Safe Routes to School, Cycle IV- Marine View ❑ We are sending you: ❑ By Mail ❑ By Fax Mail(Number of pages including this sheet:) ® We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other: Notice Inviting Sealed Bids Item# Copies Pages Description 1 1 1 Notice Inviting Sealed Bids for CC-1244 2 (Safe Routes to School Program, Cycle IV -In the vicinity of Marine View Middle School 3 These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other: Remarks: Per Resolution 2007-55 (adopted on September 4, 2007), the City Council authorized the advertisement of the above Safe Routes to School Project. Please find attached the Notice Inviting Sealed Bids for advertisement on 8/21/08, 8/28/08, & 9/4/08. The bid opening is scheduled for 9/11/08. Please contact me at 374-1628 with any questions you may have. c: file By: William F. Janusz, Prin i Civil Engineer G:\CONSTRUCTION CONTRACTS (CCS)\CC 1244\NISB TRANSMITALTo CLERK-CC-1244.DOC AFFIDAVIT OF PUBLICATION STATE OF CALIFORNIA, ) )" ss. County of Orange ) I am a citizen of the United States and a resident of the County aforesaid; I ani over the age of eighteen years;and not a party to ,or interested in the above entitled matter..I am the principal clerk of The Orange County Register, a,newspaper of general circulation, ;published in the 'city of Santa Ana, County of Orange, and which newspaper has Proof of Publication of been adjudged to be a newspaper, of general circulation by the Superior Court of the County of Orange, State of California, under the date of Paste Clipping of 1/18/52, Case No. A-21046, that the, notice, of Notice which the annexed is a true printed copy, has been NOTICE INVITINoG SEALED BIDS CC-1244 published in each regular and entimissu'Of said Notice is hereby given that sealed bids will be received by the City of Huntington Beach at the office of the City Clerk at newspaper and not in any supplement thereof on..City Hall, 2000 Main Street, Huntington Beach, CA 92648, until the hour of 2:30 PM on September 15, 2008, at - -. which time bids will be opened publicly and read aloud in the followingdates to wit: the Council Chambers for the Safe Routes to School , - i Program, Cycle IV )In the vicinity of Marine View Middle School) - CC•1244 in the City of Huntington - - - . I Beach. . - August 25, September 1, 8; 2608 A set of plans, specifications, and contract documents may be obtained starting August 21, 2008 at City Hall, Depart- - ment of Public Works upon receipt of a non-refundable fee of $40.00, sales tax included, if picked up or $50.00 if - - - mailed. "I certify or declare underthe Pena Of' er I) ty h Each bid shall be made on the Proposal Form provided in .lam the contract documents, and shall be accompanied by a certified or cashier's check or a bid bond for not less than under the laws of the State of California that the 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 foregoing Is true correct": g g rue and of the State of California and other Laws of the State of Cali- i - fornia applicable thereto, with the exception only of such variations that may be required under the special statutes Executed at Santa Ana,- Orange County, - -;pursuant to which proceedings hereunder are taken and - - -which have not been superseded by the -provisions of the California, on Labor Code. Preference to labor shall be given only in the - - manner provided by law. - Date: September 8; 2008 - No bid shall be considered unless it is made on a form fur - : nished by the City of Huntington Beach, Department of Pub- ,lic 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 Beachreserves Si ature the right to reject any or all bids. By order of the City Council of the City of Huntington Beach, California the 4th day of September 2007, by RESOLUTION 1 - - The Orange "County Register 2007-55. . loan L. Flynn - 625 N. Grand Ave. City Clerk of the City of Huntington Beach - 2000 Main Street. (714) 536-5431 Santa Ana CA 92701 Publish: Orange County Register - 1 Aupust�25. September 1 8 2008 R-1844 8667533 - (714) 796-7000 ext. 2209 — — --- PROOF OF PUBLICATION UNSUCCESSFUL BIDS CC-1244 Safe Routes to School (Marine View) 2008 SEP 15 PH 2• 12 SEALED BID for: Safe Routes to School, Cycle IV In the vicinity of Marine View middle School CC 1244 l}sAlrbili Tr�b9 8654 601,4� 8058 r_ ..-, __ _ _ Number From axa p.essAad. 4a Express Package Service Packages uptof50lbs- Date Senders FedEx �G98� 5 s6— AccountNumber FedExPriority0vemigM �KFed��StandardOvemight ❑ Ne business mammg.`F dyinessa enmon' FedE FrstOvemight ❑ Earnest m rt, monIng shipments win be delivered on Monday Setokday Dafrvery Nm evadable n deriverytuselectleafixI Senders Name �j y-r� `/�. �� 1/ �j y� �/ unless SATURDAY Delivery is selected. �J 1 May Fed Express Saver �T Saturday Delivery NOT avagable. (`�/ 7 l-�—^-f\ C_% Phone 1�� �JO seeenatasnaaaaay.•ma:day Thirdh neasaavr ❑ so—d ❑ be T shipments will be delivered on Monday Saturday Delivery NOT waeable, unless SATURDAY Delivery is selected. L-- FedEx, Envelope rate not available. charge: charge: One -pound rate. 'Toaroat beaGaos. ComparryC I i OF '_-UNTINGTQN BEACH 4b Express Freight Service Packages over Mbs. ❑FedEx}Oa�Freight* FedEx2DayFre�M Ned business V. Fnday Second business day. Thursday FedEx3DaYFreight ❑ Third business ,-,.., ,.1 ,., p S F Ctitu 1f34ii-`t ST FL shipments will be delivered on Montlay shipments will be degverad on Monday umen SATUfiDAYDalkery is selected. umesssATIR{DAYDeloeryisseleted. y." Saturday Derivery Nor evadable. address Dept/Roar/Sube/l oom UNTINGTON BEACH State CA zip 92648-2763 2 Your Internal Billing Reference a_ nrst24 characters wdl appear on tmrome. 3 To Recipients Name `Jj= /� ( X� �[/ Phone(7 ��'y/►p�=7—VW Compa rA) Recipienrs,_.4`. Address / /-TL�,'1 We cannot deliverto P.O. boxes or P.C. ZIP codes. Damj9FIom/Sate/Rmm Address ?E' / ! /_V To request a package be held at a specific FedEx location, pnm FeJ6 address here. 0377659294 -CagforCordirmadon: »Tommrl«anom. 5 Packaging FedEx ❑ FedEx Pak* ❑ FedEx ❑ FedEx ❑ Other Envelope* includes Fed"cSmadPak Box Tube FedEx Large Pak and FadEx Sturdy Pak • Declaredvalue ard[5500. 6 Special Handling ncludeFedExaddressinsection3. -� SATURDAY Delivery HOLD Weekday HOLD Sate tar ❑ NO} Available. for ❑ at FedEx Location ❑ at Fed Ex LcMon FadExStandara0vemight NOTAvailablefor Available ONLY for FedEx First Gvem rt,Fed&Express Fin Ex Rrst Overnight FedEx Pdomy Ovemight and Sr_, or FadEx 30ay Freight FadFx 2Deyto select locations. Does this shipment womin dangerous goods? --- Up. box must he checked. NO ❑Yes ❑ ❑ D Ice AA' rottached S Irpersoeclaradon Dryce,9, UN 1845 x kg ShippefsDecimation- nmraq ed. Dangerous goods(itmhlding dry ice) canna be shipped in FedEx packaging. ❑ Cargo Aircraft Only 7 Payment Bill to_ erns. Fed& A=Na.orCredncaraaabaIM --I Sender ❑ Recipient ❑Third Party ❑ Credit Card ❑ Cash/Check Act No. in section 1 will he billed. FadE. Ace, No. F.P. Credit U d No. Data Total Packages Total Weight Total Declared Valuet $ -m r0urllabdity is limited he$100 Mless you declare a higher value. See back for details. By using this Airbillyou agree lolhe service conditions on due back of this AuN'Y and in the currem FedEx Service Guide, including temp Nat gmrt our lianday. 8 Residential Delivery Signature Options Ityou require a signature, check Duet or Indirect No Signature Direct Signature tndirectSigqnature ❑Re cared ❑ S—maasnmipierrcs ❑ Uheone isawnable9 519 Paco ga may he left address may sign for mcipiem's address, someone without obtaimnga de livery. fee applies are neighboring address may signaturefindelivery. sign forderrvery.Fee apples. Rev. Date 10la 0158279-0199l -20,05 FedErPRINTEO IN U.SA.•SRF • • • e • • s - e e e 63656 11OFFICIAL CHECK 6365601082 Office AU # 12i0(8) 0(� m Operator I.D.: cu005335 0 September 15, 2008 0 PAY TO THE ORDER OF 'THE CITY OF HUNTINGTON BEACH*** � a , v ***Nine thousand seven hundred fifty dollars and no cents*** **$9,750.00** v WELLS FARGO & COMPANY ISSUER VOID IF OVER US $ 9,750.00 420 MONTGOMERY STREET SAN FRANCISCO, CA 94163 PAYABLE AT WELLS FARGO BANK, N.A. CONTROLLER FOR INQUIRIES CALL (480) 394-3122 F!Q& _-! O:p ti Oto `FS...`j7) SC tfDO1. G yG�G I V 111116365601082na P:b2L000248e:L,86L SOS3t,5it, SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No.1244 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 therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find tr ''c,I in the amount of �-7 5"D,, bd which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received IXid44 's Signature Z I `©9 C-a Project Bid Schedule Safe Routes to School — Cycle N (Marine View Middle School) CC-1244 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Monument Preservation. @ twd uGs "' $ 2 qOO + CV $ 2-, 00 Per L.S. 3 1 L.S. Furnish Project Traffic Control. @ +'�'Oo ,.gyp $ 2�2-W-cc, $ 2�ZL►b,L 11 uv�Ot-d, Per L.S. _ 4 I L.S. Wr4O stall fFi�c Str� an igning. eV Al $V � R t�`v $9-0 S— Per L.S. 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and $OVD . OD $ 51� Om - AC Paving Replacement. nn Per EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type 1A $ l , S S®. $ UO' DD Poles are City Furnished) @ Off- C1A ve- Per EA. 1- 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan _ $ 12- ® $ Si 5b- ` DO 207. Sidewalk Locations as Determined by the City. ee 44-4 •A C.e�ui-c Per S.F. 7 J1 Total Amount Bid in Figures: $ li,ii;;i:;;�l;i��,��c Total Amount Bid in Words: $t%C�M4L�—s" 1E Note: The City will provide the radar feedback signs and Type 1A poles (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-2.1 F.. 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 Fork Name and Address of Subcontractor State License Number Class rl 5L 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 fixrnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 O BE EXECUTED BY BIDDER r SUBMITTED WITH N �r State of California ss. County of Orange Tito m A 3 S E c s v P , being first duly sworn, deposes and says that he or she is _ S E c f=;r"'I-A imy of PAC 11:71 (, C,pfiS,'( 'rW Nz sw ucr uaE 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. Name of Bidder 213'43 L-A PALMA AVE,) C,i-r— 411-1 '/O-Ki9 (A i—iNllA, c A c .z 93 -7 Address of Bidder Subscribed and sworn to before me this IS ju day of -' _ � RAIPH P! A8H8AUGH COmmiaalon * 1702726 Notary Public - California Orange County MyC0M-bVkft Nov 3, 2010 NOTARY PUBLIC J/Jjj � C-4 NOTARY SEAL UTILITY AGREEMENT HONORABLE MAYORAND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: glz104 C-5 Az IF IC CQA! i rd�F(Z�l�i Rtxu�v�KC T*C_ Contractor By Title 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 ONO If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 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: CI Iz,] o4 C-7 Contractor By S6cRi=�`F1�� Title EI i E ;" (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 S'-t,f2 FTt} y Title Date: 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: s�►Fr�A- `PAc F1C- C,QA5 SirZ�l�Ttht�C I=Arc Bidder Name ^7T3L 3 LA PAL.MA AVr--N .tF— S V iTe 119 Business Address yof�(3A L-100A c A CIZ 6ti City, State Zip ( -1 H) OF70 - 7Z 2 2, Telephone Number G1iS3�,1� CLhes A1►���i��Nt�- State Contractor's License No. and Class Original Date Issued 51S�jio Expiration Date The work site was inspected by'Ta m tXAA t,`T t W 1C-,z, of our office on 6108 20 The following are persons, firms, and corporations having a principal interest in this proposal: SRc.� c r�A�T Sti�R�STt�Vtt it,LR,� INC. ,T 5 P4'.ta L PALS QUM6= W�STMtA°-, �'RGst�ENi nAcy'At6�, SreC LVjA Zy 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. `iae, % F i < C.DAST rf3FRi\'S RiACJkE zi . Company Nate --, Signature of Bir TWo-mR. 6y-- W o SeGRr=rA-P-Y Printed or Typed Signature Subscribed and sworn to before me this IS day of ='"�JUL RAIPH P. ASHBAUGH COmtnisslon * 1702726 NOfaay Public - California job Orange County fYa)rC0M- EVkVS Nov 3. 2010 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: L ?L-eA% SeC AT INc-1tEb sTl,—% R-M; N1 of: Q%A6L1 lCK—%iof,' :, 9, FG�i=t�t S Name and Address of Public Agency P,S U S 2. 11 Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 (For federally funded projects, use this following page) HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or X Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Gaaqz ����rtsTRuTt.c�h+� Contact Person: +L RA \ CT w Gc.` m A W f-J a it T- ► 0 (,ti Ar , Contact Phone: 1 -70 -i.Z Signed: Date: ci Ilzl 0 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C t .) (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS W19WAREA PART OF THIS PROPOSAL) EQUAL EMTLOYMfENT OPPORTUNITY CERTIFICATION .. . The bidder PAC V FI C C n&5 r --V-NfFWT9�tAG—� proposed subcontractor 'TIR D 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. Paae 12-79 LPP 01-04 March 15, 2001 - Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THUS FORM TO DtSC1.A5E LU1313Y INU ACTIVITIES PURSUANT TO 31 U.S.G. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: N�A a. contract a bid/offer/application F14 a. initial b. giant b. initial award b. material change C. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity S. If Reporting Entity In No. 4 is Subawardee, Enter Name and Address of Prime: ® Prime Subawardee PAC-11=1C. "A,;r Wr-M-Tier if known 2Z3y3 LAfAL.MA Air. SVT I)f-1 10'f-&A t_I ND A / C-A { Congressional District, if known 6. Federal Department/Agency: NlA 8. Federal Action Number, if known: 1J/ N Congressional District, if known - 7. Federal Program Name/Descriptioh: tj)A CFDA Number, if applicable 9. Award Amount, if known: �% 10. a. Name and Address'of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. 10a) (last name, first name, W) (attach Continuation Sheets) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) 3 ❑ actual planned 0- retainer J Qc b. one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee . b. in -kind, specify: nature a deferred value L—Jf. 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 II: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes 11 No 16. Information requested through this form is authorized by Tale 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature:_ was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name' %1t0 tM 1351 This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: f Llelt ftp— to a civil penalty of not less than S 10,000 and not more than $t 00,000 for each such fiilure. Telephone No.: (I Psi ) T70"-1T2z.. Date: Z Authorized for Local Reproduction 1 Federal Use Only: Standard Form - LLL Standard Form Lt.L Rev. 09-12.97 Page 12-87 LPP 01-04 March 15, 2001 EXIMIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal -recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action_ Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the hull name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g_, the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment.. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1(e.g., Request for Proposal (RFP) number; Invitation for Bid (IF$) number, grant announcement number, the contract grant or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action- (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 1249 March is, 2001 LPP 01-04 STATEMENT OF TECBNICAL ABILITY AND EXPERIENCE Safe Routes to School, Cycle IV,M9,r'-'WView Middle School, CC No. 1244 Pacific Coast Infrastructure (PCI) is a startup company specializing in heavy civil construction. As such, the company has no similar projects to reference. However, the principals of PCI have extensive experience in mass grading projects, highway projects, water works projects, and other assorted infrastructure related construction projects. We have included the work histories of our superintendent for this project (Tom Martinez), our project engineer (Fred Susoeff), and our president (Craig Westmann) for your use and information. Each work history provides projects and experience information for these key personnel that will be involved with the construction of the Safe Routes to School. We are also pleased to inform you that PCI is signatory to the Operating Engineers union, the Carpenters union, the Laborers union, and the Cement Masons union. These memberships will ensure that your project will not only have quality project management, but also that our craft personnel will be of the highest caliber. At this time none of the personnel at PCI are involved in litigation of any kind. Furthermore, our company has not had any litigation or disputes of any kind. We have provided a list of references for your use, and we encourage you to contact them or us with any questions you may have regarding our company. PCI also has approximately one million dollars in working capital. Statements can be provided to demonstrate our financial capability to complete this project. PCI is fully insured and bonded at this time, and we have confirmed complete compliance from our providers with your contract documents. Thus there should not be any difficulties with insurance certifications or performance/payment bonds once a contract is awarded. In the event that PCI is the low bidder on September 151", then we would encourage you to meet with us as soon as possible thereafter to discuss our plan to construct your project. We will gladly show the City of Huntington Beach our means, methods, and resources planned for the construction of this project. We are looking forward to doing business with the City of Huntington Beach. Sincerely, Pacific Coast Infrastructure Thomas Jessop Vice President Page 1 of 2 PACIFIC COAST INFRASTRUCTURE 22343 La Palma Ave, Suite 114 Bob Schneider Area Manager, C.C. Myers Inc. 1822 South Lewis Street Anaheim, CA. 85302 (714) 412-3882 (cell) Brad Spies President, SEMA Construction 7353 S Eagle Street Centennial, CO 80112 (303) 638-8207 (cell) Bruce Ilimes President, Western Waterworks, Inc. 5831 Pine Avenue Chino Hills, CA. 91709 (909) 597-7000 Ashok Dhingra Vice President, Metcalf & Eddy 999 Town & Country Road Orange, CA. 92868 (909) 224-3160 Matt Tice Vice President, Century Reinforcing Steel 10840 Norwalk Blvd. Santa Fe Springs, CA. 90670 (714)692-7082 Ivan Benavidez Senior Project Manager, TCM Group 8676 Wheeler Avenue Fontana, CA. 92336 Cell: (909) 203-3589 Yorba Linda, CA. 92887 Phone (714) 970-7822 Fax (714) 970-7899 License No. 915351 �rk a aye � Page 2 of 2 EXPERIENCE PROFILE Craig Westmann is the President of Pacific Coast Infrastructure. He has over 20 years of experience in the construction industry. Craig has worked across California and held positions as Project Manager, Project Engineer, Estimator, and Area Manager. His expertise lies in the areas of heavy civil construction including DOT work, local highways and bridges, and reservoirs. Education: B.S., Engineering/Construction Mgmt 1992 California State University - Long Beach Years of Experience: 20 years While at SEMA, Craig was involved in project management, claims resolution, [ business development, and engineering roles for heavy civil construction. He managed SEMA's general operations and coordinated between the office and field. Craig directed the support of the office with the field to assure projects met schedules, were properly manned, and subcontractors were performing work. He also aided in new project bidding and job set-up. Craig was also instrumental in claims resolution for SEMA. Craig's project resume includes numerous projects with both project management and supervisory roles, with his more notable projects listed as follows: • Coldwater Reservoir, City of Beverly Hills, CA — $22 million • Hillcrest Park 5 MG Prestressed Reservoir, Fullerton, CA - $7.6 million • Secondary Effluent & Recycled Water Storage Tanks, Escondido, CA - $6.3 million • Santa Anita Reservoir No. 4 for City of Arcadia, Sierra Madre, CA - $5.3 million • Highway 60 Moreno Valley, Riverside County, CA - $24 million • St. Joseph Rerservoir #1, Arcadia, CA - $3 million • Two-8 MG Reservoirs and Pump Station, Westminster, CA - $7.7 million • Overcrossing for Route 30, La Verne, CA - $11 million • New Main Street Bridge Overcrossing, San Jacinto, CA - $5 million • Crown Valley Parkway at Ladera Ranch, CA - $4 million • Imperial Highway Grade Separation, Los Angeles, CA - $11 million • Pier J Grade Separation, Port of Long Beach, CA - $10 million • Widening of Route 110 at Rosecrans, Los Angeles, CA - $18 million • Route 241 in South Orange County #F5, Orange County, CA - $12 million • Route 241 in South Orange Conty #F9, Orange County, CA - $20.5 million • Widening of 1-5 at Main Street, Orange County, CA - $38 million • Widening of Route 110 from 37th Street to 18th Street, Los Angeles, CA - $17 million RELEVANT EXPERIENCE SEMA Construction, Inc. As Area Manager, Craig was responsible for managing the general operations of the California Division. He also coordinated between the office and the field. Pacific Hydrotech As an Estimator I Project Manager, Craig was responsible for providing project supervision, CPM scheduling, change order negotiations and processing, cost control, dispute resolution, and technical assistance for other project supervisors, as well as assisting the estimating team. MCM Construction Craig was the Project Manager on several highway projects for this firm. He provided project supervision, cost control, and technical assistance for supervisors in the field. CC Myers As the Chief Engineer for Southern California, Craig was responsible for project management on several multi -million dollar projects in Southern California. Pacific Coast Infrastructure, Inc. 22343 La Palma Ave, Suite 114 Yorba Linda, CA. 92887 Tom Martinez Experience Profile Tom Martinez is a General Superintendent with proven success in project building. His experience spans more than 17 years beginning in 1991. Primarily working in Southern California, he has held positions as General Superintendent, Project Superintendent, General Foreman, and Project Foreman. Tom's multi faceted carrier in heavy civil construction has included, international airports, military airports, regional highway interchanges, bridges, underground, general roadwork and street improvements. In performing the aforementioned duties, Tom has coordinated material resources and jobsite logistics. That coordination involves procurement of site specific materials, proper employment and set up of equipment, and the management of manpower involving various trades. This experienced leadership provides essential elements to scheduling