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HomeMy WebLinkAboutR J Noble Company - 2004-10-18 (2) x• RECEIVED BY. ;L CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Narhe) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Sh ri Freidenrich, City Treasurer FROM: /t . . V — �- DATE: SUBJECT: Bond Acceptance I have received'the bonds for _L-- (Company Name) Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Re: Tract No. CC No. 4;0 MSC No. Approved Agenda Item No. (Cduncil pprova/Uate) City Clerk Vault No. #27 gdfollowup/bondletter dnc City of Huntington Beach INTER-DEPARTMENT COMMMUNICATION HUNTINGTON BEACH TO: THOSE LISTED HEREON FROM: Eric R. Charlonne, Construction Manager DATE: November 3, 2005 SUBJECT: Retention Release Payment Company Name: R.J.Noble Company, Inc. Address: 15505 E. Lincoln Ave City, State and Zip Code: Orange, CA 92856-6620 Phone Number: (714) 637-1550 Business License Number:A 005420 Local Address: N/A Notice of Completion Date:July 28, 2005 Contract Purpose: Retention Release for Cash Contract 1154, Gothard Street Rehabilitation Project 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 e j tat this time. //:310�- Date Robert F. Beardsley, Public Works Director I certify that there are no outstanding invoices on file. Date r' reidenrich, City Treasurer I certify that no stop notices are on file on the subject contract, and that a guaranty bond has been filed with this office. Date, Joan lynn, City k retention release memo.doc 11/3/2005 9:56 AM PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: �— AND WHEN RECORDED MAIL TO: Recorded in Official Records, Orange County Tom Daly, Clerk-Recorder i Ili I I!li Ili I Illi!II III i I! I!!il II III I IiIINO FEE WHEN RECORDED MAIL TO: 200500058474211.01am 07/28105 CITY OF HUNTINGTON BEACH Attn: Robert A. Martinez 115 45 N12 1 P.O. Box 190—2000 Main Street 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Huntington Beach, CA 92648 THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT: NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to R.J. Noble Company who was the company thereon for doing the following work to-wit: GOTHARD STREET REHABILITATION IMPROVEMENTS, CASH CONTRACT-1154 That said work was completed July 22,2005 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 July 22, 2005, per City Council Resolution No.2003-70 adopted October 6,2003. That upon said contract Travelers Casualty and Surety 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 cote plated under Government Code Section 6103 and should be recorded free of charge. Dated at Huntington Beach, California,this July 22,2005. rector of Public Works or City Engineer City of Huntington Beach,California STATE OF CALIFORNIA) County of Orange )ss: City of Huntington Beach ) I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof; the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and t t said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of O a ge County. Dated at Huntington Beach,California,this July 22,2005. Aerector of Public Works or City Engineer City of Huntington Beach, California THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) 00-.059-TITLE PAGE(R7/95) City of Huntington Beach Department of Public Works . Post Office Box 190 Huntington Beach, CA 92648 Subject: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Gentlemen: The undersigned, contractor on &ehab Project No. Title hereby certifies that all laborers, mechanics, apprentices,trainees,watchmen and guards employed by him or by any subcontractor performing work under the contract on the project have been paid wages at rates not less than those required by the contract provisions, and that the work performed by each such laborer,mechanic, apprentice'or trainee conformed to the classifications set forth in the contract-or training program provisions applicable to the wage rate paid. S ign ature and Title a' ,ASS+ - �,-P-+a L� g:cs Q3hcanl DECLARATION OF SATISFACTION OF CLAIMS J t\ -bb le- Payn o!4 ,state: 1. I am the general contractor for the City of Huntington Beach, as to the project mote fully described in the public ivorks contract entitled o-,`1 �`?and ­.S4, -& h 1 b and dated 2. All workers and persons employed, all firms suppl}zng materials, and all subcontractors for the above-mentioned project have been paid in full. 3. The following are either 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: (if none, state"NONE') N3 NL I declare under 1penalty of perjury that the foregoing is true and correct. Executed at- on this 1 h day of �O5 , (Signature Contractor) p6cashconI v�'+Q r� Bond No. 104452175 MAINTENANCE BOND FORM R J. Noble Comoany Orange, CA is Principal, and Travelers Casualty and Surety Company of America is a corporation organized under the laws of the State of Connecticut and authorized.to transact a surety business in the State of CA Principal and surety bind themselves, their assigns and successors jointly and severally to pay to HUNTINGTON BEACH a municipal corporation the sum of Six hundred fifty-nine thousand seven hundred twenty- nine and 70/100 ($659,729.70 ) dollars. Principal has constructed the following public improvements within the;CITY OF HUNTINGTON BEACH Gothard Street Rehabilitation Improvements; Cash Contract No. 1154 Principal has applied to HUNTINGTON* to accept the above improvements. Principal agrees to maintain and keep in good repair these improvements for 1 year from City Council acceptance. *BEACH If any required repairs are not made in accordance with City specifications within the 1 year maintenance period, the City may declare this bond in default and collect from Surety the sum payable thereunder. Upon receipt of such payment from Surety,the City shall make the required repairs covered by this bond. Dated: July 15,2005 Surety: Travelers Casualty and Surety Company of America By: M CHAFT, D, MNG ATTUNEY IN FACT Principal: R J. Nobk Company B STAN HILTON, SEKRETARY S-6187(1/02) AP VED AS)(2LRM JE04FER McGRATH,City Attorney !,V_ CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5907 State of CALIFORNIA County of ORANGE On 7-i I S ( O S before me, JENNIFER DE IONGH, NOTARY PUBLIC DATE NAME,TITLE OF OFFICER-E.G.,-JANE DOE,NOTARY PUBLIC" personally appeared STAN HILTON, SECRETARY, R.J. NOBLE COMPANY NAME(S)OF SIGNER(S) ®.personally known to me - sis of satisfactory evidence to be the personal whose namek' is/a+e-- subscribed to the within instrument 'and ac- knowledged to me that he/s4@A4@y-executed the - same in hisA +r- authorized capacity(ies), and that by his/# #&# JENNIFERDEIONGIi signatureA on the instrument the persorl(8-r, NOTARY PUBLIC-CALIFORNIA or the entity upon behalf of which the a , • COMMISSION#1448237 a ORANGE COUNTY persons) acted, executed the instrument. My Comm.Exp.October 28,2007 WITNESS my and and official seal. ' SIGNATURE OF NOTARY OPTION Though the data below is not required bylaw, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE OR TYPE OF DOCUMENT TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) SIGNER(S)OTHER THAN NAMED ABOVE 01993 NATIONAL NOTARY ASSOCIATION•8236 Remmet Ave.,P.O.Box 7184•Canoga Park,CA 91309-7184 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT -.....-.-.- -.-.-.-.- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - State of California ss. County of RIVERSIDE On , lt-� before me, R. CISNEROS ate Name and Title of Officer(e.g.,'Jane Doe.Notary Public") personally appeared MICHAEL D. STONG Name(s)of Signer(s) N personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person'whose name is/vlg' R.CISNEROS subscribed to the within instrument and Iq COMM. #1488731 � acknowledged to me that he/she/they executed 'NOTARY PUBLIC-CALIFORNIA 9 RIVERSIDE COUNTY the same in his/fir authorized •' M Comm.Ex Tres June 7,2008 capacity(Le , and that by his/hefArhi4 signature,(5 'on the instrument the personXor jq the entity upon behalf of which the person(,8'J acted, executed the instrument. WITNESS my hand and official seal. ?� Place Notary Seal Above - - Signature of Notary Public - OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual i. Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 1999 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatswonh,CA 91313-2402•www.nationalnotary.org Prod.No.5907 Reorder.Call Toll-Free 1-800-876-6827 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARNMGTON CASUALTY COMPANY Hartford,Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEYS)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed,and do by these presents make, constitute and appoint: Michael D. Stong, Shawn Blume, Susan C. Monteon, Rosemary Cisneros, of Riverside, California, their true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred to sign, execute and " acknowledge, at any place within the.United States, the following instrument(s): by his/her sole•signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the.acts of said Attorney(s)-in-Fact, pursuant to the authority herein given,are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of.authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed)under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (05-04)Unlimited .t Consent of Surety to Release of Retention Owner ❑ Contractor ❑ Surety ❑ To Owner: CITY OF HUNTINGTON BEACH Architects Project No: Contract For: GOTHARD STREET REHABILITATION IMPROVEMENTS:CASH CONTRACT NO. 1154 Project: GOTHARD STREET REHABILITATION Contract Dated: JANUARY 13, 2005 IMPROVEMENTS; CASH CONTRACT NO. 1154 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA ,Surety, on bond of R. J. NOBLE COMPANY ,Contractor, hereby approves the Release of Retainage to the Contractor. The Surety agrees that such release of retainage to the Contractor shall not relieve the Surety of any of its obligations to CITY OF HUNTINGTON BEACH ,Owner, as set forth in said Surety's bond. IN WITNESS WHEREOF, the surety has hereunto set its hand on this date: JULY 15, 2005 TRAVELERS C SUALTY AND ORETY COMPANY OF AMERICA Auru3 ture of auilkTiEzed entative) MIC EL D. STONre ATTORNEY IN UCT (Printed name and title) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of RIVERSIDE On before me, R. CI_SNEROS Name and Title of Officer(e.g.,"Jane Doe,Notary Public") personally appeared MICHAEL D. STONG ti Name(s)of Signer(s) IN personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person'whose name is/v subscribed to the . within instrument and i acknowledged to me that he/she/they executed R.CISNEROS same in his/he4We authorized a•. "" ` COMM. #1488731 capacity(ie ), and that by his/h � Q` q NOTARY PUBLIC-CALIFORNIA signature(,s�'on the instrument the person,(,a')'or RIVERSIDE COUNTY ?� M Comm.Fx June 2008 the entity upon behalf of which the person(4 acted, executed the instrument. WITNESS my hand and official seal. Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. t� 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 I Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑General ❑ Attorney in Fact I ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 01999 National Notary Association•9350 Oe Soto Ave.,P.O.Box 2402•Chatsworth.CA 91313-2402•www.nationainotary.org Prod.No,5907 Reorder:CM 1 Toll-Free 1-800-676.6827 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY Hartford, Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEYS)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Michael D. Stong, Shawn Blume, Susan C. Monteon, Rosemary Cisneros, of Riverside, California, their true and lawful Attorney(s)-in-Fact, with full power and authority.hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sole.signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attorneys)-in-Fact, pursuant to the authority herein given,are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies,which Resolutions are now in full force and effect: VOTED: That the Chairman, the President, any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman,the President, any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (05-04)Unlimited Bond No. 104452175 MAINTENANCE BOND FORM R.J. Noble Company Orange,CA is Principal, and Travelers Casualty and Surety Company of America is a corporation omanized under the laws of the State of Connecticut and authorized.to transact a surety business in the State of CA Principal and surety bind themselves, their assigns and successors jointly and severally to pay to HUNTINGTON BEACH , a municipal corporation the sum of Six hundred fifty-nine thousand seven hundred twenty- nine and 70/100 ($659,729.70 )dollars. Principal has constructed the following public improvements within the;CITY OF HUNTINGTON BEACH Gothard Street Rehabilitation Improvements; Cash Contract No. 1154 Principal has applied to HUNTINGTON* to accept the above improvements. Principal agrees to maintain and keep in good repair these improvements for 1 year from City Council acceptance. *BEACH If any required repairs are not made in accordance with City specifications within the 1 year maintenance period,the City may declare this bond in default and collect from Surety the sum payable thereunder. Upon receipt of such payment from Surety, the City shall make the required repairs covered by this bond. Dated: July 15, 2005 Surety: Travelers Casualty and Surety Company of America By: M CHAEL D. MNG ATT NEY IN FACT Principal: R. J. Nobk Company By: STAN HILTON; SE RETARY 5-6187 (1/02) AP \ El)AS TO,.FORM-. JE FER McGRATH,City Attomey '/'D� RECEIVED BY: /+ CITY CLERK RECEIPT COPY Return DUPLICATE to �in.. City Clerk's Office (Name) �— P after signing/dating (Date) J, CITY OF HUNTINGTON BEACH 0 INTERDEPARTMENTAL COMMUNICATION TO: Shari Freidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for ' (Company Name) Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Re: Tract No. CC No. MSC No. Approved pp � r � Agenda Item No. ( ouncil/Abproval Date) City Clerk.Vault No. . #27 g:ffollowuplbondletter.doc RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) A CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: S ri Freidenrich, City Treasurer FROM: DATE: T SUBJECT: Bond Acceptance have received the bonds for - (Company Name) Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Re: Tract No. CC No. MSC No. Approved /04Qe'nda Item No. ( uncil Approval ate) City Clerk Vault No_ r,j - � #27 gdfollowup/bondletter doc CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5907 State Of CALIFORNIA County of ORANGE On � ' j S S before me, JENNIFER DE IONGH, NOTARY PUBLIC DATE NAME,TITLE OF OFFICER-E.G.,-JANE DOE,NOTARY PUBLIC- personally appeared STAN HILTON, SECRETARY, R.J. NOBLE COMPANY NAME(S)OF SIGNER(S) ® personally known to me - ISIR polaved te ffie on the b is of satisfactory evidence to be the person(4 whose nameW is/afe- subscribed to the within instrument and ac- knowledged to me that he/s4eAh4 y-executed the . same in his+� authorized capacity(ies), and that by his/ e4 JENNIFER DE ION-- signatureX on the instrument the person,(. NOTARY PUBLIC-CALIFORNIA or the entity upon behalf of which the • COMMISSION#1448237 c v' ORANGE COUNTY persono) acted, executed the instrument. My Comm.Exp.October 28,2007 ------------- WITNESS my hand and official seal. SIGNATURE OF NOTARY OPTION Though the data below is not required bylaw, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE OR TYPE OF DOCUMENT TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) SIGNER(S)OTHER THAN NAMED ABOVE 01993 NATIONAL NOTARY ASSOCIATION•8236 Remmet Ave.,P.O.Box 7184•Canoga Park,CA 91309-7184 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of RIVERSIDE On ( before me, R. CI_SNEROS ate Name and Title of Officer(e.g.,"Jane Doe.Notary Public") personally appeared MICHAEL D. STONG Name(s)of Signer(s) ® personally known to me ❑ proved to me on the basis of satisfactory evidence to be the personnX whose name is/�IK q R.CISNEROS subscribed to the within instrument and iq ' COMM. #1488731 M acknowledged to me that he/she/they executed NOTARY PUBLIC-CALIFORNIA C2 RIVERSIDE COUNTY the same in his/fir authorized M Comm.Ex ires June 7,2008 capacity(ie�), and that by his/h. 4h-e4 sign ature-(,s-non the instrument the persons , or the entity upon behalf of which the person�'J acted, executed the instrument. WITNESS my hand and official seal. I� Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. I� Description of Attached Document Title or Type of Document: I Document,Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer � Signer's Name: _ id ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 1999 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.nationalnotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 ' TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA r-c TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY Hartford,Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEYS)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Michael D. Stong, Shawn Blume, Susan C. Monteon, Rosemary Cisneros, of Riverside, California, their true and lawful Attomey(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby.as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attomey(s)-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman,any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President, the Treasurer,any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company.may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (05-04)Unlimited IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 7th day of August, 2004, STATE OF CONNECTICUT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY )SS.Hartford FARMINGTON CASUALTY COMPANY COUNTY OF HARTFORD dJM � 'J�tY Alyo 9 OpP�Rf fL Vy SG 2 f y,3 ¢ HARTFORD, i t4 19 S 2 O BY CONN. o � a; George W. Thompson 41 N ;�► �`61 '; Senior Vice President �w Z On this 7th day of August, 2004 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. �.TL? My commission expires June 30, 2006 Notary Public Marie C.Tetreault CERTIFICATE I, the undersigned, Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority, are now in force. y-. Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this '" day of 1LC LY 12 d , JrLlY ANos GASU& i �$G `Y� u~ GD O? l l� � Y ✓M e 3 i'i WiR7FORD 5 W HARTFORD no CONN. I g � CONN. o �q, D By 1 fad �`bt Fa+a� 6`'yyNE. Ada Peter Schwartz "° Senior Vice President —ompany.Profile Page 1 of z Company Profile TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA ONE TOWER SQUARE, 4MN TRAVELERS / Mary T. Restelli HARTFORD, CT o6183 877-877.'8737 Former Names for Company Old Name: ' AETNA CASUALTY & SURETY COMPANY OF AMERICA Effective Date: 07-01-1997 Agent for Service of Process LORI CASTANEDA, 273o GATEWAY OAKS DR SUITE ioo SACRAMENTO, CA 95833 Unable to Locate the Agent for Service of Process? Reference Information NAIC #: 31194 NAIC Group #: 3548 California Company ID #: 2444-8 Date authorized in California: July 31, 1981 License Status: UNLIMITED-NORMAL. Company Type: Property & Casualty State of Domicile: CONNECTICUT Lines of Insurance Authorized to Transact the company is authorized to transact business within these lines of insurance. For an explanation of any of these :erms, please refer to the glossary. AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY CREDIT ittp://cdinswww.insurance.ca.gov/pls/wu_co_prof/idb_co_prof utl.get_co_pr6Pp_EID=6i82 7/26/2005 �ouipany.Profile Page z of z DISABILITY FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION Company Complaint Information .� j j� Company Enforcement Action Documents Company Performance & Comparison Data Composite Complaint Studies Want More? Help Me Find a Company Representative in My Area Financial Rating Organizations Last Revised-November 04, Z004 im8 AM Copyright©California Department of Insurance Disclaimer ►ttp://cdinswww.insurance.ca.gov/pls/wu_co_prof/idb_co_prof utl.get_co_proPp_EID=6i8z 7/z6/2005 C� C 6rA -L-- FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND R's (130A1t Cowxpo(,nY / FOR ( 60V�'R2 1 -%/c"7 TABLE OF CONTENTS Pam 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 3 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 4 7. NOTICE TO PROCEED 5 8. BONDS 5 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 6 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 9 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 10 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 10 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT&TERMINATION 14 24. TERMINATION FOR CONVENIENCE 14 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON-ASSIGNABILITY 15 27. CITY EMPLOYEES AND OFFICIALS 15 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 15 29. NOTICES 16 30. SECTION HEADINGS 16 31. IMMIGRATION 16 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT 1 TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 17 34. INTERPRETATION OF THIS AGREEMENT 17 35. GOVERNING LAW 18 36. DUPLICATE ORIGINAL 18 37. CONSENT 18 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 18 39. CALIFORNIA PREVAILING WAGE LAW 18 40. CALIFORNIA EIGHT-HOUR LAW 19 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 20 42. EMPLOYMENT OF APPRENTICES 20 43. PAYROLL RECORDS 20 44. FEDERAL PARTICIPATION 21 45. DAVIS-BACON ACT 21 46. DISCRIMINATION,MINORITIES, ALIENS 21 47. EQUAL EMPLOYMENT OPPORTUNITY 21 48. COPELAND "ANTI-KICKBACK" ACT 22 49. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 23 50. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 23 51. ENERGY CONSERVATION 24 52. HOUSING AND URBAN DEVELOPMENT 24 53. ENTIRETY 24 2 FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND IZ KJ ob I e C0,1\PAA y .1.� l FOR I �DIhcA2� ��Ceel QF �Ah� ��T.:��d1 (olr E���S Ule7"L THIS AGREEMENT ("Agreement") made and entered into this � day of 20 p , by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and a1j a California hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as G bk ,,Vj j S-k e e+ kE:�A�3; fr.tw, P-A,-e o N E c l A in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of agree/forms/federal 4-20 1 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; D. The current edition of Standard Specifications for Public Works Construction, published by Builders'News, Inc., 10801,National Boulevard, Los Angeles, CA agree/forms/federal 4-20 2 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 and the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference); 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. 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 agree/forms/federal 4-20 3 Tl,�ws�•�a `�Q c five N.�vLdlsd Se�eN�e¢� tlo��ai5 cad �r J �� o�, 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 consecutive 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 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 agree/forms/federal 4-20 4 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 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 agree/forms/federal 4-20 5 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 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 o e Nu►��� C Dollars ($ C3 R C, ) per day for each and every working day's delay in completing the work in excess of the number of agree/forms/federal 4-20 6 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. 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. 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. agree/forms/federal 4-20 7 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 (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. agree/forms/federal 4-20 8 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 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, ten percent (10%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work,will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, agree/forms/federal 4-20 9 if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the Agreement price shall not be considered as a acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. agree/forms/federal 4-20 10 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. 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 agree/forms/federal 4-20 11 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 limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above-mentioned insurance contain a self-insured retention, or a"deductible"or any other similar form of limitation on the required coverage. 21. CERTIFICATES OF INSURANCE: ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; agree/forms/federal 4-20 12 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 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 agree/forms/federal 4-20 13 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 to a termination for convenience under Section 23 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 plus seven and one-half percent(7 '/z %) for overhead and profit less all such payments already made. 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. agree/forms/federal 4-20 14 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: agree/forms/federal 4-20 15 TO CITY: TO CONTRACTOR: City of Huntington Beach R.J. NOBLE COMPANY ATTN: 'OAde Jefc,n2 2000 Main Street 15505 E. LINCOLN AVENUE Huntington Beach, CA 92648 ORANGE, CA 92865 30. SECTION HEADINGS The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of United States Code 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. agree/forms/federal 4-20 16 33. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the non- prevailing 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 date agree/forms/federal 4-20 17 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 twenty-five dollars ($25) for each calendar day or portion thereof for each agree/forms/federal 4-20 18 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. 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. agree/forms/federal 4-20 19 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 included4n 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. 45. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined by the Secretary of Labor in accordance with the Davis-Bacon Act(40 USC Section 176a, et seq.) for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply agree/forms/federal 4-20 20 with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 46. DISCRIMINATION, MINORITIES, ALIENS CONTRACTOR shall not discriminate nor allow its employees, agents,principals, or subcontractors to discriminate against any employee or applicant for employment on the basis of race, religious creed,national origin or sex. CONTRACTOR shall take affirmative steps to hire local qualified minority individuals when job opportunities occur and utilize local business firms when possible. 47. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled "Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). 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 discharge and(2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. agree/forms/federal 4-20 21 To ensure compliance with these requirements,the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 48. COPELAND "ANTI-KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti-Kickback" Act(18 USC Section 874), as supplemented in Department of Labor regulations, which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 49. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act(40 USC 327 et seq.) as supplemented by Department of Labor regulations (29 CFR,part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight(8) hours and standard workweek of forty (40)hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in excess of eight(8)hours in any calendar day or forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. agree/forms/federal 4-20 22 50. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency(EPA)List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 114 of the Clean Air Act and section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a)thorough(d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. 51. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act(42 USC Section 6201, et seq.). agree/forms/federal 4-20 23 52. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 53. ENTIRETY The foregoing, and Exhibit "A" 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, 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 offices the day, month and year first above written. agree/forms/federal 4-20 24 CONTRACTOR CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California R.J. NOBLE COMPANY A CALIFORNIA CORPORATION Ar By: ATTEST: MI EL J RV ER print name ITS: (circle one)Chairma reside ice President ity 1 3 AND APPROVED AS TO FORM: By: XZ , STAN HILTON City ey _1p print name ll`` ITS: (circle one) ecreta hief Financial Officer/Asst. Secretary-Treasurer INITIATE ND PROVED: REVIEWED AND APPROVED: /Director o ublic Works Ciq Administrator agree/forms/federal 4-20 25 SECTION C PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 C-1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanyingthis proposal of bid find> 8JDBIDDER'S . p ro p in the amount of$------------ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature C-2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: $ TOTAL AMOUNT LUMP SUM BID IN WORDS: C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 ` / GOTHARO STREET (CC4154) PROJECT BID SCHEDULE An L.S. @ELEVEN THOUSAND SEVEN HUNDREDDollars NO Cents L.S. @ FITHTEEN THOUSAND Dollars NO Cents 3 1 Furnish Project Traffic Control $ NIZ) Cents FTTHTFEN Cents C.Y. @TWENTY NINE Dollars NO Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, $ 41-16 $ 4-23�9AE3) Ton Full Depth etc.) S.Y. Seal of Cracks @SIX Dollars TWENTY Cents 8 46 Adjust Sewer/Storm Drain Manhole to Grade $ 305.00 $14,030.UU Each @THREE HUNDRED FIVE Dollars No Cents 9 91 Adjust Water Valve to Grade s 25-5.00 .00 NO Cents Each @ONE HUNDRED EIGHTY TWO Dollars I NO Cents Each @ONE THOUSAND NINE HUNDRED Dollars NO Cents 13 3 Adjust Survey Monument Well to Grade $ 260.( $780.00 Each @ TWO HUNDRED SIXTY Dollars NO Cents Each @ two hundred eighty Dollars -L NO Cents Sub Total Bid Amount, Bid in Figures: $ 511.30 Sub Total Bid Amount, Bid in Words: LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion. Name.,and Address of Subcontractor:' State License Class of:Work.' Number_: . C�N�•, CA A72oo��o A Z•Z 7° `�►►4rt�-8a� �tR.0• tD4z eel (o/�Sl a cP Cat (OYz 312 c-3Z By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange MICHAEL J. CARVER , being first duly sworn, deposes and says that he or she is PRESIDENT of R.J. NOBLE COMPANY 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. R.J. NOBLE COMPANY Name of Bidder Sirnature of Bidder MICHAEL J. CARVER, PRESIDENT 15505 E. LINCOLN AVENUE, ORANGE, CA Address of Bidder Subscribed and sworn to before me this 16th day of NOVEMBER JENNIFER DE IONGH NOTARY PUBLIC-CALIFORNIA y m COMMISSION#1448237 c ORANGE COUNTY My Comm.Exp.October 28,2007 NOTARY PUBLIC Q0L/ tFt E IONGH NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the IMPROVEMENTS, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. R.J. NOBLE COMPANY Contractor By dv MICHAEL J. CARVER, PRESIDENT Title Date: NOVEMBER 16, 2004 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under.penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who-has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes XN 0 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. R.J. NOBLE COMPANY Contractor MICHAEL J. CARVER, PRESIDENT Title Date: NOVEMBER 16, 2004 C-7 1 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: R.J. NOBLE COMPANY Contractor B MICHAEL J. CARVER, PRESIDENT Title Date: NOVEMBER 16, 2004 Note: This form is required for eveiy Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDERS INFORMATION BIDDER certifies that the following information is true and correct: R.J. NOBLE COMPANY Bidder Name 15505 E. LINCOLN AVENUE Business Address ORANGE, CA 92865 City, State Zip (714 ) 637-1550 Telephone Number - A-782908 State Contractor's License No. and Class AUGUST 14, 2000 Original Date Issued AUGUST 31, 2006 Expiration Date The work site was inspected by STEVE MENDOZA of our office on 11-08 , 2004 . The following are persons, firms, and corporations having a principal interest in this proposal: R.J. NOBLE COMPANY A CALIFORNIA CORPORATION MICHAEL J. CARVER, PRESIDENT STAN HILTON, SECRETARY C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. R.J. NOBLE COMPANY Company Name Si Lure of Bid er MICHAEL J. CARVER, PRESIDENT Printed or Typed Signature Subscribed and sworn to before me this 16Yhday of NOVEMBER , 2004 . jD\iNIFER DE IONGH NO i'ARY PUBLIC-CAUFORNIA y n COMMISSION#1448237 c NOTARY PUB ORANGE COUNTY My Comm.Exp.October 28,2007 J N ER DE IONGH NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1 COUNTY OF RIVERSIDE, 4080 LEMON STREET, RIVERSIDE, CA Name and Address of Public Agency Name and Telephone No. of Project Manager: STAN DERV, 909-955-6785 $825,885.00 PAVEMENT REHABILITATION JUNE 2002 Contract Amount Type of Work Date Completed 2. CITY OF ANAHEIM, 200 S. ANAHEIM, CA Name and Address of Public Agency Name and Telephone No. of Project Manager: RALPH HARP $437,191.47 TUSTIN'AVENUE STREET IMPTS. $437,191.47 Contract Amount Type of Work Date Completed 3 CITY OF FULLERTON, 303 W. COMMONWEALTH AVENUE, FULLETON, CA Name and Address of Public Agency Name and Telephone No. of Project Manager: RON BOWERS 714-738-6322 $972,271.00 ALTON PARKWAY REHABILITATION FEBRUARY 2003 Contract Amount Type of Work Date Completed C-10 1 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: R.J. NOBLE COMPANY Phone. 714-637-1550 Address: 15505 E. LINCOLN AVENUE Fax: 714-637-6321 ORANGE, CA 92865 .Contact Person: MICHAEL J. CARVER No. of years in business 54 YRARs Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? ASPHALT PAVING What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million o Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million )ff More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide.a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a "Bidder's" list to assist in the annual DBE goal setting process. Firm Name: ALL AMERICAN ASPHALT Phone: 909-736-7600 Address: P.O. BOX 2229 Fax: 909-739-4671 CORONA, CA 92878 Contact Person: DICK OWENS No. of years.in business 35 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? PAVING, GRADING, CONCRETE What was your Erin's.Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million �3 More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C:-11 1 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name:R�_4�Gr,��VI,Y�GJ c. Phone:q,©q ' a'f/7J'uvq C Address: q 1 W• Fa.Y: r)Y\ 'IGIX d .Contact Person:(3aMCB 'b Qn C-VA No. of years.in business 15 Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by R.? U I n I I What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: CASE LAND SURVEYING, INC. Phone: 714-628-8948 Address: 1010 N. BATAVIA STREET STE. ,D Fax: 714-628-8905 ORANGE, CA 92867 Contact Person: LARRY CASE No. of years in business 18 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? SURVEY SERVICES What was your firm's.Gross Annual receipt's for last year? 0 Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: C.L. .CONCRETE Phone: 626-334-2357 Address: 1035 W. GLADSTONE ST Fax: 626-334-3517 AZUSA, CA 91702 Contact Person: CAMILO LOPEZ No. of years.in business 35 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? CONCRETE, CURB, GUTTER, SIDEWALKS What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million 6 Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information, C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: ��IY1 �WV41 QC, : 'I A Phone:114 A - HS ��` �- _ Address: cJ l Wait 50T,-1_ Fax: -71 .Contact Person: (1014 No. of years.in business3,5 Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firml 4t lG What was your Erm's Gross Annual receipt's for last year? R ❑ Less than $1 Million ❑ Less than $5 Million ❑ Liss than $10 Million Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 11/16/2004 11: 16 9092799112 EBS INC PAGE 03/03 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidd,.rs/proposers are required to provided the following information for all DBE and non- DBE con tractors,who provide a proposal, bid, quote, or were contracted by the proposed prune. This information is also required from the proposed prime contractor, and must be submitted with tbeir bid-proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: SF�y�' ', Phone: ` �/� Z-7`j'` Address; ,�3,zc, e_c, S-- oez-, Fax: a•��- _ C �2�9�7ar� .Contact il'erson:Df A No. of years in business A2 1 Is the firm currently certified as DBE under 49 CFR Part 26? YES O Type of work/services/materials provided by firm? What wv syour irm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than$S Million ❑ Less than$10 Million ❑ Less than$15 Million More than $1 S Million This f6rm can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. G11 j CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: GLOBAL ROAD SEALING, INC. Phone: 714-893-0845 Address: 6341 KLAMATH DR. , Fax: 714-893-0945 WESTMINSTER, CA 92683 .Contact Person: TRI No. of years,in business 4 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? CRACK FILLING What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million d� Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: J & S SIGN COMPANY Phone: 714-639-4921 Address: 822 W. KATELLA AVE. , Fax: 714-538-2779 ORANGE, CA 92867 1 Contact Person: CLINT RIEBER No. of years.in business 33 YEARS Is the firm currently certified as-DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? TRAFFIC STRIPING, MARKINGS What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million 8 Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide.a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. n Firm Name: SAW � W Phone:�Q��• "L(D� ' ��� Address: I5WO Z. 1 65CAA aVC, . Fax: 44 .Contact Person:l2T 1 r 1-J YY\ No. of years.in business r'S Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 i CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a "Bidder's" list to assist in the annual DBE goal setting process. Firm Name: Phone.