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HomeMy WebLinkAboutJohn S. Meek Company. Inc - 2014-08-04DATE - TO: FROM SUBJECT: CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION 3/14/2016 THOSE LISTED HEREON John Griffin, PW Contract Administrator` Retention Release Payment - PO #20865 OJ Supplier #95011 Co #213 Warner Avenue Bridge Preventive Maintenance, Project # CC 1356 Contractor's Name John S Meek Address 14732 S Maple Ave City, State and Zip Code Gardena, CA 90248 Phone Number 310-830-6323 City Business License Number A178098 Notice of Completion (Date by City Clerk) 5/13/2015 The conformed copy of the Notice of Completion for the above contract has been filed The thirty-five (35) day waiting period has elapsed or will elapse before payment is made Processing of the retention payment is recommended so long as no stop notices or outstanding invoices are on file with the City I certify that no stop notices are on file !� / , ate I certify that there are no outstanding invoices on file Date Travis K n I a W1 I certify that no stop notices are on file, and that a guaranty bond has �Ijlwff_ A a Awan ns, Director of Public Works puty City Treasurer filed with the City Clerk's Office Flyri�i, City Clerk Attachments 1 Certificate of Compliance with P ev cling Wage Laws 2 Contractor's Certificate 3 Certificate of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 4 Consent for Release letter from the Surety Company 5 Maintenance Bond 6 Notice of Completion 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: CC-1356 Project: Warner Avenue Bridge Preventive Maintenance 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 22nd day of September , 20:eek , at Gardena , California. C John S. Company, Inc. (Contractor Name) APPROVED O FO By: *,;,Attorney el E. Gates CONTRACTOR'S CERTIFICATE I, John S. Meek , state and certify that: (Name of Declarant) 1. John S. Meek Company, Inc. is the general contractor to the City of Huntington Beach ("City") on Contract No. CC-1356 (the "Contract") for the construction of the public work of improvement entitled: Warner Avenue Bridge Preventive Maintenance, Project #CC-1356 (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"): NONE 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"). NONE I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Gardena, Califomia on this 22nd day of September , 2015 tz��- /J/-" K (Signs a of Declarant) APPROVED AS ORM Michae . Gates City ttorney 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: CC-1356 Project: Warner Avenue Bridge Preventive Maintenance 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, color, religion, sex, sexual orientation, gender identity, 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, color, religion, sex, sexual orientation, gender identity, 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 22nd day of 2015 , at Gardena , C ifornia. ee CoXanY, Inc. or Name) APPROVED By: Mic el E. Gates Ci Attorney 1 CONSENT OF SURETY TO OWNER: ❑ ARCHITECT: ❑ REDUCTION IN OR PARTIAL coNTRAcroR: ❑ RELEASE OF RETAINAGE SURETY: ❑ Bond Number 5186116 OTHER: ❑ PROJECT: Wainer Avenue and Pack Coast Highway (Over the Bolsa Chica Channel) TO OWNER: Warner Avenue Bridge Preventative Maintenance PROJECT NAME: (Over the Boise Chica Channeq ( City t of Huntington Beach PROJECT NO: CC 1356 2000 Main Street CONTRACT DATE: August 11, 2014 Huntington Beach, CA in accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety as it appears in the frond) SureTec Insurance Company 15901 Red Hill Avenue, Sude 100, Tustin, CA 92780 , SURETY on bond of (here insert name and address of Contractor as it appears in the bond) John S Meek Company, Inc 14732 So Maple Avenue, Gardena, CA 90248 ,CONTRACTOR (PRINCIPAL) hereby approves the reduction in or partial release of retainage to the Contractor as follows: Release of Partial Retainage ($34,861 82) The Surety agrees that such reduction in or partial release of retainage to the Contractor shall not relieve the Surety of any of its obligations to (here insert name and address of Owner) City of Huntington Beach 2000 Main Street, Huntington Beach, CA , OWNER (OBLIGEE) as set forth in the said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand this 15th day of May in the year of 2015 SJ�cFc NG '9 09 rr Attest: Michele Fedoruk ,(Seal): SureTec Insurance Company Surety By Signature of Authorized Representative Erik Johansson Title Attorney -In -Fact Surety Phone No 714-824-8364 •RNIA ALL-PURPOSE ACKNOWLEDGMENT• L.:\� :�2/t'�:.1f. \<..'.it �t�t •.�i ft/.:'\t���.c\iN.i\r.�it .'a'✓.'.�t.�..�.tl •.�fru.at afi'.� aJ .�2. at/'.���c�t/'T <�•t/�.:/.� ✓.' t.a�t/:\n A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On MAY 1 5 2015 before me, Michele A Fedoruk, Notary Public Date Here Insert Name and Title of the Officer personally appeared Erik Johansson Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isfew subscribed to the within instrument and acknowledged to me that hefahefttM executed the same in hisAwrMv6r authorized capacity(iees), and that by hisAwir ttlMr signature(aj on the instrument the person(e), or the entity upon behalf of which the person(o acted, executed the instrument. MICHELE A FEDORUK Commission # 2062160 -d Notary Public - California = Orange County M Comm Expires Mar 23, 2018 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 Signature of .: Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: 0 Corporate Officer — Title(s): 0 Partner — 0 Limited 0 General D Individual 0 Attorney in Fact D Trustee 0 Guardian or Conservator ❑ Other. Signer Is Representing: Signer's Name: 0 Corporate Officer — Title(s)- 0 Partner — 0 Vmrted 0 General D Individual 0 Attomey in Fact D Trustee 0 Guardian or Conservator 0 Other: Signer Is Representing* 02014 National Notary Association • www.Nationa]Notary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 POA #: SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation drily 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 Enk Johansson Tusbn, CA its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recogmzances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for. Surety Bond No.: 6186116 Principal: John S. Meek Company, Inc. Obligee: City of Huntington Beach Amount. See Bond Form and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and dully attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment is made tinder 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 Attomey(s)-in-Fact to repmmt 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, recogmzances, 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-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 hi simile, 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 god' of Aprg 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 21 st day of March, A.D. 2013. SURETECMPANY �yUa""cF Q .1 � By: aW 5 John oFC State of Texas ss: 7� 1 County of Harris On this 21st day of March, A.D. 2013 before me personally came John Knox Jr., 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 mstrcm ant; that he Imows 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. JAC� MALDONADO . . Noteiy Pub9c Stets o1Texffi any Comm, t:xp.8i18=17 Jacquelyn Maldonado, Notary Public My commission expires May 18, 2017 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, at out in the Power of Attorricy. are in full force and of ecL 'l i! " Given under my hand and the seal of said Company at Houston, Texas this 15th day of May of 2015 A.D. J 1 B t Beaty, Assistant S cretary Any Instrument Issued % excess of the penalty stated above is totally void and without any validity. For verifieaden of the authority of this power you may call (713) 8124=0 any business day between 8:00 am and &00 pm CST. RECEIVED BY CITY CLERK RECEIPT COPY IAXI�17, Return DUPLICATE to s City Clerk's Office ( ame) yri � ° after signing/dating F'/ C (Date) ` CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO City Treasurer FROM City Cler DATE le5;,� SUBJECT Bond Acceptance I have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. .w TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re:, Tract No CC No A� 473; MSC No Other No g /forms/bond transmittal to treasurer Approved (CouncilApproval Date) Agenda Item No — 9 City Clerk Vault No 60 0 • SIRE System ID No !J Duplicate Original MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS Bond No.- M5186116 Premium. Included In Cost of Performance Bond That John S Meek Company, Inc. (contractor's name) street address, city and state and zip code) as Principal (hereinafter called Contractor), and name) city and state and zip code) a corporation organized and existing under the laws of the State of Texas with its principal office in the City of lJpU51on as Surety (hereinafter called Surety), are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of * Dollars ($ 684,853 00 ), equivalent to the entire contract amount including all orders, for the payment whereof Contractor and Surety bind themselves, their heirs executors, administrators, successors, and assigns, jointly and severally, firmly by these presents, WHEREAS, Surety is a duty admitted surety insurer under the laws of the State of California, and Surety is certified and listed in the U.S Department of the Treasury Circular 570, and able to provide proof of bonding limitation shown in said circular is sufficient to provide bonds in the amount required by said Contract, and Surety has provided financial strength ratings from reputable companies, such as from A M Best, Moody's, Standard & Poor's, to validate that Surety has positive ratings of being secure or stable, and Surety is registered and listed with the California Department of Insurance, and Contractor has by written agreement dated 20_15, entered into a contract with Owner for the Wainer Avenue Bridge Preventative Main%nance (Over Bolsa Chica Channel) CC-1356 in accordance with drawings and specifications prepared by Bi-gas Cordosa Associates Inc which contract is by reference made a part hereof (hereinafter referred to as the Contract), and The Contract provides that the principal wdl guarantee, for a period of one year, the work performed as part of the Contract from and against all defects in materials and workmanship, and The Contract also provides that the Contractor shall secure Conlractor's obligations during the one-year period with a bond executed by a surety duly admitted in the state of California, and The Contract has been completed, and the Owner, Contractor and Surety agree that the commencement date for this Guarantee and Bond shall be May 8th , 2C 15 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects ansing in the Work, whether resulting from defective materials or defective workmanship, then this obligation shall be null and void, otherwise it will remain in full force and effect The Surety hereby waives notice of any alteration or extension of time made by the Owner Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within thirty (30) days following Owner's written notice of default, either (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall save the Owner harmless from any claims, judgments, liens or losses ansing from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner *Six Hundred and Eighty Four Thousand Eight Hundred Fifty Three and 00/100 15-45941118138 Whenever the Principal shall be, and declared by the Owner to be in default under the Contract, which shall include without limitation, any breach or default of the Contract, then, after written notice from the Owner to the Surety, as provided for below, the Surety shall either (a) remedy the default or breach by the Pnncipal, or (b) shall promptly and faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a contractor other than the Principal, at its own expense, and make available as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to (a) remedy the default(s) of the Principal promptly, or (b) arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond In said Notice of Election, the Surety shall state the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the Contract The Surety's obligations for cure or remedy, include but are not limited to correction of defective work and completion of the Contract, additional legal, design professional and delay costs ansing from Surety's actions or failure to act, and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages caused by delayed performance or non-performance by the Pnncipal) The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s) of its performance of the Contract If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Pnncipars default(s) of as Performance of the Work within thirty (30) days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond, and the Owner shall be entitled to enforce any remedy available to Owner No right of action shall accrue on this bond to or for the use of any person or corporation other than the owner named herein or the successors of Owner Signed and sealed this 24th day of September 2015 Principal Raised Corporate Seal [MUST BE AFFIXED] Principal Raised Corporate Seal [MUST BE AFFIXED] NOTES Acknowledgments must be completed and returned as part of the bond Raised Corporate Seats are mandatory Please attach Power of Attomey 154584/118138 7 John S Meek Company, Inc. eobnS. (ContractorName) B/ (Seal) k President (Title) SureTec Insurance Company (Surety Name) By. `7�+� (Seal) Erik Johansson, Attomey-In-Fact APPROVED AS Z B !� Michael E Ga es, City Attorney E POA#: 510083 SureTec Insurance Company MUTED POWER OF ATTORNEY Know AU Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Kevin S Bogart, Scott M Milne, Erik Johansson its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for. Five Million and 00/100 Dollars ($5,000,000 00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 10131/2016 and is made under and by authority of the following resolutions of the Board of Directors of the SulreTec 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: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, aclmowledge and deliver, any and all bonds, recognizances, contracts, agreements or mdemmty 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 herd 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 2 e of Apri4 1999) In Witness P%ereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 21st day of March, A.D. 2013. SURETEC INSURANCE COMPANY SVAANCF u►0 X 9 O; By: 6 W y y John 4ox Jr. resident State of Texas ss: County of Hams On this 21st day of March, A.D. 2013 before me personally came John Knox Jr., 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 inscument; that be ]mows 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. JACOUELYN MAI DONADO NOWY Public _ Stele of Texas Is a My cam, Exp 5118 017 Aiacqelyn Maldonado, Notary Public My commission expires May 18, 2017 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 Z 4 4' 1 day of SQPkyV)bCC Z.015 , A.D. Bra t Beaty, assistant Secretary Any Instrument Issued in excess of the penalty stated above Is totally void and without any validity. For verifleatlon 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 Orange } On SEP 2 4 2015 before me, Mehssa A. Lopez Notary Public, Date It personally appeared Erik Johansson (here insert name and title of the officer) who proved to me on the basis of satisfactory evidence to be the person(x) whose name(a) is/an subscribed to the within instrument and acknowledged to me that he/sue executed the same in his/he Widw authorized capadty(i*, and that by hiss signature(s) on the instrument the person(a), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. MELTS _A A LOPEZ Commission # 2011078 Rli,-z ,'Notary Public - California z z'� Orange County My Comm Expires Mar 22, 2017 Signature.. (Seal) OPTIONAL IDescription of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: ME CALIFORNIA .. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document State of Califo la ) County o Q.A- 6kW_z_4__ On -25 20l4r before m�a`'"/, Date He Insert Name and Title a Officer personally appeared °/J. Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name* is/are subscribed to the within instrument and acknowledged to me that he/We/they executed the same in hiss/their authorized capacltyks), and that by his/be/their signature(a) on the instrument the person(a), or the entity upon behalf of which the person(s) acted, executed the instrument. Q0NNAALISA PAILACommission # 1978245 Notary Public - Californiazz Los Angeles County My Comm Expires May 14.2016 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 ►gnature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signers) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer — Title(s): Partner — Limited i General ❑ Individual ❑ Attomey in Fact D Trustee ❑ Guardian or Conservator i Other: Signer Is Representing: Signer's Name: Corporate Officer — Tiltle(s): Partner — ❑ Limited General E Individual ❑ Attomey in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other. Signer Is Representing: 02014 National Notary Association - www.NationaiNotary.org-1-800-US NOTARY (1-800-876-6827) Item #5907 This Document was electronically recorded by City of Huntington Beach PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT John Griffin P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder III III II 111111111111111111111111111111111111111111111111111119.00 2015000248711 1O:33am 05/13/15 143 401 N12 F13 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to John S. Meek, who was the company thereon for doing the following work to -wit: Warner Avenue Bridge Preventive Maintenance , Project # CC 1366 That said work was completed 05/08/2015 by said company according to plans and specifications and to the satisfaction of the City Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on 05/08/2015, 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. S Director of Public Work or City Engineer D to City of Huntington Beach, California STATE OF CALIFORNIA) County of Orange ) ss: City of Huntington Beach ) _ I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof; the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. This document is solely the official business of the City of Huntington Beach, as contemplated under Government code section. 6103 and should be recorded free of charge. Director of Pubri6wgfks or City Engineer Date City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) RECEIVEASY:f ',(Name) (Date) TO: FROM: DATE: SUBJECT CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH 1 -V -A' COMMUNICATION City Treasurer City Clerk 9 Bond Acceptance I have received the bonds forr�I`e (,� . y it (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. Other No. g:/forms/bond transmittal to treasurer Approved Q /Y—// y pp (Council Approval Date Agenda Item No. City Clerk Vault No. SIRE System ID No. V) r FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND JOHN S. MEEKS COMPANY FOR WARNER AVENUE BRIDGE PREVENATIVE MAINTENANCE 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 4 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 5 7. NOTICE TO PROCEED 5 8. BONDS 6 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 7 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 11 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT & TERMINATION 14 24. TERMINATION FOR CONVENIENCE 15 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 16 27. CITY EMPLOYEES AND OFFICIALS 16 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 16 29. NOTICES 16 30. SECTION HEADINGS 17 31. IMMIGRATION 17 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 1 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS continued Pam 33. ATTORNEY'S FEES 18 34. INTERPRETATION OF THIS AGREEMENT 18 35. GOVERNING LAW 18 36. DUPLICATE ORIGINAL 19 37. CONSENT 19 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 19 39. CALIFORNIA PREVAILING WAGE LAW 19 40. CALIFORNIA EIGHT -HOUR LAW 20 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 21 42. EMPLOYMENT OF APPRENTICES 21 43. PAYROLL RECORDS 21 44. FEDERAL PARTICIPATION 21 45. ADDITIONAL FEDERAL REQUIREMENTS 22 46. DAVIS-BACON ACT 22 47. DISCRIMINATION, MINORITIES, ALIENS 23 48. EQUAL EMPLOYMENT OPPORTUNITY 23 49. COPELAND "ANTI -KICKBACK" ACT 24 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 24 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 25 52. ENERGY CONSERVATION 26 53. HOUSING AND URBAN DEVELOPMENT 26 54. SIGNATORIES 26 55. ENTIRETY 26 ii FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND JOHN S. MEEKS COMPANY FOR WARNER AVENUE BRIDGE PREVENATIVE MAINTENANCE 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 John S. Meek�Company, a [type of entity and state] Californai Corporation, hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as Warner avenue Bridge Prevenative Maintenance (Over the Bolsa Chica Channel) CC-1356 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 g/agree/ surfnet/federal const Page I of 27 12/11 of work, and for all other risks of any description in connection with the work, including, but not limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; g/agree/ surfnet/federal const Page 2 of 27 12/11 D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference), and the Federal Requirements from FHWA 1273 and additional requirements (which is attached hereto as Exhibit "B"); F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. g/agree/ surfnet/federal const Page 3 of 27 12/11 Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed six hundred eighty four thousand eight hundred fifty three Dollars ($684,853.00), 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 one hundred thirty (130) consecutive working days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/ surfnet/federal const Page 4 of 27 12/11 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/ surfnet/federal const Page 5 of 27 12/11 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/ surfnet/federal const Page 6 of 27 12/11 secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of seven hundred Dollars ($700.00) per day for each and every working day's delay in completing the work in excess of the number of working/calendar days set forth herein, which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. g/agree/ surfnet/federal const Page 7 of 27 12/11 CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DIFFERING SITE CONDITIONS A. Notice: CONTRACTOR shall promptly, and before such conditions are disturbed, notify DPW in writing of- (1) Subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents; or g/agree/ surfnet/federal const Page 8 of 27 12/11 (2) Unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the character to be performed under this Agreement. DPW shall promptly investigate the conditions and if it finds that such conditions do materially so differ and cause an increase or decrease in the time required for performance of any part of the work under this Agreement, whether or not changed as a result of such conditions, an equitable adjustment shall be made and the agreement modified in writing accordingly. B. Time Extension: No claim of CONTRACTOR under this Section shall be allowed unless CONTRACTOR has given the notice required hereunder provided, however, the time prescribed therefor may be extended by CITY. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an g/agree/ surfnet/federal const Page 9 of 27 12/11 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, five percent (5%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Provided, however, that in the event of a dispute between CITY and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the contract price shall not be considered as a acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. g/agree/ surfnet/federal const Page 10 of 27 12/11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE. HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY, its officers, elected or appointed officials, employees, agents, and g/agree/ surfnet/federal const Page 11 of 27 12/11 volunteers. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single g/agree/ surfnet/federal const Page 12 of 27 12/11 limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above -mentioned insurance contain a self -insured retention without the prior written consent of CITY; however an insurance "deductible" of $5,000.00 or less is permitted. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the g/agree/ surfnet/federal const Page 13 of 27 12/11 policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 23. DEFAULT AND 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 make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted g/agree/ surfnet/federal const Page 14 of 27 12111 to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. g/agree/ surfnet/federal const Page 15 of 27 12/11 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: TO CONTRACTOR: City of Huntington Beach John S. Meek, Company,, ATTN: David Verone 2000 Main Street Huntington Beach, CA 92648 g/agree/ surfnet/federal const Page 16 of 27 12/11 30. SECTION HEADIN The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 33. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear g/agree/ surfnet/federal const Page 17 of 27 12/11 its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 34. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 35. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 36. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the g/agree/ surfnet/federal const Page 18 of 27 12/11 date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 37. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 39. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit g/agree/ surfnet/federal const Page 19 of 27 12/11 twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 40. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty- five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. g/agree/ surfnet/federal const Page 20 of 27 12/11 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 42. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 43. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 44. FEDERAL PARTICIPATION The PROJECT pursuant to which the work covered by this Agreement is being executed is being assisted by the United States of America. Several Agreement provisions embodied herein are included in this Agreement in accordance with the provisions applicable to such federal assistance. As federal funds are financing all or part of this work, all of the statutes, rules and regulations promulgated by the Federal Government and applicable to the work will apply, and CONTRACTOR agrees to comply therewith. Attached is FHWA Form 1273, known as Exhibit "B", which describes required contract provisions for federal -aid construction contracts. g/agree/ surfnet/federal const Page 21 of 27 12/11 Additionally, the CONTRACTOR shall insert in each subcontract all of the stipulations contained in the Required Contract Provisions of Form 1273, and further require their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. Certain sections of Form 1273 may not be applicable depending upon the project and will be crossed out. 45. ADDITIONAL FEDERAL REQUIREMENTS CONTRACTOR agrees to abide by the additional requirements necessary for federal aid (see pgs. 12-14 of Exhibit "B"). The CONTRACTOR agrees to buy only steel and iron made in the United States for all federal -aid construction projects (`Buy America"). The CONTRACTOR also agrees to be subject to the legislative and regulatory Disadvantaged Business Enterprise (DBE) requirements (42 USC Section 2000d, et seq.). If the CONTRACTOR does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non -collusion certification. Select projects may also require "Federal Trainee" or "On -the -Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined by the Department of Labor (29 CFR part 5) in accordance with the Davis -Bacon Act (40 USC Section 276a to 276a-7) for each craft or type of worker needed to perform this Agreement. g/agree/ surfnet/federal const Page 22 of 27 12/11 CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 47. DISCRIMINATION, MINORITIES, ALIENS The CONTRACTOR or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The CONTRACTOR shall carry out applicable requirements of 49 CFR, Part 26 in the award and administration of DOT -assisted contracts. Failure by the CONTRACTOR to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as recipient deems appropriate. 48. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled "Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit "B"). CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 (38 USC Section 219 et seq.) prohibits job discrimination and requires affirmative action to comply and advance in employment (1) qualified Vietnam veterans during the first four (4) years after their g/agree/ surfnet/federal const Page 23 of 27 12/11 discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 49. COPELAND "ANTI -KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations (29 CFR part 3), which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight (8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in excess of eight (8) hours in any calendar day or forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined g/agree/ surfnet/federal const Page 24 of 27 12/11 under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 306 of the Clean Air Act and section 508 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. g/agree/ surfnet/federal const Page 25 of 27 12/11 52. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 USC Section 6201, et seq.). 53. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 54. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 55. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, g/agree/ surfnet/federal const Page 26 of 27 12/11 inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on .,$% , 20—// CONTRACTOR John S. Meek/Company � TrtC Yl-� n __ Johr/ S / Meek, President print name ITS: (circle one) Chainnan/President/Vice President print name ITS: (circle one) Secretary/Chief Financial Officer/Asst. Secretary - Treasurer CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California APPROVED: anager �VED AS TO FORM: '�y T' Z�;� City ttorney g/agree/ surfnet/federal const Page 27 of 27 12/11 ALL-PURPOSECALIFORNIA CIVIL O. C.c!s�•,,"I'll,c_.�N,T•:a�r�i¢r�t�..'N.t!a¢_...,.....c.c�c!sCN.�<!�•..�._.�.!si¢._s�. State of California County �a aak12 On lfore me,' Date re /n ert Name and it/e o the fficer personally appeared ��"'�" • )bd_ Name(s) of Signer(s) ANNA LISA PAILA Commission # 1978245 Notary Public - California z Z Los Angeles County D My Comm. Expires May 14, 2016 who proved to me on the basis of satisfactory evidence to be the persono whose name(s) Ware subscribed to the within instrument and acknowledged to me that he/sly/they executed the same in hisftw/thQrr authorized capacity(ies), and that by his/hsr/thi r signature(s) on the instrument the person(a), or the entity upon behalf of which the person(} acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Place Notary Seal Above Signature: ignature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document �" Title or Type of Document: eatjh., /01 eaubad Document Date: Number of Pages: �7 Signer(s) Other Than Named Above: Capacity(ies) Clain edby Si ie�(s) Signer's Name: B'Corporate Offi — Title(s): resi dCA4'_ ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: A- Signer's Name: CTCorporate O ' er — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: o 1 • • • • • • • • ill 1' ill i • •i •1 SECTION C for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER's default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount of $ 10% of Bid Tot*hich said amount is not less than 10% of the aggregate of the total amount bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for %", as the case may be). Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda 1Yo. Date ReceivedI Bidder i nature 1 07/02/2014 li C-2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 1 LS Mobilization 1 $ t% $ 6g OX 1 LS Prepare Storm Water Pollution Prevention Plan 2 G $ '�500 $ �600`'� 1 LS Water Pollution Control 3 $ 1 LS Access Grading 4 $$ %✓�� 1 LS Traffic Control 5 $ ll5 $ (I� 13020 SF Saw Cut, Grind and Remove AC Pavement 6 $ ;I $ aSY7 82 TN Asphalt Tack Coat and AC Leveling Pavement 163 TN ARHM Finish Course Pavement 8 $ ) 35"Dv $ 3� 3 C-2.1 PROJECT DID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 8 LF Saw Cut and Remove Existing PCC Curb/Gutter 8 LF Construct Variable Height PCC Curb and Gutter 10 $ 9375 $ 124 LF Install 4' High Environmental Protection Fence 11 $ 3�0., $ 37Cya 2 EA Adjust Gas Valve Frame and Cover to Grade 12 1 LS Install Striping and Pavement Markings 13 $ �l ✓�C��o $ r7v .Ti bQc� 33 CF Remove Unsound Concrete 14 $ &0 234 LF Remove Concrete Barrier 15 $ d `/ $ 5Z 3�� 234 LF Remove Chain Link Railing 2 f O 031 ' 16 $ $ C-2.2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 65 LF Remove Metal Beam Guard Railing 17 $ ✓�� '�= $ 3 Ja� 65 LF Metal Beam Guard Railing 00 �q 50 LF Remove and Reconstruct Wood Rail Fence 19 $ 6 01 - $ < f%%id 33 CF Portland Cement Concrete (Patch) 20 $ �,D�a� $ 310 CY Rock Slope Protection (1/4 Ton Method A) 21 $ $ 310 SY Rock Slope Protection Fabric (Class 8) 22 $ $ 3 7-20 117 LF Concrete Barrier (Type 26 Modified) 23 $ � $ 2- 117 LF Concrete Barrier (Type 732 Modified) 24 $ , �. $ C-2.3 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 234 LF Wildlife Protection Railing 01 2 25 $ 6480 SF Seal Concrete Bridge Deck 26 $ $ CO 1 LS Planting and Habitat Mitigation 27 $ 1-5 6ro $ ',�40 1 LS Planting Maintenance 28 35-e 3�UO Total Amount Bid in Figures: $ 4?a Total Amount Bid in Word ............. ..... ............... . . .. ... ........ lne�. ... .. ;;X0 ... ....... %2- C-2.4 SECTION C 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Portion of Work f Subcontractor Name an dAddress o � ��� State License Number Glass_ _ �p © 7961513 C-- 3) c w a;[�eft!Lc©JI a,4 "7 d{ 1 `1 J 7� y ps 0' j" t R'0 G 54y"c-kn.e-& GPisF Cc cclf� 0 .59��7b A C 4-F I A' c� l(. Cw,c CA- ,570 3 / D 04 t C 9 ior too`"`"zk ,�,�ti�,,� S. �,.�� �. P�►� �i�L, (Jlf o 776 Sob � 3'� C3� ACCorw -A AAial,C P�c� �v�srrKiu eVE 63909.E R . R. LF_C1JAteA) - P n Act C010reuGT.f4Q Lr�se� r�ccs � �� 0 A By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on July 9, 2014 at Gardena , CA Date City State John S. Meek , being first duly sworn, deposes and says that he or she is President of John S. Meek Company, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. John S. Meek Company, Inc. Name of Bidder Si a re of Bidder 14732 So. Maple Avenue, Gardena CA 90248 Address of Bidder Subscribed and sworn to before me this day of , 201 _ NOTARY PUBLIC NOTARY SEAL C-4 CALIFORNIA••ACKNOWLEDGMENT CIVIL CODE § 1189 <;T�.�•_Ts.�.c.:�<;=:e_ae..e� e.=:,,,.z.�:e�:,�,.T,.::,.:.e.�•:=c:.:ce%s.....=ce......._�<;....�•:=c_...�.,:.z,::e,:cc.-:.e.�c.:.<., Tz c.:..:..c�:,:: �,.:.,_.. State of California County, 1A_ On )11, . t before me, Date A personally appeared ANNA LISA PAILA Commission # 1978245 z .- Notary Public - California z Z ' Los Angeles County My Comm. Expires May 14, 2016 7, 1 iiiq ;"jL Name and Title`o�the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ape subscribed to the within instrument and acknowledged to me that he/sere/thOy executed the same in his/he(/theiF authorized capacity(ios), and that by his/hor/their signature(a) on the instrument the personal, or the entity upon behalf of which the persons' acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Place Notary Seal Above Signature: Signature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: �'%�✓:�✓i�✓,:�%6�✓,.�✓,.�✓,.�i`�!i�✓,:�✓,i�✓,.�✓,.�✓,.�✓i�%A✓i�✓i�.�✓,�.�%i�✓.i�i�✓,i�i�' e/i�.� '✓i�✓:�✓,1�✓.'Jib✓,i�✓,.\✓,i`�".�✓,.�✓,i�i�✓,i�i�✓,4�%i' Q • • • • • • • • --111i i • • i • 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 WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (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: "QuaYified 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: July 9, 2014 John S. Meek Company, Inc. Contractor President Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ® Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: July 9, 2014 John S. Meek Company, Inc. Contractor Bt) President Title C-7 BIDDER certifies that the following information is true and correct: John S. Meek Company Bidder Name 14732 So. Maple Avenue Business Address Gardena, CA 90248 City, State Zip ( 310 ) 830-6323 Telephone Number 709151 A, B, Haz State Contractor's License No. and Class July 5, 1995 Original Date Issued July 31, 2015 Expiration Date The work site was inspected by Jim Jilk of our office on July 8 , 2014. The following are persons, firms, and corporations having a principal interest in this proposal: John S. Meek Company, Inc. John S. Meek, President C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. John S. Meek Company, Inc. Company N Signature John S. Meek Printed or Typed Signature Subscribed and sworn to before me this _ day of , 201_ NOTARY PUBLIC NOTARY SEAL C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of California CountAt7 4411 On t before me,'� Date F6reAsert Name and Title t e Officer personally appeared ��'"' )Alu `-- Name(s) of Signer(s) ANNA LISA PAILA +� Commission # 1978245 z Notary Public - California z "' Los Angeles County D My Comm. Expires May 14, 2016 who proved to me on the basis of satisfactory evidence to be the person(aj whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/ahfb/tlxey executed the same in his/h,er/th& authorized capacity(ie*, and that by his/hadtl­wfir signature(sr on the instrument the person(), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Place Notary Seal Above Signature: ignature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: .�✓:"✓i,�rr,S'y "•✓ "t/i",✓.'•✓4"y �5�5'✓5�.\L:'y4'✓4�.'yi-✓4�Ay5'ti.-s.'y.'y.'ai •t/:"✓6� y •'� "� -y ti •'� y6�.1•'�.5�.� � y �y6\s?.�: y�" • • • • • • • • i i Si • • i BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: County of Los Angeles, 900 S. Fremont Avenue, Alhambra CA 91803 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Robert Eisenheimer (626) 458-3155 Queensway Southbound Ramps J & K $2.8 Million September 6, 2013 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Concrete Bridge Repair 2. County of Orange, 1152 E. Fruit Street, Santa Ana CA 92701 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Ham id Abedzadeh (714) 245-4501 Island Way $1.4 Million May 23, 2014 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Repair Concrete Bridge over Harbor County of Los Angeles 900 S. Fremont Avenue, Alhambra CA 91803 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Tim Bazinet (626) 458-2158 Beverly Blvd. over UPRR $1.0 Million September 5, 2012 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Repair of Concrete Bridge over Railroad C-10 BIDDER'S CRITICAL. STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. 1 Ken Allred Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: (310) 830-6323 Queensway Southbound Ramps J & K, Bridge Repair Project Name & Contract Amount Type of Work September 6, 2013 Date Completed Island Way Bridge Repair May 23, 2014 Project Name & Contract Amount Type of Work Date Completed Beverly Blvd. Bridge Repair Project Name & Contract Amount Type of Work 2. Robert Hinojosa Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: (310) 345-2334 September 5, 2012 Date Completed Island Way Bridge Repair May 23, 2014 Project Name & Contract Amount Type of Work Date Completed Beverly Blvd. Bridge Repair September 5, 2012 Project Name & Contract Amount Type of Work Date Completed Rail Corridor Pedestrian Bridges & Trail November 1, 2008 Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: John S. Meek Company, Inc. Contact Person: Contact Phone: Signed: Date: John S. Meek *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-12 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder John S. Meek Company, 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 1 of 8 C-13 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION )10285.)1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 101162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. Page 2 of 8 C-14 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-15 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder, declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. John S. Meek, President July 10, 2014 Page 4 of 8 C-16 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-17 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLODDYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-18 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES cs.�,u-rwa.-r�■.�w� 1. Type of Federal Action: ® a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance IU UlJl LUDtL LU15t5Y1NU At.AIVML1 )YUKJUAIVI 1U.51 U.DAI 1 2. Status of Federal Action: ® a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity ® Prime ® Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11. 12. 14. 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) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ ® actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission ea. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached. Yes ® No t 14 Information re ested throw h this form is authorized b qu g Y Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Signature: Print N e: John S. Meek Title: resident Telephone No.: (310) 830-6323 Date:07/09/14 Authorized for Local Reproduction Standard Form - LLL Standard Form LLL Rev. 09-12-97 Page 7 of 8 C-19 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid 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. 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. Check all boxes that apply. If other, specify nature. 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.06-04-90oENDIFN Page 8 of 8 C-20 June 11, 2014 Local Assistance Procedures Mannal ENIIEBIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts) F+ x HiBIT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCALACENCY: City of Huntington Beach LOCATION: Htint"ingWm_Be�h PROJECT DESCRIPTION: arner Ave TOTAL CONTRACT AMOUNT: $ 684 853.00 BID DATE: BIDDER'S NAME: John S. Meek Company Inc. i CONTRACT DBE GOAL: 1 0% i CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a DBE) DBE CERT NO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT DBE 15 Demolition 8735 6/1/16 G&F Concrete Cuttin $30 455.00 1006 E. Ches nu Ave. Santa Ana, CA 92701 714-648-0397 21,22 Rock Work 14054 7/27/15 Roc Structures $65,100.00 11126 Silverton Ct. Corona, CA 92881 - �1-371-1112 For ]Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number. Total Claimed DBE Participation $ 95,555.00 13.9 % d er 310 830-6323 ec (Area Code) Tel. No. John S. Meek, President Person to Contact (Please Type or Print) Local Agency Bidder DBE Coimnitinent (Construction Contracts) (Rev 6/26/09) Distribution: (1) Copy —Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-1 OB 12-04 C-21 June 29, 2012 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 June 29, 2012 C-22 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort EXHIBIT 15-II DBE INFORMATION —GOOD FAITH EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. BPMPL-5181 (169) Bid Opening Date 7/10/14 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 10 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation Page 1 OB 12-04 C-23 June 29, 2012 Exhibit 15-H DBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (Y/N) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: Page 2 June 29, 2012 C-24 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 3 OB 12-04 C-25 June 29, 2012 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) FART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ 4--x; Address</ Cit , State, ZIP.Recei Phone/ Fax Annual Gross p is _ Description of Portion of Work to be Perfo.med cail�enc;�Ie - Name Southern California Barricades Phone 714-676-8460 Fax 714-252-9143 ❑ < $1 million 0 < $5 million ❑<$lomillion ❑ < $15 million ❑ > $15 million Traffic control ........ ......_............................ ... _... ............. ._.. ..... ...__.. _...--..... ..... __...... FA �❑Alf � p � . � t try of „��6"TO, 'flak _ Address5930 Lakeshore Dr City State ZIP C 1 eSS, CA, 90630 Name p 9 Pacific Waterproofing and Restoration Inc. Phone 909-444-3052 Fax 909-444-3054 ❑ 0 ❑ ❑ ❑ < $1 million < $5 million < $10 million <$15 million > $15 millionAg�zoitrz(Yrs Water Proofing - ........ _ -- -- - _ ... ........ ............................................ _.. ___............................................. _ _. ❑ � � NW � i ITS hti .,,..:_::_t..: ? Address 2845 Pomona Blvd. City State ZIP Pomona, CA 91768 Name Rock Structures Phone 951-371-1 112 Fax 951-278-2802 ❑ ®< ❑ ❑ ❑ ❑> < $1 million $5 million < $10 million <$15 million $15 million Rock Rock (Slope Protection) -. .... - - ....... _..... .. _.- _... _...._ . _ _....... _... ......... ._._-........ ❑ ES . .. pNo $ K i�IrES �zslDF')� " Address 11126 Silverton Ct. City State ZIPCO�tOn, CA 9288� Name G&F Concrete Cuttin Phone 714-648-0397 Fax 714-550-0624 ❑ ❑ 0 ❑ < $1 million < $5 million < $10 million < $15 million Remove Concrete Barrier ...... ....... _... - _.. v��� �5'A' t �° Address 1006 E. Chestnut Ave City State ZIP Santa Ana CA 92701 ❑ > $15 millionfFu tg�ur- Distribution: 1) Original - Local Agency File Page 1 of 2 DLA-OB 13-06 C-26 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Address/ Phone/ Fax Annual Gross Description of Portion of Work to be Performed City, State, ZIP Receipts Name Pavement Recycling Systems Phone ❑ < $1 million El$5 Grind AC Paving .. ------------------------------------------------------------------------------------------------------------------------------------------- 951-682-1091 million ❑ < $10 million Address 10240 San Sevaine Way Fax 951-682-1094 ❑ < $15 million ❑■ > $15 million City State ZIP Jurupa Valley, CA91752 Name Pavement Superior Pt Markin p g Phone $1 m Ilion Eli El < $5 Striping 714-995-9100 million X < $10 million .................. - .......... .--_ Address 5312 Cypress St YP Fax 714-995-9400 ❑ < $15 million > $15 million ........................ . .......................... ..... --.............................-......... -- -- --- - -- ..._-- - - - - - - - - -..._ - -- City State ZIP Cypress, CA 90630 Name Alcorn Fence Co. Phone 714-744-9 ❑ < $1 million Railin -- - -9............................................................_...... ...............---- 447 ❑ < $5 million < $10 million . - -- -- - -- - - -...- - - - -- -- -- _ - - - - Address 1206 W Struck Ave. Fax 714-744-9415 El < $15 million ® > $15 million , ,-. ................ -. - ....................................................... City State ZIP Orange, CA 92867 Name Western Paving Phone ❑ < $1 million - ............................... . ...----.......------....-.....------ -- - - --- ------................----- 626-338-7889 Fax 626-338-3799 ❑ < $5 million < $10 million ❑ < $15 million Paving Address 15533 E. Arrow HwyEl City State ZIP Irwindale, CA91706 ■❑ > $15 million Distribution: 1) Original - Local Agency File Page 1 of 2 DLA-OB 13-06 C-26 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Naive/ Phone/ =Annual`Gross` Address/ Ci ' ,State; ZIP m Fax Receipts rr N Name R.R. Leonard Co. Phone ❑ ❑ < $1 million < $5 million 562-941-2288 El <$1million, Address 1910 Shoemaker Ave Fax 562-941-2028 ■❑ ❑ < $155 million > $15-million— City State ZIP Santa Fe Springs, CA 90670 Name ACL Construction Company p y Phone El< 0 $1 million <$5 million 909-391-4477 El < $10 million Address 207 W. State St. Fax 909-391-4472 ❑ ❑ < $15 million > $15 million City State ZIP Ontario, CA 91709 Name Phone ❑<$1 million ❑ < $5 million ❑ < $10 million Address Fax ❑ < $15 million ❑ > $15 million tia<, City State ZIP Name Phone ❑ < $1 million ❑ < $5 million ❑ < $10 million Address Fax ❑ < $15 million City State ZIP ❑ > $15 million Distribution: 1) Original - Local Agency File Rebar Barrier Railing ortion of Work to be Performed Y Page 1 of 2 DLA-OB 13-06 C-26 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Firm -Name/ - _ z Phone/ Address/ Fax Annual Gross Receipts Description of Portion of Work to be Performed 401 City, 9tate, ZIP 1,7 Name Phone ❑ < $1 million Railing 14 CraneVe or Corp 626-442-1524 ❑ < $5 million �mi g M ............. ...................................................... ... .. Address ❑ < $10 million%S 1524 North Potero Ave.................. _..................... _..__.......................................... Fax ❑ < $15 million E. City State ZIP 626-442-7308 ❑■ > $15 million Aef�rs El Monte, CA 91733 y �� E _..............., Name Phone ❑ < $1 million Traffic Control � BC Traffic Specialist ......................._......._....... ......................................................................-..-.._...... (' 714-974-1190 ❑ < $5 million Nt Address 638 W Southern Ave. El< $10 million _ It8 ' Fax < $15 million .. .. ...-..--....... ........................-..............._.... - City state ZIP714-974-1753> $1s million Orange, CA 92865 Name Phone ❑ < $1 million Paving FA& All American As haltp951-736 7600 ❑ < $5 million .........-............... .. ..... ................... ... .. _.......... Address400 E. 6th St. ❑ < $10 million Fax ❑ < $15 million _......... - ..........City State ZIP 951-379-4671 ❑® > $15 million Firm r0ft _ Corona, CA 92878 '' d Name Phone ❑ < $1 million ❑ < $5 million Address ❑ < $10 million Fax ❑ < $15 million City State ZIP ❑ > $15 million Distribution: 1) Original — Local Agency File Page 2 of 2 DLA-OB 13-06 August 12, 2013 C-27 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5161(169) C.C. No. 1356 July 1, 2014 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356: The following Project Plan sheets, originally advertised on 6/19/2014, shall be respectively replaced by the attached Project Plan sheets APPROVED BY TRANSPORTATION ENGINEERING on 7/01/14: • SHEET NO.4 OF 14 (TC1) TRAFFIC CONTROL PLAN 1 • SHEET NO.5 OF 14 (TC2) TRAFFIC CONTROL PLAN 2 • SHEET NO.6 OF 14 (TC3) TRAFFIC CONTROL PLAN 3 • SHEET NO.7 OF 14 (TC4) TRAFFIC CONTROL PLAN 4 • SHEET NO.8 OF 14 (SS1) SIGNING AND STRIPING PLAN 2. The Federal Labor Rates contained in Appendix I — Part 2 of the Project Specifications for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 06/20/2014). The attached FEDERAL LABOR RATES (Publication Date 06/20/2014) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 1, 2014'. John S. Meek Company, Inc. Company Name July 9, 2014 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 Jonathan Claudio at (714) 536-5431. 13 BID BOND KNOW ALL MEN BY THESE PRESENTS, that we John S. Meek Company, Inc. -14732 So. Maple Ave., Gardena, CA190248 as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 9737 Great Hills Trail, Suite 320, Austin, Tx 78759, as surety, hereinafter called the "Surety," are held and firmly bound unto City of Huntington Beach, Public Works Department as obligee, hereinafter called the Obligee, in the sum of ten percent of the total bid 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 Warner Avenue Bridge Preventative Maintenance (over Bolsa Chica Channel). NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 60 days of the date hereof. SIGNED, sealed and dated this 7th day of Jam, 2014. John S. Meek Company, Inc. (Principal) BY: TITLBa rIlf re ILL SureTec Insurance Company BY: Sc M. Mi e, Attorney -in -Fact Bid Bond Uncapped Rev 1.1.06 CIVIL CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of DeA .Ia g On D vq l `i before me, L� Date Here Insert Name and Title of the dfficer personally appeared � � +--M4l 1 _kl g� Name(s) of Signer(s) fiAICHELE A. FanRUK Commission # 2062160 x Notary PuMIc - California a a Orange County n My Comm. Expires Mar 23, 201 who proved to me on the basis of satisfactory evidence to be the personal whose name( is/�re subscribed to the within instrument and acknowledged to me that he/sgeft� executed the same in his/her*reir authorized capacity(ie , and that by his/b.reir signatures} on the instrument the person*, or the entity upon behalf of which the persons} acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my h and official seal4_a�ar� Place Notary Seal Above Signature: 1 �dxz" Signature of Nb6ryPublic OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s)': ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: '�4V4�✓,ti4� �� '� 6� 'y '+yam: � �.14�4�✓. '� �� �� �✓,•a �d4 ��4�Ga'4`�.4�4v��4��4'd4�4V4'y4'd6�i.�-� '�A�Now" POA #: 510083 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 Kevin S. Bogart, Scott M. Milne, Erik Johansson its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 10/31/2016 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 Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: in the name of and of behalf of the Company, to execute, acknowledge and Attorney -in -Fact may be given full power and authority for 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,, SUR.ETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 21 st day of March, A.D. 2013. pNlllllll Vln„� SURETEC INSURANCE COMPANY SVFANCF By. w : w j D= John ox Jr resident State of Texas ss: County of Harris ` 'r• On this 21 st day of Nlarr.h, A.D. 2013 before me personally came John Knox Jr.; tome known, who, being by me duly sworn, did depose and say, that he resid1cs 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. I(& JACQUELYN MALDONADO Notary Public nState oiTezas My Comm. Exp. 5/18/2017 JacgVielyn Maldonado, Notary Public My commission expires May 18, 2017 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. 7th July 2014A.D. Given under my hand and the seal of said Company at Houston, Texas this ^day of / — n Bredt Beaty, Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of Calif nia County 04tW On4 before me, , 0 ' Date 1- re sert Name and Title of t e Officer A.,PX personally appeared ° Name(s) of Signer(s) ANNA LISA PAILA Commission # 1978245 Notary Public - California z z ' �'� z z �' ' Los Angeles County D My Comm. Expires May 14, 2016 who proved to me on the basis of satisfactory evidence to be the personW whose name(g) is/are subscribed to the within instrument and acknowledged. to me that he/sl4/they executed the same in his/her/their authorized capacity(ieig), and that by his/he6th& signature(4 on the instrument the person(s), or the entity upon behalf of which the person(g) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand official seal. Place Notary Seal Above Signature: Si nature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: L0.✓G�4v4`y,.tiy � �✓4'y.',ti4�4����!4�4��'.G'✓i•�.��✓,4�/�/.��.4'.•✓4�4�/�✓ -y4'e� •✓G'v4�4� � ��' •yG� 'ei �y.'e� e�4•ti4�4�G�G�G'a'G'.3�=y Lo • • • • • • • • i i i • • i • JOHN S. COMPANY, INC. 14732 So. Maple Avenue Gardena, CA 90248 j City of Huntington Beach City Clerk — Second Floor 2000 Main Street Huntington Beach, CA 92648 131D ENCLOSED for the construction of WARNER AVENUE BRIDGE PREVENTATIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) Federal Aid Project BPMPL — 5181 (169) C.C. No. 1356 l4ia'1 CY�frs.• '8'9....... ,J ,_..1..�._ an inn.. Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language FHWA-1273 -- Revised May 1, 2012 REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS I. General II. Nondiscrimination III. Nonsegregated Facilities IV. Davis -Bacon and Related Act Provisions V. Contract Work Hours and Safety Standards Act Provisions VI. Subletting or Assigning the Contract VII. Safety: Accident Prevention VIII. False Statements Concerning Highway Projects IX. Implementation of Clean Air Act and Federal Water Pollution Control Act X. Compliance with Governmentwide Suspension and Debarment Requirements XI. Certification Regarding Use of Contract Funds for Lobbying ATTACHMENTS A. Employment and Materials Preference for Appalachian Development Highway System or Appalachian Local Access Road Contracts (included in Appalachian contracts only) I. GENERAL 1. Form FHWA-1273 must be physically incorporated in each construction contract funded under Title 23 (excluding emergency contracts solely intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require its inclusion in all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services). The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Form FHWA-1273 must be included in all Federal -aid design -build contracts, in all subcontracts and in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services). The design -builder shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Contracting agencies may reference Form FHWA-1273 in bid proposal or request for proposal documents, however, the Form FHWA-1273 must be physically incorporated (not referenced) in all contracts, subcontracts and lower -tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 2. Subject to the applicability criteria noted in the following sections, these contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and FHWA. 4. Selection of Labor: During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal -aid highway unless it is labor performed by convicts who are on parole, supervised release, or probation. The term Federal -aid highway does not include roadways functionally classified as local roads or rural minor collectors. II. NONDISCRIMINATION The provisions of this section related to 23 CFR Part 230 are applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The provisions of 23 CFR Part 230 are not applicable to material supply, engineering, or architectural service contracts. In addition, the contractor and all subcontractors must comply with the following policies: Executive Order 11246, 41 CFR 60, 29 CFR 1625- 1627, Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The contractor and all subcontractors must comply with: the requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3. Note: The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60, and 29 CFR 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), and Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The following provision is adopted from 23 CFR 230, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements. 1. Equal Employment Opportunity: Equal employment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 1630, 29 CFR 1625-1627, 41 CFR 60 and 49 CFR 27) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract. In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO: a. The contractor will work with the contracting agency and the Federal Government to ensure that it has made every good faith effort to provide equal opportunity with respect to all of its terms and conditions of employment and in their review of activities under the contract. b. The contractor will accept as its operating policy the following statement: "it is the policy of this Company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre -apprenticeship, and/or on- the-job training." 2. EEO Officer: The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so DLA-OB 13-06 Page 8 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action, or who are substantially involved in such action, will be made fully cognizant of, and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and its implementation will be reviewed and explained. The meetings will be conducted by the EEO Officer. b. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer, covering all major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor. c. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's procedures for locating and hiring minorities and women. d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees. e. The contractor's EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of meetings, employee handbooks, or other appropriate means. 4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees the notation: "An Equal Opportunity Employer." All such advertisements will be placed in publications having a large circulation among minorities and women in the area from which the project work force would normally be derived. a. The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minorities and women. To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority and women applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, the contractor is expected to observe the provisions of that agreement to the extent that the system meets the contractor's compliance with EEO contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions. c. The contractor will encourage its present employees to refer minorities and women as applicants for employment. Information and procedures with regard to referring such applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without regard to race, color, religion, sex, national origin, age or disability. The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to insure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage practices. c. The contractor will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is found, the contractor will promptly take corrective action. If the review indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly investigate all complaints of alleged discrimination made to the contractor in connection with its obligations under this contract, will attempt to resolve such complaints, and will take appropriate corrective action within a reasonable time. If the investigation indicates that the discrimination may affect persons other than the complainant, such corrective action shall include such other persons. Upon completion of each investigation, the contractor will inform every complainant of all of their avenues of appeal. 6. Training and Promotion: a. The contractor will assist in locating, qualifying, and increasing the skills of minorities and women who are applicants for employment or current employees. Such efforts should be aimed at developing full journey level status employees in the type of trade or job classification involved. b. Consistent with the contractor's work force requirements and as permissible under Federal and State regulations, the contractor shall make full use of training programs, i.e., apprenticeship, and on- the-job training programs for the geographical area of contract performance. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. The contracting agency may reserve training positions for persons who receive welfare assistance in accordance with 23 U.S.C. 140(a). c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of employees who are minorities and women and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for minorities and women. Actions by the contractor, either directly or through a contractor's association acting as agent, will include the procedures set forth below: a. The contractor will use good faith efforts to develop, in cooperation with the unions, joint training programs aimed toward qualifying more minorities and women for membership in the unions and increasing the skills of minorities and women so that they may qualify for higher paying employment. b. The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. c. The contractor is to obtain information as to the referral practices and policies of the labor union except that to the extent such information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the contractor, the contractor shall so certify to the contracting agency DLA-OB 13-06 Page 9 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language and shall set forth what efforts have been made to obtain such information. d. In the event the union is unable to provide the contractor with a reasonable flow of referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability; making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to provide sufficient referrals (even though it is obligated to provide exclusive referrals under the terms of a collective bargaining agreement) does not relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from meeting the obligations pursuant to Executive Order 11246, as amended, and these special provisions, such contractor shall immediately notify the contracting agency. 8. Reasonable Accommodation for Applicants / Employees with Disabilities: The contractor must be familiar with the requirements for and comply with the Americans with Disabilities Act and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. 9. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract. a. The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract. b. The contractor will use good faith efforts to ensure subcontractor compliance with their EEO obligations. 10. Assurance Required by 49 CFR 26.13(b): a. The requirements of 49 CFR Part 26 and the State DOT's U.S. DOT -approved DBE program are incorporated by reference. b. The contractor or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT -assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy as the contracting agency deems appropriate. 11. Records and Reports: The contractor shall keep such records as necessary to document compliance with the EEO requirements. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work and shall be available at reasonable times and places for inspection by authorized representatives of the contracting agency and the FHWA. a. The records kept by the contractor shall document the following: (1) The number and work hours of minority and non -minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment opportunities for minorities and women; and (3) The progress and efforts being made in locating, hiring, training, qualifying, and upgrading minorities and women; b. The contractors and subcontractors will submit an annual report to the contracting agency each July for the duration of the project, indicating the number of minority, women, and non -minority group employees currently engaged in each work classification required by the contract work. This information is to be reported on Forni FHWA-1391. The staffing data should represent the project work force on board in all or any part of the last payroll period preceding the end of July. If on-the-job training is being required by special provision, the contractor will be required to collect and report training data. The employment data should reflect the work force on board during all or any part of the last payroll period preceding the end of July. III. NONSEGREGATED FACILITIES This provision is applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The contractor must ensure that facilities provided for employees are provided in such a manner that segregation on the basis of race, color, religion, sex, or national origin cannot result. The contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's obligation extends further to ensure that its employees are not assigned to perform their services at any location, under the contractor's control, where the facilities are segregated. The term "facilities" includes waiting rooms, work areas, restaurants and other eating areas, time clocks, restrooms, washrooms, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees. The contractor shall provide separate or single -user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. IV. DAVIS-BACON AND RELATED ACT PROVISIONS This section is applicable to all Federal -aid construction projects exceeding $2,000 and to all related subcontracts and lower -tier subcontracts (regardless of subcontract size). The requirements apply to all projects located within the right-of-way of a roadway that is functionally classified as Federal -aid highway. This excludes roadways functionally classified as local roads or rural minor collectors, which are exempt. Contracting agencies may elect to apply these requirements to other projects. The following provisions are from the U.S. Department of Labor regulations in 29 CFR 5.5 "Contract provisions and related matters" with minor revisions to conform to the FHWA-1273 format and FHWA program requirements. 1. Minimum wages a. All laborers and mechanics employed or working upon the site of the work, will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Page 10 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph 1.d. of this section; also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, That the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under paragraph 1.b. of this section) and the Davis -Bacon poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. b. (1) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (i) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (ii) The classification is utilized in the area by the construction industry; and (iii) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (2) If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (3) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Wage and Hour Administrator for determination. The Wage and Hour Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30- day period that additional time is necessary. (4) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs 1.b.(2) or 1.b.(3) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. c. Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. d. If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. 2. Withholding The contracting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor under this contract, or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to Davis - Bacon prevailing wage requirements, which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the contracting agency may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. 3. Payrolls and basic records a. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. Page 11 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language b. (1) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the contracting agency. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee ( e.g. , the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available for this purpose from the Wage and Hour Division Web site at http://www.dol.gov/esa/whd/formstwh347instr.htm or its successor site. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to the contracting agency for transmission to the State DOT, the FHWA or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this section for prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records, without weekly submission to the contracting agency.. (2) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (i) That the payroll for the payroll period contains the information required to be provided under §5.5 (a)(3)(ii) of Regulations, 29 CFR part 5, the appropriate information is being maintained under §5.5 (a)(3)(i) of Regulations, 29 CFR part 5, and that such information is correct and complete; (ii) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations, 29 CFR part 3; (iii) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (3) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 3.b.(2) of this section. (4) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. c. The contractor or subcontractor shall make the records required under paragraph 3.a. of this section available for inspection, copying, or transcription by authorized representatives of the contracting agency, the State DOT, the FHWA, or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the FHWA may, after written notice to the contractor, the contracting agency or the State DOT, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. 4. Apprentices and trainees a. Apprentices (programs of the USDOL). Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Office of Apprenticeship Training, Employer and Labor Services or a State Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. If the Administrator determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. b. Trainees (programs of the USDOL). Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration. DLA-OB 13-06 Page 12 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. c. Equal employment opportunity. The utilization of apprentices, trainees and journeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR part 30. d. Apprentices and Trainees (programs of the U.S. DOT). Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal -aid highway construction programs are not subject to the requirements of paragraph 4 of this Section IV. The straight time hourly wage rates for apprentices and trainees under such programs will be established by the particular programs. The ratio of apprentices and trainees to journeymen shall not be greater than permitted by the terms of the particular program. 5. Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. 6. Subcontracts. The contractor or subcontractor shall insert Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. 7. Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. 8. Compliance with Davis -Bacon and Related Act requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein incorporated by reference in this contract. 9. Disputes concerning labor standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR parts 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. 10. Certification of eligibility. a. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). b. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). c. The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001. V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The following clauses apply to any Federal -aid construction contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be inserted in addition to the clauses required by 29 CFR 5.5(a) or 29 CFR 4.6. As used in this paragraph, the terms laborers and mechanics include watchmen and guards. 1. Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. 2. Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (1.) of this section, the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph (1.) of this section, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1.) of this section. 3. Withholding for unpaid wages and liquidated damages. The FHWA or the contacting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same DLA-OB 13-06 Page 13 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (2.) of this section. 4. Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (1.) through (4.) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1.) through (4.) of this section. VI. SUBLETTING OR ASSIGNING THE CONTRACT This provision is applicable to all Federal -aid construction contracts on the National Highway System. 1. The contractor shall perform with its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the contracting agency. Specialty items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractor's own organization (23 CFR 635.116). a. The term "perform work with its own organization" refers to workers employed or leased by the prime contractor, and equipment owned or rented by the prime contractor, with or without operators. Such term does not include employees or equipment of a subcontractor or lower tier subcontractor, agents of the prime contractor, or any other assignees. The term may include payments for the costs of hiring leased employees from an employee leasing firm meeting all relevant Federal and State regulatory requirements. Leased employees may only be included in this term if the prime contractor meets all of the following conditions: (1) the prime contractor maintains control over the supervision of the day-to-day activities of the leased employees; (2) the prime contractor remains responsible for the quality of the work of the leased employees; (3) the prime contractor retains all power to accept or exclude individual employees from work on the project; and (4) the prime contractor remains ultimately responsible for the payment of predetermined minimum wages, the submission of payrolls, statements of compliance and all other Federal regulatory requirements. b. "Specialty Items" shall be construed to be limited to work that requires highly specialized knowledge, abilities, or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid or propose on the contract as a whole and in general are to be limited to minor components of the overall contract. 2. The contract amount upon which the requirements set forth in paragraph (1) of Section VI is computed includes the cost of material and manufactured products which are to be purchased or produced by the contractor under the contract provisions. 3. The contractor shall furnish (a) a competent superintendent or supervisor who is employed by the firm, has full authority to direct performance of the work in accordance with the contract requirements, and is in charge of all construction operations (regardless of who performs the work) and (b) such other of its own organizational resources (supervision, management, and engineering services) as the contracting officer determines is necessary to assure the performance of the contract. 4. No portion of the contract shall be sublet, assigned or otherwise disposed of except with the written consent of the contracting officer, or authorized representative, and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the contract. Written consent will be given only after the contracting agency has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. 5. The 30% self -performance requirement of paragraph (1) is not applicable to design -build contracts; however, contracting agencies may establish their own self -performance requirements. VII. SAFETY: ACCIDENT PREVENTION This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. 2. It is a condition of this contract, and shall be made a condition of each subcontract, which the contractor enters into pursuant to this contract, that the contractor and any subcontractor shall not permit any employee, in performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety, as determined under construction safety and health standards (29 CFR 1926) promulgated by the Secretary of Labor, in accordance with Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 3704). 3. Pursuant to 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Secretary under Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C.3704). Vill. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers, contractors, suppliers, and workers on Federal -aid highway projects, it is essential that all persons concerned with the project perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or misrepresentation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these and similar acts, Form FHWA-1022 shall be posted on each Federal -aid highway project (23 CFR 635) in one or more places DLA-013 13-06 Page 14 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language where it is readily available to all persons concerned with the project: 18 U.S.C. 1020 reads as follows: "Whoever, being an officer, agent, or employee of the United States, or of any State or Territory, or whoever, whether a person, association, firm, or corporation, knowingly makes any false statement, false representation, or false report as to the character, quality, quantity, or cost of the material used or to be used, or the quantity or quality of the work performed or to be performed, or the cost thereof in connection with the submission of plans, maps, specifications, contracts, or costs of construction on any highway or related project submitted for approval to the Secretary of Transportation; or Whoever knowingly makes any false statement, false representation, false report or false claim with respect to the character, quality, quantity, or cost of any work performed or to be performed, or materials furnished or to be furnished, in connection with the construction of any highway or related project approved by the Secretary of Transportation; or Whoever knowingly makes any false statement or false representation as to material fact in any statement, certificate, or report submitted pursuant to provisions of the Federal -aid Roads Act approved July 1, 1916, (39 Stat. 355), as amended and supplemented; Shall be fined under this title or imprisoned not more than 5 years or both." IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. By submission of this bid/proposal or the execution of this contract, or subcontract, as appropriate, the bidder, proposer, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows: 1. That any person who is or will be utilized in the performance of this contract is not prohibited from receiving an award due to a violation of Section 508 of the Clean Water Act or Section 306 of the Clean Air Act. 2. That the contractor agrees to include or cause to be included the requirements of paragraph (1) of this Section X in every subcontract, and further agrees to take such action as the contracting agency may direct as a means of enforcing such requirements. X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal -aid construction contracts, design -build contracts, subcontracts, lower -tier subcontracts, purchase orders, lease agreements, consultant contracts or any other covered transaction requiring FHWA approval or that is estimated to cost $25,000 or more — as defined in 2 CFR Parts 180 and 1200. 1. Instructions for Certification — First Tier Participants a. By signing and submitting this proposal, the prospective first tier participant is providing the certification set out below. b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective first tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction. If it is later determined that the prospective participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the contracting agency may terminate this transaction for cause of default. d. The prospective first tier participant shall provide immediate written notice to the contracting agency to whom this proposal is submitted if any time the prospective first tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. e. The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," "principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). f. The prospective first tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. g. The prospective first tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions," provided by the department or contracting agency, entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. h. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (htti2s://www.epis.yov/), which is compiled by the General Services Administration. i. Nothing contained in the foregoing shall be construed to require the establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and DLA-®B 13-06 Page 15 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language information of the prospective participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. j. Except for transactions authorized under paragraph (f) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 2. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — First Tier Participants: a. The prospective first tier participant certifies to the best of its knowledge and belief, that it and its principals: (1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency; (2) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and (4) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. b. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Participants: (Applicable to all subcontracts, purchase orders and other lower tier transactions requiring prior FHWA approval or estimated to cost $25,000 or more - 2 CFR Parts 180 and 1200) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d. The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," 'principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions' refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant' refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant' refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (https://www.epls.aov/), which is compiled by the General Services Administration. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph a of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, . including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Lower Tier Participants: 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency. Page 16 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING This provision is applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 (49 CFR 20). 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 2. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 3. The prospective participant also agrees by submitting its bid or proposal that the participant shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such recipients shall certify and disclose accordingly. Page 17 of 22 DLA-013 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 12. FEMALE AND MIONORITY GOALS To comply with Section II, "Nondiscrimination," of "Required Contract Provisions Federal -Aid Construction Contracts," the following are goals for female and minority utilization goals for Federal -aid construction contracts and subcontracts that exceed $10,000: The nationwide goal for female utilization is 6.9 percent. The goals for minority utilization [45 Fed Reg 65984 (10/3/1980)] are as follows: MINORITY UTILIZATION GOALS Goal Economic Area (Percent Redding CA: 174 Non-SMSA (Standard Metropolitan Statistical Area) Counties: 6.8 CA Lassen; CA Modoc; CA Plumas; CA Shasta; CA Siskiyou; CA Tehama Eureka, CA 175 Non-SMSA Counties: 6.6 CA Del Norte; CA Humboldt; CA Trinity San Francisco -Oakland -San Jose, CA: SMSA Counties: 7120 Salinas -Seaside -Monterey, CA 28.9 CA Monterey 7360 San Francisco -Oakland 25.6 CA Alameda; CA Contra Costa; CA Marin; CA San Francisco; CA San Mateo 7400 San Jose, CA 176 CA Santa Clara, CA 19.6 7485 Santa Cruz, CA CA Santa Cruz 14.9 7500 Santa Rosa CA Sonoma 9.1 8720 Vallejo -Fairfield -Napa, CA CA Napa; CA Solano 17.1 Non-SMSA Counties: CA Lake; CA Mendocino; CA San Benito 23.2 Sacramento, CA: SMSA Counties: 6920 Sacramento, CA 16.1 177 CA Placer; CA Sacramento; CA Yolo Non-SMSA Counties 14.3 CA Butte; CA Colusa; CA El Dorado; CA Glenn; CA Nevada; CA Sierra; CA Sutter; CA Yuba Stockton -Modesto, CA: SMSA Counties: 5170 Modesto, CA 12.3 178 CA Stanislaus 8120 Stockton, CA 24.3 CA San Joaquin Non-SMSA Counties 19.8 CA Alpine; CA Amador; CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne Page 18 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 179 Fresno -Bakersfield, CA SMSA Counties: 0680 Bakersfield, CA CA Kern 2840 Fresno, CA CA Fresno Non-SMSA Counties: CA Kings; CA Madera; CA Tulare 19.1 26.1 23.6 Los Angeles, CA: SMSA Counties: 0360 Anaheim -Santa Ana -Garden Grove, CA 11.9 CA Orange 4480 Los Angeles -Long Beach, CA 28.3 CA Los Angeles 180 6000 Oxnard -Simi Valley -Ventura, CA 21.5 CA Ventura 6780 Riverside -San Bernardino -Ontario, CA 19.0 CA Riverside; CA San Bernardino 7480 Santa Barbara -Santa Maria -Lompoc, CA 19.7 CA Santa Barbara Non-SMSA Counties 24.6 CA In o; CA Mono; CA San Luis Obispo San Diego, CA: SMSA Counties 181 7320 San Diego, CA 16.9 CA San Diego Non-SMSA Counties 18.2 CA Imperial For each July during which work is performed under the contract, you and each non material -supplier subcontractor with a subcontract of $10,000 or more must complete Form FHWA PR-1391 (Appendix C to 23 CFR 230). Submit the forms by August 15. 