subcontractors, inspection and partnering with government agencies at the local, state and federal level. Tom also manages the liaison the corporate office and the field offices. A list of his most notable projects is as follows: * Ontario Airport 26R / 8L Rehabilitation, Ontario, Ca - $49.5 Million * Long Beach Airport 12R / 30L Rehabilitation, Long Beach, Ca - $39.8 Million * Jackson Street Bridge, Riverside, Ca - $8 Million * Warner Street Rehabilitation, Costa Mesa, Ca - $2.8 Million * Whittier Narrows Dam, Pico Rivera, Ca - $2.5 Million * Crown Valley Parkway, Ladera Ranch, Ca - $4 Million * 1-5 / 91 Interchange, Fullerton, Ca - $6 Million * 71 Fwy Segments 2 & 3, Chino Hills, Ca - $7.3 Million * 1-5 / 22 / 57 Orange Crush Interchange, Orange, Ca - $4.9 Million * Grand Avenue Realignment Music Center, Los Angeles, Ca - $14.8 Million Relevant Experience Beador Construction As Superintendent, Tom is overseeing two bridge widenings and one on / off ramp widening. He is responsible for the planning and execution of the field operations. Griffith Company As Project Superintendent, Tom was responsible for the scheduling, coordinating of subcontractors, cost control, problem solving and partnering. California Engineering and Grading As General Foreman, Tom supervised multiple operations, multiple crews and multiple shifts. Fred F. Sus®eff III FSUSOEFF@PCINFRASTRUCTURE.COM Education California State Polytechnic University Pomona Bachelor of Science Degree in Construction Engineering Recipient of the Vinnel Foundation Scholarship Relevant Experience June 2008 — Present June 2007 to June 2008 March 2007 to June 2007 September 2006 to March 2007 September 2005 to September 2006 June 2005 to September 2005 November 2004 to June 2005 Construction Projects Senior Project Engineer/Pacific Coast Infrastructure Project Engineer/Field Engineer, SEMA Construction Superintendent, Tilden -Coil Constructors Asst. Superintendent, Tilden -Coil Constructors Project Engineer, Tilden -Coil Constructors Project Intern/Field Engineer, Kiewit Pacific Co. Project Intern, Tilden -Coil Constructors SEMA Construction Chevy Chase Reservoir and Pump Station Replacement — Project/Field Engineer December 2007 to Present Valley Blvd. Grade Separation — Project/Field Engineer June 2007 to December 2007 Responsibilities with SEMA consisted of a working knowledge of the entire project including original estimate comprehension, plan interpretation, project specifications, project cost code knowledge, and the overall construction schedule. Provided technical support for the field operations, including formwork design and the procurement of materials. Tilden -Coil Constructors La Sierra University — Superintendent (Phase 2 and 3) March 2007 to June 2007 The General Contractor of a college university commons. Construction consists of a new chiller, steel canopy structures, and kitchen/cafe. Patricia Beatty Elementary School — Assistant Superintendent September 2006 to March 2007 Construction Manager of a 51,000 square foot wood framed elementary school. The Grove Community Church Worship Center — Project Engineer September 2005 to September 2006 General contractor of a 161,000 square foot church and school facility consisting of four tilt -up buildings and 3 wood framed buildings. The facility is held on a 37 acre site with sport activity accommodations. The site required extensive grading and blasting of 31,000 yards of rock. Kiewit Pacific Co. Joseph Jensen Treatment Plant — Field Engineer June 2005 to September 2005 A $120 million dollar water treatment facility constructed for the Metropolitan Water District. Duties consisted of managing and coordinating piping penetrations in poured in place concrete contactor basins. Estimating small bore yard piping for Robert A. Skinner Treatment Plant. Provide layout drawings and cut sheets of new and existing utilities for field use. City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 Nobest, Inc. P O Box 874 Westminster, CA 92684-0874 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citie4.�fA"/Lapii6k,tfreWakdka"oNew Zealand ( Telephone: 714-536-5227 NEST; INCORPORATED: Pa Box 874 WESTMINSTER, CA 92684.0874 AwAzal S&O eliq a/oc 1"710 6 C�iu/ ��G 1141(-IV7-1�1410161-1 2600 SEP 5 p1j, 2: 06 1 11 U m SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. X.- Accompanying this proposal of bid, find R/D AMD in the amount of $ D 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: Date Received Bidderk Sign�q= FA C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 in ;�+1�;=1�.11:.ta.��� I �F��� I L.S. RE- Wall ;M .Sr_� ice- Aa 3.T" .as dlr« �lil..�-;?-i�ai+.�.J*r'?c.".'ld. aiz"rnr�"r_'� Mobilization. rive Theu!�,qnd '-dk -IZL/ O, T k=�.: vi^'.n'#a�F $ tv All >'k,T�+is'ty���__a{�4���---�P«y... $ 000. Per L.S. 2 1 L.S. Monument Preservation. @- r-ive 7-hods ood Vellars $ S 0 C? $ 3.1600,— Per L.S. 3 1 L.S. Furnish Project Traffic Control. Rile T17ou5a,"d r� $ oe)a $ P11 4 1 L.S. Per L.S. Furnish and Install Traffic Stripm' and Signing. (a-) r0qr ThOu S a M OIAK $ q 006. $ IL 000. 5 13 EA. Per L.S. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and 0 $ 3 $W 60, AC Paving Replacement. na Thre e I hO(4SqJn, 7 WO 1yodired Oollgec Per EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type I A 00 $ 1,666.— $ Poles are City Furnished) , Osm e l3itS20d i, S I Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ to. $ 207. Sidewalk Locations as Determined by the City. '76-1V 00/hes Per S.F. Total Amount Bid in Figures:$ 6q.600,00 Total Amount Bid in Words: $ 5ir- kne 7hou.5-e?.&I Lo -11-a r Note: The City will provide the radar feedback signs and Type 1A poles (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-2.1 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class C t'a h9eL5�/ll 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 ODG/1�4 , being first duly sworn deposes and says that he or she is �4 T _ of ,f�G�LfSTC 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. larxzav- T-"Ve- �r rr• t i Address of Bidder Subscribed and sworn to before me this / / " day of SEP- , 2005. NOTARY PUBLIC �....... KAY E. ANDERSON COMM. #1579663 n V "A NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY My Comm. Expims June 13, 2009 NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: 47'i ` I —0 Contractor 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 ,-,<N0 If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 9 � l f —0 F 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: S - U kg,-.,1 1 itle Date: Q -) t -D 7 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 �1 Business Address City, State Zip )/4/) 9�12 Telephone Number 3.57(/ z State Contractor's License No. and Class Original Date Issued Expiration Date The work site was inspected by ZL-WIS of our office on 20o The following are persons, firms, and corporations having a principal interest in this proposal: L.:VA I xffm= �L�GS%ir7�7 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. Subscribed and sworn to before me this /5 day of _ _ - 2W IE- - _ -- - KAY E. ANDER SON H COMM. #1579563 U NOTARY PUBLIC-CALIFORNIA n 0 ORANGE COUNTY / u W Cmmn E)pires June 13.2 � NOTARY PUBLIC NOTARY SEAL Listed below are the namV, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1 2. K1 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 REFERENCE LIST 1. CITY OF ANAHEIM (MAINTENANCE DEPT.) $ 1,03500.00 Project: Concrete Replacement Contact: Craig Allen Phone: (714) 765-6935 P 2. CITY OF HUNTNGTON BEACH $ 3560000.00 Project: Reconstruct Various Streets Contact: Dereck Livermore Phone: (714) 960-8861 3. CITY OF HUNTINGTON PARK $ 441,000.00 Project: Various Locations Street Improvements Contact: Pat Fu Phone: (323) 584-6253 4. CITY OF NEWPORT BEACH $ 8275000.00 Project: Alley Reconstruction Contact: Stephen Luy Phone: (949) 644-3311 5. CITY OF FOUNTAIN VALLEY $ 142,000.00 Project: Concrete Improvements Contact: Tony Vega Phone: (714) 593-4613 M (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: 0� Contact Person: Contact Phone: 71 LJ Signed: Date: g^' 1 s-A b g *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 t .) (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder �OJiL55y'� ,proposed subcontractor , hereby certifies that he has ✓ . has not_, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency,"or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIM ES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: Fla. contract Ha bid/offer/application ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter_ f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: Congressional District, if known 7. Federal Program Name/Descriptioh: CFDA Number, if applicable 8. Federal Action Number, if known: 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) ��,,,�Sheet(s) (last namePfirst name, MI) (attach Continnecessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c, commission Ba. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than �—�7 p $100,000 for each such failure. Telephone No.: (7 L) -gel�`� Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Form LLL Rev. 09-12-97 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-UL-instructions Rev.06-04-KuENDIFv. Page 12-89 LPP 01-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum NUmher nnP rtatPd August 91 9008 10,605r Company Name ell?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 of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Nun Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. 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 Contractors Bonding and Insurance Company a corporation duly organized under the laws of the state of Washington 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 (10%) of the total amount of the 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 1244 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 ORSC 21328 (5/97) Witness 9th day of September 2008 Nobest Contractors B ding and Insur�nce Company Sure (Seat) Witness By. Linda D. Coats Attorney -in -Fact ♦� a i,,• ��'' .� i �' � �' �� �� ,` State of California County of Orange On -���^��-%� before me, Kay E. Anderson/Notary Public , (Here insert name and title of the officer) personally appeared Larry Nodland who proved to me on the basis of satisfactory evidence to be the person whose names;4 is/a{ subscribed to the within instrument and acknowledged to me that he/slye�{ executed the same in his/hpr/1W authorized capacity(, and that by hisll r/t4eli signatureXon the instrument the person , or the entity upon behalf of which the personXacted, 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. ANDERSON THE h and official seal. v .,� COMM. #1579663 NOTARY PUBLIC -MIFORNIA n ORANGE COUNTY c s , my Comm Fires Jute 13, 2009 (Notary Seal) S e of Notary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ® Corporate Officer 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 outside of California In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegalfor a notary in California # e. certifying the authorized capacity of the signer). Please check the document carefullyfor proper notarial wording and attach this form if required • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed_ • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signct(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. Wshe/dwy- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. fi Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document Indicate tide or type of attached document, number of pages and date. is Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the tide (i.e. CEO, CFO, Secretary)_ • Securely attach this document to the signed document 2008 Version CAPA v12.10.07 800-873-9865 www.NotaryClasses.com CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On Sept. 9, 2008 before me, Linda A. Kight, Notary Public , (Here insert name and title of the officer) personally appeared Linda D. Coats who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isle subscribed to the within instrument and acknowledged to me thaWWshe/diey executed the same in 4"'her/their authorized capacity(ies), and that by WWhedAleii-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. LINDA A. KIGNT � Commission # 1712533 ��► Notary Public • California WI �� SS my hand and official seal. � ry � Orange County Comm "21, 2011 (Notary Seal) Si a otary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2008 Version CAPA v12 10.07 800-873-9865 www.NotaryClasses.com INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in Calijornia must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of Califonua In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form ifrequired • 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(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. ltetsheldwy- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. 4 Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. �} Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e_ CEO, CFO, Secretary). • Securely attach this document to the signed document City ®f Huntington Beach 2000 Main Street a Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK April 3, 2009 International Pavement Solutions, Inc. P O Box10458 San Bernardino, CA 92423 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister CitiVifA6"/Jgp&;�tfreVA"bg6gbt�ew Zealand ( Telephone: 714-536-5227 ) INTERNATIONAL �,oi_UTIONS INC- -#;NVE ' MEN'T 't , � - ' LIC', a'; <92215 AB p 0. Box 10458 San Bernar dino, ' dino, CA-92423 ar Project: sc, k Bid Date: Bid Time: 50 PO/I 2008 SIEP 15 P11 1: 42 WRT "rWiRrourn City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. 13 Company Name c —Date,,, All bidders must ackn ledge 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 of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. �r eta i P(G le 0, Company Name By,� Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor hates dated August 29, 2008 shall be the labor rates In effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. Company Name By - q C, 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) 536-6431, SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 I I L.S. W5 N n' Y'e Z' 'v- 'M Nh Ril eat Mobilization. "e PORM 2 1 L.S. Per L.S. Monument Pr9;4servation ./-/ me S-2i ®. honareof I 3 1 L.S. Per L.S. Furnish Project T raffic C tr I 4 5 1 L.S. 13 EA. Per L.S. Furnish and I stall Traffic Striping and SigniOg (a SeVeh A, recl PeeL. S. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and s WIS. $ s 'V79.C. $ '412 AC Pavinp Rep 4cgment. a a f-Pee- W-- - I r, I vt" di " A 6 4 EA. Per EA. Of Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $/1(72 $ S 11 Poles are C* Furni ed Ity bhe -1-h& Wis -!2)411* &�Iwewq bffo 1 Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ D6 $ 0 0. 207. Sidewalk Locations as Determined by the City. e-1 . a elpllg /-,r 4 ?'/7"'t/ LOZIA .0 Per S.F. Total Amount Bid in Figures: $ ;6v o h,�elzele -ed 777e�-Oy Total Amount Bid in Words: $ J Note: The City will provide the radar feedback signs and Type 1 A poles (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-2.1 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. i3iduers Accompanying this proposal of bid, find in the amount of $ 10 000• which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Si nature 1 '. 61/ 0: C-z LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion o Work Name and Address of Subcontractor State License Number Class M-7 ® o e-- 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 of44wigt,,•-"--);qA 6em" '/tc &Ye!,�G� �� , bein first duly sworn, deposes 4nd s�a 's that he or she is ftsi �� of �%1 �??a 1 bnlii PCI�fl./17Q ,SU( l to 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. Name of Bidder Signature of Bidder PO 60Y l C?� � �S� q arCb;17o � Address of Bidder `1� Zj Subscribed and sworn to before me this '3' day of ' 200 NOTARY PUBLIC SE Aa NOTARY SEAL C-4 CALIFORNIA JURAT WITH AFFIANT STATEMENT See Attached Document (Notary to cross out lines 1-6 below) See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 State of California County of PQCAX)0AA61C r Y.,; /IWrEN H�ENiREDER sslon # 1794029 d iary public California .;Qn Bernardino County NNLommb"le AP142012 + APRiI KIMMEN HERGENREOER Commission # 1794029 Notary Public -California San Bernardino County Aq►O4rrrr►6�I1p 10.2D1Z Signature of Document Signer No. 2 (if any) Subscribed and sworn to (or affirmed) before me on nnithis dayofti�i7 ��-L��/»✓ , 20 �U , by Date Mon Year Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me (.) (,) (and (2) '17 let - Name of Signer proved to me on the basis of satisfactory evidence to be the per n who appeared before me.) Signatur Signature of Notary Public Place Notary Seal Above 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. Further Description o�fAny , / Attached Document Title or Type of Document:A/"/d,V Co` /uslo/ l Document Date: W J/QNumber of Pages: / Signer(s) Other Than Named Above: A on%F— RIGHTTHUMBPRINT RIGHTTHUMBPRINT OF SIGNER #1 OF SIGNER #2 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary.org Item #5910 Reorder: Call Toll -Free 1-800-876-6827 iTI'ILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: 913)d Contractor G 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 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: Inkf r o4j'mAt. Pav6wA,-1-so t�?v Inc . Contractor WA By Title UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor G By PSIDI Nr Title Date: % 3 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. i 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 Business Address jag P '.rna,,, d-1 A0 -0,�. cf,�-y9 3 City, State Zip �qD9 ) l q- jq o l Telephone Number -72.922t-a A/r3 State Contractor's License No. and Class Original Date Issued Expiration Date 1 The work site was inspected by�'of our office on9, 20-. The following are persons, firms, and corporations having a principal interest in this proposal: a� Pe 5%nrN-r- 8 �jT C • keeiec C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name G Signature of Bidder ,6kEIQT C. t 1E(:7Ek, Printed or Typed Signature Subscribed and sworn to before me clayof of , 2000 . NOTARY PUBLIC * CSEE j4#0L j' /J0 L 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: D0 p 15 i (W-55 Park- Dr�v,-` Name and Address of Public Agency Name and Telephone No. of Project Manager: QS 1 - b LJ Ll Ou C" Uvi112. .. Contract Amount Type of Work Date Completed 2. b4 6a-/11ti1 Vt. Name and Address of Public Agency J a. 5 hhDn� sin Name and Telephone No. of Project Manager: q Z 2 S/ qZ. Contract Amount Type of Work Date Completed � S'Ctyt �3P.r�°1 tn e ?z 5 ��" �� h lr�9 Sfre� � .3. 1� 1 San ,r- rn of -&6 D , Ca-, Name andjAddress of Public Agency rr�k-.1/ n.. LaiL01-1 Name and Telephone No. of Project Manager: (�D°I t,3 q 1 2 4 e�e n(&� " Contract kmount Type ot Work Date Completed C-10 1® CALIFORNIA JURAT WITH AFFIANT STATEMENT See Attached Document (Notary to cross out lines 1-6 below) See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 State of California County of (36t, Signature of Document Signer No. 2 (if any) Subscribed and sworn to (or affirmed) before me on this day of 20� , by Date Month Year (1) Name o igner proved to me on the basis of satisfactory evidence to be the person who appeared before me (and (2)�- Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared befor me.) Signature( Signature of Notary Publi Place Notary Seal Above 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. Further Description of Any Attached Document Title or Type of Document:6&&4 ahUvLi Document Date: �/ o� Number of Pages: Signer(s) Other Than Named Above: 92ahie RIGHTTMUMBPRINT RIGHT THUMBPRINT OF SIGNER #1 OF''SIGNER #2 _ •0 a . - - •p of thumb here ©2007 National Notary Association • 9350 De Soto Ave , PC. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary org Item #5910 Reorder: Call Toll -Free 1-800-876-6827 Tor federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or _ Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: l�%��-/ttyn l�lG'r��'1'1Pa1v�0�1i�5; InL, Contact Person: Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder_ I n 415—n-0 M aL palu&ye' mL:& C71s1 / f) C--, proposed subcontractor , hereby certifies that he has has not-41 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 foimer 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. 8ge mr C �� LPP 01-04 Page 12-79 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions UUMML I b 1 t11J 1. Type of Federal] Action: Da. contract ' '" k b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G lU 1J1b"VJI;J.VJJt311N11 At_11v11Mb rUKb UANl LU J1 U-6-t— 1»G 2. Status of Federal Action: Fla- bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 3. Report Type: Fla. initial b. material change For Material Change Only: year quarter_ date of last report S. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) . $ 11 actual planned 12. Form of Payment (check ail that apply): 8 a. cash b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee _ e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including ofiicer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes11 No 4 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: G was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress ��C semiannually and will be available for public inspection r k&S Any �10e/V IF person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than $100,000 for each such failure. Telephone No.: Date: Federal Use Only: Farm LLL Rev_09-12-97 Authorized for Local Reproduction Standard Form - LLL n Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G a 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send continents regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90«END[F» Page 12-89 LPP 01-04 March 15, 2001 ARCH INSURANCE COMPANY Bond No: 5013231 KNOW ALL MEN BY THESE PRESENTS: That we, International Pavement Solutions, Inc., as Principal, and the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, and authorized to do business in the State of California as Surety, are held and firmly bound unto City of Huntington Beach as Obligee, in the sum of 10% of the total amount bid not to exceed Twenty thousand and 00/100 ($20,000.00) DOLLARS, lawful money of the United States of America, to the payment of which sum well and truly to be made, the Principal and Surety bind themselves, and each of their heirs, executors, administrators, successors and assigns, jointly and severally by these presents. The condition of this obligation is such, that, if the Obligee shall make any award to the Principal for Safe Routes to School Cycle IV -CC 1244/Mobilization Traffic Control Striping Bid Date: September 15, 2008 According to the terms of the proposal or bid made by the Principal therefore and the Principal shall duly made and enter into a contract with the Obligee in accordance with the terms of said proposal or bid and award and shall give bond for the faithful performance thereof, with the ARCH INSURANCE COMPANY, as Surety or with other Surety or Sureties approved by the Obligee; or if the Principal shall, in case of failure so to do, pay to the Obligee the damages which the Obligee may suffer by reason of such failure not exceeding the penalty of this bond, then this obligation shall be null and void; otherwise it shall be and remain in full force and effect. SIGNED, SEALED, DATED: September 15, 2008 International Pavement Solutions, Inc. Arch Insurance Company (Principal) (Surety) l Raymond E. Gail, Attorney In Fact DIRECT CORRESPONDENCE TO: ARCH CONTRACTORS & DEVELOPERS GROUP, 135 N. LOS ROBLES AVE., STE. 825., PASADENA, CA 91101 PHONE (626) 639-5200 • FAX (626) 639-5210 CALIFORNIA O A ALL-PURPOSE ACKNOWLEDGMENT �.S!