- T 4- Io �- Address:Lk1 qC) e• �M s+4e-C-t Fax: .Contact Person: 110(l�t(M�l No. of years.in business 5 f Is the firm currently certified as DBE under 49 CFR Part 26? S NO Type of work/services/materials provided by firm? p.5 What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 1 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: ORANGE COUNTY STRIPING, INC. Phone: 714-639-4550 Address: 183 N. PIXLEY STREET FaX: 714-639-6353 ORANGE, CA 92868 Contact Person: ROBERT LITCHFIELD No. of years.in business 32 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES ONO Type of work/serviceslmaterials provided by firm? STRIPING" What was our firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million In Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: PAVEMENT RECYCLING Phone: 909-682-1091 Address: P.O. Box 1266 Fax: 909-682-1094 RIVERSIDE, CA 92502 Contact Person: DON. SANTE No. of years,in business 15 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? COLD PLANE, PULVERIZING What was your Erm's Gross Annual receipt's for last year? �3 Less than $1 Million ❑ Less than $5 Million o Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. i CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prune contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a`Bidder's" list to assist in the annual DBE goal setting process. Firm Name: �� Phone: Address: Ito Is t—�•tI iI S1 Fax �S(Q21 2'11� J bLp .Contact Person: No. of years,in business L Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? ` What was your fiam's.Gross Annual receipt's for lastyear? ❑ /Less than $1 Million than $5 Million ❑ Less than$10 Million ❑ Less than$15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. NOV—' 17-2004 01 :06 AM P. 01 11/16/2004 18:54 15494928324 ORION CONTRACTING PAGE 01 MY OF HUNTINGTON BFACM BIDDERS LIST All Biass/proposers on required to provided the following informatida fr all 5BB and no%- DB$cae►UactoM,who provide a proposal,bid,quote,or were comtmotsd by,the proposed pl M. This info=atiou is also required fmm the proposed pritne contractor, and must be submitted Wit thou bidiproposal. TU City of Xmtington Beach will use this i OMiftion V m6utairr and update a"Biddwr's"list to aaaic in the annual!DBE,goal aettinj process. Finn N me: &—e j'c r rL e114 p"i A l Phone:101 2 2'Z 2 .. Ad4StC88'��Qfi ll��l`L,��..ylGi'O h �•aX: �� Cl 'Comact Pet=- 73, , , �� ,,ter, Na: of yeers in business . Is the i=ouxmmly certified as DBE under 49 CPA Part 26? YES ONO Typo cfwotWservioeslmaterials providod by fum? What wus your We 8ro/as AnAU41 Ti or & v &&thaw$I Mflluion' . a Less than $S Miltlon n Lees than$14 Minton o Lass than$1 S Million M More thou$15 M119on f` ' This form can be duplicated if nooemary to report all bidders�Ms and.rion DBB,$).,fit"bnratiaa. 1 - , &�, lw+ono r r �► ` !mac B j CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide.a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: RAMIREZ CONSTRUCTION Phone: 626-967-5790 Address: 656 E. SAN 'BERNARDINO RD Fax: 626-967-5688 COVINA. CA 91723 j Contact Person: ART BALLIN No. of years,in business 10 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm?UTILITIES ADJUSTMENTS What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million W Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C'-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a "Bidder's" list to assist in the annual DBE goal setting process. Firm Name: STERNDAHL ENT. , INC. Phone: 818-834-8199 Address: 11861 BRANFORD STREET Fax: 818-834-8618 SUN VALLEY, CA 91352 1 Contact Person: DENNY STERNDAHL . No. of years.in business 21 YEARS Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? STRIPING What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million XX Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. r.1i ' CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a `Bidder's" list to assist in the annual DBE goal setting process. Firm Name: SMITHSON ELECTRIC, INC. Phone: 714-997-9556 Address: 1938 E. KATELLA AVE. , Fax 714-997-9559 ORANGE, CA 92867 .Contact Person: PATRICK T. SMITHSON No. of years.in business 16 YEARS. Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? TRAFFIC LOOPS What was your firm's.Gross Annual receipt's for lastyear? ❑ Less than$1 Million 13 Less than$5 Million ❑ Less than$10 Million ❑ Less than$15 Million ❑ More than$I5 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide.a proposal, bid, quote, or were contracted by the proposed prune. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name:Wocv�'bt V1 Phone: lX-p V-2 Address: f "L� n • 2U 6-t 91 .Contact Perso 'LI' u ( 49. of years.in business Is the firm currently certified as DBE under 49 CFR Part 26? YES 0' Type of work/services/materials provided by What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ess than $5 Million Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. LOCal A5915L8nCC rFU%;WUA-rJ i.iauuo, Lea••UAA 1L-Z PS&E Checklist Instructions Attachment C (THE BLDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CER2VICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder R.J. NOBLE COMPANY ,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. 12-4-89 C-12 Page 12-45 Local Assistance Procedures Manual EX IIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. JA•`A 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: NONE NONE NONE ❑ a. contract ❑ a. bid/offer/application ❑ a. initial b. grant b. initial award b. material change c.cooperative agreement r- post-award d, loan . For Material Change Only: e. loan guarantee date of last re ear quarter_rter f. loan insurance Po 4. Name and Adress of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee.Enter Prime ❑ Subawardee Name and Address of Prime: Tier ,if known NONE NONE Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: T. Federal Program Name/Description: NONE NONE CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: NONE $ NONE 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (d individual,last name,first name,MI): different from No. 10a) (last name,first name,MI): NONE NONE (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply): 13. Type of Payment(check all that apply) $ NONE ❑ actual planned NONE❑ a. retainer 12. Form of Payment(check all that apply): b. one-time fee a. cash c. commission H b. in-kind;s p ec nature NONE d. contingent fee �� e. deferred value f. other,specify: P�fY: 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: NONE (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s)attached: Yes No g 16- Information requested through this form is authorized by Title 31 U.S.C.Section Signature: + 1352 This disclosure of lobbying activilles is a material representational!fact MI HAEL J. CARVER upon which reliance was placed by the tier above when this transaction was Print Name: made or entered Into.This disclosure is required pursuantto 31 U.S.C.1352. PRESIDENT This information will be reported to the Congress semi-annuaily and will be Title: available for public inspection. Any person who fails to Me the required disclosure shall be subject to a civil penalty of not less than$10,000 and not more than Telephone No.:714-6 3 7—15 5 0 Date: 11-16-0 4 $100,000 for each such failure. Federal Use Only Authorized for Local Reproduction Standard rn- Standard Form LI.L Rev.01-03-95 C-13 Page 12-55 February 1, 1998 EXIB$IT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the ice of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address,city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number.for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EK IIBIT 12-E PS&E Checklist Instructions Attachmegt G, 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and,telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. C-15 Page 12-55 11/18/2004 02:17 7143741573 CHB ENG PAGE 01/01 Local Assistance Procedures Manual EXHIBIT 15-G Local Agency Bidder DBE Information LOCAL AGENCY BIDDER-DBE -INFORMATION This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received by the administering agency. no later than the tunespecified in the special provisions. CO.1RTE./P•M.: /2-v1ZA -d FI<Nra BIDDER'S NAME: R.J. NOBLE COMPANY CONTRACT NO.: •'r VrM--5 t 41) ADDRESS: 15505 E. LINCOLN AVE. , BID AMOUNT:$ _115 ORANGE- CA 92865 BID OPENING DATE; 11-16-04 DBE GOAL FROM CONTRACT ITEM OF WORK AND DESCRI.FTION NAME OF DBE** DOLLAR PERCENT CONTRACT OF WORK OR SERVICES TO 13E (Name of DBEs,Certification Number,, AMOUNT +** ITEM NO. SUBCONTRACTED OR MATERIALS and Telephone Number) **# DBE TO.BE PROVIDED D.BE 7,8,13 ADJUSTING UTILITIES RAMIREZ CONSTRUCTION $37,346.00 100% 626-967-5790 CT 024273 6 PORTION OF ASPHALT OIL WC GOOLSBY $13,000.00 100% 800-839-9697 CT 002822 X 60% $7,800.0 Total Claimed $45.146. O$ Participation 100 % NO If 100%of item is not to be petformcd or furnished by DBE,describe exact portion,including planned location of work to be performed,of item to be performed or furnished by DBE ** DBEs must be certified by Caltrans on the date bids are opened, Subcontractors and suppliers certified State-funded only cannot be used to meet goals on federally funded contracts, *'• Credit for a D13E supplier,who is not a.manufacturer is limited to 60%of the amount paid to the supplier. (See Section "Disadvantaged Business"(DBE)of the special provisions) IMPORTANT: Nantes of DBE subcontractors and their respective item(s)of work listed above should be consistent with the name and items of work in the "List of Subcontractors"submitted with your bid PursuantAq,jhe Subcontractors Listing Law. 11-16-04 714-637-1550 4'atur idder Date (Area Code)tel. No. MICHAEL J. CARVER, PRESIDENT Person to Contact (Please.type or print) Distribution for all Projects; (1)Original-Caltrans OLAE for NHS Projects,(2)Copy-Local Agcncy project file DEPT.OF TRANSPORTATION (FED DBE)MODIFIED DC-OP-19(REV 09.18.95) EXHWIT 15-K Local Assistance Procedures Manual Report of DBE Awards REPORT OF DBE AWARDS COMPLETE TMS FORM FOR EACH CONTRACT Locode: 12•0,94- 0-11A11-7-3 Agency: CITY OF HUNTINGTON BEACH Project No. CC1154 vrm-sfaiC/¢I�) DBEGoal: 7 Total.Contract Bid: $638,517.)<'45- Reimbursement do �30% Federal Share: 4f! D Award Date: Combined DBE Percent of Federal Share for this Project: 7% DBE Subcontractors(excluding women Awarded by Ethinic Group and other Disadvantaged Black Hispanic Native Asian- Asian- Other Total A Indian Pacific No. 0 1 0 0 0 0 Total $ $37,346. 0 37,346, 0 Fed$ DBE Subcontractors(exciudin men) Grand Total MWBE WWBE I Total B Total A+B No. 1 No. 2 Total $ $7,800, 0 1 Total$ $45,146.00 Fed$ Fed$ Number of subcontracts awarded by type of work: Professional and Consultant Services DBE MWBE WWBE (excluding women) 1. Engineering 2. Architectural 3. Right of Way 4. Other Construction 1. Grading/Drainage 2. Paving 3. Structures/Buildings 4. Materials 5. Equipment 6. Trucking 7. Traffic Control 8. Landscaping 9. Other TOTALS: Note: For the purpose of this report,use the foll6wing definitions. • DBE=disadvantaged business enterprise • MWBE=minority women business enterprise • WWBE=white women business enterprise C-17 Local Assistance Procedures Manual EX MIT 12-E PS&E Checklist Instructions Attachment L LOCAL AGENCY BIDDER-DBE INFORMATION This information may be submitted with your bid proposal. If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received by the administering agency no later than the timespecified in the special provisions. CO./RTE./P.M.:/9- p - II/17-ES, BIDDEWSNAME: R..T_ NoRT.F. cnMPANY CONTRACTNO.: CC1154 g�rPC 541,64) ADDRESS: 15505 E. LINCOLN AVENUE BID AMOUNT: $ s ORANGE, CA 92865 BID'OPENING DATE: 11-16-04 DBE GOAL FROM CONTRACT .7 ITEM OF WORK AND DESCRIPTION NAME OF DBE** DOLLAR PERCENT CONTRACT OF WORK OR SERVICES TO BE (Name of DBEs, Certification Number, AMOUNT **' ITEM NO. SUBCONTRACTED OR MATERIALS and Telephone Number) *** DBE TO BE PROVIDED DBE 7,8,13 ADJUSTING UTILITIES RAMIREZ CONSTRUCTION $37,346.00 100% 626-967-5790 CT 024273 6 PORTION OF ASPHALT OIL WC GOOLSBY $13,000.00 100% 800-839-9697 CT 002822 X 60% =$7,800.00 Total Claimed $ 45,146 0C_ Participation 100 % % * If 100%of item is not to be performed or furnished by DBE,describe exact portion,including planned location of work to be performed,of item to be performed or furnished by DBE ** DBEs must be certified by Caltrans on the date bids are opened. Subcontractors and suppliers certified state-funded only cannot be used to meet goals on federally funded contracts. *** Credit for a DBE supplier,who is not a manufacturer is limited to 60%of the amount paid to the supplier. (See Section "Disadvantaged Business"(DBE)of the special provisions) IMTORTANT: Names of DBE subcontractors and their respective item(s)of work listed above should be consistent with the name and items of work in the "List of Subcontractors" submitted with your bid pursuant to the Subcontractors Listing Law. 1-16-0 -1 50 Si tune of 92der Date (Area Code)tel.No. MICHAEL J. CARVER, PRESIDENT Person to Contact (Please type or print) Distribution for NHS Projects: (1)Original-Caltrans DLAE for NHS Projects,(2)Copy-Local Agency project file Distribution for non-NHS Projects: (1)Original Local Agency project file DEPT.OF TRANSPORTATION (FED DBE)MODIFIED DC-OE-19(REV 09-18-95) C-16 Page 12-67 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford, Connecticut 06183 Bond No. N/A KNOW ALL MEN BY THESE PRESENTS, That we, R. J. NOBLE COMPANY as Principal, hereinafter called the Principal, and TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, of Hartford,Connecticut, a corporation duly organized under the laws of the State of Connecticut, as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH aC Ohliripp hprPinnf pr Galled the nhligee in tha SLIM of TEN PERCENT OF THE AMOUNT OF THE BID ..y...., ..—e. ._.._. ..�__, ... ...- Dollars($ 10% OF BID AMT). 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 GOTHARD STREET REHABILITATION IMPROVEMENTS 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 fumished in the prosecution thereof,or in the event of the failure of the Principal to enter such Coniract 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 r nL,act th a---'her party to perform the tNork severed by said bid, then this obligation shall be null and void,otherwise to remain in full force and effect. Signed and sealed this 8th day of NOVEMBER 2004 R. J. NOBLE COMPANY ('Ari?Hess) (Principal)(Seal) MI(ZEL J.ZZRVER, PRESIDENT (Title) TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA (Vviiness) By Id A HAEL D.. YNG ("lVr1.E�r r fact) PrintArl in cooperation With the American institute of Architects (AIA)by Travelers Casualty and Surety Company of America. The language in this document conforms exactly to the language used in AIA Document A310, February 1970 edition. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT r State of California ss. 1 County of RIVERSIDE On Fi 'O'� before me, R. CISNEROS Dale Name and Title of Officer(e g,'Jane Doe.Notary Public') � personally appeared MICHAEL D. STONG Name(s)of Signer(s) personally known to me r D proved to me on the basis of satisfactory ` evidence to be the persorX whose name is/gK R.CISNEROS subscribed to the within instrument and COMM. #1488731 M acknowledged to me that he/she/they executed ¢` NOTARY PUBLIC-CALIFORNIA T the same in his/hefA49efr authorized RIVERSIDE COUNTY M Comm.E fires June 7,2008 capacity(iv�), and that by his/hef44ew signature(,sron the instrument the person(.81,or the entity upon behalf of which the person(.4 acted, executed the instrument. WITNESS my hand and official seal. ,�ccJJ }-� Place Notary Seal Above Signature of Nolary,Public 1 OPTIONAL Though the information below is not required by law it may prove valuable to persons relying on the document �I and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ?� ❑ Guardian or Conservator ❑ Other: I Signer Is Representing: 0 1999 National Notary Association•9350 De Soto Ave.,P 0 Box 2402•Chatsworth.CA 91313 2402•www nationalnotary org Prod No 5907 Reorder.Call Toll-Free 1-800-876-6627 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5907 State of CALIFORNIA County of ORANGE On 1 1'00--o f before me, JENNIFER DE IONGH, NOTARY PUBLIC DATE NAME,TITLE OF OFFICER-E.G.,-JANE DOE,NOTARY PUBLIC' personally appeared MICHAEL J. CARVER, PRESIDENT, R.J. NOBLE COMPANY NAME(S)OF SIGNER(S) l personally known to me - OR n pfaved to me en the basis of satisfactory evidence to be the personV) whose name(A is/efe subscribed to the within instrument and ac- knowledged to me that he/e4e4lciey executed �J NNIFERDEIOyGH the same in his/ m-rw authorized NOTARY PUBLIC-CALIFORNIA o COMMISSION#1448237 g capacity(ies), and that by his/n tA4ier- H ' ORANGE COUNTY My Comm.Exp.October28,2007 signatures on the instrument the personN, or the entity upon behalf of which the personN acted, executed the instrument. WITNESS my nd and official seal. SIGNATURE OF NOTARY OPTI AL 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE OR TYPE OF DOCUMENT TITLE(S) ❑ PARTNER(S) ❑ LIMITED 1-1 GENERAL ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) SIGNER(S)OTHER THAN NAMED ABOVE ©1993 NATIONAL NOTARY ASSOCIATION•8236 Remmet Ave.,P.O.Box 7184•Canoga Park,CA 91309-7184 One Tvnvr Square Travelens HaWord,CT 06183 IMPORTANT n1:;CLOSURF= 110-FICE OF TERRORISM INSURANCE COVERAGE On. November 26, 2002, President Bush signed into law the Terrorism Risk Insurance Act'of 2002 (the "Act"). The-Act establishes a short-term program under which the Federal Government will share in the payment of covered losses caused by certain .acts of international terrorism.. We are providing you with.this notice to inform you of the key features of the Act, and -to let you know what effect, if any, the Act will have on your premium. Under the Act, insurers are required .to -provide coverage for certain _ losses caused by international acts of terrorism as defined in the Act. The Act further provides that the Federal Government will pay.a share of such losses. Specifically, the Federal Government-will pay 90% 'of the amount of covered losses caused by certain acts of_terrorism which is in excess of Travelers' statutorily established deductible for that year. The Act also caps the amount of terrorism-related losses for which the Federal Government or an insurer can be responsible at $1 00,000,000,000.00, provided that the insurer has met its deductible. Please note that passage of the Act does not result in any change in coverage under the attached policy or bond (or the policy .or bond being" quoted). Please also note that no separate additional premium charge has been made for the terrorism coverage required by the Act. The premium charge that is allocable to'such coverage is inseparable from and imbedded in your overall premium, and is no more than one percent of your premium. TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY 'FARMINGTON CASUALTY COMPANY Hartford,Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Michael D. Stong, Shawn Blume, Susan C. Monteon, Rosemary Cisneros, of Riverside, California, their true and lawful Attomey(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attomey(s)-in-Fact, pursuant to the authority herein given,are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman, any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President, the Treasurer,any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power.of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (05-04)Unlimited IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 7th day of August, 2004. STATE OF CONNECTICUT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY }SS.Hartford FARMINGTON CASUALTY COMPANY COUNTY OF HAR'ITORD y�0 �v�AfryC 'J�TY,1�'O S9 P' &r'' . (J G •r HARZIR RD,1 16. ¢ NaRTFORD, < 1 9 S 2� o By a(91. 0 j g CONN. oc�, t ;` D,� George W. Thompson ��"; Senior Vice President On this 7th day of August, 2004 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. �G.TETiq My commission expires June 30, 2006 Notary Public Marie C.Tetreault CERTIFICATE I, the undersigned, Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority,are now in force. Signed andf�Scaled at the Home Office of the Company,in the City of Hartford, State of Connecticut. Dated this �"(�� day of 1 20 oLk O", ly ANON It G9 2 pAP � A t7 'F 3 HAW-FORD '`2 a NARTFORD, < tl 1982 p CONN.f f ; CONN. i° `i ; Ja By •. a1�•-�,\a `bl �a�° e'y ♦ r`' Peter Schwartz Senior Vice President a CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK March 1, 2005 JOAN L. FLYNN CITY CLERK R. J. Noble Company 15505 E. Lincoln Avenue Orange, CA 92865 Re: Gothard Street Rehabilitation —CC-1154 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 Declaration of Satisfaction of Claims and a Certificate of Compliance form must be returned to this office after the protect 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 536-5432. Sincerely, an L. Flynn ity Clerk J F:pe cc: Paul Emery, Acting Public Works Director Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Declaration of Satisfaction Certificate of Compliance Bid Bond (original) g:followu p\cash cunt\cashcon-letter.doc (Telephone:714-536-5227) RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) A, CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Sh i Freidenrich, City Treasurer FROM: DATE: 3O S� SUBJECT: Bond Acceptance I have received the bonds for ' ! (Company Name) Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Re: Tract No. CC No. JAL MSC No. Approved Agenda Item No.(Co u n c AApproval D a t City Clerk Vault No. 3 #27 gJfollowup/bondletter.doc PERFORMANCE BOND TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford, Connecticut 06183 Bond No. 104452175 KNOW ALL MEN BY THESE PRESENTS: R.J. NOBLE COMPANY, 15505 E. LINCOLN AVE., ORANGE, CA 92865 that as Principal,hereinafter called Contractor,and,TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA,of Hartford,Connecticut,a corporation duly organized under the laws of the State of Connecticut,as Surety,hereinafter caged Surety,are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee,hereafter caged Owner,in the amount of SIX HUNDRED THIRTY-EIGHT THOUSAND FIVE HUNDRED SEVENTEEN AND 301100 Dollars ($638,517.30),for the payment whereof Contractor and Surety bind themselves,their heirs,executors,administrators,successors and assigns,jointly and severally,firmly by these presents. WHEREAS,Contractor has by written agreement dated JANUARY 13,2005, entered into a contract with Owner for GOTHARD STREET REHABILITATION IMPROVEMENTS;CASH CONTRACT NO.1154 which contract is by reference made a part hereof,and is hereinafter referred to as the Contract. NOW,THEREFORE,THE CONDITION OF THIS OBLIGATION is such a contract between such bidder and Owner,and make available as Work that,if Contractor shall promptly and faithfully perform said Contract,then progresses (even though there should be a default or a succession of this obligation shall be null and void;otherwise it shall remain in fug force defaults under the contract or contracts of completion arranged under this and effect. This bond shall remain in effect for one year after City's paragraph)sufficient funds to pay the cost of completion less the balance acceptance of the work. of the contract price; but not exceeding, including other costs and damages for which the Surety may be Gable hereunder,the amount set The Surety hereby waives notice of any alteration or extension of time forth in the first paragraph hereof. The term'balance of the contract made by the Owner. price', as used in this paragraph,shag mean the total amount payable by Owner to Contractor under the Contract and any amendments thereto, Whenever Contractor shag be, and declared by Owner to be in default less the amount property paid by Owner to Contractor. under the Contract, the Owner having performed Owner's obligations thereunder, the Surety may promptly remedy the default, or shag Arry suit under this bond must be instituted before the expiration of two(2) promptly years from the date on which final payment under the Contract falls due. 1) Complete the Contract in accordance with its terms and conditions,or No right of action shall accrue on this bond to or for the use of any person 2) Obtain a bid or bids for completing the Contract in accordance with its or corporation other than the Owner named herein or the heirs,executors, terms and conditions, and upon determination by Surety of the lowest administrators or successors of the Owner. responsible bidder, or, if the Owner elects, upon determination by the Owner and the Surety jointly of the lowest responsible bidder,arrange for Signed and sealed this I ft day of JANUARY 2005 R.J.NOBLE COMPANY (Principal) (Seal) (Witness) M CHAEL CARVER, PRESIDENT (1-ifle) TRAVE RS CASU D SURE COMPANY OF AMERICA (Witness) B MI CH D.STO in-Fact Printed in cooperation with the American Institute of Architects(AIA)by TravelersACaalty and Surety parry of America. The language in this document conforms exactly to the language used in AIA Document A311,Feb1970 edition. Page 1 of 2 APPROVED AS TO FORM: JE IFER Mc-- (�Y Attorney c_iR'7n-F (m_o7) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT c State of California ss. n County of RIVERSIDE On 11CIM before me, R. CISNEROS Date Name and Title of Officer(e.g..-Jane Doe.Notary Public') � �! personally appeared MICHAEL D. STONG <`1 Name(s)of Signerts) S G personally known to me C) proved to me on the basis of satisfactory evidence to be the person whose name is/.�K R.CISNEROS subscribed to the within instrument and COMM.#1488731 rn NOTARY PUBLIC-CALIFORNIA acknowledged to me that he/she/they executed RIVERSIDE COUNTY the- same in his/her4#teir authorized M Comm.E fires June 7,2008 capacity(ie�, and that by his/ k signature(sfon the instrument the person(8 , or the entity upon behalf of which the person(4 acted, executed the instrument. WITNESS my hand and official seal. Place Notary Seal Above Signature of Notary Public /j OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: . Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer ?� Signer's Name: _ El Individual Top or thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General ❑ Attorney in Fact ?� Trustee El Guardian or Conservator I Other: I� Signer Is Representing: ?� 0 1999 National Notary Association•9350 De Soto Ave..P.O Box 2402•Chatsworth.CA 91313-2402•www.natronalnolary org Prod No 5907 Reorder:Call Toll-Free 1-800 876 6827 - CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5907 State of CALIFORNIA County of ORANGE 1 i /� On 1 l"t-oD before me, JENNIFER DE IONGH, NOTARY PUBLIC DATE NAME,TITLE OF OFFICER-E.G.,-JANE DOE,NOTARY PUBLIC- personally appeared MICHAEL J. CARVER, PRESIDENT, R.J. NOBLE COMPANY NAME(S)OF SIGNER(S) 7 personally known to me - basis of satisfactory evidence to be the personV) whose nameV is/a,re subscribed to the within instrument and ac- knowledged to me that he/sheAhey executed the same in histheritheir- authorized JENNIFER DE IONGH t capacity(ies), and that by his/h 'zrr`z;e;T- NOTARY CAUFORNIA W signatureN on the instrument the person 3 COMMISSION#1448237 c ORANGE COUNTY or the entity upon behalf of which the MX Comm.E2.October 28,2007 personN acted, executed the instrument. WITNESS my and and official seal. SIGNATURE OF NOTARY 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE OR TYPE OF DOCUMENT TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) ❑ GUARDIANICONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) SIGNER(S)OTHER THAN NAMED ABOVE 01993 NATIONAL NOTARY ASSOCIATION-8236 Remmet Ave.,P.O.Box 7184-Canoga Park,CA 91309-7184 PAYMENT BOND-PUBLIC WORK TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA SECTIONS 3247-3252,CIVIL CODE Hartford,Connecticut 06183 (CALIFORNIA) Bond No.104452175 KNOW ALL MEN BY THESE PRESENTS: THAT WHEREAS, The CITY OF HUNTINGTON BEACH has awarded to R.J. NOBLE COMPANY as Contractor, a contract for the work described as follows: GOTHARD STREET REHABILITATION IMPROVEMENTS; CASH CONTRACT NO. 1154 AND WHEREAS, Said Contractor is required to furnish a bond in connection with said contract, to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW, THEREFORE, We the undersigned Contractor and Surety are held and firmly bound unto the State of California in the amount required by law, the sum of SIX HUNDRED THIRTY-EIGHT THOUSAND FIVE HUNDRED SEVENTEEN AND 30/100 ($638,517.30) Dollars, for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, That if said Contractors shall fail to pay (1)Any of the persons named in Civil Code Section 3181, (2)amounts due under the Unemployment Insurance Code for work or labor performed in connection with said contract by any such claimant, or (3) any amounts required to be deducted, withheld and paid over to the Employment Development Department from wages of the employees of Contractor and his sub-contractors with respect to such work and labor, pursuant to Section 13020 of the Unemployment Insurance Code, then the Surety or Sureties herein will pay for the same in an aggregate amount not exceeding the sum specified in this bond, and also in case suit is brought upon the bond, a reasonable attorney's fee, to be fixed by the court, otherwise the above obligation shall be void. This bond shall inure to the benefit of any of the persons named in Civil Code Section 3181 so as to give a right of action to such persons or their assigns in any suit brought upon this bond. This bond is executed and filed to comply with the provisions of the act of Legislature of the State of California as designated in Civil Code, Sections 3247 -3252 inclusive, and all amendments thereto. IN WITNESS WHEREOF, We have hereunto set our hands and seals on this 19TH day of JANUARY, 2005 R.J. NOBLE COMPANY MI EL J. ARVER, PRESIDENT Contractor TRAVE ERS CASUALTY SURETY C MPANY OF AMERICA BY MIC EL D. ONG ey-in-Fad APPROVED S TO FORM: IFER cGRATH,City Atsnrney S-2061-B(07-97) ) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT i State of California ss. County of RIVERSIDE On q/05 before me, R. CISNEROS Date Name and Title of Officer(e.g.,-Jane Doe.Notary Public-) � personally appeared MICRAEL D. STONG Name(s)of Signer(s) j [X personally known to me ❑ proved to me on the basis of satisfactory evidence to be the personX whose name is/Vt� R.CISNEROS subscribed to the within instrument and COMM.#1488731 r ` NOTARY PUBLIC-CALIFORNIA I acknowledged to me that he/she/they executed °C RIVERSIDE COUNTY the same in his/heir authorized M Comm. ices June 7,2008 capacity(iee-), and that by his/he,414ie4 signature(,%ron the instrument the persorim or the entity upon behalf of which the person(4 acted, executed the instrument. WITNESS my hand and official seal. Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document t� and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: ?� S Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual Top of thumb Here ❑ Corporate Officer—Title(s): Partner—❑ Limited ❑General Attorney in Fact ?� Trustee iJ Guardian or Conservator < ❑ Other: Signer Is Representing: ?� 0 1999 National Notary Association•9350 De Soto Ave..P.D Box 2402•Chatsworth.CA 91313-2402•www nanonalnotary org Prod No 5907 Reorder Gan Toll-Free 1-800-676 6827 - CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5907 State of CALIFORNIA County of ORANGE On l" ko6 before me, JENNIFER DE IONGH, NOTARY PUBLIC DATE NAME,TITLE OF OFFICER-E.G.,-JANE DOE,NOTARY PUBLIC' personally appeared MICHAEL J. CARVER, PRESIDENT, R.J. NOBLE COMPANY NAME(S)OF SIGNER(S) l personally known to me - OR proved te Ffle en the basis of satisfactory evidence to be the person) whose name(A is/-afe subscribed to the within instrument and ac- knowledged to me that WsheAhe executed JENNIFERDEIONGH the same in histherftheir authorized �'.'. NOTARYPUBLIC-CALIFORNIA y capacity(ies), and that by his/ht—rAhezir"- h COMMISSION#1448237 a ORANGE COUNTY signatureN on the instrument the person(:, My Comm.EKP.October 28,2007 or the entity upon behalf of which the personN acted, executed the instrument. WITNESS my hand and official seal. SIGNATURE OF NOTARY 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER mtE(s) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) SIGNER(S)OTHER THAN NAMED ABOVE 01993 NATIONAL NOTARY ASSOCIATION-8236 Remmet Ave.,P.O.Box 7184-Canoga Park,CA 91309-7184 sTPAUL TRAVELERS IMPORTANT DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE On November 26, 2002, President Bush signed. into law the Terrorism Risk Insurance Act of 2002 (the "Act"). The Act establishes a short-term pro- gram under which the Federal Government will share in the payment of covered losses caused by certain acts of international terrorism. We are providing you with this notice to inform you of the key features of the. Act, and to let you know what effect, if any, the Act will have on your premium. Under the Act, insurers are required to provide coverage for certain losses caused by international acts of terrorism as defined in the Act. The Act fur- ther provides that the Federal Government will pay a share of such losses. Specifically, the Federal Government will pay 90% of the amount of cov- ered losses caused by certain acts of terrorism which is in excess of an in- surer's statutorily established deductible for that .year. The Act also caps the amount of terrorism-related losses for which the Federal Government or an insurer can be responsible at $100,000,000,000.00, provided that the insurer has met its deductible. Please note that passage of the Act does not result in any change in cov- erage under the attached policy or bond (or the policy or bond being quoted). Please also note that no separate additional premium charge has been made for the terrorism coverage required 'by the Act. The premium _. .___charge _that is allocable to such coverage is inseparable from and imbed- ded in your overall premium, and is no more than one percent of your pre- mium_ ILT-1018(9A)4) TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY Hartford,Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Michael-D. Stong, Shawn Blume,Susan C. Monteon, Rosemary Cisneros, of Riverside, California, ,their true and lawful Attorney(s)=in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by.the duly authorized officers of the Companies, and all the acts of said Attorneys)-in-Fact, pursuant to the authority herein given,are hereby ratified and confirmed. This appointment:is-made under and by authority of the following Standing.Resolutions:of said Companies, which Resolutions are now in full force and effect: VOTED: That.the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President;any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the.foregoii g authority to one or more officers or employees,ofthis-Company,.provided that each such delegation is in writing and a copy thereof is fileddirthe office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing-obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and bin .up dm on the Company when(a)signed.by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or,more Company officers pursuant to a written delegation of authority. This,Power,of Attorney and Certificate of Authority is signed and sealed by facsimile.