13. FEDERAL TRAINEE PROGRAM For the Federal training program, the number of trainees or apprentices is This section applies if a number of trainees or apprentices is specified in the special provisions. As part of your equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types of trades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract part, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1 st year of apprenticeship or training. Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of journeymen in the various classifications within a reasonable recruitment area. Before starting work, submit to the City/County of Page 19 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 1. Number of apprentices or trainees to be trained for each classification 2. Training program to be used 3. Training starting date for each classification Obtain the City/County's of approval for this submitted information before you start work. The City/County of credits you for each apprentice or trainee you employ on the work who is currently enrolled or becomes enrolled in an approved program. The primary objective of this section is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area. Show that you have made the efforts. In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status or in which the employee has been employed as a journeyman 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training Ask the employee if the employee has successfully completed a training course leading to journeyman status or has been employed as a journeyman. Your records must show the employee's answers to the questions. In your training program, establish the minimum length and training type for each classification. The City/County of and FHWA approves a program if one of the following is met: 1. It is calculated to: ■ Meet the your equal employment opportunity responsibilities ■ Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training, and it is administered in a way consistent with the equal employment responsibilities of Federal -aid highway construction contracts Obtain the State's approval for your training program before you start work involving the classification covered by the program. Provide training in the construction crafts, not in clerk -typist or secretarial -type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved, by the division office. Off -site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. The City/County of reimburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on -site training 2. For off -site training if the apprentice or trainee is currently employed on a Federal -aid project and you do at least one of the following: ■ Contribute to the cost of the training ■ Provide the instruction to the apprentice or trainee ■ Pay the apprentice's or trainee's wages during the off -site training period 3. If you comply this section. Page 20 of 22 DLA-®B 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language Each apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice's or trainee's skill 2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification or until the apprentice or trainee has completed the training program Furnish the apprentice or trainee: 1. Copy of the program you will comply with in providing the training 2. Certification showing the type and length of training satisfactorily completed 14. TITLE VI ASSURANCES During the performance of this Agreement, the contractor, for itself, its assignees and successors in interest (hereinafter collectively referred to as CONTRACTOR) agrees as follows: (1) Compliance with Regulations: CONTRACTOR shall comply with the regulations relative to nondiscrimination in federally assisted programs of the Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the REGULATIONS), which are herein incorporated by reference and made a part of this agreement. (2) Nondiscrimination: CONTRACTOR, with regard to the work performed by it during the AGREEMENT, shall not discriminate on the grounds of race, color, sex, national origin, religion, age, or disability in the selection and retention of sub -applicants, including procurements of materials and leases of equipment. CONTRACTOR shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the agreement covers a program set forth in Appendix B of the Regulations. (3) Solicitations for Sub -agreements, Including Procurements of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by CONTRACTOR for work to be performed under a Sub -agreement, including procurements of materials or leases of equipment, each potential sub -applicant or supplier shall be notified by CONTRACTOR of the CONTRACTOR'S obligations under this Agreement and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin. (4) Information and Reports: CONTRACTOR shall provide all information and reports required by the Regulations, or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the California Department of Transportation or FHWA to be pertinent to ascertain compliance with such Regulations or directives. Where any information required of CONTRACTOR is in the exclusive possession of another who fails or refuses to furnish this information, CONTRACTOR shall so certify to the California Department of Transportation or the FHWA as appropriate, and shall set forth what efforts CONTRACTOR has made to obtain the information. (5) Sanctions for Noncompliance: In the event of CONTRACTOR's noncompliance with the nondiscrimination provisions of this agreement, the California Department of Transportation shall impose such agreement sanctions as it or the FHWA may determine to be appropriate, including, but not limited to: (a) withholding of payments to CONTRACTOR under the Agreement within a reasonable period of time, not to exceed 90 days; and/or (b) cancellation, termination or suspension of the Agreement, in whole or in part. (6) Incorporation of Provisions: CONTRACTOR shall include the provisions of paragraphs (1) through (6) in every sub -agreement, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. Page 21 of 22 DLA-OB 13-06 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language CONTRACTOR shall take such action with respect to any sub -agreement or procurement as the California Department of Transportation or FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance, provided, however, that, in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub -applicant or supplier as a result of such direction, CONTRACTOR may request the California Department of Transportation enter into such litigation to protect the interests of the State, and, in addition, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. MAINTAIN RECORDS AND SUBMIT REPORTS DOCUMENTING YOUR PERFORMANCE UNDER THIS SECTION Page 22 of 22 DLA-OB 13-06 August 12, 2013 'r. CERTIFICATE OF LIABILITY INSURANCE � HIS CERT FICATE IS ESSUEDAS A MA'(icq OF INFORMATION ONLY AND CONFERS Pro RrCHTS UPON THE CER'IFICATE HOLDER. THIS CERTIFICATE: WES NOT AFFIRMATIVELY OR NEGAThiE:LY Amp —ND, FJCTEP.r_7: OR ALTER THE .CO EPAGE AFFORDED SY'THE POLICI€S BELOW. THIS CERTIFICATE OF.I"URANCE DQES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING ifd$URER(Sil ALITHORJZED RE'PRE SENTATIVE.OR PRODLfCEt?..AND THE CERTIFICATEHOLDER. .. '... ... . WPORTANM If the ce-tifica a hoicer Is an AIDDiT,CiNAI INSURED} he;N Iicy(il n=ust t:€ andcrsed. if SUBROGATIDN iS WAIVED SE -cct to { the ler N:, it€,:3 cak ditions of the poll y, certain policies n.ay require an rrrorse: ent. A staternent on this certificate riot's not confer rNt& to.t,_e 11 certificate holder in lieu of sucti'endoms rrentrs):. r auu c 101 €ar A cr ' Yw i i-. ti� 31'�uL .hr n tT .... 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"r7 .. ^ Y4�" f 1 ° _'.0.;:.W1 4� i-ldO1i ") rCrl�eEf :G +TATi"t°F � _ -i, A -201� ACORD CORPORATION: All rlplats reserved. ACORD_25 (20,14101 i The ACORD narne and lbao, arc rogirtered rtiarks of ACORD ENDORSEMENT NO:: 1 EFFECTIVE: 2!1f20,14 A .,. ATTACHED TO AND FORMING PART OF POLICY IYO.:r M kSILLA00000.1614 OF TH STARR'[NDrMNJTV & LIABILITY COMPANY. ISSUED TO: John S. MeekCompany. Inc... ADI)ITIONAI, ASSURED FND0RSEN1ENT. OWNERS; LESSEES OR CONTRACTORS —COMPLE Er) OPERATIONS. [1te "\ 'ho is an 1s•riccu",p.ovision is ameoded to'i cludc,as an addiJonal urssuied the ',personf } or olLmniiation(s) named beliiit; lout only with respect to liabilitk for injurt%' car "prc?pe ty daniagc caused. in whole or in;;oart. lid ih,: ,1ssured's Av6&"- at the .ocaltion deli -hated anal described• n the schedule, belotE performcd.iur:mat additieinal a; Lured and included in the pruduct� eojn +leted opc rations hazard Additional Assurefl: Location and Description of Completed Operations: C'i(V OFI[Uni-inaton Beach CC4356. Wanner Avemue Bridge Prevent ion'. Maintenance. lts officers, elected or appointed officials €?mplotices, agents and volunteers AI,L OTH Ell TF101S, CONDITIONSI LINiITAT1()LS AM) EXCLUSIONS REMAIN" t:\CII,'1SGED. rM�4 AUTHORIZED S,I(; CATIi12E STARR INDEMNITY & LIABILITY COMPANY F NDORSEMENT NO:; I EFFECTIVE: : /I:'2p1 A.M., ATT.AC14ED TO AItiD FORMING PART bF POLICYNO.: 11IASILLAO'0001614. OF THE:- STARR-INDEMNiTV &.LIABILITY COMPANY. ISSLjED'ro:'John 'S. Meek Company Inc. .ADDITION'At. AssuRED'F,:nDORSFAIENT OWNFRS; LESSEES OR CONTRACTOkS-SCFIFDt-LED YF:RSOti'OR'ORe. %%:, IZ KTf01\ A. -t-he provision is'aine nded to i ndude as; an add€tional assured the person(s);ot o pnira io .- c) named - vclowi but onk ivkh respect to habihivy for ?Dodil7 njur�g' . } ru}7e t� dania'e or "person:il..,a€td avvrti_ing itijtn" caused, in :hole, or in part.'bt: 1 :Acts or omissions,of thr Namcd Assured. or ?. Acts or otnissionsof those actir,:on the Nanied Assured's behalff,,. in the performance of the Nkmed Assur d"s m-,0ing operations ib the additional assuredts) f.t the locatii)n(�) desisnat d d I3- x iti€ re�}?cct t« the insurance: tTcird d to these additional a�ssureds the ti€iloMin € dditional exclu..oii apply'. T7iis in;arance dwo not apple to.:hodily €ntu l" or -prcip crt da€nave"occurring. after 1, :'!fl-N4ork, including natcnals.:part or -equipment furnished in connection': with such work, on the,proJeci (othi:-th-a€i service, maintenancc or rapairsi to be performed by or on behalf of the addit€onal.assured(s) at the;locatiean,of th; catered operations has been completed; or- "hiiat portion'of One 'lamed As,sured's.taork out of high the iniury or damap .rises has been putto its intended Use bx any person or or`ani.-WiOri ether than am)(ier contritctor or subconthictvr m2aped in puformin,- operatioiis l'or a. pri€icipal a% it part Of the a€ is project C. This tnsuraiice shall be pr itti try as respects the -1 abilities of the Named. Assured and non-contributory to any other'existing, Nalid and collectible, in urancc, This insurance shall apply Separately to each Assured aeaiiistwhom ctuhm is made orsuit is brought, butthe inciusion oftmeore"than Zane Assort shalt:not oper=ite to incre;tse the contptuly,.N limits of uabiltty, T , llre, Cor pane hereby Naives its r:_ltt of .subrogttion;.igaitlst the additional assured(s) named be-;i\;- lout o l� as respects;the coe ered operation, described herein. Additional Ass jred- Location of Covered Operations; City of-Iiuncinytc€tt.Beach C'C>-13�6, Warner Avenue 13i'idye Prevention Maintenance. Its ofwers, elected or appointed officials Eniplm es, agents and volunteers ALL 01 iIEW E RNIS, CONDITIONS; t,. mF7_, Ti0\S AND EXCLUSIONS 1.1N UNCHANGED. AUTHORIZED 5IGNA-r RE STARR I DE 4NITV & LIABILITY CONIPAaNY ACCORD® CERTIFICATE ®F LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/6/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Venbrook Insurance Services CA Lic OD80832 6320 Canoga Avenue 12th Floor Woodland Hills, CA 91367 NAME: CONTACT PHONE FAX a/c No Ext: 818-598-8900 a/c No: 818 598-8910 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Insurance Company 23043 www.venbrook.com INSURED John S. Meek Company, Inc. INSURER B: Starr Indemnity & Liability Company 38318 14732 South Maple Avenue INSURERC: INSURER D : Gardena CA 90248 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 21134764 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 0 OCCUR DAMA PREM SES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PDLICY PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY ✓ BAA(15)55924111 2/1/2014 2/1/2015 Ee aBINGLE LIMIT c"en S $ 1,000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED ✓ HIRED AUTOS ✓ AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N (Mandatory m NH) N / A ✓ 1000001090-0 1/1/2014 1/1/2015 �/ STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 B (USL&H/Jones) 1000001090-0 1/1/2014 1/1/2015 Ea. Acc 1M Dis/Empl. 1 M/1 M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Warner Avenue Bridge Preventative Maintenance Project CC-1356 City of Huntington Beach Its agents, officers, and employees are named as Additional Insured's under the Automobile Liability policy if required by written contract with the Named Insured but only for coverages and limits provided by the policy and the additional insured endorsement. *10 Days Notice of Cancellation for Non -Payment of Premium, 30 Days All Others. CERTIFICATE HOLDER CANCELLATION City Of Huntington ton Beach Y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Public Works Contract Administrator ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 190 2000 Main Street AUTHORIZED REPRESENTATIVE e/ J/� Huntington Beach CA 92648 C.(�s_k- (WH) Eileen Parnes ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 21134764 Mercedes Cedillo 8/6/2014 4:19:32 PM (PDT) Page 1 of 2 POLICY NUMBER:1000001090-0 NAMED INSURED: John S. Meek Company, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 1% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization As per written contract. Job Description As per written contract CERT NO.: 21134764 Mercedes Cedillo 8/6/2014 4:19:32 PM (PDT) Page 2 of 2 RECEIVED BY: (Name) (Date) TO: FROM: DATE: SUBJECT: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION City Treasurer City Clerk (? q // Y-/- Bond Acceptance I have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. Other No. g:/forms/bond transmittal to treasurer zC- (Company Name) .Z/ Approved F"V- (Council Approval Date Agenda Item No. City Clerk Vault No. SIRE System ID No. Bond No. 5186116 Premium: $8,808.00 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereinafter referred to as "City) has, by written agreement dated August _11th_ , 20 14 , entered into a contract with John S. Meek ComDau. Inc. 14732 So. Maple Ave. Gardena CA 90248 (name and address of Contractor) (hereinafter referred to as "Principal`), for performance of the work described as follows: Warner Avenue Bridge Preventative Maintenance over Bolsa (Project TWO) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to fumish a bond guaranteeing the prompt, full and faithful performance of said Contract. NOW THEREFORE, we, the undersigned, as Principal, and SureTec Insurance Company, 3033 5th Avenue Suite 300 San Diego CA 92103 (name and address of Surety) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as "Surety), as Surety, are held and firmly bound unto City in the penal sum of SIX HUNDRED AND EIGHTY FOUR THOUSAND EIGHT HUNDRED FIFTY THREE and 011D0_— Dollars ($ 684 853.00 ), this amount being not less than one hundred percent of the price set forth in the Contract, in lawful money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the Principal shall promptly, fully and faithfully perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall Indemnify and save harmless City and all of City's officers, agents and employees (hereinafter collectively referred to as "Obligees') from any and all losses, liability and damages, claims, judgments, stop notices, fees and costs of every description, whether Imposed by law or In equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract, including all alterations, amendments and modifications thereto, and any warranties or guarantees required thereunder, then this obligation shall be void; otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees, for value received, that no adjustment of the time or price in the Contract or any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract time or contract price, and PERFORMANCE BOND 277S".I Page I of 2 Bond No. 5186116 any other alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, and agrees to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations, changes, deletions, additions or other modifications. Surety agrees to provide written confirmation of such adjustments -in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code §§ 2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: August 11 th 2014 ATTEST John S. Meek Company Inc (Corporate Seal) (Principal Name) By: John "et In Name: ~' Title: esi ent ATTEST SureTec Insurance Company (Corporate Seal) (Surety Name) By. Scott M. Milne, Atto .5Uey-JrA Fact Name: y- (Si orney-in-Fact for Surety) (Attach Attorney -in -Fact Certificate) (619 ) 400-4100 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY qF. UNTINGTON BEACH ae�nnifer 6- ath M ty c 5f64 iAttorney Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attomey-in-fact must be attached. 277591.1 PERFORMANCE BOND Page 2 of 2 POAv. 510083 ureec InsuranceCompany 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 Kevin S. Bogart, Scott M. Milne, Erik Johansson its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 10/31/2016 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 Attomey(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 Attomey-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 21 st day of March, A.D. 2013. ,�ulllll,v,,,,,�^ SURETEC INSURANCE COMPANY +�SVFANCFe'ar X..�,., By: John ox Jr resident State of Texas ss: County oFHarris bMwMlMlli * ann�` On tnis 21st day of March, A.D. 2013 before me personally came John Knox Jr., tome known, who, being by me duly swom, did depose and say, that he resides in Hssuston, 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. MM DONADOlicas 11812017 Jacquelyn Maldonado, Notary Public My commission expires May 18, 2017 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 1 1 th ^day of August 79 2014 , A.D. Bredt Beaty; Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 C2�C.aC!s�2�C.v..� �C.•.��..�C.s�%v2.0 CC�'C�C.c�C�•.c�C..^�C�C�C .aC t.:�C State ofCalifornia /-i'UP� j County of _ On 4 before me, ate Here Insert Name and Title of the Off er personally appeared - % Name(s) of igner(s) who proved to me on the basis of satisfactory evidence to be the person(5'J' whose name,* is/4re- subscribed to the within instrument and acknowledged to me that he/sloe{-hgy executed the same in by MiCHELE A. FE DORUK DORUi0 his/hart De�authorized capacity(i�), and that the Commission his/ eir signature(e)- on the instrument Notary Public - California > person*,or the entity upon behalf of which the z Orange County person(s)-acted, executed the instrument. MI Comm. Expires Mar 23, 2018 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS official seal. Place Notary Seal Above Whaand Signature: Signature of Not ublic OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: �ei4 ei -ti4�4� � -✓4`�/4'✓4v "u'6'✓ '.•�4V -s.'d '✓ L4��ti4C�:� a:4�4C�'.'L6�r/.4 �4 ✓4v4v4� WWW"4v4'm�4-ai4�A CALIFORNIA ALL-PURPOSE POACKNOWLEDGMENT CIVIL •D CC a �C�Cs� � �C_u� � �C�C�C�C�C.� �•�C_c�C�C.•.�C�C� �C�C.c�C�C�C�C CGECC �C C�C� ..� �Cs� �Cc� �C��C�C..�C�C. State of Califor 'a County On 12 2VA-/ before me, Date I personally appeared ANNA LISA PAILA Commission # 1978245 Notary Public - California z z • •_� ' Z "' Los Angeles County D My Comm" Expires May 14. 2016 f�ere Irliert Name and Title of Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(aj, whose name( is/are subscribed to the within instrument and acknowledged to me that he/sloe/they executed the same in his/h,e/tbeir authorized capacity(ieg), and that by his/her/their signature(g) on the instrument the person*, or the entity upon behalf of which the person(o 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 nd official seal. Place Notary Seal Above Signature: v Si nature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: L4��.5�✓.4�4'✓4V4�4�4�.4�✓4�0�✓4�4�✓,4�4�4�4�✓,4�. y. ✓.4�ti✓.4� 4�ti4�4'✓4�4�✓,� ✓4�✓4�4�✓,4\5.�4'�'4�4" 4=21_4:*4�4�G�✓.4�4�4 Bond No. 5185116 PAYMENT BOND Premium included in performance bond. (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS, the City of Huntington Beach (hereinafter referred to as "City") has awarded to John S. Meek Company, Inc. - 14732 So. Maple Ave., Gardena, CA 90248 (name and address of Contractor) (hereinafter referred to as "Principal"), a contract ("Contract') for the work described as follows: Warner Avenue Bridge Preventative Maintenance (over Bolsa Chico Channel) CC-1356 (project title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW THEREFORE, we, the undersigned Principal, and SureTec Insurance Company, 3033 5th Avenue Suite 300 San Diego, CA 92103 (name and address of Surety) (a duly admitted surety Insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of SIX HUNDRED AND EIGHTY FOUR THOUSAND EIGHT HUNDRED FIFTY THREE 01100 dollars, ($ 684,853.00 __), this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code ("Claimants") for all labor, materials or services used or reasonably required for use in performance of the work described in the Contract, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the 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 received, that no change, extension of time, alteration, addition or modification to the terms of the Contract, or any contract document or any work to be performed thereunder, whether made after notice or not, shall in any way affect, Impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such .change, 277599.1 - PAYMENT BOND Page it of 2 Bond No. 5186116 extension of time, alteration, addition, or modification to the terms of the Contract, the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEROF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: —August 11th, 2014 ATTEST (Corporate Sea[) ATTEST (Corporate Sea[) (Attach Attorney -in -Fact Certificate) John S. Meek Company Inc. (Principal Name) /zBy: lLilt- Name: Its: Prelsident SureTec Insurance Company (Surety Name) --- , ��6 - k---- By: Na e: Scott M. ilne, Attorney- In- Fact" IS'ignature of Attorney -in -Fact for Surety) 6{ 19) 400-4100 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH By. ennifer M rath 1 � � ��f ��66 ity Attorney Note: This bond must be executed in duplicate and dated, ail signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached. 277589.1 PAYMENT BOND - Page 2 of 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of California County of On before me, Here Insert Name and Title of the personally appeared c/1'1 1-1 1 N 1 , hj (,.jj L, Name(s) of Sgner(s) who proved to me on the basis of satisfactory evidence to be the person(o whose name(W is/aro' subscribed to the within instrument and acknowledged to me tl�h t he/she?f a executed the same in his/4elnheir by authorized capacitand that y MICHELE A. FEOORUK "� his/her�ir signature on the instrument the • Commission 0 2062160 Z . �+ Notary Public - California z personK,' or the entity upon behalf of which the Z Orange County ' person*acted, executed the instrument. My Comm. Expires Mar23, 2018+ I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my haAd and official 161. Place Notary Seal Above Signature: t Signs ure of Not ublic OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: L4`y,'4'y4�t/4�✓,4�✓4'� -cam -v 'ei4�4�4�=:6�i.J4�4��':'4V ��4'U4�4�4'y ��4'✓4�4'el4`✓4�.4�6��=�.'y4�4'e.4's�4'✓4'y4� 'a' ✓G'v/G� ✓ �✓4n'4_ • • . • • ISM 10ne • • i i i • • i • POA#: 510083 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 Kevin S. Bogart, Scott M. Milne, Erik Johansson its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 1013112016 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 Attomey(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, 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 20M 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 21 st day of March, A.D. 2013. SURETEC INSURANCE COMPANY RAN 0' By: John oz Jr: resident State of Texas ss: County of Harris r°S On this 21 st day of March, A.D. 2013 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he r=sides 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. �t,arrua�, JACOUELYN MALDONAD0 Notary Public State of Texas J'•F ov ��� My Comm. Exp. 511812017 Jacq elyn Maldonado, Notary Public My commission expires May 18, 2017 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 11 th day of August / 201 4 , A.D. Bredt Beaty, Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL • . State of California County oA e�;� On kd1 - 12 2Qi before me, L Date t' 1 #/-C' ) personally appeared ANNA LISA PAILA Commission # 1978245 z@My Notary Public - California zLos Angeles County Comm. Expires May 14, 2016 Name and Title Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person* whose name* is/afe subscribed to the within instrument and acknowledged to me that he/sbm/they executed the same in his/her/th& authorized capacity(iea), and that by his/herr/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(45) 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. Place Notary Seal Above Signature: S nature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: LL�✓,G�.'yG't>G�✓G�✓, r�G'e:G�'�4vL'e.G'✓�G�G�G�1.G�G�'A;��L�G`�!Gv4�✓G�✓. '�'i.`yi-di-✓L�G�.'✓G�tiGC� uG�,:�GC✓G'tiG'✓G�G�1�:�� Certification of Compliance with Prevailing Wage Lays To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification .of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of 20 , at (Type Contractor Name) By. Name: [Type Name] Title: [Type Title] California. -TLS o3- ab • tstp 247542_1 CONTRACTOR'S CERTIFICATE I, , state and certify that: (Name of Declarant) l . is the general contractor to the City of Huntington Beach C City') on Contract No. _ (the "Contract") for the construction of the public work of improvement entitled: (the "Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3_ Except for the claims listed.below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract,- have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at on this day of , 20 (Signature of Declarant) APPROVED AS TO FORM By: f t -) f a -1tJ 3. Name: [Type Name] Title: [Type Title] 245914.1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20_, at , California. (Type Contractor Name) By: Name: [Type Namej Title: [Type Title] E > IF R A t�RNEY I-L) 3-2�6-CP 245911.1 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk September 10, 2014 John S. Meek Company, Inc. 14732 So. Maple Ave. Gardena, CA 90248 Re: Warner Ave. Bridge Preventative Maintenance — CC-1356 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. JF:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand T Dept. ID PW 14-046 Page 1 of 2 Meeting Date: 8/4/2014 CITY OF HUNTINGTON BEACH REQUEST FOR. CITY COUNCIL ACTION MEETING DATE: 8/4/2014 SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Award and authorize execution of a construction contract in the amount of $684,853.00 to John S. Meek Company, Inc., for the Warner Avenue Bridge Preventive Maintenance, CC-1356; approve an appropriation of $170,000 from Gas Tax funds; and, approve the withdrawal of the apparent low bidder Statement of Issue: On July 10, 2014, bids were opened for the Warner Avenue Bridge Preventive Maintenance, CC- 1356. Staff requests that the City Council award the contract to John S. Meek Company, Inc., the lowest responsive and responsible bidder. Financial Impact: A total of $620,000 is budgeted in the BPMP Account Nos. 21390010 and 97085001. Approximately 88% of eligible construction costs will be reimbursed to the City through Bridge Preventive Maintenance Program (BPMP) grant funds, up to a maximum of $580,757. Recommended Action: A) Approve withdrawal of the apparent low bid from Peterson -Chase GEC, Inc.; and, B) Accept the lowest responsive and responsible bid submitted by John S. Meek Company, Inc., in the amount of $684,853.00; and, C) Approve an appropriation of $170,000 from the undesignated Gas Tax fund balance to Account 20785412.82800; and, D) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids, and provide staff with alternative direction. Analysis: The Warner Ave. Bridge was constructed in 1981. Parts of the bridge have deteriorated due to vehicular traffic and from tidal flux over the last three decades. This preventive maintenance .project will remove and replace: 1) the concrete barrier and chain link railing on both sides of the bridge; 2) the asphalt pavement and seal the underlying bridge deck; 3) unsound concrete at the bridge bents and columns; and 4) replace missing rock slope protection to prevent further embankment erosion. BPMP grant monies will fund approximately 88% of eligible construction costs up to a maximum $580, 757. ii B -2 9- Item 9. - I Dept. ID PW 14-046 Page 2 of 2 Meeting Date: 8/4/2014 Bids were opened publicly on July 10, 2014. The verified bid amounts are listed below: Bidding Contractor Verified Bid Amount Peterson -Chase GEC, Inc.* $540,749 John S. Meek Company, Inc. $684,853 Beador Construction Co. $690,300 Powell Constructors Inc. $714,215 Los Angeles Engineering Inc. $854,040 M.S. Construction Mgmt. Group $906,819 Future DB International Inc. $991,324 *Bidder requested relief from its bid On July 14, 2014, the apparent low bidder, Peterson -Chase GEC, Inc., submitted a written request to be relieved from its bid due to a clerical error that resulted in a substantially lower bid price than intended (see Attachment 2). Accordingly, the City may consent to give the bidder relief and withdraw its bid pursuant to Public Contracts Code Section 5101. Staff found the bid package received from the second apparent low bidder, John S. Meek Company, Inc., to be acceptable and mathematically accurate. The reference check for John S. Meek Company, Inc. provided acceptable responses from past clients. Therefore, staff recommends award of the construction contract to John S. Meek Company, Inc., in the amount of $684,853.00. The project management, construction contract, contingency, and supplemental costs are estimated at $790,000. Consequently, a budget appropriation of $170,000 is requested from the Gas Tax fund. Public Works Commission Action: The Public Works Commission reviewed and approved that the Warner Avenue Bridge Preventive Maintenance, CC-1356 was in general conformance with the previously approved CIP on May 21, 2014, with a vote of 6-0-0. Environmental Status: A Categorical Exclusion was approved on March 29, 2012, in compliance with NEPA. Mitigated Negative Declaration No. 12-06 was approved on November 7, 2012, in compliance with CEQA. Strategic Plan Goal: Improve the City's infrastructure Attachment(s): 1. Location Map 2. Peterson -Chase GEC, Inc. correspondence dated July 11, 2014 Item 9. - 2 11B -250- I ICI ITY P W "T_S. r+ CD W r.,s � *.fit s \ T ►, r: TO: City of Huntington Beach Deaprtment of Public Works 2000 Main St Huntington Beach CA 92648 EMAIL: ATTN: JONATHAN CLAUDIO JOB#: CONTRACT #: C.C. NO. 1356 6 SUBJECT: Relief of Bid Request C.C. No. 1356 PH#: (949) 252-0441 FAX#: (949) 252-0266 Peterson Chase hereby submits our Relief of Bid Request for Contract # C.C, No. 1356, bid opening date 7/10/14 for the following reasons: - We hereby notify the City of Huntington Beach that a mistake was made in the our bid for this contract. 1 41, - The mistake in filling out the bid was in Bid Item # 26 - "Seal Concrete Bridge Deck". The intended unit price was $15.00 per square foot, not the $1.50 per:SF written in the bid document. The result was our bid being too low in the amount of ($15.00 - $1,50 = $13.50 difference times 6,480 SF) $ 87,480M (16.2% of the total bid). Accordingly, due to the error in filling out the bid form for bid item 26, Peterson Chase's bid total was $87,480.00 too low. We respectfully request for relief of bid, and the Cityof Huntington Beach should award this contract to the next responsible bidder. Please call if questions arise. Sincerely, /Dick ogels `--Vr66 President Item 9. - 4 1 IB -252- CITY OF I3LTNTINGI'ON BEACH PROJECT NAME: Warner Ave. Bridge Preventive Maintenance CC#: 1356 BID OPENING DATE: 7/10/2014 TIME & LOCATION: 2:00pm ENGINEER'S ESTIMATE: $580,206.00 BIDS SUBMITTED (AS READ AT OPENING) BIDDER'S NAME FINAL APPARENT BID RANK AMOUNT All American Asphalt -'Seat #2 Beador Construction Co;: CC Myers, Inc. Excel Paving Futwre'DB International Inc.' -� A Highland Construction, Inc. John S. Meek�i- Los Angeles Engineering Inc. 2 M.S. CONSTRUCTION MGMNT. GROUP 0OA/ k✓61 O'Donnell Construction, Inc Peterson Chase GEC, Inc.t PowellConstructors Inc. 0 Reyes Construction, Inc. CIPP Version 7 CC1356.x1sm X", eta v38 �dOIDNIIN(IH AIIO I S J Idd 01 in "tilt o �n - tlC .arnrn IK z� .. C7 r' o x o SECTION A NOTICE INVITING SEALED BIDS for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated project and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach; California 92648, up to the hour of 2:00 P.M. on July 10, 2014. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $30.00 nonrefundable fee if picked up, or payment of a $50.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). This is a Davis -Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code, Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. All extensions of unit prices will be subject to verification by the AGENCY. In the case of a discrepancy between the unit price and the extended amount, the unit price will govern. A- 1 The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: This bridge preventive maintenance project consists primarily of the removal and replacement of:. the concrete barriers, chain link railing, asphalt pavement overlay, unsound concrete at the bridge bents and columns, the replacement of missing rock slope protection in the channel, and appurtenant work as required. The contract allows the Contractor 130 working days to complete the contract. The engineer's estimate of probable construction cost for the work included in the basis of award is $580,206. The Project Disadvantage Business Enterprises (DBE) goal is 13%. The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 3rd day of September 2013, by Resolution No. 2013-48. Attest: Joan L. Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH A- 2 2000 Main Street P.C. Box 190 Huntington Beach, CA 92648. Attention: Joan L. Flynn To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 Fax (714) 374-1573 Date: June 16, 2014 ProjectIC.G. No.: C.C. No. 1356 Regarding: Warner Ave, Bridge Preventive Maintenance 117 We are sending you: ❑ By Mail ❑ By Fax Mail (Number of pages including this sheet:)_ I QWe are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: QShop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications F]Copy of letter ❑ Change Order Z Other: Notice Inviting Sealed Bids item Description 1 1 2 NISB for Warner Ave, Bridge Preventive Maintenance (Word. doc) 2 1 2 NISB for Warner Ave. Bridge Preventive Maintenance (pdo 3 These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval NFor your use ❑ Approved as noted ❑ Submit copies for distribution ❑ For your action ❑ Returned for corrections ❑ Return— corrected prints ❑❑ For reviewlcomment ❑ Other: Remarks- Per Resolution 2013-49 (adopted on September 3, 2013), the City Council authorized the advertisement of the above listed street improvement project. Please find attached the Notice Inviting Sealed Bids for advertisement on 6/19/14, 6/26/14 & 7/3/14. The public bid opening is scheduled for 2:00 P.M. on Thursday, July 10, 2014. Please contact me at 374-5380 with any questions you may have regarding this. By - Jonathan Claudio, Senior Civil Engineer c: file GACONSTRUCMON CONTRACTS (CCS)\CC1356 WAF.vex BPJDGEREHABILiTATIONPROGRAM\ENGINEERING\ADvERTisEmENT\NISB TRANSWrrAL TO CLERK - CC-1356.130C 'Los Timle;� An-ades _ Order ,• GROSS PRICE * : $607.36 PACKAGE NAME: Legal-HBl-Bids Waniorl Product(s): Huntington Beach Independent, hbindependent.com, CApublicnotice.com_HBI AdSize(s): 2 Column, Run Date(s): Thursday, June 19, 2014, Thursday, June 26, 2014, Thursday, July 03, 2014 Color Spec. B/W Preview a, rp� t dy ifl real ' 16ffi`ti ct7e € ce'e�t ltre Jly.: ^� �r ����r It'��i���� klsdjr�5tr-v, Fpa n��� G'aVqrrrtKa. 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Nrtiu asp of a dis" t,paY�, t e't.eet thy° t piricJGiii itt ntfed amount, tf,e un pfice Mil pazi o. The n:d nttrsr kip a,mr npatied'byac(�i��red therk hies k, it b deb'' b,Dru rraa4. payable tG lh A EUC for �n ai oun, rro It t:;tl,an .. rise airiic.r,t Ud, Tri s ccr}5 1 tri3dc�r.3hata'he ilcers r� in" �".YII��B�iM'd°'i"�i,l�'I�IwwyKY�V+Gl1a �� 61 a liuslftMss.'anri i°"Ifl.rl,l"ift5 �4ri",'a+YYs;1 `I pus�ess a;S a lar�krac'nr s lti a C!ass; A at,th timeof i 'tad up rrfr TrW i; ens Wl' Ccntradaf allldllfils S~ehrdi;r actcIa will 6 r �ti sd t pgises-s urllr sS Ei snare? :frrr rt'C AG, u!'C . ro:silty pltfftariiy Gf tl :re wval;any Mep.x; :'r1pni,�pf the r-rerNt Barr grs �a ,ijn raiilrlg,: Cric�S�t c aps; e- eMyr xosdandtmciiif at �r�td l�ndae befft�� �Y n +-�iffrrtn , tl�e �repiacemen6 Y��f -nYss�n r�£f� sI�ttY�e reti'14r a .if e ;cannel, arc agp,,wrfenant ti ark �s re"Fr. theCtrargpr 14 4,�r1 ir,g dar'atstb he` r eefrs_ t at rdhabl :coe9stru fin. t fdr the ti et'�: Y d0,cJ tr the t awl of dl'i k $ 80, 0 , � t rCSf eS fle 1 ik r�l ,ttf�inGrdil h4 5 t� 1sa exarif f�r�dralal4rti and �,Y ake uid'ipi �"Y,v�wor°;'a�dfwsls�n�e: tort � �,�'sV�ime� pfV!p,11 CY .°'rFwn 1.'':- �«� J°'S'�i lii�ll �:$"'.,..., finz Ar, 6i1t,-.`wrTAA, ZCA5sg Printed: 6/17/2014 9:38:46 AM Page 2 of 3 * Agency Commission not included EosAnOdes iVM6 • •- • GROSS PRICE * : $607.36 PACKAGE NAME: �LAegal-HBl-Bids CFi`31�.iy+fpt�GW°map L. hLaft 11,]z :�uitY �pwMo _rF Ck Y(LL GW'fl� ti 8n 1� 1i fr I LY ( f Printed: 6/17/2014 9:38:46 AM Page 3 of 3 * Agency Commission not included UNSUCCESSFUL BIDS CC-1356 Warner Avenue Bridge Maintenance City ®f Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk September 22, 2014 Beador Construction Company, Inc. 26320 Lester Circle Corona, CA 92883 RE: Warner Avenue Bridge Maintenance—CC-1356 Enclosed please find your original bid bond for CC-1356. - Sincerely, Joan L. Flynn, CIVIC City Clerk JF:pe enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand Beador Construction Company 26320 Lester Circle Corona, CA 92883 uny f F E 1 i i r tFtJ - t t '- 3-+ e-L I.� a r F t;. , ,t-' 1 Ya .F Y r L3a 4 1 i - (>•*-{ >{'� �'i7F xF !+� 'q' } f :,"r 161. i7. - ;#'r,� - "t`,Jty ..ts$+A�-+�t'{!°: �Y' aW y hp a ya'1 t ,t•'�h i t1 zr r h>u '!ra6( �"i+$lyt;�rFrr1y! :- y'itdx.`i`,ixut �4t, tr `ej,��xt{ �. a r., iRi1- t.A+t� ri' �• k Q^sjG£+r�V"t is Yi tdTtar -j� FYi'fi "V Y2 e 1 yq,`fEf�" Y*{ ,t q'3t � , ' 1 r + 6 t{ f t Jy l 7 ti42 t i x2-t`T� ' �.'S +fit t tt # s d E a 14 4 otF a+ ncy 4r ���� $ r} S, aser t i� ;tr�r. t �" >, tlr e �� tj} .d �i�. x�y,' r' 1!. r 1: .{ q,�P ! r.+;`Pt^ $ Sq ya ii"i'e} + tan'a r s ,'„s•., 1�t1 s,r E '�YGw t}�$' UP, ; :' �."'^i '335`-? Sf i uq r ( �j ":r• .4 { J. .T -.',i .� " Y.yt rs`fY4�,�ti;'�' € �>. '' .k t,�. ;t.. &q"`- c,k rx•-. +,'.1 s- 1 n,1 ` a k , I r+y-�'t''9 { F 5, 'F'pd fi irk r xit fi �!^b „' • 7 'i qg ( � {-urra l� a� t��e��j, to-.$ i� Qyr i ,, -�F yy ey .�'x,i s �i l�';• r(sr»ft,ne.i�s`Y4�'.--. "SEALED BID" for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No.,1356 in the CITY OF HUNTINGTON BEACH - DO NOT OPEN WITH REGULAR MAIL - rS:°� r'i,P•li``.':itaitvlt.St-�.. r - ,.. .,. •'�' .` .. .--G'.a� ,< ,. -.,',St.' ..?.'- SECTION C PROPOSAL for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE . (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the inanner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids, and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 6on4 in the amount of $ 6 v 300 which said amount is not less than 10% of the aggregate of the total amount bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for jo %", as the case may be). Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if W n Addenda No. Date Received Bidder's Signature % / / C-2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 1 1 LS Mobilization $(00,000. $ b poo w 2 1 LS Prepare Storm Water Pollution Prevention Plan $6,00Y, $ cry 3 1 LS Water Pollution Control $ 39 0�0 $ 6 060 4 1 LS Access Grading $ 000 a $ S DVo c� 5 1 LS Traffic Control $ qd ')U $ 3 0 � 6 13020 SF Saw Cut, Grind and Remove AC Pavement $ 2�s $3S��oS 7 82 TN Asphalt Tack Coat and AC Leveling Pavement $ 8 163 TN ARHM Finish Course Pavement $ �.l o �" �t3e 1P $' C-z.1 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 8 LF Saw Cut and Remove Existing PCC Curb/Gutter 8 LF Construct Variable Height PCC Curb and Gutter 10 00 $ 00 OD $ 000 124 LF Install 4' High Environmental Protection Fence goo. 2 EA Adjust Gas Valve Frame and Cover to Grade 12 vd $ So v� $ 300. 1 LS Install Striping and Pavement Markings � Vo v� 13 $ 1,0 $ (po 33 CIF Remove Unsound Concrete 14 ua $ �0' oto- $ 234 LF Remove Concrete Barrier vJ 3� DO. � 15 $ $ 234 LF Remove Chain Link Railing p oJ Q 16 $ $ k1l�U C-2.2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 65 LF Remove Metal Beam Guard Railing CP 17 $ �OcA $ 65 LF Metal Beam Guard Railing Ov $ �o. `P $ 5200 18 50 LF Remove and Reconstruct Wood Rail Fence $ 19 33 CF Portland Cement Concrete (Patch) $ $ 20 310 CY Rock Slope Protection (1/4 Ton Method A) 21 $ � $ 0' 25p 310 SY Rock Slope Protection Fabric (Class 8) 22 J $ Iou � $ too- 117 LF Concrete Barrier (Type 26 Modified) 23 $ y po � $ 117 LF Concrete Barrier (Type 732 Modified) 24 $ C-2.3 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 25 234 LF Wildlife Protection Railing $ co 0110 $ 26 6480 SF Seal Concrete Bridge Deck $ Li 0 $ 1 ILS Planting and Habitat Mitigation 27 $ $ 1 ILS Planting Maintenance 28 $ $ Total Amount Bid in Figures-$ (acjt)�-30o Total Amount Bid in Words 'dr ei ............................................................................................... ..... tx.han ..e..4 r. I.%#;. C /�Y ..... 0.v.ySa. o.1..1 h.;a4 C-2.4 SECTION C 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class Qr+ 4 C�►''t s C+� r�. �,� yz ,, , h 6X 7 n0 q23 6 p �3 0 "/ID Pe-e 441tt Z u/ C e >° nt r 18,141 to -C 65916 10 LQ 't I 'K, A C "r CQ 2 Sai. fame In wa �c. 102�0 �N 5to 13 S"z l�sZ By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 7 / , at (f,,r-onc , ,Q Date City State �V� 1'ye-keLO - , being first duly sworn, deposes and says that he or she is �reSide "t of3ead0r 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. Sign 2 b3.Ra Le s k.