�S�S�S 5;�.�5!�S!�S�S • �i,.--�.'� S�> ��,�`.� S ��..^�.'S J,.--�.'� ��S.y�S!��,��s�.v S i ��.-�.'gss�!.��!�e%-�.'S�S •.:.�t����.��!:,S�c.�$ �.!�� State of California County of San Bernardino On SEP 1 5 2008 Date before me, Stacia C. Baker, Notary Public Here Insert Name and Title of the Officer personally appeared Raymond E. Gail Names) of Signer(s) N/A STACIA C. BAKER Commission # 1776731 Notary Public - California San Bernardino County fCorrsn.=W29,2011 who proved to me on the basis of satisfactory evidence to be the persons) whose name( is/a+e subscribed to the within instrument and acknowledged to me that he/&hoAhoy executed the same in his/4e#4;ei+• authorized capacity(ies), and that by his/berg heir signatures) on the instrument the person(s), or the entity upon behalf of which the person(.acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official ea. Signature Place Notary Seal Above Si nature of Notary —Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact 6 ❑ Trustee Top of thumb here ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: jRIGHTTHUMBPRINT, 'OF:SIGNER-.71 i .�✓G:�:�✓:�✓4:yc�.�:�✓..:✓:�✓:�<�✓::✓�<:��.�'✓..C✓ � .✓.�✓<V.C✓.�✓:�✓.�✓�.�'✓..:✓av<:�.�✓.C✓a�✓.'rrc�✓:c� v',�'�..�✓.�✓::✓s:� ✓<.✓..�✓41✓✓.`✓ Know All Men By These Presents: That the Arch insurance Company, a corporation organized and existing under the laws of the State of Missouri, having its principal office in Kansas City, Missouri (hereinafter referred to as the "Company") does hereby appoint Raymond E. Gail and William J. Shupper of Rancho Cucamonga, CA (EACH) its true and {awful Atttsmey(s)4h-Fact, to make, execute, seat, and deliver from the date of issuance of this power for and on its behalf as surety, and as its act and deed. Any and all bonds and undertakings EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note, check, draft or letter of credit This authority does not permit the same obligation to be split into two or more bonds in order to being each such bond Within the dollar limit of authority as set forth, herein. The Company -may revoke this appointment at any time. The execution of such bonds and undertakings in pursuance of these. -presents -shall be as binding upon the said Company as fully and amply to all intents, and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office in Kansas City, Missouri. This Power of Attorney Is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on March 3, 2003, true and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect: "VOTED, That the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, or the Secretary -shall have -the power and authority to appoint, agents and attorneys -in -fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings, obligatory In the nature thereof, and any such officers of the Company may appoint agents for acceptance of process This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of Directors of the Company on March 3, 2003: VOTED,. That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seat of the Company, and certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified With respect to any bond or undertaking to which it is attached, shall continue to be valid and binding upon the Company. 00ML0013 00 03 03 Page 1 of 2 Printed in U.S.A. CALIFORNIA ALL-PU.-S OACKNOWLEDGMENT 3.S. S..'�S, State of California Couq[A_� Onbefore me,JW__A�_jtt ' t� Date �_ „ert Name and Tit e f the Officerpersonally appeared �% I1 ca:�e ' Namets) of Sianer(s) who proved to me on the basis of satisfactory evidence to be the person{) whose name(6) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ie#, and that by his/her/their signature() on the instrument the person(X), or the entity upon behalf of 97� which the personO acted, executed the instrument. - Cwwrda County I certify under PENALTY OF PERJURY under the laws 11 WNMW*G=m8Vb9s*p1lA2012 t of the State of California that the foregoing paragraph is true and correct WITNESS my hand and official seal. ry j Signature a)Aj _ �1i Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law. it may prose valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document, Description of ,attached Docume Title or ;ype of Docurnent.��_-- _ _ �e �q - Docun�- rent Date- 5l os Nurnber of Pages: _ Signer(s) Other 1 ban Named Above: G apacity(ies) Claimed bySigner(s) Signer's Name - x Individual j Corporate Officer _ ? itle(.$): Pu,� �-T- Partner - Limited f- General Attorney in Fact "thumb IrtorneTnp stee Aardian or Gonseivalel Other I ----__-- Signers Name. (ndividua Corporate Office? Titie(s): Partner - Limited General Attorney in Fact ° _ T,nf� o{ ihuinh here �. I ("ustee I I �3t1`c;PdIHYI nr (;C•nSe0V2'.f�t I Vher - f Signer is tlepresenong: ©2007 National Notary Association - 9350 De Soto Ave , P.O. Box 2402 -Chatsworth. CA 91313-2402- wwnv.NationalNotaryorg from #5907 Reorder Call Toll -Free 1-800-876-6827 City of Huntington Beach 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 H Y M Engineering, Inc. 15361 Eucalyptus Avenue Bellflower, CA 90706 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citi4lfA�"/dgpaatpteW it Eby d(;3oNew Zealand ( Telephone: 714-536-5227 ) r 2003 SEP 15 PH 1: 45 SECTION C PROPOSAL for the Safe routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-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 Sgo in the amount of $__ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bid er's Si mature Onel Zco8 OV C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV ® CC 1244 August21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office The following shall be amended as shown: Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review ofAddendumNumber One, dated August 21, 2008. Company Name Y a�U2i tJcc �Eyl �9 2Z �oof3 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 of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 i For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View (Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. NAM r-1147r) , -7A- C- Company Name By \jaVtA)0a lk� 9 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Project Bid Schedule School — Cycle IV (Marine View Middle School) tea 43: 19 1 1 L.S. Mobilization- $ -10 0010 Per L.S. 2 1 L.S. Monument Preservation. @ -Jn VOC 3, cao Per L.S. 3 1 L.S. Furnish Project Traffic Control d $ L&O E Per L.S. 4 1 L.S. Furnish and Install Traffic S iping and Signing. 'el pilell 1-'en".5 $ $ I/ "t-op :L-Ify. Per L. S. 5 13 EA. Construct Curb Ramp Inchrlin g Adjacent Gutter Plate per Caltrans Standard Plan No. ASSA and AC Paving Replacement. Per EA. 6 4 EA. Install Radar Feedback Sign, Including 6oQ$ Foundation (Radar Feedback Signs and Type I A $ Poles are City Furn e 37-x hiAl Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ 2-?- $ 4, QUO 207. Sidewalk Locations as Determined by the City. -A�Wggjy Per S.F. Total Amount Bid in Figures: $_2,, Total Amount Bid in Words: -Lzt),Q 46"Ad 4'Tye- Note: The City will provide the radar feedback signs and Type 1A poles (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-2.1 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4144, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion Name and Address of Subcontractor State License 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 NONCOLL,USION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange J A e ik= �Ta3 n , being first duly sworn, deposes and says that he or she is bw; gym-- of c the party making the foregoing bid that the bid is not made in the intere of, or on die behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. ■ t� BO O Ed�� . :.. .. Signature of f3idder ,6f 5L,((LJytLtG 1 i1 ow�� C- 9ogo -d Address of Bidder Subscribed and sworn to before me this I_ day of V , 20 09- NOTARY PUBLIC C-4 NOTARY SEAL UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (f)(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 per, formed and the hazards involved " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein.. Date: ��� �1 xoo}i C-s ►i l 1 Contractor By n�-5� 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? L7 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 C)FRTWICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and i will comply with such provisions before commencing the performance of the work of this contract. Date: 9 // �k / -)� �, s C-7 Contractor By �(G1P�1 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 1-8004224133 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 US A. during the course of the Work Additioncd forms may be obtained from the AGENCY upon request. C-8 E, BIDDER'S IN OR1bLMON BIDDER certifies that the following information is true and correct: Bidder Name 12M! ucnslypb6 Ave. Business Address T— �O'Ocwe'r CA 90700/- City, State Zip Telephone State Contractor's License No. and Class an Original Date Issued j uUp 30 2010 Expiration Date The work site was inspected by j�TO-cm of our office on .S?p_ 20a ptQS'TCAe1gt ' The following are persons, firms, and corporations having a principal interest in this proposal: C-4 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name Signature of ��� Printed or Typed Signature Subscribed and sworn to before me this 14- day of Se426kk, 200-S. 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: -Qp, vo0 Contract Amount Name and Address of Public Agency Type of Work Completed Name and Telephone No. of Project Manager: ew(p kdj�L Q4-q — 000, 000 A aid c v &—rc64, CAR6 Ll)�t Contract Amount Type of Work Date Completed Name and Address of Public Agency Name and Telephone No. of Project Manager: 'S��—�At o, otoz xo Contract Amount Type of Work C-10 Date Completed (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED 1N 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Lout -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10°% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: WM �j i Y1�Yy Contact Person: T-e-©y► Contact Phone: �4U Signed: Date: Zo a *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BLODER'S EXECUTION ON THE SIGNATURE PORTION OF TWS PROPOSAL SHALL ALSO CONSTITUT.B AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WIECH ARE A PAP,T OF THIS PROPOSAL} EQUAL ENIPLO YI' MNT OPPORTUNITY CERTIMCATION The bidder N11I� proposed subcontractor hereby certifies that he bas 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 Cornmiuee, 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- I .S. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO -I) is the only report required by the Executive Orders or their implementing regulations, Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, Z001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES l tihdl'L131E 11i13 I UkU4 lU U1Jl;LVSI: iAJtSiSY 1NS i AU HV 1 L Type of Federal Action: 2. Status of Federal Action: LIa. conitact E] a. bidlofferlappiication b. grant b. initial aware) c, coopamtivc agrccmeut c. post -award d. loan e. loan guarantee f. loan insurance 4. Name and Address of Reporting Entity ❑- Prune El Subawardec Tier , if known Congressional District, if known Federal Department/Agency— S. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, fast name, lr4i) 11. 12. 14. EXHIBIT 12-E Attachment G i ry CSUAN I l U 31 U.S.G. ISo1 3. Report Type: a. initial b. material change For Material Change Only: year q— date of last report — 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known . 7. Federal Program NameMescription: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. l Oa) (last name, first name,ldl) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S Q actual planned e. retainer b. one-time fee Form of Payment (check all that apply): C. commission Ha. cash d_ contingent fee b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheets) if necessary) 15. Continuation Sheet(s) attached: YesEl No El 16. information requested through this form is authorized by Title 31 U.S.C. Section [352. This disclosure of lobbying reliance Signature: I was placed by the tier above when his transaction was made or catered into. This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This infomution will be reported to Congress semiannually and will be available for public inspection Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than $ I DO,000 for each sueb £aiturc Telephone No.: Date: Federal Use Only: ­li[ _C0_-RL _--IL-71 LPP 0l-04 Authorized for Local Reproduction standard Form - LLL Page 12-87 March 15, 2001 = EXIIIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Cbecklist Instructions INSTRUCTIONS FOR C0WLETION 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 m officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member ofCoagmss in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report: Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g_, the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment Include at least one organization level below agency name, if known_ For example, Department of Transportation, United States Coast Guard 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (iF$) number, grant announcement number, the contract grant or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-00L" 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prune entity identified in item 4 or 5_ l0. (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 foil 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 whetlier 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 1Z-88 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 employees) contacted or the officer(s) employees) or Member(s) of Congress that were contacted. 15. Chcck 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. 20543- SF-LL4nrtme on; Rcv.06-N-MEND[F» Page 12-89 LPP 01-44 March 15, 2001 .THE AMERICAN INSTITUTE OF ARCHITECTS Bond No.: 70581982 KNOW ALL MEN BY THESE PRESENTS, that we H Y M Engineering, tne., 15361 Eucalyptus Avenue, Bellflower, CA 90706 1 Here insert full name ,and address or legal title of Contractor) as Principal, hereinafter called the Principal, and Western Surety Company, P.O. Box 5077, Sioux Falls, SD 57117-5077 a corporation duly organized under the laws of the State of So. Dakota as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach, 2000 Main Street, Huntington Beach, CA 92648 (Here insert full name ,and address or legal title of Owner) as Obligee, hereinafter called the Obligee, in the sum of (10%) Ten percent of the attached bid amount { 10% ) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Safe Routes to School, Cycle IV, C.C. No. 1244 Huntington Beach, California (Here insert frill name, address and description of project) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 9th day of September, 2008 ( Witness) H Y M Engineering, Inc. (Principal) eai) (Title IDS I � weternSuretv Com an (Seal) (Witness) am y Soto ( it e) ich rd rney-in-Fact ALA DOCUMENT A310 BID BOND AIA ,2) FEBRUARY 1970 ED THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 N.Y. AVE._ N.W. WASHINGTON. D.C. 20006 WARNING: Unlicensed photocopying violates U.S. copyright laws and is subject to legal prosecution. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange } On " f - O q --J-C ' before me, Tammy Soto, Notary Ptubhc Date Here insert Name and Title of the Othcer personally appeared TARZ SO TO TO Comm lan # 1646040 Notary Public - California Orange County My Comm. Explre3 Feb 18, 2010 Place Notary Seal Above Mark Richardson Names) of who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness m wand of cial seal. Signature Signature of No Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer Title(s):_ ❑ Partner — ❑ Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 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: :.`t%t:t`•C:�``(._,� � � — — — — — _' _'`�t1��?�c�'=4�'�`,.�%t:�`C;`�-`�t1^�4-'�ti`�r�G�i'�Z%Co�k,�r`�%C'''�S._?Z%Pv"�`.��iE-`�,�i` 0 2007 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 - Chatsworth, CA 91313-2402 • www.NationalNotary.org hem #5907 Reorder: Call Toil -Free 1-800-876-6827 Western 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 Eric Lowey, Mark Richardson, Brad L Settgast, Individually of Costa Mesa, CA, its true and lawful Attomey(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 Whereof, 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 15th day of February, 2007. er WESTERN SURETY COMPANY "spj SEAy.'s� .r�lM OpµO'gP Paul . Bruflat, Senior Vice President Stare of South Dakota I ss County of Minnehaha On this 15th day of February, 2007, 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 + .r D. KRELL f November 30, 2012 f E � NOTARY PUBLICf r SOUTH DAKOTA S r CERTIFICATE /&a D. Krell, No Public 1, 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 Drinted on the reverse hereof is still in force. In testimony whereof 1 have hereunto subscribed my name and affixed the seal of the said corporation this 9th jsuacrrc, ��t�ORq��; z a `SC A�ire� arN �Na�P day of September 2008 WESTERN SURETY COMPANY C-Y 27��� L. Nelson, Assistant Secretary Form F4280-09-06 Authorizing By -Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 GMC Engineering, Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, JF:pe Enclosure Sister Citij;fA6"/jSVtiAt?retllYf�WtlbV6i('doC�ew Zealand ( Telephone: 714-536-5227 ) GMC Engineering Inc. $401"WameiAvenu" Suite a M� �92780 15 Pirl 2: 15 GMG Engineering Inc. SECTION C 1401 Warner Avenue, Suite 8 Tustin, CA 92780 PROPOSAL. for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bidders Bond in the amount of $ 1 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: Addenda No. Date Received B'd er's Si nature one 1 8 21 08 Two (2) 9/4/08 CIVIC Engineering Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 C-2 GMG Engineering Inc, 1401 Warner Avenue, Suite B City of Huntington Beach Tustin, CA 92780 Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. ✓� P GMC Engineering, Inc. Company Name By Gennady Chizhi September 15, 2008 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GMC Engineering Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. GMC Engineering,Inc. 141 AL Company Name By Gennady Chiz ' k September 15, 2008 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. GIVIG Engineering Inc. 1401 Warner Avenue, Suite B Tustin, CA 92780 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 i,, pgR I L.S. - —n"o, �saej L N f?hSc�A �1nM Mobilization. R, $ N M O N1N $ Per L.S. 2 1 L.S. Monument reserva on. (a)-A'vc --97 Per L.8. (1/ $'fSO. aq $ .53D. 0-0 3 1 L.S. Furnish Project Traffic Control. US $ $/ 'Zo. PC iTer- L.S. 4 1 L.S. Furnish and Install Traffic Stripy*g and Signing. s.30 &I $ 3 -0 elS 0-0 Per L.S. $3, OJT $317, ?A5-. PO 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and AC Paving Replacement @ c� rke4x�ea aew 7-7- C/ J P�e-r EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type 1 A $ 2-4!�v•PC $ 0 1(0 Go Poles are City Furnished) Per EA. V 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ 10. 00 $ 2 207. Sidewalk Locations as Determined by the ;e city. Per S.F. L Total Amount Bid in Figures:$ 4�' 4/' Poo. Ge:) Total Amount Bid in Words: $ .4 "(-6p /G,.W?l U y Note: The City will provide the radar feedback signs and Type 1 A poles (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-2.1 CIVIC Engineering Inc, LIST OF SUBCONTRACTORS 1401 Warner 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 Address of Subcontractor State License Number Class /1 I/ ORANGE COUNTY STRIPING SERVICE INC. 183 North Pixley Orange, CA 92668 714-639-4550 Lic. # 346095 C 32 O MARTINEZ CONCRETE INC. 920 West Foothill Blvd. Azuza, CA 91702 626-334-2979 Lic. # 394471C8 CONCRETE FLATWORK MACADEE ELECTRICAL 4755 Lanier Road Chino Hills, CA 91710 909-627-1336 Lic. # 583125 ELECTRICAL By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 GMC Engineering Inc. 1401 Warner Avenue, Suite B NONCOLLUSION AFFIDAVIT Tustin, CA 92780 TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Gennady Chizhik , being first duly sworn, deposes and says that he or she is President of GMC Engineering, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will .not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. GMC Engineering, Inc. Name of Bidder Signature of Bidder Genn dy Chizhik GMC Engineering Inc: 1401 Warner Avenue, Suite B Tustin. CA 92780 Address of Bidder Subscribed and sworn to before me this day of , 20 SEE ATTACHED PUBLIC NOTARY SEAL C-4 Jurat State of California County of d Subscribed and sworn to (or affirmed) before me on this iS day of 20oK_ by Ge/o"o oty Ch t`zht h proved to me on the basis of satisfactory evidence to be the person(.