(mechanical or printed)under.and by authority of the fallowing Standing.Resolution voted:by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY .OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY. and.FARMINGTON CASUALTY COMPANY,which Resolution is now in full force and effect: . VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds_and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (OM4)Unlimited Company Profile Page 1 of z Company Profile TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA ONE TOWER SQUARE, 4MN TRAVELERS / Mary T. Restelli HARTFORD, CT o6183 877-87z-8737 Former Names for Company Old Name: AETNA CASUALTY & SURETY COMPANY OF Effective Date: 07-01-1997 AMERICA Agent for Service of Process LORI CASTANEDA, 273o GATEWAY OAKS DR SUITE ioo SACRAMENTO, CA 95833 Unable to Locate the Agent for Service of Process? Reference Information NAIL #: 31194 NAIC Group #: 35_8 California Company ID #: 2444-8 Date authorized in California: July 31, 1981 License Status: UNLIMITED-NORMAL Company Type: Property & Casualty State of Domicile: CONNECTICUT Lines of Insurance Authorized to Transact The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY COMMON CARRIER LIABILITY CREDIT DISABILITY http://cdinswww.insurance.ca.gov/pls/wu_co_prof/idb_co_prof utl.get_co_prof?p_EID=... 2/9/2005 Company Profile Page z of z FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY TEAM AND VEHICLE WORKERS' COMPENSATION Company Complaint Information ( , Company Enforcement Action Documents Company Performance & Comparison Data Composite Complaint Studies Want More? Help Me Find a Company Representative in My Area Financial Rating Organizations Last Revised-November 04,2004 na8 AM Copyright©California Department of Insurance Disclaimer http://cdinswww.insurance.ca.gov/pls/wu_co_Prof/idb_Co_prof utl.get_co_profpp_EID=... 2/9 2005 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY) 01/19/2005 PRODUCER (949)857-4500 FAX (949)857-4800 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Millennium Risk Management & Insurance Services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR License # OC13480 �/l .s(� ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 5530 Trabuco Road ll�. JJ VAu�T P INSURERS AFFORDING COVERAGE Irvine, CA 92620 6_ INSURED R. 7. Noble Co. INSURER A: Liberty Surplus Insurance Corp./CRC 15505 Lincoln Ave. ,Q� INSURERB: American States Insurance Co. P. 0. Box 620 rbyhe "'' ��MT INSURERC: SeaBright Insurance Company Orange, CA 92865-1015 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY GLB0200108-023 07/01/2004 07/01/2005 FIRE DAMAGE(Any one fire) $ 50,000 CLAIMS MADE F� OCCUR ME EXP(Any one person) $ Excluded A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ X ANY AUTO DlCE919671 07/01/2004 07/01/2005 (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ O FORM: AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ �IF oG ( TH,City Ate ey $ DEDUCTIBLE OS $ RETENTION $ $ WORKERS COMPENSATION AND X I TORY LIMITS ER EMPLOYERS'LIABILITY B1040259 07/01/2004 07/01/200S E.L.EACH ACCIDENT $ 1,000,000 C E.L.DISEASE-EA EMPLOYEE $ 1,000,000 E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER )ESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificate Holder et al named Additional Insured/Primary/Waiver as respects General Liability per ndorsement CG 2010 11/85; WC Waiver per endorsement WC 04 03 06 E: RJN Job #90986-Gothard Street rehabilitation Improvements, Cash Contract #1154 10 day notice of cancellation in the event of non-payment of premium. :ERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILLRNWw MAIL *3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Huntington Beach 2000 Main Street R9CPM� PXy(�IMk�>Ji �9 �QlNfd ��9�X�M�RJd#1@1�l�XX PO Box 190 1dxx4lNPx�tPR9t R (h!X (Qc�NR3(S�R( )PJF4(�€ltTQ9d €�(X X X X X X X Huntington Beach, CA 92648 LAUTHORIZEDREPRE TIVE eonard Zi s c City of Huntington Beach Certificate issued to City of Huntington Beach 01/19/2005 Millennium Risk Management & Insurance Services 01/19/200S Additional Insured(s) : City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers PROVED AS TO FORM: NIFER McGRATH,City to ey IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon. Policy Number : EGLB0200108-023 Commercial General Liability THIS ENDORSEMENT CHANGES THE POLICY - PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART: SCHEDULE Name of Person or Organizations: Any person or organization that the insured is required by written contract to name as an additional insured. City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers 2000 Main Street PO Box 190 Huntington Beach, CA 92648 RE: RJN Job#90986-•Gothard Street rehabilitation Improvements, Cash contract#1154 It is further agreed that such insurance as is afforded by this policy for the benefit of the above Additional Insured(s)shall be primary insurance as respects any claim, loss or liability arising out the Named Insured (s) operations, and any other insurance maintained by the Additional Insured(s) shall be excess and non- contributory with the insurance provided hereunder. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization shown in the Schedule, but only with respects to liability arising out of "your work" for that insured by or for you. CG 20 1011 85 Copyright Insurance Services Office, Inc. 1984 ,I THIS NN'DOMS EMEN FT CHANGES'FHE POLICY. PLEASE READ IT CAREFULLY: rr�rvER Ol✓DIL& 'SELB OF W!51371 OF hECOVERY6(iA)t%STOTHL-RS TOM 71;s tndos:cmtnt mod;6` inmisinct pro idtd undo slat fokwinig COMMERCIAL- GENIERALUABFIXIYCONTRAGEPART SCHEDULE N larat of Ptnon of Orgarua.atiore y - (if no entry spptars about,information reou;rcd to(ompkte this tndocxmtnl wW be shown to the Declarnt»nt es spplks bit to this cndorstmtnt) The 771A 'SFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Conditiow (Stction V1- CCIANEXC]AL GENERAL L]AEILITY CONDITIONS)is amended by tht addition of the follovine wt waive any r;Fht of sitcovegywe tray have &gainst the ptnon of oiganizst;on shown in the Schedule above because of payments we make for injury os dwyagt ln0./ng out of Pouf ongoing operaoons or 'yow voile" done under i contract with that person or oTaLLe6on> A included in slit"product:-eompitted opuv&ns hasars!". City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers 2000 Main Street PO Box 190 Huntington Beach, CA 92648 RE: RJN Job#90986—Gothard Street rehabilitation Improvements, Cash contract #1154 LSI rorpor�rion Prcrosurn: . Effrct;vc Date: 7/01/04 Pxpiraoon Date_ 7/01/05 Fos attachment to Policy or Bond Na EGLB0200108-023 ]surd to. Bp 1A%ertL1 Wits 1n5usrncg1Co� oo Countt r.;gncd by - Authorized Rtprr mutivt End.Se r;s l No. WORKERS COMPENSATION.AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) 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 U.S.) You must maintain payroll,records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium'fbr this endorsement shall be 2%.of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description WHERE REQUIRED BY WRITTEN CONTRACT, PROVIDED THE CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF .LOSS TO WHICH THIS WAIVER APPLIES.. IN NO INSTANCE SHALL THE PROVISIONS AFFORDED. BY THIS .ENDORSEMENT BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE. City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers 2000 Main Street PO Box 190 Huntington Beach, CA 92648 RE: RJN Job #90986—Gothard Street rehabilitation Improvements, Cash contract #1154 This endorsement changes the:policy to which it is attached:and is effective on the:date Issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective. 7/1/04 .Policy No, BB1040258 Endorsement No. 8 Insured R.J. Noble.Company Policy Effective Date 7/1/04 Insurance Company SeaBright Insurance Company / Countersigned By UV WC 04 03.06 (Ed.4-84) 01M by the Workers'Compensation Insurance Rating Bureau.of.Caiifornia.All rights reserved. i J City of Huntington Beach' Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Subject: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 1 Gentlemen: The undersigned, contractor on: Project No. Title hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract on the project have been paid wages at rates not less than those required by the contract provisions, and that the work performed by each such laborer, mechanic, apprentice or trainee conformed to the classifications set forth in the contract or training program provisions applicable to the wage rate paid. (Signature and Title) APPROVED AS TO FORM JEN IFER M�GRATH,CkAttmw Sarah,Sutton putyC;tyAttorney IZ(`�( g:followup\cash cunt\cashcon 1.doc procedure#14 1V DECLARATION OF SATISFACTION OF CLAIMS state: (Name of Contractor) 1. 1 am the general contractor for the City of Huntington Beach, as to the project more fully described in the public works contract entitled: i and dated 2. All workers and persons employed, all firms supplying materials, and all subcontractors for the above-mentioned project have been paid in full. 3. The following are either 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: (if none, state"NONE") declare under penalty of perjury that the foregoing is true and correct. Executed at on this day of , 20_. (Location) (Signature of Contractor) A PPRO VW AS TO FORM 4EVIFER McGRATH,CkAttozney arab Sutton 21���3 g:followup\cashcont\cashcon2.doc // procedure#15 �P�tY C;ty AttonzCy tA)A4�J Council/Agency Meeting Held: 0 Deferred/Continued to: Approved ❑ Conditionally Approved ❑ Denied �itytlerl�$ Sigqqure Council Meeting Date: 12/20/2004 Department ID Number: PW 04-095 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL MFMBERS co SUBMITTED BY: PENELOPE LBRET -GRAFT, CITY AD TEA R PREPARED BY: ROBERT F. BEARDSLEY, PE, DIRECTOR O UBL C ORKS � SUBJECT: Award Contract for Gothard Street Rehabilitation, CC 1154i� Statement of Issue,Funding Source, Recommended Action,Alternative Action(s),Analysis,Environmental Status,Attachment(s) Statement of Issue: On November 16, 2004, bids were received for the Gothard Street Rehabilitation Improvements, CC-1154. Staff recommends award to R.J. Noble Company, 15505 E. Lincoln, Avenue, Orange, CA 92856, as the lowest responsive and responsible bidder. Funding Source: Sufficient project funds have been budgeted in the Gas Tax, Arterial Rehabilitation, Street Improvements Account No. 20790008.82300. Grant funds in the" amount of$190,923 are included in the budgeted funds. The engineer's preliminary estimate was $652,343. Recommended Action: Motion to: 1. Accept the lowest responsive and responsible bid submitted by R.J. Noble Company, in the amount of $638,517.45 for Gothard Street Rehabilitation Improvements, CC- 1154; and 2. Authorize the Mayor and City Clerk to execute a construction contract in substantially the same form as the sample contract (Attachment 2). Alternative Action(s): Reject all bids and direct staff to readvertise or abandon the project. �q 1 REQUEST FOR ACTION MEETING DATE: 12/20/2004 DEPARTMENT ID NUMBER:PW 04-095 Analysis: The City was awarded funds under the Orange County Transportation Authority (OCTA) Arterial Highway Rehabilitation Program (AHRP) for a total of fourteen street rehabilitation projects over three fiscal years. Gothard Street (Attachment 1) is the final project in this award. The following table reflects the funding breakdown of awarded federal dollars and City matching funds required for the construction contract. Street Project Limits AHRP Award City Match (Gas Tax) Gothard CC-1154 Ellis to Heil $190,923 $447,594.45 Rehabilitation of the roadway generally will include pavement crack sealing, grinding, selective pavement reconstruction and asphalt overlay. This project also includes placing new signing/striping, new traffic detection loops and adjustment of existing water valves, manholes and similar appurtenances to the new surface. Pavement rehabilitation work of this nature will increase the life of the arterial street by approximately 10 years. Bidding Contractor Bid Amount 1. R.J. Noble Company $638,517.30 (Corrected to: $638,517.45) 2. All American Asphalt $640,288.07 3. Hardy & Harper, Inc. $654,432.85 4. Orion Contracting Inc. $683,856.25 5. Sully-Miller Contracting Co. $695,875.05 6. Palp, Inc. DBA Excel Paving Co. $721,827.32 7. Sequel Contractors, Inc. $744,644.06 (Corrected to: $744,644.22) 8. Alliance Streetworks, Inc. $778,309.40 9. . Ben's Asphalt, Inc. $705,000.00 (Corrected to: $901,800.00) The reference check for R.J. Noble Company provided acceptable responses from past clients. Staff recommends that the City Council accept the bid from R.J. Noble Company, the lowest responsive and responsible bidder. Public Works Commission Action: The Public Works Commission on May 21, 2003, recommended that City Council authorize the Director of Public Works to advertise the project for bids, by a vote of 5-0-2 (Absent Commissioners: Gartland and Johnson). Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15301 (C). Attachment(s): City Clerk's . • - Number No. Description 1. Location Map (Gothard Street, Ellis Avenue to Heil Avenue) 2. 1 Sample Federally Funded Construction Contract G:\R C A\2004\04-095 Dec 20 Taite (Gothard Award).doc -2- 12/2/2004 9:03 AM ATTACHMENT # 1 �0 9ti BOLSA AVE. CO NTS cn cn Cn cn N Q Mc FADDEN AVE. v~i U _ 0 z " EDINGER = AVE. Y J M J 0 W O 0-1 o Z EILM Q z AVE. m Df O af z o W 0 Ft W o N a WARNER o AVE. SLATER 11 AVE. 4.05 TALBERT AVE. PACIFIC ,o 9 ELLIS AVE. GARFIELD AVE. 0 N (~ V) Ln H (YORKTOWN AVE. a ADAMS oz AVE. N W Q cr D 'Q9'yc� INDIANAPOLIS AVE. o PROPOSED PROJECT qL = O APPROX. 2 MILES ATLANTA AVE. M m m HAMILTON AVE. Gothard Street Rehabilitation OCEAN and y�'1' BANNING Communications Conduit AVE. Improvements GOTHARD STREET; CC- 1154 LOCATION MAP CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS 1 of 1 ATTAC H M E N T #2 FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND FOR TABLE OF CONTENTS Paize No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ' ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 3 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 4 7. NOTICE TO PROCEED 5 8. BONDS 5 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 6 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 9 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 10 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 10 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE,HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. DEFAULT & TERMINATION 14 23. TERMINATION FOR CONVENIENCE 15 24. DISPOSITION OF PLANS,ESTIMATES AND OTHER DOCUMENTS 15 25. NON-ASSIGNABILITY 15 26. CITY EMPLOYEES AND OFFICIALS 15 27. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 15 28. NOTICES 16 29. SECTION HEADINGS 16 30. IMMIGRATION 16 31. LEGAL SERVICES SUBCONTRACTING PROHIBITED, 17 32. ATTORNEY'S FEES 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS. continued Paize No. 33. INTERPRETATION OF THIS AGREEMENT 17 34. GOVERNING LAW 18 35. DUPLICATE ORIGINAL 18 36. CONSENT 18 37. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 18 38. CALIFORNIA PREVAILING WAGE LAW 18 39. CALIFORNIA EIGHT-HOUR LAW 19 40. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 20 41. EMPLOYMENT OF APPRENTICES 20 42. PAYROLL RECORDS 20 43. FEDERAL PARTICIPATION 21 44. DAVIS-BACON ACT 21 45. DISCRIMINATION, MINORITIES, ALIENS 21 46. EQUAL EMPLOYMENT OPPORTUNITY 21 47. COPELAND "ANTI-KICKBACK" ACT 22 48. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 23 49. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 23 50. ENERGY CONSERVATION 24 51. HOUSING AND URBAN DEVELOPMENT 24 52. ENTIRETY 24 2 4 FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND FOR THIS AGREEMENT ("Agreement") made and entered into this day of 20 , by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and , a California , hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and, the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be-encountered in the prosecution of agree/forms/federal 11-14-01/9/27/02 1 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; D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA agree/forms/federal11-14-01/9/27/02 2 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 and the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference); 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. 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 _ agree/forms/federal11-14-01/9/27/02 3 Dollars (S ), 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 (_) consecutive from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. THE 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 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 agree/forms/federal 11-14-01/9/27/02 4 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 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 CONTRACTORs 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 agree/forms/federal 11-14-01/9/27/02 5 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 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 Dollars ($ ) per day for each and every working day's delay in completing the work in excess of the number of agree/fonns/federal 11-14-01/9/27/02 6 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. 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. 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. agree/forms/federal 11-1"1/9/27/02 7 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 (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. agree/forms/federal 11-14-01/9/27/02 8 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 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, ten percent (10%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more'of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, 'as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, agree/forms/federal I 1-14-01/9/27/02 9 if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Payments shall be made on demands drawn in the mariner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the Agreement price shall not be considered as a acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS. SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work. contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOM 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: agree/forms/federal 11-14-01/9/27/02 10 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 CONTRACTOWs 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. CONTRACTOR will conduct all defense at its tD 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 agree/forms/federal 11-14-01/9/27/02 11 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 limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above-mentioned insurance contain a self-insured retention, or a"deductible" or any other similar form of limitation on the required coverage. 21. CERTIFICATES OF.INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: I. provide the name and policy number of each carrier and policy; agree/forms/federal 11-14-01/9/27/02 12 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 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. 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 agree/forms/federal 11-14-0119/27/02 13 which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 23 and any damages shall be assessed as set forth in Section 23. 23. 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 plus seven and one-half percent (7 '/2 %) for overhead and profit less all such payments already made. 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. 24. 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. 25. NONASSIGNABIL.ITY 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. agree/forms/federal 11-14-01/9/27/02 14 26. 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. 27. 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. 28. 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 ATTN: 2000 Main Street Huntington Beach, CA 92648 agree/for,ns/federal l 1-14-01/9/27/02 15 29. SECTION HEADINGS The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 30. WNQGRATION 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 United States Code Section 1324a regarding employment verification. 31. 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. 32. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each.party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the non- prevailing party. agree/forms/federal l 1-14-01/9/27/02 16 33. 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. 34. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 35. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. agree/forms/federal 11-14-01/9/27/02 17 36. 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. 37. 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. 38. 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 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. agreeft ms/federal 11-14-01/9/27/02 18 39. 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 o 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. .40. 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. agree/forms/federal l 1-14-01%9/27/02 19 41. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 42. 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. 43. 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. 44. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined by the Secretary of Labor in accordance with the Davis-Bacon Act (40 USC Section 176a, et seq.) for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply agree/forms/federal 11-14-01/9/27/02 20 with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 45. DISCRIMINATION, MINORITIES. ALIENS CONTRACTOR shall not discriminate nor allow its employees, agents, principals, or subcontractors to discriminate against any employee or applicant for employment on the basis of race, religious creed, national origin or sex. CONTRACTOR shall take affirmative steps to hire local qualified minority individuals when job opportunities occur and utilize local business firms when possible. 46. 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). 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 discharge and(2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. agree/forms/federal 11-14-0119/27102 21 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. 47. COPELAND "ANTI-KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti-Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations, which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 48. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act(40 USC 327 et seq.) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight(8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in excess of eight(8) hours in any calendar day or forty(40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required.to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. agree/forms/federal 11-14-01/9/27/02 22 49. . IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA)List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 114 of the Clean Air Act and section 308 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized.purstiant 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. 50. 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.). agree/forms/federal 11-14-01/9/27/02 23 51. .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. 52. ENTIRETY The foregoing, and Exhibit "A" 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, 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 offices the day, month and year first above written. agree/forms/federal l 1-14-01/9/27/02 24 CONTRACTOR CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California Mayor By: ATTEST: print name ITS: (circle one) Chairman/President/Vice President City Clerk AND APPROVED AS TO FORM: By: City Attorney print name ITS: (circle one) Secretary/Chief Financial Officer/Asst. Secretary-Treasurer INITIATED AND APPROVED: REVIEWED AND APPROVED: Director of Public Works City Administrator agree/forms/federal 11-14-01/9/27/02 25 RCA ROUTING SHEET INITIATING DEPARTMENT: Public works SUBJECT: Award Contract for Gothard Street Rehabilitation CC 1154 COUNCIL MEETING DATE: December 20, 2004 RCA ATTACHMENTS STATUS Ordinance (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Resolution (w/exhibits & legislative draft if applicable) Attached ❑ Not Applicable Tract Map, Location Map and/or other Exhibits Attached Not Applicable ❑ Contract/Agreement (w/exhibits if applicable) Attached ��� Not Applicable Signed in full b the CityAttorne Subleases, Third Party Agreements, etc. Attached ElNot Applicable (Approved as to form by City Attorne Certificates of Insurance (Approved b the CityAttorne Attached El pp y Y� Not Applicable Attached ❑ Fiscal Impact Statement (Unbudget, over$5,000) Not Applicable Bonds (If applicable) Attached ElNot Applicable ❑ Staff Report (If applicable) AttachedNot Applicable Commission, Board or Committee Report If applicable) Attached ❑ p ( pp ) Not Applicable Find in s/Conditions for A roval and/or Denial Attached El pp Not A licable EXPLANATION FOR MISSING ATTACHMENTS REVIEWED RETU D FO A ED Administrative Staff Assistant City Administrator Initial -City Administrator Initial -City Clerk EXPLANATION FOR MTURN OF ITEM:--- Space . Only) RCA Author: L Taite CITY OF HUNTINGTON BEACH GOTHARD STREET REHABILITATION, CC-1 154 BID DATE: NOVEMBER 16, 2004 TIME: 2:00 PM ENGINEER'S ESTIMATE: $652,343 BID LIST L. . ......... 1 All American Asphalt 2 Alliance Street Works 09, 4o 3 Ben's Asphalt, Inc. 4 Elite Bobcat Service, Inc. 5 -Excel Paving Co. -6 Hardy & Harper, Inc 7 L.A. Signal, Inc. 8 Orion Contracting, Inc. j xa3 , 9 R.J. Noble 10 Sequel Contractors, Inc. 11 Sterndahl Enterprises, Inc. 12 Sully-Miller Contracting Co. 13 14 15 16 17 18 19 file: Bid List& Results CC-1 154.xls i -iIM CIT Or � o HUNTINGTO.11M REACH, CA 0 1004 NOV I b P 2: G 1 T �ti n U_U lL 0 8 :I d 9 I AON h001 i � N Ait A.1IJ PROOF OF PUBLICATION STATE OF CALIFORNIA) ) SS. COUNTY OF ORANGE ) INURING SEALED BIDS the provisions of the fpr proposal requirements. am a Citizen of the United States and a «-1154 licensed bidder must be licensed and..also Notice is hereby given prequalified,as required resident of the County aforesaid; I am that sealed bids wdl be f received b the City of bylaw. ' g;9F y y The City Council of the over the age of eighteen years and not a Huntington Beach at the City of Huotin on Beach office of the City Clerk reserves: the--right to —- party to or interested in the below entitled at City Hall, 2000 Main reject any all bids. Street, •Huntington ,.�gy order of the City matter. I am a principal clerk of the Beach, CA 92648, until Council'of the City of the hour of 2:00 PM on Huntington Beach, Cali- HUNTINGTON BEACH INDEPENDENT, November 16ds will a 2003a the 16th of June Which time bids will be opened publicly and read Joan'L.Flynn a newspaper of general circulation, aloud in the Council City Clerk•of the City of Chambers for the Huntington Beach, 2000 printed and published In the City of GOTHARD STREET RE- Main Street. (714) 536- HABILITATION,CC- 5431 Huntington Beach County of Orange 11 IMPROVEMENTS published Huntington > > i in,the City of,Huntington Beach Independent State of nd that attached Beach. 14,11,2004 November California,, A set of plans, speci= 4,11,2004 104-138 fications, and'contract Notice is a true' and complete copy as documents may bei obtained starting Octo- was .. printed :. - and published- ' in the ber 28, 2004 at City Hall, Department of Huntington Beach issue of said Public,Works upon receipt of a non-re- newspaper to wit the Issue(s) of: fundable fee of$65.included, if sales tax included, f picked up or $85.00 if mailed (Bidder shall pay additional cost for; special delivery). Each bid shall be made OCTOBER 28 r 2004 provided the Proposal Form provided in the contract documents, and shall be NOVEMBER 4 i 11, 2004 accompanied by . cer- tified or cashier's check or a bid bond for not less than 10% of the amount of the bid,made payable to the City of, Huntington Beach..The Contractor shall, in the performance of the work declare, under penalty of perjury, that and improvements, conform to the Labor Code of the State of the foregoing is true and correct. California and other Laws of the State of California applicable thereto, with the ex- ception only of such Executed on NOVEMBER 11, 2004 variations that may be required under the at Costa Mesa California. special which statutes proceedings , ant to which -r g hereunder are taken and which have not been superseded by the provisions of the.Labor Code. Preference to labor-shall be given only in the manner provided Signature. bylaw. No bid shall be con- sidered unless it is made on a form furnished by the City of Huntington Beach, Department'of Public Works, and is made in accordance with H UNTINGTON B EACH BIDS INDEPLEL-iNDENT INVITING fEAI;.1 is 1154 Notice is hereby givor n ill be that sealed tithe City of received by _ Huntington Beach aClehk office .1 all 2000r-ity Main ,at City Huntington Street,CA 92648, until IBeach, the hour of 2:00 PM on November 16,2004,at which time bids will be �_ opened publthe an' Client Reference # aloud �n Chambers for the HABILITATION CC- 1 AB IMPROVEMENTS Huntington Beach Independent Reference # /0�— �J in the City of Huntington Beach. ,f plans, s;^eci ducuments i,,,ty bLFt obtained starting-Octo- ber 28, 2004 at City Hall, Department of j Public Works upon receipt of a non-re- fundable fee of$65.00, sales tax included, if ,picked up or $85.00 if mailed (Bidder shall pay additional cost for special delivery). Each bid shall be made on the Proposal Form Dear advertiser. provided in the contract documents,and shall be accompanied by a cer- tified or cashier's check or a bid bond for not less than 10% of the amount of the bid,made Enclosed is a clipping of your ad from the first publication, beainninQ on payable to the City ofHuntin . each. The /0'Z� Vand expiring on / —/�0V ` ` Contragctor hall, in the performance of the work and improvements, conform to the Labor Code of the State of If you need to make any changes or corrections, please call me at your California and other Laws of the State of earliest convenience. California applicable ,., thereto, with the ex- ception only of such variations that may be Q The cost of this ad is O/ /� O required under the �D (((�//�, � special statutes pursu- ant to which proceedings hereunder are taken and which have not been Thanks for your cooperation and patronage. superseded by the provisions of the Labor Code. Preference to labor shall be given only in the manner provided by law. No bid shall be con- Sincerely, sidered unless it is made on a form furnished by the City of Huntington Beach„ Department of Public Works, and is made in accordance with the provisions of the Michael Sletten proposal requirements. Each•biddei must be Legal Advertising licensed and also prequalified as required by law. y The City Council of the City of Huntington Beach reserve's the -right to reject any or all bids. By order of the City Council of the City of Huntington Beach, Cali- fornia the 16th of June 2003. Joan L.Flynn City Clerk of the City of Huntington Beach, 2000 Main Street. (714) 536- 5431 Published, Huntingtom1 18682 Beach Blvd.,Ste.160,Huntington Beach,California 92646 Beach Independent October 28, November � (714)965-3030 "Fax(714)965-7174 a,11,2ooa 1oa-13a i A Publication of Times Community News •A Division of the Cos Angeles (Times F+Y— a E M/--/L ;Le u S 7 f - /C) // /5/ NOTICE INVITING SEALED BIDS for CC-1154 Notice is hereby given that sealed bids will be received by the City of Huntington Beach at the office of the City Clerk at City Hall, 2000 Main Street, Huntington Beach, CA 92648, until the hour of 2:00 PM on November 16, 2004, at which time bids will be opened publicly and read aloud in the Council Chambers for the GOTHARD STREET REHABILITATION, CC-1154 IMPROVEMENTS in the City of Huntington Beach. A set of plans, specifications, and contract documents may be obtained starting October 28, 2004 at City Hall, Department of Public Works upon receipt of a non-refundable fee of$65.00, sales tax included, if picked up or $85.00 if mailed (Bidder shall pay additional cost for special delivery). Each bid shall be made on the Proposal Form provided in the contract documents, and shall be accompanied by a certified or cashier's check or a bid bond for not less than 10% of the amount of the bid, made payable to the City of Huntington Beach. The Contractor shall, in the performance of the work and improvements, conform to the Labor Code of the State of California and other Laws of the State of California applicable thereto, with the exception only of such variations that may be required under the special statutes pursuant to which proceedings hereunder are taken and which have not been superseded by the provisions of the Labor Code. Preference to labor shall be given only in the manner provided by law. No bid shall be considered unless it is made on a form furnished by the City of Huntington Beach, Department of Public Works, and is made in accordance with the provisions of the proposal requirements. Each bidder must be licensed and also prequalified as required by law. The City Council of the City of Huntington Beach reserves the right to reject any or all bids. By order of the City Council of the City of Huntington Beach, California the 16th of June 2003. Joan L. Flynn City Clerk of the City of Huntington Beach 2000 Main Street. (714) 536-5431 i NISB-CC-1154 • J. e 0LjCITY OF HUNTINGTON BEACH 2000 Main Street P . O . Box 1 90 Huntington Beach , CA 92648 LETTER OF TRANSMITTAL Fax (714) 374-1573 Attention: Joan L. Flynn Date: October 25, 2004 To: City Clerk's Office Project/C.C. No.: C.C. No. 1154 2000 Main Street Regarding: Gothard Street Rehabiliation Improvements Huntington Beach, CA 92648 ❑ We are sending you: ❑ By Mail ❑ By Fax Mail(Number of pages including this sheet:) ® We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other: Notice Inviting Sealed Bids Item# Copies Pages Description 1 1 1 Notice Inviting Sealed Bids 2 Gothard Street Rehabilitation Improvements, CC-1154 3 4 5 These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other: Remarks: On June 16, 2003, the City Council authorized the advertisement of the Gothard Street Rehabilitation Improvements project, CC-1154. Please find attached the Notice Inviting Sealed Bids for advertisement on 10/28/04, 11/04/04 & 11/11/04. Bid opening is scheduled for 1l/16/04 @ 2:00 pm. Please contact me at 536-5590 with any questions you may have. c: file By: ite, Civil Engineering Assistant GACONSTRUCTION CONTRACTS(CCs)\CC1154\PRE-AWARD No.2\ADVERTISE\NISB TRANSMITALTo CLERK CC-1154.DOc Council/Agency Meeting Held: __�C)/a.IQ V Deferred/Continued to: Approved El Conditionally Approved El Denied ;4it CI rk's igna re j Council Meeting Date: October 18, 2004 Department Number: PW 04-081 V � CITY OF.HUNTINGTON BEAG:H REQUEST FOR CITY COUNCIL ACTION = SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL ME BERS vi > SUBMITTED BY: PENELOPE CULP�R T -G A , City Administrat r PREPARED BY: ROBERT F. BEARDSLEY, PE, Director of Public Works % SUBJECT: Authorize the Rejection of Bids and the Permission to Re-advertise-the Gothard Street Rehabilitation Improvements Project, CC-1154 Statement of Issue,Funding Source,Recommended Action,Alternative Action(s),Analysis,,Environmental Status,Attachments) l Statement of Issue: Bids received for Gothard Street Communications Conduit Project, CC- 1107 exceeded the budgeted amount by over $350,000. Authorization is requested to reject all . bids for.I the Gothard __:.Street Rehabilitation Project,. .CC-1:154 and_ Gothard .Street. Communications Conduit Project, CC-1 and to '`re'advertise the. Gothard,: Street s Rehabilitation Project, CC-1154 without the communications element. Fundinq Source: Project funds are budgeted in the Gas Tax, Arterial Rehabilitation, Street Improvements Account No. 20790008.82300. The engineer's preliminary estimate is $628,850. Recommended Action: Motion to: 1. Reject all bids, received for the Gothard Street Rehabilitation Project, CC-1154 and Gothard Stre municat' se 1), CC-1107 combined projects, and dir t the City Clerk to return all bid bonds; and 2. Authorize the Irec or s o re-advertise the.Gothard .Street Rehabilitation Project, CC-1154 for bids.. Alternative Action(s): Accept the lowest responsive and responsible bid by R.J. Noble Company, in the amount of$1,278,410.49. This action would require an additional $350,000 be appropriated from the General Fund. This action is not recommended since the higher than expected bids for the communication portion of the project indicate that the current approach to this element of the project (CC 1107) is not feasible based on available funding sources. 