- L' , ✓ c,l c Address of Bidder Subscribed and sworn to before me this I day of , 201 --� . NOTARY PUBLIC M. k„L A 1 c C C-4 Cpmmitslw # 2051960 N"y Pole - Ctmorliit 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 WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: C-5 Pre-s i,d ei1;t- Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes 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: 7b /IV C-7 P& 46 1 - Title BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Af6 elm (�on 4m e-^orl l erY�� A e Bidder Name aka 3aa Lc,r&L r; rC- le Business Address C "nG Ca 9-2993 City, State Zip (qS/ ) 6 74t 735.2 Telephone Number 7,16 �2/ 2 State Contractor's License No. and Class 6' lyo19-b Original Date Issued Expiration Date The work site was inspected by Zg Rck of our office on Jw�� 1 , 20lq The following are persons, firms, and corporations having a principal interest in this proposal: �v, 0-k i3 e C:kd 0,,- C-8 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: ox14-ak7J 36ao 3Q4t,-rn S+. Name and Address of Public Agency Name and Phone # of Agency's Project Manager: W t4 �j'�/5'--2 /;2-0Go3/N - '57 LrCew 2-70 90n.— Project Name Contract Amount Date Completed Detailed "scription of bidder's scope of work to demonstrate similar work experience: WidPh �II✓vn.."'. 1.I'.JoI- R Ar`.jntc i".✓1r4.1.An44- /C- 12Ole- ;n;.,_ /A1n/, 2. �'a�an3 3as1 '��1 Lln�✓ry�i�.. Or.1�cte.(�s 9alal� Name and Address of Public Agency Name and Phone # of Agency's Project Manager: ��o� J %had gvi qqq-Ski - ro23 57e1/ - S- C rce k �l, poi, 35-0. w Co/aN��'i Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Mdt" COaJW5M. '61flkcs , 00011-r► C1 re in i► WILD J Be✓naroliha 00uh14 'rians,�nif� un Auf �•���La 1-w�4 �o YuC•Jpa Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Kyl qs- C 1 D /90 - fiU - Y1411 h2edle, wdJ 093 Too. Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: tow&,,t l00%A,VVJ (&KC Ck�G�id-11� n . KOo �w�.. exc�a Safi a h C'6n[�`ebt, 4jJ2bA 0 9Q�a�n� n� u14�i, 129rk 6/er►kd- , Fryyon da ue--y/ C-10 BIDDER'S CRITICAL STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: ci 151—?35-2— See. (,4r'dC'CCJ Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work 2. '�-nmiro Aotvtd i> Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: Date Completed Date Completed S-e� Q,�Ar,CW Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work C-11 Date Completed Date Completed Beador Construction Company, Inc. Attachment "A" 111112013 MAJOR CONSTRUCTION PROJECTS / COMPLETED Updated 5-13-14 PHONE NUMBER PROJECTMGR PROJECTSUPT CONTRACT CONTRACT GROSS PERCENTAGE DATE PROJECTNAME OWNER CONTACTPERSON PHONENUMBER PHONE NUMBER AMOUNT COSTS MARGIN MARGIN COMPLETION Orange -Chapman Ave. County of Orange Stan VanderMay David Beador Robert Hinojosa $175,000.00 $ 175,000.00 100.0% May-98 Seismic Retrofit 714 567-7832 951-674-7352 951-674-7352 Los Angeles - 10 CalTrans David Nloya David Beador Robert Hinojosa $635,000.00 $ 635,000.00 100 0% May-98 Approach 8 Departure Slabs 310 577-9605 951-674-7352 951-674-7352 Long Beach CalTrans Dat Pham David Beador Robert Hinojosa $146,000.00 $ 146,000.00 100.0% Jun-98 Treat Bridge Decks 714 556-1746 951-674-7352 951-674-7352 Long Beach -Westminster Ave L.A County -DPW Neil Munaweera David Beador Robert Hinojosa $380,000.00 $ 380,000.00 100.0% Dec-97 Rem/Rep Overhang Sidewalk 626 458-3122 951-674-7352 951-674-7352 Baldwin Park - Merced Ave. City of Baldwin Park Anne Garvey David Beador Robert Hinojosa $460,000.00 $ 460,000.00 100.0% Sep-97 Bridge Widening 626 960-4011 951-674-7352 951-674-7352 Irwindale -Irwindale Ave. CalTraos Ernie Ardales David Beador Robert Hinojosa $250,000.00 $ 250,000.00 100.0% Aug-97 Pavement Rehab 909 305-1250 951-674-7352 951-674-7352 Long Beach - DelAmo Blvd. L A. County - DPW Neil Munaweera David Beador Robert Hinojosa $750,000.00 $ 750,000 00 100.0% Sep-98 Seismic Retrofit 626458-3122 951-674-7352 951-674-7352 Carson - 213th Street L. A. County- DPW Neil Munawfera David Beador Robert Hinojosa $160,000.00 $ 160,000.00 100 0% Sep-98 Bridge Seismic Retrofit 626 458-3122 951-674-7352 951-674-7352 Downey - Firestone Blvd. CalTrans John Vassihades David Beador Robert Hinojosa $180,000.00 $ 180,000.00 100 0% Sep-98 Modify ON -Ramp 562401-3333 951-674-7352 951-674-7352 San Juan Capistrano City of San Juan Cap. Brian Perry David Beador Robert Hinojosa $119,000.00 $ 119,000.00 100 0% Oct-98 City Bridge Repairs 949 443-6353 951-674-7352 951-674-7352 Garden Grove - Beach Blvd. CalTrans Leida Neidecker David Beador Robert Hinolosa $370,000.00 $ 370,000 00 100.0% Feb-99 On -Ramp Improvements 714 556-8202 951-674-7352 951-674-7352 Irvine - Michelle Drive Griffith Company Allen Perkovich David Beador Robert Hinolosa $260 000.00 $ 260,000 00 100 0% Feb-99 Bridge Widenin 714549-2291 951-674-7352 951-674-7352 Newport Beach County of Orange Raymond Douglass David Beador Robert Hinolosa $90,000.00 $ 90,000 00 100 0% Aug-99 Coyote Basin Repairs 949-262-2427 951-674-7352 951-674-7352 Spring Valley -Bancroft Drive CalTrans Gustavo Dallarda David Beador Robert Hinojosa $930,000 00 $ 930,000 00 100 0% Sep-99 Bridge Widening 619-462-0662 951-674-7352 951-674-7352 Oceanside CalTrans Jeff Brown David Beador Robert Hinojosa $129,000 00 $ 129,000.00 100.0% Oct-99 Slope Erosion Control 858-467-4088 951-674-7352 951-674-7352 San Onofre State Park California Department of Greg Kania David Beador Robert Hinojosa $85,000.00 $ 85,000 00 100.0% Oct-99 Outlet Repairs Parks 8 Recreation 949-366-8598 951-674-7352 951-674-7352 Carson -Avalon Avenue CalTrans Massod Akbarian David Beador Robert Hinojosa $200,000.00 $ 200,000.00 100.0% Nov-99 Replace Approach Slabs 310-5164140 951-674-7352 951-674-7352 Long Beach -Trinidad Lane County of Orange Mike Reetz David Beador Robert Hinojosa $180,000 00 $ 180,000.00 100 0 % Oct-99 Bridge Seismic Retrofit 714-567-7821 951-674-7352 951-674-7352 Colton Avenue CalTrans Manny Yagarajah David Beador Robert Hinojosa $160,000.00 $ 160 000.00 100.0% May-99 Repair Steel Girders 909-949-3095 951-674-7352 951-674-7352 Cerritos CalTrans Kelvin Tran David Beador Robert Hinojosa $268,000.00 $ 268,000 00 100 0 % May-99 Construct Infiltration Basin 562-9404276 951-674-7352 951-674-7352 San Bernardino Department of Water Bob Ross David Beador Robert Hinojosa $106,000.00 $ 106,000.00 100.0% Ju1-99 Surge Chamber Seismic Retrofit Resources 805-946AO24 951-674-7352 951-674-7352 Los Angeles CalTrans Reza Jahromi David Beador Robert Hinojosa $498,000.00 $ 498,000.00 100.0% Mar-99 Replace PCC 310-609-0264 951-674-7352 951-674-7352 Ontario City of Ontano Fahim Boulos David Beador Robert Hinojosa $308,000.00 $ 308,000.00 100.0% Sep-99 Seismic Retrofit-3 Bridges 909-931-9331 951-674-7352 951-674-7352 Anaheim - Kraemer191 California Private Fahim Boulos David Beador Robert Hinojosa $612,000.00 $ 612,000.00 100.0% Jan-00 Bndge Widening Transportation Company 909 931-9331 951-674-7352 951-674-7352 Los Angeles -Century Blvd. CalTrans Mohamad Pasebani David Beador Robert Hinojosa $175,000.00 $ 175,000.00 100.0% Mar-00 B rWge Repair 310609-0272 951-674-7352 951-674-7352 Pomona CalTrans Billy Rojas David Beador Robert Hinojosa $618,000.00 $ 618,000.00 100.0% Jun-00 Median Barrier 909305-1284 951-674-7352 951-674-7352 Riverside CalTrans Ray Stokes David Beador Robert Hinolosa $169 000.00 $ 169,000.00 100.0% Jun-00 Bridge Repair 08-493104 909 275-0211 951-674-7352 951-674-7352 Los Angeles CalTrans Joseph Tehrani David Beador Robert Hinolosa $173,000.00 $ 173,000.00 100.0% Jun-00 Glare Screens 310 768-1704 951-674-7352 951-674-7352 Route 60 - Repl PCC Pave CalTrans Kelvin Tran David Beador Robert Hinojosa $530,000.00 $ 530,000.00 100.0% Nov-00 Atlantic Blvd 074G7304 562401-3333x239 951-674-7352 951-674-7352 Irvine CalTrans Nahid Baghbaoian David Beador Robert Hinojosa $191,000.00 $ 191,000.00 100.0% Nov-00 Construct Check Dam 12-071304 714632-2535 951-674-7352 951-674-7352 Long Beach CalTrans Mashur Ali David Beador Robert Hinojosa $920,000.00 $ 920000.00 100.0% Nov-00 Repl PCC Pave 310 609-0264 951-674-7352 951-674-7352 Long Beach CalTrans Amlad Obeid David Beador Robert Hinojosa $1,515,000.00 $ 1,515.000.00 100.0% Mar-01 Collector Road 8 Bridge 07-185004 562 401-3333 951-674-7352 951-674-7352 Downey Ortiz Tom Meyer David Beador Robert Hinojosa $56,250.00 $ 56,250.00 100.0% Mar-01 Construct Barrier 07-195704 949 753-1414 951-674-7352 951-674-7352 Vernon ACTA Paul Buckley David Beador Robert Hinojosa $4,343,000 00 $ 4,343,000.00 100 0% Jun-02 Bridge Widening C0099 323 526-7051 951-674-7352 1 951-674-7352 Fountain Valley CalTrans Dat Pham David Beador Ramiro Acevedo $560,000.00 $ 560,000.00 100.0% Jun-01 Widen Ram 12-OA5204 714 556-9425 951-674-7352 949-279-0057 Long Beach & Signal Hill CalTrans Massod Akbarian David Beador John Brink $333,000.00 $ 333,00000 100.0% Apr-01 . Hwy 8 App Slabs Replaced 07-144614 310-516-4140 951-674-7352 949-279-3676 Garden Grove CalTrans Xavier Avila David Beador Ramiro Acevedo $405,00000 $ 405,000.00 1000% Dec-00 am at Valley View Widen Ramp 12-OA5004 714 632-2539 951-674-7352 949-279-0057 Rancho Cucamonga So Cal Underground Jim Jackson David Beador Ramiro Acevedo $305,000.00 $ 305,000.00 100.0% Apr-Ot Deer Creek Bridge Widening 310 639-2257 951-674-7352 949-279-0057 San Diego Hazard Construction / David Beador Ramiro Acevedo $24,408.00 $ 24,408.00 100.0% Jun-01 Median Barrier CalTrans 858587-3600 951-674-7352 949-279-0057 710 Freeway Excel Paying Will Harris David Beador Ramiro Acevedo $1,713,951.00 $ 1,783,050.00 $ (69,099.00) -4.0% Feb-04 Barrier Rail 562 599-5841 951-674-7352 949-279-0057 Costa Mesa GCI Tom Taylor David Beador Ramiro Acevedo $133,000.00 $ 133,000.00 100.0% Sep-02 Calvary Chapel Bridge 714957-0233 x22 951-674-7352 949-279-0057 Ludlow CalTrans Frank Lozano David Beador John Brink $700,000.00 $ 700,000.00 100.0% Feb-02 Repair Earthquake Damage to Bridge 08-496004 760 256-7316 951-674-7352 949-279-3676 Colton CalTrans Mario Savala David Beador Robert Hinojosa $180,000.00 $ 180,000.00 100.0% May-02 Mt Vernon Traffic Signal 08-427204 909 519-2422 951-674-7352 951-674-7352 $an Diego CalTrans Hassan Mustafa David Beador John Brink $220,000.00 $ 220,000.00 100.0% Dec-01 - �staIICDS Unit 11-172864 619957-4604 951 $74-7352 949-279-3676 Riverside County of Riverside Dick Clefand David Beador John Brink $1,300,000 00 $ 1,300,000.00 100.0% Feb-02 Median Barrier on Van Buren Blvd. 909 826-5889 951-674-7352 949-279-3676 Los Angeles County of Los Angeles Tony Hui David Beador Robert Hinolosa $638,302.00 $ 629,732 00 $ 8,570.00 1 3% Feb-02 Sierra Madre Dam Bridge Replacement 626 458-4954 951-674-7352 949-279-0402 Walnut City of Walnut Jason Welday David Beador John Brink $133,000.00 $ 133,000+00 100.0% Dec-03 Lemon Creek Outlet Structure 909594-9702 951-674-7352 949-279-3676 San Bernardino Yeager Construction Al Artega David Beador Ramiro Acevedo $483,000.00 $ 483,000.00 100.0% Dec-02 Barrier rail on 30 Freeway 909 721-9746 951-674-7352 949-279-0057 Santa Ana City of Santa Ana Tyrone Chesanaek David Beador Ramiro Acevedo $2,946,017.00 $ 2,659,285.00 $ 286,732.00 9.7% May-03 Bristol Street Bride Widening 714 647-5045 or 29 951-674-7352 949-279-0057 Playa Vista Playa Capital Cliff Ritz David Beador Ramiro Acevedo $2,860.403.00 $ 2,460,175.00 $ 400,228.00 14.0% Feb-04 Perimeter Landscape 8 Retaining Wall 714-345-6941 951-674-7352 949-279-0057 LaJolla CalTrans Gary Le Vine David Beador Terry Brown $1,798,002.00 $ 1,561,215.00 $ 236,787.00 13.2% Jun-03 Construct Median Barrier 11-243704 760 738-6021 951-674-7352 949 279-0385 710 Freeway Excel Paving Will Harris David Beador Ramiro Acevedo $1,738,700.00 $ 1,738,700.00 100.0% Feb-04 Construct median barrier 07-1384U4 562591-7485 951-674-7352 949-279-0057 Rainbow Rainbow Water Dist. Ken O'Connor David Beador John Brink $346,000.00 $ 346,000.00 100.0% Jan-03 Construct water main 1 1 760 942-0366 X158 951-674-7352 949-279-3676 San Bernardino County CalTrans Ali AI Saadoon David Beador John Brink $1,269,319.00 $ 1,142,723.00 $ 126,596.00 10.0% Feb-03 Metal Beam Guard Rail 08-477904 909 682-1715 949-724-0264 949-279-3676 Beador Construction Company, Inc. Attachment "A" 111112013 MAJOR CONSTRUCTION PROJECTS / COMPLETED Updated 5-13-14 PHONE NUMBER PROJECTMGR PROJECTSUPT CONTRACT CONTRACT GROSS PERCENTAGE DATE PROJECTNAME OWNER CONTACT PERSON PHONE NUMBER PHONE NUMBER AMOUNT COSTS MARGIN MARGIN COMPLETION Palos Verdes Estates City of Palos Verdes Wendy Force David Beador John Brink $1,010,000 00 $ 1,010,000.00 100.0% Sep-02 Construct Storm Drain #3 310 378-0383 951-674-7352 949-279-3676 Beaumont -Marshall Creek City of Beaumont John Wilder David Beador John Brink $672000.00 $ 672,00000 100.0% Mar-02 Flood Control Channel 909 769-8520 951-674-7352 949-279-3676 Laguna Hills City of Laguna Hills Ken Rosenfeld David Beador Ramiro Acevedo $489,205.00 $ 338,762.00 $ 1501443.00 30.8% Apr-03 Turtle Mitigation Plan 949 707-2655 951-674-7352 949-279-0057 Los Angeles CalTrans Simon Wang David Beador John Brink $377,000.00 $ 377,000.00 100.0% Sep-02 Slope Repair & Irrigation 07-4H5404 213 620-2039 x209 951-674-7352 949-279-3676 Downey CalTrans Wale Alofe David Beador Ramiro Acevedo $203,000.00 $ 203,000.00 100.0% Oct-02 Install Bridge Deck Storm Drains 07-4G3804 562 401-3333 x261 951-674-7352 949-279-0057 Southgate City of Southgate AB Fakhouri David Beador Ramiro Acevedo $2,427,249.00 $ 2,096,763.00 $ 330,486.00 136% Jun-04 Reconstruct 710/Firestone Interchange 310-592-1829 951-674-7352 949-279-0057 Oceanside City of Oceanside Gary Kellison David Beador John Brink $150,000.00 $ 150000.00 100.0% May-03 Install Storm Drain 760 435-5112 951-674-7352 949-279-3676 Corona CalTrans All Fathi David Beador John Brink $171,000.00 $ 171 000.00 100 0% Aug-03 Drainage Improvements 08-467104 909 232-7259 951-674-7352 949-279-3676 County of L. A. L. A County Chandra McCloud David Beador John Brink $108,000.00 $ 108,000.00 100.0% Sep-03 Box Replacement Line A FCC0000892 626 458-4967 951-674-7352 949 279-3676 Temecula Eastern Municipal Water Arlen Nielson David Beador John Brink $512,016.00 $ 537,239.00 $ (25,223 00) -4.9% Sep-04 First Street Sewer District Project 867S 909 298-3777 951-6744352 949 279-3676 Long Beach Port of Long Beach Alex Reus David Beador Ramiro Acevedo $173,592.00 $ 149,312.00 $ 24,280.00 14.0% Jun-04 Storm Drain Pump Station 28 562 590-4173 951-674-7352 949 279-0057 San Juan Capistrano CalTrans Andy MyDounig David Beador Ramiro Acevedo $1,391,750.00 $ 1,391,750.00 100 0% Nov-03 Stonehill Drive median barrier 12-OA4004 714 556-1334 951-6744352 949 279-0057 Laguna Nigel CalTrans Kifah Ramadan David Beador John Brink $291,832.00 $ 261,755.00 $ 30,077.00 10.3% Apr-04 Repair slope erosion & modify drainage 12-OF3804 714418-5004 951-674-7352 949279-3676 LA / Redondo Beach CalTrans Wendell Davidson David Beador John Brink $341,651.00 $ 252,155.00 $ 89,496.00 26 2% Feb-04 Install metal beam guard rail 07-4G5004 213 79MO48 951-674-7352 949 279-3676 Highland CalTrans Imad Abu-Gharbieh David Beador John Brink $421,281.00 $ 322,222.00 $ 99,059 00 23 5% Dec-03 Remove & reconstruct bridge railing 08-437204 909 390-4503 951-674-7352 949 279-3676 Live Oak Spreading Ground Three Valleys Municipal Thomas Bayles David Beador John Brink $336,568.00 $ 258,516.00 $ 78,052.00 23.2% Jan.05 Imported water connection Water District 626 357-0588 951-674-7352 949 279-3676 Riverside County of Riverside Hugh Smith David Beador John Brink $331,300.00 $ 331,300.00 100.0% Mar-04 Traffic signal @ Van Buren & Jurupa 909 955-6885 951-674-7352 949 279-3676 Torrance City of Torrance Steve Finton David Beador John Brink $1,016,068.00 $ 832,039.00 $ 184,029.00 18.1% Nov-03 234 Street channel improvements 310 618-2975 951-674-7352 949 279-3676 Fullerton CalTrans James Decker David Beador John Brink $207,300.00 $ 207,300 00 100.0% Jan-04 Euclid Street Undercrossing 12-OF8304 714688-1951 951-674-7352 949279-3676 City of Carlsbad City of Carlsbad Grant Clavier David Beador John Brink $423,698.00 $ 377,737.00 $ 45,961 00 10.8% Dec-04 El Camino Real Sewer Line Contract # 38911 760-602-2780 951-6744352 949 279-3676 County of Orange County of Orange Mil Thornton David Beador John Brink $1,863,859.00 $ 1,677,645.00 $ 186,214.00 10.0% Oct-06 Tustin Avenue Widening ER 08930 714-5674834 951-674-7352 949-279-3676 Playa Vista Playa Vista Cliff Ritz David Beador Romero Acevedo $2,500,000.00 $ 2,500,000.00 a 100.0% Jun-04 Riparian Corridor 310-345-6941 951-674-7352 949-279-0057 Moreno Valley CalTrans Ali AI-Saa loon David Beador John Brink $602,700.00 $ 602,700.00 100.0% Mar-05 Widen 60 Freeway Exit Ramp 08-486204 951-276-1945 951-674-7352 949-279-3676 Fontana City of Fontana Paul Lemoine David Beador John Brink $618,700.00 $ 618,700.00 100 0% Aug-05 Catawba & Curtis Avenue Storm Drain 951-686-1070 951-674-7352 949-279-3676 Oceanside City of Oceanside/ Danielle Maxwell David Beador John Brink $3,119,640.00 $ 2,321,980.00 $ 797,660.00 256% 00-06 Douglas Avenue Storm Drain D R.Horton Homes 760-929-1600 951-674-7352 949-279-3676 Costa Mesa CalTrans Kifah Ramadan David Beador John Brink $420,272.00 $ 268,789.00 $ 151,483.00 36.0% Dec-05 Repair Joint Seal 12-OG8304 949-279-8625 951-674-7352 949-279-3676 Tustin CalTrans Kugan Ramananthan David Beador John Brink $2.449,368.00 $ 1,846,862.00 $ 602,506.00 24.6% Mar-06 (17th & 55) AC Pavement 12-OF2604 949-279-8495 951-674-7352 949-279-3676 Hunnington Beach CalTrans Issac Tabar David Beador John Brink $2,191,183.00 $ 1,975,194.00 $ 215,989.00 9.9% Oct-06 (405 & Beach) Add Offramp Lane 12-OA7614 949-279-8411 951-674-7352 949-279-3676 Santa Ana CalTrans Gassem Ziaeian David Beador John Brink $162,945.00 $ 103,728.00 $ 59,217.00 36.3% Jul-06 (SB 55 & Einger) 12-OF3604 949-279-8468 951-674-7352 949-279-3676 Hagador Canyon Creek/Orchard Glen Centex Homes Glen Land David Beador John Brink $6,250,665.00 $ 4,585,783.00 $ 1,664,882.00 26.6% Nov-06 Centex Homes 949-453-0113 951-674-7352 949-279-3676 Dana Point Dana Point/Sewer Repairs Tom Townsend David Beador John Brink $32 000.00 $ 32,000.00 100.0% Dec-05 Sewer Repair/Dana Point Harbor Dana Pont Harbor 949-923-3795 951-674-7352 949-279-3676 City of Corona SE Corporation Hamid Soroosh David Beador John Brink $2,554,198 00 $ 2,080,512.00 $ 473,686.00 18.5% Oct-06 Dos LogosRemesc.l Canyon/Bedford Wash Channel 213-926-2640 951-674-7352 949-279-3676 City of Oceanside PBSBJ Jeff Moody David Beador John Brink $1,243,125.00 $ 868,884 00 $ 374,241.00 30.1% Jun-06 Douglas Drive Street Improvement 760-525-8647 951-674-7352 949-279-3676 Tustin Countyof Orange Octavio Rivas David Beador John Brink $1,611,976.00 $ 1,266,513.00 $ 345,463.00 214% Jan-06 Skyline Drive/Storm Sewer 714-567-7814 951-674-7352 949-279-3676 Huntington Beach Caltrans James Yu David Beador John Brink $458,056.00 $ 340,837.00 $ 117,219.00 25 6% Aug-06 405&SB Edinger Avenue On -Ramp 12-OG3804 714-556-8202 951-674-7352 949-279-3676 San Diego Caltrans Con Konlaxis David Beador John Brink $370,100.00 $ 255,692.00 $ 114,408.00 30.9% Nov-06 Stale Hwy Modify Existing Drainage 11-091604 619-397-6254 951-674-7352 949-279-3676 Los Angeles Caltrans Redo Karoul David Beador John Brink $532,368.00 $ 369,435.00 $ 162,933 00 30.6% 00-06 Reconstruct Drainage Invert 07-4G7004 626-338-3340 951-674-7352 949-279-3676 Colton Caltrans Ali Falhi David Beador Ramiro Acevedo $159,405.00 $ 100,187.00 $ 59 218.00 37A% Jun.06 Repair Drainage Girder 08-OF2704 951-276-1945 951-674-7352 949-279-0057 City of Oceanside City of Oceanside Gary Bodman David Beador John Bnnk $508,596.00 $ 527,894.00 $ (19,298 00J -3.8% Jan-07 Hoover Street Sewer Line Improvement 760-435-5908 951-674-7352 949-279-3676 Laguna Coast Wilderness Park Countyof Orange W.P. Niemann David Beador John Brink $370,909.00 $ 293,405.00 $ 77,50400 20.9% Jun-07 SCE Bride 714-834-7801 951-674-7352 949-279-3676 Irvine Caltrans Kifah Ramadan David Beador John Brink $9,184,704.00 $ 7,474,361.00 $ 1,710,343.00 18.6% Jul-07 5/133/Barranca 12-OF9504 949-279-8625 951-674-7352 949-279-3676 Irvine Caltrans James Yii David Beador John Brink $2,104,60000 $ 1,415,47100 $ 689,12900 32.7% Apr-07 73/Bonita Canyon/El Toro 12-OC9834 949-279-8743 951-674-7352 949-279-3676 Colton Caltrans Nahro Saoud David Beador John Brink $4,400,720.00 $ 3,917,724.00 $ 482 996.00 11.0% Apr-07 215 08-OC1804 951-232-9778 951-674-7352 949-279-3676 City of Temecula City of Temecula Scott Harvey David Beador John Brink $4,956,168.00 $ 4,145,358.00 $ 810,810.00 16.4% Feb-07 79 South 951-694-6411 951-674-7352 949-279-3676 City of Newport Beach City of Newport Beach Michael Sinacori David Beador John Brink $4 555025.00 $ 3,500,61200 $ 1,054,413.00 23.1% Apr-07 Big Canyon 949-644-3311 951-674-7352 949-279-3676 Corona SE Corporation Hamid Soroosh David Beador John Brink $1,258,500.00 $ 825,961.00 $ 432,539.00 34 4% 00-06 Weirick Road & 15 213-926-26640 951-674-7352 949-279-3676 Huntington Beach Caltrans Jose Berries David Beador John Brink $422,006 00 $ 327,128.00 $ 94,878 00 22.5% Jun-07 Westminster & Edinger 12-OH0014 949-279-8502 951-674-7352 949-279-3676 Anaheim Caltrans Jose Berries David Beador John Brink $1,063,311.00 $ 1,150,894 00 $ (87,583.00) -8.2% Jul-08 Gene Autry 12-OF9404 949-279-8502 951-674-7352 949-279-3676 J:ange & Anaheim Caltrans Kifah Ramadan David Beador John Brink $634,227,00 $ 471,780 00 $ 162,447.00 25.6% Aug-07 57 FWY 12-OH2484 949-279-8625 951-674-7352 949-279-3676 Corona County of Riverside Ivan Mendoza David Beador John Bonk $1,507,457.00 $ 1,365,753 00 $ 141,704.00 9 4% Jul.07 E alco/Harle Road 562-254-9351 951-674-7352 949-279-3676 Irvine City of Irvine Steve 011o David Beador John Brink $22,983,169.00 $ 19,058,240.00 $ 3,924,929.00 17.1 % Dec-09 McArthur& Redhill 949-724-6000 951-674-7352 949-279-3676 Yorba Linda Countyof Orange Doren Shappet David Beador John Brink $1,697,571.00 $ 1,268,632 00 $ 428,939.00 25.3% Sep-08 Santa Ana River Bike Trail 1 714-567-7837 951-674-7352 949-279-3676 South Gale of Soulh'Gale Jim Hannigan David Beador Bob Ortega' $11.160,875.00 $ 9,079,207.00 $ 2,081,668.00 18.7% Oct-08 Firestone Bride Wdenin -Rio Hondo Icily 585-205-7730 951-674-7352 1 949-678-2041 San Diego Caltrans Rahim 858-688-1318 David Beador John Brink $179,700.00 $ 119,878.00 $ 59,822.00 33.3% Jun-07 Route 52 11-280604 1 Akhondzadzadeh 951-674-7352 949-279-3676 Lucerne Valley Caltrans Mohsen Parvinlah David Beador John Brink $489,016.00 $ 412,024.00 $ 76,992.00 15.77 Aug-07 Route 247 08-OH6404 I 951-232-7755 951-674-7352 949-279-3676 1 Iyanous luaitrans I warren rut I uavio ueaaor I .ionn cnnn I xiu auu,<ao.uu I a o,e o.uu I a ,­.uu 1 1-11 .,a.. Beador Construction Company, Inc. Attachment "A" 111112013 MAJOR CONSTRUCTION PROJECTS / COMPLETED Updated 5-13-14 PHONE NUMBER PROJECTMGR PROJECTSUPT CONTRACT CONTRACT GROSS PERCENTAGE DATE PROJECTNAME OWNER CONTACTPERSON PHONENUMBER PHONE NUMBER AMOUNT COSTS MARGIN MARGIN COMPLETION 210 FWY-CCTV 07-129934 562-755-9218 951-674-7352 949-279-3676 Tustin Caltrans Hossain Mansoud David Beador John Brink $213,027.00 $ 163,522.00 $ 49,505.00 23 2% Oct-07 5 FWY & 55 FWY 12-OH3704 949-598-3587 951-674-7352 949-279-3676 Costa Mesa Caltrans Kugan Ramanathan David Beador John Brink $309,148.00 $ 311,735.00 $ (2,587.00) -0.8% Oct-07 Paulanon Avenue 12-OG1904 714-567-6172 951-674-7352 949-279-3676 Laguna Coast Wilderness Park County of Orange Chris Kubasek David Beador John Brink $598,965.00 $ 415,046.00 $ 183,919.00 30.7% Nov-08 Mulfi-Use Trail 714-448-6251 951-6744352 949-279-3676 Fountain Valley Caltrans Malid Javahernashan David Beador John Brink $876,273.00 $ 824,800.00 $ 51,473.00 5 9% Jan-09 Brookhuist& 405 Freeway 12-OH5404 949-279-8743 951-674-7352 949-279-3676 City of Corona City of Corona Reza Zolghadr David Beador John Brink $1,762,710.00 $ 1,914,086 00 $ (151,376.00) -8.6% Jul-08 El Cerrito Interchange Improvements - 1-15 951436-2441 951-674-7352 949-279-3676 City of Costa Mesa City of Costa Mesa Raja Sethurarman David Beador Ramiro Acevedo $3,582,420 00 $ 3,477,075.00 $ 105,345.00 2.9 % Apr-09 Harbor Boulevard Improvements -405 714-754-5032 951-674-7352 949-279-0057 Corona Caltrans Imad Abugharbieh David Beador John Brink $13,773,532.00 $ 12,740,597.00 $ 1,032,935.00 7.5% Oct-09 Widen Bridge/Interchange Improvments 08-452204 951-232-3610 951-674-7352 949-279-3676 Los Angeles CalTrans Darrell McKenzie David Beador John Brink $502,733.00 $ 389,385.00 $ 113,348.00 22.5% Sep-08 Various 07-246704 818-637-2506 951-674-7352 949-279-3676 San Diego CalTrans Greg McClendan David Beador John Brink $517,031.00 $ 590,580.00 $ (73,549.00) -14.2% Oct-08 Ramp Rehabilitation 11-284004 760-355-8666 951-674-7352 949-279-3676 Los Angeles Caltrans Hassan Azima David Beador John Brink $259,503.00 $ 173,835.00 $ 85,668.00 33.0% Sep-08 Paving &Slope Paving 07-4S7404 323-981A795 951-674-7352 949-279-3676 Mira Loma City of Loma Linda Ivan Benaviclez David Beador Bob Ortega $3,947,214.00 $ 3,759,863 00$_ . 187,351.00 4.7% Jan-10 Mountain View Avenue Bride Widening 909-350-2144 951-674-7352 949-678-2041 Vista Point CalTrans Seni Paibul David Beador John Brink $442,690 00 $ 426,696 00 $� 15,994.00 3.6 % Aug-08 Paving 08-005004 909-381-1939 951-674-7352 949-279-3676 Hesperia & 15 FWY CalTrans Ehab Mina David Beador John Brink $222,359 00 $ 228,551.00 $ (6,192.00) -2.8% Sep-08 Paving 08-OH1204 951-232-6415 951-674-7352 949-279-3676 San Diego CalTrans Carlos Cortez David Beador John Brink $457,544.00 $ 571,259.00 $ (113,715.00) -24.9% Apr-09 Ramp Rehab & Widening 11-285904 619-697-0217 951-674-7352 949-279-3676 San Bernardino CalTrans Alfonso Gonzales David Beador John Brink $1,821,655.00 $ 1,518,672.00 $ 302,983.00 16 6% Jul-08 Errergency Jobs 08-OL7604/08-OL7704 760-843-5844 951-6744352 949-279-3676 Ventura CalTrans Joseph Tehrani David Beador John Brink $394,576 00 $ 405,622 00 $ (11,046.00) -2.8% Sep-08 Cold lane & hot mix as halal overla 07-2Y6604 805-375-9247 951-674-7352 949-279-3676 Monterey Park CalTrans Miguel Rodriguez David Beador John Brink $523,297.00 $ 517,900.00 $ 5,397.00 1.0% Sep-08 Cold plane & hot mix asphalat overlay 07-1X2404 323-981-1795 951-674-7352 949-279-3676 Long Beach Port of Long Beach ,; Alex Reus David Beador Bob Ortega $555,170.00 $ 230,736.00 $'_ 324,434.00 58.4% Jan-09 Straighten Bridge Girder @ 1Oth Street 562-590-4172 951474-7352 949-678-2041 Los Angeles CalTrans Sam Gallardo David Beador Jeff Barglowski $9,998,043.00 $ 8,681,396.00 $ 1,316,647.00 13.2% Mar-10 Se ulveda Ram & Bridge Widening 07-178504 31 OM609-0264 951-674-7352 949-337-0543 San Bernardino SANBAG Mario Alarcon David Beador Ramiro Acevedo $1,150,416.00 $ 784,975.00 $ , 365,441.00 31.8% SR 210 Muscoy Underpass Seismic C08-191 909-795-1003 951-674-7352 949-279-0057 Newport Beach -Crystal Heights Drive CalTrans Fred Hamidl David Beador John Brink $707,545.00 $ 594,075 00 $ 113,470.00 16.0% Mar-10 Drainage, Cold Plane, Paving, Planting 12-OG5304 949-279-8486 951-674-7352 949-279-3676 Riverside LNR Riverside, LLC John Schaefer David Beador Jeff Barglowski $1,860,621.00 $ 1,216,523.00 $ 644 098.00 34.6% Sep-09 Cactus Ave & 215 Bridge Widening 949-885-8500 951-674-7352 949-337-0543 Beaumont CalTrans Mahfual Alam David Beador John Brink $44,234,240.00 $ 41,572,430.00 $ 2,661,810.00 6.0% Start Feb 2009 Construct Bride & Street Works 08472304 951-276-1938 951-674-7352 949-279-3676 Santa Ana City of Santa Ana - 5lh William Albright David Beador Jeff Barglowski $2,415,273.00 $ 1,975,745.00 $ 439,528.00 18.2% Mar-10 Construct Bridge & Street Works Sth St & McFadden Bridge 714-647-5029 951-6744352 949-337-0543 Barstow t CalTrans Taghreed AI-Khaleeb David Beador Bob Ortega '$477,254.00 $ 530,212.00 .$i (52,958.00) -11.1% .Sep-09 Rehabilitate Bridge Decks 08492904 951-2324793 951-674-7352 949-678-2041 ' Ontario/Rancho Cucamonga CalTrans Elvira Lenart David Beador Bob Ortega $473,773.00 $ 414,862.00 .$' , : 58,911.00 12.4% Sep-09 Rehabilitate Bride Decks 08-OG7404 951-232-8949 951-674-7352 949-678-2041 Anaheim 55181 CalTrans Sam Khafibi - David Beador Bob Ortega a$189,668.00 $ 169,784 00 ;$_� , 19,884.00 10 5% Jul-09 Re lace Concrete Slabs_,' 12-OH3904 949-279-8418 951-674-7352 949-678-2041 County of Los Angeles County of Los Angeles Victor Bermudez David Beador Jeff Barglowski $250,300.00 $ 246,175.00 $ 4,125.00 1.6% Oct-09 Carson/1232-1-ine A FCC0001099 626-688-8275 951-674-7352 949-337-0543 County of Los Angeles County of Los Angeles Selman Khan David Beador Bob Ortega $197,120.00 $ 200,887.00 .$.. a (3,767.00) -1.9% Start Sept 2010 Anaheim Street Over LB Freeway RDC0011234 6264584956 951-674-7352 949-678-2041 "' Complete Feb 2011 County of Orange County of Orange Hamid Abedzadeh David Beador Ramiro Acevedo $4,776,21200 $ 4,432,24L00 $ 343,971.00 7.2% Start Apr 2010 Moulton Parkway Widening ER08402 714-567-7800 951-674-7352 949-279-0057 Complete Dec 2011 County of Los Angeles County of Los Angeles Alex Carlos David Beador Bob Ortega $1,595,361.00 $ 1,469,838.00 $: 125,523.00 7.9% . Start May 2010 Valle Blvd over Old Valle Rd 8 UPRR RDC0012368 626-786-5813 951-674-7352 949-678-2041 Complete 2012 Irvine CalTrans Steve Kinaly David Beador Ricardo Covarrubias $309,122.00 $ 266,978.00 $ 42,144.00 13.6% Aug-10 Rte 133-Hot Mix Asphalt Overlay 12-OK2704 949-279-8800 951-674-7352 951-453-3378 Moreno Valley CalTrans Miguel Calixto David Beador Evan Burden $4,433,631.00 $ 4,111,764.00 $ 321,867.00 7.3% Start July 2010 Rte 60 - Rubberized HMA Overlaly 08-ON3004 951-232-8957 951-674-7352 909-721-1642 Dec-10 San Juan Capistrano CalTrans Malid Javahernashan David Beador Ramiro Acevedo $8,404,700.00 $ 8,404,700 00 100.0% Start June 2011 Rto 5 - Wden Roadway and Bridges 12-OE5704 949-289-3551 951-674-7352 949-279-0057 Complete June 2013 Irvine City of Irvine Steve Sherwood David Beador Larry Coleman $248,567.00 $ 144,783.00 $ 103,784.00 41.8% Start Nov 2010 Macarthur Median Drainage Impwmnts 314120 949-724-6000 951-6744352 949-279-0386 Complete Sept 2011 Irwindale - Bridge County of Los Angeles Salman Khan David Beador Bob Ortega $1,929,786.00 $ 1,560,714.00, $_ = 369,072.00 19.1% Start May 2011 Foothill Blvd over San Gabriel River RDC0011613 626-458-4956 951-6744352 949-678-2041 Complete A nl 2012 Long Beach - Road Improvements Port of Long Beach PK Wang David Beador Bob Ortega $428,822.00 $ 272,808-00 $ 156,014.00 36.4% Start Oct 2010 710- Ninth and Shoemaker Bridge HD-S2339 562-901-1759 951-674-7352 949-678-2041 Complete 2012 Long Beach - Bridge Girder Repair Port of Long Beach PK Wang David Beador Bob Ortega $439,371.00 $ 271,191.00 $ 168,180.00 38.3% Start Oct 2010 SR 710- Anaheim Street Bridge HD-.HD 562-901-1759 951-6744352 949-678-2041 Complete 2012 Newport Beach Seismic Retrofit City of Newport Beach Thomas Sandefur David Beador Ramiro Acevedo $780,759.00 $ 605,420.00 $ 175,339.00 22.5% Start Dec 2010 Brid a Seismic Retroft #3531 949-644-3312 951-674-7352 949-279-0057 Complete Aug 2011 57 FWY CalTrans Adrian Wu David Beador Jeff B & Bob Ortega $28,581,800.00 :$�_ 28,581,800.00 100.0% Start Feb 2011 Rte 57 in Placentia & Fullerton 12-OF0314 949-279-8488 951-6744352 951-674-7352 Complete 5-2019 1-10 WB Lane addition SANBAG Ken Loncharich David Beador Ramiro Acevedo $16,083,300.00 $ 16,083,300 00 100.0% Start Feb 2011 Rte 10 in Redlands & Yucaipa C10190 STPLN 6053(088) 949-283-0854 951-674-7352 949-279-0057 Complete 2013 City of Newport Beach City of Newport Beach AB Fakhouri David Beador Ramiro Acevedo $3,522,723.00 $ 3,099,055.00 $ - 423,668.00 12.0% Start May 2011 Jamboree Road over SR-73 #3724 949-644-3312 951-674-7352 949-279-0057 Complete 2012 County of Orange County of Orange Hiram Downard David Beador Ramiro Acevedo $20,053,300.00 $ 20,053,300.00 100.0% Start June 2011 Antonio Parkway #ER08990 714-567-7838 951-674-7352 949-279-0057 1 Complete 2013 City of Moreno Valley City of Moreno Valley Viren Shah David Beador Bob Ortega $229,000.00 $ 212,902.00 $ 16,098.00 7.0% Start April 2011 2011 Ci 'de Brid a Maintenance Pro ram 11-22679828 951-314-2288 951-6744352 94"78-2041 Complete June 2011 County of San Bernardino County of San Bernardino David Beador Bob Ortega $360,422.00 $ 212,968.00 $ 147,454.00 40.9% Start May 2012 Hwy 330 08-OJ8004 951-674-7352 949-678-2041 County of Riverside City of Corona/Murrieta David Beador Bob Ortega "" $726,521.00 $ 609,111.00 $ 117,410.00 16.2% 15215/91 08-002104 951-674-7352 949-678-2041 County of Riverside - County of Riverside David Beador Bob Ortega $11,870.00 $ 9,529.00 $ 2,341.00 19.7% BI he Emer enc Re air. 08-007004 951-674-7352 949-678-2041 ' County of Los Angeles County of Los Angeles David Beador Bob Ortega' $1,169,693.00 $ 868,738.00 $ 300,955 00 25.7% PCH Bride 07-3X4604 951{74-7352 949-678-2041 - Coun[y of Orange County of Orange David Beador Ramiro Acevedo $235,551.00 $ 199,686.00 $ 35,865.00 15.2% 91 Freewa Emer enc 12-OM7904 951-674-7352 949-279-0057 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirernents of Section 3 of CFR Part 135 of the HUD Act of 1968; or !t 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-12 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (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 r3W,& z< c C%,A bM _.hg►., C&"C My I I Y LC• 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 1 of 8 C-13 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not P been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No -L If the answer is yes, explain the circumstances in the following space. Page 2 of 8 C-14 June ll, 2014 Local Assistance Procedures Manual PUBLIC CONTRACT CODE 10232 STATEMENT Exhibit 12-H Sample Bid In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-15 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of A14 h -�(10I }Ur, "�ea DEPARTMENT OF BLIC WORKS. in conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal ,prosecution. Page 4 of 8 C-16 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-17 June 11, 2014 Local Assistance Procedures Manual NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS Exhibit 12-H Sample Bid The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-18 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES uUMYLC It I H16 rUKNl I U VIN-LU6L LUtili Y llVU AI, I IyI I ICJ rUKJUAIV I I U J I U.J.I,. I.JJG 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a. contract ® a. bid/offer/application a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. load For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 0� 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 0 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. IOa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount f 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 ea. cash d. contingent fee b. in -kind; specify: nature e deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Datc(s) of Service, including offieer(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 Signature: reliance was placed by the tier above when his transaction _1 was made or entered into. This disclosure is required Print Name:s/ pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required Title: r2bse��V disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: 9�J1 -tQ�� rZ S g2 Date: 7ZI 'JM4 Authorized for Local Reproduction Federal Use Only: Standard Fonn - LLL Standard lonn LLL Kev. 09-12-97 Page 7 of 8 C-19 June11,2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid 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. 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. Check all boxes that apply. If other, specify nature. 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 8 of 8 C-20 June 11, 2014 ACOR 1 0 C" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/20/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED " REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Patriot Risk & Insurance Services 8105 Irvine Center Drive #400 Irvine, CA 92618 CONTACT NAME: AHCO"No. Ext: 949 486-7900 FAX No: 949 486-7950 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 www.patrisk.com OG55454 INSURED Beador Construction Company, Inc. 26320 Lester Circle INSURER B: National Union Fire Insurance Co. of Pittsburgh PA 19445 INSURERC: INSURER D: Corona CA 92883 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 19547805 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DD/YYPOLICY YY POLICY EXP MM /DD/YYYY LIMITS A �/ COMMERCIAL GENERAL LIABILITY TB2Z91455893024 1/15/2014 1/15/2015 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE F _v/1 DCCUR AMAIE TO RENTED MIS ES (E. occu ence)$ 300,000 ✓ _PRE ME EXP (Any one person) $ 5,000 Separation of Interests ✓ Deductible $10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY ✓❑ PR� LOC PRODUCTS-COMP/OPAGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY AS2Z91455893014 1/15/2014 1/15/2015 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 �/ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 1HIRED NO Deductible for Auto Liability BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED AUTOS AUTOS B ✓ UMBRELLA LIAB ✓ OCCUR BE034784252 1/15/2014 1/15/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I ✓ I RETENTION$10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY.PROPRIETORIPARTNER/EXECUTIVE —] WC49342321 1/15/2014 1/15/2015 ,/ STATUTE OERH E L. EACH ACCIDENT $ 1,000,000 _ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 1,000,000 A Inland Marine YM2Z91455893054 1/15/2014 1/15/2015 Rented/Leased Equipment: $500,000 Deductible: $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: BIDDING PURPOSES ONLY 30 days notice of cancellation, 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION BIDDING PURPOSES ONLY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i . Leonard E. Ziminsky 11 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 19547805 Annette Romero 3/20/2014 10:57:29 AM Page lof 1 This certificate cancels and supersedes ALL previously issued certificates. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181(169) C.C. No. 1356 July 1, 2014 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356: The following Project Plan sheets, originally advertised on 6/19/2014, shall be respectively replaced by the attached Project Plan sheets APPROVED BY TRANSPORTATION ENGINEERING on 7/01/14: • SHEET NO.4 OF 14 (TC1) TRAFFIC CONTROL PLAN 1 • SHEET NO. 5 OF 14 (TC2) TRAFFIC CONTROL PLAN 2 • SHEET NO.6 OF 14 (TC3) TRAFFIC CONTROL PLAN 3 • SHEET NO. 7 OF 14 (TC4) TRAFFIC CONTROL PLAN 4 SHEET NO. 8 OF 14 (SS1) SIGNING AND STRIPING PLAN 2. The Federal Labor Rates contained in Appendix I — Part 2 of the Project Specifications for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 06/20/2014). The attached FEDERAL LABOR RATES (Publication Date 06/20/2014) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 1, 2014. I&rAe �01/ 6CZfh'ue.&h � �, �f�C• �l �J ccoY , Pre3��C� Company Name By G11I& Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Commitment (Construction Contracts) EXHIBIT 15-G LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: n LOCATION: F u h�%nS // PROJECT DESCRIPTION: Wo-V 1 ly )N,V �d� �a tV>vi �I-ApI ciC4 Gyrll �a NU//17f/ TOTAL CONTRACT AMOUNjjT:$ CPl0, 300, BID DATE: I 1 0] I i BIDDERS NAME:& 0 -CXCv `ooy)-�,Ao l ,U' nl7p r-111 , / VI CONTRACT DBE GOAL: 1 O , 1 CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a DBE) DBE CERT NO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) OLLAR AMOUNT DBE 1 'u6ee 3 ee r-erl �o r-babn I, 3q I53 6&_ C- 3.7 ' % e,4 G0 3(4153 A '2U • OA v rrl 3 iA-dKp rS3 ¢ 0—n 6, 8dS.o0 19 kemwrgae W 3 Ise Ee 3 il53 5•7,o-Ov a c. k S i�*-2rn u d S i `off For Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number: Federal Share. Total Claimed DBE Participation o t y % Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number: Si e idder Date (Area Code) Tel. No. [)at4il &e&,.&a✓ Person to Contact (Please Type or Print) Local Agency Bidder DBE Conunitment (Construction Contr_acis)t (Rev 6/26/09) J Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract execution. Failure to send a copy to the DLAE within 30 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-1 OB 12-04 C-21 June 29, 2012 EXHIBIT 15-G Local Assistance Procedures Manual Local Agency Bidder DBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive Th;, form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-2 June 29, 2012 C-22 OB 12-04 ACSTAR INSURANCE COMPANY 30 SOUTH ROAD • FARMINGTON, Cr 06032 • (860) 415-8400 BOND NO. B29414 BID BOND KNOW ALL MEN BY THESE PRESENTS, that We Beador Construction Company, Inc., as Principal, and ACSTAR INSURANCE COMPANY, 30 South Road, Farmington, Connecticut 06032, a corporation duly organized under the State of Illinois as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 as Obligee, hereinafter called the Obligee, in the penal sum of TEN PERCENT OF BID AMOUNT Dollars (10% OF AMOUNT BID) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for CC-1356-WARNER AVE. BRIDGE, BRIDGE PREVENTIVE MAINTENANCE, CITY OF HUNTINGTON BEACH NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee, or in the event of the failure of the Principal to enter into such Contract and 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. This obligation shall expire and be null and void 90 days from the date executed as set forth below. This obligation shall expire and be null and void 90 days from the date of execution as set forth below. No action may be commenced upon this bond later than 90 days from the date of execution, as set forth, below, provided that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof, such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. This bond is null and void unless signed by Principal and Surety. Signed and sealed this 3ro day of July, 2014. ATTEST: Pri ction Comganv. Inc. (Seal) ATTEST: ACSTAR INSURANCE COMPANY Surety (Seal) BY N ry W. Nozko, Jr. Title: resident CSTARPOWER OF ATTORNEY INSURANCE COMPANY NO. 3 5 6 5 2 30 SOUTH ROAD • FARMINGTON, CT 06032 • (860) 415-8400 This Power of Attorney must have original corporate seal and red and blue ACSTAR logo to be valid. Know all men by these presents: That ACSTAR Insurance Company, a corporation of the State of Illinois, having its principal office in the Town of Farmington, Connecticut, pursuant to the following Resolution, which was adopted by the Board of Directors of the said Company on November 14, 2013, to wit: RESOLVED, That the following Rules shall govern the execution for the Company of bonds, undertakings, recognizances, contracts and other writings in the nature thereof: (1) That the Chairman, the President, Executive Vice President and General Counsel, or any Attomey-in-fact, may execute for and on behalf of the Company any and all bonds, undertakings, recognizances, contracts and other writings in the nature thereof, the same to be attested when necessary by the Corporate Secretary, or any Assistant Corporate Secretary, and the seal of the Company affixed thereto; and that the Chairman or President may appoint and authorize any other Officer (elected or appointed) of the Company, and Atto meys-in -Fact to so execute or attest to the execution of all such writings on behalf of the Company and to affix the seal of the Company thereto. (2) Any such writing executed in accordance with these Rules shall be as binding upon the Company in any case as though signed by the President and attested to by the Corporate Secretary. (3) The signature of the Chairman, the President, or Executive Vice President of the Company may be affixed by facsimile on any power of attorney granted pursuant to this Resolution, and the signature of a facsimile to any certificate of any such power, and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. (4) Such other Officers of the Company, and Attomeys-in-Fact shall have authority to certify or verify copies of this Resolution, the By -Laws of the Company, and any affidavit or record of the Company necessary to the discharge of their duties. does hereby nominate, constitute and appoint HENRY W. NOZKO, JR., HENRY W. NOZKO III, GARY M. CASE, CARMEN CARLTON, each individually, its true and lawful Attomey-i n -fact, to make, execute, seal and deliver on its behalf, and as its act and deed any and all bonds, undertakings, recognizances, contracts and other writings in the nature thereof in penalties not exceeding TEN MILLION DOLLARS ($10,000,000.00) each, and the execution of such writings in pursuance of these presents, shall be as binding upon said Company, as fully and amply, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office. IN WITNESS WHEREOF, Henry W. Nozko, Jr., President, have hereunto subscribed his name and affixed the corporate seal of the ACSTAR INSURANCE COMPANY this 15" day of November 2013. STATE OF CONNECTICUT ) ) ss. FARMINGTON COUNTY OF HARTFORD ) ACSTAR Insurance Company By�"44t4VO-I- Henry W. zko, Jr., Pk4dent On this 15t' day of November A.D. 2013, before me, a Notary Public of the State of Connecticut came, Henry W. Nozko, Jr., President of the ACSTAR Insurance Company, to me personally known to be the individual and officer who executed the preceding instrument, and he acknowledged that he executed the same, and the seal affixed to the preceding instrument is the corporate seal of said Company; that the said corporate seal and his signature was duly affixed by the authority and direction of the said corporation, and the Resolution adopted by the Board of Directors of said Company, referred to in the preceding instrument, is now in force. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal at the Town of Farmington the day and year first above written. N0111t11111"J/ 10 'IOTA. Diane L. Plante - Notary Public My Commission Expiration Date: November 30, 2018 lflllll I, the undersigned, Secretary or Assistant Secretary of ACSTAR Insurance Company, do hereby certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy, is in full force and.effect. In witness whereof, I have hereunto subscribed my name as Secretary or Assistant Secretary, and affixed the corporate seal of the Corporation, this 3rd day of July 2014 Henry W. Nozko III/Maurice C. Shea Secretary/Assistant Secretary State of Connecticut ACKNOWLEDGEMENT County of Hartford on July 3, 2014 before me, Tamara Lee Kokiel, Notary Public (here insert name and title of the officer) personally appeared Henry W. Nozko, Jr. personally known to me (or 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 acknowledge 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. TAMARA LEE KOKIEL WITNESS m and and official seal. NOTARY PUBLIC My COlu m=M EXPIRES MA 311016 Signature (Seal) OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE(S) ❑ PARTNER(S) H LIMITED GENERAL �❑ ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT Bond No. B29414 TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES 7/3/14 DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE FRP City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Joan L. Flynn, City Clerk September 22, 2014 Future DB International, Inc. 8707 Research Drive Irvine, CA 92618 RE: Warner Avenue Bridge Maintenance— CC-1 356 Enclosed please find your original bid bond for CC-1356. Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand �yw 5, 4 Wool' �0 j,P 0 Future DB International Inc. Q y - `,!N" 41, a, 8707 Research Drive 4"po" y"-YjMKA �- loci-, , W " : , - - � 2 - �, . ­ � � , J, Irvine CA 92618 q, PY low pCj v '1 4 Qf I ra 01- Y-M,-Q, I "Q WV 1 As A :40"2" OAK, _4 ,j o" 'tw" 14 - r,5 jjq p i4 Is, Nil It q! Sy f MEN, A A Not I �Lj, ;i4 T 11,rl�L, 1, J�-6 q- �,;,e p 'VI PM �Ml ,, . , I il A .— X � 11 a, p VAIN _,­ � "I" � Kole, Ws -W, ON F I - Alt, YT W, -J, hp- T a P, % %go JW RE , 2 N _01 All, 31 ql� 1� a yN M d M,­!­�" ur, Nit MAI lcx 7 0*` Ps af'-" a.. ! "Y,17 •" e itRw 14 + AA"IVA 40 air M a.1 1 1 sk T N U W—M tkp"01 t 1, WIW` Q= ME mop, MIMI IR 11 x Jim AM PC z A 14t OTC 04W52% QVIAC, WAR. on TOM .0 50- was -T Q_,Q! 4 new A" "�M­j pa"M"We WA 41 1 jp r Qq Ply It, A. - , �­ `_ 0 IQC 31 9_4 j): 101 i EVE M Q -Ill 16 41 Mew, 1" i4 " 2 Nuriw N5 9 AM "SEALED EUD" 11 Qg pb. j for the construction of jy � . ­­ - "%r 1'� . i�6� & INARNER AVENUE BRIDGE PREVENTIVE MAINTE 41ill W, MAINTENANCE IryJ ­.'. -:­ ,11­1 va, (OVER BOLSA CHICA CHANNEL) Federal Aid Project EIPNqPL-519-1 (109)plw V, C.C. No. 1356 Q7 PVT Ina III _1e .',4, a "Un AWN !Oro I- n Z V5 'j; �4",4 TIP, Mill, loci a OKM, in the City of Huntington Beach Uf ply axe, lot R --As IS had p.- gp IQ 7 "Im.PY 71, T"i U�; IT IS a. W W ii umv g! 1 1 "Tom--; rilyq- W'" JAW Q Z-0 J wy 01% A I e 1-5. ajk��. WaW V", t V-0 -vow AMP 'k Amm" fa own 0 5, Al, t 1WE NM'Y 144 __ -• WZY, IL MOW "PTO t, A W N, Xj�', q no 0- F.'lam"W Ulm "WAYNAA -&,�Twmk "woo 00, 4--b-, MIN f ­0,��­._, . I , , qp% 0%; A f F-w �"qr� zk V J bx'rlF " I-; 'Vis Amt1 A L." pw�. gm low -nybz- I,1`11 W", 0,01 mgm -o' WAW AV K y"I q­�n C", X �, � " -W . Nor 611 Xot 11410111�-j 0 "'A I 'T 4P V4 UG! Nj T" , I . SECTION C PROPOSAL for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 a bidder's bond in the amount of $ 10% of total bid which said amount is not less than 10% of the aggregate of the total amount bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for %", as the case may be). Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received B' der's Signature,—, 1 July 1, 2014 C-2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 1 1 LS Mobilization $ 100 000 . At $ (CO oc�o 2 1 LS Prepare Storm Water Pollution Prevention Plan $ $ ow" 3 1 LS Water Pollution Control q $l3 OCK5•o0 $ 00 4 1 LS Access Grading JIS (00.°O $ $ 5 1 LS Traffic Control $ 6 (000. / $ b (000. 6 13020 SF Saw Cut, Grind and Remove AC Pavement $ 2 , vo 7 82 TN Asphalt Tack Coat and AC Leveling Pavement $S oZ . Qo 8 163 TN ARHM Finish Course Pavement $ C-2.1 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 8 LF Saw Cut and Remove Existing PCC Curb/Gutter g $ S 00 , 00 $ v0o 6 8 LF Construct Variable Height PCC Curb and Gutter 10 $ Soo. 00 $ Ooo . ao 124 LF Install 4' High Environmental Protection Fence 11 $ 33 . 00 $ Z. 2 EA Adjust Gas Valve Frame and Cover to Grade 12 $�OLO•a 0 $ 2 q0 1 LS Install Striping and Pavement Markings 13 *� $� 7 o•o d d 3 ND.0 33 CF Remove Unsound Concrete 14 $3100, $1az3Go. 234 LF Remove Concrete Barrier 15 $ 500 . °O $�(� 00o.'1 234 LF Remove Chain Link Railing 16 $ 0S.00 60 $3s(o. C-2.2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 65 LF Remove Metal Beam Guard Railing 17 s101,00 $ 0 M 65 LF Metal Beam Guard Railing 18 $ 1� , OD $ qS 0,� 50 LF Remove and Reconstruct Wood Rail Fence 19 $ $ 00.6 33 CF Portland Cement Concrete (Patch) 5do �/�rC i I.Joo,o 20 •0 $ $ 310 CY Rock Slope Protection (1/4 Ton Method A) 21 r,.q $05 O .00 $107110. 310 SY Rock Slope Protection Fabric (Class 8) 22 $ . 0 o $ 3 10 . o0 117 LF Concrete Barrier (Type 26 Modified) 23 $ 0 -�� 0 $ 0 �. 117 LF Concrete Barrier (Type 732 Modified) 0 24 C-2.3 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 234 LF Wildlife Protection Railing 25 $ 6480 SF Seal Concrete Bridge Deck 26 $ Z . Vo $���60. 1 LS Planting and Habitat Mitigation 27 q $ 0 OOb . $ � 000.oe 1 LS Planting Maintenance 28 (� $ S��O . [� $ J ri00 ,� Total Amount Bid in Figures: $ qj O . 0 o Total Amount Bid in Words:...c�....n�{r..�.�....�j.�.ne..�'..... .Oc/S�cn ..............w...o............ eVP F �- C-2.4 SECTION C 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class Thm 13 N4 SC c k Yes mpa" r d , (ac k,,; n C A l 3 0 0 0 c' 13 C 32 l h�s(qft2o Yn den uc '"` nAve �0ctn e �2Z- `� C-�3 3 (r) Ca((f S rrh rcj COS �c a �' o 8( r5 ode 71 (�� 2 Q -11 r e a C- (2 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange I declare under penalty of perjury under the laws of the St e o California that the foregoing is true and correct and that this declaration is executed on In , at Irvine ,CA Date City State Bisher Aljazzar , being first duly sworn, deposes and says that he or she is CEO/President of Future DB International 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. Future DB International Inc. Name of dder gnature of Bidder 8707 Research Dr., Irvine, CA, 92618 Address of Bidder Subscribed and sworn to before me this �b day ofy�, 201 ­ &LU NOTARY PUBLIC /v� a Y CATHERINE MORRISSEY I COMM. #2029293 z Notary Public • California o Orange County _ 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 WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (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: _;� — /0 ' /Y Future DB International Inc. Contractor By CEO/President/Secretary Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes )4 No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 7- w - / y Future DB International Inc. Contractor Title CEO/President/Sec C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Future DB International Inc. Bidder Name 8707 Research Dr. Business Address Irvine City, ( 949 ) 390-2111 Telephone Number 976670 Class A and B State Contractor's License No. and Class 9/14/2014 Original Date Issued 9/30/2014 Expiration Date The work site was inspected by Tom Smulski CA 92618 State Zip of our office on July , 2014. The following are persons, firms, and corporations having a principal interest in this proposal: Bisher Aljazzar, CEO/President/Secretary C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Future DB International Inc. Bisher Aljazzar Printed or Typed Signature /� Subscribed and sworn to before me this W day of U- , 201 1I 'CATHERINE MURISSEY L COMM. #2029293 z Notary Public • California o z Orange County -� NOTARY PUBLIC Comm. Expires June 16, 2017 J NOTARY SEAL C-9 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: Caltrans, District 07, 902 San Gabriel Boulevard, Rosemead, CA 91770 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Pravin Patel, (213) 798-6053 projected completion Caltrans 07-272404 $1,128,198.50 date: August, 2014 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Highway improvement project. Concrete, rock slope protection, landscaping, irriaation. 2. Los Angeles Department of Public Works, Bureau of Engineering Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Nur Malhis, (213) 485-5096 projected completion Avenue 26 Bridge over Arroyo Seco Seismic Retrofit $796,921.95 date: February 2014 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Bridge seismic retrofit. New structural concrete, FRP wrap. CA/Department of Transportation, 334 Michelson Dr., Suite 100 Irvine, CA, 92612 Name and Address of Public Agency Name and Phone # of Agency's Project Manager Caltrans 12-OM5804 Kifah Ramadan, (949) 279-8625 projected completion $796,184 date: Nov. 2014 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Construct sidewalk with minor concrete and drainage culvert. C-10 BIDDER'S CRITICAL STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. 1. Faisal Shari Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: (949) 701-2601 building, seven story Teaching & Learning Center, $53.5 Million teaching & learning center 07/2012 Project Name & Contract Amount Type of Work Date Completed building, two-story Hollenbeck Police Station, $34.5 Million ultra -modern police station 08/2009 Project Name & Contract Amount Type of Work Date Completed slope protection & Caltrans 07-272404 $1,128,198 landscaping 07/2014 Project Name & Contract Amount Type of Work Date Completed 2. Carlos Mendoza Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: (951) 675-5154 Port of Los Angeles Police demolition and building Headquarters, $60 Million two-story police facility 02/2012 Project Name & Contract Amount Type of Work Date Completed building, two-story Hollenbeck Police Station, $34.5 Million ultra -modern police station 08/2009 Project Name & Contract Amount Type of Work Date Completed Burbank Airport $72.2 Million parking structure Summer 2014 Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Future DB International Inc. Contact Person: Bisher Aliazzar Contact Phone: 949 390- 1 Signed: Date: /0 - ly *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-12 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (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 Future DB International Inc. , proposed subcontractor , hereby certifies that he has has notX., 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 1 of 8 C-13 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has notXbeen convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. Page 2 of 8 C-14 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-15 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Orange DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-16 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-17 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for snaking or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-18 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES k.,U1VIYLC I C I 1­11S I'UKM I U UISGLUSC. LUbt3 Y lNU AU I IV 1 I I t. , FUKSUAN I l U S l U.S.G. 1 SQL 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application = a. initial grant b. initial award b. material change c. ooperative agreement c. post -award d. 1 n For Material Change Only: e. loa uarantee year quarter f. loan i urance date of last report 4. Name and ddress 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, i nown Congressional District, if known 6. Federal Department/Agenc • 7. Federal Program Name/Description: ��j 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) (last name, first name, MI) (attach Continuation Sheet if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer one-time fee 12. Form of Payment (check all that apply): c. commission 8riti a.cash d. ngent fee b. in -kind; specify: nature e de ed value f, other, p 14. Brief Description of Services Performed or to be performed and Date(s) of officer(s), employee(s), or member(s) contacted, for Payment Indicated in 1 (attach Continuation Sheet(s) if necessary) rvice, including n 11: 15. Continuation Sheet(s) attached: Yes No M Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying Signature: reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required Print Name: pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required Title: disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: Date: Federal Use Only: Authorized for Local Reproduction Standard Form - LLL Standard Form LLL Rev. 09-12-97 Page 7 of 8 C-19 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid 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 I). 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) perfonning services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). It. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item I0). 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. 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. Check all boxes that apply. If other, specify nature. 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.06-04-9NENDIF» Page 8 of 8 C-20 June 11, 2014 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181(169) C.C. No. 1356 July 1, 2014 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356: The following Project Plan sheets, originally advertised on 6/19/2014, shall be respectively replaced by the attached Project Plan sheets APPROVED BY TRANSPORTATION ENGINEERING on 7/01/14: • SHEET NO.4 OF 14 (TC1) TRAFFIC CONTROL PLAN 1 • SHEET NO. 5 OF 14 (TC2) TRAFFIC CONTROL PLAN 2 • SHEET NO.6 OF 14 (TC3) TRAFFIC CONTROL PLAN 3 • SHEET NO. 7 OF 14 (TC4) TRAFFIC CONTROL PLAN 4 • SHEET NO. 8 OF 14 (SS1) SIGNING AND STRIPING PLAN 2. The Federal Labor Rates contained in Appendix I — Part 2 of the Project Specifications for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 06/20/2014). The attached FEDERAL LABOR RATES (Publication Date 06/20/2014) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 1, 2014. Ti Off=-- .li0�i�l�e�r��iar.�c 1 T� c . K —a - zo:: � � �� Company Name By (0-- /y Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. FEDERAL LABOR RATES (Publication Date 06/20/2014) General Decision Number: CA140035 06/20/2014 CA35 Superseded General Decision Number: CA20130035 State: California Construction Types: Building, Heavy (Heavy and Dredging) and Highway County: Orange County in California. BUILDING CONSTRUCTION PROJECTS; DREDGING PROJECTS (does not include hopper dredge work); HEAVY CONSTRUCTION PROJECTS (does not include water well drilling); HIGHWAY CONSTRUCTION PROJECTS Modification Number 0 1 2 3 4 5 6 7 8 9 10 11 ASBE0005-002 07/01/2013 Publication Date O1/03/2014 O1/10/2014 O1/24/2014 02/21/2014 03/07/2014 03/14/2014 04/25/2014 05/09/2014 05/23/2014 06/06/2014 06/13/2014 06/20/2014 Rates Fringes Asbestos Workers/Insulator (Includes the application of all insulating materials, protective coverings, coatings, and finishes to all types of mechanical systems) ..... $ 34.51 18.55 Fire Stop Technician (Application of Firestopping Materials for wall openings and penetrations in walls, floors, ceilings and curtain walls) ...........................$ 24.34 16.09 ASBE0005-004 06/24/2013 Rates Fringes Asbestos Removal worker/hazardous material handler (Includes preparation, wetting, stripping, removal, scrapping, vacuuming, bagging and disposing of all insulation materials from mechanical systems, whether they contain asbestos or not) .... $ 16.95 10.23 ---------------------------------------------------------------- * BRCA0004-010 05/01/2014 Rates Fringes BRICKLAYER; MARBLE SETTER ........ $ 36.35 13-22 *The wage scale for prevailing wage projects performed in Blythe, China lake, Death Valley, Fort Irwin, Twenty -Nine Palms, Needles and 1-15 corridor (Barstow to the Nevada State Line) will be Three Dollars ($3.00) above the standard San Bernardino/Riverside County hourly wage rate ---------------------------------------------------------------- * BRCA0018-004 06/01/2014 Rates Fringes MARBLE FINISHER ..................$ 28.45 11.38 TILE FINISHER ....................$ 23.78 9.84 TILE LAYER .......................$ 35.14 14.33 ---------------------------------------------------------------- BRCA0018-010 09/01/2013 Rates Fringes TERRAZZO FINISHER ................$ 26.59 10.34 TERRAZZO WORKER/SETTER ........... $ 33.63 11.13 ---------------------------------------------------------------- CARP0409-001 07/01/2010 Rates Fringes CARPENTER (1) Carpenter, Cabinet Installer, Insulation Installer, Hardwood Floor Worker and acoustical installer ...................$ 37.35 11.08 (2) Millwright ..............$ 37.85 11.08 (3) Piledrivermen/Derrick Bargeman, Bridge or Dock Carpenter, Heavy Framer, Rock Bargeman or Scowman, Rockslinger, Shingler (Commercial) ................$ 37.48 11.08 (4) Pneumatic Nailer, Power Stapler ...............$ 37.60 11.08 (5) Sawfiler...............$ 37.44 11.08 (6) Scaffold Builder ....... $ 28.55 11.08 (7) Table Power Saw Operator ....................$ 37.45 11.08 FOOTNOTE: Work of forming in the construction of open cut sewers or storm drains, on operations in which horizontal lagging is used in conjunction with steel H-Beams driven or placed in pre- drilled holes, for that portion of a lagged trench against which concrete is poured, namely, as a substitute for back forms (which work is performed by piledrivers):'$0.13 per hour additional. ---------------------------------------------------------------- CARP0409-005 07/01/2010 Rates Fringes Drywall DRYWALL INSTALLER/LATHER .... $ 37.35 11.08 STOCKER/SCRAPPER ............ $ 10.00 6.67 ---------------------------------------------------------------- CARP0409-008 08/01/2010 Rates Fringes Modular Furniture Installer ...... $ 17.00 7.41 ---------------------------------------------------------------- ELECO011-002 11/25/2013 COMMUNICATIONS AND SYSTEMS WORK Rates Fringes Communications System Installer ...................$ 27.75 12.36 Technician ..................$ 29.55 12.42 SCOPE OF WORK: Installation, testing, service and maintenance of systems utilizing the transmission and/or transference of voice, sound, vision and digital for commercial, educational, security and entertainment purposes for the following: TV monitoring and surveillance, background -foreground music, intercom and telephone interconnect, inventory control systems, microwave transmission, multi -media, multiplex, nurse call systems, radio page, school intercom and sound, burglar alarms, fire alarm (see last paragraph below) and low voltage master clock systems in commercial buildings. Communication Systems that transmit or receive information and/or control systems that are intrinsic to the above listed systems; inclusion or exclusion of terminations and testings of conductors determined by their function; excluding all other data systems or multiple systems which include control function or power supply; excluding installation of raceway systems, conduit systems, line voltage work, and energy management systems. Does not cover work performed at China Lake Naval Ordnance Test Station. Fire alarm work shall be performed at the current inside wireman total cost package. ELEC0441-001 02/24/2014 Rates Fringes CABLE SPLICER ....................$ 43.03 15.24 ELECTRICIAN ......................$ 41.14 15.18 ---------------------------------------------------------------- * ELEC0441-003 05/26/2014 COMMUNICATIONS & SYSTEMS WORK (excludes any work on Intelligent Transportation Systems or CCTV highway systems) Rates Fringes Communications System Installer ...................$ 29.09 11.60 Technician ..................$ 30.89 11.66 SCOPE OF WORK The work covered shall include .the installation, testing, service and maintenance, of the following systems that utilize the transmission and/or transference of voice, sound, vision and digital for commercial, education, security and entertainment purposes for TV monitoring and surveillance, background foreground music, intercom and telephone interconnect, inventory control systems, microwave transmission, multi -media, multiplex, nurse call system, radio page, school intercom and sound, burglar alarms and low voltage master clock systems. A. Communication systems that transmit or receive information and/or control systems that are intrinsic to the above listed systems SCADA (Supervisory control/data acquisition PCM (Pulse code modulation) Inventory control systems Digital data systems Broadband & baseband and carriers Point of sale systems VSAT data systems Data communication systems RF and remote control systems Fiber optic data systems B. Sound and Voice Transmission/Transference Systems Background -Foreground Music Intercom and Telephone Interconnect Systems Sound and Musical Entertainment Systems Nurse Call Systems Radio Page Systems School Intercom and Sound Systems Burglar Alarm Systems Low -Voltage Master Clock Systems Multi-Media/Multiplex Systems Telephone Systems RF Systems and Antennas and Wave Guide C. *Fire Alarm Systems -installation, wire pulling and testing. D. Television and Video Systems Television Monitoring and Surveillance Systems Video Security Systems Video Entertainment Systems Video Educational Systems CATV and CCTV E. Security Systems, Perimeter Security Systems, Vibration Sensor Systems Sonar/Infrared Monitoring Equipment, Access Control Systems, Card Access Systems *Fire Alarm Systems 1. Fire Alarms -In Raceways: Wire and cable pulling in raceways performed at the current electrician wage rate and fringe benefits. 2. Fire Alarms -Open Wire Systems: installed by the Technician. ELEC0441-004 02/24/2014 Rates Fringes ELECTRICIAN (TRANSPORTATION SYSTEMS, TRAFFIC SIGNALS & STREET LIGHTING) Cable Splicer/Fiber Optic Splicer .....................$ 41.74 15.20 Electrician .................$ 41.14 15.18 Technician ..................$ 30.86 14.88 SCOPE OF WORK: Electrical work on public streets, freeways, toll -ways, etc, above or below ground. All work necessary for the installation, renovation, repair or removal of Intelligent Transportation Systems, Video Surveilance Systems (CCTV), Street Lighting and and Traffic Signal work or systems whether underground or on bridges. Includes dusk to dawn lighting installations and ramps for access to or egress from freeways, toll -ways, etc. Intelligent Transportation Systems shall include all systems and components to control, monitor, and communicate with pedestrian or vehicular traffic, included but not limited to: installation, modification, removal of all Fiber optic Video System, Fiber Optic Data Systems, Direct interconnect and Communications Systems, Microwave Data and Video Systems, Infrared and Sonic Detection Systems, Solar Power Systems, Highway Advisory Radio Systems, highway Weight and Motion Systems, etc. Any and all work required to install and maintain any specialized or newly developed systems. All cutting, fitting and bandaging of ducts, raceways, and conduits. The cleaning, rodding and installation of "fish and pull wires". The excavation, setting, leveling and grouting of precast manholes, vaults, and pull boxes including ground rods or grounding systems, rock necessary for leveling and drainagae as well as pouring of a concrete envelope if needed. JOURNEYMAN TRANSPORTATION ELECTRICIAN shall perform all tasks necessary toinstall the complete transportation system. JOURNEYMAN TECHNICIAN duties shall consist of: Distribution of material at job site, manual excavation and backfill, installation of system conduits and raceways for electrical, telephone, cable television and comnmunication systems. Pulling, terminating and splicing of traffic signal and street lighting conductors and electrical systems including interconnect, dector loop, fiber optic cable and video/data. ---------------------------------------------------------------- ELEC1245-001 06/01/2013 Rates LINE CONSTRUCTION (1) Lineman; Cable splicer..$ 50.30 (2) Equipment specialist (operates crawler tractors, commercial motor vehicles, backhoes, trenchers, cranes (50 tons and below), overhead & underground distribution line equipment) ........... $ 40.17 (3) Groundman...............$ 30.73 (4) Powderman...............$ 44.91 Fringes 15.00 14.56 13.48 13.48 HOLIDAYS: New Year's Day, M.L. King Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day and day after Thanksgiving, Christmas Day ---------------------------------------------------------------- ELEV0018-001 01/01/2014 Rates Fringes ELEVATOR MECHANIC ................$ 49.03 26.785 FOOTNOTE: PAID VACATION: Employer contributes 80 of regular hourly rate as vacation pay credit for employees with more than 5 years of service, and 6% for 6 months to 5 years of service. PAID HOLIDAYS: New Years Day, Memorial Day, Independence Day, Labor Day, Veterans Day, Thanksgiving Day, Friday after Thanksgiving, and Christmas Day. ---------------------------------------------------------------- ENGI0012-003 08/26/2013 Rates Fringes OPERATOR: Power Equipment (All Other Work) GROUP 1....................$ 38.20 21.10 GROUP 2....................$ 38.98 21.10 GROUP 3....................$ 39.27 21.10 GROUP 4....................$ 40.76 21.10 GROUP 5....................$ 41.86 21.10 GROUP 6....................$ 40.98 21.10 GROUP 8....................$ 41.09 21.10 GROUP 9....................$ 42.19 21.10 GROUP 10....................$ 41.21 21.10 GROUP 11....................$ 42.31 21.10 GROUP 12....................$ 41.38 21.10 GROUP 13....................$ 41.48 21.10 GROUP 14....................$ 41.51 21.10 GROUP 15 ....................$ 41.59 21.10 GROUP 16 ....................$ 41.71 21.10 GROUP 17 ....................$ 41.88 21.10 GROUP 18 ....................$ 41.98 21.10 GROUP 19 ....................$ 42.09 21.10 GROUP 20 ....................$ 42.21 21.10 GROUP 21 ....................$ 42.38 21.10 GROUP 22 ....................$ 42.48 21.10 GROUP 23 ....................$ 42.59 21.10 GROUP 24 ....................$ 42.71 21.10 GROUP 25 ....................$ 42.88 21.10 OPERATOR: Power Equipment (Cranes, Piledriving & Hoisting) GROUP 1 ....................$ 39.55 21.10 GROUP 2 ....................$ 40.33 21.10 GROUP 3 .................... $"40.62 21.10 GROUP 4 ....................$ 40.76 21.10 GROUP 5 ....................$ 40.98 21.10 GROUP 6 ....................$ 41.09 21.10 GROUP 7 ....................$ 41.21 21.10 GROUP 8 ....................$ 41.38 21.10 GROUP 9 ....................$ 41.55 21.10 GROUP 10 ....................$ 42.55 21.10 GROUP 11 ....................$ 43.55 21.10 GROUP 12 ....................$ 44.55 21.10 GROUP 13 ....................$ 45.55 21.10 OPERATOR: Power Equipment (Tunnel Work) GROUP 1 ....................$ 40.05 21.10 GROUP 2 ....................$ 40.83 21.10 GROUP 3 ....................$ 41.12 21.10 GROUP 4 ....................$ 41.26 21.10 GROUP 5 ....................$ 41.48 21.10 GROUP 6 ....................$ 41.59 21.10 GROUP 7 ....................$ 41.71 21.10 PREMIUM PAY: $3.75 per hour shall be paid on all Power Equipment Operator work on the followng Military Bases: China Lake Naval Reserve, Vandenberg AFB, Point Arguello, Seely Naval Base, Fort Irwin, Nebo Annex Marine Base, Marine Corp Logistics Base Yermo, Edwards AFB, 29 Palms Marine Base and Camp Pendleton Workers required to suit up and work in a hazardous material environment: $2.00 per hour additional. Combination mixer and compressor operator on gunite work shall be classified as a concrete mobile mixer operator. SEE ZONE DEFINITIONS AFTER CLASSIFICATIONS POWER EQUIPMENT OPERATORS CLASSIFICATIONS GROUP 1: Bargeman; Brakeman; Compressor operator; Ditch Witch, with seat or similar type equipment; Elevator operator -inside; Engineer Oiler; Forklift operator (includes loed, lull or similar types under 5 tons; Generator operator; Generator, pump or compressor plant operator; Pump operator; Signalman; Switchman GROUP 2: Asphalt -rubber plant operator (nurse tank operator); Concrete mixer operator -skip type; Conveyor operator; Fireman; Forklift operator (includes loed, lull or similar types over 5 tons; Hydrostatic pump operator; oiler crusher (asphalt or concrete plant); Petromat laydown machine; PJU side dum jack; Screening and conveyor machine operator (or similar types); Skiploader (wheel type up to 3/4 yd. without attachment); Tar pot fireman; Temporary heating plant operator; Trenching machine oiler GROUP 3: Asphalt -rubber blend operator; Bobcat or similar type (Skid steer); Equipment greaser (rack); Ford Ferguson (with dragtype attachments); Helicopter radioman (ground); Stationary pipe wrapping and cleaning machine operator GROUP 4: Asphalt plant fireman; Backhoe operator (mini -max or similar type); Boring machine operator; Boxman or mixerman (asphalt or concrete); Chip spreading machine operator; Concrete cleaning decontamination machine operator; Concrete Pump Operator (small portable); Drilling machine operator, small auger types (Texoma super economatic or similar types - Hughes 100 or 200 or similar types - drilling depth of 30' maximum); Equipment greaser (grease truck); Guard rail post driver operator; Highline cableway signalman; Hydra-hammer-aero stomper; Micro Tunneling (above ground tunnel); Power concrete curing machine operator; Power concrete saw operator; Power -driven jumbo form setter operator; Power sweeper operator; Rock Wheel Saw/Trencher; Roller operator (compacting); Screed operator. (asphalt or concrete); Trenching machine operator (up to 6 ft.); Vacuum or much truck GROUP 5: Equipment Greaser (Grease Truck/Multi Shift). GROUP 6: Articulating material hauler; Asphalt plant engineer; Batch plant operator; Bit sharpener; Concrete joint machine operator (canal and similar type); Concrete planer operator; Dandy digger; Deck engine operator; Derrickman (oilfield type); Drilling machine operator, bucket or auger types (Calweld 100 bucket or similar types - Watson 1000 auger or similar types - Texoma 330, 500 or 600 auger or similar types - drilling depth of 45' maximum); Drilling machine operator; Hydrographic seeder machine operator (straw, pulp or seed), Jackson track maintainer, or similar type; Kalamazoo Switch tamper, or similar type; Machine tool operator; Maginnis internal full slab vibrator, Mechanical berm, curb or gutter(concrete or asphalt); Mechanical finisher operator (concrete, Clary -Johnson -Bidwell or similar); Micro tunnel system (below ground); Pavement breaker operator (truck mounted); Road oil mixing machine operator; Roller operator (asphalt or finish), rubber -tired earth moving equipment (single engine, up to and including 25 yds. struck); Self-propelled tar pipelining machine operator; Skiploader operator (crawler and wheel type, over 3/4 yd. and up to and including 1-1/2 yds.); Slip form pump operator (power driven hydraulic lifting device for concrete forms); Tractor operator -bulldozer, tamper -scraper (single engine, up to 100 h.p. flywheel and similar types, up to and including D-5 and similar types); Tugger hoist operator (1 drum); Ultra high pressure waterjet cutting tool system operator; Vacuum blasting machine operator GROUP 8: Asphalt or concrete spreading operator (tamping or finishing); Asphalt paving machine operator (Barber Greene or similar type); Asphalt -rubber distribution operator; Backhoe operator (up to and including 3/4 yd.), small ford, Case or similar; Cast -in -place pipe laying machine operator; Combination mixer and compressor operator (gunite work); Compactor operator (self-propelled).; Concrete mixer operator (paving); Crushing plant operator; Drill Doctor; Drilling machine operator, Bucket or auger types (Calweld 150 bucket or similar types - Watson 1500, 2000 2500 auger or similar types - Texoma 700, 800 auger or similar types - drilling depth of 60' maximum); Elevating grader operator; Grade checker; Gradall operator; Grouting machine operator; Heavy-duty repairman; Heavy equipment robotics operator; Kalamazoo balliste regulator or similar type; Kolman belt loader and similar type; Le Tourneau blob compactor or similar type; Loader operator (Athey, Euclid, Sierra and similar types); Mobark Chipper or similar; Ozzie padder or similar types; P.C. slot saw; Pneumatic concrete placing machine operator (Hackley-Presswell or similar type); Pumperete gun operator; Rock Drill or similar types; Rotary drill operator (excluding caisson type); Rubber -tired earth -moving equipment operator (single engine, caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds. up to and including 50 cu. yds. struck); Rubber -tired earth -moving equipment operator (multiple engine up to and including 25 yds. struck); Rubber -tired scraper operator (self -loading paddle wheel type -John Deere, 1040 and similar single unit); Self- propelled curb and gutter machine operator; Shuttle buggy; Skiploader operator (crawler and wheel type over 1-1/2 yds. up to and including 6-1/2 yds.); Soil remediation plant operator; Surface heaters and planer operator; Tractor compressor drill combination operator; Tractor operator (any type larger than D-5 - 100 flywheel h.p. and over, or similar -bulldozer, tamper, scraper and push tractor single engine); Tractor operator (boom attachments), Traveling pipe wrapping, cleaning and bendng machine operator; Trenching machine operator (over 6 ft. depth capacity, manufacturer's rating); trenching Machine with Road Miner attachment (over 6 ft depth capacity): Ultra high pressure waterjet cutting tool system mechanic; Water pull (compaction) operator GROUP 9: Heavy Duty Repairman GROUP 10: Drilling machine operator, Bucket or auger types (Calweld 200 B bucket or similar types -Watson 3000 or 5000 auger or similar types-Texoma 900 auger or similar types -drilling depth of 105' maximum); Dual drum mixer, dynamic compactor LDC350 (or similar types); Monorail locomotive operator (diesel, gas or electric); Motor patrol -blade operator (single engine); Multiple engine tractor operator (Euclid and similar type -except Quad 9 cat.); Rubber -tired earth -moving equipment operator (single engine, over 50 yds. struck); Pneumatic pipe ramming tool and similar types; Prestressed wrapping machine operator; Rubber -tired earth -moving equipment operator (single engine, over 50 yds. struck); Rubber tired earth moving equipment operator (multiple engine, Euclid, caterpillar and similar over 25 yds. and up to 50 yds. struck), Tower crane repairman; Tractor loader operator (crawler and wheel type over 6-1/2 yds.); Woods mixer operator (and similar Pugmill equipment) GROUP 11: Heavy Duty Repairman - Welder Combination, Welder - Certified. GROUP 12: Auto grader operator; Automatic slip form operator; Drilling machine operator, bucket or auger types (Calweld, auger 200 CA or similar types - Watson, auger 6000 or similar types - Hughes Super Duty, auger 200 or similar types - drilling depth of 175' maximum); Hoe ram or similar with compressor; Mass excavator operator less tha 750 cu. yards; Mechanical finishing machine operator; Mobile form traveler operator; Motor patrol operator (multi -engine); Pipe mobile machine operator; Rubber -tired earth- moving equipment operator (multiple engine, Euclid, Caterpillar and similar type, over 50 cu. yds. struck); Rubber -tired self- loading scraper operator (paddle -wheel -auger type self -loading - two (2) or more units) GROUP 13: Rubber -tired earth -moving equipment operator operating equipment with push-pull system (single engine, up to and including 25 yds. struck) GROUP 14: Canal liner operator; Canal trimmer operator; Remote- control earth -moving equipment operator (operating a second piece of equipment: $1.00 per hour additional); Wheel excavator operator (over 750 cu. yds.) GROUP 15: Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (single engine, Caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds. and up to and including 50 yds. struck); Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (multiple engine -up to and including 25 yds. struck) GROUP 16: Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (single engine, over 50 yds. struck); Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (multiple engine, Euclid, Caterpillar and similar, over 25 yds. and up to 50 yds. struck) GROUP 17: Rubber -tired earth -moving equipment operator, operating equipment with push-pull system (multiple engine, Euclid, Caterpillar and similar, over 50 cu. yds. struck); Tandem tractor operator (operating crawler type tractors in tandem - Quad 9 and similar type) GROUP 18: Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - single engine, up to and including 25 yds. struck) GROUP 19: Rotex concrete belt operator (or similar types); Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - single engine, Caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds.and up to and including 50 cu. yds. struck); Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - multiple engine, up to and including 25 yds. struck) GROUP 20: Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - single engine, over 50 yds. struck); Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps, and similar types in any combination, excluding compaction units - multiple engine, Euclid, Caterpillar and similar, over 25 yds. and up to 50 yds. struck) GROUP 21: Rubber -tired earth -moving equipment operator, operating in tandem (scrapers, belly dumps and similar types in any combination, excluding compaction units - multiple engine, Euclid, Caterpillar and similar type, over 50 cu. yds. struck) GROUP 22: Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (single engine, up to and including 25 yds. struck) GROUP 23: Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (single engine, Caterpillar, Euclid, Athey Wagon and similar types with any and all attachments over 25 yds. and up to and including 50 yds. struck); Rubber -tired earth -moving equipment operator, operating with the tandem push-pull system (multiple engine, up to and including 25 yds. struck) GROUP 24: Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (single engine, over 50 yds. struck); Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (multiple engine, Euclid, Caterpillar and similar, over 25 yds. and up to 50 yds. struck) GROUP 25: Concrete pump operator -truck mounted; Rubber -tired earth -moving equipment operator, operating equipment with the tandem push-pull system (multiple engine, Euclid, Caterpillar and similar type, over 50 cu. yds. struck) CRANES, PILEDRIVING AND HOISTING EQUIPMENT CLASSIFICATIONS GROUP 1: Engineer oiler; Fork lift operator (includes loed, lull or similar types) GROUP 2: Truck crane oiler GROUP 3: A -frame or winch truck operator; Ross carrier operator (jobsite) GROUP 4: Bridge -type unloader and turntable operator; Helicopter hoist operator GROUP 5: Hydraulic boom truck; Stinger crane (Austin -Western or similar type); Tugger hoist operator (1 drum) GROUP 6: Bridge crane operator; Cretor crane operator; Hoist operator (Chicago boom and similar type); Lift mobile operator; Lift slab machine operator (Vagtborg and similar types); Material hoist and/or manlift operator; Polar gantry crane operator; Self Climbing scaffold (or similar type); Shovel, backhoe, dragline, clamshell operator (over 3/4 yd. and up to 5 cu. yds. mrc); Tugger hoist operator GROUP 7: Pedestal crane operator; Shovel, backhoe, dragline, clamshell operator (over 5 cu. yds. mrc); Tower crane repair; Tugger hoist operator (3 drum) GROUP 8: Crane operator (up to and including 25 ton capacity); Crawler transporter operator; Derrick barge operator (up to and including 25 ton capacity); Hoist operator, stiff legs, Guy derrick or similar type (up to and including 25 ton capacity); Shovel, backhoe, dragline, clamshell operator (over 7 cu. yds., M.R.C.) GROUP 9: Crane operator (over 25 tons and up to and including 50 tons mrc); Derrick barge operator (over 25 tons up to and including 50 tons mrc); Highline cableway operator; Hoist operator, stiff legs, Guy derrick or similar type (over 25 tons up to and including 50 tons mrc); K-crane operator; Polar crane operator; Self erecting tower crane operator maximum lifting capacity ten tons GROUP 10-: Crane operator_(over 50 tons and up to and including 100 tons mrc); Derrick barge operator (over 50 tons up to and including 100 tons mrc); Hoist operator, stiff legs, Guy derrick or similar type (over 50 tons up to and including 100 tons mrc), Mobile tower crane operator (over 50 tons, up to and including 100 tons M.R.C.); Tower crane operator and tower gantry GROUP 11: Crane operator (over 100 tons and up to and including 200 tons mrc); Derrick barge operator (over 100 tons up to and including 200 tons mrc); Hoist operator, stiff legs, Guy derrick or similar type (over 100 tons up to and including 200 tons mrc); Mobile tower crane operator (over 100 tons up to and including 200 tons mrc) GROUP 12: Crane operator (over 200 tons up to and including 300 tons mrc); Derrick barge operator (over 200 tons up to and including 300 tons mrc); Hoist operator, stiff legs, Guy derrick or similar type (over 200 tons, up to and including 300 tons mrc); Mobile tower crane operator (over 200 tons, up to and including 300 tons mrc) GROUP 13: Crane operator (over 300 tons); Derrick barge operator (over 300 tons); Helicopter pilot; Hoist operator, stiff legs, Guy derrick or similar type (over 300 tons); Mobile tower crane operator (over 300 tons) TUNNEL CLASSIFICATIONS GROUP 1: Skiploader (wheel type up to 3/4 yd. without attachment) GROUP 2: Power -driven jumbo form setter operator GROUP 3: Dinkey locomotive or motorperson (up to and including 10 tons) GROUP 4: Bit sharpener; Equipment greaser (grease truck); Slip form pump operator (power -driven hydraulic lifting device for concrete forms); Tugger hoist operator (1 drum); Tunnel locomotive operator (over 10 and up to and including 30 tons) GROUP 5: Backhoe operator (up to and including 3/4 yd.); Small Ford, Case or similar; Drill doctor; Grouting machine operator; Heading shield operator; Heavy-duty repairperson; Loader operator (Athey, Euclid, Sierra and similar types); Mucking machine operator (1/4 yd., rubber -tired, rail or track type); Pneumatic concrete placing machine operator (Hackley-Presswell or similar type); Pneumatic heading shield (tunnel); Pumperete gun operator; Tractor compressor drill combination operator; Tugger hoist operator (2 drum); Tunnel locomotive operator (over 30 tons) GROUP 6: Heavy Duty Repairman GROUP 7: Tunnel mole boring machine operator ENGINEERS ZONES $1.00 additional per hour for all of IMPERIAL County and the portions of KERN, RIVERSIDE & SAN BERNARDINO Counties as defined below: That area within the following Boundary: Begin in San Bernardino County, approximately 3 miles NE of the intersection of I-15 and the California State line at that point which is the NW corner of Section 1, T17N,m R14E, San Bernardino Meridian. Continue W in a straight line to that point which is the SW corner of the northwest quarter of Section 6, T27S, R42E, Mt. Diablo Meridian. Continue North to the intersection with the Inyo County Boundary at that point which is the NE corner of the western half of the northern quarter of Section 6, T25S, R42E, MDM. Continue W along the Inyo and San Bernardino County boundary until the intersection with Kern County, as that point which is the SE corner of Section 34, T24S, R40E, MDM. Continue W along the Inyo and Kern County boundary until the intersection with Tulare County, at that point which is the SW corner of the SE quarter of Section 32, T24S, R37E, MDM. Continue W along the Kern and Tulare County boundary, until that point which is the NW corner of T25S, R32E, MDM. Continue S following R32E lines to the NW corner of T31S, R32E, MDM. Continue W to the NW corner of T31S, R31E, MDM. Continue S to the SW corner of T32S, R31E, MDM. Continue W to SW corner of SE quarter of Section 34, T32S, R30E, MDM. Continue S to SW corner of T11N, R17W, SBM. Continue E along south boundary of T11N, SBM to SW corner of T11N, R7W, SBM. Continue S to SW corner of T9N, R7W, SBM. Continue E along south boundary of T9N, SBM to SW corner of T9N, R1E, SBM. Continue S along west boundary of R1E, SMB to Riverside County line at the SW corner of T1S, R1E, SBM. Continue E along south boundary of Tls, SBM (Riverside County Line) to SW corner of T1S, R10E, SBM. Continue S along west boundary of R10E, SBM to Imperial County line at the SW corner of T8S, R10E, SBM. Continue W along Imperial and Riverside county line to NW corner of T9S, R9E, SBM. Continue S along the boundary between Imperial and San Diego Counties, along the west edge of R9E, SBM to the south boundary of Imperial County/California state line. Follow the California state line west to Arizona state line, then north to Nevada state line, then continuing NW back to start at the point which is the NW corner of Section 1, T17N, R14E, SBM $1.00 additional per hour for portions of SAN LUIS OBISPO, KERN, SANTA BARBARA & VENTURA as defined below: That area within the following Boundary: Begin approximately 5 miles north of the community of Cholame, on the Monterey County and San Luis Obispo County boundary at the NW corner of T25S, R16E, Mt. Diablo Meridian. Continue south along the west side of R16E to the SW corner of T30S, R16E, MDM. Continue E to SW corner of T30S, R17E, MDM. Continue S to SW corner of T31S, R17E, MDM. Continue E to SW corner of T31S, R18E, MDM. Continue S along West side of R18E, MDM as it crosses into San Bernardino Meridian numbering area and becomes R30W. Follow the west side of R30W, SBM to the SW corner of T9N, R30W, SBM. Continue E along the south edge of T9N, SBM to the Santa Barbara County and Ventura County boundary at that point whch is the SW corner of Section 34.T9N, R24W, SBM, continue S along the Ventura County line to that point which is the SW corner of the SE quarter of Section 32, T7N, R24W, SBM. Continue E along the south edge of T7N, SBM to the SE corner to T7N, R21W, SBM. Continue N along East side of R21W, SBM to Ventura County and Kern County boundary at the NE corner of TBN, R21W. Continue W along the Ventura County and Kern County boundary to the SE corner of T9N, R21W. Continue North along the East edge of R21W, SBM to the NE corner of T12N, R21W, SBM. Continue West along the north edge of T12N, SBM to the SE corner of T32S, R21E, MDM. [T12N SBM is a think strip between T11N SBM and T32S MDM]. Continue North along the East side of R21E, MDM to the Kings County and Kern County border at the NE corner of T25S, R21E, MDM, continue West along the Kings County and Kern County Boundary until the intersection of San Luis Obispo County. Continue west along the Kings County and San Luis Obispo County boundary until the intersection with Monterey County. Continue West along the Monterey County and San Luis Obispo County boundary to the beginning point at the NW corner of T25S, R16E, MDM. $2.00 additional per hour for INYO and MONO Counties and the Northern portion of SAN BERNARDINO County as defined below: That area within the following Boundary: Begin at the intersection of the northern boundary of Mono County and the California state line at the point which is the center of Section 17, T10N, R22E, Mt. Diablo Meridian. Continue S then SE along the entire western boundary of Mono County, until it reaches Inyo County at the point which is the NE corner of the Western half of the NW quarter of Section 2, TBS, R29E, MDM. Continue SSE along the entire western boundary of Inyo County, until the intersection with Kern County at the point which is the SW corner of the SE 1/4 of Section 32, T24S, R37E, MDM. Continue E along the Inyo and Kern County boundary until the intersection with San Bernardino County at that point which is the SE corner of section 34, T24S, R40E, MDM. Continue E along the Inyo and San Bernardino County boundary until the point which is the NE corner of the Western half of the NW quarter of Section 6, T25S, R42E, MDM. Continue S to that point which is the SW corner of the NW quarter of Section 6, T27S, R42E, MDM. Continue E in a straight line to the California and Nevada state border at the point which is the NW corner of Section 1, T17N, R14E, San Bernardino Meridian. Then continue NW along the state line to the starting point, which is the center of Section 18, T10N, R22E, MDM. REMAINING AREA NOT DEFINED ABOVE RECIEVES BASE RATE ENGI0012-004 08/05/2013 Rates Fringes OPERATOR: Power Equipment (DREDGING) (1) Leverman................