*) who appeared before rne. Signattlr� (Notary sea]) KATHY L. BURNUM Commission # 1705358 4b Notary Public • California zf Orange County Comm. Nov 16, 2010 OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT ('I'itle or description of attached document) (I rile or description of attached document continued) Number of Pages ( Document Date (Additional information) INSTRUCTIONS FOR COMPLETING THIS FORM The wording of all Jurais completed in C'alhfornio after.lanuary 1, 2008 must be in the,form as setforth 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 ajurat stamp containing the correct wording or attaching a separate jurat form such as this one which does certain proper wording. In addition, the notary muss require an oath or affirmation from the document signer regarding the truthfulness of the contents of the document. The document must be signed AFTER the oath or affirnnanon. If the document was previously signed, it must be re -signed in front of the notary public during the jurat process. • State and County information must be the State and County where tile. document signer(s) personally appeared before the notary public. • Date of' notarization must be the date that the signer(s) personally appeared which must also be the same date the jurat process is completed. • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Signature of the notary public must match the signature on file with the office of the county clerk • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal il'a sufficient area permits, otherwise complete a different .1urat form Additional information is not required but could help to ensure this jurat is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date • Securely attach this document to the signed document ! i 2008 Version CAPA vl .9.07 800-873-9865 www.NotaryClasses.com I GMG Engineering Inc. UTILITY AGREEMENT 1401 Warner Avenue, Suite B Tustin, CA 92780 HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: September 15, 2008 GMC Engineering, Inc. Contractor By Gennady Chizh k President Title C-5 DISQUALIFICATION QUESTIONNAIRE GMG Engineering Inc. 1401 Warner Avenue, Suite B 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 09 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 GMG Engineering Inc. COMPENSATION INSURANCE CERTIFICATE 14DI Warner Avenue, Suite 6 Tustin, CA 92780 Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: September 15, 2008 GMC Engineering, Inc. Contractor 1eq A --- - By Gennady Chizhi President Title C-7 UNDERGROUND SERVICE ALERT GMe f -ngineering Inc. IDENTIFICATION NUMBER 1401 Warner Avenue, Suite B Tustin, CA 92780 (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: GMC Engineering, Inc. Contractor A14 A ---- - - By Gennady Chizhi President Title Date: September 15, 2008 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION GMG Engineering Inc. 1401 Warner Avenue, Suite B BIDDER certifies that the following information is true and correct: Tustin, CA 92780 GMC Engineering, Inc. Bidder Name 1401 Warner Avenue, Suite B Business Address n City, ( 714) 247-1040 Telephone Number 739091 A; B State Contractor's License No. and Class 8/11 /97 Original Date Issued 8/31 /09 Expiration Date CA 92780 State Zip The work site was inspected by Gennady Chizhik of our office on Sept. 2 , 20 0.8 The following are persons, firms, and corporations having a principal interest in this proposal: GMC Engineering, Inc. 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. GMG' Engineering Inc. 1401 Warner Avenue, Suite B GMC Engineering, Inc. Tustin, GA 2780 Company Name 1A Signature of Bidder Gennady Chizhik Printed or Typed Signature Subscribed and sworn to before me this day of , 200_ SEE ATTACHED N Is] NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for the bidder has performed similar work within the past two years: 1 F) SEE ATTACHED Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Name and Address of Public Agency Name and Telephone No. of Project Contract Amount 3. Name and Addre� Name and eleph ontract 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 O ^otnl q e. Subscribed and sworn to (or affirmed) before me on this (.5 day of S2nernloe_!- 20 o g- by i7-e.N NCJ�� CA iZ Ad<' proved to me on the basis of satisfactory evidence to be the persons who appeared before me. %f 4. Slgna�CR'+�` (Notary seal) KATHY L. BURNUM Commisalon # t 703358 Notary Public - California Orange County Carom Novi6,2010 OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT t --f3i cis-l�s ..�, N'�o(`✓)t<z'{�t°o�J - ('frtle or description of attached document) (Iltle or description of attached document continued) Number of Pages--; Document Date (Additional information) INSTRUCTIONS FOR COMPLETING THiS FORM The ivordnng of all Jurats completed in Cahforma gftev January 1, 2008 must be in the form as set forth within this Jurat. There are no exceptions. zf a Jurut to be completed does not folloiv this form, the notary must correct the verbiage by using a jurai stamp containing the correct ivordmg or aitachrng o separate jurat form such as this one which does contain proper u�ordmn ,g I addition, the notary must require an oath or afFrrnalion from the do( ument ,signer regarding the truthfulness of the contents of the document. The document must be signed AFTER the oath or affirmation. [f the document eras previously signed, it must be re -signed nrftront of the notary public during the j urat 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 signers) personally appeared which must also be the same date the jurat process is completed • Print the name(s) of document signcr(s) who personally appear at the time of notarization • Signature of the notary public must match the signature on file with the office of the county clerk • The notary seal impression must be clear and photographically reproducible Impression must not cover text or lines If seal impression smudges., re -seal if a sufficient area permits, otherwise complete a different jurat form Additional information is not required but could help to ensure this jurat is not misused or attached to a different document. Indicate title or type of attached document, number oi'pages and date. • Securel,, attach this document to the signed document 2008 Version CAPA v1.9.07 800-873-9865 www.NotarvClasses.coni GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST ADDRESS 200 E. Anaheim Anaheim, CA 92807 OUR JOB# 194-05 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT State College Blvd. / Ball Road Intersection Improvements $ 1,377,713.00 OUR JOB# 202-06 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT Lincoln Avenue Street Improvements $ 1,678,026 00 OUR JOB# 203-06 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT Harbor Blvd. / Ball Road Intersection Improvements $ 394,010.00 OUR JOB# 204-06 CONTACT Dan Debasio PHONE (714) 765-5285 DESCRIPTION & CONTRACT AMOUNT Lincoln Ave. / Sunkist St. Intersection Improvements $ 421,003.00 OUR JOB# 206-06 CONTACT Keith Laster PHONE 714-231-8373 DESCRIPTION & CONTRACT AMOUNT State College Median & Landscape Improvements $ 1,687,843 50 OUR JOB# 209-07 CONTACT Keith Laster PHONE 714-231-8373 DESCRIPTION & CONTRACT AMOUNT Harbor Blvd. Roadway and Parkway Improvements $ 331,785.56 OWNER City of Beaumont / F.J. Hanshaw Properties ADDRESS 10921 Westminster Avenue, Garden Grove, CA 92843 OUR JOB# 208-07 CONTACT Richard Borden PHONE 714-573-9644 DESCRIPTION & CONTRACT Realignment of Second Street at Highland Springs Avenue City of AMOUNT Beaumont for F.J Hanshaw Properties $ 3,500,000.00 OWNER City of Brea ADDRESS One Civic Center Circle, Brea, CA 92621 OUR JOB# 173-03 CONTACT Raul Lising PE PHONE (714) 671-4450 DESCRIPTION & CONTRACT State College Blvd./Lambert Rd Intersection Impts. & Brea Blvd. / AMOUNT Central Ave Intersection Impts. $ 1,220,294 48 OUR JOB# 189-05 CONTACT Raul Lising PE PHONE (714) 671-4450 DESCRIPTION & CONTRACT AMOUNT Lambert & Kraemer Intersection Improvemetns $ 287,506 00 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 iNGINEEMNG It GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER Boeing Realty Corporation / The Moote Group ADDRESS 1516 Brookhollow Drive, Santa Ana, CA 92705 OUR JOB# 199-05 CONTACT Steve Morrow PHONE 714-751-5557 DESCRIPTION & CONTRACT Pacific Gateway OnSite Street Improvements Tract 16375 City of AMOUNT Seal Beach $ 1197,453.38 OUR JOB# 200-06 CONTACT Steve Morrow PHONE 714-751-5557 DESCRIPTION & CONTRACT Pacific Gateway OffSite Street Improvements Tract 16375 City of AMOUNT Seal Beach $ 3,852,196 32 OUR JOB# 201-06 CONTACT Steve Morrow PHONE 714-751-5557 DESCRIPTION & CONTRACT Pacific Gateway Storm Drain Improvements Seal Beach Blvd. City AMOUNT of Seal Beach $ 1,491,235.76 OWNER City of Chino ADDRESS 13220 Central Avenue, Chnio CA 91710 OUR JOB# 165-03 CONTACT Naghmen Imani PHONE (909) 464-8367 DESCRIPTION & CONTRACT AMOUNT Mountain Ave Neater Main $ 338,020.04 OWNER City of Colton ADDRESS 650 N. La Cadena Drive Colton, CA 92324-2897 OUR JOB# 157-02 CONTACT Amer Jakher, PE PHONE (909) 370-5067 DESCRIPTION & CONTRACT AMOUNT Santa Ana River Project Area - Washington Street Medians $ 617,569.71 OUR JOB# 172-03 CONTACT Victor Ortiz PHONE (909) 370-5065 DESCRIPTION & CONTRACT AMOUNT Valley Blvd. Median Improvements $ 351,437.60 OWNER City of Costa Mesa ADDRESS 77 Fair Drive, Costa Mesa; CA OUR JOB# 175-04 CONTACT Tom Banks PHONE (714) 754-5029 DESCRIPTION & CONTRACT Bike Trial L'}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 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Downey ADDRESS 11111 Brookshire Ave Downey, CA 90241-7016 OUR JOB# 162-02 & 162A-02 CONTACT Anthony La PHONE (562) 904-7118 DESCRIPTION & CONTRACT AMOUNT Paramount Gateway Streetscape $ 1,132,265.62 OUR JOB# 205-06 CONTACT Jim Bautista PHONE (562) 904-7117 DESCRIPTION & CONTRACT AMOUNT Paramount Blvd. $ 394,771.00 OWNER City of Huntington Beach ADDRESS 2000 Main Street Huntington Beach, CA OUR JOB# 190-05 CONTACT Eric Charlonne PHONE (714) 536-5430 DESCRIPTION & CONTRACT AMOUNT Adams & Brookhurst Intersection Improvements $ 434,974.00 OUR JOB# 195-05 CONTACT Eric Charlonne PHONE (714) .536-5430 DESCRIPTION & CONTRACT AMOUNT Underhill Lane Improvements $ 577,577.50 OUR JOB# 212-08 CONTACT Eric Charlonne PHONE (714) 536-5430 DESCRIPTION & CONTRACT AMOUNT Safe Routes to School, Cycle V - Sowers School $ 274,688.00 OWNER City of Irvine ADDRESS One Civic Center Plaza Irvine, CA 92623-9575 OURJOB* 168-03 CONTACT Steve 011o PHONE (949) 724-7562 DESCRIPTION & CONTRACT AMOUNT Harvard Blvd. Bike Trail 329,030.31 OWNER City of Irvine ADDRESS One Civic Center Plaza Irvine, CA 92623-9575 OUR JOB# 210-07 CONTACT Louie Martinez PHONE (949) 724-7343 DESCRIPTION & CONTRACT AMOUNT Michelson Drive Improvements (From Royce to University Dr.) $ 497,710.50 OWNER City of Laguna Hills ADDRESS 24035 El Toro Road, Laguna Hills, CA 92653 OUR JOB# 196-05 CONTACT Kenneth Rosenfield PE PHONE 949-707-2655 DESCRIPTION & CONTRACT AMOUNT Intersect Wide/Pvrnt Resurf & Median Impts Molton Pkwy $ 1;064,003.60 OWNER City of La Mirada ADDRESS 15515 Phoebe Ave La Mirada, CA 90638 OUR JOB# 155-02 CONTACT Gary Sanui PHONE (714) 522-6821 DESCRIPTION & CONTRACT Rosecrans Pavement & Median Reconstruction Valley View to AMOUNT Biola $ 525,467.27 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 0GINEERING It GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Mission Viejo ADDRESS 200 Civic Center, Mission Viejo, CA 92691 Our Job # 160-02 CONTACT Marc Changon PHONE (949) 470-3091 DESCRIPTION & CONTRACT AMOUNT Improvement of El Paseo Roadway & Traffic Signal Impts $ 223,734.33 Our Job # 171-03 CONTACT Marc Chagnon PHONE (949) 470-3091 DESCRIPTION & CONTRACT Alicia Pkwy / Trabuco Cyn Intersection Traffic Signal Impts & Alicia AMOUNT Pkwy Median Landscaping $ 396,256 58 OWNER City of Newport Beach ADDRESS 3300 Newport Blvd., Newport Beach, CA 92663 Our Job # 179-04 CONTACT Robert Stein P.E. PHONE (949) 644-3322 DESCRIPTION & CONTRACT AMOUNT Newport Blvd. / Balboa Blvd. Merger (Mixmaster) $ 273,625.75 Our Job # 211-07 CONTACT Andy Tran P.E. PHONE (949) 644-3315 DESCRIPTION & CONTRACT AMOUNT Superior Avenue Median Improvements $ 634,118.50 OWNER City of Paramount ADDRESS 16400 Colorado Avenue, Paramount, CA 90723 OUR JOB# 167-03 CONTACT Robert French — Willdan & Associates PHONE 562-714-5599 DESCRIPTION & CONTRACT Street, Traffic & Landscape Impts on Paramount Blvd. & Harrison AMOUNT Streets $ 867,957.00 OWNER City of Riverside ADDRESS 3900 Main Street Riverside, CA 92522 OUR JOB# 174-04 CONTACT Juan Rojas PHONE (951) 826-5236 $ 330,076.68 DESCRIPTION & CONTRACT AMOUNT Central Ave to Chicago, Alleys, Fairmount from Strong to 60 Fwy OUR JOB# 176-04 CONTACT Juan Rojas PHONE (951) 826-5236 DESCRIPTION & CONTRACT AMOUNT Van Buren Blvd. Median Improvements $ 740,000.15 OWNER City of Torrance ADDRESS 3031 Torrance Blvd., Torrance Ca 90503 Our Job # 166-03 CONTACT Sandy Cohen PHONE (310) 618-2824 DESCRIPTION & CONTRACT Hawthorne Blvd. / Del Amo Blvd. Traffic Signal and Interesection AMOUNT Improvements $ 336,841.11 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 GENERAL ENGINEERING CONTRACTOR Lic. No. 739091 CONTRACTORS PROPOSAL REFERENCE LIST OWNER City of Upland ADDRESS 1370 N. Benson Ave Upland, CA 91786 OUR JOB# 177-04 CONTACT Alex Qishta PE PHONE (909) 931-4272 DESCRIPTION & CONTRACT AMOUNT Foothill Blvd. Medians $ 110,073.96 OWNER City of Wesminster ADDRESS 8200 Westminster Blvd. OUR JOB# 197-05 CONTACT Jake Ngo PHONE (714) 898-3311 x 217 DESCRIPTION & CONTRACT AMOUNT Westminster Blvd. Median improvements from Beach to Edwards $ 2,100,000.00 OUR JOB# 198-05 CONTACT Jake Ngo PHONE (714) 898-3311 x 217 DESCRIPTION & CONTRACT AMOUNT City Hall North Parking Lot Improvements $ 287,287.00 ADDRESS TOUR JOB# CONTACT PHONE DESCRIPTION & CONTRACT AMOUNT OUR JOB# CONTACT PHONE DESCRIPTION & CONTRACT AMOUNT 4845 Casa Loma Ave POBox 87014, Yorba Linda, CA 169-03 Fernando Saldivar (714) 961-7170 Yorba Linda Blvd. Median Improvements $ 556,270 26 207-07 Mark Stowell 714-961-7172 Esperanza Road Mitigation Project $ 4,137,990.00 1401 Warner Avenue, Suite B, Tustin, California 92780 • (714) 247-1040 • Fax (714) 247-1041 (For federally funded projects, use this following page) AMC Engineering Inc. I4Qt Warner Avenue, Suite B BIDDER'S CERTIFICATION* Tustin, CA 92780 HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or X Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: GMC Engineering, Inc. Contact Person: Gennady Chizhik Contact Phone: 71 4-247-1 040 Signed: Date: September 15, 2008 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 GMC Engineering Inc, Local Assistance Procedures Manual 1401 Warner Avenue, Suite B EXHIBIT 12-E PS&E Checklist Instructions Tustin, CA 92780 Attachment C t 1 (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION . The bidder GMC Engineering, Inc. , proposed subcontractor , hereby certifies that he has X has not_, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering'agency,"or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rcv.06-04-90aEND1Fn Page 12-89 LPP 01-04 March 15, 2001 I GMe Engineering Inc. EXHIBIT 12-E 1401 Warner Avenue, Suite B Local Assistance Procedures Manual Attachment G Tustin, CA 92180 PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 GMe Engineering Inc. Local Assistance Procedures Manual 1401 Warner Avenue, Suite B EXHIBIT 12-E PS&E Checklist Instructions Tustin, CA 92780 Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. R/Subawardee, pe: a, contract Fla- bid/offer/application ❑ a b. grant b. initial award bchange c. cooperative agreement c. post -award d. loan For C ge Only: e. loan guarantee quarter f. loan insurance t report 4. Name and Address of Reporting Entity 5. If Reporting Entity in ubawardee, Enter Name and Addre: Prime Subawardee Tier if known Congressional District,if known 6. Federal Department/Agency: g a 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, i Congre onal District, if known - 7. Fed 1 Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11./employce(s), Payment( eck all that apply) 13. Type of Payment (check all that apply) $actual planned a. retainer b. one-time fee 12.ent (check all that apply): c. commission d. contingent fee ind; specify: nature a deferred value f. other, specify 14.tion of Services Performed or to be performed and Date(s) of Service, including loyee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes NoLN 16. Information requested through this form is authorized by Title . 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. print Name: Gennady Ch i z hik 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any President person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than 71 4 — 2 4 7 —1 0 4 0 9 / 1 5 / 0 S I00,000 for each such failure. Telephone No.: Date: l I Federal Use Only: Standard Form LLL Rev. 09-12-97 Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 March 15, 2001 4333 111MMYS AWW N.I� f wx&, WA4SfAS BID BOND KNOW ALL BY THESE PRESENTS, That ®e, GMC Engineering. Inc. _ of 1401 Warner Avenue, Suite B. Tustin, CA 92780 (hareloafter aaIBmd the hinaip % as Psiacipa , and FITiS1" AMME MURANCE MMPANV OF AM —CA, R Mdtre, Waslsingto®, a "Frrati6a duty ptgaai&W sodas the lei of the State of Wmbiagtan es Surety, hereinafter miled the Surety, are held and fh'"dy bound uate the City of Huntington Beach (bovieftw t141W tb ob ) in W EMI Ten Percent of the Total Amount Bid ------------ —----- —----- - --------------------------------------------------------------------------------Dollars 0------- 10 % for the payment of which the priarGF41 and the Sur®ty bind themgelyas, their heir®, ewutors, arm stars, succemmvre and awkm jointly and amwally, firmly by the pteeents. THE CONiDMON OF THIS Ql LIVATION I5 SUCH, That Whereas, the Arinelpai ham submitted or is abmtt to Aubmit a proposal to the Obli p a a mairmat for Safe Routes to School, Cycle IV in the vicinity of Marine Middle School C.C. No. 1244 NOW, THEREMRE, If tba said Coatraot be timely awarded to the Principal and the Principal sbail, within mush time as may be spe-616l, enter iota the contract in writing, omd give band, if bond is reqbired, with tulrety aegftble to tits (Tiger for the faithful pmrfarmsnce of the said t untrani, than this obligation shalt ba void, otherwise to remsia in full Isms and affect. Signed sad pled thin 10th day of September, 2008. GMC Engineering, Inc. (seat) Principal Title FIRST NATIONAL INSURANCE 00VIVANY OF AMHRICA BY -°`e- -1re R Gryc e Attorney -in_ wt 840p V" I POWER First National Insurance Companyo America Safeco Plaza OF ATTORNEY -•••••- Seattle. WA 98185 No. 9392 KNOW ALL BY THESE PRESENTS: That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint ************ **********************1EFFREY R. GRYDE; Costa Mesa, its true and lawful attorney(s}in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 20th day of October STEPHANIE DALEY-WATSON, SECRETARY TIM MIKOLAJEWSKI, SENIOR VICE-PRESIDENT, SURETY CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business.., On any instrument making or evidencing such appointment. the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seat, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking," Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." 1, Stephanie Daley -Watson , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 10th STZA L ;i928 . S-1049/DF 4I05 f day of September , 2008 STEPHANIE DALEY-WATSON, SECRETARY Safes and the Safeco logo are registered trademarks of Safeco Corporation. WED PDF CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT fir, az?: $F a�Cn@?�' �a ��.��.$�..�a T.� ibs'�. �. i�. '� i. � ti � '�Sw �. tiW�4� '�D. '�?' W �-n �.w'•J. ti '�.. Via. A� . iJ nib WG.'� i$d. a4�. w'�? State of California County of Lclf On—S€.p.tcmj�10 9009 before me, 0 `10 5�L n e �Glne e� � Dafe Here Insert Name and Title of the Officer `J personally appeared CHR"TII JANE THATCHER Commission # 1716548 • `� Notary Public - California Z Los Angeles County *C=M EtresJa n 26, 20l l Place Notary Sea! Above who proved to me on the basis of satisfactory evidence to be the person whose name(,tf;) is/aF& subscribed to the within instrument and acknowledged to me that he/s4eAhW executed the same in his/her tfteir authorized capacity(4e5), and that by his/heAheir-signature(,) on the instrument the person(W, 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 tf foregoing paragraph is true and correct. � / WITNESS my hand and q(figfal seal. Signature OPTIONAL Of Notary vuuic Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing RIGHTTHUMBPRINT L01FISIGNER 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: fiIGHTTHUMRRFRN � OF1SIGNER + Top of thumb here 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NabonalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 ffi [ L p• M � �', � a,1 a �', �\, i,, i A!n i f � `.� _ State of California County of Q>w Q r q Q- On Se-&entbet- l� aoog- before me, %�a T AV L Q �t� ✓kx I Me��� P, A/, IC. (Here insert name and title of the officer) personally appeared (3-e-4t,)JV Chi Ali K who proved to me on the basis of satisfactory evidence to be the person(g) whose name(o is/,re subscribed to the within instrument and acknowledged to me that heZAii AKy executed the same in his/Jazt7L eir authorized capacity(ie,5), and that by his/their signature(.) on the instrument the person($), or the entity upon behalf of which the personjacted, 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. FITNESS my hand and official seal. Signatur.n r Public C. KATHY L. BURNUM Commission * 1705358 IL .� Notary Public - California orange County p &WComn.ExM*%Nov 16, 2010 (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (rifle or description of attached document) (Title or description of attached document continued) Number of Pages % Document Date 10 4 (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) -K 7$1'porate Officer f Pule) ❑ Partner(s) C1 Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknon,7edgment completed in Calrforma must contain rerbuige exactlI as appears above in the notary section or a separate acknou ledgnient form roust be properly completed and attached to that document 7'he only exception is ri a document is to be recorded outside tf Calrforma. In such uisiouces, am allern7tive 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 notciri in California it e. certifying the authorized capacity of the stgner) Pleasc check the document carefully for proper notarial n ordmg and attach this f rrnr if, cquired • State and County information must be the State and CountV 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 0)ich must also be the same date the acknowledgment is completed_ • The notary public must print his or her name as it appears wrthm hi, or her commission followed by a comma and then your title (notary publicf • Print the name(s) of document signer(s) who personallti appear at the nine of notarization • Indicate the correct singular or plural forms by crossing off incorrect term, (I c he/she/fliey, is Jane ) or circling the correct forms failure to correctly indicate thu information may lead to rejection ofdocument recording • The notary seal impression must be clear and photographically reproducible Impression must not cover text or Imes If seal impression smudges. re -seal it a sufficient area permits, otherwise complete a diflerent acknowledgment form • Signature of the notary public trust match the signature on file wnh 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 ol' pages and date Indicate the capacity claimed by the signer If the claimed capacity is a corporate officer, indicate the title (i c CEO, CPO. Secretary ) • Securely attach this document to the signed document 2008 Version CAPA % 12 10 07 800-873-9865 www NotaryClasses corn City ®f Huntington Beat 2000 Main Street o Huntington Beach, CA 02648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK April 3, 2009 Golden State Constructors, Inc. 6162 Galipean Dr. Huntington Beach, CA 92647 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, j Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citi(§sAoftd�*aiAt/peW,N jiL%6iI.