04-081 Oct 18 Taite(Arterial Road Rehab CC1154&CC1107)-- 10/5/2004 8:33 Al REQUEST FOR CITY COUNCIL ACTION MEETING DATE: October 18, 2004 DEPARTMENT ID NUMBER: PW 04-081 Analysis: Staff combined two current capital projects on Gothard Street, between Ellis Avenue and Heil Avenue, to reduce overall.construction costs and minimize future pavement impacts.on Gothard Street. The Gothard.Street Rehabilitation Project,;CC4154 and1he' Gothard Street'Communications Conduit Project, CC-1107 were combined into'orie bid package. Bids were received on September 28, 2004 for the combined project. The basis of award for the combined project was the sum of both bid schedules (i.e. the total bid for both projects). The bids are listed below: No. BIDDER'S NAME Pavement Communications, TOTAL BID Rehab, CC-1154 CC-1107 AMOUNT 1 R.J. Noble Company $656,745.49 S621,665.00 $1,278,410.49 2 All American Asphalt $637,847.00 S661,036.00 $1,298,883.00 3 Pal ., Inc. DBA Excel Paving $712,534.88 S595,990.00 $1,308,524.88 4 Sequel Contractors, Inc. $758,684.06 S557,530.00 $1,316,214.06 5 Ranco Corporation $733,345.62 S598,300.00 $1,331,645.62 The lowest responsive and responsible bid for the Gothard Street Rehabilitation element of the project, CC-1154 was within budget, however, the bid for the Gothard Street Communic.ations.element of the project, CC-1107.was approximately $.350,000.over,.budget... .. Therefore,.staff recommends that.all-bids be rejected and.the Gothard-Street Rehabilitation 'Project; CC- 4154, be�bid as'a single project. Requesting' bids for the Gothard Street Communications Conduit Project, CC-1107 would be cancelled at this time pending further evaluation of alternatives to the current project approach. Since the basis of award for the project was the sum of work elements for both projects, and the communications element of the project represents a significant portion of the total bid, the City Attorney's office has indicated that it would not be appropriate to award a contract for the pavement rehabilitation portion of the project based on the submitted bids. Therefore, staff is recommending rejection of all bids and that the project be repackaged to include only the pavement rehabilitation portion of the project. Public Works Commission Action: The Public Works Commission recommended the . .project for bids on May 21, 2003, by a vote of 5-0-2 (Absent Commissioners. Gartland and - Johnson). Environmental Status: These projects are categorically exempt pursuant to the California Environmental Quality Act, Section 15301 (C). G:\R C A\2004\04-081 Oct 18 Taite(Arterial Road Rehab CC1154&CC1107).doc -2- 10/5/2004 8:33 AM REQUEST FOR CITY COUNCIL ACTION MEETING DATE: October 18, 2004 DEPARTMENT ID NUMBER: PW 04-081 Attachment(s): City Clerk's Page Number No. Descripfion 1 Location Map: Gothard (Ellis to Heil) RCA Author: Larry Taite:jg G:\R C A\2004\04-081 Oct 18 Taite(Arterial Road Rehab CC1154&CC1107).doc -3- 10/5/2004 8:33 AM Ci i'Y OF HUNTINGTON BEACH G MEETING DATE: June 16, 2003 DEPARTMENT ID.NUMBER:PW 03-034 Council/Agency Meeting Held: Deferred/Continued to. pproved ❑ Conditionally Approved ❑ Denied City Clerk's Signat re Council Meeting Date: June 16, 2003 Department ID Number: PW 03-034 CITY OF HUNTINGTON BEACH REQUEST FOR ACTION OR/(o/N19-L C4 /A) /CiLE .' O/' - FOO. V0 #/ops' 10 SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS t SUBMITTED BY: RAY SILVER, City Administrator aza T REPARED BY: ROBERT F. BEARDSLEY, Director of Public Works I SUBJECT: AUTHORIZE ADVERTISEMENT OF ARTERIAL HIGHWAY REHABILITATION PROJECTS; CC-1150 TO CC-1156, CC-1158 & CC=1159 IEEE Issue,Funding Source,Recommended Action,Alternative Action(s),Analysis,Environmental Status,Attachment(s) Statement of Issue: Plans and specifications are complete for the following nine (9) Arterial Highway Rehabilitation Projects, and permission to advertise the projects is requested: • Warner Avenue CC-1150 • Hamilton Avenue CC-1155 e:1�306,r • Springdale Street CC-1151 • Yorktown Avenue CC-1156 oK • McFadden Avenue CC-1152 • Graham Street CC-1158 • Magnolia Street CC-1153 CK •Warner Avenue CC-1159 ov- • Gothard Street CC-1154 . Funding Source: A combination of Federal Arterial Highway Rehabilitation Program. (AHRP) Grant and Gas Tax Funds will be used. The following breakdown identifies the allocation of funding: Gas Tax $1,448,976 Federal AHRP Grant $1,333,211 Total Project Construction Funding $2,782,187 Project funds in the full amount are budgeted in the Gas Tax, Arterial Rehabilitation, Street Improvements Account No. 20790008.82300. Recommended Action: Motion to: Approve the project plans and specifications and authorize the Director of Public Works to request bids for the Arterial Highway Rehabilitation Projects, CC-1150 to CC-1156, CC-1158 & CC-1159. G:\R C A\2003\03-034 June 16 Lee (OCTA-AHRP).doc -2- 5/29/2003 8:11 AM/ / REQUEST FOR ACTION MEETING DATE: June 16, 2003 DEPARTMENT ID NUMBER: PW 03-034 Alternative Action(s):.. Deny approval of the arterial highway -rehabilitation projects and forego the rehabilitation projects and their respective awarded federal funds. Analysis: In 2000, the Public Works Department applied for funding under the Orange County Transportation Authority's (OCTA) Arterial Highway Rehabilitation Program for various street rehabilitation projects. As a result of the applications, the City was awarded funding for-fourteen-street rehabilitation projects over three--fiscal years. The remaining nine ---------- --- -- - streets were awarded funding for Fiscal Year 2002-2003, which are as follows: Street Project # Limits Award City Match 1. Warner CC-1150 Bolsa Chica to Sims $ 82,973 $ 132,849 2. Springdale CC-1151 McFadden to Edinger 230,781 65,270 3. McFadden CC-1152 Goldenwest to 1-405/City Limit 98,947 182,862 4. Magnolia CC-1153 Atlanta to Indianapolis 117,107 183,651 5. Gothard CC-1154 Ellis to Heil 190,923 461.419 6. Hamilton CC-1155 Bushard to Santa Ana River 89,227 119:699 7. Yorktown CC-1156 Bushard to Brookhurst 66,199 128,525 8. Graham CC-1158 Warner to Heil 57,054 95,911 9. Warner CC-1159 Graham to Springdale $400,000 78,790 Total. $1,333,211 $1.,448,976 Rehabilitation of the roadways generally includes pavement crack sealing, grinding, selective pavement reconstruction and asphalt overlay. The project also includes new curb access ramps, curb, gutter, sidewalk, signs and striping, and traffic detection loops, as well as the adjustment of valves and manholes to the new surface. Pavement rehabilitation work of this nature will increase the life of the arterial streets by approximately ten years. The awarded amount is reimbursable to the City for construction and engineering costs. The estimated cost for all nine projects is $2,782,187. The project will be advertised after Caltrans approves the plans, specifications and estimate. Approval is anticipated within the next 60 days. Public Works Commission: The Public Works Commission reviewed and approved this project on May 21, 2003, by a'vote of 5-0-2 (Commissioners Gartland &Johnson absent). Environmental Status: These projects are Categorically Exempt pursuant to the California Environmental Quality Act, Section 15301 (C). Attachment(s): DescriptionCity Clerk's Page Number No. 1. Location Map RCA Author: DSL:jm G:\R C A\2003\03-034 June 16 Lee (OCTA-AHRP).doc -3- 5/29/2003 8:11 AM ATTACHMENT # 1 viol BOLSA. 4NAVE! C0 3 NTS N Mc FADDE U W F-z ( U EDINGER 0 2 (n AVE. Z Z N p J M p o z HEILm a N N a AVE. m r S U U O N Q WARNER 0 AVE. w p 5 J 1 SLATER AVE. 405 8 TALBERT AVE. PACIFIC 9 ELLIS JAVE. GARFI ELD AVE.. YORKTOWN AVE. 3 CO ,y�`�� Z J (D PROJECT LOCATIONS o�° .,'� ADAMS 3 Oz. AVE. o K Z Q 0Warner Avenue CC-1150 INDIANAPOLIS 4 AVE. o 2� Springdale Street CC-1151 L = 0 3� McFadden Avenue CC-1152 6 ATLANTA s AVE. 03 5 ® Magnolia Street CC-1153 1 0° HAMILTON AVE. O5 Gothard Street CC=1154 © Hamilton Avenue CC-1155 OCEAN tip'}- BANNING 6 70 Yorktown Avenue CC-1156 AVE. 80 Graham Street CC-1158 90 Warner Avenue CC-1159 AHRP FY 2002/2003 LOCATION MAP F � t CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS — 0' BOLSA AVE. NTS U) V) V) U) N Q Mc FADDEN AVE. v~i U z N EDINGER = AVE. Q o 0HEILM Q 3 z AVE. m m o Q z 0 w E w o (< ¢ WARNER o AVE. U SLATER AVE. 405 TALBERT AVE. PACIFIC ,o 9 ELLIS AVE. GARFIELD AVE. cn cn cn U) Q YORKTOWN AVE. ADAMS oz AVE. 1` w0 Of o��tic� INDIANAPOLIS AVE. Y PROPOSED PROJECT �yL = M o APPROX. 2 MILES F Of ATLANTA � AVE. 0D m D m HAMILTON AVE. Gothard Street Rehabilitation OCEAN y� 1: BANNING Improvements AVE. CC-1 154 GOTHARD STREET; CC- 1154 LOCATION MAP 'j� per CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS 1 of 1 ; �►?p CERTIFICATF OF LIABILITY INSUR CE DATE(MM/DD/YY) O1/19/2005 �)I➢UCER'.(y'49)857-4500 FAX (949)857-4800 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE llennium Risk Management & Insurance Services HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 11, cense # OC13480 �/I �LL ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 5530 Trabuco Road Irvine, CA 92620 �( V�.t�T r INSURERS AFFORDING COVERAGE INSURED R. J. Noble Co. INSURER A: Liberty Surplus Insurance Corp./CRC 15505 Lincoln Ave. ,Q� INSURERB: American States Insurance Co. P. 0. Box 620 (70 �7 �'SI�MI:MT INSURERC: SeaBright Insurance Company Orange, CA 92865-1015 ' INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT;TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY GLB0200108-023 07/01/2004 07/01/2005 FIRE DAMAGE(Any one fire) $ 50,000 CLAIMS MADE FX�OCCUR MED EXP(Any one person) $ Excluded A - PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 F 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ X ANY AUTO DlCE919671 07/01/2004 07/01/2005 (Ea accident) 1,000,000 ALL-OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ O FORM: AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ �IFER LG TH,City Attp ey $ DEDUCTIBLE � CdS $ RETENTION $ $ WORKERS COMPENSATION AND X I T'OR Y LIMITS ER EMPLOYERS'LIABILITY _ B1040258 07/01/2004 07/01/2005 E.L.EACH ACCIDENT $ 1,000,000 C E.L.DISEASE-EA EMPLOYEE $ 1,000,000 E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate Holder et al named Additional Insured/Primary/Waiver as respects General Liability per ndorsement CC 2010 11/95; WC Waiver per endorsement WC 04 03 06 E: RJN Job #90986-Gothard Street rehabilitation Improvements, Cash Contract #1154 10 day notice of cancellation in the event of non-payment of premium. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL MAIL `3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Huntington Beach 2000 Main Street !€4CIk�P1(7Q7 (3Pi9� 1F 9��SF3i4�(�MP9NXI Ik7l9F' )NS�7PJ�9Q R�11It 1�X X PO Box 190 f�5(�CIX4Q4tNPx+�Pf�x R_ �(hK�i(7( �C4�fNR�CtR9(7t�P>�4(�€AT(9�1N1€�C X X X X X X X Huntington Beach, CA 92648 AUTHORIZEDREPiMREIVELeonard Zi c Y' 600 / /?z 3-r City of Huntington Beach tllennium rtificate issued to City of Huntington Beach 01/19/2005 Risk Management & Insurance Services O1/19/2005 Additional Insured(s) : City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers VN'IFEIR D TO F RM; McGRATH,C'ty,A�tO rev 1% IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Policy Number : EGLB020L _-d-023 Corr.oercial General Liability THIS ENDORSEMENT CHANGES THE POLICY - PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART: SCHEDULE Name of Person or Organizations: Any person or organization that the insured is required by written contract to name as an additional insured. City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers 2000 Main Street PO Box 190 Huntington Beach, CA 92648 RE: RJN Job #90986—Gothard Street rehabilitation Improvements, Cash contract#1154 It is further agreed that such insurance as is afforded by this policy for the benefit of the above Additional Insured(s) shall be primary insurance as respects any claim, loss or liability arising out the Named Insured (s) operations, and any other insurance maintained by the Additional Insured(s) shall be excess and non- contributory with the insurance provided hereunder. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respects to liability arising out of "your work" for that insured by or for you. CG 20 10 11 85 Copyright Insurance Services Office, Inc. 1984 THIS ENDORSEMENTT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. gt.Iti'ER OF TRANKELFt��' F.lC,H7'c OF RECOVERYAGA]NSTOTHERS_TO IJS This endcimmtnt modifies inmtanct prodded under the following. COMMERCIAL GENERALLIABIIJ Y COVERAGE PART SCHEDULE N'arnc of Pcrron or Organiiatiom no entry appears sbove,;nforrnbrion rrqu;red to complete this "on-cm-tnt will be abowo m the Declarations @5 appLcsble to thi cndontrntnt.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Conditions (Section Vl- COMN RCIAL GENERAL 1JABILTTY CONDITIONS)i; mended by the addition of the fonovine We waive any right of ttcoYcry we may lave :ga;nst the ptnon or organizstion shown in the Schedule above becsuw of payrru.nts we make for injury of damage :rising out of your ongoing opetstions or 'your vodr^ done under i contract with that person of organization and included in the"product-completed operations hw--a ". City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers 2000 Main Street PO Box 190 Huntington Beach, CA 92648 RE: RJN Job #90986—Gothard Street rehabilitation Improvements, Cash contract #1154 LSI l'orpors eion prcmivin: Effective Date: 7/01/04 Expiration Date: 7/01105 For attachment to Policy or Bond No. EGLB0200108-023 lssucd to. By: Lber lus lnsut qn C,.oyry�tioo Countc n;pcd by..... .._.. . ..».._____............._ Autborized Repmentative End.Serial No. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04.03 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT--CALIFORNIA We have the right to recover bur 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 2% of the Califomia workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description WHERE REQUIRED BY WRITTEN CONTRACT, PROVIDED THE CONTRACT IS SIGNED AND DATED PRIOR TO THE DATE OF LOSS TO WHICH THIS WAIVER APPLIES. IN NO INSTANCE -SHALL THE PROVISIONS AFFORDED. BY THIS ENDORSEMENT BENEFIT ANY COMPANY OPERATING AIRCRAFT FOR HIRE. City of Huntington Beach, its officers, elected and appointed officials, employees, agents and volunteers 2000 Main Street PO Box 190 Huntington Beach, CA 92648 RE: RJN Job #90986-Gothard Street rehabilitation Improvements, Cash contract #1154 This endorsement changes.the policy to which it is;attached:and is effective on the:date::lssued unless otherwise stated. (The information below is required only when thls:endorsement is issued subsequent to preparation of the policy.), Endorsement Effective 7/1104 Policy No. BB1040258 'Endorsement No. 8 Insured R.J. Noble.Company Policy Effective Date 7/1/04 Insurance Company SeaBright Insurance Company l / Countersigned By WC 04 03 0.6 (Ed.4-84) ©1998 by the Workers'Compensation Insurance Rating Bureau of.California.All rights reserved. CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK To: L� '{ ^��r 1A)C. Enclosed please find your original bid bond issued by �I for \ 1-6 31 Joan L. Flynn City Clerk JF:pe Enclosure g:/fol lowup/cashcont/retumbidbond.doc (Telephone: 714-536-5227) �' � ' . � f ��� a� . �� ��� � �w ��. a ra }� '"` �'rS� �w. 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"�".'�'*'�o.. * ay."u,� eL. �. is�. ., .. >;., :i w- + ..� (;•.x. ,,. � r � ,,. .:.> m � r xv�a ,,. .,, � ,.k,., ,.. .. ,ns" �e. . ,. ��x� � �?, e,. �r x-ys�' ;tr`�,,..�,. 'a4 �"' �,5 a1f P fi „". :4 t�,++. i 1�. �'6� *��'��."�. 3 -�, a. m,av 4?.� '- r�F„�,�" .u�.�a..�%:��".' .�`. � `+,. �.,,a'tr",. .�+ ..}..`C ��;.. .T� � �� sY �'�:..�^5� �� .,,�`Y,. t a "`+�+�. p a ,:, i 4, h " I Tmarad St.Paul Fire and Marine lnsumuce Company Surety St.Paul Guardian Insurance Company St Paul Mercury lasaranee Company United States Fidelity and Guaranty Company Fidelity and Guaranty Insurance Underwriters,Inc. Fidelity and Guaranty insurance Company Principal Office: 38$Washington Street St Paul,Minnesota 55102 Seaboard surety Company Principal Office: 5801 Smith Avenue BID BOND Baltimore,Maryland 21209 KNOW ALL MEN BY THESE PRESENTS,that _Hardy& Harper, Inc. 1312 E. Warner, Ave. of Santa Ana, CA 92705 as Principal, and St. Paul Guardian Insufanee Company a Minnesota corporation,as Surety,are held and firmly bound unto CITY OF HUNTINGTON BEACH as Obligee,in the full andjust sum of (10%) TEN PERCENT OF AMOUNT BID (10%) Dollars,lawful money of the United States,for the payment of which stun, well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors and assigns,jointly and severally,firmly by these press u. WHEREAS,the said Principal is herewith submitting its proposal GOTHARD STREET REHABILITATION CC1154, FROM ELLIS AVE. TO HEIL AVE. STPL 5181(141) THE CONDITION OF THIS OBLIGATION is rich tha: if the aforesaid Principal shall be awarded the contract the said Principal will,within the time required,enter into a formal contract and give a good and sufficient bond to secure the performance of the terms and conditions of the contract,then this obligation to be void;otherwise the Principal and Surety will pay unto the Obligee the difference in money between the amount of the bid of the said Principal and the amount for which the Obligee legally contracts with another patty to perform the work if the latter amount be in excess of the former,but in no event shall liability hereunder exceed the penal sum hereof. Signed,sealed and delivered 4th ,day of NOVEMBER , 2004 Har , I (Seal) (Seal) STEVE KIR CHNER VICE PRESIDENT Surety Company: St. Paul Guardian Insurance Company L__' _ �z_-- Anomey-in-Fad KATHLEEN E. MAAS 85274 Rev.9-2000 Printed In U.S.A. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Orange ss. On November 4 , 2004 beforemeKristen S . Paulino Notary Public Date Name and Title of Officer(e.g,"Jane Doe.Notary Public') personally appeared Steve Kirschner Name(s)of Signer(s) [Xpersonally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(* whose name($) is/aW subscribed to the within instrument and acknowledged to me that he/so/thW executed the same in his/tpr/their authorized -� O capacity(iO@), and that by his/*/their 11 KCOMM.RISTEN S. 413262O signature(e) on the instrument the person(%, or cal NOTARY PUBLIC #14A3262 9 the entity upon behalf of which the erson � � •�'NOTARY PUBLIC•CALIFORNIA o Y P P (gi ?� ORANGE COUNTY ro acted, executed the instrument. 1 My Comm.EXP.May 20,2007 I[ 7I ( WITNESS my hand and off iial seal. Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Bid Bond Document Date: November 4 , 204 Number of Pages:_L__ None--------_----_—____--.—_——_------- Signer(s)Other Than Named Above: _ Capacity(ies) Claimed by Signer Signer's Name: Steve Kirschner ❑' Individual Top of thumb here X Corporate Officer — Title(s): Vice President ❑ Partner —❑ Limited ❑General ❑ Attorney-in-Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Hardy & Harper, Inc . O 1999 National Notary Association•9350 De Soto Ave,P.O.Box 2402•Chatsworth,CA 91313-2402•www.nationalnotary.org Prod.No.5907 Reorder Call Toll-Free 1-800-876r8827 r CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Orange ss. on November 4,2004 , before me, Susan Pugh, Notary Public , Date Name and Title of 011icar(e.g..-Jane Doe,Notary Public') personally appeared Kathleen E. Maas Name(e)of Signer(-) personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person whose nameW isiW w ... SUSAN PUGH subscribed to the within instrument and COMM.0 1407795 acknowledged to me that):(Oshe4Wexecuted NOTARYPueUc•cAUFoRM► the same In XV/herAW authorized J ORANGE COUNTY ? Comm.Exp.MARCH 28,2007 capacityWsif, and that by W/her/W& signature(Oon the instrument the person;or the entity upon behalf of which the person(, acted, executed the instrument. WITNESS my hand and officialif 4 seal Plere Notary Seal Above Susan Pugh s'g"aaue'Notary Pub6`�,/ 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: November 4,2004 Number of Pages: t Signer(s)Other Than Named Above: None----------------------------------------------- Capacity(tes)Claimed by Signer Signer's Name: Kathleen E. Maas ❑ Individual Top of thuft here ❑ Corporate Officer—Title(s): ❑ Partner--❑Limited CI General ff Attorney In Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: St. Paul Guardian Insurance Company 0 199r National Notary Aaaocletbn-9=De Soto Ave.,P.O.Box 24M•Chatsworth,CA 91313.2402 Prod.No.6907 Reorder.Call Totl-Free 11-60a4764M TheStftl POWER OF ATTORNEY Seaboard Surety Company United States Fidelity and Guaranty Company St.Paul Fire and Marine Insurance Company Fidelity and Guaranty Insurance Company St.Paul Guardian Insurance Company Fidelity and Guaranty Insurance Underwriters,Inc. St.Paul Mercury Insurance Company 20675 Power of Attorney No. Certificate No. 2102917 KNOW ALL MEN BY THESE PRESENTS:That Seaboard Surety Company is a corporation duly organized under the laws of the State of New York,and that St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company and St.Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota,and that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland,and that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters,Inc.is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the "Companies"), and that the Companies do hereby make,constitute and appoint H.J.Dueck,Dwight Reilly,Christopher S.Hopper,Claudette N.Martin and Kathleen E.Maas Upland California of the City of ,State ,their true and lawful Attorneys)-in-Fact, each in their separate capacity if more than one is named above,to sign its name as surety to,and to execute,seal and acknowledge any and all bonds,undertakings, contracts and other written instruments in the nature thereof on behalf of the Companies in-their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakingsti_required prpermitted-iri`•,any actions or proceedings allowed by law. � a 19'� February 2003 IN WITNESS WHEREOF,the Companies have caused this instrumehtbtb be signed and sealed-,this_ day of e Seaboard Surety Company ` t s United States Fidelity and Guaranty Company St.Paul Fire and Marinejnsu�ance Company �,. Fidelity and Guaranty Insurance Company ' " Fidelity and Guaranty Insurance Underwriters,Inc. St.Paul Guardian Insurance Company r, y y �- � . St.Paul Mercury Insurance-Company, anr7� FIFE 6 �N MgG P M4uq k' Sy•t/(� y yam. * ' 'Ze �.LOPPOR,,ifn Q`�ppPON�tF'`ni ��W ` 92 1�896 197] g PETER W.CARMAN,Vice President r SfiAL%i' N br QFNE'H N JV<n NCE c� CIS.'AN y+J fg '?a �faYt AW State of Maryland City of Baltimore THOMAS E.HUIBREGTSE,Assistant Secretary On this 19 day of February 2003 before me, the undersigned officer, personally appeared Peter W. Carman and Thomas E.Huibregtse,who acknowledged themselves to be the Vice President and Assistant Secretary,respectively,of Seaboard Surety Company,St. Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,United States Fidelity and Guaranty Company,Fidelity and Guaranty Insurance Company,and Fidelity and Guaranty Insurance Underwriters,Inc.;and that the seats affixed to the foregoing instrument are the corporate seals of said Companies;and that they,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing the names of the corporations by themselves as duly authorized officers. Zp,EA NprgR yo In Witness Whereof,I hereunto set my hand and official seal. p Y ? �BUc S My Commission expires the 1st day of July,2006. O9ECM�O REBECCA EASLEY-ONOKALA,Notary Public 86203 Rev.7-2002 Printed in U.S.A. This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Seaboard Surety Company,St.Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company,St. Paul Mercury Insurance Company, United States Fidelity and Guaranty Company, Fidelity and Guaranty Insurance Company,and Fidelity and Guaranty Insurance Underwriters,Inc.on September 2, 1998,which resolutions are now in full force and effect,reading as follows: RESOLVED,that in connection with the fidelity and surety insurance business of the Company,all bonds,undertakings,contracts and other instruments relating to said business may be signed,executed,and acknowledged by persons or entities appointed as Attorney(s)-in-Fact pursuant to a Power of Attorney issued in accordance with these resolutions. Said Power(s)of Attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman,or the President,or any Vice President,or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved,printed or lithographed. The signature of each of the foregoing officers and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Attomey(s)-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and subject to any limitations set forth therein,any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company,and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is validly attached;and RESOLVED FURTHER,that Attomey(s)-in-Fact shall have the power and authority,and, in any case,subject to the terms and limitations of the Power of Attorney issued them,to execute and deliver on behalf of the Company and to attach the seal of the Company to any and all bonds and undertakings,and other writings obligatory in the nature thereof,and any such instrument executed by such Attorney(s)-in-Fact shall be as binding upon the Company as if signed by an Executive Officer and sealed and attested to by the Secretary of the Company. I,Thomas E.Huibregtse,Assistant Secretary of Seaboard Surety Company,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company, St.Paul Mercury Insurance Company,United States Fidelity and Guaranty Company,Fidelity and Guaranty Insurance Company,and Fidelity and Guaranty Insurance Underwriters,Inc.do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I hereunto set my hand this 4th day of NOV�•yEMBER 2004 $URE7� 'F\RE G` O\'M�N`rG•D JP �MSUggy � _yam .I . 1927 m �SZ�aP01,�F'm Qi�p0.1OC,l�;^ �—�•`wY �py�,,.� n896.,p< �•,y9n,$� �9�� AwS� `'� 'k P Thomas E.Huibregtse,Assistant Secretary To verify the authenticity of this Power of Attorney,call 1-800- = 880 an i ask for the Paver of Altoratey clerk. Please refer to the Power of Attorney number, 4. the above-named individuals and the details of the bond to which the power`is attached." s w .1 le,, SECTION C PROPOSAL for the construction of L GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 G1 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 1 0% bid botlidthe amount of$ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature G2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: $ 654 ,432 .85 TOTAL AMOUNT LUMP SUM BID IN WORDS: SIX HUNDRED FIFTY FOUR THOUSAND FOUR HUNDRED THIRTY TWO DOLLARS AND EIGHTY FIVE CENTS C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 GOTHARD STREET (CC-1 154) PROJECT BID SCHEDULE ""�,�U,N,IT'�PRICE��-,�'�'EXT NDEq- ITEK D, E OUNT,-'• 'AM QUANT(T- 1 Mobilization $ luuuu .uu L.S. @ ten thousand Dollars no Cents 2 1 Traffic Control Plan $ 1 U UUL) - $ luouu .UO L.S. @ ten thousand Dollars no Cents 3 1 Furnish Project Traffic Control $ 16500 . $ 16500 .00 L.S. @ sixteen thousand five Dollars hundred doilars and no Cents 4 188,917 Cold Milling & Header Cutting $ . 185 $ 34949 . 65 S.F. @ eighteen and a half centl§611ars Cents 5 471 Unclassified Excavation $- .25 C.Y. @ twenty six Dollars �b seventy five Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, $44 . 50 $ 450 , 9 3 .00 Ton Full Depth etc.) @ forty four Dollars I I I Ly Cents 7 2,347 Pavement Reinforcement Fabric & Route and $2 .85 $)688 .95- S.Y. Seal of Cracks @ two Dollars eighty five Cents 8 46 Adjust Sewer/Storm Drain Manhole to Grade $210 .00 $ 9660 . 0-0 Each @ two hundred ten Dollars no Cents 9 91 Adjust Water Valve to Grade $26J .U0 $ 2 3,9 3 37.00 Each @ two hundred sixty three Dollars no Cents 10 1 Traffic Striping .$4! ► 500 ., $ 41 , 500. 00 L.S. @ forty one thousand five Dollars hundred doilars and no Cents 11 80 Traffic Loop $ 19U .UU $ 15, 200 . 0 Each @ one hundred ninty Dollars Ilu Cents 12 8 Remove & Reconstruct Access Ramp $16 U 0 .0 0' $ 14400 .-UD Each @ eighteen hundred Dollars no Cents 13 3 Adjust Survey Monument Well to Grade $2 6 3 .0 U $ /69 .UU Each @ two hundred sixty three Dollars no Cents 14 25 Survey Monumentation $290 .OU— $ Each @ two hundred ninety Dollars I no Cents Sub Total Bid Amount, Bid in Figures: $ 654 , 432 .85 Sub Total Bid Amount, Bid in Words: SIX HUNDRED FIFTY FOUR THOUSAND FOUR HUNDRED THIRTY TWO DOLLARS AND EIGHTY FIVE CENTS C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion 1Vame and Address..of Subcontractor State:License Class` of Work Number: 10 g080P.O. BOX 16118 LONG BEACH, CA. 823802 C32 CASE LAND SURVEYING 1010 N. BATAVI 14 STREET, STE. D, ORANGE, CA. 92867 L 5411 RAMIEREZ CONSTRUCTION, INC. 656 E. 8 , 9 , 13 SAN BERNARDINO RD. COVINA, CA. 91723 683241 c6l /d64 4 PAVEMENT RECYCLING SYSTEMS, INC. 121 N. MAIN ST. RIVERSIDE, CA. 92502 569352 A 11 '=TRAFFIC LOOPS CRACKFILLING, INC. 946 S. EMERALD ST. ANAHEIM, C42804 652956 C-10 C-3 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. c-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange STEVE KIRSCHNER , being first duly sworn, deposes and says that he or she is VICE PRESIDENT of HARDY & HARPER, 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. HARDY & HARPER, INC. Name of Bidder Oignature oKBIiTder STEVE KIRSCHNER - VICE PRESIDENT 1312 E. WARNER AVE. SANTA ANA, CA.92705 Address of Bidder Subscribed and sworn to before me this 16 day of November , 2004 T KRISTEN S. PAULINO i a COMM. #1413262 ::Z- g �® •^ NOIARY PUBLIC-CALIFORNIA ORANGE COUNTY N 9I " My Comm.Exp.May 20,2007 IL NOTARY PUBLIC r NOTARY SEAL Kristen S . Paulino Notary- Public C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the IMPROVEMENTS, (1)(we)(1t) 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. HARDY & HARPER, INC. *ContraVE KIRSCHNER VICE PRESIDENT Title Date: 11 /16/04 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under.penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who-has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes El 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. HARDY & HARPER, INC. Contractor *YSTEVEOSCHNER VICE PRESIDENT Title Date: 11 /16/04 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: HARDY & HARPER, INC. Contractor ii�STEVE K SCHNER VICE PRESIDENT Title Date: 1 1 /1 6/04 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: HARDY & HARPER, INC. Bidder Name . 1312 E. WARNER AVE. Business Address SANTA ANA, CA. 92705 City, State Zip 714 ) 444-1851 Telephone Number 215952 CLASS A HIC C-8 C-12 State Contractor's License No. and Class 03/13/63 Original Date Issued 12/31 /05 Expiration Date The work site was inspected by STEVE KIRSCHNE$four office on 11 /08/04 , 200_. The following are persons, firms, and corporations having a principal interest in this proposal: HARDY & HARPER, INC. FRED T. MAAS, JR. PRESIDENT/TREASUER SIEVE KlRbUHNER VICE R DENT KRISTEN S. PAULINO CORPORATE SECRETARY C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. HARDY & HARPER, INC. Nme id STEVE KIRSCHNER Printed or Typed Signature ,�— KRISTEN S. PAULINO iE Subscribed and sworn to.before me this 16 day o v tuber , 200 4 Q� COMM. #1 :132 2 �® NOTNRr PUBLIC 0 ORANGE COUNTY 9 My Comm:Exp.May 20,2007 I� NOTARY PUBLIC Kristen S . Paulino Notary Public NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: l CITY OF RANCHO PALOS VERDES 30940 HAWTHORNE BLVD. RANCHO PALOS VERE Name and Address of Public Agency Name and Telephone No. of Project Manager: BINDU RASH (310 )5 4 4-5 2 5 4 (ASPHALT) 561 , 008 .02 CREST ROAD STREET IMPROVEMENTS 08/04 Contract Amount Type of Work Date Completed 2. CITY OF NORCO P.O. BOX 428 NORCO, CA. 92860 Name and Address of Public Agency Name and Telephone No. of Project Manager: DOUGLAS NORFOLK ( 9 0 9 )7 3 5-3 9 0 0 400 ,430 .00 PAVEMENT REHABILITATION SEPTEMBER 2004 Contract Amount Type of Work Date Completed 3. COUNTY OF ORANGE 1750 DOUGLASS RD. ORANGE, CA. 92806 Name and Address of Public Agency Name and Telephone No. of Project Manager: HOLLY FELIPES (71 4 ) 567-6253 404 , 575 . 07 ASPHALT RESURFACING OF VARIOUS STREETS AUGUST 2004 Contract Amount Type of Work Date Completed C-10 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: HARDY & HARPER, _ INC.. Phone:. (71 4 )4 4 4-1 8 51 Fax:Address: 1312 E. WARNER AVE. (714 )444-2801 SANTA ANA, CA. 92705 STEVE KIRSCHNER 58 YEARS .Contact Person: No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? ASPHALT PAVING What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million §3 More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 TO:917144442801 P:1'2 NOV-16-2004 11:31 FROM:PCI 5622188021 Nov-16-04 11 :20A HARPY & HARPER, INC. 7144442801 R..02 CITY OF UUNTINGTON BEACH BIDDERS LIST All Biddersiproposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bj d, quote,or were contracted by the proposed prime. This information is also required from the p,reposed prune contractor, and must be submitted with their bid/proposal. The City of Huntington.beach will use this information to maintain and update a"Biddcr's"list to assist in the annual DBE coal scttin process. Finn Name: � - -— - C Address: d k 4 Fax .Contact person: ��M No. of yaws in business �_ Is the firm,currently certified as DBE under 40 CFR part 26? YES Type of worklservices/materials provided by =irm? 1 1f �.J ✓1 �1 d What w�your firm's Gross Annual receipt's for last a Less than $1 Million 6�Less than$5 Million o Less than$14 Million L) Less than$15 Million o More than$15 Million This form can be duplicated if necessary to r°port all bidders(DBEs and aon DBEs) information.' C-11 11- 4-04,10:42AM:Sens ASOnelt ;7:45401709 9 3/ 3 i 1. CITY OF HUNTINGTON BEACH BIDDERS LIST r All Bidders/proposers are required toprovidedthe following information for all DBE and non- DBE contractors,who provide.a proposal,bid,quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor,and must be submitted with their bid/proposal.The City of Huntington Beach wW use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. f Firm Name: (�ASE L-A�D ctRv`=A4L.-A4 1AJC- 'Phone: (71,4) Address: 10(o N. 3 ,A u I n 5r Fax:f-714) QkA j Cq e- C rt -7 Contact Person: L,d k'e' C-A s6 No. of years.in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NOJ Type of woridservices/materials provided by firm? i Rv�a� �� ,���Rv,c--O—R What was your frm's Gross Annual receipt's for last ear? ❑ Less than$1 Million Q,d—Less than$5 Million o Less than$10 Million u Less than$15 Million ! ❑ More than$13 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs)information. C-11 f z •d sose-eas-AIL OUIJ �!1?If1S tItJd� 3SUO ey�:BO fro 9T not Nov 16 04 10: 45a p. 1 e CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors,who provide.a proposal, bid,quote,or were contracted by the proposed prime. This information is also required from the proposed prime contractor,and must be submitted with their bid/proposal.The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name:. Address: Lal...,(".o `7� L' t ax: �� c:7+ tic:bt {�l C_4Q tNF) QP 1 1u23 .Contact Person: ACV 109\. .U-4 No. of years.in business 1 Is the firm currently certified as DBE under 49 CFR Part 26 YES NO Type of work/services/materials provided by.firm? V►<TeL-? I What was your fi m's Gross Annual receipt's for last ? o Less than$1 Million' "1. Less than$5 Million ❑ Less than$10 Million a Less than$15 Million o More than$1 5 Million ' This form can be duplicated if necessary to report all bidders(DBEs and non DBEs)information. � i C-1 I ` 289 P01 NOV 16 104 01:05 ' I CITY OF HL,,NTINGTON BEACH BXDERS LIST All Bidders/proposers are required to proviZI the following information for all DDE and non- DHE contractorg, who provide a proposal, quote, or were contracted by the proposed prime. This itiformatioft is also required from the pro�osed prime contractor, and must:be submitted with their bid;proposal. The City of Huutington Be. h will use this information to r.► .aittain and update a"Bidder's"list to assist in the annual DEE jo l setting process. I ' i Firm Name:_..'1_,A1g ELje I X PS (�iJ�1��.K��G IV Address:. iz �t Fax: .Contact Person .IV A)CrU 1� No. of years in business . Is the firm cux'rindy certified as DSE under 49 CFR Part 26?' YES 1'?O Type of of work'srviccsimaterials provided by rmUsif}C(�O P _ !k....