$ 47.70 21.20 (2) Dredge dozer ............ $ 41.73 21.20 (3) Deckmate................$ 41.62 21.20 (4) Winch operator (stern winch on dredge) ............ $ 41.07 21.20 (5) Fireman -Oiler, Deckhand, Bargeman, Leveehand...................$ 40.53 21.20 (6) Barge Mate ..............$ 41.14 21.20 ---------------------------------------------------------------- IRON0377-002 07/01/2013 Rates Fringes Ironworkers: Fence Erector ...............$ 26.58 17.74 Ornamental, Reinforcing and Structural ..............$ 33.00 26.30 PREMIUM PAY: $6.00 additional per hour at the following locations: China Lake Naval Test Station, Chocolate Mountains Naval Reserve-Niland, Edwards AFB, Fort Irwin Military Station, Fort Irwin Training Center -Goldstone, San Clemente Island, San Nicholas Island, Susanville Federal Prison, 29 Palms - Marine Corps, U.S. Marine Base - Barstow, U.S. Naval Air Facility - Sealey, Vandenberg AFB $4.00 additional per hour at the following locations: Army Defense Language Institute - Monterey, Fallon Air Base, Naval Post Graduate School - Monterey, Yermo Marine Corps Logistics Center $2.00 additional per hour at the following locations: Port Hueneme, Port Mugu, U.S. Coast Guard Station - Two Rock ---------------------------------------------------------------- LABO0300-005 01/01/2014 Rates Fringes Asbestos Removal Laborer ......... $ 28.00 15.25 SCOPE OF WORK: Includes site mobilization, initial site cleanup, site preparation, removal of asbestos -containing material and toxic waste, encapsulation, enclosure and disposal of asbestos- containing materials and toxic waste by hand or with equipment or machinery; scaffolding, fabrication of temporary wooden barriers and assembly of decontamination stations. ---------------------------------------------------------------- LABO0345-001 07/01/2013 Rates Fringes LABORER (GUNITE) GROUP 1.....................$ 33.04 17.86 GROUP 2.....................$ 32.09 17.86 GROUP 3.....................$ 28.55 17.86 FOOTNOTE: GUNITE PREMIUM PAY: Workers working from a Bosn'n's Chair or suspended from a rope or cable shall receive 40 cents per hour above the foregoing applicable classification rates. Workers doing gunite and/or shotcrete work in a tunnel shall receive 35 cents per hour above the foregoing applicable classification rates, paid on a portal-to-portal basis. Any work performed on, in or above any smoke stack, silo, storage elevator or similar type of structure, when such structure is in excess of 75'-0" above base level and which work must be performed in whole or in part more than 75'-0" above base level, that work performed above the 75'-0" level shall be compensated for at 35 cents per hour above the applicable classification wage rate. GUNITE LABORER CLASSIFICATIONS GROUP 1: Rodmen, Nozzlemen GROUP 2: Gunmen GROUP 3: Reboundmen LABO0652-001 07/01/2013 Rates Fringes LABORER (TUNNEL) GROUP 1.....................$ 34.84 16.02 GROUP 2.....................$ 35.16 16.02 GROUP 3.....................$ 35.62 16.02 GROUP 4.....................$ 36.31 16.02 LABORER GROUP 1.....................$ 28.99 16.02 GROUP 2.....................$ 29.54 16.02 GROUP 3.....................$ 30.09 16.02 GROUP 4.....................$ 31.64 16.02 GROUP 5.....................$ 31.99 16.02 LABORER CLASSIFICATIONS GROUP 1: Cleaning and handling of panel forms; Concrete screeding for rough strike -off; Concrete, water curing; Demolition laborer, the cleaning of brick if performed by a worker performing any other phase of demolition work, and the cleaning of lumber; Fire watcher, limber, brush loader, piler and debris handler; Flag person; Gas, oil and/or water pipeline laborer; Laborer, asphalt -rubber material loader; Laborer, general or construction; Laborer, general clean-up; Laborer, landscaping; Laborer, jetting; Laborer, temporary water and air lines; Material hose operator (walls, slabs, floors and decks); Plugging, filling of shee bolt holes; Dry packing of concrete; Railroad maintenance, repair track person and road beds; Streetcar and railroad construction track laborers; Rigging and signaling; Scaler; Slip form raiser; Tar and mortar; Tool crib or tool house laborer; Traffic control by any method; Window cleaner; Wire mesh pulling - all concrete pouring operations GROUP 2: Asphalt shoveler; Cement dumper (on 1 yd. or larger mixer and handling bulk cement); Cesspool digger and installer; Chucktender; Chute handler, pouring concrete, the handling of the chute from readymix trucks, such - as -walls, slabs, decks, floors, foundation, footings, curbs, gutters and sidewalks; Concrete curer, impervious membrane and form oiler; Cutting torch operator (demolition); Fine grader, highways and street paving, airport, runways and similar type heavy construction; Gas, oil and/or water pipeline wrapper - pot tender and form person; Guinea chaser; Headerboard person - asphalt; Laborer, packing rod steel and pans; Membrane vapor barrier installer; Power broom sweeper (small); Riprap stonepaver, placing stone or wet sacked concrete; Roto scraper and tiller; Sandblaster (pot tender); Septic tank digger and installer(lead); Tank scaler and cleaner; Tree climber, faller, chain saw operator, Pittsburgh chipper and similar type brush shredder; Underground laborer, including caisson bellower GROUP 3: Buggymobile person; Concrete cutting torch; Concrete pile cutter; Driller, jackhammer, 2-1/2 ft. drill steel or longer; Dri-pak-it machine; Gas, oil and/or water pipeline wrapper, 6-in. pipe and over, by any method, inside and out; High scaler (including drilling of same); Hydro seeder and similar type; Impact wrench multi -plate; Kettle person, pot person and workers applying asphalt, lay-kold, creosote, lime caustic and similar type materials ("applying" means applying, dipping, brushing or handling of such materials for pipe wrapping and waterproofing); Operator of pneumatic, gas, electric tools, vibrating machine, pavement breaker, air blasting, come-alongs, and similar mechanical tools not separately classified herein; Pipelayer's backup person, coating, grouting, making of joints, sealing, caulking, diapering and including rubber gasket joints, pointing and any and all other services; Rock slinger; Rotary scarifier or multiple head concrete chipping scarifier; Steel headerboard and guideline setter; Tamper, Barko, Wacker and similar type; Trenching machine, hand -propelled GROUP 4: Asphalt raker, lute person, ironer, asphalt dump person, and asphalt spreader boxes (all types); Concrete core cutter (walls, floors or ceilings), grinder or sander; Concrete saw person, cutting walls or flat work, scoring old or new concrete; Cribber, shorer, lagging, sheeting and trench bracing, hand -guided lagging hammer; Head rock slinger; Laborer, asphalt- rubber distributor boot person; Laser beam in connection with laborers' work; Oversize concrete vibrator operator, 70 lbs. and over; Pipelayer performing all services in the laying and installation of pipe from the point of receiving pipe in the ditch until completion of operation, including any and all forms of tubular material, whether pipe, metallic or non-metallic, conduit and any other stationary type of tubular device used for the conveying of any substance or element, whether water, sewage, solid gas, air, or other product whatsoever and without regard to the nature of material from which the tubular material is fabricated; No -joint pipe and stripping of same; Prefabricated manhole installer; Sandblaster (nozzle person), water blasting, Porta Shot -Blast GROUP 5: Blaster powder, all work of loading holes, placing and blasting of all powder and explosives of whatever type, regardless of method used for such loading and placing; Driller: All power drills, excluding jackhammer, whether core, diamond, wagon, track, multiple unit, and any and all other types of mechanical drills without regard to the form of motive power; Toxic waste removal TUNNEL LABORER CLASSIFICATIONS GROUP 1: Batch plant laborer; Bull gang mucker, track person; Changehouse person; Concrete crew, including rodder and spreader; Dump person; Dump person (outside); Swamper (brake person and switch person on tunnel work); Tunnel materials handling person GROUP 2: Chucktender, cabletender; Loading and unloading agitator cars; Nipper; Pot tender, using mastic or other materials (for example, but not by way of limitation, shotcrete, etc.); Vibrator person, jack hammer, pneumatic tools (except driller) GROUP 3: Blaster, driller, powder person; Chemical grout jet person; Cherry picker person; Grout gun person; Grout mixer person; Grout pump person; Jackleg miner; Jumbo person; Kemper and other pneumatic concrete placer operator; Miner, tunnel (hand or machine); Nozzle person; Operating of troweling and/or grouting machines; Powder person (primer house); Primer person; Sandblaster; Shotcrete person; Steel form raiser and setter; Timber person, retimber person, wood or steel; Tunnel Concrete finisher GROUP 4: Diamond driller; Sandblaster; Shaft and raise work LABO0652-003 07/01/2013 Rates Fringes Brick Tender .....................$ 28.37 15.78 LABO1184-001 07/01/2013 Rates Fringes Laborers: (HORIZONTAL DIRECTIONAL DRILLING) (1) Drilling Crew Laborer ... $ 30.11 11.83 (2) Vehicle Operator/Hauler.$ 30.28 11.83 (3) Horizontal Directional Drill Operator ..............$ 32.13 11.83 (4) Electronic Tracking Locator .....................$ 34.13 11.83 Laborers: (STRIPING/SLURRY SEAL) GROUP 1.....................$ 31.06 14.53 GROUP 2.....................$ 32.36 14.53 GROUP 3.....................$ 34.37 14.53 GROUP 4.....................$ 36.11 14.53 LABORERS - STRIPING CLASSIFICATIONS GROUP 1: Protective coating, pavement sealing, including repair and filling of cracks by any method on any surface in parking lots, game courts and playgrounds; carstops; operation of all related machinery and equipment; equipment repair technician GROUP 2: Traffic surface abrasive blaster; pot tender - removal of all traffic lines and markings by any method (sandblasting,•waterblasting, grinding, etc.) and preparation of surface for coatings. Traffic control person: controlling and directing traffic through both conventional and moving lane closures; operation of all related machinery and equipment GROUP 3: Traffic delineating device applicator: Layout and application of pavement markers, delineating signs, rumble and traffic bars, adhesives, guide markers, other traffic delineating devices including traffic control. This category includes all traffic related surface preparation (sandblasting, waterblasting, grinding) as part of the application process. Traffic protective delineating system installer: removes, relocates, installs, permanently affixed roadside and parking delineation barricades, fencing, cable anchor, guard rail, reference signs, monument markers; operation of all related machinery and equipment; power broom sweeper GROUP 4: Striper: layout and application of traffic stripes and markings; hot thermo plastic; tape traffic stripes and markings, including traffic control; operation of all related machinery and equipment LABO1414-001 08/07/2013 Rates Fringes LABORER PLASTER CLEAN-UP LABORER .... $ 27.45 16.36 PLASTER TENDER ..............$ 30.00 16.36 Work on a swing stage scaffold: $1.00 per hour additional. ---------------------------------------------------------------- PAIN0036-001 01/01/2014 Rates Fringes Painters: (Including Lead Abatement) (1) Repaint (excludes San Diego County) ...............$ 26.49 11.73 (2) All Other Work .......... $ 29.82 11.73 REPAINT of any previously painted structure. Exceptions: work involving the aerospace industry, breweries, commercial recreational facilities, hotels which operate commercial establishments as part of hotel service, and sports facilities. ---------------------------------------------------------------- PAIN0036-008 01/01/2014 Rates Fringes DRYWALL FINISHER/TAPER ........... $ 34.03 15.41 ---------------------------------------------------------------- PAIN0036-015 06/01/2014 Rates Fringes GLAZIER ..........................$ 37.95 22.69 FOOTNOTE: Additional $1.25 per hour for work in a condor, from the third (3rd) floor and up Additional $1.25 per hour for work on the outside of the building from a swing stage or any suspended contrivance, from the ground up ---------------------------------------------------------------- PAIN1247-002 01/01/2014 Rates Fringes SOFT FLOOR LAYER .................$ 29.85 12.56 ---------------------------------------------------------------- PLAS0200-009 08/07/2013 Rates Fringes PLASTERER ........................$ 36.11 13.13 ---------------------------------------------------------------- PLAS0500-002 07/01/2013 Rates Fringes CEMENT MASON/CONCRETE FINISHER ... $ 30.85 21.00 ---------------------------------------------------------------- PLUM0016-001 07/01/2013 Rates Fringes PLUMBER/PIPEFITTER Plumber and Pipefitter All other work except work on new additions and remodeling of bars, restaurant, stores and commercial buildings not to exceed 5,000 sq. ft. of floor space and work on strip malls, light commercial, tenant improvement and remodel work .......................$ 43.60 20.16 Work ONLY on new additions and remodeling of bars, restaurant, stores and commercial buildings not to exceed 5,000 sq. ft. of floor space .................$ 42.26 19.18 Work ONLY on strip malls, light commercial, tenant improvement and remodel work ........................$ 34.11 17.51 ---------------------------------------------------------------- PLUM0345-001 01/01/2014 Rates Fringes PLUMBER Landscape/Irrigation Fitter.$ 28.56 19.55 Sewer & Storm Drain Work .... $ 32.50 17.23 ---------------------------------------------------------------- ROOF0036-002 08/01/2012 Rates Fringes ROOFER ...........................$ 34.65 11.38 FOOTNOTE: Pitch premium: Work on which employees are exposed to pitch fumes or required to handle pitch, pitch base or pitch impregnated products, or any material containing coal tar pitch, the entire roofing crew shall receive $1.75 per hour "pitch premium" pay. ---------------------------------------------------------------- SFCA0669-008 07/01/2013 DOES NOT INCLUDE SAN CLEMENTE ISLAND, THE CITY OF SANTA ANA, AND THAT PART OF ORANGE COUNTY WITHIN 25 MILES OF THE CITY LIMITS OF LOS ANGELES: Rates Fringes SPRINKLER FITTER .................$ 34.19 19.37 ---------------------------------------------------------------- SFCA0709-003 01/01/2014 SAN CLEMENTE ISLAND, THE CITY OF SANTA ANA, AND THAT PART OF ORANGE COUNTY WITHIN 25 MILES BEYOND THE CITY LIMITS OF LOS ANGELES: Rates Fringes SPRINKLER FITTER (Fire) .......... $ 40.61 24.02 ---------------------------------------------------------------- SHEE0105-003 01/01/2014 LOS ANGELES (South of a straight line drawn between Gorman and Big Pines)and Catalina Island, INYO, KERN (Northeast part, East of Hwy 395), MONO ORANGE, RIVERSIDE, AND SAN BERNARDINO COUNTIES Rates Fringes SHEET METAL WORKER (1) Commercial - New Construction and Remodel work ........................$ 40.79 22.88 (2) Industrial work including air pollution control systems, noise abatement, hand rails, guard rails, excluding aritechtural sheet metal work, excluding A-C, heating, ventilating systems for human comfort ... $ 40.79 22.88 TEAM0011-002 07/01/2013 Rates Fringes TRUCK DRIVER GROUP 1....................$ 27.59 22.69 GROUP 2....................$ 27.74 22.69 GROUP 3....................$ 27.87 22.69 GROUP 4....................$ 28.06 22.69 GROUP 5....................$ 28.09 22.69 GROUP 6....................$ 28.12 22.69 GROUP 7....................$ 28.37 22.69 GROUP 8....................$ 28.62 22.69 GROUP 9....................$ 28.82 22.69 GROUP 10....................$ 29.12 22.69 GROUP 11....................$ 29.62 22.69 GROUP 12....................$ 30.05 22.69 WORK ON ALL MILITARY BASES: PREMIUM PAY: $3.00 per hour additional. [29 palms Marine Base, Camp Roberts, China Lake, Edwards AFB, El Centro Naval Facility, Fort Irwin, Marine Corps Logistics Base at Nebo & Yermo, Mountain Warfare Training Center, Bridgeport, Point Arguello, Point Conception, Vandenberg AFB] TRUCK DRIVERS CLASSIFICATIONS GROUP 1: Truck driver GROUP 2: Driver of vehicle or combination of vehicles - 2 axles; Traffic control pilot car excluding moving heavy ' equipment permit load; Truck mounted broom GROUP 3: Driver of vehicle or combination of vehicles - 3 axles; Boot person; Cement mason distribution truck; Fuel truck driver; Water truck - 2 axle; Dump truck, less than 16 yds. water level; Erosion control driver GROUP 4: Driver of transit mix truck, under 3 yds.; Dumperete truck, less than 6-1/2 yds. water level GROUP 5: Water truck, 3 or more axles; Truck greaser and tire person ($0.50 additional for tire person); Pipeline and utility working truck driver, including winch truck and plastic fusion, limited to pipeline and utility work; Slurry truck driver GROUP 6: Transit mix truck, 3 yds. or more; Dumperete truck, 6-1/2 yds. water level and over; Vehicle or combination of vehicles - 4 or more axles; Oil spreader truck; Dump truck, 16 yds. to 25 yds. water level GROUP 7: A Frame, Swedish crane or similar; Forklift driver; Ross carrier driver GROUP 8: Dump truck, 25 yds. to 49 yds. water level; Truck repair person; Water pull - single engine; Welder GROUP 9: Truck repair person/welder; Low bed driver, 9 axles or over GROUP 10: Dump truck - 50 yds. or more water level; Water pull - single engine with attachment GROUP 11: Water pull - twin engine; Water pull - twin engine with attachments; Winch truck driver - $1.25 additional when operating winch or similar special attachments GROUP 12: Boom Truck 17K and above WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. ---------------------------------------------------------------- Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (ii)) . The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of "identifiers" that indicate whether the particular rate is union or non -union. Union Identifiers An identifier enclosed in dotted lines beginning with characters other than "SU" denotes that the union classification and rate have found to be prevailing for that classification. Example: PLUM0198-005 07/01/2011. The first four letters , PLUM, indicate the international union and the four -digit number, 0198, that follows indicates the local union number or district council number where applicable , i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. The date, 07/01/2011, following these characters is the effective date of the most current negotiated rate/collective bargaining agreement which would be July 1, 2011 in the above example. Union prevailing wage rates will be updated to reflect any changes in the collective bargaining agreements governing the rates. 0000/9999: weighted union wage rates will be published annually each January. Non -Union Identifiers Classifications listed under an "SU" identifier were derived from survey data by computing average rates and are not union rates; however, the data used in computing these rates may include both union and non -union data. Example: SULA2004-007 5/13/2010. SU indicates the rates are not union majority rates, LA indicates the State of Louisiana; 2004 is the year of the survey; and 007 is an internal number used in producing the wage determination. A 1993 or later date, 5/13/2010, indicates the classifications and rates under that identifier were issued as a General Wage Determination on that date. Survey wage rates will remain in effect and will not change until a new survey is conducted. WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be. * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling On survey related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis -Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7). Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. END OF GENERAL DECISION The 4' Hanover Insurance Group° CONTRACTOR: (Name, legal status and address) Future DB International, Inc. 8707 Research Drive Irvine, CA 92618 OWNER: (Name, legal status and address) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 BOND AMOUNT: ten percent of the total amount bid (10% of total bid) PROJECT: (Name, location or address, and Project Number, if any) Warner Avenue Bridge Preventive Maintenance (Over Bolsa Chica Channel) SURETY: (Name, legal status and principal place of business) The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. The Hanover Insurance Company vouches that the original text of this document conforms exactly to the text in AIA Document A310 (2010 Edition) . Bid Bond. Signed and sealed this 8th day of July, 2014. Witness �o..t� S.uut_Sk Witness Future DB International, Inc. By: (Seal) Name: g,sL- Title: !i^2�i'� f16Ep The Hanover Insurance Company IFY A. — Name: Natalie K. Trofimoff, Attorney -in -Fact Title: Attorney -in -fact The Hanover Insurance Company vouches that the original text of this document conforms exactly to the text in AIA Document A310 (2010 Edition) Bid Bond. CALIFORNIARLL-PURPOSE' ACKNOWLEDGMENT State of California - County of Los Angeles On ji li before me, B. Wong, Notary Public, persona y appeared Natalie K. Trofimoff 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 4i+s/her1#w4 authorized capacity0e,s}, and that by b4s/her/t-h ir-signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. (seal) Signatui B. B. WONG Commission # 1910243 i ,'� Notary Public - California Z Z Los Angeles County D My Comm. Expires Oct 24, 2014 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA t-UWtFCJ Ut— A i i UFCIVL- Y CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan, do hereby constitute and appoint Jeffrey Strassner, Tenzer V. Cunningham, Natalie K. Trofimoff, Patricia Talavera Brenda Wong and/or Kari A. Davis of Los Angeles, CA and each is a true and lawful Attorney(s)-in-fact to sign, execute, seal, acknowledge and deliver for, and on, its behalf, and as its act and deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds, recognizances, undertakings, contracts of indemnity or other writings obligatory in the nature thereof, as follows: Any such obligations in the United States —in any amount and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED, That the President or any Vice President, in conjunction with any Vice President, be and they are hereby authorized and empowered to appoint Attorneys -in -fact of the Company, in its name and as its acts, to execute and acknowledge for and on its behalf as Surety any and all bonds, recognizances, contracts of indemnity, waivers of citation and all otherwritings obligatory in the nature thereof, with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys -in -fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons." (Adopted October 7, 1981 - The Hanover Insurance Company; Adopted April 14, 1982 - Massachusetts Bay Insurance Company; Adopted September 7, 2001 - Citizens. Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this .1st day of November 2013. THE HANOVER INSURANCE COMPANY MASSACHUS,ETTS BAY INSURANCE COMPANY CITIZENS INSU�ANCE MPANY�OF`AMERICA } 18W2 l9sa8pii Robert Thomas, Vice President THE COMMONWEALTH OF MASSACHUSETTS ) /Ma1 ViC= COUNTY OF WORCESTER . ) ss. / On this 1 st day of November 2013 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me personally known to be the individuals and officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. �wt, A. GARLICK 0RARBARA ��' � Nciary Public Cemmon.eakn of �tassadwseris an ' Uy Cam:u� Ec�r4s SeC 2�, 2tis Barbara A. Garlick, Notary Public My Commission Expires September 21, 2018 I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power of Attorney issued by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED, That any and all Powersof Attorney and Certified Copies of such Powers ofAttomey and certification in respect thereto, granted and executed by the President or any Vice President in conjunction with any Vice President of the Company, shall be binding on the Company to the same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile." (Adopted October 7, 1981 - The Hanover Insurance Company; Adopted April 14, 1982 - Massachusetts Bay Insurance Company; Adopted September7, 2001 - Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this day of 20 JUL 0 8 2014 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA ;ion Margosian, Vice President City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk September 22, 2014 Los Angeles Ingineering, Inc. 633 N. Barranca Avenue Covina, CA 91723 RE: Warner Avenue Bridge Maintenance—CC-1356 Enclosed please find your original bid bond for CC-1356. Sincerely, a 9Jon L. Flynn, CMC*d City Clerk JF:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand CITY o I't.,U?J TING TON. BEACH ? 2 wpv 0117 o.lv "t2 SECTION C PROPOSAL for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF .THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. C-1 If awarded -the Gontract,;=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 thc=security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Bidder's Bond for 10% Accompanying this proposal of bid, find in the amount of $ which _ said amount is not less than 10% of the aggregate of the total amount bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for %", as the case may be). Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received 4 Bidder's Signature' 1 07/07/2014 C-2 PROJECT BID SCHEDULE -WARNER AVE BRIDGE .PREVENTIVE MAINTENANCE, C.C. No. 1356 __Item_ No. __Contract-- Quantity- --__. Unit- -__ _ - _ _ - Description- Unit Price Extended Amount -- 1 .1 LS_ Mobilization $ too 000 °O $ 2 1 LS Prepare Storm Water Pollution Prevention Plan 1 LS Water Pollution Control q 1 LS Access Grading 5 1 LS Traffic Control $ 3S 6 13020 SF Saw Cut, Grind and Remove AC Pavement $ 5.00 $(° 1 wo.o 7 82 TN Asphalt Tack Coat and AC Leveling Pavement $ o o. _o $-LB wy0.00 8 163 TN ARHM Finish Course Pavement $ t Vo.°_ $ C-2.1 _-- '12OJECT BID SCHEDULE - -_= --:WARNER.AVE-BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity-- - . Unit _ - _. _ . Description - Unit Price Extended Amount —=-_- 9 8 LF Saw Cut and Remove Existing PCC Curb/Gutter - 10 8 LF Construct Variable Height PCC Curb and Gutter $ bo• . 124 LF Install 4' High Environmental Protection Fence 2 EA Adjust Gas Valve Frame and Cover to Grade 13 1 LS Install Striping and Pavement Markings $6,0 o00.00 $ 6-o oou •o 14 33 CIF Remove Unsound Concrete $ S= $ 15 234 LF Remove Concrete Barrier $ 150.E $ 234 LF Remove Chain Link Railing C-2.2 ._..,PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity_. -Unit -._- Description-_ Unit Price Extended Amount 65 LF Remove Metal Beam Guard Railing $ 5 $ 3 Aso =° 17 18 65 LF Metal Beam Guard Railing $ l50•%= $ �So 19 50 LF Remove and Reconstruct Wood Rail Fence $ boo. ao $ S 000.`= 20 33 CF Portland Cement Concrete (Patch) $ boo $ 21 310 CY Rock Slope Protection (1/4 Ton Method A) $ 3ca►.°� $ 93 000.E 22 310 SY Rock Slope Protection Fabric (Class 8) 23 117 LF Concrete Barrier (Type 26 Modified) 24 117 LF Concrete Barrier (Type 732 Modified) $ H4o. $ C-2.3 ' BID SCHEDULE -�- —-- �— WARNER AVE BRIDGE PREVENTIVE MA|NTENANCE.C.C.No. 135G ' Item Contract Unit Extended No. Quantity Unit Description Price Amount 234, LF Wildlife Protection Railing 6480 SF Seal Concrete Bridge Deck 1 LS Planting and Habitat Mitigation 1 LS Planting Maintenance Total Amount Bid in Words- F = rI - -- - - SECTION C w 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. (FAf_no%L:) (Av�nAL) Portion of Work Name and Address of Subcontractor State License Number Class r4gjwRa Af -- io ZS u-ti-r+A 1 r4 M I'EW LA HAegA ( CA % •5 /y SV-O 7� s„w e�4 SL�PEf�I®� fA T r^ s�14s 5 3 i z.. Pr�-"S s—r. eY P� S rI 1 co 3 o to G-31, 32 F�.►c� ruT /�Z,co" F-6n1 C-4-7 120 ` s`lYt.kc K ACE,. �Iir►�r� , c,f� f 229 S y C-13 0604om- A. c. t. . F 0. Boaz. M z9 C14it4 a H I CL S CA 96%S -[ 0 it Av-$f-0- STE6t_ P.u, BmX_ 9 0o AJ A1..I-o CA S to b 1, _reJ_% tt46 cicf f ►_ 4s t ct `i [ A U-Ec- fit'. IJ A Nit r�.J CA By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 SECTION C 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 or $10,000, whichever is jreater, 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: That he is able to. and will perform the balance of all work which is not covered in the above subcontractors listinc'. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 6 _ - - -- SECTION C.:_, _ -- - -- - -- - - _ LIST --OF SUBCONTRACTORS - .In accordance with Government Code Section 4104, the Biddershall 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 or $10,000, —_ whichever.is areater,-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: That he is able to and will_perform the balance of. all work which is not covered in: the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered_ into and bonds - furnished by subcontractor for this project. C-3 -- NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of,California - — - ss. County of Orange I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 0 7 / 10 / 14' at Covina CA Date City State Aaron O'Brien , being first duly sworn, deposes and says that he or she is Chief Estimator of Los Angeles 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. • J. NELSON Commission No. 1933056 �• NOTARY PUBLIC-CALIFORNIA a� LOS ANMLES COUNTY INy Comm. Expires APRIL 10. 201S Los Angeles Engineering, Inc. NamMder Signature o - der Aaron O'Brien, Chief Estimator 633 N. Barranca Ave., Covina, CA 91723 Address of Bidder Subscribed and swornto before me this loth day of July 1201 4 NOTARY PUBLIC J Nelson, Notary Publiic C-4 NOTARY SEAL 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 WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (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: 07/10/2014 C-5 Los Angeles Engineering, Inc. Contracto By Aaron O'Brien, Chief Estimator Title - DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire.. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 07/10/2014 C-7 Los Angeles Engineering, Inc Contractor By Aaron O'Brien, Chief Estimator Title BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Los Angeles Engineering, Inc. Bidder Name 633 N. Barranca Ave. Business Address Covina CA 91723 City, (626 ) 454-5222 Telephone Number 591176 - A.B.Cl0.C27.HAZ State Contractor's License No. and Class 03/26/1990 Original Date Issued Expiration Date State Zip The work site was inspected by Mitch Ward of our office on July 2nd , 2014 . The following are persons, firms, and corporations having a principal interest in this proposal: Los Angeles Engineering, Inc. Angus O'Brien - President/Treasurer Aaron O'Brien - Secretary/Chief Estimator C-8 The undersi , ed-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. Los Angeles Engineering, Inc. _ . Company Name Signature of Bidder Aaron O'Brien, Chief Estimator Printed or Typed Signature Subscribed and swornto before me this lotrday of July , 201 4 . NOTARY PUBLIC J Nelson, Notary Public NOTARY SEAL C-9 ..� J. NELSON U �= Commission No. 1933056 _ NOTARY PUBLIC-CALIFORNIA n as LOS ANGELES COUNTY My Comm. Expires APRIL 18. 2015 BIDDER'_S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the_ WARNER_ AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format _.. shown, to further demonstrate his/her history of similar work experience. Listed below are the names,. address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. See Attached References Name and Address of Public Agency Name and Phone # of Agency's Project Manager: 2. Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: 3. Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: C-10 -- v F� INEE R PROJECT INFORMATION: PROJECT NAME: Rosemead Blvd Beautification PROJECT ADDRESS: Rosemead Blvd, Temple City, CA PROJECT MGR/PHONE: Jeff Bird SUPERINTENDENT/PHONE: Jack Togneri OWNER INFORMATION: OWNER NAME: City of Temple City OWNER ADDRESS: 9701 Las Tunas Drive, Temple City, CA 91780 OWNER PHONE: 626-285-2171 OWNER FAX: 626-285-8192 OWNER -CONTACT: Kristi Twiley CM INFORMATION: CM NAME: Transtech CM ADDRESS: 9701 Las Tunas Drive, Temple City, CA 91780 CM PHONE: 909-263-1734 CM FAX: 909-595-8863 CM CONTACT: Michael Ackerman PROJECT NUMBER: 1440 CONTRACT INFORMATION: CONTRACT AMOUNT: $15,773,914.50 CONTRACT NUMBER: P08-11-07.31.12 CONTRACT TYPE: Street DURATION: 16 months COMPLETION DATE: Mar-14 ARCHITECT INFORMATION: ARCHITECT NAME: Gruen & Associates ARCHITECT ADDRESS: ARCHITECT PHONE: ARCHITECT FAX: ARCHITECT CONTACT: SCOPE OF WORK: Demolition, grading, site utilities, site concrete, decorative concrete, ac paving, monument signs, traffic signals, pedestrian lighting, decorative seating nodes, bus shelters, landscape & irrigation. This is a beautification project that spans across 2 miles of Rosemead Blvd. "An Employee -Owned Company" icy ANC,FL fitP �GINEER PROJECT INFORMATION: PROJECT NAME: Seville Avenue PROJECT ADDRESS: Florence & Seville Ave, Walnut Park, CA PROJECT MGR/PHONE: Brenda Maldonado SUPERINTENDENT/PHONE: OWNER INFORMATION: OWNER NAME: County of Los Angeles, Dept of Public Works OWNER ADDRESS: 900 S Freemont St, 8th FI, Alhambra, CA 91803 OWNER PHONE: 626-458-3145 OWNER FAX: 626-458-2197 OWNER -CONTACT: Salman Kahn CM INFORMATION: CM NAME: County of Los Angeles, Dept of Public Works CM ADDRESS: 900 S Fremont St, 8th FI, Alhambra, CA 91803 CM PHONE: 626-458-3145 CM FAX: 626-458-2197 CM CONTACT: Salman Khan skha n2 a gw.la cou nty.g ov PROJECT NUMBER: 1420 CONTRACT INFORMATION: CONTRACT AMOUNT: ' $869,849.00 CONTRACT NUMBER: RDC0014874 CONTRACT TYPE: Street DURATION: 60 working days COMPLETION DATE: Jan-11 ARCHITECT INFORMATION: ARCHITECT NAME: County of Los Angeles, Dept of Public Works ARCHITECT ADDRESS: 900 S Fremont St, 8th FI, Alhambra, CA 91803 ARCHITECT PHONE: 626-458-3122 ARCHITECT FAX: 626-458-2197 ARCHITECT CONTACT: Wieeen Babakhanians SCOPE OF WORK: Street rehabilitation to include: Demolition of existing street and removal or railroad ties and tracks, reconstruction of street, modification of traffic signal, and construction of handicap ramps "An Employee -Owned Compony" Oc� ANGFC Fs �SA a5� ,NEEA�G PROJECT INFORMATION: PROJECT NAME: Alameda St/N Spring St Arterial Redesign Ph V PROJECT ADDRESS: Alameda St/N Spring St, Los Angeles, CA 90012 PROJECT MGR/PHONE: Aaron O'Brien SUPERINTENDENT/PHONE: OWNER INFORMATION: OWNER NAME: City of Los Angeles OWNER ADDRESS: 200 N Spring St, Rm 355, Los Angeles, CA 90012 OWNER PHONE: 213-978-0261 OWNER FAX: 213-978-0262 OWNER -CONTACT: Mary Carter CM INFORMATION: CM NAME: City of Los Angeles CM ADDRESS: 200 N Spring St, Rm 355, Los Angeles, CA 90012 CM PHONE: 213-485-4503 CM FAX: 213-485-4839 CM CONTACT: Peter Blikian PROJECT NUMBER: 1412 CONTRACT INFORMATION: CONTRACT AMOUNT: $1,639,673.05 CONTRACT NUMBER: E6000634 CONTRACT TYPE: Street DURATION: 180 working days ARCHITECT INFORMATION: ARCHITECT NAME: City of Los Angeles ARCHITECT ADDRESS: 200 N Spring St, Rm 355, Los Angeles, CA 90012 ARCHITECT PHONE: 213-485-4503 ARCHITECT FAX: 213-485-4839 ARCHITECT CONTACT: Peter Blikian SCOPE OF WORK: Realignment of Spring Street, reconstruction of College Street, storm drain, remove and replace deck of existing catch basin, street lighting traffic signal, striping and landscaping. = "An Employee -Owned Company" BIDDER'S CRITICAL STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. 