®ocNew Zealand (Telephone: 714-536-5227 ) (*3sci Go(den State Constructors, Inc. 6162 Gahpeaii Dr. Huntington Beach, CA 9264T 2000 SEP 15 AN 0* CIO jl� SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL, OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices: The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find tJi h6ijin the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as require& by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received A, Bidder's Signature C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 n• I I L.S. I—M'"AI "O ffiB U N Mobilization. Per L.S. $ '12 0-1 2 $ 2 1 L.S. Monument Preservation. $ ©D $ 390c) A- botg 'S.. Per L.S. 3 1 L.S. Furnish Project Traffic Control. &-0-y-t &..' % a &A VAJe- 11) Ar e,A Per L.S. $ DC) $ 15 0 4 1 L.S. Furnish and Install Traffic Striping and Signing. Per L.S. $ L1P00 $ 14 tp C) 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and $ y $ AC Paving Replacement. bi a CPS(') 6 4 EA. Per EA. Install Radar Feedback Sign, Including -0 0 C) Foundation (Radar Feedback Signs and Type I A $ Poles are City Furnished) Owe It U C Per EA. IL 11 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ 207. Sidewalk Locations as Determined by the City. w, Per S.F. Gk Total Amount Bid in Figures: $ W el- J 5 Total Amount Bid in Words: $ "r-s Note: The City will provide the radar feedback signs and Type IA poles (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-2.1 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class bid i 5'0!3 Lot�t� D2:vL LA MiX DA A Rn g 3�� By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 State of California ss. County of Orange o o s i C cc A rtti ", , being first duly sworn, deposes and says that he or she is p:-e-g�A-L'.'y of G,,(c4,j Slak �rut✓}yo 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. Name of Bidder - r� , a Signature of Bidder Address of Bidder Subscribed and sworn to before me this \o day of SL4�,SQK, 20 oe . CLAIJDIA COCHRAN .- •' •y. COMM, #1722119 mtn ) as Notary PuNlo-Cali(omia r ORANGE COUNTY My Comm, Exp. Jan 30, 2011 NOTARY PUBLIC AJ©� 0 0 0 � 1 C�- NOTARY SEAL C-4 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of (Doa e On before me, 40atola Orkran, PjAw 1>01it , (Here insert name and title of the officer) personally appearedIOIIItit' who proved to me on the basis of satisfactory evidence to be the person(o whose � name (�s are -subscribed to l�i i the within instrument and acknowledged to me that NwAho-y executed the same in authorized capacity0fo, and that b3(pkeF4" signature( Yon the instrument the person(&, or the entity upon behalf of which the person(o 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 o al Signature of Notary Public CLAUDIA COCHRAN s I COMM. #1722119 m W Notary Publiozaliiomis LA ORANGE COUNTY My Comm. Exp. Jan 30, 2011 4 AR (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form if required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. He/she/they- is /ere ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. ep 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. +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 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: �' lV'Ub Contractor p 0 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 �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- `® - 0$ C, I CAL, u ircrJ 6 Contractor By P(--C- 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: (' 4tk (' Date: q - to - L C k C ''3tradb rS Contractor i C"rC4-� By pir'e- --,A" ot��- 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: Bidder Name Business Address City, IS'- 9� 8 Telephone Number 2 t(A" State Contractor's License No. and Class I (- os- Original Date Issued 93 - J o ©l Expiration Date State Zip The work site was inspected by ,) GA-rc-j of our office on 1 — b. , 2069 The following are persons, firms, and corporations having a principal interest in this proposal: OtJ ai+� E'�►e.s 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. ru Co r ame h-x Signature of Bidder Printed or Typed Signature Subscribed and sworn to before me this 10 day ofS�Wry"Y;&-0, 200e . CLAUDIA COCHRAN • COMM. #1722119 � Notary PubllaCeiifomia GILWc7E C4tJN7Y + i� My Comm, , Jan 30, 2011 NOTARY PUBLIC` PO 6C.i` 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. ro,44c Aar 4?,,&j &c.L-e-L -load kv"A' W- 5�-tt� Name add Address of Public Name and Telephone No. of Project Manager: bLQ �,� �t Up�Pi�► O�rL(7f'i�z - y�r�7 Curb Contract Amount Type of Work Date Com ted 2. L V 61 N01-c--c, IV- 12.?oo Name and Address of Public Agency Name and Telephone No. of Project Manager: to A l#wd 5bZ ! — 5 4 Contract Amount The of Work 3. O .,- 1166 6 1,1,40 Nam and Address of Public Agency Date Completed C4 %9,,6 7 Name and Telephone No. of Project Manager: etlrl� 5r70';-3Z7 /17 7 l� w✓ Contract Amount 1ype of Work Date Completed C-10 AI " 04, 15A, 0 � 101 State of California County of Ormwe On k--( c)--,D before me, Caubia 0—m- 4 notnotm Vubl9t , (Here insert name and title of the officer) personally appeared t(onnit 04M who proved to me on the basis of satisfactory evidence to be the person(�r} whose name(} s-subscribed to the within instrument and acknowledged to me that(&?sheAkey executed the same in his/her/their authorized capacity(icfg), and that by(0hen4te4r signatureO 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. CLAUDIAR. COCHRAN •° COMM. #1722119 m --- V1 = Notary PubExlfo•CaNlomia to WITNE y hand and o ea . w MAKE rouwly My Commp. Jan 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 CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a docrmrent so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authori_ed capacity of the signer). Please check the document carefidly for proper notarial wording and attach this form if required • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. Ere/she/they- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form • Signature of the notary public must match the signature on file with the office of the county clerk. sr Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. -b 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 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: t)lce�J 6,���� Contact Person: ,y�,y � �c�� fCrr Contact Phone: 7 f l 5-8 Signed: Date: q-10 __ D 8 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECU77ON OF THOSE CERTIFICATIONS WHICH AREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder_ L7614 ,tJ C,OR.�S IYaC.l`e rS ,proposed subcontractor - !v , hereby certifies that he has;x, has not_, participated in a previous contract or acontract 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. LPP 01-04 Pape 12-79 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: IX Ia. contract 7" b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: ® a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime El 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) 3. Report Type: ® a. initial b. material change For Material Change Only: year quarter_ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check ail that apply) 13 . S actual planned 12. Form of Payment (check all that apply): 8 a. cash b. in -kind; specify: nature value Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: YesEl No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. print Name: 0iui e 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any `Q - person who fails to file the required disclosure shall be subject Title: �QS-e!/�f W to a civil penalty of not less than S 10,000 and not more than S100,000 for each such failure. Telephone No.: 27.7)? Date: Federal Use Only: standard Form LLL Rev, 119-12-97 LPP 01-04 Authorized for Local Reproduction Standard Form - LLL Page 12-87 March 15, 2001 - EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered.. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date,the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90«ENDIF,, Page 12-89 LPP 01-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PICA, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. T is to acknowledge receiptand review of Addendum Number On ed August 21, 008. r� jv,vr`e 1', -,/ ompany Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, d e eptem 4, 2008. filaw 5" ors a/ - Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. NORTH AMERICAN SPECIALTY INSURANCE COMPANY BOND NO.: GOLST-047 KNOW ALL MEN BY THESE PRESENTS: That we, GOLDEN STATE CONSTRUCTORS, (hereinafter called the Principal), and NORTH AMERICAN SPECIALTY INSURANCE COMPANY a corporation organized and doing business under and by virtue of the laws of the State of NEW HAMPSHIRE, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of CALIFORNIA, as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH, (hereinafter called the obligee) in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of TEN PERCENT OF THE TOTAL AMOUNT BID Dollars (10% OF BID AMOUNT), for the payment of which, well and truly to be made, we hereby bind ourselves and our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the above bounden Principal as aforesaid, is about to hand in and submit to the obligee a bid for SAFE ROUTES TO SCHOOLS CYCLE IV AT MARINE VIEW MIDDLE SCHOOL JOB/BID NO. 1244, in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefore. NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said obligee, and said principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 9TH day of SEPTEMBER, 2008. BY: GOLD" STAJE BONSTRUCTORS NORTH AMERICAN SPECIALTY INSURANCE COMPANY BY: / V/RGU�.i /[ MATTHE vd R. DOBYNS, ATTORNEY-IN-F NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL, POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of Arizona and having its principal office in the Cityof ltaseat 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 24th of March, 2000: "RESOLVED, that any two of the President, any Executive Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." ptN1N11llttllq/ry p„auuu..r„� r t;? bo¢Poq�r Steven P. Andes on, President & Chief Executive Officer of Washington International Insurance Company & Vice President of North American Specialty Insurance Company E A 1_ ' C RR3ZGN.i David M. Layman, Vice President of Washington International Insurance Company & Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 16th day of June 2008 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Du Page SS: On this 16th day of June , 20 08 , before me, a Notary Public personally appeared Steven P. Anderson , President and CEO of Washington International Insurance Company and Vice President of North American Specialty insurance Company and David M. Layman , Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. i1, r o CIA , sE.AU „ 1 DONNA D. SKIENs Notary Public, State of itiinois My Commission Expires t0/ti672fl1I Donna D. Sklens, Notary Public I, James A. Carpenter , the duly elected Assistant Secretary of North American Specialty insurance Company and Washington Intemational 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 9th day of September , 20 08 . James A_ Carpenter, Vice President & Assistant Secretary of Washington [nternanonal Insurance Company & North American Specialty Insurance Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of CALIFORNIA County of ORANGE / On 01b. 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. ®� I certify under PENALTY OF PERJURY under the laws of the State of ERIKAGUiDO California that the foregoing paragraph is true and correct. COMM. # 1576135 pOrORAN' �u $ WITNESS my hand and official seal. AVcanm� �, 2000 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 �' _ -�R ;, CERTIFICATE OF ACKNOWLEDGMENT State of California County of On &j —1 0 - 0 <? before me, 1/-e,7 CD c(ti9 �D TArlt-o iP 0/3 U ( , (Here insert name and title of the officer) personally appeared zk7- Q , who proved to me on the basis of satisfactory evidence to be the persons whose name I are -subscribed to the within instrument and acknowledged to me tha&AMhey--executed the same . fit authorized capacity(,iqsT, and that b signature(} -on the instrument the person(}, or the entity upon behalf of which the person(p)-acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS m I 81111aifin'' I al. Signature of Notary Public CLAUDIA COO~ COMM.#1722119 -n a Notary PubBc-Celifwnla j w ORANGE COUNTY My Comm. Exp- Jan 30, 2011 (Notary Seal) ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT f t4,1u,D Ls- V C3tj (Title or description of attached document) (Title or description of attached dd6ument continued ) Number of Pages Document Date -02 (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2008 Version CAPA 02.10.07 800-873-9865 www-NotaryClasses.com INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that documrent. The only exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e_ certifying the authorized capacity of the signer). Please check the document carefidly for proper notarial wording and attach this form if required • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment- • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural fortes by crossing off incorrect forms (i.e. WshcAhey- 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 seat 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. Ae 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 City of Huntington Beach 2000 Main Street . Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK April 3, 2009 C. J. Concrete Construction, Inc. 10142 Shoemaker Avenue Santa Fe Springs, CA 90670 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citigtfd b6"/j0&htheWnf "q&�iO ew Zealand (Telephone: 714-536-5227) Cj Construction, Inc. 10142 shoemaker Avenue Santa Fe Springs, CA 90670 2000 SEP 15 P11 1: 20 H'U !"I T!l i T G d J A.J E A w11 SECTION C PROPOSAL for the Safe Routes to School, Cycle IV .1 In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this -proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award; BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into" a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the; purpose of comparing bids and that final compensation under the contract will be based upon the *tual quantities of work satisfactorily completed: THE AGENCY RESERVES THE RIGHTTO 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 61da(,0' S � in the amount of $ 11, 3 60 "C" which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature Cl C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 J w?c.t`F-...s`�j 1 p��' �v / 'ter:. 1 L.S. �W i.'�F.'t�'`,'` - •�,. � „u*i.�t'c` ':: 'v'°, _ _ .'N.+3,4-_.r Y�? �plll. ;.��.U.: , V VetiV�F�L�' -r� .tr :t fii3 � +{' �':",ckx ..E. : 21=- �. •i �,.. ,�.c2"e.�i�; i7-^� s . - ..„..:r,..x_ Mobilization. @ f-Car fhoescp)c,4 live I.R:`�.SfO,Y �.S�' iv+�h"��{W'Ftff'XFT ;='a --,^�.'�,'. _ _ $ y, SGG�°"` «,�J'qy;.ZK M�� cr;^t,_ z- - ;N"�-_>> $ ��� 4 00c) cc tnc/recl oI/emi qny oo relif'S Per L.S. 2 1 L.S. Monument Preservation. @ f"vy% -%1'7Oi ,5Q1W ru i)e Rvnclro C/C//Q" cy7a $ l�- , �'!GO $ �-I. C100 nc Per L.S. 3 1 L.S. Furnish Project Traffic Control. @ Se veh % hGr3G� -five 1�Ul�dffd clot/,qr,S c4ne4 Gc.en-fs, $ 7, Sc `0 $ .7, 5"00 . c4, Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. vn@lire/ d—ello s Pna Per L.S. 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and AC Paving Replacement. @ -7hf g vs670 d -f v e -t'WCJrr'd C101Mri eancl 04 errrf's $ 3, 5"cG'i ° $� �l 4-1O 5 • 0 Per EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type I $ , 000 �' $ Clio Poles are City Furnished) We Tho14;,c-y11L4 Bind 00 ,e/ 's. Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan �� $ ° p $ / dG40 207. Sidewalk Locations as Determined by the City. @ ne - c iiclrs j-e4-nt4 O r el' Per S.F. Total Amount Bid in Figures: $ 2rJ/ % 00 GCl Total Amount Bid in Words: $ F ih f1 ,F1 q h-t % 1)!qU5 q hcY seven h unare a/ GIG nC c Ce Note: The City will provide the radar feedback signs and Type IA poles (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-2.1 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 and Address of Subcontractor State License Class of Work ,� ! % Number f"/A By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange al2n C. , being first duly sworn, deposes and sa s that he or is cC sen of C; / CGI?%'%-efe rr112Sj1-V(-^Ve peaking the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. r j ConclHe Ccn5l -uch and .-Tnc - Name of Bidder <ignattire of Bidder �� e/)2qker Ave. mofq fesg„l? Address of Bidder CCO e70& 70 Subscribed and swornto before me this -"Iday of lh�4 69 . COU 2 0 41 RO GULICK Commission # 1712023 Notary Public - California Z los Angeles County 1 0 MyCcrrm BpkesDec21.2010 NOTARY PUBLIC '�/��(� U �Ci1 I i LAN- NOTARYSEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: I rv/G� i cr�/� cr�s� vC�%0�, Contractor B 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 -/N"'o If the answer is yes, explain the circumstances in the space provided. JV 1A" 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: C, C-oncre-tc Ccins- hucti-cn,,-Tr�c Contractor By nle 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: I"/ C� ConC/'e �e CGas l'yc�/�r� I Tt-k.-I. Contractor Title Date: q / 10 108 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: CCIXI eg cens ti'uCfi on, ..fin c Bidder Name iry,- a' s f rifn)(f Business Address ,San fr fe � r(n City, et Ave Cq b&70 State Zip 56,a-) 777- c;P05. Telephone Number 'WOClY ?-14 State Contractor's License No. and Class 0Z/- 0&?' / & Original Date Issued D 41.30. ,2GIC Expiration Date The work site was inspected by C/'�� s SCr/JG of our office on /'O , 200,F The following are persons, firms, and corporations having a principal interest in this proposal: j l0h17 C, rnC-- Pms)den,�- �Ghn C. SC710G - dec,- rrr ichn C. Scir-ocl - 'Tr 4surer %t� c'� c�r-��� ncoy�� There of C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. C con c) Comnanv Name rucn �1�, Iny Signature of Bidder ch C, Printed or Typed Signature Subscribed and sworn to before me this / day of 'j'1Pee- 200 0. COURTNEY BROOK GULICK Commission # 1712023 Z Notary Public - California z Los Angeles County MVC omm.E PkesDec21,20100 NOTARY PUBLIC CD r � y „?i'(J0!C 07f, l 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. P/ct--Q,5e See ,f)-Pc%% 2. 3 Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount w1k Name and Address of Public Agency Type of Work -I, Name and Telephone No. of Project Manager: Contract Amount Type of Work C-10 Date Completed Date Completed Date Completed CJ Concrete Construction, Inc. 10142 Shoemaker Avenue • Santa Fe Springs, CA 90670 • Phone (562) 777-2222 • Fax (562) 777-2222 Citywide Sidewalk, Curb and Gutter Repairs in the City of Cerritos City of Cerritos 18125 Bloomfield Avenue Cerritos, Ca 90703-2130 (562) 860-0311 Mary Anne Wozniak Started 05/19/06 Completed 10/27/06 Final contract price $637,703.00 Installation & Repair Concrete PK0001-4 (Year 3 of 3 year contract) City of Ontario 1425 S. Bon View Ave. Ontario, Ca 91761-4406 (909) 395-2624 Dale Adcock Completed 4-14-03 Final contract price $825,000.00 with change orders original contract price $696,578.00 2004/2005 Annual Concrete Repair Project City of Arcadia 240 Huntington Dr. Arcadia, CA 91107 (626) 256-6552 Mark Rynkiewicz Started 01/30/04 Completed 05/31/05 Final contract price $240,119.00 with change order, original contract price $185,780.25 Remove/Replace curb, gutter, and sidewalks on various city streets City of La Palma 7822 Walker St. La Palma, CA 90623-1771 (714) 690-3312 Dave Gaudio Started 10/14/05 Completed 10/1/06 Final contract price $74,957.02 with change order, original contract pricec $59, 201.00 CJ Concrete Construction, Inc 10142 Shoemaker Avenue • Santa Fe Springs, CA 90670 • Phone (562) 777-2222 • Fax (562) 777-2220 Curb/Gutter and Sidewalk Reconstruction Project No. 4474 City of Fullerton 303 W Commonwealth Avenue Fullerton, CA 92832-1775 (714) 738-6875 Karen Kobeyashi Completed 5-13-06 Final contract price $338,934.00 with change orders, original contract price $275,060.00 1219 Sidewalk Repair Project City of Burbank 275 E. Olive Ave. Burbank, Ca 91510-6459 John Molinar (818) 238-3919 Started 4-30-2007 Completed 8/07 Final contract price $892,000.00 ADA Bus Stop Modifications Phase 3, Package 1 Orange County Transportation Authority P 0 Box 14184 Orange, Ca 92863-1584 Started 9-7-05, completed 2-28-05 Final contract price $300,368.00 with change orders, original contract price $282,765.00 George Saba (714) 560-5432 Landscape Construction/Maintenance for Pacific Electric Right of Way C-0872 Orange County Transportation Authority P 0 Box 14184 Orange, Ca 92863-1584 Started 6/09/03 3 year maintenance Final contract price $1,059,852.00 with change orders, original contract price $960,000.00 George Saba (714) 560-5432 2 Cj Concrete Construction, Inc. 10142 Shoemaker Avenue • Santa Fe Springs, CA 90670 • Phone (562) 777-2222 • Fax (562) 777-2220 Irvine Avenue Sidewalk Maintenance C-3175 City of Newport Beach 3300 Newport Blvd. Newport Beach, Ca 92663-3884 Started 9-26-05 Maintenance to June 1, 2006 Final contract price $222,011.00 with change orders, original contract price $202,250.00 Rob Masters (949) 644-3312 Bonding Agent - Dwight Reilly Crosby Insurance Co. P 0 BOX 31150 Anaheim, Ca 92809 (909) 920-5811 Surety Co. First National Insurance Co. 2677 N. Main St. #600 Santa Ana, Ca 92705 (714) 437-3744 Insurance Agents Crosby Insurance Co. P O Box 31150 Anaheim, CA 92809 (909) 920-5811 1 John C. Sarn — President (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): GS Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: C' % Cclgcrele CC0S f rUChC1n, _ThC Contact Person: ; Tol2n C. 52rno Contact Phone: & i) 777- ge?OQ- Signed: Date: 9 /01 *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 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated Au st 21, 2008. C', j C'U/�C�c 7�e Cc S�"uc f io��i�c �— C-ompany Name By 1/167 ��� 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 of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. Company Name By '7LleeAe 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 of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. CT C�nc�ee t'�ns irv�i�r�7��' Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rcv.06-04-90«END[F+p Page 12-89 LPP O1-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G THIS FORMTO I MULOSib LUBBYlNU AU11Y111bS FUFSUANI W 31 U.S.U. U_"Z 1. Type of Federal Action ® a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: ® a. bid/offer/application b. initial award c. post -award 3. Report Type: ITa. initial b. material change For Material Change Only: year quarter_ date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime � Subawardee Tier if known Congressional District, if known Congressional District, if known - 6. Federal Department/Agency: 7. Federal Program Name/De cription: ,•`//�e / CFDA Number, if applicable L_0� 8. Federal Action Number, if known: 9. Award Amount, if known: ) /v /-�- Id/A 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount df Payment (check all that apply) S —� actual planned 13. Type of Payment (check all that apply) a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission d. contingent fee Ha.cash b. in -kind; specify: nature e deferred value IF " Elf. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including i officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necess ) 15. Continuation Sheet(s) attached: Yes 11 No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: 1100 was placed by the tier above when his transaction was trade or entered into. This disclosure is required pursuant to 31 U.S.C. print Name: 1352- This information will be reported to Congress semiannually and will be available for public inspection. Any Title: p r t person who fails to file the required disclosure shall be subject to a civil penalty of not less than S 10,000 and not more than I100,000 for each such failure. Federal Use Only: LPP 01-04 ;-&' h-7- 2,3�2 Date: 9 iu 's Telephone No.: Authorized for Local Reproduction Standard Form - LLL Jr300arO rOrrn LLL KCV. VY-II-Y/ Page 12-87 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C t _) (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder C / 07170 e fe CvfiS t/�/G� 1'GI% , -7/7C. , proposed subcontractor N t:4 , hereby certifies that he has " � has not_, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering *agency,'or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 4333 Brooklyn Avenue N.E. Seattle, WA 98105 BID BOND Conforms with The American Institute of Architects, A.I.A. Document No. A-310 KNOW ALL BY THESE PRESENTS, That we, C.J. CONCRETE CONSTRUCTION, INC. and the FIRST NATIONAL INSURANCE COMPANY OF AMERICA of 120 VANTIS, ALISO VIEJO, CA 92656 as Principal, hereinafter called the Principal, , a corporation duly organized under the laws of the State of Washington , as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH as Obligee, hereinafter called the Obligee, in the sum of TEN PERCENT OF THE TOTAL AMOUNT BID --------------------------------------------------------------------- Dollars($ 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 ROUTES TO SCHOOL, CYCLE IV VARIOUS LOCATIONS 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 12TH day of SEPTEMBER 2008 Witness Witness C.J. CONCRETE CONSTRUCTION, INC. (Seal) -�rincipal Title FIRST NATI NAL INSURANCE COMPANY OF AMERICA By. ' DWIGHT REILLY Attomey-in-Fact S-0054IFNEF 7198 0 Registered trademark of SAFECO Corporation. State of California County of ORANGE On SEPTEMBER 12, 2008 ACKNOWLEDGMENT before me, SUSAN PUGH, NOTARY PUBLIC (insert name and title of the officer) personally appeared DWIGHT REILLY , who proved to me on the basis of satisfactory evidence to be the person(.K) whose name( is/we subscribed to the within instrument and acknowledged to me that he%kebr executed the same in his1h,@d# W, authorized capacity(, and that by his/kaDWVjC signature(X) on the instrument the person(s,), 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. • SUSAN PUGH Commission # 1734680 WITNESS my hand and official seal. Z :-m Notary Public - California € Orange County ' MVC0Mm- 6gires Mor28, 2011 f" r Signature (Seal) SUSAN PUGH S A F E C ®a POWER FIRST NATIONAL INSURANCE COMPANY OF AMERICA OF ATTORNEY PO sox 34526 FIRST NATIONAL SURETY SEATTLE. WA 98124-152e PO ROX 34526 SEAM-H.E. WA 98124.1526 No. 9551 KNOW ALL BY THESE PRESENTS: That FIRST NATIONAL INSURANCE COMPANY OF AMERICA. a Washington corporation, does hereby appoint ..e..•..re.•..•o..e••..r...e....o.o•..e.e.e.....ell J. DUECK; DWIGHT REILLY. Anaheim, California•...o.a.....ev....e.•v. •..•.e•........•.•.•••..e its true and lawful aftomey(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this IIth day of January . 2005 AM C_4 ' d4-, CHRISTINE MEAD. SECRETARY MIKE MCGAVICK, PRESIDENT CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BLINDS .. the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attomeys-in-tact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of Its business. On any instrument making or evidencing such appointment, the signatures may be affixed by facslmile. On any Instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking " Extract from a Resolution of the Board of Directors of FIRST NATIONAL -INSURANCE COMPANY OF AMERICA adopted July 28. 1970 "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (I) The provisions of Article V, Section 13 of the By -Laws, and (ir) A copy of the power -of -attorney appointment, executed pursuant thereto, and (III) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, Christine Mead, Secreiary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, 00 hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the Sy -Laws, the Resolution and the Power of Attorney are still In full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation abcf CO oaw SEAL i 1928 ~jai?°ju+7�j�� e e S-10491FNEF 7193 this 12TH day of SEPTEMBER 2008 CHRISTINE MEAD, SECRETARY CA registered trademark of SAFECO Corporation 011012005 POF CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Le A n 6s On 9.16? - OR before me, Date personally appeared &0- &%"DO t, iG Q t 0 f- 6- Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persono whose nameX is/w-subscribed to the within instrument and acknowledged to me that he/sll/tfte"xecuted the same in his/bO.� authorized capacity(j)R4 and that b his/t eg# signature(kon the instrument the per on, or the entity upon behalf of which the person acted, executed the instrument. COURTNEY BROOK GULICK Commission # 1712023 1 certify under PENALTY OF PERJURY under the laws -� Notary Public - California = of the State of California that the foregoing paragraph is Los Angeles county = KWCorrM EleaDec21, 2010 true and correct. WITNESS my hand and official seal. / Signature <� Place Notary Seal Above @Anature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document 0/ d �j/� j% � nd Title or Type of Document: /t� Document 9 a a e Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) f70-7 0 Signer's Name: Signer's Name: ❑ Individual ❑ Individual Cw�/ Corporate Officer —Title (s): ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited General ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact • ❑ Attorney in Fact • Top of thumb El Trustee here Top of thumb here ❑Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Representing: 02007 National Notary Association • 9350 De Soto Ave., PO. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 City ®f Huntington Beat 2000 Main Street o Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 California Engineering & Contracting 16027 Brookhurst St., Ste. G-240 Fountain Valley, CA 92708 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Citi(osfoftd4t�tc6p&-t"tipetkyr 6W6weD New Zealand 1 Telephone: 714-536-5227 ) 2008 SEE 15 PM 2-- 14 SUBMITTED BY: CALIFORNIA ENGINEERING & CONTRACTING, INC. OFFICIAL BID 16027 Rroolchurst St. Suite G # 240 COO OPEN) Fountain Valley, CA 927o8 "OFFICIAL. EII)" OPENING DATE: 5wt. l ?, o�,' 3d A.1VI. P.1VI. DELIVER TO: PROJECT NO: l a 4'7 PROJECT NAME: 3A J r .TU S01 00 1 4 97 a ty I V 1A 4.e UI o �Ui1 �1►ddl.e S0iooL e SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL, OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find w V—) in the amount of $ O 1 which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature #� t 6 Z,/ov - `L C-2 Project Bid Schedule Safe Routes to School - Cycle IV (Marine View Middle School) CC-1244 y"ln ".k,,..;.'.s�^�� •.0 1 �='v. �" h�AP��x..="-..-.�..w 'S...u�" I L.S. SL%n5`�-+3ritY'3",',1F.�`z�-''%�,m:��nZ.`�u�„j`���"...la� -�`, ^�9 v %�µ 3� .:'X#,:. Mobilization. .S^ z.LL�' i2a. .�SMs•z33.C� ..d��i.'Y,�" Per L.S. 2 1 L.S. Monument Preservation. Per L.S. 3 1 L.S. Furnish Project Traffic Control. @ j:;W" . ;r�r 4 $ � � - $ s / , - �_- Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. -e7fA Per L. . 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and $ $ ? AC Paving Replacement /.�1 y Per EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ $_ CS t✓ Poles/dare City Furnished) Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ _ $ Zoety t'-' 207. Sidewalk Locations as Determined by the City. @ 1'-e;. Per S.F. Total Amount Bid in Figures: $� �. Total Amount Bid in Words: $4�Vr4*- 5 e#rZA"- Da OCJs. { 41 CX J- A107,1,— c Note: The City will provide the radar feedback signs and Type IA poles (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-2.1 I �i,. ' 'fit ' .," •, � il, ,' I�� In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class r t5_ 4/ k2o �}H 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 _ P � Dut�k , being first duly sworn, deposes and says that he or K is Pre5iCl&,* of < nr 81 c(iA r I the party making the foregoing bid that the bid is not made in the intePest 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. Name of Bidd Signature of Bidder ton by-00040 " CZ Address of Bidder Subscribed and sworn to before me this \ I day of � 20A. NOTARY PUBLIC C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defindd, 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. I C Contractor By iris C 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 INSUZ2ANCE 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: 'IJ 1 24 Contractor fiuk'. By Title C-7 (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor B frvsid&O� Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. t 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: 0 FolnewAa k Conlrochne M Bidder Name U J `" il07 brMk S - S 6#a�® Business Address fo U0 tabu) VUW c 9 V City, I State Zip c74) 74-35-44 Telephone Number — yy9 yyy 4 . C -/0 State Contractor's License No. and Class /- 22- Zoo-7 Original Date Issued /- 31— doM Expiration Date The work site was inspected by JOV z�- of our office on P , 200p The following are persons, firms, and corporations having a principal interest in this proposal: tit sQSi d C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Nance ___ E�9& 3)0,a . PrvsldeAJ Pr tens d or Typed Signature Subscribed and sworn to before me this i day of , 200Y TIFFANY VAISANEN NOTARY PUBLIC - CALIFORNIA y S COMMISSION # 1669354 ORANGE COUNTY My Comm. Exp. May 23, 2010 NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 2 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Date Completed Date Completed C-10 (For federally funded projects, use this following page) BIIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons z The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person; Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C t ' (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE APART OF =S PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION .. The bidder eo�' e=-C ;-c , proposed subcontractor f %°"c —,hereby certifies that he has !/ has not, participated in a previous co act 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 adrninistering'agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: ® a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: Fla- bid/offer/application b. initial award C. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11. 12. 14. 3. Report Type: Fla. initial b. material change For Material Change Only: year quarter_ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name[Descriptioh: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. 1 Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: YesEl No 9__� ' 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. print Name: / AYei­ J2A 14 �^i1 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Rr-e, person who fails to file the required disclosure shall be subject Title: 1 �'`�"���' to a civil penalty of not less than S 10,000 and not more than p // e S 100,000 for each such failure. Telephone No.: tS 41' —7J 44 Date: I D� Federal Use Only: JranaarO AOrM LLL KCV. VY-1 L-V / Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF LLL, DISCLOSURE OF LOBBYING ACTP TFIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known.. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered_ Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information- Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90«END1bt Page 12-89 LPP 01-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel . (714) 536-5431, Fax (714) 374-1573 For Safe routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders-, Please note the following clarification to the project Plans, Specifications, and Technical Provisions The Federal Labor Dates contained In Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Biddle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Dates dated August 29, 2008 shall be the labor rates In effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. Company Name — By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. Company Name /00. Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. California Engineering &Contracting, Inc. Project Completed Caltrans Mohamed Elsayed Traffic Signal 949-279-8806 wheel chair ramp O.L. Development Omer Levin 818-402-0600 Caltrans Issac Tabar 949-279-8411 City of laguna beach Bob Milani 949-497-792 Placentia Mamoun Aldwir 714-993-8131 Signal & Street lighting and sidewalk and curb and gutter Bus Pad Modification Sidewalks Street improvement AC, sidewalk, C&G Bus Pad, sidewalk, wheel Chair ramp $115,000 2008 $350,000 2007/08 $62,000 2008 $80,000 2008 $41,000 2008 16027 Brookhurst St, Suite G #240, Fountain Valley, CA 92708 Phone (714)708-3544. Fax (714)708-3581. Email caengcont@gmail.com License #88988 4aN INSCO INSURANCE SERVICES, INC. , cj.0 Underwriting Manager for: �pO�p Developers Surety and Indemnity Company Indemnity Company of California 17780 Fitch, Suite 200 • Irvine, California 92614 • (949) 263-3300 Bond No.: 11-428-074 KNOW ALL MEN BY THESE PRESENTS, that we California Engineering & Contracting Inc as Principal, and Developers Surety and Indemnity Company a corporation duly organized under the laws of the State of Iowa as Surety, are held and firmly bound unto City Of Hunington Beach as Obligee, in the sum of Fifteen Thousand Dollars ($15,000.00) for payment of which sum well and truly to be made, Principal and Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Safe Routes to School Cycle IV @ Marine View Middle School NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 11th day of September 12008 PRINCIPAL: SURETY: California Engineerin & cacting Inc Develope Sur t and Indemnity Company !� e �� �Ly- Blake A Pfister, Attorney-in-F-act ID-1118 (REV. 1/01) CONFORMS TO AIA DOCUMENT A310 2170 ED. CALIFORNIA- ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On September 5, 2008beforeme, Lianne Nahina, Notary Public Date Here Insert Name and Title of the Officer personally appeared Blake A. Pfister LIANNE NAHINA Commission # 1767633 -� Notary Public - California = _ ° Orange County MyComM E,#%Sep 14, 2011 Name(s) who proved to me on the basis of satisfactory evidence to be the person whose name) is/A& subscribed to the within instrument and acknowledged to me that he/ executed the same in his/koaWmir authorized capacity( ), and that by hisAWWWatir signature& on the instrument the person(0), or the entity upon behalf of which the person(fP) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand rtd official seal. Signatur Place Notary Seal Above Si ature of Notary Public -- - OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond No. 11-428-074 Document Date: September ll , 2008 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) None Signer's Name: Blake A. Pfister ❑ Individual ❑ Corporate Officer — Title(S):— ❑ Partner ❑ Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Developers Surety an Indemnity Company Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Off icer—Title(s); ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 1 O 2007 National Notary Association • 9350 De Soto Ave., PO. Sox 2402 • Chatsworth, CA 91313-2402 • ww),v-NationalNotary org Item #5907 Reorder Call Toti-Free 1-800.876-6827 POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263-3300 Attached to Bid Bond No. 11-428-074 KNOW ALL MEN BY THESE PRESENTS, that as except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each, hereby make, constitute and appoint: ***Blake A. Pfister*** as their true and lawful Attomey(s)-in-fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of surety- ship giving and granting unto said Attorneys) -in -Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s)-in-Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Board of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st, 2008, RESOLVED, that the chairman of the Board, the President and any Vice President of the corporation be, and that each of them hereby is, authorized to execute Powers of Attorney, qualifying the attomey(s) named in the Powers ofAttomey to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship; and that the Secretary or any Assistant Secretary of the corporations be, and each of them hereby is, authorized to attest the execution of any such Power of Attorney, RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, undertaking or contract of suretyship to which it is attached. IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused these presents to be signed by their respective Vice President and attested by their respective Assistant Secretary this January 1st, 2008. /G � / 011 By:0^_/ .AND'.- 014, Stephen T. Pate, Senior Vice PresidentOgP4'$�fvr By ;o' o W i:9ti7 <tFL3R� Charles L. Day, Assistant Secretary State of California County of Orange On January 1st, 2008 before me, Christopher J. Roach, Notary Public Date Here Insert Name and Title of the Officer personally appeared Stephen T. Pate and Charles L. De Name(s) of Signer(s) i.� •9 .19s- ii 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/herltheir 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 offs 'al seal. Signature Chr erJ. Roach CERTIFICATE The undersigned, as Assistant Secretary, of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the resolutions of the respective Boards of Directors of said corporations set forth in the Power of Attorney, are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, the 1 1 `-d2ty of September , 2008 By Albert Hiliebrand, Assistantlretary ID-1380 (VVet)(Rev.07/07) City ®f Huntington Beach 2000 Main Street o Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 Elite Bobcat Service, Inc. 1320 E. Sixth, Ste. 100 Corona, CA 92879 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, JF:pe Enclosure Sister Citits�fyt,�ds�5i,t/ief,i6��ew Zealand ( Telephone: 714-536-5227 ) Q5INC. ELITE BOBCAT SERVICE GENERAL ENGINEERING 1320 E. SIXTH, SUITE 100 ® CORONA, CA 92879 Tel: (951) 279-6869 ® FAX: (951) 279-6832 City of Huntington Beach i,, Clerk 2000 Main St Huntington Beach, CA 92648 LD � w c�a SEALED BID FOR Safe Routes to School, Cycle IV, in the vicinity of Marine View Middle School CC No. 1244 Due: 09/15/08 @ 2:30 PM SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1 244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's iFignature 1 09/08/2008 2 09/08/2008 C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 , �i e �' � �� °�r�#°� —� IN _ y.a eiv:.r� i. arc9.t�:x�.a: 030 41 5a.+. • ..Q„ 1 1 L.S. M@obijyzat' �r -400 Per L.S. %/ ZOO.O 2 1 L.S. Monu nt Preservati n. $ $ oc>. do ! Per L.S. 3 I L.S. Furnis roject Tr is Co trol. @ r - )e $�iD $ 4 .w 0— Per L.S. 4 1 L.S. Furnish d Insta ffic Striping and Signing. m ,� Per L.S. 