� 1kbat was yotwfirm s Gross .Annual receipt's for las�year. Less than$1 Millio { Less than$5 Millio v Less than$10 Million o Lass than$15 Million :�i More than $15 Million This form cag bd duplicated if necessary-to 'report all bidders(DBEs and nett DBEs) ;bitotrnatiori. { 1 11/16/2004 12:16 FAX 909 6821094 PAVEMENT RECYCLING Q 001/001 NOV-16-04 01 :OOP HARDY & HARPER, XNC. 7144442801 P_02 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non-. DBE contractors, who provide a proposal,bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal- The City of Huntington Beach will use this information to maintain and update, a"Bidder's"'list to assist in the annual DBE goal setting process. Firm Name Pbonels"�— t Z ^ ko 'IM Address Fax; �) � ��Z� � O .Contact Person: }--"ot�S No_ of years in business Is the firm currently certified as DBE under 49 CFR Part 26? 'YES Type of work/services/materials provided by firm? w1 What was your firm's Gross Annual recei is for last earl o Less than$1 Million ' ❑ Less than$5 Million ❑ Less than$1 Q Million Y-Uss than$15 Million a More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information . C-11 Local ASSISIaIICC rrV1ZCuui ca ATAauuai yd%A "A.L IA-P, PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORMHATAND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder HARDY & HARPER, INC. ,proposed subcontractor ,hereby certifies that he hasX , 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. 12-"9 C-12 Page 12-45 Local Assistance Procedures Manual EXIIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. •nrn 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract Fal a. bidiofferiapplicabon a 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 date of last re ear quarter I. loan insurance po 4. Name and Adress of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee.Enter Prime Subawardee Name and Address of Prime: Tier ,if known Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: N/A CFDA Number, if applicable 8. Federal Action Number, ifknown: 9. Award Amount, if known: N/A $ 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (d individual,last name,first name,MI): different from No. 10a) NONE (last name,first name,MI): NONE (attach Continuation Sheet(s)if necessary) 11. Amount CUP (check all that apply): 13. Type of Payment(check all that apply) $ actual planned a. retainer 12. Form of Payment(check all that apply): b. one-time fee a. cash c. commission H b. in-kind;specify: nature d. contingent fee p e. deferred value f. other,specify: NONE 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: HARDY & HARPER HAS NOT PAID ANY FUNDS TO ANYONE REGARDING THIS PROJECT. (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s)attached: Yes 11 No 16- Information requested through this form is authorized by Tide 31 U.S.C.Section Signature: 1352.This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the fier above when this transaction was Print Name: TE VE KZSCHNER made or entered Into.This disclosure is required pursuant to 31 U.S.C.1352. This information will be reported to the Congress semi-annually and will be Title: VICE PRESIDENT available for public inspection. Any person who fails to file the required disclosure 714 4 4 4—1 8 6.4e: 1 1 /1 6/0 4 shall be subject to a civil penalty of not less than$10,000 and not more than Telephone No.: $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction FormStandard LLL - Standard Form LU Rev.01-03-95 C-13 Page 12-55 February 1, 1998 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. ,The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of. Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence„the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address,city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number.for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal (RFP)number,Invitation for Bid(IFB)number;grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXHMIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and,telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. C-15 Page 12-55 1bU{SV�ty St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Fidelity and Guaranty Insurance Company St.Paul Mercury Insurance Company Fidelity and'Guaranty Insurancepnderwriters,Inc. Seaboard Surety Company St.Paul Medical Liability lasurance Company Bond No. RIDER CONTAINING DISCLOSURE NOTICE OF TERRORISM COVERAGE This disclosure ngtice is required by the Terrorism Risk Insurance Act of 2002. No action is required on your part. This Disclosure Notice is incorporated in'and a part of 'the attached bond. You should know that, effective November 26, 2002, any losses caused by certified acts of terrorism would be partially reimbursed by the United States under a formula established by the Terrorism Risk Insurance Act of 2002. Under this formula, the United States reimburses 90% of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. There, is a cap on our liability to pay for such losses if the aggregate amount of insured losses under the Act exceeds.$100,000,000,000 during the applicable period for all insured and all insurers combined. In that case, we will not be liable for the payment of any amount which exceeds that aggregate amount of$100,000,000,000. The portion of your premium that is attributable to coverage for acts of terrorism is 0.00. IMPORTANT NOTE: THE COST OF TERRORISM COVERAGE IS SUBJECT TO CHANGE ON ANY BOND THAT PREMIUM IS CHARGED ANNUALLY. SIGNED AND SEALED this Ott► day of NOVEMBER , 2004. ST. .PAUL GUARDIAN SEAL SURETY: INSURANCE COMPANY I Signature: J��//�,i� - 'Attorney-in-Fact KATHLEEN E. MAAS s NOV 03 2004 9: 13AM (562) 439-1398 P. 5 Hardy and Harper,Inc.'s Compliance Log 11/2104 4:49 Ph9 Step 9 of 9: Priru'Phis Page 13R=WJJ VIl aj Of3t Important: Record Solicitation Phone Calls Below DVBE Good-Faith Effort requires a minimum of 2 solicitation phone calls be made by Hardy and Harper,Inc..The results of the phone calls must be recorded below.All other Good Faith Efforts for DBE,WBE,MBE,etc.require calling all firms listed below. Affidavit of Fax Solicitation The undersigned employee of Compliance News Publishing,located in the City of Long Beach,County of Los Angeles,and the State of California,declares that bid solicitation letters have been faxed to the following 17 firms listed below on Tue Nov 02 16:56:04 PST 20041 am over the age of 18 years and a citizen of the United States.I am not a party to and have no interest in this matter.I declare under penalty of perjury that the foregoing is true and correct.Executed at Long Beach, Califomia Henry Sprague III Hardy and Harper,Inc. LOG Good-Faith Effort for Bid Solicitation:STPh-5181 (141)Gothard St.Rehabilitation-CC-1154,from Ellis Ave to Heil Ave. The following firms were located using one of the following databases: CAMS,Caltrans,or Pronet AGENCY CONTACT:Many California Good-Faith Efforts may require the bidding contractor to CALL the agency or caner and talk with their Good-Faith representative.SEE YOUR CONTRACT DOCUMENTS FOR THIS TELEPHONE O.Call it and record the result below. Hardy and Harper,Inc,contacted the agmcv 'ssuing this contract at tel number at(time) ` _ on(date) and discussed Good-Faith Effort with(Agency Contact) emarks:(left message,etc.) _ Phone call was made b Prime Re Vs Si 'aturc) OTHER CONTACTS n 11/02/2004,Hardy and Harper,Inc.contacted: 1.Federal Agency ProNet at http://pro-net.sba.gov/11/02/2004 at 4:51:04 Plvl PST. State Agency OSBCR at www.osmb.dgs.ca.gov/bisLquerie&fbi.s_(iucrics_menu.asp at 11/02/2004 at 4:46:04 PM PST. 3.Local referral organization:Advanced On ine DV13E Resource Center(www.dvbe.net)at 11/02/2004 at 4:41:04 PM PST, FIRMS CONTACTED: The following 17 DBE subcontractors were recommended. Company Name:PRE-CON PRODUCTS LTD. P.O.BOX 2109240 W.LOS ANGELES AVE. SIMI VALLEY,CA 93062 Telephone#:(805)527-0841 Fax#:(805)584.0769 Date Solicitation Letter Faxed:1 1102/2 0 04 at 4:41.04 PM PST Work Categories: MISC SUPPLIERS,CONCRETE&CEMENT,MINOR CONCRETE STRUCTURE,ERECT PRECAST CONCRETE,CONCRETE BLOCK MASONRY RETAINING WALL,REINFORCED CONCRETE CRIB WALL,SOUND WALL(MASONRY BLOCK-CONCRETE), REINFORCED CONCRETE PIPE,JACKED REINFORCED CONCRETE PIPE,NON-REINFORCED CONCRETE PIPE,PLASTIC PIPE, REINFORCED CONCRETE SEWER PIPE,SEWER MANHOLE,CEMENT,HYDRAULIC,CONCRETE,GYPSUM,&PLASTER PRODUCTS,MISC DURABLE GOODS hone SoGeitatio Information: *Date/s-Time/s Solicited by Phone 11 leJ Dq L/NI 21�( Person Contacted and Commments for olicitatiori-ISTPh-5181(141)Gothard St.Rehabilitation-CC- 1154,from Ellis Ave to Heil Ave- Company Name:COAST SURVEYING,.INC 15031 PARKWAY LOOP, SUITE B USTIN,CA 92780 Telephone#:(714)918-6266 Fax#:(714)919.6277 Date Solicitation Letter Faxed: 11/02/2004 at 4:41:04 PM PST Work Categories: CONSTRUCTION STAKING,CONSULTANT,RIGHT OF WAY ENGINEER;SURVEYOR,DRAFTING,LAND SURVEYING '1 Phone So citation Information: *Date/s-Tim J I ille/s Solicited by Phone 04 b NA I:V-;,j Q Person Contacted and Com mnents for Solicitation:STPh-5181 (141)Gorhard St.Rehabilitation-CC-1154,from Ellis Ave o Heil Ave.. htip://www.compliancenews.com/SuperCommand.de?sabmit=Click+Here+to+Buitd—you:—I.og--ar.d+Sand+Faxes&token=4Qecaefd932463122112e13393d59cd Page I of S NOV 03 2004 9: 13AM I562I439-1398 P. 6 Hardy and Harper,rnc.'s Compliant Log 1112104 4:49 PM Company Name:T S C M CORPORATION . 18281 GOTHARD ST.,STE. 109 HUNTINGTON BEACH,CA 92648 Telephone#:(714)941-1988 Fax#:(714)841-3222 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST ork Categories: PAINTED TRAFFIC STRIPE&MARKING,SERVICES TO BUILDINGS,BUILDENG MAINTENANCE SERVICES P one Solicitation Information: Date/s-Time/s Solicited by Phone i D W- _rt1lAJ"Ile_, Person Contacted and Commments for 5 licitahon:STPh-5181(141)Gothard St.Rehabilitation-CC-1154,from Ellis Ave to Heil Ave.. 6 Company Name:BALI CONSTRUCTION,INC. $52 JOE VARGAS WAY EL MONTE,CA 91733 Telephone#:(626)442-8003 Fax#:(626)442-8315 Date Solicitation Letter Faxed:11/0212004 a:4:41.04 PM PST Work Categories: ASBESTOS-CEMENT PIPE,REINFORCED CONCRETE PIPE,JACKED REINFORCED CONCRETE PIPE,NON-REINFORCED CONCRETE PIPE,DOWNDRAIN,PLASTIC PIPE,CORRUGATED STEEL PIPE INLET&RISER,CORRUGATED STEEL PIPE ENERGY ISSIPATOR,WELDED STEEL PIPE,JACKED WELDED STEEL PIPE;DEBRIS RACK-DRAINAGE GATE,REINFORCED CONCRETE EWER PIPE,CLAY SEWER PIPE,ASBESTOS-CEMENT SEWER PIPE,CAST IRON SEWER PIPE,SEWER MANHOLE,JUNCTION CHAMBER,WATER METER&TEMP FACILITIES,SEWER CONNECTION Phone Solicitation Information: *Date/s-Time/sSolicited by Phone W VD A'�Vl Person Contacted and Commments for Solicitation:STPh-5 81(141')Gothard St.Rehabilitation-CC-1154,from Ellis Ave to Heil Ave,. Company Name:RADICH CONSTRUCTION,INC. 680 EAST LOS ANGELES AVE.SUITE 0 IMI VALLEY,CA 93063 Telephone k:(805)584-9697 Fax#:(805)582-1226 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST ork Categories: ONCRETE&CEMENT,STRUCTURE BACKFILL,DITCHES EXCAV, TION,EROSION CONTROL,CONCRETE STRUCTURE, MINOR CONCRETE STRUCTURE,PIPE LINING(CEMENT MORTAR),ALTERNATIVE PIPE CULVERT,ASBESTOS-CEMENT PIPE, CORRUGATED METAL PIPE(CSP),STRUCTURAL STEEL PLATE PIPE,AR CB&PIPE ARCH,SUBSURFACE DRAJN,EDGE RAIN,DOWNDRAIN,PLASTIC PIPE,CORRUGATED STEEL PIPE INLET&RISER,WELDED STEEL PIPE,REINFORCED CONCRETE SEWER PIPE,CLAY SEWER PIPF,ASBESTOS-CEMENT SEWER PIPE,SEWER MANHOLE Phone Solicitation Inform tion: 'L:P5tP_"Date/s Time/s Solicited by Phone t1i1yj0� P 1 C- (e_- t Person Contacted and Commments for Solicitation:STPh-5181 (141)Gothard St.Rehabilitation-CC-1154,from Ellis Ave o Heil Ave.. N� XCC\ Company Name:TRAFFIC LOOP CRACKFILLING INC 6 S.EMERALD STREET NAHEIM,CA 92804 Telephone#:(714)520-4026 Fax#:(714)520-4027 Date Solicitation Letter Faxed: 11/02/2004 at 4:41:04 PM PST Work Categories: PAVING ASPHALT(ASPHALT CONCRETE),PAVEMENT REINFORCING FABRIC,PLACE ASPHALT CONCRETE DIKE&MISC, LIGHTING,MESSAGE SIGNS,LIGHTING&SIGN ILLUMINATION,D_ BCTOR,TRAFFIC COUNT STATION Phone Solicitation Information: *Date/s-Time/s Solicited by Phone 111t6104, T�01 pjM Person Contacted and Comtrtments for elicitation:STPh-5181(141)Gothard St.Rehabilitation-CC-1154,from Ellis Ave o Heil Ave.. ��� ✓ r�I Company Name:GOLDEN SUN CONSTRUCTION,INC KING EIDER LANE LISO VIEJO,CA 92656 Telephone 4:(949)380-9797 Fax#:(949)830-4390 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST Work Categories: GUARD RAILINGS&BARRIERS,CAST-IN-DRILLED-HOLE CONCRE-IE PILING,PRESTRESSING CONCRETE CAST-IN-PLACE, CONCRETE STRUCTURE,MINOR CONCRETE STRUCTURE,CONCRETE SURFACE FINISH,CONCRETE OVERLAY-DRILL& BOND,ERECT PRECAST CONCRETE,CONCRETE BLOCK&MASONRY RETAINING WALL,REINFORCED CONCRETE CRIB ALL,SOUND WALL(MASONRY BLOCK-CONCRETE),JOINT SEAL-WATER STOP,ALTERNATIVE PIPE CULVERT,CAST-IN- LACE CONCRETE PIPE,REINFORCED CONCRETE SEWER PIPE,CLAY SEWER PIPE,CAST IRON SEWER PIPE,SEWER http://www.comptioncenews.com/SuperCommand.do'!submtt=Click+Here+to+Build--,our=Log+and=3-nd—Faxes&token-40eciefd932463122117cf3393d39cd Page 2 of 5 NOV 03 2004 9: 13f1t9 (562) 439-1398 p. 7 Hardy and Harper,Inc.'s Compliance Log I It2/04 4:49 PM MANHOLE,JUNCTION CHAMBER P one Solicitation Informaj{op Dates-Time./s Solicited by Phone �' CJ1� Z:W 12 1�1 &I Person Contacted and Commments for Solicitation:STPh-5181.(14, 1)C� 7othard St.Rehabilitation-CC- 1154,from Ellis Ave o Heil Ave.. 06-4 cvtv uu Company Name:LLAMAS PLASTIC INC 12970 BRADLEY AVENUE YLMAR,CA 91342 Telephone#:(818)362-0371 Fax#:(818)-162-9780 Date Solicitation Letter Faxed:1 V0212004 at 4:41:04 PM PST Work Categories: 14ERMOPLASTIC TRAFFIC STRIPE&MARKING,GLASS INSTALLATION,MISC PLASTICS PRODUCTS,NEC,AIRCRAFT& ARTS,MISC TRANSPORTATION EQUIPMENT Phone Solicitation Information:. Date/s-Time/s Solicited by Phone Person Contacted and Commments for Solicitation:STPh-5181(141)Gothard St.Rehabilitation-CC-1154,from Ellis Ave o Heil Ave.. Cl X2 6-� vv�� j CL Company Name:ANTHONY MARMOLEJO CONSTRUCTION COMPA'NTY,INC. 52 E.RAMSEY STREET,SUITE B BANNING,CA 92220 Telephone#:O 922-3996 Fax#:(909)922-3997 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST Work Categories: CONSTRUCTION AREA SIGNS,TRAFFIC CONTROL SYSTEM,CLEARING&GRUHHING,ROADWAY EXCAVATION,STRUCTURE XCAVATION,STRUCTURE BACKFILL,DITCHES EXCAVATION,IMPORTED BORROW,CAST-IN-DRILLED-HOLE CONCRETE PILING,CONCRETE STRUCTURE,FURNISH PRECAST CONCRETE DECK I`NIT,ERECT PRECAST CONCRETE,CONCRETE BLOCK&MASONRY RETAINING WALL,REINFORCED CONCRETE CRIB Nb:ALL,SOUND WALL(MASONRY BLOCK- ONCRETE),REINFORCING STEEL,REINFORCED CONCRETE SEWER PIPE,CAST IRON SEWER PIPE,SEWER MANHOLE, CONCRETED-ROCK SLOPE PROTECTION,MISC BRIDGE METAL PUMPING PLANT METAL,FENCING,CONCRETE BARRIER, BUILDING CONSTRUCTION,SMALL STRUCTURES,CONSTRUCTION CLEAN UP,SANDBLASTING,DEMOLITION Phone Solicitation Information: *Date/s-Time/s Solicited by Phone �1���j�04 a 7 \� Person Contacted and Commiments for olicitation:S h-5181(141) thard St.Rehabilitation-CC-1154,from Ellis Ave o Heil Ave.. -V Company Name:D&N CONSTRUCTION,INC. 74 DOUGLAS AVENUE OXNARD,CA 93030 Telephone#:(805)445-4459 Fax#:(805)445-4458 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST Work Categories: ITCHES EXCAVATION,IRRIGATION SYSTEM,ALTERNATIVE PIPE CULVERT,PLASTIC PIPE,CORRUGATED STEEL PIPE INLET&RISER,DEBRIS RACK-DRAINAGE GATE,CLAY SEWER PIPE,SERVER MANHOLE,SEWER CONNECTION,PIPELINES, EXCEPT NATURAL GAS,WATER SUPPLY,SEWERAGE SYSTEMS,IRRIGATION SYSTEMS Phone Solicitation Information: *Datels-Time/s Solicited by Phone I� 2104 2A k2 AAWO Person Contacted and Commments for oli itation:STPh-5181 (141)Gothard St.Rehabilitation-CC-1154,from Ellis Ave o Heil Ave.. �k0 1 4 Company Name:METROPOLITAN CONSTRUCTION P.O.BOX 477 ONITA,CA 91908 Telephone#:(619)475-5651 Fax#:(619)475-1607 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST Work Categories: OADWAY EXCAVATION,GRADING,STRUCTURE EXCAVATION.STRUC"CURE BACKFILL,DITCHES EXCAVATION,MINOR ONCRETE STRUCTURE,ALTERNATIVE PIPE CULVERT,REINFORCED CONCRETE PIPE,NON-REINFORCED CONCRETE PIPE, ORRUGATED METAL PIPE(CSP),SUBSURFACE DRAIN,PLASTIC PI?E,CORRUGATED STEEL PIPE INLET&RISER, 'OP RUGATED STEEL PIPE ENERGY DISSIPATOR,WELDED STEEL PIPE.,DEBRIS RACK-DRAINAGE GATE,REINFORCED ONCRETE SEWER PIPE,CLAY SEWER PIPE,CAST IRON SEWER PIPE,SEWER MANHOLE,JUNCTION CHAMBER,SEWER ONNECTION,PIPELINES,EXCEPT NATURAL GAS,WATER SUPPLY;SEWERAGE SYSTEMS Phone Sol tation formation: *Date/s-Time/s Solicited by Phone 1 Qr Z ri-I etson Contacted and Commments for olicita ion:STP -5181 (141)&othard St.Rehabilitation-CC-1154,from Ellis Ave Heil Ave.. http://www.complianccncws.corrV uperCommand.do?sub =Click+Here+to+Build your—Log+and+Send+Foxes&token-40ecaefd932463122117ef3393d59cd Page 3 of 5 NOV 03 2004 9: 14AM (562) 439-1398 P. 8 Hardy and Harper,Inc.'s Compliance Log 1112/04 4:49 PM Company Name:PREMIER WEST CONTRACTORS,INC. 40 W.GROVE AVENUE RANGE,CA 92865 Telephone 4:(714)279-0903 Fax#:(714)279-0865 Date Solicitation Letter Fazed: 11/02/2004 at 4:41:04 PM PST Work Categories: GRADING,STRUCTURE EXCAVATION,SEAL COAT,ASPHALT CONCRETE,PAVING ASPHALT(ASPHALT CONCRETE), FENCING,ELECTRICAL,WALL COVERING,MASONRY Phone Solicitation Information: *Date/s-Timels Solicited by Phone ;'t V. iCjO1M k l aylc\l Person Contacted and Commments fo Sol citation:STPh-5 8�)Gothard St.Re bilitation-CC-1154,from Ellis Ave o Heil Ave.. � U �1C� Company Name:STANDARD ENGINEERING 73 BREA HILLS AVENUE BREA,CA 92823 Telephone#:(714)57870127 Fax#:(714)578-0123 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST Work Categories: ASPHALT,CONCRETE&CEMENT,REINFORCING BAR SECTION,DOORS&FRAMES,FENCING,ELECTRICAL&SIGNALS, CONSTRUCTION AREA SIGNS,TRAFFIC CONTROL SYSTEM,RESET.ADJUST ROADWAY ITEMS,PLANE ASPHALT CONCRETE, ROADWAY EXCAVATION,GRADING,STRUCTURE EXCAVATION,STRUCTURE BACKFILL,EMBANKMENT CONSTRUCTION, IMPORTED BORROW,AGGREGATE SUBBASE,AGGREGATE BASE,ASPHALT CONCRETE,PAVING ASPHALT(ASPHALT ONCRETE),PLACE ASPHALT CONCRETE DIKE&MISC,PORTLAND CENIENT&CONCRETE PAVEMENT,GROOVE&GRIND PAVEMENT,CONCRETE STRUCTURE,MINOR CONCRETE STRUCTURE,CONCRETE SURFACE FINISH,CONSULTANT, BUSINESS ADMINISTRATION,DESIGN,DESIGN BRIDGES,ENGINEERING.COMPUTER,ARCHITECTURAL ENGINEER,CIVIL ENGINEERING,SURVEYOR,DRAFTING,CONSTRUCTION MANAGEhtEN'i' hone Solicit 'on Information: *Date/s-Timels Solicited by Phone Person Contacted and Commments for olicit lion:STPh- 81(1417 Gerhard SL Rehabilitation-CC-1154,from Ellis Ave to Heil Ave.. Company Name:STATEWIDE STRIPES;INC .0.BOX 900287 AN DIEGO,CA 92190 Telephone#:(858)560-6887 Fax#:(858)560-0158 Date Solicitation Letter Faxed:11/02/2004 at 4:41:04 PM PST Work Categories: FAINT,PAVEMENT MARKERS,THERMOPLASTIC TRAFFIC STRIPE&MARKING,PAINTED TRAFFIC STRIPE&MARKING, PAVEMENT MARKING Phone Solicitation Inform 'on:��n *Date/s-Timels Solicited by Phone ��'� 2104 -A dtPY�(l (L Person Contacted and Commments for olici ation:STPh-5181(141)Gothard St.Rehabilitation-CC- 1154,from Ellis Ave to Heil Ave.. tin �cl - �.�CAkl�uv� A&Vel'i ivo Q41- Company Name: SUN MAPS 3185 AIRWAY AVE,SUITE D-1 COSTA MESA,CA 92626 Telephone#:(714)540-7669 Fax#:(714)540-7672 Date Solicitation Letter Faxed;11/02/2004 at 4:41:04 PM PST Work Categories: SURVEYOR ho a Solicitation InformatioN. "Date/s Timels Solicited by Phone I(Cj�0� 2 ��� e/ Person Contacted and Commmems for Solicitation:STPh-5181(141)Gothard S hilitation-CC-1154,from Ellis Ave o Heil Ave.. ` O -�-7 .`� � ���,.� � ��j' � �y1 '`I,►'�I� �� � I Company Name:MUNOZ CONSTRUCTION CORPORATION t Y 3165 YUCAIPA BOULEVARD UCAIPA,CA 92399 Telephone#:(909)797.2258 Fax#:(909)790-9325 Date Solicitation Letter Faxed: 11/02/2004 at 4:41:04 PM PST Work Categories: GRADING,DOWNDRAIN,SEWER MANHOLE,SEWERAGE SYSTEMS Phone Solicitation lnfor i t'1on; Dateis-Time/s Solicited by Phone bq Z yV11__ L/J erson Contacted and Commments for alit tation:STPh-5181 l41)Gothard S,t.lte abilitation-CC-1154,from Ellis Ave http:l/www.compliaccenews.rom/SuperCommand.do?submit-Click+Here+to+Build-your+Log+and+Send+Faxes&token=4oecaefd932463122117eri393d59ed Page 4 of 5 NOV 03 2004 9: 14RM (562) 439-1398 P. 9 Hardy and Harper,Inc.'a Compliance Log 1112/04 4:49 PM o Heil Ave.. Company Name:P.A.ENGINEERING 10112 EDGEWOOD LANE IL ARDEN GROVE,CA 92840 Telephone#:(714)537-0618 Fax#:(714)537-2168 ate Solicitation Letter Faxed:I V02l2004 at 4:41:04 PM PST ork Categories: NSTRUCTION AREA SIGNS,TRAFFIC CONTROL SYSTEM,CLEARING&GRUB3ING,DEVELOP WATER SUPPLY,HIGHWAY ANTING,SOIL AMENDMENTS.HYDROSEEDING,SEAL COAT,ASPHALT CONCRETE,PAVING ASPHALT(ASPHALT NCRETE).PAVEMENT REINFORCING FABRIC,PLACE ASPHALT CONCRETE DIKE&MISC,RECYCLE,RECLAIM ASPHALT NCRETE,PORTLAND CEMENT&CONCRETE PAVEMENT Phone Soucitation Informatio *Datets-Times Solicited by Phone I 2-. f 0 erson Contacted and Commments for Solicitation:STPh-5181 041)Gothard St.Rehab'' -1154,from E is o Heil Ave.. http:ltwww.compliancenews.corn/SaperCommand.do?subailt-Click+Here+to+Build-your+Log-and"Send+Faxes&token=40ecae:d932463122ll7ef3393d59od Page 5 of 5 . ............ .... .. .. . .. ... .... ................ . . .. .. . Hardy and Harper, Inc. ` BID 1312 E. Warner Ave. Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: 714 444-2801 ( ) INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: PRE—CON PRODUCTS LTD. P. O.BOX 2109240 W.LOS ANGELES AVE. SIMI VALLEY, CA 93062 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Strip in Manholes, Traffic Loops, Survey Monumentation. Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner ......... .. .... .... ..... ....... - .. .. .. . .. . ... ........ . ...... Hardy,and Harper, Inc. BID 1312 E. Warner Ave. REQUEST Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST , Attn: COAST SURVEYING,INC. 15031 PARKWAY LOOP, SUITE B TUSTIN,CA 92780 We are seeking bids fi-om qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner. Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to scriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract hid; issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner ...................... . . .. .. Hardy and Harper, Inc. BID 1312 E. Warner Ave. Santa Ana, CA 92705 '. Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID I t/02/2004 at 4:30:41 PM PST Attn: T S C M CORPORATION 18281 GOTHARD ST., STE. 109 HUNTINGTON BEACH, CA 92648 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping. kfanholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract. No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project niust be prepared to furnish sub-contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner ........................ . .. ... Hardy and Harper, Inc. BIB 1312 E. Warner Ave. Santa Ana, CA 92705 ...::. ...:...... Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn:BALI CONSTRUCTION,INC. 9852 JOE VARGAS WAY EL MONTE,CA 91733 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Coll Milling, Striping. Alaiiholes, Traffic Loops, Survey Monumentation. Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at.our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept,alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner ............... . .. .. Hardy and Harper, Inc. BID 1312 E. Warner Ave. Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: RADICH CONSTRUCTION,INC. 4680 EAST LOS ANGELES AVE. SUITE O SIMI VALLEY, CA 93063 We are seeking bids from qualified Disadvantaged Business Lnterprise. Project : Gothard St. Rehabilitation —.CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Alanholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at.our sole discretion,reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Hardy and Harper, Inc. , .,,... BID 1312 E. Warner Ave. REQUEST Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: 714 444-2801 ( ) INVITATION TO BID 11/02/2004 at 4:30:41 PM PST '. Attn: TRAFFIC LOOP CRACKFILLING INC 946 S.EMERALD STREET ANAHEIM, CA 92804 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Fold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at.our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept.alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment.for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner .......... .. ... .. . .............. ... . Hardy and Harper, Inc. BID 1312 E. Warner Ave. REQUEST " Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: GOLDEN SUN CONSTR UCTION,INC 9 KING EIDER LANE ALISO VIEJO, CA 92656 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping. Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project.and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at.our sole discretion,reserve the right to waive the requirement of such bonds, to permit substitute security or to accept.alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Nov-03-04 12:01 From- T-653 P.01/01 F-244 Hardy and Harper, Inc. BID 1312 E. Warner Ave. REQUEST Santa Ana, CA 92705 Phone: (714) 444-1851 F ax: 7 14 2801 444- INETATI N TO RID 11/02/2004 at 4:30:41 PM PST Attn:LLAMAS PLASTIC INC 12970 BRADLEY AVENLr2 SYLMAR,CA 91342 We are seeking bids from qualified Disadvantaged Business Enteiprise. ' 4/0 Project : Gothard St. Rehabilitation - CC - 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops,Survey Mon umentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 —Yes, we will bid. _No,not interested We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractotx and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub-contractors/vendors awarded wodc on this project must be prepwvd to furnish sub-conuact performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept altematc guarantee in lieu of such bonds. Plans and specifications are available by appointinent for review/takeoff at above address.If you have any questions please do not hesitate to contact us- Sincerely, Corey Kirschner .............. ... .. .... .......... .. ...... Hardy and Harper, Inc. ' '. BID 1312 E. Warner Ave. �REQUEST Santa Ana, CA 92705 Phone: (714) 444-1851 . Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: ANTHONY MARMOLEJO CONSTRUCTION COMPANY,INC. 952 E.RAMSEY STREET,SUrM B BANNING,CA 92220 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00'PM Contact : Corey Kirschner, Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 _Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid; issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the tight to waive the requirement of such bonds,to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Hardy and Harper Inc ' - BID 1312 E. Warner Ave. Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: D N CONSTRUCTION,_INC. 674 DOUGLAS AVENUE OXNARD, CA 93030 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner, Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 _Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project. must,be prepared to furnish sub-contract performance and payment bonds,for the amount of the subcontract bid. issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept.alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Hardy and Harper, Inc. } B11LJ 1312 E. Warner Ave. Santa Ana, CA 92705 .. . .::.:.. Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: METROPOLITAN CONSTRUCTION P.O.BOX 477 BONITA,CA 91908 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation - CC - 1.154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16,2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Monholes, Traffic Loops, Survey Monumentcation Please indicate if you will be bidding on this project.and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract..No modifications to the contract are permitted. All sub-contractors/vendors awarded work on this project niust be prepared to furnish sub-contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept.alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Hardy and Harper, Inc. BID 1312 E. Warner Ave. �'REQUEST , Santo Ana, CA 92705 . . Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: PREMIER WEST CONTRACTORS,INC. 740 W. GROVE AVENUE ORANGE,CA 92865 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation. Please indicate if you will be bidding on this project.and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub-contractors/vendors awarded work on this project must be prepared to furnish sub-contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Hardy and Harper, Inc. ` BID 1312 E. Warner Ave. REQUEST Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: STANDARD ENGINEERING 373 BREA HILLS AVENUE . BREA,CA 92823 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA - Bid Date : November 16, 2004 at 2:00 PN/1 Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling,Striping;, .41anholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and tax your response to: (714)444-2801 _Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds, to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner .. .... ......... . Hardy and Harper, Inc. BID 1312 E. Warner Ave. . ....REQUEST Santa Ana, CA 92705 Phone: 714 444-1851 Fax: ( )714 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: STATEWIDE STRIPES,INC P. O. BOX 900287 SAN DIEGO, CA 92190 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping. Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at out sole discretion,reserve the tight to waive the requirement of such bonds,to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner Hardy and Harper, Inc. ;. BID 1312 E. Warner Ave. REQUEST Santa Ana, CA 92705 .> ;:.. Phone: (714) 444-1851 ,: .......;.:;: Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: SUN MAPS 3185 AIRWAY AVE,SUITE D-1 COSTA MESA,CA 92626 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154;from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 _Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project niust be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, i ssued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at.our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept.alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner <: Hardy and Harper, Inc. :.� BID 1312 E. Warner Ave. Santa Ana, CA 92705 Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST- Attn: MUNOZ CONSTRUCTION CORPORATION 33165 YUCAIPA BOULEVARD YUCAIPA,CA 92399 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Manholes, Traffic Loops, Survey Monumentation. Please indicate if you will be bidding on this project anti fax your response to: (714)444-2801 _Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept altemat.e guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner ............ r Hardy and Harper, Inc. BID 1312 E. Warner Ave. . Santa Ana, CA 92705 . ..... Phone: (714) 444-1851 Fax: (714) 444-2801 INVITATION TO BID 11/02/2004 at 4:30:41 PM PST Attn: P.A.ENGINEERING 10112 EDGEWOOD LANE GARDEN GROVE, CA 92840 We are seeking bids from qualified Disadvantaged Business Enterprise. Project : Gothard St. Rehabilitation — CC — 1154, from Ellis Ave to Heil Ave. Location : Huntington Beach, CA Bid Date : November 16, 2004 at 2:00 PM Contact : Corey Kirschner Solicitation Number : STPh-5181 (141) Quotes are needed for: Cold Milling, Striping, Alai holes, Traffic Loops, Survey Monumentation Please indicate if you will be bidding on this project and fax your response to: (714)444-2801 _Yes, we will bid. _No,not interested. We are an Equal Opportunity Employer and intend to seriously negotiate with qualified DBE subcontractors and suppliers for project participation. Contractors will be required to enter into our standard contract.No modifications to the contract are permitted. All sub—contractors/vendors awarded work on this project must be prepared to furnish sub—contract performance and payment bonds,for the amount of the subcontract bid, issued by an admitted corporate surety acceptable to our company. We will pay premium up to 1.5% of bid amount and at our sole discretion,reserve the right to waive the requirement of such bonds,to permit substitute security or to accept alternate guarantee in lieu of such bonds. Plans and specifications are available by appointment for review/takeoff at above address.If you have any questions please do not hesitate to contact us. Sincerely, Corey Kirschner CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK MM 200 To: l,YY/O/l� �/�l T72/�f17�J 6 �n� C, 9'0.6 E. CIE /`:e d — & . .T-33 -7- Enclosed please find your original bid bond issued by /jM4�*C19,j /J,(777Z4 for Joan L. Flynn City Clerk JF:pe Enclosure g:/fol lowup/cashcont/retumbidbond.doc (Telephone:714-536-5227) �D 'r - i-t 1.1 l i. : i i U .J r'I./ L•i l: G ti OR,ION CONTRA(�91TNG, INO. not l L P n 806 E.Ave Pico Suite 1-#337 `, , San Clemente,CA 92672 e C-C 1 �54 t6 ri'.ca BID BOND Conforms with The American Institute of Architects,A.I.A. Document No.A-310 KNOW ALL BY THESE PRESENTS,That we, ORION CONTRACTING, INC. as Principal,hereinafter called the Principal, and the WESTERN SURETY COMPANY of 2355 EAST CAMELBACK ROAD, SUITE 500, PHOENIX, AZ 85016 ,a corporation duly organized under the laws of the State of SOUTH DAKOTA ,as Surety,hereinafter called the Surety,are held and firmly bound unto CITY OF HUNTINGTON BEACH as Obligee,hereinafter called the Obligee, in the sum of TEN PERCENT OF GREATER AMOUNT BID---------------------------------------------- Dollars($ 10% of Bid Amount ) ,for the payment of which sum well and truly to be made,the said Principal and the said Surety,bind ourselves,our heirs,executors,administrators,successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for GOTHARD STREET REHABILITATION IMPROVEMENTS,. PROJECT NO. CC154 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5193 State of CALIFORNIA OPTIONAL SECTION SAN DIEGO CAPACITY CLAIMED BY SIGNER County of Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the document. 11/15/2004 DEBORAH D. .DAVIS, NOTARY PUBLIC INDIVIDUAL On before me, , DATE NAME,TITLE OF OFFICER-E.G.,'JANE DOE,NOTARY PUBLIC' ®CORPORATE OFFICER(S) personally appeared KENNETH A. WEIR, KAREN JEAN HALL PRESIDENT NAME(S)OF SIGNER(S) TITLE(S) ®personally known to me-OR-El proved to me on the basis of satisfactory evidence ❑ PARTNER(S) LIMITED to be the person(s) whose name(s) is/are ❑ GENERAL subscribed to the within instrument and ac- ®ATTORNEY-IN-FACT knowledged to me that he/she/they executed TRUSTEE(S) the same in his/her/their authorized ❑GUARDIAN/CONSERVATOR ��5E�11';rys DEBORAH D.DAVIS capacity(ies), and that by his/her/their N COMM.#1412744 ?. ❑OTHER: U) m t o NOTARY PUBLIC-CALIFORNIA N signature(s) on the instrument the person(s), r' SAN DIEGO COUNTY or the entity upon behalf of which the My Comm Exp APRIL 21,2007 �v person(s)acted, executed the instrument. SIGNER IS REPRESENTING: WITNESS my hand and Official seal. NAME OF PERSON(S)OR ENTITY(IES) SIGNATURE OF NOTARY OPTIONAL SECTION THIS CERTIFICATE MUST BE ATTACHED TO TITLE OR TYPE OF DOCUMENT THE DOCUMENT DESCRIBED AT RIGHT: NUMBER OF PAGES DATE OF DOCUMENT Though the data requested here is not required by law, it could prevent fraudulent reattachment of this form. SIGNER(S)OTHER THAN NAMED ABOVE Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint Helen Maloney, John G Maloney, Mark D Iatarola, Karen Jean Hall, Matthew C Gaynor, Individually of Escondido,CA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds,undertakings and other obligatory instruments of similar nature -In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Liw printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof,WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to be hereto affixed on this 15th day of July,2004. ?SvaEr), WESTERN SURETY COMPANY o l o Paul .Bruflat,Senior Vice President State of South Dakota ss County of Minnehaha On this 15th day of July,2004,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires + `+ D. KRELL '+ November 30,2006 f AAL NOTARY PUBLIC Stc^AL f SOUTH DAKOTA D.Krell,No Public CERTIFICATE I,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attomey hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 15TH day of NOVEMBER 2004 �S�►RErC WESTERN SURETY COMPANY Me4pPORq fi�Lv s sfpV �� nr� L.Nelson,Assistant 6(- Secretary Form F4280-01-02 NOTICE In accordance with the Terrorism Risk Insurance Act of 2002, we are providing this disclosure notice for bonds and certain insurance policies on which one or more of the Writing Companies identified below is the surety or insurer. To principals on bonds and insureds on certain insurance policies written by any one or more of the following companies (collectively the "Writing Companies") as surety or insurer: Western Surety. Company, Universal Surety of America, Surety Bonding Company of America, Continental Casualty Company, National Fire Insurance Company of Hartford, American Casualty Company of Reading, PA, The Firemen's Insurance Company of Newark, NJ, and The Continental Insurance Company. DISCLOSURE OF PREMIUM The premium attributable to coverage for terrorist acts certified under the Act was Zero Dollars ($0.00). DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States will pay ninety percent (90%) of covered terrorism losses exceeding the applicable surety/insurer deductible. Form F7310 SECTION C PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. ,t BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 G1 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. l Accompanying this proposal of bid, find Alt he amount of$ A'"- which said amount is not less than 10% of the aggregate of the total bid price, as required y the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature C-2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL- 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: $ TOTAL AMOUNT LUMP SUM BID IN WORDS: h u red ei4ainjrem �,..s d { ' {� ►�d d-e -ft f+� 5(y- clo 0:'rs +-wt4/k-t -Fc vt C +S . C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC N0: 1154 STPL - 5181 (141) C-2.2 GOTHARD STREET (CC-1154) PROJECT BID SCHEDULE ITEM:. `'ESTIMATEDYl . �-;-� --'-`ITEM:WITH'UNI:T PRICE WRITTEN°IN�a�. : �=�f� " IJNITaPR10E., :EXT.ENDED'`: NO: �QUANTITY � _ �w �K, arw , ,;UV �� : err � � AMOUNT, . � N.k`{' ORDS°� r � � � 1 1 Mobilizations � $� 00•O $ ?00.0 L.S. @-6evevA1uK,5"S&,eA hk.r ,cd Dollars 4- A.o Cents 2 1 Traffic Control Plan $moo $ / 600.m L.S. @ �� f-c�-t.