1. Jeff Bird Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: See Attached Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work 2. Todd Petersen Name of proposed Construction Superintendent 626-454-5222 Date Completed Date Completed Date Completed Phone # of proposed Construction Superintendent: 6 2 6 - 5 9 0 -.a 041 See Attached work Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work C-11 Date Completed Date Completed ANGe�Fif+ . RAIIk4 A iSi 14RyR i EER �G PROJECT NUMBER: 1440 PROJECT INFORMATION: CONTRACT INFORMATION: PROJECT NAME: Rosemead Blvd Beautification, CONTRACTAMOUNT: $15,773,914.50 PROJECT ADDRESS: Rosemead Blvd, Temple City, CA CONTRACT NUMBER: P08-11-07.31.12 PROJECT MGR/PHONE:, Jeff Bird CONTRACTTYPE: Street. SUPERINTENDENT/PHONE:, JackTogneri DURATION: 16 months COMPLETION DATE: Mar-14 OWNER INFORMATION: OWNER NAME: City of Temple City OWNER ADDRESS: 9701 Las Tunas Drive, Temple City, CA 91780 OWNER PHONE: 626-285-2171 OWNER FAX: 626-285-8192 OWNER -CONTACT: Kristi Twiley CM INFORMATION: CM NAME: Transtech CM ADDRESS: 9701 Las Tunas Drive, Temple City, CA 91780 CM PHONE: 909-263-1734 CM FAX: 909-595-8863 CM CONTACT: Michael Ackerman ARCHITECT INFORMATION: ARCHITECT NAME: Gruen & Associates ARCHITECT ADDRESS: ARCHITECT PHONE: ARCHITECT FAX: ARCHITECT CONTACT: SCOPE OF WORK: Demolition, grading, site utilities, site concrete, decorative concrete, ac paving, monument signs, traffic signals, pedestrian lighting, decorative seating nodes, bus shelters, landscape & irrigation. This is a beautification project that spans across 2 miles of Rosemead Blvd. An Employee -Owned Compony" ANGE4Fif�_ G9II1 )d �A �iSt. 198A �tiG�NEEFt PROJECT INFORMATION: PROJECT NAME: Seville Avenue PROJECT ADDRESS: Florence & Seville Ave, Walnut Park, CA PROJECT MGR/PHONE: Brenda Maldonado SUPERINTENDENT/PHONE: OWNER INFORMATION: OWNER NAME: County of Los Angeles, Dept of Public Works OWNER ADDRESS: 900 S Freemont St, 8th FI, Alhambra, CA 91803 OWNER PHONE: 626-458-3145 OWNER FAX: 626-458-2197 OWNER -CONTACT: Salman Kahn CM INFORMATION: CM NAME: County of Los Angeles, Dept of Public Works CM ADDRESS: 900 S Fremont.St, 8th FI, Alhambra, CA 91803 CM PHONE: 626-458-3145 CM FAX: 626-458-2197 CM CONTACT: Salman Khan s khamIDdpw.lacountv.aov PROJECT NUMBER: 1420 CONTRACT INFORMATION: CONTRACTAMOUNT: $869,849.00 CONTRACT NUMBER: RDC0014874 CONTRACTTYPE: Street DURATION: 60 working days COMPLETION DATE: Jan-11 ARCHITECT INFORMATION: ARCHITECT NAME: ARCHITECT ADDRESS: ARCHITECT PHONE: ARCHITECT FAX: ARCHITECT CONTACT: County of Los Angeles, Dept of Public Works 900 S Fremont St, 8th FI, Alhambra, CA 91803 626-458-3122 626-458-2197 Wiggen Babakhanians SCOPE OF WORK: Street rehabilitation to include: Demolition of existing street and removal or railroad ties and tracks, reconstruction of street, modification of traffic signal, and construction of handicap ramps An Employee -Owned Company" vOS ANGe, b011I vc, k3i.:4fl6 y ENGINEER PROJECT INFORMATION: PROJECT NAME: Alameda St/N Spring St Arterial Redesign Ph V PROJECT ADDRESS: Alameda St/N Spring St, Los Angeles, CA 90012 PROJECT MGR/PHONE: Aaron O'Brien SUPERINTENDENT/PHONE: OWNER INFORMATION: OWNER NAME: City of Los Angeles OWNER ADDRESS: 200 N Spring St, Rni 355, Los Angeles, CA 90Q12 OWNER PHONE: 213-978-0261 OWNER FAX: 213-978-0262 OWNER -CONTACT: MaryCarter CM INFORMATION: CM NAME: City of Los Angeles CM ADDRESS: 200 N Spring St, Rm 355, Los Angeles, CA 90012 CM PHONE: 213-485-4503 CM FAX: 213-485-4839 CM CONTACT: Peter Blikian SCOPE OF WORK: PROJECT NUMBER: 1412 CONTRACT INFORMATION: CONTRACT AMOUNT: $1,639,673,05. CONTRACT NUMBER: E6000634 CONTRACT TYPE: Street DURATION: 180 working days ARCHITECT INFORMATION: ARCHITECT NAME: City of Los Angeles . ARCHITECT ADDRESS: 200 N Spring St, Rm 355, Los Arigeles, CA 90012 ARCHITECT PHONE: 213-485-4503 ARCHITECT FAX: 213-485-4839 ARCHITECT CONTACT: Peter Blikian Realignment of Spring Street, reconstruction of College Street, storm drain, remove and replace deck of existing catch basin, street lighting traffic signal,,striping and landscaping. "An Employee -Owned Company" - -- - BIDDER'S CERTIFICATION* -- ==HOUSING AND URBAN DEVELOPMENT ACT OF -1968 AS AMNIENDED 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: Los Angeles Engineering, Inc. Contact Person: Aaron O'Brien, Chief Estimator Contact Phone: 626-4 5222 Signed: &�i� Date: 07/10/2014 *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-12 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (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 T,ns Angeles Rngi neeri ng, Tnc- _ , 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 1 of 8 C-13 June 11, 2014 ---L-ocal Assistance Procedures Manual -- Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT --- In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, - ' or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. Page 2 of 8 C-14 June 11, 2014 -_._- -_-.Local Assistance.Procedures Manual- Exhibit 12-H Sample Bid PUBLIC CONTRACT -CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-15 June 11, 2014 --Local Assistance Procedures Manual Exhibit 12-H Sample Bid - -- -- _ - -- -- Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) - To the.CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of S C-16 June 11, 2014 —Local Assistance Procedures Manual Exhibit 12-H Sample Bid ------------DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. None Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-17 June 11, 2014 --Local Assistance Procedures Manual - Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-18 June 11, 2014 - - -Local Assistance Procedures Manual - — Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES Not Applicable COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application = a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 11 12. 14. Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheets) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission Ba. cash d. contingent fee b. in -kind; specify: nature e 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 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 Signature: reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required Print Name: Aaron O'Brien pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Title: Chief Estimator TelephoneNo.: 626-454-5222 Date: 07/10/2 Authorized for Local Reproduction Standard Form - LLL Standard Form LLL Rev. 09-12-97 14 Page 7 of 8 C-19 June 11, 2014 __Local Assistance Procedures Manual __= Exhibit 12-H Sample Bid —------- - ---- 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. 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. Check all boxes that apply. If other, specify nature. 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 8 of 8 C-20 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE). EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ _ Phone/ � ,_ �..�l:ocalA�eiic�,U'se ,+l Address/ --. Fax Annual Gross Description of Portion of Work to be Performed - ry Oiily`:, x Cit j, State; ZIP Receipts s ..,., Certified,DBE Name Phon S'lo2 ❑ < $1 million M ioy� �'�1�.A-i�%� �.�- � Tl YES = ?''u °"" "',r. i ,' �w, :o:�: .I.a`:. �dNn-7ieLl+nnt? 1+4c— q 1 < 5 million < $1 mn 0 0 .........__.-.---------------------------.........__----------.---._-------__----_------___----.---_----------- _y.,, ITI'ES#hst i�BT''#k'� " `ail"11ii,r'° .. .................l..r...i.m4 Address to 2.S L�.n1'Ta41 hax ia2— S t9 q-1-2039 ❑ <$15 million > $15 million - ..........................-_............................"....."...--..".".----------------------------------------------------- +u:,...,. rstijiks .... ?X9 of..Fir'm�;(Yxrs.: City State ZIP g 6fi ua 2q t'#}- Name Phase ` � � <$1 million-�Pl-�•i[." -.J#d�T1�4t- - - Sr _❑:.".._;;...."..-.._.:.._'., .: 51�,P�ERaols iA�i'�iST' r+^RKlG agS—q� C ❑ < $5 million < 0 million "---------------------------------------------------------------._.......... -.._._............................................... - - - ❑N.O,:.�;-: ," `�� �•° _ ..::.......:::::_..._............... ................ ... .......... I Address Address 53 12-yfRFSS 3T. Tax "1 l `f 5--9Ll00 ❑ ❑> ...... <$l5 million $15 million _,,"-- ,.,v, .,... -_..._........._."....."..".."...._...-.. - - - - ....._ .."-..-. ...""....._._....... - -....- ---- - - - ----------------------------------------------------------------------------------------------------------------..._._... ..........._....--- .:;�.. -f-ESlrs r r........................................: . .. h.._{.�._:.a:............" :. A"'e,of°Fi"A',- Yrs. g - --- - - - City Yale ZIP A�/.�y. -cyr�/(� ,..;,. a!�2�4�":",�.��;:;�.•,����,`"'�':hw�,•IP,a�;.lfl � Name Phone `{, ❑<$I million -E'1J�tw1 iz:nFbi._ �-----.."....-"......._.-�""".....".."._ :❑YES; `, I;1�;!7 �y t;" ;:rh L CoKA•� F C-£ ❑ �< <$5 million $ .o 10 million -- - - --- ............................................................ -...-"...""-........."................._.._......... --"- --- - - - -::- --: - -- = _ F` ❑NO-,... a:d^ '�f:?-- ES=IU13Lr## ,.;I„, . . Address------------------- 17-o to Srnt" 1 - WF Fax l� ❑ ❑ <$IS million > $ 15 million - - - - - -- - - ------..:.......... - - - ---------------------------- - ---"------------ - -- - - ------------------"-------"-----------.- .y:,::.:..',:..4 `; .: ...............................,__................... ............. Age °" ofFicm (:Yrs.) City Stale ZIP J O*Af3 Cc Cat n qq—g q l5 _,,:., - - --- - ------------------- ------------------....._....._........"......_..... ;,xrs Nance Phan/9 0 % ❑ < $1 million..... - - - ❑ S } t,!`i, :: i,°,;:3 A.C,�-. 3 1 Lt Lr �1 ❑<$5million .. ,rQ'&60 `' ti 1' - :::.,, ,c,� _' ,..,...—..:! Address ®< $10 million _....__.". .."...."". ......_.."."". ':If 2'FS hst'T/3/.1,#' akin! an4a i Fax %R 39 l —�i �i"72 < 15 million -- -- -- -- - - -- - -- - --........ e.d'w�.—m ........................... .. �.. -- ..._... .... MI 6aia. ''. = _, ;, P �,,:ia!lill!VGi;I!I�w�ma City Stale ZIP ❑ > $15 millionFirm Yis�`);' c,N►sc �� �/� Distribution: 1) Original -Local Agency File Page 1 of 2 DLA-OB 13-06 C-26 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and Nan -DBE) i EXFI[BIT 12-B BIDDER'S L[S-r OF SUBCONTRACTORS (DBE AND NON -DBE) PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49y Section 26.1 1 of the Code of Federal Regulations. This listing is required in addition to listing DBE SUbcontractors elsewhere in the proposal. Photocopy this form for additioilal firms. I , I Firm Name/ Phase/ LocAfAsiedc� Use Address/ Fax Annual Gross Description of Portion of Work to be Perforiiied �'�0itl "r � Cil ZIP Receipts r G�° �) Cel �ilied DBE. ;Stale, �`"YES Mime Phone �ii < 1 million ❑ $ ------------ -- { - ;A-RT1.Alr� - - ---- ---------- ;,<7E""' '.,... 1: - ❑; -- - -- - rn 8 E f� STE. tJ _ < 5 million $10 million If PEShsWE # /,nx ` <$15 million ❑ > $15 million ..-...... -- ----- ,..-.. ,,_.-.... - --- ._..---.-... . ................. ----------------_... - --------------------------------------------------- ,r Age:o,f> iiiii'',(,Ycs": Cily S'lule ZIP LTO . �;�;";�rxs"''';"',,;•a rF�s'�"a�;.,,,.,<s. a, _v�-'', Nnme Pho 1 �� ❑ <$,1 million -�- �7�.TTL�1_� - .❑YESE'!;;': T�G-ifiD Co 4-S lad - I o 3 ❑ < $5 million <;;�, ®- $10 million ---- ----------------------------------------------------- ---------------- --- ------------ --------------------------- - ❑N.Oatr, --------------------------- -- -- ......_.._.... If:I'LS;`]is[DBE.:. ,';I- Address a� li�G 5-r' Fnx ( '^ ❑ <$15 million ❑ > $ 15 million -------------------_---------------------------------------------------------------------------------- ............... - — - - - _..---_...___-.-- - - - ---- -- -- -- -- -; - - -- - -- - - - ...,..................._..--............._............._ .......!. .., �}�;-� .. �: ,............;•� . V i e,of F,�riir_ Z rs: City ,Slcrle ZIP t� mow} V�V 1 V/ 3S—, V35-� �� "-:'ae* Fy 5Y xsYi .-._.__ _ _-.-- ....._.. .._.._, .. ......._ -_--__ t k- Name Phone ❑ <$1 million ;❑YLS„����� _ ;'; ,,:,,•_:, ,. ❑ ❑ <$5 million < $10 million ---------- ----- -------------------------- -------------------------- ------------------------------------------------------------------------ .... --- -------------- -.. .❑N©ir: Jj;,) LS _lis% b1i #,; Address FnxEl ❑ < $15 million > $15 million - ( t , A e of Elriit Yts Cily Slnle ZIP wJ,.4 :w�.ti �I41�Id jl 4�Lll Nnme Phone ❑ < $] million ❑YES,,n;.';:< _;; ._;`<<_ '`:..:-:;: ❑ < $5 million <$10 million - ----- ---- -----... _....-_ -- -- NO<' 1;;1'ES;list,;U/3L;#.;`:;:';.:; i - - - Address Fnx ❑ < $15 million Cily S/u/e ZIP ❑ > $15 million A,`yeMu,;, i Dish ibulioii: I) QI Iginal -'Local Agency File Page I of 2 DLA-013 13-06 C-26 August 12, 2013 Local Assistance Procedures Manual Exliibill2-B Bidder's List of Subcontractors (DBE and Non' -DBE) I i EXHIBIT 12-B BIDDER'S LIS'T OF SUBCONTRACTORS (DBE AND NON -DBE) I PA RT I i I The bidcier shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 2621 In, ofjithe Codei,1,: oif Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firuis.' 1 j hint► Name/ Phone/ Local As?enc� Use Address/ Fax . Annual Gross Descrilrtion of Portion of Work to be Performed O11 Cil ,Stale, ZIP Receipts Certified DBE ) Name Phone ❑ < $ I million YES .;. El <$5 million ❑ < $10 million ----------- --------------- ----------------------------------- ----------- -- ----------------._.------------------------------- -------------------------------------------___.........----------------- - -- ----------------- ................... -0 -- °=< I.-..� :-.::_..:.::__-_.: ❑N' '' r.:-.,,, ._ - " f ., ''�:''' Address Fax ❑ < $15 million ❑ > $15 million = >,=''; : ,`;;:::::-,.t;:.'.:''% <.. ,,;:...... y;A"'e.of.) iiiii,.(Yi"s�):,=,'•' Cil}%State 71P - Name Phan ❑ < $1 million ❑1'ES; ;i p ;:'a',,;i',;,,;' _':';' El ❑ < 5 million <$10 million _------------------------------------------------- - - ------ Adch-ess Fax ❑ ❑> < $15 million $15 million ._._..-- - -- --- -- - - -- --- - - - _ '� �, ,, ,•:,t�,,,�','•s ,y�µs_:.: e of Fir m Yr 011)State ZIP q---------------------------------------- t -------------- Name Phan ❑ <$I million `❑YEASk _ . .... ❑ < $5 million < 10 million _.,.......... . :--- ;.1 '.};ES,lis%'IJI :, ... Address Fax ❑ ❑$IS <$15 million million Ag;of.F'h�"i��� G Slcle ZIP 1 &;��iIQ.,`I„kl. - - -- - - Afame Phone ❑ < $ I million ; ❑YES- `.- ;t:; `' - ❑ ❑ < $5 million < 10 mullion --------------------------------------------------------------------------------- - -- - - _ ------------._...............-------------------------------- -------------------------------- r -:.: :- y _4 ❑NO`d`'.1 ..;1f 2'ES;1ist' '`..n„.;,•.; , : .. , �.. Address Fax ❑ < $15 million - --- - - - - - -- - - --- --- ... - City, State ZIP ❑> $15 million }� r�r„ we'd .,,a};•�'i, 9'a r E°2�a7•! Distribution: 1) Oiiginal - Local Agency File Page 1 of 2 DLA-OV 13-06 C-26 ` '" """ "" Aiighst 12" 2013 ' Local Assistance Procedures Manual Exhibit 12-I3 Bidder's List of Subcontractors (DBE and Nou-DBE) Fx"lBi,f 12-B BIDDER'S LIST OF SUBCONTRACTORS (DBE AND NON -DBE) PART1 I +i The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per 'Title 49, Section.261.1 l of the Code of � Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms' I , Firiu Name/ Phone/ M .Local`Al=ericy..Use Addi-ess/ Fax Annual Gross- Receipts Description of Portion of Work to be Perforniecl r Cit ', State, ZIP . _. Name Phone ❑ < $1 million ❑YES„;'' ,l ❑ < $5 million < 10 million ----------------- - ..........- - - --- - - - ----....... -- - EINO�� I �`Ij,)` 5l si D; Adch- ss Fax ❑ < $15 million ❑>$ISmillion --- -----------------._.............-......_ --- - -- - --- - -_`A ` ^`_ `°'t;-' C'it)%Stcrt'e7I1 --..._---..-------------------------........__..........._....... ....._ . Nance Phone ❑ <$1 million ❑,Y,ES ;h;;' ❑ <$5 million ❑ ------------------ ..... - - ---.-. --------------------------------------------------------------------------------------- - - :l,, l"ES;lisla�l3E. {� .......(;,_•. % -. ,., :: Far ❑ < $15 million >$15 million ❑:._ - -- - ---- - - ........ - - - ---------------------------------------- r= -lrebfFirir:, ". -= : "...:..::....... r- ):(Y GtF Stale 711 Name Phone ❑ < $1 million ❑Y S ❑ El< $10 million -------------- --- ---- -- -- - ... ---- _ .... ------ ..... _......-............ :, r-'i�:......'�.:':.-_,:.;;i ❑ - :, .d.,;: /f )'ES hst,1>I3L�t� , Address ; Fax ❑ <$15 million ❑ > $15 million -- _... ---------------------- ------------------------------------ - - ---.................._.-... - - - _��:=,::_::-_:.L::..::.:-...:�-_.:,._:..:.::-: . '. �. i;A--eof Fiti� Yi=s; City Slate 7.^/P -- - -- Name Phone ❑<$1 million " YGS`si;-:`�;;;,F,-�.�^.,. El_......... < $5 million ❑ < $10 million - ---- ----------------------------------------------- ----- -- --------------------------------------------------------------- : ❑NQ : .........:..-...:;.::-.,- Address Fax ❑ < $15 millio❑,.�„!, -- ._.- - City State Z/1' ❑ > $15 million Distribution: 1) Original - Local Agency File Page I of 2 DLA-013 13-06 C-26 August 12, 2013 Local Assistance Procedures Manual i III i I Exliibitl12-B I Bidder's List of Subcontractors (DBE and Non -DBE) i E` CUBIT 12-13 BIDDER'S LIS"r OF SUBCONTRACTORS (DBE AND NON -DBE) PA R"I' I l i The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Ville 49, Section 26' 1 1 of the Code of Federal Regulations. This listing is Required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. (+. Firm'.Naive/ . Phone/ ocal'AIzelicy;,Use.:::;_ Address/ . Fax Annual Gross llescriptioi> of Portion of Wont to be Performed& + Oiil`%:."-i Ci't �, State, ZIP Receipts+, .. „ leiif eDBE )- �� .� Name Phone El < 1 million ..-...-------- -- - ..----- ----- - ..._...--------- -- ------------- YES;i;' =;w°i{ -------- - -- - ---° ==- =- ❑ ❑ < $5 million < $10 million ---------------------- - - --._...---------- :❑NO'; -.;a` `= :' ;,ii:. + ----- `:' Adc/re.cs i. Fax I' ❑ <$15 million > $15 million - --- - -- -- -......_......_......._.............. --............ ..._----------------.If']'ES;lisi"DBE:-- -------- -- s + (Yts);;;='- C'it)- Slate ZIP I`.,.`'er�:z:-- - -------------- ------ ------------- --- _ - Name Phone ❑ < $ l million ;.❑YES:=µ,>;,='=:;- El ❑ million < $10 million ---------------- .._------------------------------------------------------- - - - - - - - ---------------------------------------------------------- ---------- ----- ------------- __....... -EINO,r, :-..:...-•:::,-..... . list DBE, AcicG ess Fax ❑ ❑ < $15 million - $15 million � � - - ---- -- ..._..---- ---- ----- ----- ----------- - ---- ----- ---------------------------------- ---- ---- --........... - � + � A' .e:of.",Fir> ...-..,.,. _.:�_ ..: `,ii (Yi'-- �. s- . --; C'it1 ,State ZIP - - - -- - Nance Phone ❑ < $ hmillion ❑YES,'ra" °1"'" ❑ < $5 million❑NO'"•' < $10 mullion -...-----------------------------------------------..... --- .............._._.-..._....------------ ....-.....-. - ------------------------------------- - ............ ............_.................... --- -- .,_ .•il'.:-: . ... , Acich ess Fcz� ❑ ❑ < $15 million > $ 15 millione ------------------ �.„i:`�. -_ -,,: ,.:. �. ... , ,, -- of.Einii (Y%s);;y ., CiI); Stale ZIP ---------------------------------..............._.._..... -- ---......... - .._..------------ Nance Phone < 1 million +' ❑ < $5 million--- < $10 million - - ------.._....------------- ------ --- ----- ` ;.................. •` _'.- _------------ Address Fax ❑ < $15 million - - - - - - ---_____________ -..- -❑-.N..-..- CilySta(eZIP 0>$15 million � •34 Cllt�.7 �++rP ll� it 'III ��, �,� y. " � �'� Vislribulinu: 1) Oi iginal - Local Agency Pile Page I of 2 DLA-OB 13-00 C-26 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-B, Bidder's List of Subcontractors (DBE and Noii-DBE), EXHIBIT 12-B BIDDER'S LIST OF SUBCONTRACTORS DBE AND NON -DBE i PART 11 i The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance,with Title . 49, Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Firm Name/ Phone/ Local Ageiicy Use Onlyt Address/ _ Fax Annual Gross Receipts Description of Portion of Work to be Performed (Certified Cit , State, ZIP : Ft Name Phone ❑ < $1 million ❑YES`:�V:. `: ❑ < $5 million❑NO ❑ < $10 million --------------------...._------....._.-._-----...._------------------------._....__--------------------------- -...__.--..::_...----------------'- .. - :.'r Ir;3'ES'%ist DI3E?# Address Fax ❑ < $15 million ❑ > $15 million A e;of,Fii:m (Yrs,) City Slate ZIP _._........._..__..............................................._.......... ....,_.,,..,..,,. Name Phone El<$I million ❑YBS; ❑ < $5 million ❑ $10 million ...-------------------------------------------------------------------------------------------------------------------------------- .._......._......,-- ...,.,,.. ------------------------------------------------------------------------------ -..-....---.----_-......._......-._;.,....,.,....,.,.,,....:,_.::.,. "ONO"'-- r.- 4_.. k•--f;-:._,.::_:........._.;;,_:: s-,.- - . --- Address Fax ❑ < $15 million ❑ > $15 million ----------..._._..-....__.......... - ---------------------...._...._........_..,._._._........------ .._..._-._........ _..._.. __...__......... - .:YLS,/rst,I>..... :#._-:..'-' , '." j '.' xn} ...._';..: ;Age of,Frrm �Yrs) „ a4„;€ Cily Slate ZIP -----........_....... ,........... ,......,.....,......,..._...._.._...._..,._._..........._.......... -------- ------------------------------- - _ Name Phone ❑<$1 million QYE S,' ',r! :, t, ❑ ❑ < $5 million <$10 millionlf'�:LiSli'sfII3Er#`c --------------------------------------------------------------------------------------------------- ,gyp �--�:";,.; ,,'115 1[17:S;Viti. ......... ��.'.'._..'; :• ❑NO ' Address Fax ❑ ❑ < $15 million > $15 million .............................................- - --_....- ------------- ------------------------------------------------ ................................. ........------------.-.-,--------------------------------------- - ....,.....,.,_:::......:..............,:........:.-..................... '. ...... ......: Ae of Fir''m (Yrs ,'41 �::i;:�::, :_...... CNy State ZIP --------------------------------.-.....-._......................................_...........-.....-...-..,...........-................_._-----.- ......-. _.........._........._....., -::..- -�% Name Phone ❑ <$1 million ;01E'Sa ii;;; El < $5 million ❑ <$10 million -----------_....................................._...._.......-.....-.._.. .......... .............. ----------------------- - -- ............ ..... -..--...-.....------------....-..-.... - ..,.............- ------............( - - ---- ------------.--.........-............,.,.......-.......-.._.. NO'�i!' ':;�4���!r•��PGr,I��l'G IishDBE Address Fax $15 million ❑ > $15 million --_-----.-.---__--------_------_---------_--..-_-.-.--.._-------------------------------------------------- -- - - - - ;'��i'�,,;;„ ji,, of;Fii n'(!1 rs';'�ij 9,ii . CiIF Slate ZIP ----------------------------------------------------------------------------- - - -- - .., ......-....,.....,..,....-.-..,-,--..-....,.........._a.:.::.:-:_.....:...::..................., Distribuliow 1) Original — Local Agency File Page 2 of 2 DLA-OB 13-06 August 12, 2013 C-27 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) `536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181(169) C.C. No. 1356 July 1, 2014 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356: 1. The following Project Plan sheets, originally advertised on 6/19/2014, shall be respectively replaced by the attached Project Plan sheets APPROVED BY TRANSPORTATION ENGINEERING on 7/01/14: • SHEET NO.4 OF 14 (TC1) TRAFFIC CONTROL PLAN 1 • SHEET NO.5 OF 14 (TC2) TRAFFIC CONTROL PLAN 2 • SHEET NO.6 OF 14 (TC3) TRAFFIC CONTROL PLAN 3 • SHEET NO.7 OF 14 (TC4) TRAFFIC CONTROL PLAN 4 • SHEET NO.8 OF 14 (SS1) SIGNING AND STRIPING PLAN 2. The Federal Labor Rates contained in Appendix I — Part 2 of the Project Specifications for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 06/20/2014). The attached FEDERAL LABOR RATES (Publication Date 06/20/2014) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and.review of Addendum Number One, 4dated 1, 2014. Los Angeles Engineering, Inc. Company Name By 07-07-2014 Date Aaron O'Brien, Chief Estimator All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. MINUTES OF SPECIAL MEETING OF THE BOARD OF DIRECTORS OF LOS ANGELES ENGINEERING, INC. A California Corporation The Directors of LOS ANGELES ENGINEERING, INC.., A California Corporation, held the special Meeting of the Board of Directors at 633 N. Barranca, Covina, California, on December 28, 2012 at the hour of 2:00 p.m. for the purpose of passing on any business which might be brought before the meeting. There were present at said meeting the following Directors, constituting a quorum of the full Board: ANGUS O'BRIEN AND AARON O'BRIEN ANGUS O'BRIEN acted as Chairman of the meeting and ANGUS O'BRIEN acted as Secretary of the meeting. RESOLVED - Aaron O'Brien as Chief Estimator and Secretary is authorized and directed to sign all bid documents and contracts concerning the corporation business and thereby bind the corporation to the contract and is authorized to do all things necessary and properly to carry out negotiations and execution of contracts with a public agency. RESOLVED - The following persons are confirmed as the duly elected officers, serving in their said capacity until their successors are elected and qualified: Angus O'Brien President Aaron O'Brien Secretary Angus O'Brien Chief Financial Officer Aaron O'Brien. Chief Estimator There being no further business to come before the meeting and upon motion duly made, seconded and unanimously carried, the meeting was adjourned. AARON O'BRIEN,Secretary ATTEST: This Corporate Resolution is in force. Signe this l n r b day of T„ i , 2014. ANGUS O'BRIEN, Chairman and President Aaron O'Brien, Secretary Liberty Mutual Bid Bond CONTRACTOR: (Name, legal status and address) Document A31OTM — 2010 Conforms with The American Institute of Architects AIA Document 310 Los Angeles Engineering, Inc. 633 N. Barranca Ave. Covina, CA 91723 OWNER: (Name, legal status and address) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 BOND AMOUNT: $ 10% SURETY: (Name, legal status and principal place of business) Liberty Mutual Insurance Company 790 The City Drive South, Suite 200 Orange, CA 92868 Mailing Address for Notices Liberty Mutual Insurance Company Attention: Surety Claims Department 1001 4th Avenue, Suite 1700 Seattle, WA 98154 Ten Percent of Amount Bid PROJECT: (Name, location or address, and Project number, if any) This document has important legal consequences. Consultation with an attorney is encouraged - with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. Warner Avenue Bridge Preventive Maintenance (Over Bolsa Chica Channel); Federal Aid Project BPMPL-5181 (169);C.C. No. 1356 The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full: force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal: requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall: be construed as a statutory bond and not as a common law bond. Signed and sealed this 2nd day of July, 2014 ,v4w (Witness) (Witnes) Lis ton Los Angeles gngineering, Inc. (Principal) (Seal) (Title) Aaron O'Brien, Chief Est' 0 `gtcrosngRy� Liberty Mutual Insurance Company (Surety) ~ a ? 2 3 Wm� 9'rSAC�P1`'�T= (Title) Maria Pena Attorney -in -Fact S-0054/AS 8/10 ACKNOWLEDGMENT State of California County of Los Angeles On July 2, 2014 before me, J. Nelson, Notary Public (insert name and title of the officer) personally appeared Aaron O'Brien who proved to me on the basis of satisfactory evidence to be the persono whose name ) is/ e subscribed to the within instrument and acknowledged to me that he/s /t y executed the same in his/(/th r authorized capacity(), and that by his/(t it signature on the instrument the person , or the entity upon behalf of which the persoRK 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. °m J. NELSON ° Commission No. 1933056 z -:. =�ffi b NOTARY PUBLIC-CALIFORNIA LOS ANGELES COUNTY My Comm. Expires APRIL 10. 2015 Signature (Seal) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California" ) ss County of Los Angeles ) JUL 2 2014 On , before me, Noemi Quiroz, Notary Public, personally appeared. Maria Pena , who proved to me on the basis of satisfactory evidence to be the personj&) whose name{&; is/a�e subscribed to the within instrument and acknowledged to me that #e�she/they executed the same in 4+s/herA4& authorized capacity{ie&}, and that by 4+s/herA4e4f signature{&; on the instrument the person{&;, or the entity upon behalf of which the person{&; acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. . _�c 1 40525 Corrlm�sslor. Public - Calfornia z r LP,o�eles Cauniy , Los p�?y Comm. Expires Jun -�?;6.t`.0.Y-v Signature: (Seal) . .... -. .' - ,THIS� P,0WER OF ATTORNEY IS NOT VALID"UNLESS IT".IS PRINTED ON RED BACKGROUND - - This.Powerof Attorney limits th6,acts of-those.named herein; and they have no authority to bind.the Company except in tfie manner and to the.extent herein stated. - -1. , -.' - -_: -- _ _ :. _ Certificate"No.- sas711 a' - American Fire and Casualty_ Company ; Liberty Mutual Insurance Company : _ The:Ohio Casualty.lnsurance Company' : WestAmencan Insurance.Company n .. _. ' - _.. - , P WER OF ATTORNEY;, ."--.. ..-__.: - = - - KNOWN ALL PERSONS BY THESE PRESENTS: That American" Fin 8_Casuatty Company and The Ohio Casualty -Insurance Com an are co orations-dul o anized under_the l6M of - P . Y rP_ Y- t9 the State of New Hampshire, that,Liberty Mutual Insurance Company is,corporation dulyo`njanized-under the laws of the State of Massachusetts; and West mencan InsurancejCompany - is a corporation duly organized under'the laws - e Stateof Indiana (harem collectively called the Companies), -pursuant to andby authority herein set fbrl - does henay name; constitute ..and appoint, - C. K. Nakamura; E:=S:"Albrecht. Jr. ""Lisa L:Thornton; Maria Pena Noemi Quiroi Tiro=M.'Tofnko= - . . all ofthe city of Los Angeles '', state of`CA each individually if there be more than one named, its true and lawful attorney m-fact to make execute; seal acknowledge and deliver,"for and on its behalf as surety and as its act and deed any and alfundertakings; bonds, recogruzances arid;other: suretyobl#gations in "pursuance of tnesepresents end.shall.. be as binding upon the Companies as if they have been duly sigried:by the president and attested by the secretary of the Companies in their own proper persons _ _ 1N ITN - - - - = . W ES WHEREOF,`this Powerof Attorne "lids been.siibscribad.b" an -authorized officeror officiafof the Com anies-and orate seals of ttie-Com-anies tiave been `affixe . - �. . - . ._ -- . - thereto.this 2otn day_of';Febri,ary , 2oia== :- .,-.,:,-- -;.- :.: . P ro P _ -'- ,: - _ - Am1.erican Fire an1.d Casualty Company - I Q./<, = ` ; - / r, ".+` j ; n'F1. The Ohio Casualty:InsuranceCompany : v - t 1 g¢j�='=f f Libert Mut __ I'l surance Corn an 44) It�� 1 ".q i , , �, t Y -P Y _ ti.f ., _ 1. WestAmerican Insurance Company 14 Jp tll - ley `max r/�, �:. , �K: y / f.:s' \ ..� 7 . 1. - _ - - _ v �� ` - _ gY' ' - - ~ * ,M. - _71 ' . STATE OF PENNSYLVANIA~, := _ , ss ;David M. Care ", Assistant Secretary = �- +-�= L COUNTY OF MONTGOMERY _ _ . . M :,On this loth day of February = 2oia ;before me personally appeared`David M:`Can y, -who acknowledged hiquelf to be the Assistant Secretary, of American Fin,""andT "0 - 4.' Casual Corn an , Liberty. .- -,. a� Casualty p y rry Mutual Insurance Company, The Ohio ;Casualty"Insurance Company, and WestAmerican Insurance Company, andthat he as such,:being authorized so to do, .,may. '*-.. = 6 , p "� execi.ute the foregoing instrument for the purposes then:m contained by signing on behalf of the corporations by himself as a duly authorized officer. _ . ~ <� ar :> - IN WITNESS WHEREOF I have hereunto subsc rim and affixed my notarial seal at Plymouth Meeting Pennsylvania on the day and year first above written. O.O. �! .: - /��� - _____ __ - - p �. - - €. t < 5 g.. � i7• a" "r:v ` '.Teresa Pastella ", Notary Public:- - L L 0 .. S._ a , :;y1:T.435i:G.^. Lx�pimi's %1,%.'C^, lam, � ��'' _ - _ - - "� ,"�. ai. p i _ ----_ -= — - 3 :a:: : i jj.^ I'SSCCE<e J.3G '"f35 0 m - _ a' ,, " c This Povuer ofAttorney is made and execute puratt nd`6yauthonty ofthe following"By laws and Authorizations ofAmencan.Fire and Casua Com an `,The Ohio Casua Insurance: N �, � - . - _ ... _ nY. P _ Y �Y. o L . _s eY,r O. y „Company, Liberty Mutual Insurance Company; aft WestAme c n Insurance Company which resolutions an now in full force and effect reading as folloHrs,` '. '= :` ` ,_ . tM VI -. , ...:.- -..:. % Q1 L ARTICLE IV OFFICERS Section 12 Power, of Attorney: Any officer or other official of the Corporation authonzedfor. that purpose m writing bythe Chairmen'or the President and subject-' .O c: � ,; to.such limitation as the Chairman orthe President may prescribe, shall appoint such attomeys-in-fact, as may be necessary" to act in behalf ofthe Corporation t' make execute seal , V O C acknowledgeand-deliver as surety anyand all undertakings bonds,-recognizances and other surety obligations._ Such attomeys m fact;aubject to.the limdations set forth in their respe- ive; ;-p , y "powers of attorney shall have full power to bindahe Corporation6y their -signature and execution of "any such instruments and to attach thereto`the seal ofthe,Corporation:When so.: '� d L � executed, suchinstniments shall be as bindin as if signed b" the President and attested to b the Secret, An oweroraLA -' ranted to an n resentative"orattome m-fact under.- > =: O to _. _ 9 9 - .Y - _. y- ry_. Y-P" _..!g_. Y. P - " :� � M r ARTICLE XIII - Execution of Contracts - SECTION�5: Surety Bonds anii Undertakings Any officer of the Company authorized for that, urpose in writing 6y the chairman or the resident;= � co . P _P _ �. _L and subject to such limitations.as,fhe chairman or,the presidenfmay prescribe; shall appoint such attomeys rn=fact,.as maybe necessary to actin behalf of the"Company,' rnake, execute,:. ;_ ���: 0,. ", seal :ackn'wleiige�and deliver as,surety any -and all undertakings; bonds recognizances and other surety obligations -Such attomeys in.fact subject to. the limitations seffort6."in their = a?: . . "respective powers of attorney; "shall have.full power to bind the`Com ' — y by their signature, and execution of any such"instruments:and to attach-iheret'the seal of the Company."When so..:O o : c�.�_ executed sucli'iinstrumentsshall be. as binding as'rfsigned by the pn ident and attested'by the`secietary% = - - W_ - - = ,. "._ - C .., . ,- Certificate.of Designation -_The Prdsident_of the- ompany,'acting:pursuant to the Bylaws of the"Company; authorizes:David.M. Carey, Assistant Secretarytoappoint such::attomeys in= -'.: _f. - . may be necessary, to -act on behalf-of-the-Company.t. make execute seal, acknowledge and deliveras'surety any and all undertakings;.b'nds recognizances and other surety obligations - - - - - - - ; __. ... Authorization -:By unanimous consent of the.Companys Board.of Directors the.Company consents"that facsimtle or meehanically rej3roduced-signature of any assistant secretary of the _,,..� - . ~ Company wherever appearing upon _a certified copyof any power.of attomey-issued.by the Company rn connection Huth surety"bonds; shall be.valid"and bintling uponahe.Company"uirith; . the same force and effect as though.manuallyaffixed _ �.-::. ".:..:: - _ - - I,,GregoryW. Dagehp6 , the undersigned, Assistant Secretary,;"of American Fire and -Casualty Company, The Ohio C - - _' i Insurance. Company; Liberty Miitual Insurance Company; -and _, - - .West American IHsuranc om an" - e C p ; y do hereby certify that the original power of attomey,of which the ton going,is a full true_and correct copy of the Power of Attorney executed=by said Com anies is in full force and etfectaiid has.not been revoked.`.:: = - P_......,.- - - I. _. .: --,-_ ,. IN TESTIMONY WHEREOF I have hereunto set_my hand and.affixe'd the seals of said "Companies this - day of 2 20 f h� C - _ _ _ ,2, 4. _. Q.. �f - zr s. , ;,y regory W airport cretary ;G Dav Assistant Se LMS_12973 122013 - 399.'f.500'rt.: City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk September 22, 2014 M. S. Construction Management Group 32565 B Golden Lantern #475 Dana Point, CA 92629 RE: Warner Avenue Bridge Maintenance—CC-1356 Enclosed please find your original bid bond for CC-1356. Sincerely, e Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand CITY CLERK CITY OF HUNTINGTON BEACH W,2 SECTION C PROPOSAL for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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. r Accompanying this proposal of bid, find J�'b e-36r4p in the amount of $ la which said amount is not less than 10% of the aggregate of the total amount bid, as,required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for %", as the case may be). Any standard Surety Bid Bond form is acceptable. C-2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 1 1 LS Mobilization $ 601060 2 1 LS Prepare Storm Water Pollution Prevention Plan $ 2 $ Z 0 3 1 LS Water Pollution Control 4 1 LS Access Grading $2 0 $ Zv 1000 5 1 LS Traffic Control $13i 04 $ 6 13020 SF Saw Cut, Grind and Remove AC Pavement $ $ 6 Z6 7 82 TN Asphalt Tack Coat and AC Leveling Pavement $Zf$�� 8 163 TN ARHM Finish Course Pavement $ Z08 $ 3 ,201 C-2.1 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 8 LF Saw Cut and Remove Existing PCC Curb/Gutter 20 10 8 LF Construct Variable Height PCC Curb and Gutter (� 1$-2qO 2 �y� $ 2 J20 11 124 LF Install 4' High Environmental Protection Fence jjqq $ 10 $ 2 2 2 12 2 EA Adjust Gas Valve Frame and Cover to Grade $ ��yy 13 1 LS Install Striping and Pavement Markings ? $ 3 2 $ J 14 33 CF Remove Unsound Concrete $ J 2c, 100 $ fa 15 234 LF Remove Concrete Barrier $ 230 $ 53 910 16 234 LF Remove Chain Link Railing $ �V•5v $ V C-2.2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 65 LF Remove Metal Beam Guard Railing 18 65 LF Metal Beam Guard Railing $ �r $ 19 50 LF Remove and Reconstruct Wood Rail Fence $ 60 $ 20 33 CF Portland Cement Concrete (Patch) ? $ J 9 $ 1f 21 310 CY Rock Slope Protection (1/4 Ton Method A) Q $ 0 7 $� 1 22 310 SY Rock Slope Protection Fabric (Class 8) $ ZI $ 23 117 LF Concrete Barrier (Type 26 Modified) $ $ O0 $ 3 coo 24 117 LF Concrete Barrier (Type 732 Modified) $ $ GO C-2.3 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 25 234 LF Wildlife Protection Railing G $ I� $22 26 6480 SF Seal Concrete Bridge Deck $ Z $ 27 1 LS Planting and Habitat Mitigation $ $50O 28 1 LS Planting Maintenance $ $ Total Amount Bid in Figures: $ Total Amount Bid in Words: ................................................................................................... .a,.......94U14.0k. ?.....Ux......7..I�.� 26-D......ENjA1....I- 0 . I C-2.4 SECTION C 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Portaon Name and Address o Subcontractor State License Class f. o Work Number , AGO R . ENC - Q RI' 4 � CA �i i229�q SOUlkiRM CRUMFIA C Y P C31 5 s 9S �. By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on,,J 1,201N at d614,?A14e q: Date City State being first duly sworn, deposes and says that he or she is /LDS' of/�J.S/M/r%l Ci 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. Name of Bidder Signature of Bidder 3zS6� $ 40/a/f.J L.4wi�w.,J e41S-- d�.9✓.� oihT, e-A 124 Zy Address of Bidder Subscribed and sworn to before me this -7A day of �v_� 1 y 201 �: °" ARTURO AYALA ' COMM. #2052517 W Notary Public -California ORANGE COUNTY LL My Comm. Expires Jan 10, 2018 NOTARY PUBLIC C-4 NOTARY SEAL CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On 7/7/14 before me, Arturo Ayala, Notary PHeure Iblic Date nsert Name and Title of the Officer personally appeared Mike Saghafi �F ARTURO AYALA a COMM. #2052517 M Notary Public•California ORANGE COUNTY m „ow.,' My Comm. Expires Jan 10, 2018 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/am subscribed to the within instrument and acknowledged to me that heldVigjx executed the same in hisMiNMiKauthorized capacity(ies), and that by hiss Mirsignature(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 a Signature Place Notary Seal Above g lure of Notary Public A yala 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: Non -Collusion Affidavit Document Date: 7/7/14 Number of Pages: One Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Mike Saghafi ❑ Individual W Corporate Officer —Title(s): President ❑ Partner— ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Other: Signer Is Representing: Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s) ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here ------------- © 2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 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 WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (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: -77 C-5 Contractor y Ci✓/ Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes XNo If the answer is yes, explain the circumstances in the space provided. r Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: -) 1-2 &4- C-7 itle BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: . 0 e�s- Lr/ /pan li7l�/�l�% �j1�00 Bidder Name 3;1, 4-5-0 4y /041f Zt*Xe-� $ -f Business Address ZDW?V11W 1 i off '1�6211 City, State Zip Telephone Number State Contractor's License No. and Class Original Date Issued Expiration Date The work site was inspected by �JA�lh'l�i of our office on 12011. The following are persons, firms, and corporations having a principal interest in this proposal: C-s The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Compan of Bidder 0 Ll�z- -&- Printed or Typed Signature Subscribed and sworn to before me this-1A day of �S-' jt , 201� . ECARTURO AYAtA . COMM. #2052517 N Notary Public -California ORANGE COUNTY LL My Comm. Expires Jan 10, 2018 NOTARY PUBLICU=Vzv�� NOTARY SEAL C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On 7/7/14 before me, Arturo Ayala, Notary Public Date Here Insert Name and Title of the Officer personally appeared Mike Saghafi ARTUR0 AYALA COMM.#2052517 N Notary Public -California tr ORANGE COUNTY LL My Comm. Expires Jan 10, 2018 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/2m subscribed to the within instrument and acknowledged to me that heXD MYfl executed the same in his t fXauthorized capacity(ies), and that by his OMKsignature(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 a Signature Place Notary Seal Above ure of Notary Public Arturo a 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: Bidder's Information Document Date: 7/7/14 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Mike Saghafi ❑ Individual W Corporate Officer —Title(s): President ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Other: Signer Is Representing: Number of Pages: Two Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s) ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here 0 2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.Nationa[Notary.org Item #5907 Reorder: Call Toll -Free 1-800.876-6827 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: 2. Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: " 3. Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: C-10 M.S. CONSTR UCTION MGMNT. GROUP "List of PMects under construction " As of 611114 1. Inland Empire Headquarter building Central Plant Improvements Owner: Inland Empire Utility Agency Project description: Central Plant Mechanical improvements including Chiller system, Boiler system, pipeline, underground electrical duct bank, structural steel supports, Rough and finish Grading, Site improvements, etc. Contract Duration: 345 days Completion Date: 98% completed Contract Amount: $1,889,885 Contact Person: Mr. Gary Dix (909)993-1670 email: gdix@ieua.org 2. San Gorgoniogh School Modernization Phase 2 Owner: San Bernardino City Unified School District Project description: High School Modernization, including some Rough & finish grading Contract Duration:194 days Completion Date: 99% completed Contract Amount: $1,605,000 Contact Person: Mr. Troy Shandy (909)361-0541 email: Troy. Shandy(@sbcusd.kI2.ca.us "List of Proiects Completed" 1. Valencia Water Reclamation plant Emergency Generator Owner: Los Angeles County Sanitation District Project description: Construction of foundation platform for new high voltage transformers and 2500-KW Emergency Generator. Removal of existing 10,000 underground diesel tank. Installation of Contract Duration: Completion Date: Contract Amount: Contact Person: new above ground tank and fueling station. Underground electrical and installation of new outdoor Power Switchboards. 