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and d. $ 2 D0• $ • a AC Paving Replacement. G 90 -- Pei EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA Poles aEa City Furnish d) @_ r Per tA. $ l pp;` $ IpQ?a �� 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $ $--GfQ•�2 207. Sidewalk Locations as Determined by the City. Per S.F. Total Amount Bid in Figures: $ ,— 11 Total Amount Bid in Words: $ asl Note: The City will provide the radar feedback signs and Type 1 A poles (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-2.1 �a 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. State License Numher M WOEM WA,06" Mlio ., 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 Joseph Nanci , being first duly sworn, deposes and says that he or she is President of Elite Bobcat Service, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Joseph Nanci Name of Bidder 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 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 09/08/2008 C-5 Elite Bobcat Service, Inc. Contractor By 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? U Yes 0 No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 09/08/2008 C-7 Elite Bobcat Service, Inc. Contractor By Joseph Nanci, President Title UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Elite Bobcat Service, Inc. Bidder Name 1320 E 6th St #100 Business Address Corona CA 92879 City, State Zip 951 ) 279-6869 Telephone Number 720016A State Contractor's License No. and Class 03/1994 Original Date Issued 03/31/2010 Expiration Date The work site was inspected by Joe Nanci of our office on September 8 , 200a The following are persons, firms, and corporations having a principal interest in this proposal: Joe Nanci, President C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Elite Bobcat Service, Inc. Company Name Signature of Bidder Joseph Nanci, President Printed or Typed Signature Subscribed and sworn to before me this _ day of , 200_ . NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: City of Vernon 4305 Santa Fe Ave, Vernon, CA 90058 Name and Address of Public Agency Name and Telephone No. of Project Manager: Vince Rodriguez (323) 855-2292 $289,000 Concrete Improvements 07/2008 Contract Amount Type of Work Date Completed 2. City of Temecula 43200 Business Park Dr, Temecula, CA 92590 Name and Address of Public Agency Name and Telephone No. of Project Manager: Jon Salazar (951) 694-6444 $2,296,618 Concrete & Asphalt 03/2008 Contract Amount Type of Work Date Completed 3. City of Anaheim 200 S. Anaheim Blvd, Anaheim, CA 92805 Name and Address of Public Agency Name and Telephone No. of Project Manager: Carl Heimberger (714) 765-5176 $775 990 Street Improvements 03/2008 Contract Amount Type of Work Date Completed C-10 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Elite Bobcat Service, Inc. Contact Person: Joseph Nanci Contact Phone: (951) 279-6869 Signed: Date: September 8, 2008 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHAREA PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION .. The bidder_ Elite Bobcat Service, Inc. . proposed subcontractor hereby certifies that he has has not_, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering *age-ncy, 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. Yape ll-7Y LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Nd- OMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 f Federal Action: 2. Status of Federal Action: 3. Report Type: ct a bid/offer/application ❑a. initial b. initial award b. material thaneratt agreement c. post -award For Material nge Only: guarantee year quarter - insurance dat of last reportand Address of R orting Entity 5. If Reporting Entity in o. 4 is Subawardee, EnterNameandA ress ofPrime: e Su wardee Tier if known Congressional District, if known ngressional District, if known - 6. Federal Department/Agency: Federal Program Namt/Description: CFDA Number, if applicable S. Federal Action Number, if known: 9. ward Amount, if known: 10. a. Name and Address of Lobby tity b. Individua Performing Services (including (If individual, last name, firs ame, Ml) address if di rent from No. 10a) (last name, firs ame, MI) (attach Continuation Sheets) if necessary) 11. Amount of P ment (check all that apply) 13. Type of Payment (check that apply) S actual planned a. retainer b. one-time fee 12. For of Payment (check all that apply): C. commission a. cash d. contingent fee b. in -kind; specify: nature a deferred value LJ f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated In Item 1l: (attach Continuation Sheets) if necessary) 15. Continuation Sheet(s) attached: Yes11 No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: Joseph Nane i 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any president person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than SI00,000for each such failure. Telephone No.: (951) 279-6869 Date: 09/OS/08 Federal Use Only: Farm LLL Rev. 09.12-97 Authorized for Local Reproduction Standard Form - LLL Page12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). if known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. I3. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Pase 12-88 March 15, 2001 LPP 01-04 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PIS, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. Elite Bobcat Service, Inc. Company Name By September 8, 2008 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated tember 4, 2008. Elite Bobcat Service, Inc. Company Name By September 8, 2008 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Bond No. -- ------08739262.---------------- Fidelity and Deposit Company POST OFFICE BOX 1227 OF MARYLAND KNOW ALL MEN .BY THESE PRESENTS: Elite Bobcat Service, Inc. Thatwe, ___---__----_-------------------------- BALTIMORE, MD 21203 ------------- ----- ____--- ------ as Principal, (hereinafter called the "Principal"), and The FIDELITY AND DErosIT CompANY OF MARYLAND, P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the taws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and - firmly bound unto_ Cif Of —Huntington Beach ----------------- -_ -- __ _ __ _____-_as Obligee, (hereinafter called the "Obligee"), ten percent of amount bid 100 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__Saf-Q-_-R)1it-e— to-_- CjacLQJ--- __-C_yc1e-Lily---_____ in the vicinity of Marine View Middle School Project #1244 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 f6r which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this----_------------____-- 8th_-__—day of .... September _-----------------A_D.,20 08 -Elite-Bobcat Service, Inc ___(SEAL). Principal --------- - - Waness �JUS�� Ng��� Tine FIDELITY AND DEPOSIT C PANY OF MARYLAND *—h�T-Tefy-E� --------------------------------------------- By -------------Witness Rn Tate c325f-Sam. 7-92 ATTORNEY -IN -FACT Co fo rm io Amer— I=4-1c of Archkmu Document A-310, Fcbc fy 1970 Fdiui . - CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange } On 9-8-08 before me, Lexie Sherwood, Notary Public Date Here Insert Name and Title of the Officer personally appeared Richard A. Coon Names) of Signer(s) LEXIE `1HERWOOD COfU M. #1593951 M NOTAM Pt."3LIC a CALIFORNIA n OPANGE COUNTY Comm. Exps_ JULY 27, 2009 r who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and fficial seal. Signature Place Notary Seal Above SignatuZoTNO)Idry Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s):_ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s) ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: © 2007 National Notary Association • 9350 De Soto Ave.. P.O. Box 2402 • Chatsworth, CA 91313-2402 . www.NalionaiNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said Company, are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date h e des by nominate, constitute and appoint Richard A. COON, Charles L. FLAKE, David L. CULB In e OOD, all of Anaheim, California, EACH its true and lawful agent and ma o ,p d deliver, for, and on its behalf as surety, and as its act and deed: any an 0 n xecution of such bonds or undertakings in pursuance of these prespt==' in as fully and amply, to all intents and purposes, as if they had been d ac n h gularly elected officers of the Company at its office in Baltimore, Md., i�p per p attorney revokes that issued on behalf of Richard A. COON, Charles L. FLAKE,M C a ew P. FLAKE, Lexie SHERWOOD, dated November 7, 2005. The said Assistant 0 s e eby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By- ' s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of November, A.D. 2006. ATTEST: to oePos�. •. fp P ww� c `V.,TLF State of Maryland ss: City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary a By: William J. Mills Vice President On this 15th day of November, A.D. 2006, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J. MILLS, Vice President, and ERIC D. BARNES, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn Notary Public My Commission Expires: July 14, 2011 POA-F 012-4150H State of California \\ County of t\\I�.v On v "JkZOD9,before me, J;�'� a notary public, personally appearedS�p� o proved to me on the basis of satisfactory evidence to be the personN whose name subscribed tot e within instrument and acknowledged to me=t&4@4h'--yexecuted the same in his ierftl authorized capacity, and that bysignatureN 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 haqg,,and official seal. s IV Signature (Seal)�Go�t< 0,p\\C, • G00 f'). GoF �Qo G� City ®f Huntington Reach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 Damon Construction Co. 8851 Watson Street Cypress, CA 90630 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, JF:pe enclosure Sister CitiVg Aj�vo&w Zealand (Telephone: 714-536-5227 ) 2903 SEP 15 PM 1: 56 FAX: (714) 9954707'. S7"A9'E-iCO14TRA&0RS,Llt,.#28059$A mz-ll SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find B►-8c,-min 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: i, rMJMWMW C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 -,, For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. =DAnnc*J C.c3. Company Name By„� ( , tom- —�---oE3 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 I ` I L.S. N �u�.'€=-�'*c:.�'.�',":��„�'a�:��'��:"t�.,��,=.:,:�..�er�%i�:��:,.T.',,'.'k:''.�.�ts.+sra: .:'.3'�;� Mobilization. thm)sQncl -HAO wOI `."3.,s'�,t�'�:=;7'a�� w'�.*";,�yTL���.Y�.'4�t���S• $ s OOQ 0' $ t•.' 00a 10 Per L.S. 2 1 L.S. Monument Preservation. @Fov9,'n400sAoo Food $ $ 4 Per L.S. 3 1 L.S. Furnish Project Traffic Control, @-ntA6C- THOM"O FOOP- $ so L/Og 9 $ 0 0 Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. H49CA; T14 OVSCWO SEMCM 00 0-0 $& ZY3 $ 7q a HOWDRGO togTy -'r1jiw=6' Per L.S. 5 13 EA. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and 00 00 $a!298 $ 7Z 6'Y!/ AC Paving Replacement. lwksbke Licy "-T-f -GrA-'&�r Per EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type I A -A $J,73,2,00 $ %0, Poles are City Furnished) TfiQ-TRM-SAPO SeV8-0 "UmDktiO T1*T9TY-'T'WO Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct Miscellaneous Sidewalk per City Standard Plan $7,65- $ 1.0 '5-20. 207. Sidewalk Locations as Determined by the City. %6VC-OU BOLLAIZS tE-J(sVRy FTje CtNrS Per S.F. Total Amount Bid in Figures: $ /06., 972 tal Amount Bid in Words: $W6 &,Zeen szxTi4ey.-.,wo ojTwe tAomDqef% S6vekfrY-TWO I To Note: The City will provide the radar feedback signs and Type IA poles (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-2.1 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class c I_AQ0 502v 6yT-Q rfjC 6'N g. c_ sr' - c 'Y L. Yl 6AAMG G0QsJ—, ( ST2rP1#76 5�/Zri�Gt id3 W. ZxL - S7' 0AA0GE c,14 %W-6,f 3V61095 �-3a 41 r'ffF.,TL3C, SCOUT G ')M a I k 2S M 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 NONCOLLUSIONAFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BIT, State of California ss. County of Orange M,c,,RC_A&g;:r7 &N N RUt_L-o , being first duly sworn, deposes and says that he or she is }=P'M,5, per- of -.r:'PAnc„J C_4=.tJST c© • 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. _DAMot4 GONE' CQ- Name of Bidder Address of Bidder Subscribed and sworn to before me this day of , 20 0 � . NIl=,R1A MARCELINA A. GODINHO COMM. #t 550552 a Y" NOTARY PUBLIC - CALIFORNIA ®� ORANGE COUNTY m °o .y C omm. Expires Feb. 0, 2009 0 NOTARY PUBLIC NOTARYSEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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. Contractor PREI rK--- ,1 Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? U 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 —1 S --C) S M>A4t%ACot,1 cot�tST cep . Contractor • i, Title C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. t 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 88!51 wA—T So W S=- Business Address _ C.Y PRESS . CA.- 9 ®Gao City, State Zip Telephone Number State Contractor's License No. and Class Original Date Issued AP t L- � &c) n Expiration Date The work site was inspected by L-.0 IS +�U of our office on S� — a% , 2008 The following are persons, firms, and corporations having a principal interest in this proposal: VA • :�, r:_ - • o"rn— ;L C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. �D A, mot --A Cagl1' T' CID . Company Name Signature of Bidder Printed or Typed Signature Subscribed and sworn to before me this day of a . �Q�a000000�oo^�oocoo�o00000000000 ® MARIA MARCELINA A. GODINHO o COMM. #1550552 NOTARY PUBLIC - CALIFORNIA ORANGE COUNTY o h • ' ray Comm. Expires Feb. 6, 2009 NOTARY PUBLIC 000eooa000000000000s000000000000® 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: _ ��SE SSE. �F7T'�'tGbEE1� �J e�T R��yRE �ES� 5T"" 2. 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Date Completed Date Completed C-10 8851 WATSON STREET - CYPRESS, CA 90630-2243 (714) 995-5490 - FAX (714) 995-5707 PROJECT REFERENCES PUBLIC AGENCIES City of Alhambra Frances Moore (626) 570-5090 City of Arcadia Mark Rynkiewicz (626) 256-6552 City of Bell. Carlos Alvarado (626) 960-1889 City of Brea Brian Ingallinera (714) 990-7600 City of Cerritos Mary Ann Wozniak (562) 860-0311 City of Commerce Martha Gomez . (323) 722-4805 City of Costa Mesa Carlos Castellanos (714) 754-5343 City of Cudahy Carlos Alvarado (626) 960-1889 City of Cypress Jim Gorin (714) 229-6748 City of Downey Jim Bautista (562) 904-7117 City of El Segundo Paul Bowen (310) 524-2356 City of Hermosa Beach Tristan Malabanan (310) 318-0228 City of Huntington Beach David Verone (714) 375-9471 .City of Inglewood Teresa Kneedler (310) 412-5333 City of Irvine Judy Morse (949) 724-7664 City of Long Beach Sadie Tuaa (562) 570-6537 City of Lynwood Antonio Perez (310) 603-0220 City of Maywood Lissette Calleros (323) 562-5700 City of Montebello Robert King (323) 887-1200 City of Newport Beach Frank Tran (949) 644-3311 City of Orange Alan Truong (714) 744-5568 City of Pasadena David Ortega (626) 744-6912 City of Pico Rivera Romeo Ligason (562) 801-4421 City of Santa Ana William Albright (714) 647-5029 City of Santa Monica Monica Diaz (310)458-2205 City of Thousand Oaks Jocelyn Bylsma (805)449-2456 City of Torrance Sue Herbers (310) 781-7532 City of Vernon Max (323) 583-8811 ex. 221 City of Whittier David Mochizuki (562) 464-3510 City of Yorba Linda Mark Stowell (714) 961-7170 City of Whittier David Mochizuki (562) 464-3510 City of Yorba Linda Mark Stowell. (714) 961-7170 County of Orange Lori Hanson (714) 567-6257 Dept of Parks & Recreation Robert Scholfield (949) 496-1866 L.A. Unified School Dist. Maria Martinez (213) 241-2702 O. C. T. A. Sarah Strader (714) 560-5633 Palos Verdes Peninsula USD Lora Dodell (310) 378-9966 ex.227 PRIVATE FIRMS Amoroso Construction Valerie Frahm (714)433-2326 ARB Structures Debbie Esparza (949) 598-9242 Archstone — Smith CJ Wiemann (949) 455-4500 Bernards Bros. Paul Richardson (949) 461-3650 Bomel Construction Elizabeth Marin (714) 279-3224 Robert Castognia Don Perea , (562) 803-3328 CT&F Manny Rosales (562) 927-2339 R.J. Daum Contt. Mark Perong (714) 894-4300 Del Arno Construction Roy Northup (310) 378-6203 Dynalectric Therese Jelnick (714) 484-2305 Excel Paving Co. Curt Brown (562) 599-5841 Eastside LRT Const. Al Guerrero (323) 980-2544 J. Fletcher Creamer & Son, Inc. Patty Padilla (818) 367-9748 GCI Construction, Inc. Janet Russell (714) 957-0233 Hathaway Dinwiddie Kip Drabeck (213) 236-0500 Henze] -Phelps Construction Ken Ketchum (949) 852-0111 Imperial Paving Co. Irene Gomez (562) 944-0975 Kemp Bros., Inc. Pegi Early (562) 236-5000 Keiter Corporation Bonch Nagata (323) 266-6302 Laird Construction Terri Duval (909) 989-5595 H. A. Lewis Inc. Herbert Lewis (310) 478-1511 McCarthy James Metoyer (949) 851-8383 Majich Bros. Paul Majich (626) 398-9992 John T. Malloy Inc. Justin Malloy (323) 780-9942 John S. Meek Company Bill Gomory (714) 830-6323 C.C. Myers Tracey Carlson (916) 635-9370 R.J. Noble Co. Jennifer De Iongh (714) 637-1550 W.E. O'Neil Construction Jim Surdyk (310) 643-7900 PCL Construction Services Paulina Cook (213) 614-0481 Peck/Jones Construction Dan Dagert (310) 423-3964 T. T_ Polich Associates Donald Kral (714) 835-4612 Powell Constructors Paul Zolezzi (909) 356-8880 Hensel Phelps Construction Clint Squire (714) 938-3300 Premier Stamp Concrete Dominick Ingraffic (909) 865-3362 Mike Prlich & Sons, Inc. Pete Serdarusich (323) 283-7852 Ryco Construction Tycanne Arceri (310) 324-1151 Sema Construction Micaiah Revero (949) 470-0500 Shawnan Corporation Jenifer Soliz (562) 803-9977 J.F. Shea Const. Jack Herrington (909) 595-4397 St. Cornelius Church Ted Brodeur (562) 425-7813 Steiny and Co. Robert Hernandez (626) 338-9923 Swinerton Builder. Kevin Hermreck (949 )622-7000 TG Construction Ed Wright (310) 640-0220 Taisei Corp. Carolyn Carpenter (714) 886-1530 Thomsen Landscape Merle Thomsen (818 )344-0158 Ken Thompson Schalk Opperman (714) 995-1371 Trade Mark Concrete Yelena Westerfield (714) 970-8200 Trammel — Crow Bill Gertsner (310) 229-8919 Valleycrest Landscape Michelle Duran (818) 834-1000 Valverde Construction Chris Valverde (568) 906-1826 Weeger Bros. Inc. Mark Weeger (714) 536-3854 Western Paving Bill Miller (626) 338-7889 Howard S. Wright Construction Linda Madrigal (949) 567-1909 Woodcliff Corporation Omead Tabrizi (818) 784-8444 N CONTRACT COMPLETION CONTRACTOR/AGENCY PROJECT AMOUNT DATE CITY OF ORANGE ROLLING GREEN LANE -QUEENS GATEWAY 68,150.00 01105 PALOS VERDES PENINSULA USD ASPHALT & CONCRETE REPAIT (PH 1) 260,000.00 02/05 AMELCO CO. ADDITIONS TO BELL GARDENS, H.S. 643,000.00 04105 CITY OF LONG BEACH ANNUAL CONTRACT R65-95 4,481,300.00 05105 CITY OF INGLEWOOD ALLEY CONST. PROG 04-79 277,420.00 07/05 KAJIMA BONNIE AVE PARKING STRUCTURE 425,390.00 11/05 LAIRD CONSTRUCTION SIDEWALK RAMPS -RIVERSIDE 128,142.50 11/05 SWINERTON BUILDERS OCTA BUS PARKING STRUCTURE 410,825.00 11105 WOODCLIFF BELMONT NEW PRIM CTR. 146,433.00 11/05 CITY OF HERMOSA BEACH CONCRETE IMPROVEMENTS 87,920.00 11/05 CITY OF WHITTIER CONCRETE IMPROVEMENTS 189,510.00 12/05 KEMP BROS. HUNTINGTON PARK E.S. 05-04 394,000.00 12/05 R.J. NOBLE CO. RESIDENTIAL ST.-FULLERTON 356,479.00 12/05 CITY OF PASADENA WASHINGTON POP -OUTS 570,752.50 12/05 R.J. DAUM CONST. LA SOUTWEST COLLEGE 256,138.00 12/05 EXCEL PAVING SOUTH ST.-ANAHEIM 114,730.00 01/06 TAISEI CONSTRUCTION DEL MAR STATION-PASADENA 153,320.00 01/06 DEL AMO CONSTRUCTION PACIFIC CHARTER-CRENSHAW, L.A. 140,232.00 02/06 CITY OF YORBA LINDA ACCESS RAMP IMPROVEMENTS 115,996.25 02/06 CITY OF SANTA ANA OMNIBUS CONCRETE REPLACEMENT 403,835.00 03/06 CITY OF MONTEBELLO SAFE ROUTE TO SCHOOL(SR2S) 229,688.00 03/06 CITY OF ALHAMBRA 2005 HUD CONCRETES/W REPAIR PROJECT 148,960.00 03/06 ROBERT CASTOGNIA STREET IMPROVEMENTS-TORRANCE 110,111.50 04/06 BERNARD BROS. SUNRISE ASSISTED LIVING -PLAYA VISTA 62,979.00 05106 CITY OF TORRANCE CURB & GUTTER REPLACEMENT 1,082,441.00 05/06 CITY OF LYNWOOD S/W CURB & RAMP IMPROVEMENTS 247,240.00 05/06 BOMEL CONSTRUCTION CAL STATE FULLERTON PKG STRUCTURE II 154,710.00 05/06 R.J. DAUM CONST. ORANGE COUNTY JUVY HALL 233,067.50 05/06 DYNALECTRIC (35030) AZUSA AVE. / SAN GABRIEL RD. - COVINA & AZUSA 12,785.00 05106 CITY OF CUDAHY CURB RAMPS -VARIOUS LOCATIONS 37,600.00 05/06 EXCEL PAVING CO. (4307) NEWPORT SHORES REHAB 322,510.00 06/06 CITY OF PICO RIVERA PROJECT 2007 WASHINGTON BLVD. 343,379.90 06/06 MAJICH BROS, INC. SEWER IMPROVEMENT -GARDEN GROVE 294,350.00 07/06 EXCEL PAVING (4205,4206 & 4207) CHARLES DREW MIDDLE SCHOOL 172,829.00 08/06 CITY OF LONG BEACH R-6666 THE ANNUAL CONTRACT 1,500,000.00 12/06 ARB STRUCTURES, INC. POINT NORTH ENTRY, WEST HILLS 105,304.00 11/06 CITY OF ARCADIA 05-'06 ANNUAL CONCRTE REPAIR 291,998.50 11/06 CITY OF CYPRESS CONCRETE IMPROVEMENTS 176,006.00 11/06 R.J. NOBLE CO.(91029) REHAB. OF ARTESIA BLVD.-BUENA PARK 64,860.00 11/06 CITY OF CUDAHY S/W REPLACEMENT - VARIOUS LOCATIONS 47,276.00 11/06 TG CONSTRUCTION 2120 AUTO CENTER DRIVE - GLENDORA 67,765.15 11/06 CITY OF MAYWOOD SIDEWALK RECONSTRUCTION 171,626.00 11/06 JOHN T. MALLOY, INC. MISC. PCC WORK - NEWPORT BEACH 51,693.00 11/06 CITY OF EL SEGUNDO ANNUAL CONTRACTO FOR CURB & SIDE WALK 92,386.00 11/06 STEINY & COMPANY LACO-PACIFIC, LONG BEACH VAR CITIES LA COUNTY 25,000.00 12105 SWINERTON BUILDERS CHOC PARKING STRUCTURE- ORANGE, CA 94,448.00 08106 EXCEL PAVING (4314) MARQUEE TOWER-MICHELSON, IRVINE 130,719.00 06/07 GCI CONSTRUCTION INC. 226TH ST. EXT. & STORM DRAIN - HAWAIIAN GARDENS 161,150.00 10/06 T. T. POLICH ASSOCIATES CORBIN & MASON BRIDGES - LOS ANGELES 38,926.00 IN PROGRESS HATHAWAY DINWIDDIE AVENUE OF THE STARS - LOS ANGELES 879,523.00 09/07 COUNTY OF ORANGE ANNUAL PCC MAINTENANCE REPAIR 100,000.00 06/07 EXCEL PAVING CO. (4339) CITYWIDE LOCAL STREET PROGRAM - LONG BEACH 520,284.00 10/06 GCI CONSTRUCTION INC. ORANGE -OLIVE ROAD & HEIM - C/O ORANGE 45,675.00 11/06 ROBERT G. CASTONGIA, INC. 1-37 DOWNTOWN SEWER REPLACEMENT - TORRANCE 67,967.50 01/06 EXCEL PAVING CO. (4340) SLAUSON AVE. IMPROVEMENTS - PLAYA VISTA 201,482.00 12/06 EASTSIDE LRT CONSTRUCTION METRO GOLD LINE EXT. PROJECT - LOS ANGELES 1,225,751.50 IN PROGRESS CITY OF LYNWOOD 2005-2006 SIDEWALK IMPROVEMENTS 41,210.00 07/06 CITY OF VERNON CITY WIDE CONRETE REPAIR 125,200.00 IN PROGRESS OCTA CONCRETE PVMT. GARDEN GROVE & ANAHEIM BUS BASES 989,000.00 01/07 CITY OF IRVINE ANNUAL CONCRETE MAINTENANCE 208,702.00 06/07 TRAMMEL - CROW CHEVIOT HILLS MEDIAN ISLANDS - LOS ANGELES 380,885.00 06/07 EXCEL PAVING CO. (4354) LA BREA AVE. STREET IMPROVEMENTS - HOLLYWOOD 18,900.00 07/06 Page 1 of 2 CONTRACT COMPLETION CONTRACTOR/AGENCY PROJECT AMOUNT DATE SWINERTON BUILDERS KAISER MEDICAL OFFICE EXPANSION - GARDEN GROVE 125,782.00 07/07 R. J. NOBLE DALE STREET REHABILITATION - BUENA PARK 9,881.25 09/06 EXCEL PAVING CO. (4329) SUNSET BLV. MANDEVILLE CYN. RD - LOS ANGELES 104,379.50 10/07 PCL CONSTRUCTION THE MARKET @ 9TH & FLOWER - LOS ANGELES 289,498.00 06/07 MAJICH BROS, INC. GLENDALE 83,083.63 11/06 R. J. NOBLE COMPANY HARBOR BLVD. IMPROVEMENTS - ANAHEIM 38,020.00 04/07 ARB STRUCTURES, INC. 636 MAPLE AVE. MULTI -MODAL - LOS ANGELES 44,537.00 01/07 CITY OF LONG BEACH SECOND AMENDMENT SIDEWALK REPAIRS 2,500,000.00 IN PROGRESS R. J. NOBLE COMPANY BREA BLVD.IMPROVEMENTS 89,966.00 02/07 ARB STRUCTURES, INC. W. HILLS CORP POINT PARKING - WEST HILLS 70,015.00 06/07 CITY OF BELL SIDEWALK REPLACEMENT FY 2006-2007 60,428.50 04/07 ARCHSTONE - SMITH DEL MAR STATION OFF SIDE WORK - PASADENA 280,089.20 08/07 EXCEL PAVING CO. (4416) STIMSON AVE. ST. IMPROVEMENT - LA PUENTE 91,403.00 04107 MIKE PRLICH & SONS, INC. STORM DRAIN IMPROVEMENT - ORANGE 19,717.50 03/07 EXCEL PAVING CO. (4419) PARKING STRUCTURE #2 - IRVINE 46,827.00 04/07 ARB STRUCTURES, INC. OLIVE STREET PARKING STRUCTURE - LOS ANGELES 50,111.00 07/07 CITY OF BREA CORSICAN VILLAS CURB ACCESS RAMPS 55,765.00 03/07 MCCARTHY VERMONT - MANCHESTER OFFICE BLDG. C/O LA 239,667.00 08/07 SWINERTON BUILDERS KAISER PALM COURT 1 C/O FONTANA 59,946.20 05/07 DYNALECTRIC ATSAC & TRAFFIC SIGNAL MOD. - SANTA MONICA 66,250.00 IN PROGRESS C.T. & F. , INC. LA COUNTY DEPT. OF PUBLIC WORK - ARTESIA 65,088.85 12/07 CITY OF INGLEWOOD 06-07 SIDEWALK, PREDESTRIAN RAMP & INTERSECTION 821,612.00 10/07 THOMSEN LANDSCAPE TRIANGLE ISLAND C/O LOS ANGELES 6,270.00 06/07 SWINERTON BUILDERS 505 CHAPMAN AVE. @ CHOC C/O ORANGE 89,807.00 09/07 KEITER CORPORATION SHERIDAN ELEMENTARY SCHOOL - LOS ANGLELES 36,000.00 IN PROGRESS SHAWNAN CORPORATION 2006/2007 SITE IMPROVEMENTS PORT OF L.A. 96,000.00 07/07 POWELL CONSTRUCTORS SUSAN ST. EXIT RAMP (07-06) - COSTA MESA 42,550.00 12107 AMOROSO CONSTRUCTION EMERGENCY/POLICE & FIRE STA. OP. CTR: LOS ANGLES 472,875.00 IN PROGRESS MIKE PRLICH & SONS, INC. WASHINGTON SIDEWALK @ HOPE ST. -LOS ANGELES 15,957.85 08/07 R.J. NOBLE COMPANY HARBOR BLVD., LA HARBA HEIGHT COUNTY OF L.A. 35,429.15 10/07 JOHN S. MEEK COMPANY TUJUNGA AVE. CITY OF LOS ANGELES 143,413.50 IN PROGRESS IMPERIAL PAVING CO. PHILADELPHIA ST. IMPROVEMENT C/O ONTARIO 33,502.50 07/07 EXCEL PAVING CO. (4370) ALAMEDA ST. N. SPRING ST. - LOS ANGELES 96,779.50 02/08 TRADEMARK CONCRETE FULLERTON COMMUNITY COLLEGE 33,828.00 09/07 WEEGER BROS. INC. MULTI - BLDG. ALISO & LINDA VISTA SCHOOLS 10,414.00 11/07 J. FLETCHER CREAMER & SON, INC. WATER REPLACEMENT - BEVERLY HILLS 32,835.00 12/07 CITY OF HUNTINGTON BEACH EDINGER AVE. PARKWAY IMPROVEMENTS 137,606.00 12/07 TRADEMARK CONCRETE CALIF. STATE UNIVERSITY - LOS ANGLES 17,420.00 10/07 COUNTY OF ORANGE PORTLAND CEMENT CONCRETE MAINTENANCE 100,000.00 IN PROGRESS EXCEL PAVING CO. (4486) LINCOLN WATERLINE @ BLUFF CREEK DRIVE 46,750.00 12/07 MIKE PRLICH & SONS, INC. JEFFERSON BLVD. & RODEO DR. - LOS ANGELES 14,005.75 10/07 CITY OF LOS ANGELES HOLLYWOOD MEDIA DISTRICT BUS STOP IMPROVEMENT 353,268.00 IN PROGRESS THOMSEN LANDSCAPE HIGHLAND MEDIAN ISLANDS C/O HOLLYWOOD 17,860.00 12/07 SHAWNAN CORPORATION PORT OF LOS ANGELES - T & M WORK AS NEEDED 30,000.00 IN PROGRESS R.J. DAUM CONTT. DOWNTOWN PARKING STRUCTUURE C/O COVINA 32,122.00 IN PROGRESS WESTERN PAVING DOLLY PAD IN DOWNTOWN - C/O LOS ANGELES 61,640.00 01/08 MIKE PRLICH & SONS, INC. 06-07 SANITARY SEWER UPGRADE C/O FULLERTON 17,250.00 IN PROGRESS TOMOVICH MEDIAN CURB ON FIGUEROA ST. - LOS ANGELES 4,345.00 01/08 CEDRO CONSTRUCTION, INC. BLOOMFIELD & ORANGE C/O HAWAIIAN GARDENS 15,311.50 02/08 CITY OF LAWNDALE CONCRETE IMPROVEMENTS PROJECT AREA III 464,259.50 IN PROGRESS Page 2 of 2 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or 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: Zi AMEN c© Contact Person: ANt►:RWL_tX=)--Fig=zlDek= Contact Phone: Signed: Date: 9--1 S—®8 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXffiBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ai1AC>0 Cat.. 0=1 • , proposed subcontractor hereby certifies that he has has notparticipated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering'agency,"or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual E IT 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. 