-�ha�sa�l d Dollars Cents 3 1 Furnish Project Traffic Control S��a.•�Lu%Arrd $ ?00.0 $� 700• O L.S. @ -1 uY �u�"� Dollars kAu) Cents 4 188,917 Cold Milling & Header Cutting $0. $ 4 AA1. d 5- S. @ 12-t(0 Dollars +W 4- U-e_ Cents 5 471 Unclassified xcavation $ 3S'Do $ X, y 8 L) C.Y. @•-hIY+ Dollars *- K6 Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, $ 0-oo $ LAD Ton Full De( th etc.) 0. .a @ 'T Dr+Q Dollars *- RU Cents 7 2,347 Pavement Reinforcement Fabric & Route and $ 3.0b $ 74 0q1.coo S.Y. Seal of Cracks @ --\Ire-e Dollars + Ko Cents 8 46 Adjust Sewer/Storm Drain Manhole to Grade $ Soo. 00 $ 13. Go,o Each @ -F-hr� kvisa 4 Dollars �— t-0 Cents 9 91 Adjust Water Valve to Grade $ 01 .00 s2 3 I•o Each hLrtdred the, Dollars +- k�o Cents 10 1 Traffic Striping $38'coo_a o $ 3 aoo. L.S. @-h;r�u e(A'-I ky's _�A Dollars Cents 11 80 Traffic Loop / $ -,06.00 $ ` 000.00 Each @ +W b ku,vyd Ir•e c Dollars Cents 12 8 Remove & Reconstruct Access Ramp $30, oa.v tb Each Dollars Cents 13 3 Adjust Survey Monument Well to Grade $ 3 Ob.00 $ 100,00 Each @AN hurtdred Dollars d` �_o Cents 14 25 Survey Monumentation $ 0.co $ ,- Each @ 4i,-t kLj_KJr-ed Dollars a- Cents Sub Total Bid Amount, Bid in Figures: $ UB3 (P Sub Total Bid Amount, Bid in Words: Si)c hun4re4 het" 41+o,ssLv 'et u V4 v- Sic4o l(a.r5 4- -E-wia4,�,+ F-i%je. C2r--(,5 C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. `.Portion Name.and Address.of Subeontractor State License.: Class: of Work Number: 40L N gF tm r t 2 u oV rnahKoIes (7.0. 6aA (800 , Wabts-* C,a 117&j �g3a�/ CT 3ybs nba. on e +•-� `czf's (,N IGIAY• Pr-, lJtS'�`►++«s�ft� C `lat6 S'g�-C3a- C7-0311 ?G PC L cTboo3b 1� W. F �o a A) GV.se.GA ,?oY 9 rVie- By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County o Orange beiW first d 1ly sworn, deposes d says that he e1:slre is of byl M �'/qiAjnqj, the party making the foreg ng bid that the bid is not made in the interest of, or on A& 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. a ie,L &J,Mr.—A - - me of Bidder Signature of Bidder CA 3 ddress of Bidder Subscribed and sworn to before me this day of OE6W1aRYDER � NOtAK11P�1�lC•CAUPOaHw c v� ORAW 00lMTY Gry Coma,SON Arch 16,2008.. NOTARY PUBLIC A P NOTARY SEAL C4 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 IMPROVEMENTS, (1)(we)(1t) 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. -.&rr_1 a � Contractor By �7� itle Date: V C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who,has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes o If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. c-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Contractor By le Date: Y[ ql/0j 4 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: ontractor By AL�J� Ti Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: G• Bidder Name Business Address State Zip r� L� `Telep one Number �3 State Contractor's License No. and Class Origi Date Issued A))4 o Expir ion Date The work site was inspected b of our office on '( 52004 The following are persons, firms, and corporations having a principal interest in this proposal: C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name Sig a re of Bidder PrIntckl or Typed Signature Subscribed and sworn to before me this`qp%day of , 2 DEBM S.RYD c OOM MOMS .. NOTARY PUBUC—CAUFORNIA p rn ORANGE COUNTY My Corm.Expires March 16,2008 NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for ich the bidder has performed similar work within the past two years: 1. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Date Completed 2. Name and Address of Public ge Name and Telephone No. of r Vanager: Contract Amount Type of Work Date Completed 3. Name and A ress of Public Agency Name d Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 ORION CONTRACTING, INC REFERENCES 2/2003 PROJECT NAME OWNER CONTACT NAME TELEPHONE CONTRACT DATES AMOUNT La Paz Rd Stabilization City of Laguna Niguel Nick Renn 949-362-4437 $170,000 May-ol Various Streets Reconstruction City of Laguna Niguel Nick Renn 949-362-4437 $166,000 Jul-01 105th Street Reconstruction LA.County Dept.of Public Works Public Works Dept. 626-458-5100 $328,000 Sep-o1 Street Realignment Hunt Club Homeowners Assoc. DMA Contracting 714-665-1995 $200,00o Mar-o1 Concrete Work Disneyland Hotel DMA Contracting 714-665-1995 $58,000 _ Mar-o1 Animal Shelter Demolition City of Long Beach Gillis Monroe 562-570-5167 $228,440 Aug-o1 Lambert Road Improvements LA.County Dept.of Public Works Jamie Engler 626-458-51-oo $449,483 Apr-02 Encinal Canyon Road L.A.County Dept.of Public Works Tony Assume 626-651-2782 $1,107,728 May-02 Avenidas Montalvo&Lobiero City of San Clemente Gary Voborsky 949-361-6132 $84,359 Apr-02 Citywide AC Overlay City of Westminster Kevin Sinn 714-898-3311 $736,000 May-02 Bastanchury Road Improvement City of Yorba Linda Pat Guzik 714-961-7170 $399,381 Jul-02 Del Obispo Median Project - City of Dana Point Bob Schoettle 949-248-3554 $729,574 . Dec-02 Ocean Ave.&Main Sewer Rehab City of Santa Monica Mick Fuller 714-428-4515 $618,118 Apr'03 Vista Pacifica City of San Clemente Pat Sullivan 61g 682 3889 $1,250,000 May'03 El Morro School Improvement Laguna Beach Unified School District Carl Neuhausen 949 497 7700 8284,500 Jun'03 Northwood HS Aquatic Facility Irvine Unifed School District David Eaves 909 907 9944 $642,428 Jul'03 Yale Ave Rehab City of Irvine Mark Stowell 949 724 7543 $728,68o Nov'03 Western Ave Rehab City of Stanton Bob Doss 949 379 9222 $283,694.70 Jan'04 Myrtle Area City of Hermosa Beach Curtis Baker 310 9914472 $418,305 Jan'04 Dyer Road Rehab City of Santa Ana Mike Girgis 714 647 5042 $398,630.50 Feb'04 Commonwealth Ave Widening City of Buena Park Sam Makar 714 562 3687 $1,507,885.75 Feb'04 Linda Lane Reconstruction City of San Clemente Gary Voborsky 949-361-6132 $72,432.10 04 Tanglewood Alleys City of Cypress Jim Gorin 714 229 6748 $462,600 4 Crescent&Valley View City of Buena Park Sam Makar 714 562 3687 $205,225 04 CDBG Street Reconstruction City of Orange Alan Truong 714 744 5568 $371,409 04 La Paz&Pacific Park City of Laguna Niguel Nick Renn 949 362 4341 $168,685 04 Corona Del Mar Pvmt. Rehab City of Newport Beach Steve Lui 949 644 3311 $892,66o 04 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, _and must be submitt with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidd-ef- sTi-sM assist in the annual DBE goal setting process. Firm Name: Phone: Address: f.• kit ,33,l Fax: I� -14 3 J(4 t(t c3 .Contact Person: No. of years in business 46:: i rV1 0. Is the firm currently certified as BE under 49 CFR Part 26? YES -NO , Type of work/services/materials provided by firm? !l What was your firm's Gross Annual receipt's for last ar? ❑ Less than $1 Million ❑ Less than $5 Million ,a[ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C=11 JUMal t15513LUMM rl VL:C4ul c,yiiauuoi ++n aiaall IA-J PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATTIRE PORTION OF THIS PROPOSAL SHALL ALSO CONS71ME AN ENDORSEAHNTAND EXECUTION OF THOSE CERTIFICATIONS 97ECHAM A PART OF THIS PROPOSAL) EQUAL EMPLOYMEENT OPPORTUNITY CERTIFICATION The bidder ro osed P P 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. 12-"9 C-12 Page 12-45 Local Assistance Procedures Manual EXI- BPT 12=E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a. contract El a. bid/offer/application a. initial b. grant b. initial award b. material change c.cooperative agreement C. post-award d, loan For Mateea,rial C nge Only: e. loan guarantee date of st re q rt der f. loan insurance Po 4. Name and Adress of Reporting Entity: 5. If Reporting Entity in No.4' Subawardee.Enter Prime Subawardee Name/Addrersis%ome: Tier if known Congressional District, ifknown: Congresown: 6. Federal Department/Agency: 7FeI Program Name/Description: Number, if applicable 8. Federal Action Number, ifknown: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual,last name,first name,MI): different from No. 10a) (last name,first name,MI): (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check a appl ll thy): 13. Type of Payment(check all that apply) $ actual planned a. retainer 12. Form of Payment(7. nature at apply): b. one-time fee a. cash c, commission H b. in-kind;sp d. contingent fee e e. deferred f. other,specify: 14. Brief Descriptio f services Performed or to be performed and Date(s)of Service,including officer(s), employee( ), member(s)contacted,for Payment Indicated In Item 11: 7 (attach Continuation Sheet(s) if necessary) 15. Xonflinuation Sheet(s)attached: Yes No W Information requested through this forth is authorized by Title 31 U.S.C.Section Signature: 1352 This disclosure of lobbying activities is a material representation of fact ae rI upon which reliance was placed by the der above when this transaction was Print Name: ht� �( - made or entered into.This disclosure is required pursuant to 31 U.S.C.1352 y This information will be reported to the Congress semi-annuaily and will be Title: V 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 Telephone No.:1 1 140 Date: $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction FormStandard LLL - Standard Forth LLL Rev.01-03.95 C-13 Page 12-55 February 1,1998 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency;a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address,city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number.for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IEB)number,grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged-by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXH[BIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 3 0 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. . C-15 Page 12-55 IN U NLOBB YEN G CERTIFICATION FOR FEDERAL-AID CONTRACTS l . ie prospective participant certifies, by signing and submitting this bid or proposal,to the best of his or her knowledge and lief, that: r (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 otncer 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. I (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. _. is certification is a material representation of fact upon which reliance was placed when this transaction was made or :ered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 52,Title;l,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of ndt less n S 10,000 and not more than$100,000 for each such failure. e prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language this certification be included in ali'lower tier subcontracts,which exceed 51,00,000 and that all such subrecipients shall -tify and disclose accordingly. 1 L.. L I Noncollusion Affidavit (Title 23 United States Code Section 112 and j Public Contract Code Section 7106) . To the CITY/COUNTY of DEPARTMENT OF P BLIC WORKS. . 1 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, i organization or corporation; that the company, association, � rp h bid is'enuine 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 t other bidder,or to secure any advantage against the public body awardin-the contract of anyone interested ( 1 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. j 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 judgement rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct with' the past 3 years. If there are any exceptions to this certification, insert the exceptio in the following space. Exceptions will not necess ily result in denial of award, but will be considered in determining bidder responsibility. For any . ception 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. CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBl_ .ji�J j}on- DBE contractors, who provide a proposal, bid, quote, or were contracted by the prop .-"I I)rime. This information is also required from the proposed prime contractor, and must be `UI.1 i i i i i,:d with their bid/proposal. The City of Huntington Beach will use this information to maintain .iii l update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: e6£ m i#-,e Phone: Address: Q.0. y[ >o Fax: lWX Lo6-(h,+ &A c, .Contact Person: k '�/ l Ire No. of years in business__ Is the firm currently certified as DBE under'49 CFR Part 26? ES i Type of work/services/materials provided by firm? Godpt 5� What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million * Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs j i:,,formation. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBI:_ :u ,_I non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the propo ­-,l prime. This information is also required from the proposed prime contractor, and must be sul:,niui`d with their bid/proposal. The City of Huntington Beach will use this information to maintain :irj,i update a "Bidder's" list to assist in the annual DBE goal setting process. Firm Name: U ��Ol 5 �► Phone: 3 Address: O 4l r" Fax: �S�`m��sei✓ C'A' 9a 6�3 .Contact Person: I No. of years in business_ Is the firm currently certified as DBE under 49 CFR Part 26? YES X�_� Type of work/services/materials provided by firm'? ('OD� What was your firm's Gross Annual recei is for last year? ❑ Less than $1 Million Less than $5 Million Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) i!i lormation. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the followintr information for all DB1=: .,i :_I non- DBE contractors, who provide a proposal, bid, quote, or were contracted by'the prop t i)rime. This information is also required from the proposed prime contractor, and must be SLIhI i,i i i,d with their bid/proposal. The City of Huntington Beach will use this information to maintain . i J update a "Bidder's" list to assist in the annual DBE goal setting process. Firm Name: 1 I lw-f Y1ent, �b",att Phone: Address: 9 d\6 W, �b4 k,Q 6 W, Fax:—( Z 5 N�- .Contact Person: ��b{J No. of years in b usiness_ar Is the firm currently certified as DBE under 49 CFR Part 26'' ES Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million Less than $5 Million Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) W ibrmation. C-11 j CITY OF HUNTNGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE DBE contractors,who provide,a proposal,bid, quote,or were contracted by the proposed prAe. This information is also rcquired from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a`Bidder's" list to assist in the annual DBE goal setting process, Firm Name:_ 1 Phone-_ 0� Address: 2 V 4'1U ' _ Fax:" qr1 1 .Contact Person:{0� Y. [AA „jg No. of years_in business Is the firm currcatly certified as DRE under 49 CFR Part 26? YES NO IPI Type of work/services./materials provided by firoa? )1� �?--- What was your d m's Gross Annual r®cei is for last ar? Less than$1 Million o Less than$5 Million o Less than$10 Million ❑ Less than$15 Million ❑ More than $IS Million This form i; i bye duplicated if necessary to report all bidders(DBEs and non DBEs) information. C-11 11-1G-2004 08: 15 M C STRIPING 190998esi31 PACaE2 T�Jdd T2Tgee000GT SNIdIaiS D 1,1 Tb:80 0002-91-TT Lj, CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK 200.E To: /100 ( �ie_AsJ6E i2A[= otOd Enclosed please find your original bid bond issued by &Saw,4jCc— Cd for Joan L. Flynn City Clerk JF:pe Enclosure glfollowup/cashcont/returnbidbond.doc (Telephone:714-536-5227) -�+wc;�s., tt;. 1� r` »'� w� `�'�'�...�ram. '=.�� �„' "f;��'^q,u;p`-..t .s'°•.f..,,�, '"`,� a��:'��8''�" �,�;F�',�k`��<�t�'ss:;}��;;�''. t s =r SEALED BIDS SULLY-MILLER CONTRACTING CO. " � p 1100 E.ORANGETHORPE AVE,STE.200 w ANAHEIM,CA 92801 y" u CITY OF HUNTINGTON BEACH 2000 MAIN STREET 2nd FL. , HUNTINGTON BEACH CA 92648 '� a" BID DATE. NOVEMBER 16 2004 2:00 P.M. BID PROJECT: GOTHARD STREET REHABILITATION From Ellis Ave. to Heil Ave. CASH CONTRACT NO. 1154 5 i�w. $�, 'ice- ;i,:".a� ,.r+,_, -��qF;;g '.;p`��g,�?�,�: y+y +Siz.�,r• yn ''�',-.. 16Y+:+, .:","-}, ^.i .A x�f•.;d a3'�. •'keR'-tye rC'+a' -fv,�Fd, 1-4 P �y�. Mir s�;�4., r ,2..'a `��<a-•.,.�.,'�5. .�'.,�:•:'.,r".+`r:..,r,.;.., 'a,� ,i.r.sty r a4.'�,�t". L t,f'+, r,y "�,` ir��• :,A, aC„�u^ 'x .�.,i"r {, `���'. ."�., c ��..;� .,..?',, .�"..: 4 <.t• �"r' ,,:S,a,:,q:n i', ,s,;:;d";',a�5�, „-.,:.,�;,_trr :� '_.,.,.>'� .:"P:• �s .t,, u,�� _ a.'#.x. r ., ,._ Bid # 04-11316 Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTSf that we SULLY-MILLER CONTRACTING COMPANY (Here insert full name and address or legal title of Contractor) 1100 E. Orangethorpe Ave. , Anaheim, CA 92801 as Principal, hereinafter called the Principal, and Liberty Mutual Insurance Company (Here insert full name and address or legal title of Surety) 8044 Montgomery Road, Cincinnati, OH 45236 a corporation duly organized under the laws of the State of Massachusetts as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON (Here insert full name and address or legal title of owner) 2000 MAIN STREET, 2ND FLOOR, HUNTINGTON BEACH, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of the Amount Bid - - - - - - - Dollars ($log - - - ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators,successors and assigns,jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for (Here insert full name,address and description of project) GOTHARD STREET REHABILITATION - CC1154 FROM ELLIS AVENUE TO HEIL AVENUE STPL 5181 (141) PROJECT NO. CASH CONTRACT NO. 1154 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 e day of November 2004 SULLY-MILLER COIJT.RACTING COMPANY (Principal) (Seal) *riNelson (Witnes Ron Sa cido (Title) Vice President Libe utual Insurance Company '00 (Surety) (Seal) Maria Lu R. A4V&Si Victoria Stockton (Title) Attorney-in-Fact Printed in cooperation with The American Institue of Architects(AIA)by Willis.Willis vouches that the language in the document conforms exactly to the language used in AIA Document A310,February 1970 Edition. 1 WC0054 STATE OF CALIFORNIA SS. COUNTY OF ORANGE On NOVEMBER 8,2004 before me, MARIA LUISA R.AGUINALDO,NOTARY PUBLIC PERSONALLY APPEARED VICTORIA STOCKTON personally known to me(or proved to me on basis of satisfactory evidence)to be the person(Q whose nam is/ re scribed to the within instrumfmtQnd acknowledged to n that hJ she/t ey e3gcukd the same in h er/ eir authorized capacity(ig),and that by hi er/t eir signature(on the instrument the person()(),or the entity upon behalf of which the person(iQ acted,executed the instrument. MARIA LUISA R.AGUINMW COMM.#1406174 > �• WITNESS my hand and official seal. NOTARY PUBLIC-CALIFOI NAORANGE WWII Carron.FP.Match 18, 2007 Signature - u•-,� This area for Official Notarial 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER BID BOND TITLE OF TYPE OF DOCUMENT TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ® ATTORNEY-IN-FACT NUMBER OF PAGES ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: NOVEMBER 8,2004 DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTITY(IES) LIBERTY MUTUAL INSURANCE COMPANY SULLY-MILLER CONTRACTING COMPANY SIGNER(S)OTHER THAN NAMED ABOVE ID-1232(REV.5101) ALL-PURPOSE ACKNOWLEDGEMENT Tills'PO1&R OF-ATTORNEY IS NOT,VALID UNLESS IT IS PRINTED ON-RED"BACKGROUND: 82 05.. 'This Power"'of Attorney-limits the acts of those named herein,arid they"have no-authority to bind the Company except in the manner and to the extent herein stated_.: LIBERTY MUTUAL INSURANCE COMPANY BOSTOWMASSACHUSETTS POWER-OF ATTORNEY KNOW ALL PERSONS":BY THESE PRESENTS: That Liberty" Mutual:Insurance Company (the "Company"),'"a Massachusetts"stock insurance company,pursuant to and,by-authority of the By-law and_Authorization hereinafterset forth,does hereby name,constitute and appoint VICTORIA STOCKTON--JOHN D: MILLER,SCOTT.SALANDI- ALL-OF THE CITY OF SANTA ANA,STATE OF CALIFORNIA". 7. ............................ each individually if"these be more"than one named,its.true-.and-lawful attomey-in-fact,to make,execute,seal,acknowledge and deliver,for and on its behalf.as surety and as its act and deed,any and all_undertakings,bonds„recognizances:and other:surety obligations,in the penal sum not exceeding ONE HUNDRED MILLION'AND'00/1 DOLLARS $ 1100,900,000.00****' ( each,and the execution of.such undertakings; bonds, recognizances:"and..othe[:surety obligations,_in pursuance of these presents, shall be as binding upon the Company as if fty,had been duly signed by the president and'attested,by the secretary of the Company in their own.proper persons: . . That thispower is.'made.and executed""pursuant.to and by authority of the following By-law and Authorization:_ ARTICLE XI11,=:Execution of Contracts:"Section-5.Surety Bonds and Undertakings: Any officer-,,of the.:Companyauthorized for that purpose in wnting',by the chairman or the president, and subject to such limitations as=the chaimian:or.'""the president.may prescribe,shall-appoint_such aftorneys-in-fact,as may be necessary to act in behalf of the Company to,make, execute;..seal,-:acknowledge and deliver-as surety:-any-and all:undertakings;;bonds, recognizances and other surety obligations;—Such-Such :_M attome s=in-fact,_sub`ect to the limitations set.forth-in-theicres_ective owers:of.attome , shall have full power to bind the'Com an b their m N Y 1 P P Y P P Y. Y O: signatuFe.and:execution of any.such.instruments.and_to-attach ttiereto.the.seal of the Company: When so''executed such instruments shall be ayi d as.biriding as if signed by the president and attested bythe;secretary C Cy By the following instrument-the chairman or thepresident:has authorized the officer-or other"official_named therein to appoint attorneys-in-fact: y �.� Pursuant:to Article:XIII,:S.ection';5,of the"By Laws, Gamet:W;..Elliott, AssistantSecretary of Liberty"Mutual Insurance Company, is hereby. authorized-to appoint such attorneys-in-fact as may be;necessary to:act-in behalf,of the:Company.to make, execute,seal,acknowledge and deliver as surety any and all"undertakings;bonds,recognizances and other surety obligations. .O v'.d. That the By4aw'and the,Authorisation set forth above are-true copies thereof and are now.in full force and effect. W j IN WITNESS_WHEREOF, this Power.of Attorney has been subscribed by an;:authorized officer or official of the Company and the corporate seal of .� .� 'Liberty Mutual Insurance Company been:affixed thereto in:Plymouth-Meeting,.Pennsylvania this . 19th _day of July 0 G 2004 Q.M .. p.i LIBERTY MUTUAL INSURANCE COMPANY 1:r a%..O k� 00, ^ Ca c to - - - - a'',Y. Garnet W:Elliott,Assistant Secretary C6 ,. � . d:.. .COMMONWEALTH OF:PE--NNSYLVANIA ss ., .. y- COUNTY-OF MONTGOMERY:-:. :O:`C c :On"this..l9th :.dayof: July =,:2004",:before rrie;:a:Nofary Public;"personally_came Garnet"W._Elliott,.to"me known,and acknowledged. =_at £O.'— that he is an AssistantSecreta'y of_.Libe Mutual Insurance:Com ari that tie.knows-the-"seal of.said co oration;:and that he executed the"above $_rY rtY . P .Y.' .... rP ..0.- Powerof Attorney=and affized:the corporate§eal_of-LibertyMutualihsurance-Goinpany thereto with the-authority.and at Elie direction"of said,corporation: �_O O.ttt `' IN TESTIMONY WH unto subscribed m name and affixed m notarial seal at Plymouth.Meetin Pennsylvania,.on the day and ear P Y: Y: 9. Y Y y t:vo •—-0 first above written. +- Al Nifarai Seat .. C-cm "Teresa Pasteita,Notary Pu'b*k _Cl) 0.3 : OF P ymouth two,:.h9on rcmery Ct v B �Q% �! � O Op Z C1 My Cumin salon Expires Mar.M MS. y � of Member.aenrsynan;asocancr,ofNoue, Teri'a Pastella,'NotaryPublic .v.� CERTIFICATE: I,the undersigned,Assistant,ecretary of Liberty Mutual Insurance C,ompan 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 on the date.of this certificate,and"I do further certify.that.the.officer.or official who executed the said power of attorney is an Assistant"secretary specially authonZedaiyahe chairman:or:the.president to:appoint attomeys=in-fact as.provided in Article _ XIII,Section 5-of.the-By=laws of Liberty"Mutual Insurance-Company This,.certificate.and'.the.above-power of attorney may:be-signed:by facsimile:_or.:mechanically"reproduced signatures.under and by,authority of.the. following vote of:theboard.oYdirectors of'Liberty Mutual1nsurance-Cornpany,at a meeting duly-called and held;on the 12th day:of March,1980. . VOTED that::.the:facsimile:or-mechanically reproduced:signature_of":any assistant secretary of the.company, wherever appearing'upon a certified-copy.of any`:power-of-attomey issued bythe companyin.connection with surety bonds,shall.be valid and binding upon the company" _with,the.same force:and"effect as tho' h_manually,attixed. IN TESTIMONY.WHEREOF-1"have hereunto subscribed myname.and affixed the_comorate seal of the-said company,this.- Bt:h. day of NO.VEMBE'R:;. :. 2-004 ." ti;: Qt By David M.Carey,Assi i Secretary. CALIFORNIA ALL PURPOSE ACKNOWLEDGEMENT State of California County of Orange On November 12, 2004 before me, Julia A. Nelson, Notary Public, personally appeared Ron Salcido, personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized .capacity, and that .by his signature on the instrument the person or entity upon behalf of which the.person acted, executed the instrument. JMIA A.EL O" COMM#1292413 > Witness my hand and official seal W NOTARY PUBLIC-CALIFORNIA Q ORANGE COUNTY :D My Commission Expires Jan,21%2005 Julia A. Nelson, t46tary Public OPTIONAL Though law does not require the information below, it may prove valuable to persons relying on the document and could prevent fraudulent removal of this form to another document. Description of Attached-Document Title or Type of Document: Bid Bond (04-11316) .Document Date- November 8, 2004 Number of.Pages, 1 Signer(s) Other Than Named Above: LIBERTY MUTUAL INSURANCE COMPANY Capacity(ies) Claimed by Signer Signer's Name: RON SAtLCIDO ❑ Individual X❑ Corp-orat-e O-fficer-Title.(s.): Vice-President 0 Partner-Limited / General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: S-MY-MILLER CONTRACTING COMPANY SECTION C PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely .for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 C-1 4 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bid Bond in the amount of$10% of Bid which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature c-2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: $ � �s, F7so ®s TOTAL AMOUNT LUMP SUM BID IN WORDS: C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 GOTHARD STREET (CC-1 154) PROJECT BID SCHEDULE .IT[H "�,'lSTI MATE D�'I­ ITEMWITTWU NIT-PRICE WRITTEN 1 �i,'.'UXIT'RRE7,IC '­��2EXTENOED"7 X, .AmoU.NT�­'­ TITY, ORDS�'0 1 1 1 Mobilizatipn 3()0 ' $!4/ZOO, @ 1A/ L.S. Dollars Cents 2 1 Traffic Control Plan $ 00. $ L.S. @ -Dollars Cents 3 1 Furnish Project Traffic Control $ 7oo. $ 6, 7eo. L.S. @ k-Il 4—11 Dollars I TO, Cents 4 188,917 Cold Milling & Header Cutting $ 0 $3-?7 4_7q3Jyv S.F. @ Dollars TY Cents 5 471 Unclassified Excavation z C.Y. @ Dollars Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, Ton Full Depth etc.) @ rl-CP`Y Dollars &Z Cents 7 2,347 Pavement Reinforcement Fabric & Route and $ 75 $12rt�.D5- S.Y. Sea[ of Cracks @ Six Dollars Cents 8 46 Adjust Sewer/Storm Drain Manhole to Grade $ Each @ T_­ � Dollars � Cents 9 .91 Adjust Water Valve to Grade $aaS- $-,;ko,(17,F, Each @ -Dollars Cents 10 1 Traffic Striping $ya, L.S. @ 4;/-ty -t,—., s9 Dollars Cents 11 80 Traffic Loop $ 1 70;' $13 Each (CD OX.0-�-1, Dollars 7 Cents 12 8 Remove & Reconstruct Access R mp $ 0700. , $ 1z;to". Each @ Dollars Cents 13 3 Adjust Surve Monument Well to Grade $ 1a36-— $ �10. Each CCP A;V t Dollars Cents 14 25 Survey Monumentation $ ;=9 $:z 000, Each Dollars Cents Sub Total Bid Amount, Bid in Figures: $ Sr 875. OJE Sub Total Bid Amount, Bid in Words: I C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion > "::.'Name and Address of'Subcontractor :.:. State license`_:` Class:`.> ': :of Work Number;:: u,,ve y case ►An✓ 5 e, �ra�KSegli CD(O�A-� ✓Gea.� Se,¢l�tir9 ��~��/ �-�o� v o s v✓es ,� Iv= �a/'&o 2,'v c 10�� By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Ron Salcido , being first duly sworn, deposes and says that he or she is Vice President of Sully-Miller Contracting Compghar 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. Sully-Miller Contracting Company, Name of Bidder Signature of Bidder Ron Sai,cidc; Vice;President 1100 E. Orangethorpe Ave. , Ste. 200 Anaheim, CA. 92801 Address of Bidder 4444444444444M�N44444N� Subscribed and sworn to before me this 12 day of November, 20 JULIAA.NELSON II COMM#1292413 D W NOTARY PUBLIC•CALIFORNIA m Q ORANGE COUNTY j MyCommisabnExpiresJan.28,2� Y �44444444444004444444444#44**-------- NOTARY PUBLIC �. H4 A. Nelson NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the IMPROVEMENTS, (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. Sully-Miller Contracting Company Contractor By Ron Salcido f Vice President Title Date: November 12, 2004 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who,has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes UNo 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. Sully-Miller Contracting Company Contractor By Ron Salcido Vice President Title Date: November 12, 2004 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor By Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Sully-Miller Contracting Company Bidder Name 1100 E. Orangethorpe Ave. , Ste. 200 • -r- r Business Address Anaheim, CA. 92801 City, State Zip ( 714 ) 578-9600 Telephone Number 747612 Class "A" State Contractor's License No. and Class March 30, 1998 Original Date Issued March 31, 2006 Expiration Date The work site was inspected by Bill Grider of our office on November 9 , 2004. The following are persons, firms, and corporations having a principal interest in this proposal: See attached Certificate of Incumbency and Resolution for a list of Car-porate Officers C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Sully-Miller Contracting Company Comp ny Name Signature of Bidder Ron Salcido, Vice President Printed or Typed Signature Subscribed and sworn to before me this 12 day.of November , 200 *„ XLIA A.NELSON D a: COMM#1292413 W NOTARY PUBLIC-CALIFORNIA M ORANGE COUNTY :01 NOTARY PUBLIC. Q MY Commission Expires jan. 8,2005 1 u is A. Nelson NO AR' Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. See attached Bidder's Experience and Qualifications Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 BIDDER'S EXPERIENCE AND QUALIFICATIONS Project Name/Number., PIER 400 BACKLANDS PHASE 2 n Start and Finish Dates: 4/01/03 8/15/04 Project Description: PIER 400 BACKLANDS PHASE 2 Agency Name., PORT OF LOS ANGELES Contact Person: MAHMOUD IRSHEID Telephone: 310-732-3525 Original Contract Amount., $29,865,750.00 Final Contract Amount.- $31,332,000.00 Project Name/Number., BERTH 100 BACKLANDS PHASE 1 Start and Finish Dates: 12/01/01 TO 12/31/03 Project Description: BUILT BERTH COMPLETE WITH CRANE LIFT AND TRANSTAINER FACILITY Agency Name: PORT OF LOS ANGELES Contact Person: STEVE IMPERATO Telephone: 310-930-0801 Original Contract Amount.- $25,500,000.00 Final Contract Amount.• $35,000,000.00 Project Name/Number., PHANTOM WEST Start and Finish Dates., 12/ 2002 8/ 2003 Project Description: UNDERGROUND, ASPHALT REHAB, CURB &GUTTER, COLD MILLING Agency Name: CITY OF VICTORVILLE Contact Person: MARK MILLER Telephone: 760-955-9158 Original Contract Amount.- $4,796,507.00 Final Contract Amount.- 4,994,840.00 Project Name/Number., JOSHUA ROAD STREET IMPROVEMENTS Start and Finish Dates: 7-2004 TO 10/2004 Project Description: STREET RECONSTRUCTION Agency Name: TOWN OF APPLE VALLEY Contact Person: TERRY GREGORY Telephone: 760-240-7000 Original Contract Amount.- $379,796.00 Final Contract Amount., 423,456.00 Project Name/Number., RECONSTRUCTION/RESURFACING OF VARIOUS STREETS FY 2001-2002/ 23358C Start and Finish Dates: OCTOBER 2003 to JANUARY 2004 Project Description: AC OVERLAY AND STREET RECONSTRUCTION Agency Name: CITY OF SANTA FE SPRINGS Contact Person: TONY OLMOS, P.E. Telephone: 562-868-0511 Original Contract Amount.• $419,119 Final Contract Amount.- $462,280 1 BIDDER'S EXPERIENCE AND QUALIFICATIONS Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number., REAR BERTH 224 BACKLAND IMPROVEMENTS- PHASE II/ 22265C Start and Finish Dates: DECEMBER 2002 to NOVEMBER 2003 Project Description: SITE DEMO, REMOVALS, R/R SAFETY DEVICES, STREET IMPROVEMENTS Agency Name., PORT OF LOS ANGELES Contact Person: MICHAEL HADDADIN Telephone: 310-732-3612 Original Contract Amount.• $1,454,300 Final Contract Amount.- $1,666,336 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number., PAVING REPAIRS &IMPROVEMENTS AT PUENTE HILLS LANDFILL/ 23346C Start and Finish Dates: JULY 2003 to OCTOBER 2003 Project Description: ROADWAY RECONSTRUCTION Agency Name: COUNTY SANITATION DISTRICT OF LOS ANGELES Contact Person: HABIB KHARRAT Telephone: 562-699-7411 Original Contract Amount.• $728,594 Final Contract Amount.- $728,594 Project Name/Number., ROUTE 213 CALTRANS DISTRICT 7/ 22275C Start and Finish Dates: JANUARY 2003 to MAY 2003 Project Description: ROUTE 213 STREET OVERLAY PROJECT Agency Name: CAL TRANS Contact Person: FRIAD AZIZ Telephone: 562-860-0385 ext. 104 Original Contract Amount: $248,319 Final Contract Amount., $237,330 Change in contract amount is due to items of work being deleted by the agency 2 BIDDER'S EXPERIENCE AND QUALIFICATIONS Project Name/Number.- ANAHEIM PUENTE ROAD/ 22261C Start and Finish Dates: SEPTEMBER 2002 to MARCH 2O03 Project Description: STREET WIDENING AND OVERLAY PROJECT Agency Name: CITY OF INDUSTRY Contact Person: GERRY PEREZ Te%phone: 626-333-0336 Original Contract Amount: $523,600 Final Contract Amount.• $613,000 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number.• PIER"E"-SLIP TWO/ 22224C Start and Finish Dates. OCTOBER 2002 to MARCH 2O03 Project Description: RECONSTRUCTION PROJECT-ASPHALT SERVICE ROAD Agency Name: CITY OF LONG BEACH - HARBOR DEPARTMENT Contact Person: DALE HILL Telephone: 562-843-6379 Original Contract Amount: $7,948,263 Final Contract Amount.• $8,339,433 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number.• BERTH 100 (PORT OF LA)/ 21198C Start and Finish Dates. DECEMBER 2001 to APRIL 2002 Project Description: TRANSTAINER DEVELOPMENT Agency Name: PORT OF LOS ANGELES Contact Person: STEVE IMPERATO Telephone: 310-732-3937 Original Contract Amount: $25,400,000 Final Contract Amount.• $27,629,266 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number.• NEWPORT BLVD./BALBOA BLVD. ROADWAY&STORM DRAIN #3373 / 22210C Start and Finish Dates: MARCH 2O02 to JUNE 2002 Project Description: STREET RECONSTRUCTION AND DRAINAGE IMPROVEMENTS Agency Name: CITY OF NEWPORT BEACH Contact Person: FONG TSE, P.E. Telephone: 949-644-3340 Original Contract Amount: $1,694,000 Final Contract Amount. $1,609,000 Change in contract amount is due to items of work being deleted by the agency 3 BIDDER'S EXPERIENCE AND QUALIFICATIONS Project Name/Number., PIER 400 CONTAINER TERMINAL/ 21130C Start and Finish Dates: JANUARY 2001 to SEPTEMBER 2002 Project Description: BACKLAND IMPROVEMENTS, PHASE I Agency Name; PORT OF LOS ANGELES Contact Person: MAHMOUD IRSHEID Telephone; 310-732-3525 Original Contract Amount.- $78,134,500 Final Contract A mount: $87,645,073 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number.