360 days May 30, 2014 $3,700,000 Mr. Jack Shirian (626)962-8605 email: jshirian(-Macsd.org Page 2 2. Wilson Elementary School Modernization Phase 2 Owner: Santa Ana Unified School District Project description: Demolition of existing grass field, and concrete structures. Rough and finish grading, construction of a new parking lot. Construction of CIP concrete retaining wall, and related handicapped ramps, etc. Contract Duration: 55 days Completion Date: August 17, 2013 Contract Amount: $1,100,000 Contact Person: Mr. Greg English (714)808-3232 email: GEn lg ishABalfourbeattyus.com 3. Greenville Elementary School Modernization Phase 2 Owner: Santa Ana Unified School District Project description: Elementary School Modernization, including some Rough & finish grading Contract Duration: 55 days Completion Date: August 17, 2013 Contract Amount: $1,297,872 Contact Person: Mr. Greg English (714)808-3232 email: GEn lg ish@Balfourbeattyus.com 4. Metrolink Maintenance Support Facility Owner: Southern California Regional Railroad Authority Project description: Design Build TI construction including Mechanical and electrical at an existing warehouse building creating office spaces. The project included Rough and finish Grading, Site improvements, and Tenant improvement Contract Duration: 270 days Completion Date: June 30, 2013 Contract Amount: $2,177,096 Contact Person: Ms. Lia McNeil-Kakaris (213)452-0237 email: mcneill@scrra.net 5. John Adams Elementary School Modernization Owner: Santa Ana Unified School District -11 Project description: Elementary School Modernization, including some Rough & finish grading Contract Duration: 56 days Completion Date: August 10, 2012 Contract Amount: $1,149,500 Contact Person: Mr. David Amundson (949)261-5100 email: damundson@cwdriver.com Page 3 "List of Proiects Completed" Continued 6. Taft Elementary School Modernization Owner: ' Santa Ana Unified School District Project description: Elementary School Modernization Contract Duration: 56 days Completion Date: August 10, 2012 Contract Amount: $1,244,975 Contact Person: Mr. David Amundson (949)261-5100 email: damundson(a.cwdriver.com 7. Sierra Preparatory Academv Modernization Owner: Santa Ana Unified School District Project description: Elementary School Modernization Contract Duration: 56 days Completion Date: August 10, 2012 Contract Amount: $1,197,292 Contact Person: Mr. Tom Haney (949)261-5100 email: thaney .cwdriver.com 8. Katella Ave. Smart Street Improvements Owner: County of Orange Department of Public Works Project description: Road widening of Katella Ave. Rough and finish Grading, Installation of Masonry sound wall, Storm drain RCB's, including underground utilities, etc. Contract Duration: 220 days Completion Date: April 2012 Contract.Amount: $8,239,000 Contact Person: Mr. Chris Kubasek (714)567-7832 email: chris.kubasek(a)ocpw.oc4ov.com 9. Sultana -Cypress Storm Drain Phase IIB Owner: County of San Bernardino Department of Public Works Project description: Rough and finish Grading, Construction of 1200 lineal feet of open concrete channel. Installation of storm drain RCB's, including underground utilities Contract Duration: 120 days Completion Date: January 2011 Contract Amount: $4,999,550 Contact Person: iVlr. Sri (909)387-7935 email: ssrirajan@dpw.sbcounty_gov Pane 4 "List .of Protects Completed" Continued 10. Palmdale Water Reclamation plant 12/4-KV Power Service Substation Owner: . Los Angeles County Sanitation District Project description: Rough and finish Grading, Construction of new masonry building, and foundation platform for new high voltage transformers. Underground electrical and installation of 12/4- Contract Duration: Completion Date: Contract Amount: Contact Person: KV power Substation. 200 days November 2011 $1,313,616 Mr. James Kahle (626)962-8605 email: jkahle(cr�,lacsd.org 11. Little Hollywood Affordable Housing Project Owner: City of San Juan Capistrano Project description: Massive grading of a vacant land, construction of -all the infrastructure including underground utilities, construction of roadway, and installation of 10 manufactured homes on new foundation. Contract Duration: 180 days Completion Date: November 2009 Contract Amount: $2,108,279 Contact Person: Ms. Laura Stokes (949)443-6313 email: lstokes@sanivancapistrano.org 12. Riverside Parking Structure # 1 &2 Repair, Improvements, and Facade Replacement Owner: City of Riverside, Dept Of Public Works Project description: Repair, Improvements, and Facade Replacement of Two existing Parking Structures Contract Duration: 180 days Completion Date: July 2, 2009 Contract Amount: $5,057,308 Contact Person: Mr. Farshid Mohammadi (951)826-5515 email: FMohammadi@riversideca.gov 13. Crestline Sanitation District office expansion and modernization Owner: County of San Bernardino, Special District Office Project description: Construction of a new two story prefabricated steel building, and renovation of the existing building Contract Duration: 190 days Completion Date: June 15, 2009 Contract Amount: $1,693,736 Contact Person: Mr. James Oravets (909)387-5940 email: joravets@sdd.sbcounty.gov BIDDER'S CRITICAL STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. 2. Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: 0-5-0 Project Name & Contract Amount Type of Work Date Completed VA/g .4 PJM gdf&PnW 46;,4 Project Name & Contract Amount * 100, 000 Type of Work Date Completed 000 Project Name & Contract Amount Type of Work Date Completed Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: Project Name & Contract Amount Type of Work l�ll�friaiA G�ie Project Name & Contract*A FIAml�rlo,z Type of Work Date Completed Date Completed 141J-11►- Alt, S.n '.5� 'S ao✓�.7�'# Y,2311000 A7°2:/ 20/2- Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 THE AMERICAN INSTITUTE OF ARCHITECTS Bond Number: MSCON-135 AIA Document A310 KNOW ALL MEN BY THESE PRESENTS, that we M.S. Construction Management Group 32565 B Golden Lantern #475 Dana Point , CA 92629 as Principal, hereinafter called the Principal, and U.S. Specialty Insurance Company 601 S. Figueroa Street, Suite 1600 Los Angeles , CA 90017 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 2000 Main Street, Huntington Beach, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid Dollars ($ 10%) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for: Warner Avenue Bridge Preventive Maintenance (Over Bolsa Chica Channel) - Federal Aid Project BPMPL-5181 (169) 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 3rd day of July, 2014 (Witness) (fitness) M.S. Construction ManagemenfGr,6up (Princi 1) (Sea/) Mike Saghafi M President U.S. Specialty Insurance Company Suref (Sea!) Arturo Ayal J )Attorney in -Fact AIA DOCUMENT A310 • BID BOND • AIA ® • FEBRUARY 1970 ED • THE AMERICAN INSTITUTE of ARCHITECTS, 1736 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ar-a-- a• a a• �- a• a• a• a a>�• a• a ar--a a- a• e� y a• a e7�a� STATE OF CALIFORNIA County of Orange } On 7/3/14 before me, Arturo Ayala, Notary Public Date Here Insert Name and Title of the Officer personally appeared Mike_ Sa_ghafi Name(s) of Signer(s) ARTURO AYALA W COMM. #2052517 n '�. Notary Public -California to .- Ir ORANGE COUNTY U. •�' My Comm. Expires Jan 10, 2018 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(a) whose name(x) is/axe subscribed to the within instrument and acknowledged to me that he/strAbW executed the same in his/hwXxElt authorized capacity(je5r), and that by his/ke signature(s) on the instrument the person(x), or the entity upon behalf of which the person(x) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand an Signature S' of Not ry Public Arturo Ay OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: 7/3/14 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) None Signer's Name: Mike Saghafi ❑ Individual V Corporate Officer—Title(s): President ❑ Partner— ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator Top of thumb here ❑ Other: Signer Is Representing: Number of Pages: One Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here ® 2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotary.org Item #5907 Reorder: Cali Toll -Free 1-800-876-6827 CALIFORNIA•ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange } On 7/3/14 before me, Karen L. Ritto, Notary Public Date Here Insert Name and Title of the Officer personally appeared Arturo Ayala Name(s) of Signer(s) Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(i4 whose name( is/xm subscribed to the within instrument and acknowledged to me that he/sfg executed the same in his/hucAb& authorized capacity(je2), and that by his/kadCo& signature(.x) on the instrument the person(:s), or the entity upon behalf of which the person(.x) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my a d " i i seal. Signature Sig re o otary Public aren L. Ritto OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: 7/3/14 Number of Pages: One Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Arturo Ayala ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner —❑ Limited ❑ General 1Z Attorney in Fact ❑ Trustee ❑ Guardian or Conservator Top of thumb here ❑ Other: Signer Is Representing: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ITopf thumb here ❑ Other: Signer Is Representing: © 2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotaryorg Item k5907 Reorder: Call Toll -Free 1-800-876-6827 �JIhl�ll 1gIIIViII. �'hi�tlll, IIII„Ii�V!I'lll� d'IIIIII� �::��� _ — —POWER OF ATTORNEY — — AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company�California corporation, United States_= II JmPll,:lli ;I" �'I �!Ilij it — S; et mpa a Maryland corporafionll;Irand �yU;I'S�IIIlg Specialty Insurance �rMM texas corporation-�lleetiy= the Ulltll IIII,lplh IIIIIP V6�hl IIIIII IIII Idle, — — _ _ mantes ' � b_y these present Imake; constitute ands appoint: _ lulllg l� IIIIIIIII IIIIIIQI��lllllllilii�li�ll'I�II'�I�I���I I''llllllllill� IIIIIII I,I a ---- -- - Danie'I I I'uckabay, Arturo Ayala or Dwight7lkz lyofOrange, California -- -its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred -in its name, place and stead, to execute, acknowledge and deliver any and alLbonds, recognizances, undertakings_ _ o_r_other instruments or contract t ss�ret s— � tM&Llude riders, amendlm'ents "a'In'i Illnslents of sure r din the -band— _penalty does not -exceed - — en Million** i �li!�li�l,��lil ��I���li!���� I�����I�III�i'I. ������I�lll���l����� llil�ll����lll, Dollars 0 OQfio p This Power of Attorney shall expir wtthouf ie etron on Decembe'r1�;08 201�6''I° T "''i�IIhIP'Io'I011111r of"'Attorne is [trader arirl IIIIII 111 IIIIII ,IIIIIII Y iM Y = authority of the following resolutions adopted by the Boards of Directors of tle Companies: 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 Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following n provisios:_ — _— I!'lluoil� IIIIIIIIIiIIIuiIfl,Vl'.. Wttorh&-ihM- q my_be given full poweeand'1'1-11. p tyi or dlmll{1?e me of and on behal o fhe tmpany,�o ex acknowledge and deliver=any-and_all bonds; _ = recoemzance� contracts, agreements or;' ndelml1utylilla�n'dl "then lconldiiilgh"aI or obligatory �ikirrgs,lnclucfin�»ny�d all consents for_rthe release of retained Br enta es=and[ fictal=estimates on engineeringIfl ,al'llnl In!, yuaml,�p• _ — _ — — _ —p- g- andconstructionucontracts, and any andL-notices-nd�b�umentcartc�ing or tennmanngthe_Company's_lrabihty= — �chllill h9,N', � Illtlp'1911 ....�••�••.. .... - thereunder, and any such in so executed'by any such Attomey-in-Fact shall be bindingupon tTfe 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_u_ndertaking to which it is attached. —_ - - - 'i IIII I il'�I I' li III I li i IIII jl 111kL. III'IIi'II II I' l III'I�l IIII IIIIII ill l'l, - INMTNESS WHEREOF, The CCCCRmpanies haeeausedttiis instrument to:bels gned,andltheir corlporate seals to b>�rer to��ed cis loth -day of December, 2012. _ _—II'll�ll'11'�IIIII V�IIIIIII,tI ''I�dll•Ilfi,l.ldli �I'1116II AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY Co orate deals— °" "'^" croRs nI�r =_ — w',•o°C S.suRFAlA i1,I. \ Danlel-P.�g uilar, Vice President —� State of California County of Los_ Angeles SS: till,,, ;;I;II'lilll pl'I'ip:''Illln llla,l ;I it Ohl -- = --_ - — — — -- — :tl,(,i.d,,, ,:,III"dll: l ��baniel —'On loth day Of December, 2012,b�brem� Varie9§Mi ght, a notary publicetsonallly I elairedP. Agin, �ce�-- residentof — lmertcan Contractors lndemnity�_ompany� UniWTMS tes�urety Company,Illanl i' �iS. Speclfal y Insurance Comparf o -- v Lwme on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. ,;�,..,,.,... nf•'iur.IV, a+Iul'Iih�CilIjU'll:ry,, 'll!liii'iVu = _--- - — RJIURY I,u�ilder tl�'lle I'Iaws of the State of �a�tfornraf�tat�_etoing paragraphill true=and correct --F- erttfy ur�efPFENALTY OF PE 'p —iiiiii J3NESMS-han-t� and official seal IIII IIII IIII III'liliillll1lll'lll,IIIIIjViGil II�IIiiI _ I;III!Iil: II 161I _ _ KWRiQMT f� Comrtdai�e ! t998S18 Signature \j ��� (Seal) NIft"P&IC-cunoron. Las Again co ivm Comm: E Ow 8.20t6� _ I=Jeanme Lee -Assistant Secretary af-Ameriear��ntf_adtors Indemnity Co„ �anl o U, 1,te,dll , t ''fe°°''Surety Company and U-, S ialtyi I' II oJllill IIII III la'llllll IIIIIIf Insurance _Company, do hereby ceitha ti) alro�an� foregoing is a'ItiJtie andllcotrec� Opy a Power of Aftora� exeute� II II II lull gp,lll II I�' III III IIIIIIIII h!Il1119h aE said Compames which is still in�ll�areeiieicfur�termore the re lu IItlIons, ofi� he 'Boards of Directors slue Powern� ' _ ' ^811'flll1, IIIIII IIIU III lo' Q U I ImCu L,m, Ai —Atforney are in full force and effect — In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this 3rd day of July , 2014. _ _ yllldi Ilk plul IIIIIII ,IIIIII 11116 I III IpI llld;l; I ('IIIIIII. — — — OratePalS — I1''' III' II� IILI _ !; !� IIIII, PI C70R `''+rag— �a��S a�Q.........., cv 011 Bond No. MSCON-135 '2__ >y' °` + roe. :.._ =y; 3= Jeannie Lee, ssistant Secretary Agency No. 46 n. o :o _ - _ s 8472 sEvr + so : t r a *.: _ — _ _ = I,III'i l �,y I�7I III, li �l �jl �II'� Ill 111 IIIII III _ _ __ ,IIII idI I I IIIII del City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk September 22, 2014 Peterson -Chase General Engineering Construction, Inc. 1792 Kaiser Avenue Irvine, CA 92614 RE: Warner Avenue Bridge Maintenance— CC- 1356 Enclosed please find your original bid bond for CC-1356. Sincerely, JF:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC. 1792 KAISER AVENUE IRVINE, CA 92614 _, �*lull,- ;=4 `. , �'✓'. �}-` I SECTION C PROPOSAL for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City .Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for"the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 S 10% which said amount is not less than 10% of the aggregate of the total amount bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for _%", as the case may be). Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received idde 's Si nat 1 7/ 1 /2014 C-2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 1 1 LS Mobilization $ $ 2 1 LS Prepare Storm Water Pollution Prevention Plan $ y o00 - $ y 00Q — 3 1 LS Water Pollution Control $ S — $ '51 $00- a 1 LS Access Grading $ $ IS 5m- 5 1 LS Traffic Control SS,ovo- $ 'bw SS,auo- $ 6 13020 SF Saw Cut, Grind and Remove AC Pavement $ 1, 35 $ 7 82 TN Asphalt Tack Coat and AC Leveling Pavement $ 250 - $ Zol 6co 8 163 TN ARHM Finish Course Pavement $ I tO' $ l 9 y8 pw'/ pvv C-2.1 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount s 8 LF Saw Cut and Remove Existing PCC Curb/Gutter $ 50- $ 4091 10 8 LF Construct Variable Height PCC Curb and Gutter $ 125 - $ 1, 000 11 124 LF Install 4' High Environmental Protection Fence $ '�-D1 $ 12 2 EA Adjust Gas Valve Frame and Cover to Grade $ 500- $ 1 Oo0 13 1 LS Install Striping and Pavement Markings $ 45 - $ IkS 14 33 CF Remove Unsound Concrete $ $ 13 ZC0- 15 234 LF Remove Concrete Barrier $ 9 — $Z�U� 16 234 LF Remove Chain Link Railing 1(0 $ -Wh Sl qqL( $ Dwl� rW ✓ C-2.2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 17 65 LF Remove Metal Beam Guard Railing $ '510 $ 18 65 LF Metal Beam Guard Railing $ $ iD 70 19 50 LF Remove and Reconstruct Wood Rail Fence $ $ 2 850 20 33 CF Portland Cement Concrete (Patch) $ $ 12, 2,= 21 310 CY Rock Slope Protection (1/4 Ton Method A) 325 — $�"' l00,`1 so $ 22 310 SY Rock Slope Protection Fabric (Class 8) $1550- 23 117 LF Concrete Barrier (Type 26 Modified) lye' $ 1b�4lo5 24 117 LF Concrete Barrier (Type 732 Modified) $ $ C-2.3 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item Contract Unit Extended No. Quantity Unit Description Price Amount 234 LF Wildlife Protection Railing 25 $ l25 Is= 6480 SF Seal Concrete Bridge Deck I, 5v q, `7Z° 26 $� $ 1 LS Planting and Habitat Mitigation 27 $ 251 ow $ 7,51 OW 1 LS Planting Maintenance 28 $ 25 1000 $ 25 coo Total Amount Bid in Figures: $ 5y O gr1 y — Total Amount Bid in Words: ........................................................................... ....... ... . ..................... .............. iVe hun -0 u'- caoll cv(-S wv C-2.4 SECTION C 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class %to -1 cq� 2S f 1 Cor r\ Fe n tx Co. o ra e CA 1??95 y iq, g� $ All k t meri can PK'0r\41i- COVOYN rl rT3 l4 CV\r�Sp C C>. 1 oyl L1 (DOC) A,� C3 C By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange I declare under penalty of perjury under the laws of the St to f California that the foregoing is true and correct and that this declaration is executed on �` c, at Irvine , CA Date City State Dick W. Vogels , being first duly sworn, deposes and says that he or she is Vice President of Peterson -Chase G.E.C., 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. State of California County of Subscribed and sw to (or off before me on the day of 20 _LLJ by Proved to me on the basis of s evidende to be the-Deftntal %& KALI GOGLANIAN Commission * 1924860 Notary Public - California NOTARY PUBLIC Dick W. Vogels Name of Bidder 1792 Kaiser Ave. Irvine, CA 92614 Address of Bidder day of , 201 _ 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 WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: C-5 Peterson -Chase General Engineering Construction,'Inc. C-*-f- Title r I QJIUM IL DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Peterson -Chase General Engineering Construction, Inc. Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Peterson -Chase General Engineering Construction, Inc. Bidder Name 1792 Kaiser Ave Business Address Irvine CA 92614 City, State Zip ( 949 ) 252-0441 Telephone Number 615876 - C13 C32 A, B State Contractor's License No. and Class 3/23/1991 Original Date Issued 3/31 /2015 Expiration Date The work site was inspected by Dick W. Vogels of our office on July 1 , 2014 . The following are persons, firms, and corporations having a principal interest in this proposal: Peterson -Chase General Engineering Construction, Inc. Greg Chase - President Dick W. Vogels - Vice President/Secretary/Treasurer C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Peterson -Chase General Engineering Construction, Inc. Company Name ,/ / W Dick W. Vogels Printed or Typed Signature Subscribed and sworn to before me this 9th day of July , 201_ NOTARY PUBLIC NOTARY SEAL State of California County of rid Subscribed and sworn to (or afirrned) before me on this C1401 day of Sul 20 by t/ KALI GOGLANIAN proved to me on the basis of sati actory Commission #� 1924860 eviden to be the pens (�4v�L� •� Notary Public California = ea d before Orange County n lure M Comm. Expires Mar 9, 2015 C-9 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar'work within the past five years: Caltrans - 1120 N Street, Sacramento, CA 95814 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Denise Sostrom (951) 232-7608 Widening, Repair Bridge Deck & Upgrade Bridge Railing 2,419,102.58 11/20/2013 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Widening, Repair Bridge Deck & Upgrade Bridge Railing .2. City of Santa Clarita - 23920 Valencia Blvd., Ste 120, Santa Clarita. CA 91355 Name and Address of Public Agency ...Name and Phone # of Agency's Project Manager: Monica Heredia (661) 255-4332 . Bridge Preventive Maintenance Program 154,277.00 5/20/2012 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Bridge Preventive Maintenance Program 3. Caltrans - 1120 N Street, Sacramento, CA 95814 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Blas Martinez (559) 651-8321 Repair Bridge 735,961.10 6/25/2013 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: C-10 BIDDER'S CRITICAL STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. Greq Stevens Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: 949-252-0441 Bridge Preventive Maintenance Program 154,277.00 5/20/2012 Project Name & Contract Amount Type of Work Date Completed Repair Bridge 735,961.10 6/25/2013 Project Name & Contract Amount Type of Work Date Completed Clean & Treat Bridge Deck, Replace Joint Seals And'Approach Slabs 2,642,763.21 1/08/2014 Project Name & Contract Amount Type of Work Date Completed Vance Wilson Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: 949-292-5793 Bridge Preventive Maintenance Program 154,277.00 5/20/2012 Project Name & Contract Amount Type of Work Date Completed Repair Bridge 735,961.10 6/25/2013 Project Name & Contract Amount Type of Work Date Completed Clean & Treat Bridge Deck, Replace Joint Seals And Approach Slabs 2,642,763.21 1/08/2014 Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Peterson -Chase General Engineering Construction, Inc. Contact Person: Dick W. Vogels Contact Phone: 949-252-0441 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-12 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (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 Peterson -Chase General Engineering Construction, 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 1 of 8 C-13 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. Page 2 of 8 C-14 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-15 June 11, 2014 Local Assistance Procedures Manual Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. Exhibit 12-H Sample Bid In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-16 June l 1, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-17 Page 5 of 8 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-18 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier , if known Congressiona is t k wn ssional District, if known 6. Federal Depa ent nc 7 Program Name/Description: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. 10a) (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 ea. 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 El 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying Signature: reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required Print Name: pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required Title: disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: Date: Federal Use Only: I.H. RP 09_1 ?_q7 C-19 Authorized for Local Reproduction Standard Form - LLL Page 7 of 8 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid 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. 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. Check all boxes that apply. If other, specify nature. 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 Rm06-04-90.ENDIF» Page 8 of 8 C-20 June 11, 2014 i _. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181(169) C.C. No. 1356 July 1, 2014 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356: 1. The following Project Plan sheets, originally advertised on 6/19/2014, shall be respectively replaced by the attached Project Plan sheets APPROVED BY TRANSPORTATION ENGINEERING on 7/01/14: • SHEET NO.4 OF 14 (TC1) TRAFFIC CONTROL PLAN 1 • SHEET NO.5 OF 14 (TC2) TRAFFIC CONTROL PLAN 2 • SHEET NO. 6 OF 14 (TC3) TRAFFIC CONTROL PLAN 3 • SHEET NO.7 OF 14 (TC4) TRAFFIC CONTROL PLAN 4 • SHEET NO.8 OF 14 (SS1) SIGNING AND STRIPING PLAN 2. The Federal Labor Rates contained in Appendix I — Part 2 of the Project Specifications for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 06/20/2014). The attached FEDERAL LABOR RATES (Publication Date 06/20/2014) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 1, 2014. � r5an-ChaseGeneral 6-evn�m GJ&Joc. Company NaWe Date W . Vo LS By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. PRE4IUM: NIL Bond No, 0284226 G7F U iV&RICAN INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS, that we, Peterson -Chase General Engineering Construction, Inc. as principal, and the GREAT AMERICAN INSURANCE COMPANY, a corporation existing under the laws of the State of Ohio, having its Administrative Office at 58Q Walnut Street, Cincinnati, Ohio 45202, as surety, are held and firmly bound unto, City of Huntington Beach Office of the City Clerk as obligee, in the penal sum of ten percent of amount bid DOLLARS ($ 10 0 ), Iawful money of the United States of America, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. SIGNED, sealed, and dated this 7th day of July 2014 WHEREAS, the said principal is herewith submitting :a proposal for Warner Ave Bridge Preventive Maintenance No. C.C. no. 1356 NOW, THEREFORE, the conditior of this obligation is such that, if the said principal shall be awarded the said contract, and shall within sixty ( 60 ) days after receiving notice of such award enter into a contract and give bond for the faithful performance of the contract, then thi! obligation shall be null and void otherwise the principal and surety will pay unto the obligee the difference in money between the amount of the principal's bid and the amount for which the obligee may legaIIy contract with another party to perform the work, if the latter amount be in excess of the former; but in no Peterson -Chase General event shall the liability hereunder exceed the penal sum hereof. Engineerinq Construction/,L GR1Ayt1ddERiCAN INSURANCE COMPANY By Spencer Flake Attorney -in -Fact F.9116K-(3182) (BID FORM) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On 7-07-14 Date before me, Lexie Sherwood Notary Public, Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake LEXIE SHERWOOD COMM. # 2031782 3 ' * NOTARY pusuC • CALIFORNIA n ORANGE COUNTY Comm. Exp. JULY 27, 2017 of Signer(s). who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of it the State of California that the foregoing paragraph is true and correct. il! Witness my hand and official seal r Signature Place Notary Seal Above Signature of Notary Public Lexie Sherwood i ii 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 the form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s):_ ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s): — ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FIVE No. 0 14901 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power DAVID L. CULBERTSONJ RICHARD A. COON ALL OF ALL CHARLES L. FLAKE LEXIE SHERWOOD ANAHEIM, $100,000,000.00 SPENCER FLAKE CALIFORNIA This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 9TH day of JUNE 1 1 2014 Attest GREAT AMERICAN INSURANCE COMPANY msu 41-- e. 3.'.� (0&a e. X4,4 Assistant Secretary Divisional Senior Vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C. KITCHIN (e77-377-2405) On this 9TH day of JUNE 2014 , before me personally appeared DAVID C. KITCHIN, to me known, being duly sworn, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. Shack C mft NotaryPL6%NIB ofOhio W Comds m Expires "2015 .0� / M-140 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorized from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof- to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bona undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this 7TH day of JULY 2014 Assistant Secretary S1029AD (12/13) City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov. Office of the City Clerk Joan L. Flynn, City Clerk September 22, 2014 Powell Constructors, Inc. 8555 Banana Avenue Fontana, CA 92335 RE: Warner Avenue Bridge Maintenance—CC-1356 Enclosed please find your original bid bond for CC-1356. Sincerely, F Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Cities: Anjo, Japan 0 Waitakere, New Zealand Powell Constructors, Inc. 8555 Banana Avenue Fontana, CA 92335 AA 4, 4 Y, q.4, "SEALED :ID" Warner Avenue Bridge Preventative Maintenance (Over Bolsa Chica Channel) 17-4-1 0maRD1 -R-10,11-laol 7i 14, 41- rP, r q SO t W 1 P% S: j, t"-. VIN 101 City of Huntington Beach Office of the City Clerk 2000 Main Street, Second Floor Huntington Beach, CA 92648 ,4, v-4,; IN11 -tP zgq �czt. Ni- ,till All, �i� 761 i'll , �t 'f V'4 5t 'Alm vmi -;.Y� v- 7 4 i­j �H SECTION C PROPOSAL for the construction of WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (169) C.C. No. 1356 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER's default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount of $ 10% which said amount is not less than 10% of the aggregate of the total amount bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for 10 %", as the case may be). Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's acre 1 July 1, 2014 C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE (OVER BOLSA CHICA CHANNEL) FEDERAL AID PROJECT BPMPL-5181(169) C.C. No. 1356 July 1, 2014 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356: The following Project Plan sheets, originally advertised on 611912014, shall be respectively replaced by the attached Project Plan sheets APPROVED BY TRANSPORTATION ENGINEERING on 7101/14: • SHEET NO.4 OF 14 (TC1) TRAFFIC CONTROL PLAN 1 • SHEET NO.5 OF 14 (TC2) TRAFFIC CONTROL PLAN 2 • SHEET NO.6 OF 14 (TC3) TRAFFIC CONTROL PLAN 3 • SHEET NO.7 OF 14 (TC4) TRAFFIC CONTROL PLAN 4 • SHEET NO.8 OF 14 (SS1) SIGNING AND STRIPING PLAN 2. The Federal Labor Rates contained in Appendix I — Part 2 of the Project Specifications for the Warner Avenue Bridge Preventive Maintenance, C.C. No. 1356 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 06/20/2014). The attached FEDERAL LABOR RATES (Publication Date 06120/2014) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 1, 2014. Powell Constructors, Inc. Company Name By Michael B. Powell 7-10-14 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 1 LS Mobilization 2 1 LS Prepare Storm Water Pollution Prevention Plan $ LS $ S000.-- 3 1 LS Water Pollution Control $ LS $ 30oco 4 1 LS Access Grading $ LS $ 9`5 U .-- 5 1 LS Traffic Control $ LS $ 3S voo.- 6 13020 SF Saw Cut, Grind and Remove AC Pavement $ $3a 50•' 7 82 TN Asphalt Tack Coat and AC Leveling Pavement $ 2vo $ tLOADO- 8 163 TN ARHM Finish Course Pavement $ $ a (,W. _ C-2.1 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 9 8 LF Saw Cut and Remove Existing PCC Curb/Gutter $ MO.— $ 10 8 LF Construct Variable Height PCC Curb and Gutter $ 1 $ 00 •" 11 124 LF Install 4' High Environmental Protection Fence $ 5 •' $ 3A00 12 2 EA Adjust Gas Valve Frame and Cover to Grade $ $ 900- 13 1 LS Install Striping and Pavement Markings $ LS $ 20,cx�:o. 14 33 CF Remove Unsound Concrete $ 2aS.' $'14 5 J 15 234 LF Remove Concrete Barrier $ `tc )o - $ q3 L000 — 16 234 LF Remove Chain Link Railing $ 50•— $-logo.— C-2.2 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 17 65 LF Remove Metal Beam Guard Railing $ 90•- $ 3[b� 18 65 LF Metal Beam Guard Railing $ N5."" $ 19 50 LF Remove and Reconstruct Wood Rail Fence $ •" $ l 20 33 CF Portland Cement Concrete (Patch) $ aas .' $ �4a6 •" 21 310 CY Rock Slope Protection (1/4 Ton Method A) $ $ Id8 547• 22 310 SY Rock Slope Protection Fabric (Class 8) $ 90.— $ `:)O0.- 23 117 LF Concrete Barrier (Type 26 Modified) $ StsD•- $ lv� E, 350 24 117 LF Concrete Barrier (Type 732 Modified) $ $�o'i,3Sl�. C-2.3 PROJECT BID SCHEDULE WARNER AVE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 Item No. Contract Quantity Unit Description Unit Price Extended Amount 25 234 LF Wildlife Protection Railing $ \coo .- $ LI Cb• - 26 6480 SF Seal Concrete Bridge Deck $ as $ 3Ll , vav 27 1 LS Planting and Habitat Mitigation $ LS $ \a Sco •- 28 1 LS Planting Maintenance $ LS $ \�1 ocao— Total Amount Bid in Figures: $ a\s .— Total Amount Bid in Words: ,u �r� ak C-2.4 SECTION C 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 or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Portion of Work Name and Address of Subcontractor State License Number Class S.aso Asp CP 3 v43 CA 37�CooD 5 ce'd G -cel �� ow L � � 0. C- ,k-•P u)� 04 plan C'o►d /�rk�. Lind S 061of 75fs2d By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 7-10-14 , at Fontana , CA Date City State Michael B. Powell , being first duly sworn, deposes and says that he or she is President of Powell Constructors, 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. Powell Constructors, Inc. Name of Bidder Signature of Bidder 8555 Banana Avenue, Fontana, CA 92335 Address of Bidder Subscribed and sworn to before me this day of , 201 NOTARY PUBLIC See Attached NOTARY SEAL C-4 State of California County of San Bernardino Subscribed and sworn to (or affirmed) before me on this 10th day of July , 2014 , by Michael B. Powell proved to me on the basis of satisfactory evidence to be the pe n s h e. SHERRI EVANS COMM. # 2017516 'z Z 4P NOTARY PUBLIC - CALIFORN1A SAN BERNARDINO COUNTY My Comm. Expires April 30, 2017 (Seal) Signature UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356, (l)(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: 7-10-14 C-5 Powell Constructors, Inc. Contractor By Michael B. Powell President Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 7-10-14 C-7 Powell Constructors, Inc. Contractor By Michael B. Powell President Title BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Powell Constructors, Inc. Bidder Name 8555 Banana Avenue Business Address Fontana City, ( 909 ) 356-8880 Telephone Number 845305 A State Contractor's License No. and Class 08-24-2004 Original Date Issued 12-31-2014 Expiration Date CA 92335 State Zip The work site was inspected by Michael B. Powell of our office on June 30 , 2014. The following are persons, firms, and corporations having a principal interest in this proposal: Powell Constructors, Inc. Michael B. Powell, Preside C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Powell Constructors, Inc. Company Name Signature of Bidder Michael B. Powell Printed or Typed Signature Subscribed and sworn to before me this _ day of , 201_ NOTARY PUBLIC SEE ATTACHED NOTARY SEAL C-9 State of California County of San Bernardino Subscribed and sworn to (or affirmed) before me on this 10th day of July , 2014 , by Michael B. Powell proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. _ SHERRI EVANS COMM. # 2017516 2 NOTARY PUBLIC - CALIFORNIA� SAN BERNARDINO) COUNTY .. My COMM. Expires April 3?! 2017 (Sea ign re BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: Los Angeles County Metropolitan Transit Authority One Gateway Plaza Name and Address of Public Agency Los Angeles, CA 90012 Name and Phone # of Agency's Project Manager: Elma McIntosh (213) 922-7225 1-405 & 1-605 Soundwall & Bridge Widening $16,178,230.00 June 2014 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Bridge Widening of existing Bridges. Construct Several Sound Walls, Construct Retaining Walls Drainage Earthwork . Pavement Structures and Manage Traffic Control 2• City of Carson 701 E. Carson Street, Carson, CA 90749 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Massoud Ghiam (310) 952-1700 Avalon Blvd Interchange Modifications at the 1-405 $14,229,331.00 April 2012 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Construct New Bridge, Widen Existing Bridge, Reconfigured on and off ramps, MSE Wall, PCC Paving, Asphalt Paving, Retaining Walls, Traffic Signals, Curb & Gutter, Earthwork. County of Orange 1152 E. Fruit Street, Santa Ana, CA 92701 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Vijay Desai (949) 655-3900 Edinger Avenue Bridge Widening Over Los Angeles River Channel $5,460,789.00 July 2014 Project Name Contract Amount Date Completed Detailed description of bidder's scope of work to demonstrate similar work experience: Widen Existing Bridge and Roadway, Construct Retaining Walls, Modify Drainage, Landscape & Irrigation, Traffic Control, Earthwork, Barrier Rail, Handrail, Block Walls. C-10 BIDDER'S CRITICAL STAFF The bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for WARNER AVENUE BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1356 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the bidder at the time the referenced projects were completed. Oscar Contreras Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: (909) 486-4465 1-405 & 1-605 Soundwall Bridge Widening, Construct And Bridge Widening Soundwalls, Barriers, Ret. Walls 6/2014 Project Name & Contract Amount Type of Work Date Completed Avalon Blvd Interchange Bridge Widening, Barriers, Modification @ 1-405 Retaining Walls, On/Off Ramps 4/2012 Project Name & Contract Amount Type of Work Date Completed Route 57 Barrier Project Remove & Replace Barrier 1/2011 Project Name & Contract Amount Type of Work Date Completed 2. Jose Lopez Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: (909) 486-4707 First Street Bridge Replacement Bridge Replacement, Road Over the Santa Ana River Widening, MSE Walls 6/2014 Project Name & Contract Amount Type of Work Date Completed Avalon Blvd Interchange Bridge Widening, Barriers, Modification @ 1-405 Retaining Walls, On/Off Ramps 4/2012 Project Name & Contract Amount Type of Work Date Completed Edinger Avenue Bridge Widening Bridge and Roadway Widening Over The Los Angeles River Channel Barrier Rail, Retaining Walls 7/2014 Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or 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: Powell Constructors, Inc. Contact Person: Michael B. Powell Contact Phone: 909 356-8880 Signed: Date: 7-10-14 *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-12 Local Assistance Procedures Manual Exhibit 12-H Sample Bid (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 Powell Constructors, 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. Pagel of 8 C-13 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has_, has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. Page 2 of 8 C-14 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 3 of 8 C-15 June 11, 2014 Local Assistance Procedures Manual Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of City of Huntington Beach/County of Orange DEPARTMENT OF PUBLIC WORKS. Exhibit 12-H Sample Bid In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 4 of 8 C-16 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 5 of 8 C-17 June 11, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 6 of 8 C-18 June 11, 2014 Not Applicable Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES UUMYLtIE IHIN PUKM IUllINULUNt LUbbYINl7AU I IV I I I tN YUKNUAN I IU31 U.J.G. IJD/ 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial b. grant b. initial award b. material change . cooperative agreement c. post -award C. an guarantee f. loci insurance 4. Name a d Address of Reporting Entity Prime riSubawardee Tier if known Congressional DistricAgif nown 6. Federal Department/Icy: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) (attach Cont 11. Amount of Payment (check all that apply) $ ❑ actual R pla5�1 12. Form of Payment (check all that ea. cash For Material Change ly: year quart date of last rep 5. If Reporting Entity in No. 4 is Sub ardee, Enter Name and Address of Pri e: Congressional Distr' t, if known 7. Federal Program ame/Description: CFDA Nurryfier, if applicable 9. Award AZunt, if known: b. dividuals 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 . commission d. contingent fee b. in -kind; speci/natu e o errs e f.oth14. Brief Description of Seformed or to be performed and Date(s)officer(s), employee(s), or(s) contacted, for Payment Indicated it (attach Continuation Sheet(s) if necessary) inuation heet(s) attached: Yes 15ilie No 16ation re ested through this form is authorized by U.S . Section 1352. This disclosure of lobbying Signature: w placed by the tier above when his transaction or entered into. This disclosure is required Print Name: t to 31 U.S.0 1352. This information will be d to Congress semiannually and will be available for inspection. Any person who fails to file the required Title: ure shall be subject to a civil penalty of not less than and not more than $100,000 for each such failure. Telephone No.: Use Only: Standard 1. onn LLL Kev. UY-IL-N/ specify ice, including 11. Authorized for Local Reproduction Standard Form - LLL Page 7 of 8 C-19 June l 1, 2014 Local Assistance Procedures Manual Exhibit 12-H Sample Bid 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 fling 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. 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. Check all boxes that apply. If other, specify nature. 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 06-04-90aENDIFH - Page 8 of 8 C-20 June 11, 2014 THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, that we POWELL CONSTRUCTORS, INC. 8555 Banana Avenue Fontana, CA 92335 as Principal, hereinafter called the Principal, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND 777 S. Figueroa Street, Suite 3900 Los Angeles, CA 90017 a corporation duly organized under the laws of the State of MARYLAND as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of the Total Amount of the Bid Dollars ($10%), for the payment of which sum well and truly to be made, the ourselves, our heirs, executors, administrators, successors and these presents. WHEREAS, the Principal has submitted a bid for said Principal and the said Surety, bind assigns, jointly and severally, firmly by Warner Avenue Bridge Preventative Maintenance (Over Bolsa Chica Channel) Federal Aid Project BPMPL-5181 (169) C.C. No.1356 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 a d ,tiled t i th day of July, 2014 mess efi-eo structors Irc. 1e Michael B. Powell, President Fidelity and Deposit Company of Maryland Michael Castaneda, Attorney -in -Fact AIA DOCUMENT A310 • BID BOND • AIA . FEBRUARY 1970 ED • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735, N.Y. AVE., N.W., WASHINGTON, D.C. 20006 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"); by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Lourdes LANDA, Mark ROSSKOPF, Adriana VALENZUELA and Michael CASTANEDA, all of ANAHEIM, California, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 15th day of April, A.D. 2014. ATTEST: lz��_ MAv,-�� ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND SAL oa , rase f%�a; V111 ? KW,—. Assistant Secretary Vice President Gregory E. Murray Thomas O. McClellan State of Maryland City of Baltimore On this 15th day of April, A.D. 2014, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O. MCCLELLAN, Vice President, and GREGORY E. MURRAY, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Sea] the day and year first above written. • �d 1 :'i . ( ^1 Constance A. Dunn, Notary Public My Commission Expires: July 14, 2015 POA-F 012-4152V ACKNOWLEDGMENT State of California County of Orange ) On July 7, 2014 before me, Rebecca Karen Saldana, Notary Public (insert name and title of the officer) personally appeared Michael Castaneda who proved to me on the basis of satisfactory evidence to be the persons whose name ) is/ re subscribed to the. within instrument and acknowledged to me that he/sKe/t °y executed t e same in his/hPr/thir authorized capacity(ies), and that by/iis/her/t��J+eit signature(p on the instrument the pers n( , or.the entity upon behalf of which the person( -'acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Si (Seal) REBECCA KAREN SALDANA Commission # 2049077 ACKNOWLEDGMENT State of California County of San Bernardino On July 10, 2014 before me, Sherri Evans, Notary Public (insert name and title of the officer) personally appeared Michael B. Powell who proved to me on the basis of satisfactory evidence to be the personN whose name(s) i0re subscribed to the within instrument and acknowledged to me that he//they executed the same in his/tier/ttiei�authorized capacity�i , and that by his/,heM - signature{.sr}on the instrument the person(o, or the entity upon behalf of which the persoaW 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 — SHERRI EVANS COMM. # 2017516 Z ® NOTARY PUBLIC - CALIFORNIA C SAN BERNARDINO COUNTY �. My Comm. Expires April 30, 2017 (Seal)