1 52 1. Ty e of Federal Action: 2. Status of Federal Action: 3. Report/change a. con ct Fla- bid/offer/application ❑ a. initi b. grant b. initial award b. mat c. coopera a agreement c. post -award d. loan e. loan guarant f. loan insurance 4. Name and Addres of Reporting Entity Prime Subawardee Tier if known Congressional District, if kn 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) (att h Continuation 11. Amount of Payment (check all t t apply) S El actual planned 12. Form of Payment (check al that apply): 8 a. cash For Ma trial Change Only: y r quarter ate of last report 5. If Reporting Ent- n No. 4 is Subawardee, Enter Name and ddress of Prime: Co ressional District, if known - 7. F deral Program P CFDA Number, 9. Award Amount, if b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) if necessary) Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee . b. in -kind; j),or :nature a deferred value . other, specify 14. Brief Description oces Performed or to be performed and D e(s) of Service, including officer(s), employeemember(s) contacted, for Payment Indica d in Item 11: (attach Continuation Sheet(s) if ne 15. Continuation eet(s) attached: Yes No 16. Information requ ted through this form is authorized by Title 31 U.S.C. Secti n 1352. This disclosure of lobbying reliance Signature:_ was placed by a tier above when his transaction was made or entered into. is disclosure is required pursuant to 31 U.S.C. Print Name: 1352. Thi nformation will be reported to Congress semiannually ad will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than S 100,00 for each such failure. Telephone No.: Date: _ Authorized for Local Reproduction t Federal Use Only: Standard Form - LLL Standard Form LLL Rev. 09-I2-97 Page 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number,- Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated.to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-instructions Rcv.06-04-90«END[F» Page 12-89 LPP O1-04 March 15, 2001 KNOW ALL MEN BY THESE PRESENTS, that we DAMON CONST. CO. as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 3033 Fifth Avenue Suite 300, San Diego, CA 92103, as surety, hereinafter called the "Surety," are held and firmly bound unto CITY OF HUNTINGTON BEACH as obligee, hereinafter called the Obligee, in the sum of TEN Percent (10%) of the Amount Bid by Principal for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the principal has submitted a bid for SAFE ROUTES TO SCHOOL, CYCLE IV, IN THE VISINITY OF MARINE VIEW MIDDLE SCHOOL, C.C. NO. 1244 BID DATE: SEPTEMBER 15, 2008 NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall fumish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 60 days of the date hereof. SIGNED, sealed and dated this 3RD day of SEPTEMBER, 2008. DAMON CONST. CO. SURETEC INSURANCE COMPANY BY: &" L� BROOKS ENZ Attomey-in-Fact SureTec Bid Bond Rev 1.1.06 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT lase®aeseweee■aeenee■■eee■eeeaeeseeee■ease■eeeeeeeeeeeeseeeeeeeeeeeeseee■ State of California County of ORANGE }.ss. On September 3, 2008, before me, Maria Marcelina A. Godinho, Notary Public, personally appeared MARGARET ANN RULLO, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. 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. v MARIA MARCELINA A. GODINHO o ,.. COMM. #1550552 @ Q !, NOTARY PUBLIC -CALIFORNIA ORANGE COUNTY s U My Comm. Expires Feb. 6, 2009 Sign tur (seal) lessee■eeaeee®aeeeeeeeeeeeseeeeseeee■eeeeeeeeeeeeeeeeeeeaseeeeseeeeeeeeee OPTIONAL INFORMATION Date of Document Type or Title of Document Number of Pages in Document Document in a Foreign Language Type of Satisfactory Evidence: Personally Known with Paper Identification Paper Identification Credible Witness(es) Capacity of Signer: Trustee Power of Attorney CEO/CFO/COO President / Vice -President / Secretary / Treasurer Other: Other Information: Thumbprint of Signer Check here if no thumbprint or fingerprint is available. _ K;d .:.stcme `otar;; vre a;a`i a . inc. -'u 334t- 5= :e rY•,+<. . _. a e. a_ :. POA #: 510034 SureTee Insurance Company LEMTED POWER OF ATTORNEY Know All Meru 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 Larry D. Cogdill, Michael W. Thomas, Brooke Lafrenz, Jeanette Seidl, Colette Chisholm of La Jolla, CA its true and lawful Attorney(s)-in fact, with full power and authority hereby conferred in its curie, place,, and stead, to execute, ackboWledge and deliver any and all bonds„ recognizances, undertakings or other instruments or contracts of suretyship to include- waivers to the conditions of contracts andconsents of surety, providing the bond penalty does not exceed Five Million Dollars and no/100 ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorneys) -in -Fast may do in the premises, Said appointment shall continue in force until 10131/09 and is made under and by authority of the following resolutions of the Board of bircoors,of the SureTec.Insurance Company:, Be it Resolver that the President, any Vice -President, any Assistant Vice -President, any .Secretary orany Assistant Secretary shall be and is hereby vested. witlj,_finit power and authority to appoint any one or more.suitable persons as Attorneys)-in=Fact to represent and, act for and on behalf.of the Companysubject to the following provisions: Attorney-M-Fact.tnay 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, recognizaaces, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and •docutnents canceling or terminating the Company's liability thereunder, and airy such instruments so executed .by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed:aud:effected :by the Corporate Secretary. Be it Resolver that the signature of any authorized officerand seat of the Company heretofore or, hereafter affixed to any powerr., of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20'h of April, 19994 In Witness ff%ereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 20th day of June, A.D. 2005. s r&URETEC RigURANCE COMPANY 04 By: yr3 a B.J.Iti g, reside t State of Texas ss: County of Harris On this 20th day of June, A.D. 2005 before me personally came B.J. King, to me known, who, being by me duly swom, 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 seal 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. No#gty Public "oft@Xt$ My ColrMbkn Eames Aught 27, 2008 lkwi'o �� Michelle Denny, Notary Pilblic My commission expires August 27, 2008 I, 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 Houston, Texas this _ 3Hn day a SEP MBER 20 08 A.D. INL Brent Bea ,• sistant Sec tary Any instrument issued In excess of the penalty stated above is totally void and without any validity. Forveriffcation of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of San Diego On 03 September 2008 before me, Gladys D. Rogers, Notary Public personally appeared Brooke Lafrenz GLADYS D. ROGERS DCommission # 1537880 Notary Public - California_ San Diego County My Comm. Dores Dec 24, 2008 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS 27= . Signature/ 4�1 OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying an the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer - Title(s): ❑ Partner - ❑ Limited ❑ General ff] Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Surety Company Number of Pages: City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK April 3, 2009 ACR Concrete & Asphalt Construction, Inc. P O Box 904 Sunset Beach, CA 90742 RE: CC-1244 — Safe Routes to School (Marine View) Enclosed please find your original bid bond for CC-1244. Sincerely, ( � 0�- j4g-oj Joan L. Flynn, CMC City Clerk JF:pe enclosure Sister Citi�sjy���,�y��New Zealand ( Telephone: 714-536-5227 ) i 2000 r 1' 15 Pi i 1: 34 Ct w titUj of SECTION C PROPOSAL for the Safe Routes to School, Cycle IV In the vicinity of Marine View Middle School C.C. No. 1244 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. 1 Accompanying this proposal of bid, find �D in the amount of $ i0 which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Rece'ved Bidd 's Si na re 6 C-2 Project Bid Schedule Safe Routes to School — Cycle IV (Marine View Middle School) CC-1244 ern � 10m, 1 1 L.S. Mobilization. - 2 1 L.S. Per L.S. Monument Preservation. @ mN� 40 )� DO L-Lw"4 $ 3 1 L.S. Per L.S. Furnish Proiect Traffic Control. @- 1itJ +r'> o, $ �✓� Per L.S. 4 1 L.S. Furnish and InstallTrafficStriping and Signing. jl� $-{" ���1u) $ 0C/(J 5 13 EA. "1�Lt�ry7� Per L.S. Construct Curb Ramp Including Adjacent Gutter Plate per Caltrans Standard Plan No. A88A and $ -o $ h2z ' AC Paving Replacement. @ �1C�h'1•'r I �Jc�� �� Per EA. 6 4 EA. Install Radar Feedback Sign, Including Foundation (Radar Feedback Signs and Type IA $ f $ 00 Poles are City Furnished) ONE ' i�-ci���,.��t�� �fp•NL Per EA. 7 200 S.F. Remove Existing Sidewalk and Construct. Miscellaneous Sidewalk per City Standard Plan $ v�- 207. Sidewalk Locations as Determined by the City. @ ,DNQL S.i Per S.F. TotaiAmount Bid in Figures: $ 1 ,IJCJ Total Amount Ric] in Words: $ 0. Ur,:— (`VO"-b Note: The City will provide the radar feedback signs and Type IA poles (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-2.1 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. Portion of Work Name and Address of Subcontractor State License Number Class t .d' M'!5—,L t l Seri �r2 C Z�� j` to CA C$ 250-7 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 being first duly sworn, deposes and says th h or she is of C.c c�--g.s✓-r.+the p''p 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. aNKz,,j, �j Mn4- CN5 arJ1((%"- ' Name of Bidder State of California, County of Subscribeg and sworn (or affrye irmed) befd _ on t 1S d y of r 20 , by personally known to me or proved to me on the basis of satisfactory evidence to the person(s) Signature of Bidder who appeared b fore me. Signatur 76erxto CA 77 ,�-7 ¢q Address of Bidder Subscribed and sworn to before me this �� day of , 200 .,,. �ENNELLLEINAALAVAN KOOY "DICOMM. # 1778521 z NOTARY PUBLIC - CALIFORNIA;— LOS ANGELES CL-6,w TY my Comm. Expires No2011 NOTARY PUBLIC NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School, Cycle IV — Marine View Middle School CC- 1244, (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: L Log AS Contractor By 6651 (I�yo - 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: Cj l2j J�3 W1�� I UkA4-�, I,- & PVALT ar4s %2A9� Contractor By Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name Business Address ANnNiA bO P 92&4i City, State Zip (,W) 0 (4)- `5 T7 _S Z, 0< Telephone Number Fl , le State Contractor's License No. and Class ,St-'P TU�-A WC 7D, t9 q 1 Original Date Issued Expiration Date The work site was inspected by ��vl1E'>Ul of our office on 61 , 2006 The following are persons, firms, an�corporationshaving a principal interest in this proposal: t C41D 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. F) k o�-f^Ul- S Company Name Signature of Bidder Printed or Typed Si Subscribed and sworn to before me this l day of � T- , 20004 NOTARY PUBLIC L 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. bMT-� F (Lo lox)r S. Name and Address of Public Agency �l�ti `-���i C c1 O`7J Name and Telephone No. of Project Manager: C% -+C�' Cl\I Contract Amount Date Completed 2. rpeeCC,- �Lc. �" Co?o I (,JkNt-44n—V—A tk� Name and Address of Public Agency W b0pL--N-iD 4-11 t.-<. S/ C-A" 13-II Name and Telephone No. of Project Manager: Tb" k iit c- 6� PE-tt I 1 G� Contract Amount au Type of Work JuNA'--o-I Date Completed 3. (�j cis CT-/(f1l/> ,!�/J�✓"f/ i Name and Address of Public Agency Name and Telephone No. of Project Manager:!`[` R VV-KkA- Contract Anfount Type of Work Date Completed C-10 ALL-PURPOSECALIFORNIA ACKNOWLEDGMENT s�S�.•'�.'S Sic S S; =�S ��..�`: R�q�.�.'� ;;��A � $ � $�� � �/.-�.'�;�C!�?';�� �;T�������.`�;�$�>!�5�.-�.'Ss.��$��.�� �.g�$S,S!�$�.��.�� � �s�$�� � State of California County of OnVe� • 15 �M before me, Date j� personally appeared A \ti,, `by)L JENNELL LEINAALA VAN KOOY COMM. # 1778521 z NOTARY PUBLIC -CALIFORNIA LOS ANGELES COUNTY My Comm. Expires Nov. 6, 2011 Place Notary Seal Above W who proved to me on the basis of satisfactory evidence to be the persorl* whose na is cIM subscribed to the hIthin instrument and acknowledged to me that sfie/theq executed the e i his er/t+�eir authorized capacity(ies), and that b his/ /tkietr slgnature(6"on the instrument the persor4(9 , or the entity upon behalf of which the personal acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Sig OPTIONAL — Though the information below is not required by law, it may prove val and could prevent fraudulent removal and reattachment of 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 Top of thumb here ❑ Guardian or Conservator ❑ Other: Signer Is Representing: persons relying on the document I to another document. 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 iU K� RIGHTTHUMBPRINT' °OF�SIGNER �.:�.� � _%a�.� :mac:-i.�.�.�:�a:� �s:�s:�a:�c�.:•-� � �:-..c� z.�c:�.� �s�:�a�s•�:v�.�.�a� � -= s.�s�.� �s:� 04 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: C,42 ��C-+iL '�.; C'fS Contact Person: C -D Contact Phone: Cr lk: �1 ��i� � -quo Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C t .) (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder M _ Ct—N� _ 4 -h F �,,ti s r-Q-,rc—naN , f r5 C- , proposed subcontractor /,# , hereby certifies that he has has notV, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering'agency,"or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Pave 12-79 LPP 01-04 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: ® a. contract b. grant c, cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: Fala- bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity R1Prime 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) 3. Report Type: Fla. initial b. material change For Material Change Only: year quarter_ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: C.12.. CD-4 ca ,A, PrSpl.t k. T SAY! kn05Z Pa'NvrfLk Ckg-ct,f Congressional District, if known - 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in -kind; specify: nature a deferred value LJ f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (2, �'� SVN3vl� ;Ct..rc� I V }�r7QirNrC V.�Nl.70Grt" Sc F4ca L 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 U.S.C. Print Name: 1352_ This information will be reported to Congress n semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than S 10,000 and not more than $100,000 for each such failure. Telephone No.: Date: Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Forth LLL Rev.09.12-97 Pave 12-87 LPP 01-04 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic- Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Inskvctions Rcv.06-04-90«ENDIFv. Page 12-89 LPP O1-04 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 August 21, 2008 Notice To All Bidders: Please note the following revision to the project, Specifications: The following shall be amended as shown: Cover Page The following shall be amended as shown: BIDS DUE: September 15, 2008 2:30 PM, 2ND FLOOR City Clerk's Office Section A PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:30 PM on September 15, 2008. Bids will be publicly open in Council Chambers. This is to acknowledge receipt and review of Addendum Number One, dated August 21, 2008. Company Name By . Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For Safe Routes to School, Cycle IV — CC 1244 September 4, 2008 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: The Federal Labor Rates contained in Appendix I of the specifications for the: Safe Routes to School, Cycle IV (in the vicinity of Marine View Middle School) CC1244 shall be replaced with the following attached documents: 1) FEDERAL LABOR RATES DATED August 29, 2008. The Federal Labor Rates dated August 29, 2008 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Two, dated September 4, 2008. Company Name By C?� 1 '::71 t�A 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. BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ACR Concrete & Asphalt Construction, Inc. as Principal, (hereinafter called the "Principal"), and SureTec Insurance Company , a corporation duly organized under the laws of the State of Texas , 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 Total Bid Amount Dollars ($10% of Total Bid Amount ), 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 schools, cycle IV in the vicinity of Marina View Middle School NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter 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 8th day of September A.D., 2008 ACR Concrete & Asphalt Construction, Inc. cipal Witness Z (SEAL) SEE ATTACHED ACKNOWLEDGEMENT Witness Printed in cooperation with the American Institute of Architects (AIA) by used in AIA Document A-310, February 1970 Edition. BID70000ZZ0701f SureQ Insurance Company Surety bAN A ByKk2G�(SEAL) Shaunna Burchfiel rney-in vouches that the language in the document conforms exactly to the language ACKNOWLEDGMENT State of California County Of Los Angeles September 8th, 2008 On before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person06 whose name I are subs ribed to the within instrument and acknowledge o me that he//they executed the same in histheir authorized capacity), and that by hi /he /their signature on the instrument the person; or the entity upon behalf of which the personss� 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. 004004440?00?44?044440440000404044004000� WITNESS my hand and official seal. TRACI LARSON COMM # 1642285 m W NOTARY PUBLIC - CALIFORNIA ITI Q LOS ANGELES COUNTY � �//, /) My Commission Expires Jan. 31, 2010 ; Signature (� L� Seal R�00400J?OA000004?400404N40000000004044 ( ) POA #: 510026 ,• 1. � & �I (�� s.' g �, +.�� S f S '� i t i �I '' �1 ► �, i �, A Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company'), a corporation duly organized and existing under the Iaws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint George Burchfiel, Shaunna Burchfiei of Corona, CA its true and lawful Attorney(s)-in fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizanees, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety, providing the bond penalty does not exceed Five Million Dollars and no/100 ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the premises, Said appointment shall continue in force until 10/31/09 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any 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 Attorneys) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -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 bidding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved,. 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 seal 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 20h 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 20th day of June, A.D. 2005. Ai �;RR TEC RANGE COMPANY r`�•.1•� .4�%'{e is # By. S.J. I{i g, reside t State of Texas ss `� f} f County of Harris On this 20th day of June, A.D. 2005 before me personalty 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 seal 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. FID Michelle Denny (V ay Publio S1016 01 �XC�telly Cotrnnisskm DOW Michelle Denny, Notary Pti tic August 27, 2008 My commission expires August 27, 2008 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 Rand and the seal of said Company at Houston, Texas this 8th day qJ Se ember 20 08 A.D. Brent Bea , sistant See tary Any instrument issued in excess of the penalty stated above is totally vold 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.