- CITY OF HAWTHORNE PROJECT NO. 01-08/ 23186C Start and Finish Dates: OCTOBER 2001 to MAY 2002 Project Description: LOCAL STREET IMPROVEMENTS Agency Name; CITY OF HAWTHORNE Contact Person: AKBAR FAROKHI Telephone: 310-970-7959 Original Contract Amount.- $852,939 Final Contract Amount., $981,358 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number: LACDPW #RDC0013639/ 21155C Start and Finish Dates; JUNE 2001 to OCTOBER 2001 Project Description: VARIOUS STREETS - LAKEWOOD Agency Name; LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS Contact Person; RAY GREEN Telephone; 626-548-3118 Original Contract Amount: $1,068,633 Final Contract Amount., $1,259,380 Change in contract amount is due to extra work and/or contract change orders adding work Project Name/Number: OCEAN AVENUE REHABILITATION / 20097C Start and Finish Dates; NOVEMBER 2000 to OCTOBER 2001 Project Description; STREET RECONSTRUCTION Agency Name: CITY OF TORRANCE Contact Person; C. BILEZERIAN Telephone: 310-781-7694 Original Contract Amount; $997,000 Final Contract Amount.- $1,163,000 Change in contract amount is due to extra work and/or contract change orders adding work 4 CERTIFICATE OF INCUMBENCY AND RESOLUTION I,Ron Salcido, do hereby certify that I am an Vice President of Sully-Miller Contracting Company, a Delaware corporation, and that as such I have access to and custody of the corporate records and minute books of said corporation. And I do hereby further certify that the following persons are duly elected officers of said corporation. TITLE NAME Chairman of the Board Louis Gabanna President&CEO R. Bruce Rieser Chief Financial Officer&Treasurer Tim P.Orchard Vice President Ron J. Salcido Vice President Mitchell P. Vigna Vice President Peter Pouwels Secretary Stewart M. Fuhrma.nn Assistant Secretary George Aldrich Assistant Secretary Mary Lawson Assistant Secretary Mike Edwards Assistant Secretary Gary Downey Assistant Secretary James Wu Assistant Secretary David Martinez I further certify that the following is a true and correct copy of a resolution duly adopted by the Board of Directors of said Company at a meeting held on January 28,2000,and that this resolution has not been in any way rescinded, annulled,or revoked but the same is still in full force and effect: "(AUTHORITY TO EXECUTIVE BIDS AND CONTRACTS) Resolved,that any officer or assistant officer of this Company be and each of them is hereby authorized to execute in the name and on behalf of this Company under its corporate seal any and all proposals for the sale of products,merchandise and services of this Company and any bids and performance bonds required in connection therewith,to the United States,and of the State,territories and dependencies of the United States,the District of Columbia,cities,towns,townships,counties,school districts, and to the department,political subdivisions,agencies or wliolly-owned corporations thereof, ofto any other person." IN WITNESS WHEREOF,I have hereunto set my hand and affixed the corporate seal this V day of July 2004. • Ron Salcido,Vice President (SEAL) 1100 E.Orangethorpe Ave Ste 200 Anaheim, Ca. 92801 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: Sully-Miller Contracting CompanyPhone: (714) 578-9600 Address: 1100 E. Orangethorpe Ave. , Ste. 20pax: (714) 578-9672 Anaheim, CA. 92801 .Contact Person: Ron Salcido No. of years in business 80 Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? AC Paving / Concrete / Underground What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million o Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million 9 More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 Local Assis[a"IM rl-u�Guu■c,iriauual PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTEAN ENDORSE,4ENTAND EXECUTION OF THOSE CERTIFICATIONS WNCHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Sully-Miller Contracting Company ,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. 12-"9 C-12 Page 12-45 Local Assistance Procedures Manual EDIT 12-E, PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. J/1 I`I7 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 Adress of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee.Enter Prime ci Subawardee Name and Address of Prime: Tier ,if known Not Applicable Congressional District, if known., Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable 8. Federal Action Number, ifknown: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address fP (if individual,last name,first name,MI): 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 12. Form of Payment(check all that apply): b. one-time fee a. cash c. commission 8 b. in-kind;specify: nature d. contingent fee p e. deferred value f. other,specify:pec fy: 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 Rem 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheegs)attached: Yes No NJ ® Sull Miller ntractin Company 16- Information requested through this form is authorized by Title 31 U.S.C.Section Signature, 1352 This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was Print Name: Ron Sa l c i do made or entered into.This disclosure is required pursuant to 31 U.S.C.1352 Vice President This information will be reported to the Congress semFannually and will be Title: 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 Telephone No.: 5 7 8—9 6 00 Date:—11 /1 2 0 4 $100,000 for each such failure. _ Federal Use Only Authorized for Local Reproduction FormStanda - Standard Form LLL Rev.01-03-95 C-13 Page 12-55 February 1, 1998 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of. Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address,city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal (RFP)number,Invitation for Bid(IFB)number,-grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. C-15 Page 12-55 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed_prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a`Bidder's"list to assist in the annual DBE goal setting process. Firm Name:l,� /vorr��aG� r�l�1� Phone:7�yS3o Ya Address:y( s �r ,a l S' Fax.71 .Contact Person: No. of years.in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? C 1/6 1-csO 5 What was your firm's Gross Annual receipt's for last ear? ❑ Less than$1 Million ❑ Less than $5 Million ❑ Less than$10 Million ❑ Less than$15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name:sip, 5a"" Phone: 7 Cy `�7 7 75,E Address: /9 3F Fax: q F Ss9 .Contact Person: No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last ear? ❑ Less than $1 Million ❑ Less than$5 Million ❑ Less than$10 Million ❑ Less than$15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. FirmName:Aa 6, larourcq—S Phone:',% Address: 'S�7 '✓- ��`D9' ��n� Fax: /Z� 'D-- .Contact Person: e No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last ear? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than$15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: Phone:?��/ 3 Address:y d a— Fax: 9/Y S 3 K a 7 9 Jag- .Contact Person: C /11 Al'e� gy- No. of years.in business Is the firm currently certified as DBE under 49 CFR Part 26? YES N Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last ear? ❑ Less than$1 Million ❑ Less than$5 Million ❑ Less than$10 Million ❑ Less than$15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: 1� 5�_, Phone: 9d, Address: Fax: qo .Contact Person: 020 ,�1M No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES QV Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last ear? ❑ Less than$1 Million ❑ Less than $5 Million ❑ Less than$10 Million ❑ Less than$15 Million ❑ More than$15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 f}" Received: 11 /16/04 11 :25AM; 714 639 6353 -> SULLY MILLER; Page 2 ?'x4'NOU-15-2004 22:11 FROM:(MNGE COUNTY STRIPI 714 639 6353 TO:SULLY MILLER P:2'2 f 1 �i CITY OF.HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the tbllowing information lbr all DBE and non. D13E contractors, who provide a proposal, bid,quote,or were contracted by the proposed pfte. This information is also inquired from the proposed prume contractor, and must be submitted with their bidlpmpoUL The City of Hunttagton Beach will use this information to maintain and update i. a"Bidder's"list to assist iA the annual DBE goal sctftg ORANGE COUNTY STRIPING Firm Name- Phoney Li �� 183 N. PIXLEY STREET -i 1 Address: ORANG C-402gfe8- 8�-- Fawn-1 lU Contact Person: �1_ No. of years in business Is the fum currently certified as DOE under 49 CFR Part 26? YES Type of work/services/materials provided by m? U Gk f�17 fir �--- What was our firm's Gross Amoual rece' is for last ear? o Less than$1 Million o Less din $5 Million Less than$10 Million Lees than$1 S Million `- o More than S IS Million This form can be duplicated if necessary to report all bidders,(DBEs and non DBEs) infbmtmtion. C-l 1 •Mr. •A'MAw .wA1•. M.h1 Tr. --s• w ..ww• �.�� .....� ���..�� �...�.. ��.-..�..__� - - t NOV-17-2004 01 :05 AM P. 01 wil ll/16I2BB4 10t54 15494928324 ORION CQNTWIICTIMG PAGE 01 CITY OF HUNT1NOTOtN SFACH DMOEM L19T All Biddors/prapasm on required to provided the following infotmetion for all DBE and n on- DHE oanttWetors,who provide a prcpo4&4 bid,quota,or were coatraated by the proposed p te. 'This inibrmadon is also required from the proposed prime nontrnotar,and must be submitted with their bid4wvosal,7%e City of Hundngton Beach will use this infoamation to maintain and update a"Bi dzr'W'list to assist in the annual DBE sal wttitg prooess. Fin Name: Lam;;i1r., , Gl P/ia ,.p Phone.- - • Address:4O e—A: l-d;o 'l Pax: .Contest PeMMCZa A L y l-t— No, of years in business Is the first ounce 4 certified as DBE under 49 CFIR Part 26? YES ONO Type of worlr/servicea/nnatcrials provided by I What was your 's Owes A=Ual rtioe' is far t sue? weo�sa*w$Y milliart. a Leas to 69 Million o Loss than$10 Miliioe a Led them$19 MiHion Moue d=$l$b illim This 4`botm can be duplicged if necessary to report all bildders ids and neon DBEs?.ittbnnv oa- po* 11d00i1 70yi r P1 I " P I 11- 4-04;10:42AM:9ens Aspnalt ;7145401709 0 8/ 3 ■ CITY OF 11UNTINGTON BEACH t BIDDERS LIST t is are required to provided the followm information for all DBE and non- DBE Bidders/proposerseqw p S DBE contractors,who provide.a proposal,bid,quote,or were contracted by the propoited prime. This information is also required from the proposed prime contractor,and must be submitted with their bidiproposal. The City of Huntington Beach will use'this information to maintain and update a`Bidder's"list to assist in the annual DBE goal setting process. 1 Firm Name: (SE �� crRy_ ,/�►� Phone: (7iy) 1 Address: to to . t3��,c�r A 5r Fax: 11714 6.T. 8' .Contact Person No. of years.in business 1 I Is the firm currently certified as DBE under 49 CFR Part 269 YES el NO Type of worktservices/materiaLs provided by firm? Scu RY£••a,,,ice , !i ii_—z What was 32uK firm's Gross Annual receipt's for last ear? o Less than$1 NMon OAL Less than$5 bbilion u Less than$10 Million a Less than$15 Million } a More than$15 Nfillion This form can be duplicated if necessary to report all bidders(DBEs and non DBEs)information. I 1 C-11 I � .d S066-6Z9-bTG 9WIA3Amns QMd1 3SUO a -- esea ` •n- ►aannTw w-i-Inc �- cnRn c»o bpi TE '80 �0 9T WN�C_n 1 /nI / 11 'nan re...... 01/01/1995 07:28 7148930945 GRSI PAGE 01 11/16/2004 10;17 19494928324 ORION CONTRA':TING rt�ut �l CITY CIF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following inform-Winn for all DBE and nost- DBE contractors, wbo provide a proposal, bid, quote, or were ooutracted by the proposed prime, This information is also required from the proposed prime contractor; and must be submitted with their bid/proposal.The City of kluntingtoi� Bsacb wi11 use this lnformatioz�to maintain and update s"Bidder's"list to assist in the annual DBE goal settin process. Address: _ _..... r Vax:, / ,Contact Person:—.— _ No. of years in business is the firrrj currently certified as DBE under 49 C1 R.Part 26? YES NO Type of work/services�imeterials provided by Whatwes our firm' Gross Annual receipt's for lasIyear I ' Le,,,, thaii S1 Million Less tha,i $5 Million a Less than $l U MA111'033 t2 Less Chan $I-� Million r f. n More tii.an S l s Million This form can be duplicated if nrcessaj v to .°port all bitiders (DBEs and non DBEs) information. Ppet• ax N -1671 Krom 1 _ bull Fsx x �VVV FBx "4f'. . � C•1� �civcu , , � ,p� y ,l.!]JJHNIj :32u 55S 8055 -� SULLY MILLER CO. ; Page 2 PAGE 2/2 SENT BY: GENERAL ENGINEERING; 023 558 8055; NOV-16-04 9:31AM; .r,..i i rvu y 3-,3d.55.58W55 NO.994 9002 My OF HUNMGTON BEACH BIDDERS LIST All BAders/proposers are required to provided the following in&rraation for aU DBE and non- DBE coubiwbrs,who provide a proposal,bid, quote, or were condaGted by the proposed prime. This information is also required$am the proposed prime contractor, and must be submitted with their bid/proposal.The City of Ffunlinptt Brach wilt use this inibrmstion to male aut and update a"Bidder's"list to assist in the annual DBE goal setting cess. Fir=Name: 69N'C kic-" I N G pbor e: 558 edo o Address: 9 00 ir£ Lx- Fax: 55 SPAS PACs PIgFAA Cam. 106;�,v .Contact Person: ,A&EL— V! .. No.ofyearsinbusiness_ _ is the firm Murwdy certified as DBE under 49 CFR Part 26?' YES NO Type OfvvOrklsorviceshnaterialsprovided by firm? _qD�l _bT1LXT1f;5 - What was your funai.'s GiG Annual reoei is for last ear? n Less than S1 Million - o Less 9m 35 Millioa a Less tYtaa$101V1 UKW �K,108 than S15 Million 1) More than$15 Million This form can be duplicated if necessary to report all bidders(DBEs and lion DBEs)information. G11 MHVd1Vwu: 1 1 / .p/ Y 1 V:YYMNIj._.� aVGG10VV0Y _PCI —,.,--. NI---- -Qao 11/16/2004 09:43 5622180634 R vv PAGE 02 Sent by: SULLY MILLER 71457891374; 11/16/04 10:43AM;JWAX_0668;Page 212 CITY OF HM(TINGTON BEACH BinDERS LIST All Bidders/proposers are required to provided :he following infonnAlian for all DBE and non- OBE crnotrsetoM who pravide a proposal,bid, luote,or were contracted by the proposed prime. m This infb adoa is also required from the proposed prime ccmtractor, and must be submitted with their bidlproposal.The City of Huntington Beach will use this idmmat w to wai.ntain and update a``Bidder's"list to assist in the annual DBE a.i getting process. F>tm Name:— S G..�- Phone:,�'L Address: rIG 1- 11t Fes;_ Zl�s-C� C..l e7TV0(0 .Coatact Person: No.of years in business is te firm currmay cxttified as DBE uu t 49 CFR part 26? YES Type of worklservicealmatarieU provided by NO � What was ME ft='s Cifross Anwuel race' is;.or last ? o Less tbau$1 Miffim �s tin$5Mail a Less than$10 Malliou o Less than$15 Million • q Mare than$15 Mill;an TW form caa be duplicated if necessary to report all bidders(DBEs and non DBEs)inibmnataon. C-11 - -. . --�~11/15/2004 13:35 FAX 818 834 8618 STERNDAHL ENT INC 9001/001 11/15/2004 10:14 19494928324 ORION CONTRACTING PAGE 01 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for ail DBE and non- DBE contractors,who provide a proposal, bid, quote, or were contracted by the proposed prime. Tlis information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a'Sidder's"list to assist in the annual DBE goal setting process. Finn Name i dca �' n ,�C. Phone ! - AddressA i%t. I -f vc:�mtG 8 A- Fax .L( .Contact person: . No. of years in business Is the firm c=ently certified as DBE under 49 CFR Part 26? YES (I NO Type of work/services/materials provided by firm? Ke Gi C� � What was your firm's Gross Annual reoe' is for last ear? Q Less than$1 Million a Less than$5 Million Z �.ess than$10 Million _ ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. ^d =E+1 d"• I / io/ • iu=zaHM� ldGCtSl 4"LtlUb -� SULLY M1LLtM GU_ ; rage le 16.2004 1E 9 26AM SUU40RKS STRIPING (WC)NG + 162581428M NO.347 P.2945 9002 ' I CITY OF M)NTINGTON BEACH BIDDERS LIST All Bidderalproposcm arc required to provided the ibnowing infbnution for all DBE and nan- DBE contractors,who provide a proposal,bid,quote, or were contracted by the proposed prima. This information is also zequired from the proposed prime contractor,aad mustbe sW=dtted whh their bid/prgposaL The City of Hunti*on Beach will use this information to mWatain and update a°°Bidder'sll list to assist In the mmual DBE&Rat=Wng E2ccas. Firnn Name; r r' , Phone: k A? Address:!!2A L/ Fax; .Contct Perron: l's No, of yagn.in busi=sa Is thl,firm currently eerdfied as DBE under 49 CPR Part 26? YES ND Type of worldservicea/materials provided by firm? What was your Em's Gross Annual,race' is for lmt ear? A Less than$1 Million Lew&=$5 lutillion m Leas than$14 Million p Less dram S15 Million o More than$15 IvYillion i This forth on be duplicated if aecmary to Mort all bidden(DBM and not DBEs) tnthrmation. C-11 CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK ?T4keJ / , 2006- To: o�o��O �-.�/�70•J �E . Lay 6 c,y 90 (1,0(0 Enclosed please find your original bid bond issued by AM&W-IC4,,) LAJ ST271,L� D l 'C-he-/7-EZ7 S for Joan L. Flynn City Clerk JF:pe Enclosure g:/followup/cashcont/retumbidbond.doc (Telephone: 714-536-5227) PALL, INC. DBA EXCEL_PAVING COMPAN'� 22120 LEMON AVENUE r LONG BEACH. CA 90W, woo �r N"A 6JA C*xrs dam, UY PC 60 LA42- Wir L �o �� ��� ,( o f �`2:0' Bond No. Bid Bond BID BOND The American Institute of Architects, AIA Document No. A310(February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS,that we PALP Inc.dba Excel Paving Company as Principal hereinafter called the Principal,and Federal Insurance Company a corporation duly organized under the laws of the state of Indiana as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten percent of the total amount of the bid Dollars ($ 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for Gothard Street Rehabilitation 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 November 2004 PALP Inc.dba Excel Paving Company Witness Principal (Seal) By: C.P. BROWN Name/ i e T Federal Insurance Company Surety (Seal) Witness By. UD Attorney-in-Fact Douglas A. app ORSC 21328(5/97) CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange On N OY 03 2004 before me, A.P. Coats, Notary Public NAME,TrrLE OF OFFICER personally appeared Douglas A. Rapp NAME OF SIGNER(S) ® 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 acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), „r,,,,.�rrrr+r•++� and that by his/her/their signature(s) on the instrument the A.P.COAL erson s , or the entity upon behalf of which the person(s) s F COMM...149b145 F P ( ) Y P P ( ) notN+r w acted, executed the instrument. yt t.+��•ahr�.'oe� WITNESS and and official seal. (SIGN URE OF RY) 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL/OWNER ❑ CORPORATE OFFICER TITLE(S) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL NUMBER OF PAGES ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR EN UY(IES) Chubb POWER Fet;ram knsurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents,That FEDERALINSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation, and PACIFIC INDEMNITY COMPANY,a Wisconsin corporation,do each hereby constitute and appoint Douglas A. Rapp Or Linda D. Coats of Laguna Hills, California----------------------------------- each as their true and lawful Attomey4n-Fad to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds)given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 2 2 nd daY on January, 2004 .L- V&4 -7 Kenneth C.Wendel,Assistant Secretary /!` E.Robertson,Vice tjre dent STATE OF NEW JERSEY i ss. County of Somerset On eft 2 2 ndiay of January, 2004 ,before me,a Notary Public of New Jersey.personalty came Kenneth C.Wendel,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,tie companies which executed the foregoing Power of Attorney,and the said Kenneth C.Wendel being by me duly swam,did depose and say that he Is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affbmdby authority of the By;taws of said Companies;and Out he signed said Power dAttomey asAssistant Secretary of said Conpanies by Ake authority;and that he is acquainted with Frank E.Robertson,and knows him to be Vice President of said Companies;and that tha signature of Frank E.Robertson, subscribed to said Power of Attorney Is In the genuine handwriting of Frank E Robertson.and was thereto subscribed by authority of said By-Laws and In detmnenrs presence. Notarial Seal Karen A.Price t; PR,�, 1%Vaq PlabGc Slate o1 New Jersey :� �, _ ¢OZ�y No.2231611 Notary PI bfiC Pv % �: .. �.CERTWCATION Extra cti of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: 'Ali po attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman or the President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary,under their respective designations. The signature of such officers may be engraved,printed or lithographed. The signature of each of the following officers: Chairman.President,any Vice President,any Assistant Vice President,arty Secretary,any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory In the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached' I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the*Companies")do hereby certify that () the foregoing extract of the By-Laws of the Companies is true and correct, (i) the Companies are duty licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S.Treasury Department;further.Federal and Vigilant are licensed in Puerto Rico and ft U.S. Virgin Islands,and Federal is licensed in American Samoa,Guam,and each of the Provinces of Canada except Prince Edward island;and (ii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 3rd day of November 2004 lit —*— � D W Y� Kenneth C.Wendel,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF CLAIM, VERIFY THE AUTHENTICITY,OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone(908)903-3485 Fax (908)903-3656 e-mail: surety@chubb.com r..�ae.an,N,7C=A A_D %dlr%N CEIT i SECTION C PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely _for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 G1 proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find in the amount of$ EN PERCENT 9Y cChUNT BID" said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: OIN'V- Addenda No. Date Received Bidder's Signature C-2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: TOTAL AMOUNT LUMP SUM BID IN WORDS: C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 GOTHARD STREET (CC-1 154) PROJECT BID SCHEDULE ITEM'' ,_ESTI MATE Dy ITEM W.ITH;U,NIT'°PRIC:E"WRITTEN,,lN n aUNITPRICE,,� DED:', 0 ' N -QUANTITY:=-- - WORDS 1 1 Mobilization $ $S(OR) L.S. a'mt4'� -Dollars V ( P V. I Cents 2 1 Traffic Control Plan $, L.S. 4g�E# —Dollars Cents 3 1 Furnish Project Traffic Control L.S., Dollars U_ Cents 4 188,917 Cold Milling & Header Cutting S.F. @ Dollars Cents 5 471 Unclassified ExcaVation C.Y. @ C g(-A A_u Ltx)-e/Y-\ Dollars Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, Ton Full Depth etc.) _ @ Jnt\ 34JPIR�J=± Dollars LL V Cents 7 2,347 Pavement Reinforcement Fabric & Route and $ d_"�_ $ S.Y. Seal of Cracks Dollars )'P Cents 8 46 Adjust Sewer/Stor ain Manhole to Grade $ $ Each -Dollars Cents 9 91 Adjust Water Valve to Grade $ Each -Dollars Cents 10 1 Traffic Striping $(4341M. L.S. ollars Cents 11 80 Traffic Loop $ $ Each Dollars Cents 12 8 Remove & Reconstruct Access Ramp $ 1416o, $ Each r'� a o AP w% Dollars Cents 13 3 Adjust Survey Monument Well to Grade $1) Each @ IVW-k) V�J Y�� ��!A Dollars I Cents 14 25 Survey Monumentation $ Each —Dollars Cents Sub Total Bid Amount, Bid in Figures: $ a Sub Total Bid Amount, Bid in Words: _43 A 10 � )\ev 0-�Af, A X)Z 0 C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion' ',`1Vameand.Address:o .Subcontractor " State License`;: . Class of Work;: '" .Number .. Or �. By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange C.P. BROWN , being first?duly*w16�; deposes and says that he or she is PRESIDENT of EXCEL PM,iMGCOMPANV 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. PPILP.G�Nc-�3A E�L w4'1;.00 COMPANY Name of Bidder Signature of idder C-P- (BROWN.PHEbl 2230 LEMON AVENUE LONG BEACH, CA 90806 Address of Bidder 3FFEATTACKED Subscribed and sworn to before me this day of , 200 NOTARY PUBLIC 3EEATTACNED NOTARY SEAL C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of Los Angeles I , . On NOV 16 2004 before me, C Phillips, Notary Public l Date Name and Title of Officer(e.g,"Jane Doe,Notary Public") l personally appeared PALP DBA EXCEL PAVING CO. By C.P.Brown, President I• Name(s)of Signer(s) l $] personally known to me C.PHILLIPS ❑ f satisfactory roved to me on the basis o Commission.#1492824 p Notary Public•California evidence ) . .li Los Angeles County I My Comm.Expires May 11,ions 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. WITNESS my hand a d offic'al seal. Place Notary Seal Above igna ure of Nota P blic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 1999 National Notary Association•9350 De Solo Ave.,PA.Box 2402•Chatsworth,CA 91313-2402•www.nationainotary.org Prod.No.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 IMPROVEMENTS, (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. PALP. F:YrEL►���;;aG OaC��i� w Contractor By C.P. RROWN,PRESIDENT Title Date: NOV 1 6 2004 G5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who-has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? —/ ❑ Yes 6 3 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. PALL.JgK.10DA EXCEL COMPANY Contractor t By C.P. BROWN,PRESIDENT Title Date: NOV 1 6 2004 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor By Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name PALP, INC. DBA EXCEL PAVING COMPANY ! 2230 LEMON AVENUE LONG BEACH, - -CA 90806 Business Address City, State Zip ( )(,562)599.5841 Telephone Number STATE(►C, 688659 WAn State Contractor's License No. and Class Original Date Issued 5.31-0b Expiration Date The work site was inspected by e- of our office on \� , 200_. The following are persons, firms, and corporations having a principal interest in this proposal: �c,ns P,RROWN.PRESIDENT&CHIEF OPERATING OFFICER CAROLYN J.BROWN,SECRETARY&CHIEF FINANCIAL OFFICER .anGEn 11 dlAr SENIORVICEPRESIDE1T la(CiyY���wiw�®°s�Tar CUFMSP BROWN III,VICE PRESIDENT BRUCE E.RAII,VICE PR DENI MICHELE E.DRAKULICH,ASSISTANT SECRETARY PALP,INC.DSA ;:xca PAV114G COMPANY C-9 ....._._. .. _.._ The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. PALP.INC.58A EXCEL PAVH1 G COMPANY Company Name 4 fir. Signature of Biddr Colo BROW�,PRESIDENT Printed or Typed Signature NOV 1 6 2004 Subscribed and sworn to before me this_ day of , 200_ . NOTARY PUBLIC 3EE ATTACHED NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: SEF.ATTACHED Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of LQS Angeles I � On Nov 1 6 2001 before me, C. Phillips Notary Public Date Name and Title of officer(e.g.,"Jane Doe,Notary Public") personally appeared PALP DBA EXCEL PAVING CO. By C.P.Brown, President I• Name(s)of Signer(s) I C.PHILLIPS K) personally known to me 1 Ntr Commission.#I IQ,) )A O proved to me on the basis of satisfactory yMp Notary Public•California cn evidence ) Los Angeles County My Comm.Expires May 31,2003 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. WITNESS myAan d fficial seal. Place Notary Seal Above Sig lure of Not ry ublic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 01999 National Notary Association•9350 De Solo Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.nationainotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: PALM, INC. DBA EXCEL. PAVING COMPANY Phone: f5621599.594t 2230 LEMON AVENUE Address: LONG BEACH, CA 90806 Fax: FAx(sg2)59A�j495 .Contact Person:k)(►, L � LV' . No. of years.in business ZS t Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 LOCal A5515Rln4;C rFU%XUUA ca iraouuoi +JA S-•• AA AA-M PS&E Checklist Instructions Attachment C (THE BIDDER'S FYECUTTON ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITLTI'EANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL.EMPLOYMENT OPPORTUNITY CERTIFICATION PALP.9ZC.C H The bidder v:y r.5i P044 COMPANY ,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. 12-"9 C-12 Page 12-45 Local Assistance Procedures Manual EX MIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1. 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 L/I J b. material change c.cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee date f last report quarter o f. loan insurance 4. Name and Adress of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee.Enter Prime ci Subawardee Name and Address of Prime: Tier if known PALM, INC. DBA EXCEL PAVING COMPANY 2230 LEMON AVENUE LONG 3EACH, CA 90806 Congressional District, if known: Congressional District, if known: 6. Federal DepartmentlAgency: 7. Federal Program NamelDescription: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual,last name,first name,MI): different from No. 10a) (last name,first name,MI): (attach Continuation Sheet(s)ifnecessary) 11. Amount of Payment(check all that apply): 13. Type of Payment(check all that apply) $ actual planned a. retainer 12. Form of Payment(check all that apply): b. one-time fee a. cash c. commission b. in-kind;specify: nature d. contingentfee- e. deferred value f. other,specify: 14. Brief Description of Services Performed or to be performed and Dates)of Service,including officer(s), employee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s)attached: Yes No 16. Information requested through this form is authorized by Tide 31 U.S.C.Section Signature: 1352.This disclosure of lobbying activities is a material representation of fact o a V MOW PRESIDENT upon which reliance was placed by the fier above when this transaction was Print Name: made or entered Into.This disclosure is required pursuant to 31 U.S.C.1352 This information will be reported to the Congress semi-annually and will be Title: available for public inspection. Any person who fails to file the required disclosure NOV i 6 2004 shall be subject to a civil penalty of not less than$10,000 and not more than Telephone No.:_.(,5621 Date: $100,000 for each such failure. Federal Use Only Authorized for Local Reproduction Standard Form- Stamdard Farm LLL Rev.0143.95 C-13 Page 12-55 February 1, 1998 EXIMIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of -Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address,city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to,be a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment Include at least one organization level below agency name, if known. For example,Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number.for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number;grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C 14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity- not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden;to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. C-15 Page 12-55 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment L LOCAL AGENCY BIDDER-DBE INFORMATION This information may be submitted with your bid proposal. If it is not,and you are the apparent low bidder or the second or third low bidder, it must be submitted and received by the administering agency no later than the timespecified in the special provisions. PALM, INC. DBA EXCEL PAVING COMPANY CO./RTE./P.M.: BIDDER'SNAME: 22301 EM0111 AIIENUE CONTRACT NO.: ADDRESS: LONG BEArH CA nno^^ BID AMOUNT: $ BID'OPENING DATE:�Irni 1 F gnnfl_ DBE GOAL FROM CONTRACT % ITEM OF WORK AND DESCRIPTION NAME OF DBE** DOLLAR PERCENT CONTRACT OF WORK OR SERVICES TO BE (Name of DBEs,Certification Number, AMOUNT *#* ITEM NO. SUBCONTRACTED OR MATERIALS and Telephone Number) *** DBE TO BE PROVIDED DBE l�tl C�Act�Sea��a oo Cilofxcl R-C�S-e� n� 1_1 100- -1-tcOk-Ito �?V%e t Uor��ft � a SS&D — Total Claimed Participation % % * If 100%of item is not to be performed or furnished by DBE,describe exact portion,including planned location of work to be performed,of item to be performed or furnished by DBE *# DBEs must be certified by Caltrans on the date bids are opened. Subcontractors and suppliers certified state-funded only cannot be used to meet goals on federally funded contracts. *** Credit for a DBE supplier,who is not a manufacturer is limited to 60%of the amount paid to the supplier. (See Section "Disadvantaged Business"(DBE)of the special provisions) DIPORTANT: Names of DBE subcontractors and their respective item(s) of work listed above should be consistent with the name and items of work in the "List of Subcontractors" submitted with your bid pursuant to tbe Subcontractors Listing Law. Ov 16 2004 Signature of Bidder Date (Area Code)tel.No. C.P. BROWN,PRESIDENT �m D Person to Contact (Please type or print) Distribution for NHS Projects: (1)Original-Caltrans DLAE for NHS Projects,(2)Copy-Local Agency project file Distribution for non-NHS Projects: (1)Original Local Ageary project file DEPT.OF TRANSPORTATION (FED DBE)MODIFIED DC-OE-19(REV 09-18-95) C-16 Page 12-67 EXHIBIT 15-K Local Assistance Procedures Manual Report of DBE Awards REPORT OF DBE AWARDS . - -� fie �,1,��,,�d► COMPLETE THIS FORM FOR EACH CONTRACT 0 AMlA��1 Locode. Agency: Project No. DBE Goal: Total Contract Bid: Reimbursement Ratio: Federal Share: Award Date: Combined DBE Percent of Federal Share for this Project: DBE Subcontractors(excludin women)Awarded by Ethinic Group and other Disadvanta ed Black Hispanic Native Asian- Asian- Other Total A Indian Pacific No. To $ Fed$ DBE Subcontractors excludin men) Grand Total MWBE WWBE I Total B Total A+B No. No. Total $ Tota1$ Fed$ Fed$ Number of subcontracts awarded by type of work: Professional and Consultant Services DBE MWBE WWBE (excluding women) 1. Engineering 2. Architectural 3. Right of Way 4. Other Construction 1. Grading/Drainage 2. Paving 3. Structures/Buildings 4. Materials 5. Equipment 6. Trucking 7. Traffic Control S. Landscaping 9. Other TOTALS: Note: For the purpose of this report,use the following definitions. • DBE=disadvantaged business enterprise • MWBE=minority women business enterprise • WWBE=white women business enterprise C-17 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT '�''L'��G`�'�-�..�4^�'•S"r..?G�:.�.���4�'�..�4Y':G�•4'<:�G�:.�..�L�'�..�4Y'�:L'�?G`�::L`��.�..��4Y':4r�.�.Gr�..:�5<:�4���.Sr�.�:4"����4'5::��Sr�.'�7� I• i ' I I State of California ss. I' County of Las Angeles I' I I I : On NOV 16 2004 before me, C. Phillips, Notary Public Date Name and Title of Officer(e.g."Jane Doe,Notary Public") If. personally appeared PALP DBA EXCEL PAVING CO. By C.P.Brown, President I t• Name(s)of Slgner(s) I• I C.PHILLIPS KI personally known to me 44 � Commission.#1492824 Elproved to me on the basis of satisfactory (• G .�,,f Notary Public California N evidence ) Los Angeles County My Comm.Er iro May 31,2008 to be the person(s) whose name(s) is/are subscribed to the within instrument and ) acknowledged to me that he/she/they executed ;l 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. WITNESS y a d d official seal. Place Notary Seal Above Signa r of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 1999 National Notary Association•9350 De Solo Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.nationalnotary,org Prod.No.6907 Reorder:Call Toll-Free 1-800-876-6627 .E%CEL PAVING COMPANY P.O. BOX 16405 A GENERAL ENGINEERING CONTRACTOR LONG BEACH, CA 90806-5195 STATE LICENSE NO. 688659A (562) 599-5841 FAX (562) 591-7485 C. P. Brown, President: 33 years experience working for other general contractors with the past 22 years being self- employed in own general engineering contracting business. y INCUMBENCY AND SIGNATURE CERTIFICATE OF PALP, INC. - The undersigned, Carolyn J. Brown, being the duly elected and Incumbent Secretary of PALP, Inc. dba Excel Paving Company, a California corporation (the "Corporation"), hereby certifies that the persons named below are, on and as of the date hereof, the duly qualified, elected and acting Officers of the Corporation holding the office set forth opposite their names below, such officers being authorized to sign, in the name of and on behalf of the Corporation. Curtis P. Brown President and Chief Operating Officer Carolyn J. Brown Secretary and Chief Financial Officer George R. McRae Senior Vice President Curtis P. Brown III Vice President Bruce E..Flatt Vice President & Assistant Secretary Michele E. Drakulich Assistant Secretary iN WITNESS WHEREOF, the undersigned has executed this Certificate as of the date set forth below. Date: November 5, 2001 r AROLYN . B , ecretary "CEL PAVING COMPANY P.O. BOX 1640! A GENERAL ENGINEERING CONTRACTOR LONG BEACH, CA 90806-519! STATE LICENSE NO. 688659A (562) 599-584 FAX (562) 591-748! CREDIT APPLICATION Excel Paving Company 2230 Lemon Avenue P.O. Box 16405 Long Beach, CA 90806 Telephone: 562-599-5841 Fax: 562-599-3679 Type of Business: General Engineering Contractors Contractors License# 688659A Fed I.D.#95-3672914 Excel Paving Company is a Corporation Owner: Palp, Inc. 2230 Lemon Avenue Long Beach, CA 90806 In business since October 1981 Same location since October 1981 Property owned by Brown & Mills Financial rating with Dun & Bradstreet: Rating 3A2, SIC# 1611 US Bank, 2633 Cherry Ave., Signal Hill, CA 90806 Account Representative: Liz Acres or Celine Gonzalez Telephone: 562-490-2068 or 562-490-2079 Checking Account#1534-9195 8689 TRADE REFERENCES: Company Phone Fax Contact Vulcan Materials 323-258-2777 323-25"102 Silvia Arredondo R.E.H. Trucking 909-591-0871 909-591-0506 Gina Mendiola Blue Diamond Materials 714-578-9507 714-449-2831 Jerry Easterwood Savala Equipment 800-223-2473 949-652-8597 Mona Covington SPECIAL BILLING REQUIREMENTS: Show job number on invoices to expedite payment. certify that the above information is true and correct, and that we can and will comply with your terms. r? C.P. Brown Date President EXCEL PAVING COMPANY P.O. Box"1' 640 A GENERAL ENGINEERING CONTRACTOR LONG BEACH, CA 90806-51% STATE LICENSE NO. 688659A (562) 599_-594 FAX (562) 591-748 Reference List As of May, 2000 1. City of Long Beach 333 West Ocean Boulevard Long Beach CA 90802 Gillis Munroe, Chief Construction Inspector (562) 570-5161 2. Burbank-Glendale-Pasadena Airport Authority 2627 Hollywood Way Burbank CA 91505 Dan Feger, P.E. (818) 840-9456 Or (818) 840-8840 3. Los Angeles County Public Works 900 South Fremont Avenue Alhambra CA 91803 Gary Hartley, Construction Division (626) 458-3100 EXCEL PAVING COMPANY P.O. BOX 16405 A GENERAL ENGINEERING CONTRACTOR LONG BEACH, CA 90806.519E STATE LICENSE N0. 688659A (562) 599-5E;41 FAX (562) 591-74S` Bonding Agent: Rapp Surety Services 23461 South Pointe Drive Suite 345 Laguna Hills CA 92653 Contact: Douglas A. Rapp Office: (714) 457-1060 Fax: (949) 457-1070 Surety: Federal Insurance Company C/O Surety Department 801 South Figueroa Street 23`d Floor Los Angeles CA 90017 OR P.O. Box 30127 Los Angeles CA 90030-0127 Insurance Carrier: The Wooditch Company One Park Plaza Suite 400 Irvine CA 92614 Contact: William Wooditch Office: (714) 553-9800 Fax: (714) 553-0670 I EXCEL PAVING COMPANY EST.FINAL % JOB OPEN JOBS, 2nd. Quarter of 2004 INCOME WORK BACKLOG- NO. PROJECT/OWNER/AGENCY AMOUNT COMPL. 3704 TAXIWAY D L.B. AIRPORT 3,711,120 99.9% : 4,146 3714 PIER T, PORT OF LB 14,292,378 100.0% 3716 710 FWY PCH TO 405 20,012,148 100.0% : 127 3723 INDIANA &WASHINGTON, VERNON 311,000 90.7% : 28,975 3747 WEST& EAST ALAMEDA 7,215,816 100.0% 3807 OVERLAND AVE LOS ANGELES 2,100,951 100.0% 3833 GRAND CANAL CRT LOS ANGELES 690,359 100.0% 3834 GATES 3 &4 L.B. AIRPORT 434,826 100.0% 3835 SECURITY GATES L.B. AIRPORT 350,251 100.0% 3843 LAUREL CYN BLVD, LOS ANGELES 722,540 100.0% 3865 2627 HOLLYWOOD, BURB/GLEN/AIRP 191,975 99.1% : 1,805 3875 ORANGE AVE., LONG BEACH 1,027,298 100.0% 3876 PARTHENIA, LA 1,068,233 100.0% 3880 BERTH 212- 225 POLA 5,249,813 100.0% 3881 BROADWAY LA 2,353,009 100.0% 3895 PIER S PORT OF LONG BEACI: 11,152,520 100.0% : 5,128 3904 ST. JOHNS HLTH CTR SANTA MONICA 307,699 100.0% 3906 ROUND MEADOW RD HIDDEN HILLS 488,500 100.0% 3909 AMGEN CTR THOUSAND OAKS 919,974 99.2% : 7,360 3915 OVERLAND ES LOS ANGELES 415,238 100.0% 3922 BELLAGIO &NEWCOMER CENTER LA 1,380,044 100.0% 3923 OLYMPIC BLVD, BEVERLY HILLS 1,093,191 100.0% 3931 PCH &ADMIRALTY, SUNSET BEACH 161,473 98.6% : 2,288 3934 ROSCOMARE RD. E.S., BELL 523,685 96.5% : 18,229 3941 SOUTH STREET, LONG BEACH 330,350 100.0% 3947 TUSTIN AVE., ANAHEIM 4,010,000 87.7% : 494,462 3950 PV. DR/SCHOONER, RANCHO PALOS VERC: 27,036 100.0% 3952 DOWNEY HOSP., DOWNEY 22,784 36.0% : 14,593 3953 PLAYA DEL REY ES, LAUSD 477,833 100.0% 3959 SANTA MONICA BLVD., LOS ANGELES 35,480,000 36.8% : 22,429,833 3961 YACHT HARBOR, 175,000 90.3% : 16,968 3969 BERTH 2O6-209 SITE, PORT OF LA 3,466,947 100.0% 3973 LOS ROBLES MED CNTR, THOUS OAKS 355,736 100.0% 3976 EXCESLIOR DR. REHAB, NORWALK 360,283 100.0% 3977 ROSECRANS, NORWALK 213,811 100.0% 3978 WARDLOW/CLAR/BELLF, LONG BEACH 752,621 96.1% : 29,069 3979 WARDLOW/PV/STUDEBAKER, LONG BEACH 866,151 100.0% 3989 PCH/ADMIRLTY SUNSET BCH 45,000 75.9% : 10,854 3990 OCEAN BLVD LONG BEACH 1,321,929 100.0% 3992 NEWPORT BLVD/VICTORIA 276,069 100.0% 3995 ALICIA PKWY/PASEO DE ALICIA 239,506 : 94.6% : 12,881 4002 170TH ST, ARTESIA 82,489 100.0% 4004 GREEN VALLY CIRCLE CULVER CITY : 1,118,606 100.0% 1 I EXCEL PAVING COMPANY EST.FINAL % JOB OPEN JOBS, 2nd. Quarter of 2004 INCOME WORK BACKLOG NO. PROJECT/OWNER/AGENCY AMOUNT COMPL. 4005 CATALINA LANDIND LB 1,402,514 99.5% : 6,702 4012 CAMELLA ES N. HOLLYWOOD 153,074 100.0% 4013 FILBERT AVE SYLMAR 28,192 100.0% 4016 STEVEN SON/JOH N SON 406,156 100.0% 4017 POLA BERTH 210-211 1,069,540 99.0% : 10,478 4018 MT SAC 1,356,922 100.0% : 506 4024 UCLA KINROSS 2,075,000 73.7% : 546,570 4025 SANTA MONICA ES 8,880 100.0% 4026 GAGE &COMPTON 439,852 100.0% 4028 CALIF/BURNETT SIGNAL HILL 99,284 82.9% : 16,952 4030 CAMINO LAS RAMBLAS 227,391 0.7% : 225,706 4033 LB AIRPORT VARIOUS 74,730 100.0% 4035 MAINT ST&MACARTHUR 485,148 94.6% : 26,301 4039 NO VLY OCC CENTER 449,762 100.0% 4041 HARVARD AVE. IRVINE 1,117,033 99.9% : 583 4042 TUDOR WESTWOOD PLAZA 752,500 : 0.6% : 748,245 4043 LAS BRISAS 70,545 100.0% 4045 5 FRWY, OR. CO 148,290 8.3% : . 135,969 4047 DAPPLEGRAY/STRAWBRY R.H.E. 392,350 100.0% 4048 4100 RPV SO RPV 399,060 94.8% : 20,889 4050 CRENSHAW BLVD LACPW 1,353,023 57.8% : 571,612 4057 PALO VERDE HSG UCI 613,000 87.4% : 76,973 4059 MARK TWAIN MS. LA 675,900 95.9% : 27,665 4060 MT SAC ATH FLDS WALNUT 1,333,196 82.9% : 227,527 4061 PANKOW BLDRS M.B. 649,000 58.1% : 272,097 4062 SANTA MONICA BLVD.- MWD LA 7,089,000 12.9% : 6,172,974 4064 WALGROVE E.S. L.A. 719,719 22.6% : 557,005 4065 LA CITY COLL LA 320,640 100.0% 4067 DEL AMO BLVD LONG BEACH 395,897 93.2% : 26,739 4069 MCCLAY MS PACOIMA 283,114 81.3% : 52,881 4070 VARIOUS LOC HUNTINGTON BEACH 179,486 100.0% 4071 SHERBOURE CEDARS-SINAI 122,050 100.0% 4072 VAR ST. LOC MONTEBELLO 133,118 100.0% 4075 7100SANTA MONICA L.A. 680,715 89.6% : 71,078 4076 JESSE OWENS PK INGLEWOOD 622,770 98.7% : 7,938 4077 CHAPMAN/ST COLL FULLERTON 130,000 42.6% : 74,601 4080 SKYLINE FULLERTON 29,190 99.5% : 141 4081 BURBANK AIRPORT BURBANK 202,575 100.0% 4083 HARBOR BLVD FULLERTON 125,400 36.6% : 79,463 4084 SAND CANYON IRVINE : 664,740 81.5% : 122,824 4,087 03-04 ST, RESURF GLENDALE 584,251 88.1% : 69,361 4,088 ANNUAL RD RESURF DANA POINT 11344,316 100.0% I EXCEL PAVING COMPANY EST.FINAL % JOB OPEN JOBS, 2nd. Quarter of 2004 INCOME WORK BACKLOG NO. PROJECT/OWNER/AGENCY AMOUNT COMPL. - 4089 20263 WESTERN TORRANCE 16,000 18.3% : 13,076 4090 CORBY AVE. ARTESIA 133,833 99.9% : 153 4091 DALEN ST. DOWNEY 50,500 6.7% : 47,136 4093 SAN FERN VLY LA 1,280,336 18.1% : 1,048,420 4096 SUNSET BLVD BEV. HILLS 40,050 62.4% : 15,073 4097 SUNFLOWER COSTA MESA 19,052 96.6% : 656 4098 BLEND E.S LA 248,797 0.7% : 247,165 4099 03 ST IMPRV INGLEWOOD 580,085 68.7% : 181,291 4100 SEPULVEDA BLVD EL SEGUNDO 2,448 0.0% : 2,448 4101 MILTON AVE WHITTLER 187,232 100.0% : 45 4102 DENA E.S. LA 174,306 1.1% : 172,401 4103 HOWLAND CNL CRT LA 280,950 9.1% : 255,310 4104 MOULTON PKWY CO OF ORANGE 494,885 0.5% : 492,262 4105 IMPERIAL&VISTA 149,600 3.8% : 143,949 4106 PIER S BRTH S102-S110 LONG BEACH 3,886,139 13.8% : 3,348,887 4108 HARBOR/CHAPMAN FULLERTON 144,026 100.0% 4109 VARIOUS STS REDONDO BEACH 738,060 0.7% : 732,993 4110 PIONEER/CARSON HAWAIIAN GRDNS 55,600 0.5% : 55,303 4111 1465 E. 3RD ST LOS ANGELES 9,500 100.0% 4112 BELMONT PIER LONG BEACH 468,358 12.8% : 425,791 4113 NO LONG BEACH LONG BEACH 1,732,631 0.5% : 1,723,692 4114 VARIOUS STS GARDEN GROVE 931,828 0.6% : 926,434 4115 WASHINGTON BLVD CULVER CITY 619,214 26.4% : 455,543 4117 VANUYS AIRPORT VAN NUYS 533,167 0.2% : 532,177 4119 WORLD WAY WEST AMER. AIR 5,800 91.0% : 524 4120 SOUTHGATE HS LOS ANGELES 673,350 0.7% : 668,656 4121 BUENA VISTA BURBANK 2,900 100.0% 4123 ANAHEIM ST LONG BEACH 3,072,342 0.5% : 3,056,372 4124 POLICE STATION GARDENA 401420 0.7% : 40,145 4125 BRAYTON ST SIGNAL HILL 6,800 93.2% : 461 4126 UNIVERSITY AVE RIVERSIDE 2,013,837 0.6% : 2,002,016 4127 UNION STATION LOS ANGELES 300,377 0.0% : 300,377 4129 MT. SAC WALNUT 729,800 0.7% : 724,595 4130 ALAMEDA CORR LONG BEACH 409,000 99.9% : 409,000 4131 DISNEYLAND ANAHEIM 32,404 93.4% : 2,151 4132 EAGLETON ST AGOURA HILLS 14,600 2.5% : 14,228 4133 SAN CANYON RD SANTA CLARITA 120,310 0.5% : 119,657 4134 DURFEE/EXLINE EL MONTE 31,720 0.0% : 31,720 4135 PIONEER HS WHITTTLER 633,698 0.0% : 633,698 EXCEL PAVING COMPANY 2,004 FINAL JOB CLOSED JOBS 1st. & 2nd. Quarters Only INCOME NO. PROJECT NAME AMOUNT 3369 ONE OCEAN TRAILS DR. 187,017 3589 MEDICI, LOS ANGELES 1,300,961 3637 12015 HARBOR BLVD., GARDEN GROVE 292,022 3721 IMPERIAL HWY., LOS ANGELES 1,037,837 3737 4341 E. WASHINGTON COMMERCE 4,354,077 3742 HENRY FORD, LA 2,700,058 3787 VARIOUS LOC SANTA MONICA 3,570,324 3789 PARAMOUNT AVE LONG BEACH 549,948 3790 WILLOW ST LONG BEACH 471,575 3836 BELLFLOWER.BLVD. LONG BEACH 587,385 3837 PARKCREST LONG BEACH 576,439 3838 COLLEGE PARK DR. LONG BEACH 129,619 3839 VARIOUS STR ' LONG BEACH 1,414,032 3844 SHADY CYN PHASE 1B . IRVINE 134,618 3853 MISSION BLVD., POMONA 1,933,686 3855 21ST ST., HERMOSA BEACH 93,674 3860 54TH ES, LOS ANGELES 373,083 3862 VARIOUS ST OVERLAY, RANCHO PALOS VERDES 1,335,586 3866 HARDING AVE, LA 1,272,458 3867 SAN FERNANDO MISSION BLVD. LA 241,389 3882 RTE 110 LOS ANGELES 13,878 3888 2001-2002 ANNUAL MAINT, BEVERLY HILLS 1,071,191 3891 DODSON MS LA 421,387 3893 CHERRY AVE OFF RAMP LONG BEACH 47,332 3894 ROWAN AVE LA 529,889 3898 1200 GETTY CTR LOS ANGELES 83,066 3900 CENTURY PK WEST LOS ANGELES 769,641 3907 ADDAMS ES LONG BEACH 299,430 3908 13652 CANTARA ST LOS ANGELES 351,000 3910 AMGEN CTR THOUSAND OAKS 181,997 3912 GRAND AVE ' EL SEGUNDO 285,134 3914 ALLEYS - 13TH SEAL BEACH 1,176,425 3916 JOHN MUIR MS LOS ANGELES 346,489 3919 AVENIDA MAZATLAN SANTA MONICA 10,371 3925 DIAMOND/CRESTVIEW, LAGUNA BCH 266,863 3926 KENNETH VILLAGE/GRANDVIEW GLENDALE 934,377 3927 BUS CENTER, INGLEWOOD 1,249,275 3929 OLYMPIC BLVD., LOS ANGELES 501,589 3933 CORONA AVE ES, LOS ANGELES 418-314 3937 1730 CORONADO, LONG BEACH 3,800 3939 GLENNEYRE ST., LAGUNA BCH 408,063 EXCEL PAVING COMPANY 2,004 FINAL JOB CLOSED JOBS 1st. & 2nd. Quarters Only INCOME NO. PROJECT NAME AMOUNT 3940 HARDING E.S., SYLMAR 634,037 3943 SOMERSET BLVD., BELLFLOWER 322,468 3945 CAMINO CAPISTRANO, SAN JUAN CAPISTRANO 299,287 3948 PALISADES CHARTER HS, LOS ANGELES 209,209 3949 2300 E. PCH, WILMINGTON 110,062 3951 2401 E. WARDLOW, LONG BEACH 399,700 3954 505 N.,FIGUEROA ST., LOS ANGELES 106,331 . 3962 S. MACLAY AVE, SAN FERNANDO 412,397 3963 EL DORADO PK, LONG BEACH 156,007 3964 LONG BEACH BLVD., LONG BEACH 343,141 3966 13652 CANTARA PANORAMA CITY 37,776 3967 5722 DAIRY AVE LONG BEACH 5,500 3971 VARIOUS &WASH BLVD., CULVER CITY 1,178,796 3982 ROSECRANS &710 FRWY COMPTON 33,850 3983 18349 FIGUEROA LOS ANGELES 10,758 3984 CADILLAC/VENICE LOS ANGELES 587,759 3985 TOWN CENTER HALL 143,281 3986 2627 HOLLYWOOD WAY BURBANK 291,290 3987 RAMSDELL AVE. LA CRECENTA 130,700 3988 VARIOUS ST REHAB SEAL BEACH 161,607 3991 ROSECRANS AVE NORWALK 91,835 3993 10801 6TH RANCHO CUCUMONGA 301,499 3998 COLLEGE PK WEST SEAL BEACH 6,600 3999 LILO PKG LOT ANAHEIM 181,180 4000 HOLLYWOOD WAY OFF RAMP 43,997 4001 BRISTOL/HEMLOCK 24,140 4003 710 FRWY/ANAHEIM 342,255 4006 LB AIRPORT PW107013 L.B. 178,897 4007 LB AIRPORT PW107104 32,010 4009 HAVEN ST, RNCHO CUCAMONGA 353,002 4010 MAPLE AVE MONTEBELLO 118,886 4011 BURB/GLEN/PASA AIRPORT 257,707 4014 CANTEBURY AVE ES 471,227 4015 MCCOY CLEAR VW DR 6,500 4021 INGLEWOOD AVE 180,462 4023 GARDENDALE DOWNEY 146,398 4027 BEVERLY HILLS 3RD/CIVIC 27,170 4029 MANCHESTER BLVD. BUENA PARK 107,900 4031 BARTON/BU RCH/PRISK 437,910 4032 DORLAND/NORWALK . 83,009 4038 RE GRP 190TH GARDENA 19,199 EXCEL PAVING COMPANY 2,004 JOB CLOSED JOBS 1st. & 2nd. Quarters Only INCOME NO. PROJECT NAME AMOUNT ------ - -------------------------- -------------------- ------------ 4040 HATH DIN ANTON BLVD 106,854 4044 BELL/33RD ST MAN. BCH 53,660 4049 TOWN CENTER DR COSTA MESA 36,009 4049 TOWN CENTER DR COSTA MESA 36,009 4051 BLDG M-4 NORTHROP GRUMAN 286,164 4052 BAKE PKWY IRVINE 26,900 4053 340 LOMA L.B. 4,200 4055 L.B. AIRPORT L.B. 15,317 4055 L.B. AIRPORT L.B. 15,317 4063 190 MARINA DR. LB TRANSIT 94,900 4066 M-4 SO PKG LOT NORTHROP 443,972 4068 WILMINGTON REFI WILMINGTON 79,954 4073 ROOSEVELT ES LYNWOOD 12,448 4074 FLORENCE PL BELL GARDENS 108,950 4078 CALIF/BURNETT SIGNAL HILL 1,000 4079 OHIO/HILL/STAN SIGNAL HILL 2,600 4082 ADAMS LA 1,227 4085 ALAMEDA/HOLLYWOOD BURBANK 2,262 4086 NAVAJO PL PV EST 12,780 4092 IMPERIAL HWY DOWNEY 5,286 4095 CEDAR BROOK ALISO VIEJO 1,494 4107 LANDFILL PUENTE HILLS 13,809 4116 FAIRFAX HS 2,428 4122 RAILROAD ST INDUSTRY 4,600 4128 MAGNOLIA BURBANK 16,785 EXCEL PAVING CO. CLOSED JOBS 2003 Year of 2003 FINAL JOB INCOME NO. PROJECT NAME AMOUNT ---------------------------------- 3498 9425 PENFIELD AVE, CHATSWORTH 524,427 3607 BRISTOL ST., SANTA ANA 8,891,538 3662 777 PAULING DR., THOUSAND OAKS 246,729 3666 555 W. TEMPLE ST., LOS ANGELES 833,768 3669 23388 MULHOLLAND, WEST HOLLYWOOD 2,166,833 3672 SHADY CYN/SAND CYN, IRVINE 11,156,694 3693 11847 W. GORHAM AVE. LOS ANGELES 181,777 3720 2699 PALOMA ST., PASADENA 109,929 3732 GARVEY & CORP CTR, MONTEREY PARK 2,292,779 3745 WARNER AVE., SANTA ANA 2,645,776 3752 PIER 400 ICTF, LA 6,718,112 3764 BERTH 230-232 POLA 2,259,075 3768 ERRINGER AVE SIMI VALLEY 520,781 3788 PALO VERDE AVE LONG BEACH 488,074 3796 VARIOUS LOCATIONS SIMI VALLEY 2,021,101 3797 GOMPERS ELEM SCH LONG BEACH 526,406 3812 2627 HOLLYWOOD WY, BURBANK 3,659,178 3814 PIER 400 LEAD TRK, POLA 3,013,820 3817 PORTSHEAD RD., MALIBU 154,668 3818 BERTH 115 SAN PEDRO. 1,603,575 3821 MACARTHUR BLVD. IRVINE 364,009 3829 COMPTON AVE LA COUNTY 1,335,672 3840 * CALIFORNIA REHAB GLENDALE 289,022 3846 42ND & ANGELES MESA E.S. LOS ANGELES 626,703 3847 * STRT REHAB GLENDALE 1,967,209 3848 SANTA MONICA MUNICIPAL POOL SANTA MONICA 4,900 3852 BANDERA RD, LA 232,256 3857 9521. DALEN ST, DOWNEY 41,478 3858 VON KARMAN & MAIN, IRVINE 122,403 3859 OLD TOWN WEST, LOS ALAMITOS 848,052 3863 E. PKG LOT AVIATION, REDONDO BCH 434,879 3869 SEPULVEDA/PCH MALIBU 41,910 3870 CRENSHAW BLVD., LA 1,301,618 3871 CARSON:& HELMS CULVER CITY 910,143 3872 TAFT ES, LOS ANGELES 371,367 3874 SYLMAR HS, LOS ANGELES 452,900 3877 LONG BEACH AIRPORT LONG BEACH 28,500 3883 15 AVE SCHOOL LOS ANGELES 245,632 3884 DANA MIDDLE SCHOOL LOS ANGELES 631,459 3885 PIER W PORT OF LONG BEA 385,401 3886 PKG LOTS D & E LONG BEACH 341,042 3889 74TH ST ES LOS ANGELES 270,412 3892 CLEVELAND HS 98,100 CLOSED JOBS 2003 Year of 2003 FINAL JOB INCOME - N0. PROJECT NAME AMOUNT 3896 FISHBURN AVE ES LOS ANGELES 304,115 3897 2100 AMGEN CTR DR, THOUSAND OAKS 113,884 _ 3899 LOCAL ST REHAB LAWNDALE 348,148 3901 VIEWLINE DR SIMI VALLEY 319,900 3903 LEXINGTON & BURTON BEVERLY HILLS 139,610 3905 RTE 5/60 AT SOTO, LOS ANGELES 7,233 3911 SUPER BLOCK PKG SANTA ANA 208,478 3917 UCLA CAMPUS LOS ANGELES 135,323 3918 MULHOLLAND HWY LA 16,629 3921 BOLSA CHICA & RANCHO HUNTINGTON BCH 25,078 3930 EL CAMINO REAL, LOS ANGELES 373,649 3935 GAULT ST. E.S., LOS ANGELES 594,379 3936 EL MORRO ES, LAGUNA BCH 29,900 3938 DORSEY H.S., LOS ANGELES 159,454 3942 LONG BEACH AIRPORT LONG BEACH 16,022 3944 DANA POINT HARBOR DANA POINT 383,919 3946 2021 E. ROSECRANS, EL SEGUNDO 2,500 3955 WASH & INDIANA, VERNON 150,698 3956 8111 VENTURA, PANORAMA CITY 13,497 3957 SOUTH BEACH IMPVTS, SANTA MONICA 19,250 3958 PIER.T GDR XING, PORT OF LONG BEA 77,912 3960 UCLA CAMPUS, LOS ANGELES 47,499 3965 2670 HOLLYWOOD WAY, BURBANK 59,560 3966 13652 CANTARA, PANORAMA CITY 0 3968 OCEAN PK, SANTA MONICA 198,605 3970 CABRILLO AVE ES, SAN PEDRO 375,255 3972 633 W. 5TH ST, LOS ANGELES 10,760 3974 DISCOVERY WELL PK, SIGNAL HILL 57,625 3975 2401 E. PCH, WILMINGTON 7,147 3980 7100 SANTA MONICA LOS ANGELES 4,361 3994 3333 SKY PK DR TORRANCE 5,029 4008 MOOG WESTERN AVE 128,302 4019 GRAND ST, LQ 1,996 4020 PIPE CON PCH 3,800 4022 BOEING PLANT 42 PLMDL 305,399 4034 OSO PARKWAY 53,354 4036 WHITTIER SCHOOLS 41,231 4037 33RD/ORANGE SH . 15,489 4046 LINCOLN/JEFFERSON L.A. 16,011 4054 WORLD WAY WEST L.A. 8,676 4056 2300 PCH L.B 3,400 4058 SANTA MONICA/HILLCREST B.H. 1,550 I - CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE-(REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT)FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF$2,000,000 COMPLETED W ITHIN THE LAST FIVE YEARS AND OPERATIONAL FOR AT LEAST ONE YEAR PROVIDE THE FOLLOWING INFORMATION: PROJECT NAME: PIER T MARINE TERMINAL PROJECT DESCRIPTION: DEMO, ASPHALT CONCRETE, CRUSHED MISC. BASE, ELECTRICAL, STRIPING, BATHROOMS, SIGN STRUCTURES, UNDERGROUND, CONCRETE FOR THE PIER T MARINE TERMINAL, LONG LOCATION: PIER T DATE OF OCCUPANCY BY OWNER: CONSTRUCTION VALUE: $33,481,910.00 PROJECT DURATION- PER CONTRACT 6/98 4fIK THRU 12/99 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: PORT OF LONG BEACH GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT:' BRUCE:;FLAT.T TELEPHONE: 562159.9-5841 OWNER INFORMATION NAME: poU OF LONG BEACH CONTACT: GARY CARDAMONS TELEPHONE:' 562/590-4172 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGR INITIAL TO AND TYPICALLY AGENCY GENE SETTLEMENT PERCENT COMPLETE: COPY ADDITIONAL PAGES AS NEEDED - 14 CONTRACTOR'S NAME P l.P INC. DBA EXCEL PAVING .COMPANY A. COMPANY EXPERIENCE-(REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT)FOR ALL PROJECT; WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 COMPLETED WITHIN THE LAST FIVE YEARS AND OPERATIONAL FOR AT LEAST ONE YEAR PROVIDE THE FOLLOWING INFORMATION PROJECT NAME: OCEAN BLVD. EAST AND WEST RECONSTRUCTION PROJECT DESCRIPTION: SEWER/WATER/STORM DRAIN, GRADE CHANGE, CMB, A/C,' STRIPING, SIGNALIZATION . LOCATION: OCEAN BLVD. EAST AND WEST DATE OF OCCUPANCY BY OWNER: CONSTRUCTION VALUE: $11,290,045.00 PROJECT DURATION - PER CONTRACT 6/99 AFL THRU 12/99 IF YOUR WORK WAS PERFORMEb AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: PORT OF LONG BEACH GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT:- BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: PORT OF LONG BEACH CONTACT: GARY .CARDAMONS TELEPHONE-56'2/590-4127 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY A INITIAL TO AND TYPICALLY AGENCY GE SETTLEMENT PERCENT COMPLETE: % COPY ADDITIONAL PAGES AS NEEDED. 14 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING. COMPANY : A. COMPANY EXPERIENCE-(REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT)FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF$2,000,000 COMPLETED W I [HIN THE LAST FIVE YEARS AND OPERATIONAL FOR AT LEAST ONE YEAR PROVIDE THE FOLLOWING INFORMATION: PROJECT NAME: THE PORT OF LONG BEACH PROJECT DESCRIPTION: PIER J SITE IMPROVEMENTS RAILROAD, WHARFS, FENCE, ELECTRICAL, STRUCTURES, LANDSCAPE, ASPHALT CONCRETE, CRUSHED MISC. BASE LOCATION: PER J HARBOR SCENIC DATE OF OCCUPANCY BY OWNER: CONSTRUCTION VALUE: $9.138.146.00 PROJECT DURATION-PER CONTRACT 4/98 PBX THRU 3/00 IF YOUR WORK WAS PERFORME'b AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: PORT OF LONG BEACH GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT:' BRUCE FLATT TELEPHONE: 5621599-5841 OWNER INFORMATION NAME: THE PORT OF LONG BEACH CONTACT: GARY CARDAMONE TELEPHONE: 562/590-41.27. DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGRI INITIAL TO AND TYPICALLY AGENCY GENE] SETTLEMENT PERCENT COMPLETE: COPY ADDITIONAL PAGES AS NEEDED 14 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE THE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORN WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: PIER S NORTH FILL PROJECT DESCRIPTION: INSTALLATION OF SEWER, WATER, STORM DRAIN, ELECTRICAL COMMUNICATION, LIGHTING, CONDUIT & VAULTS, MSE WALL CONSTRUCTOR, GRADING, CMB PLACEMENT & ASPHALT PAVING LOCATION: BERTHS S102-S110 CONSTRUCTION VALUE: $10,425,708.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: PORT OF LONG BEACH GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT: BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: PORT OF LONG BEACH CONTACT: _GARY BAKER/BUTCH MCBLAINE TELEPHONE: 562/432-1778 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AG INITIAL TO AND TYPICALLY AGENCY GEN SETTLEMENT PERCENT COMPLETE: %. COPY ADDITIONAL PAGES AS NEEDED 13 CONTRACTOR'S NAME PAL P INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE-(REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT)FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORKWITH AVALUE IN EXCESS OF $2,000,000 COMPLETED W ITHINTHE LAST FIVE YEARS AND OPERATIONAL FOR AT LEAST ONE YEAR PROVIDE THE FOLLOWING INFORMATION: PROJECT NAME: 1997-98 & 1998-99 ANNUAL INFRASTRUCTURE PROJECT PROJECT DESCRIPTION: _STREET IMPROVEMENTS ASPHALT CONCRETE COLD MlLlLi- ELECTRICAL, STRIPING, SLURRY SEAL, CONCRETE LOCATION: VARIOUS LOCATIONS, SANTA CLARITA DATE OF OCCUPANCY BY OWNER: CONSTRUCTION VALUE: $4,092 472 00 PROJECT DURATION - PER CONTRACT 7/98 AES1 M THRU 12/98 IF YOUR WORK WAS PERFORMEb AS A SUBCONTRACTOR: INITIAL SUBCONTRACT VALUE: N/A FINAL SUBCONTRACT VALUE: ARCHITECT: SANTA CLARITA GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT:' BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: CITY OF SANTA CLARITA CONTACT: KERRY BYER TELEPHONE: 805/255-4984 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGF INITIAL TO AND TYPICALLY AGENCY GEN1 SETTLEMENT PERCENT COMPLETE: COPY ADDITIONAL PAGES AS NEEDED 14 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE-(REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT)FOR ALL PROJECT WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF$2,000,000 COMELETED WITHIN TH LAST FIVE YEARS AND OPERATIONAL FOR AT LEAST ONE YEAR PROVIDE THE FOLLOWING INFORMATIOt PROJECT NAME: PARK AND RIDE,LOT PROJECT DESCRIPTION: SITE WORK, BATHROOMS, ASPHALT CONCRETE, CRUSHED MISC. BASE, STRIPING. SIGNS. BARRIERS. STRUCTURES, BRIDGE WIDENING LOCATION: 91 FWY & 405 FWY DATE OF OCCUPANCY BY OWNER: CONSTRUCTION VALUE: $11,358, 103.00 PROJECT DURATION- PER CONTRACT 4/95 AgTXn THRU 8/98 IF YOUR WORK WAS PERFORME•b AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: .ARCHITECT: CALTRANS GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT: BRUCE'FLATT TELEPHONE: 56215 99-5841 OWNER INFORMATION NAME: CALTRANS DIST. 7 CONTACT: MURRY MUM TELEPHONE: 213/897-3656 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGR INITIAL TO AND TYPICALLY AGENCY GENE SETTLEMENT PERCENT COMPLETE: COPY ADDITIONAL PAGES AS NEEDED 14 . I I 1 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE.THE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: RECONSTRUCTION OF THE BROADWAY SIDEWALK PROJECT DESCRIPTION: SIDEWALK AND BASEMENT STRUCTURAL REPAIR LOCATION: BETWEEN 2ND ST. AND 5TH ST. , LOS ANGELES CONSTRUCTION VALUE: $2,514,839.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: C/O LOS ANGELES GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT: BRUCE FLATT TELEPHONE-562/599-5841 OWNER INFORMATION NAME: CITY OF LOS ANGELES CONTACT: SIgARAT RHAKTA TELEPHONE: 213/847-8982 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGRI INITIAL TO AND TYPICALLY AGENCY GENET SETTLEMENT PERCENT COMPLETE: % COPY ADDITIONAL PAGES AS NEEDED 13 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE THE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: TUSTIN AVE. , STREET IMPROVEMENT PROJECT DESCRIPTION: A/C PAVE, CMB, RAMP WIDENING, CURB & GUTTER, STRIPING, K-RAIL, DEMO, RETAINING WALLS, BRIDGE ABUTMENTS, LANDSCAPE, IRRIGATION, SIGNALIZATION LOCATION: TUSTIN AVE. AT SR-91 FWY. , ANAHEIM CONSTRUCTION VALUE: $3,842 091 _25 IF YOUR WORK WAS PERFORMED AS_A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: C/O ANAHEIM GENERAL CONTRACTOR INFORMATION NAME: PALP. .ING'. DBA EXCEL PAVING COMPANY CONTACT: BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: CITY OF ANAHEIM CONTACT: RALPH HARP TELEPHONE: 714/7 62-5162 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AG) INITIAL TO AND TYPICALLY AGENCY GEM SETTLEMENT PERCENT COMPLETE: COPY ADDITIONAL PAGES AS NEEDED 13 r CONTRACTOR'S NAME PALp INC. DBA FXcFL PAVTNG COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE THE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH AVALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: BERTH 212-225 BACKLAND IMPROVEMENTS PROJECT DESCRIPTION: CONSTRUCT 15 FOUNDATIONS FOR 100' HIGH MAST LIGHT POLES ( jH , RELOCATE ELECTRICAL CONDUIT AND WATERLINE FOR HMPS AND RELOCATE 15 HMPS, CONSTRUCT 16,000 LF OF CRANE CONC. RUNWAY CONSTRUCT 3 SUBSTATIONS. ASPHALT PAYING. LOCATION: —SAN PEDRO CONSTRUCTION VALUE: $4,297,540.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: PORT OF LOS ANGELES GENERAL CONTRACTOR INFORMATION NAME: PALp INC DBA EX FT PAVING, (Y)MPANy CONTACT: BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: PORT OF LOS ANGELES CONTACT: JACK CHANG TELEPHONE: 310/7 32-3225 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGI INITIAL TO AND TYPICALLY AGENCY GEN' SETTLEMENT PERCENT COMPLETE: % COPY ADDITIONAL PAGES AS NEEDED 13 CONTRACTOR'S NAME PALP INC. DBA EXCEL PAVING COMPANY A. COMPANY EXPERIENCE (REFERENCE 1.05 OF THE RESPONSIBILITY STATEMENT) PROVIDE THE FOLLOWING INFORMATION FOR ALL PROJECTS WHICH INVOLVE CONSTRUCTION WORK WITH A VALUE IN EXCESS OF $2,000,000 PRESENTLY UNDER CONSTRUCTION. PROJECT NAME: . SANTA MONICA TRANSIT PARKWAY PROJECT PROJECT DESCRIPTION: UNDERGROUND, RETAINING WALLS, FWY. ON, RAMPS, A/C PAVE, SIDEWALK, CURB & GUTTER, SIGNALIZATION, LANDSCAPING LOCATION: FROM 405 FWY. TO BEVERLY HILLS CITY LIMIT, LOS ANGELES CONSTRUCTION VALUE: $34,455.152.00 IF YOUR WORK WAS PERFORMED AS A SUBCONTRACTOR: N/A INITIAL SUBCONTRACT VALUE: FINAL SUBCONTRACT VALUE: ARCHITECT: C/O LOS ANGELES GENERAL CONTRACTOR INFORMATION NAME: PALP INC. DBA EXCEL PAVING COMPANY CONTACT: BRUCE FLATT TELEPHONE: 562/599-5841 OWNER INFORMATION NAME: CITY OF LOS ANGELES CONTACT: CARL NELSON TELEPHONE: 2.1 3/847-661 3 DOLLAR AMOUNT OF CLAIMS SUBMITTED ALL CHANGES ARE MUTUALLY AGI INITIAL TO AND TYPICALLY AGENCY GENI 'SETTLEMENT PERCENT COMPLETE; COPY ADDITIONAL PAGES AS NEEDED 13 List BiJAIVI's Information fill- Vach Subcoll1radol. Illat hill Ill- quote subcollfracl., on DOT-as-sistud Nam of Subcontra is Firm: Phone: Address: Fax: 2 Type of work/services/materials provided: Number of years in business: Contact Person: T wpt Is the firm currently certified�s a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes �J 1`Io annual gross receipts last year. 0 Less than $1 million Li c, 0 Less than S5 million ❑ s than$10 million Less than S15 million 0 More than$15 million 1� List Bidders Information for each Subcontractor that bid or q te subcontracts oil DOT-assisted projects. including both DBEs and non-DBEs, liether successful 6r unsuccessful ill their allemptsi to obtain contracts. Name of Subcontractor Firm: Phone. • W Address: �koo E, (QU,,l St Fax: An 131 gtjll 4001 lug '304b Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes 0'No annual gross receipts last year. ❑ Less than $1 million C_ Xt 210,10-1 3-A ❑ Less than $5 million ❑ Less than$10 million q5' ZS�S ` 0 Less than $15 million More than$15 million List Bidder's Information for each Subcontractor that bid or quote Subcontracts oil DOT-assisted projects. i.ncluding both DBEs and n9n-DBEs, Nibether successful or unsuccessful in their attempts to obtain contracts. Name o Subcontractor's Firm: Phone: (GM 1 Address: Qj(p5'1 0vvS`� Dr, Fax: (am �Z,�j (boo' V 1A 61 nu1 Type of work/services/materials provided: Number of years in business: Contact Person:,�Q L Is the firm currently certified as a DBE under 49 CFR Check the boa below for the firm's Part 26? ❑ Yes Ao annual gross receipts last year. ❑ than$1 million LAC, Less than$5 million Ill, ��3�2 ❑ Less than$10 million�i ❑ Less than$15 million 0 More than$15 million Cold M; 0 List Bidder's 1111*61-1113tion for cach sobcolill-aclol. Illat bill Ili- 4111ole stillcollil-acis fill DO'l-a-'skled Name of ubc tract is Phone: (�� (�'� ?i20(o Address: �' L . fJ MVr'GC1r\ � Fax: (gpJ (Al " 203�1 LA r�'(A CA 1 Type of work/services/materiais provided: Number of years in business: ` Contact Person: Is the firm currently ce ed��s a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes t+�'N0 annual gross receipts last year. 0 Less than $1 million gless than $5 million 0 Less than $10 million f& W�j, ❑ Less than $15 million 33't�1 �' l ❑ More than$15 million List Bidder's Information for each Subcontractor bid or quote , projects. including both DBEs and non-DBEs. it hether successful or unsuccessful ill their attempts to obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes 0 No annual gross receipts last year. ❑ Less than $1 million 0 Less than $5 million 0 Less than $10 million 0 Less than $15 million 0 More than$15 million List Bidder's Information for each Subcontraclor that bid or quote subcon(racts oil DOT-assisted projects. including both DBEs anti non-DREs. ii hether successful oi- unsuccessful ill.their attempts to obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the bog below for the firm's, Part 26? ❑ Yes ❑ No annual gross receipts last year. ❑ Less than $1 million ❑ Less than $5 million ❑ Less than$10 million 0 Less than $15 million 0 More than$15 million EEC A r CAL List Bidder's Information for each S1111culltractol. that bid or (Itlote sullcolltrac(% on obtain contracts. Name of ubcontractor's Firm: Phone: (1►%# 2)2�B 1CM Address: AW, WYWr U Culkor Dr Fax: F1tW -A(2�} Z2AO1 S kI Type of work/services/materials provided: Number of years in business: 1 �, ` LAU Contact Person: TkN\ 6(11D Is the firm currently cerdfiea'd�Aas a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes N0 annual gross receipts last year. ❑ Less than $1 million 5SID V13 0 Less than $5 million 0 than $10 mmion OlAss than $15 million 0 More than$15 million List Bidder's Information for each Subcontractor projects. including both DBEs and non-DBEs. %%hether successful or unsuccessful in their allellipts to obtain contracts. Name of Subcontractor's Firm: Phone: Address: ,LO45t, ip�' Fax: �Qy 1�1 a1a�1S gOJA RUf'SS UA O(kqoLp Type of work/services/materials provided: Number of years in business: 1� C�(e ctr►W Contact Person: Is the firm cur ently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? V Yes ❑No annual gross receipts last year. YjG ❑ Less than $1 million L 5 l0 152) ❑ Less than $5 million ❑ Less than $10 million ess than $15 million 0 More than$15 million . List Bidder's Information for each Subcontractor that bid or quote subcontrads an DOT-assisted projects, including both DBEs anti non-DBEs, it hether successful or u nsuccessful in.Oeir attempts to obtain contracts. Name of Subcontractor's Fi Phone: (211) T-561 ST Address: .L2, N , W)MO rG Pf, J Fax: (,10 lol 8► UP S Ay-1 WL I (A 01 OOgG( Type of work/services/materials provided: Number of years in b siness: Z� l M c+L Contact Person: Is the firm currently certified a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes ®'No annual gross receipts last year. ❑ Less than $1 million ��3 0 Less than $5 million a z2d�8� 0 Less than$10 million 1 0 Less than $15 million More than$15 million JTWM Name of Subcontract is Firm: Phone: ADJ S-1 k c ?ZT, � Address: , c&K%T A Noi Fax: PM 2,12) 3 CA Oil` () Type of work/services/materials provided: Number of years in business: la t Contact Person: US Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes annual gross receipts last year. 0 Less than $1 million 0 Less than $5 million 0 Less than $10 million ❑ Less than $15 million More than$15 million List Bidder's Information for each Subcontractor projects. including both DBEs obtain contracts. Name of Subcontractor's Firm: Phone: (14)aafl 455to Address: k01% 6 , pr)() Fax: (jig Opn a5501 Or (:kC' Type of work/services/materials provided: Number of years in business: ��k Contact Person:T SiY1►�(1St� Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes d o annual gross receipts last year. 0 Less than $1 million L (p1 —Ft than $5 mimon Uless than $10 million 0 Less than $15 million 0 More than$15 million List Bidder's Information foi- each Subcontractor that hid or quote subcontracts oii DOT-assisted projects. including both DBEs anti non-DBEs, ii liether successful or unsuccessful in. their attempts to obtain contracts. Name of Subcont ctor's Firm: Phone: (119 520 Z(f i(. S J- (Xaaq6,k C. Address: qLl ip s , i✓Yl r,4.J CA 5 r Fax: 0 4) 520 gOti Type of work/services/materials provided: Number of years in business: 1,0 CK Contact Person: 4tL 1 v;,u qM Is the firm cu��ntly certified as a DBE under 49 CFR Check the boa below for the firm's Part 26? & Yes 0 No annual gross receipts last year. u G ❑ Less than $1 million D Las than $5 million O ��� Less than $10 million CIT (.Q ❑ Less than $15 million 0 More than$15 million List Bi(ldei s Ini'm ition for each sobcontrat-for that hid or quote sidicowract-, till D()'l-as%i%1cd obtaill contracts. Name of ubcont ctorI Firm:_ Phone: ( L1 12-2-oJ Address: -1 Z-1po SC4,01- Pruc) Fax: (45W a 2-1 Y \ Y1 S 411010 l Type of work/services/materials provided: Number of years in business: �,L (t CTNi Contact Person: -F()DO . S�UAIN�S Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes 8'No annual gross receipts last year. 0 Less than $1 million LPL ��t�j1'2, Gll7 0 Less than S5 million fl Less than$10 million than$15 million ❑ More than$15 million List Bidder's Information for each Subcontractor projects. including both DBEs anti non-DBEs. ii liether successful or unsuccessful in their attempts to I obtain contracts. Name of Subcontractors 1w E PhonTVV e• Address:30D0 E, COy-aAX-40 Ss Fax: (jig (032 S,&(oaj N'��M C'n` `� ' Type ofwork/services/materials provided: . Number of years in business: 1, l t �U-C;crI � Contact Person: �.Glr1A Is the firm currently certified sks firm's a DBE under 49 CFR Check the box below for the Part 26? 0 Yes VN-O annual gross receipts last year. 0 Less than $1 million C � �(,`'L',' t A - C.10 0 Less than $5 million `1 ❑ Less than $10 million * 3s - LkR l3 ❑ ess than $15 million More than$15 million List Bidder's Information for each Subcontractor that bid or quote subcontracts on DOT-assisted projects. including both DBEs anti tion-I)BEs. ii liether successful or unsuccessful in their attempts to obtain contracts. Name of Subcontrac or's Firm! Phone: ( ) A S 0 1... Address: `, (oo e Fax. ( ) 0 V SiV 4 (A ���� Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes 0 No annual gross receipts last year. ❑ Less than $1 million l•-7 ❑ Less than$5 million 0 Less than $10 million ❑ Less than $15 million 0 More than$15 million List Bidder's infornia(ion for each Subcomractor mat bid or tillote slibcolltracts (III projects. including built DBES anti non-I)BEs. ifliether succesAIA or unsuccessfid iii their attempts it) Obtain contracts. Name of Subcontractor I-- Phone:( )•�p� 5L � I-CCM Chi_ y Address: LtSkk , tSl�F1V C{ Fax: ( )'1` 3 AYW-Wit CA Type of work/services/materials provided: Number of years in business: tot Contact Person: v�- Is the firm currently certifie d a DBE under 49 CFR Check the box below for the ftrm's Part 26? 0 Yes annual grose receipts last year. LA .`-, ,� gZl so 0 Less than$1 million WLess than $5 million 0 Less than$10 million 0 Less than$15 million 0 More than$15 million List Bidder's Information for each Sit twou(rac tor that bid or quote subcomracts oil DOT-assisted projects. inchiding both DBEs anti non-DBEs, is liether succc.%sj*uj or onsuccess1*111 ill tileir aite obtaill contracts. 11)1)ts to Name of Sut I=actorl Fi Phone:(p, Si 2 Address: OrNk_ Fax: OW 40 0410 RM�t Type ofwork/services/materials provided: Number of years in business: Contact Person: \rA(\ 01� Is the firm cu ndy certified as a DBE under 49 CFR Check the box below for the firm's Part 26? Yes ❑ No an ual gross receipts last year. � �G r1a 101 Less than$1 million ,l l ❑ Less than$5 million ❑ Less than$10 million C 0 Less than$15 million 0 More than$15 million List llidder's, Inflorniation foi- each Subcontraclor that bid or (Itiote submitracts oil DOT-assisted projects. inchiding both DBEs anti non-DREs, ii hether successrul or unsuccessful ill.their attempts to Obtain contracts. Name of Subcontractor's Firm: Phone.- Address: Fax: ( ) Type of work/services/materials provided: Number of years in business.- Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes ❑ No annual gross receipts last year. 0 Less than $1 million 0 Less than $5 million 0 Less than $10 million ❑ Less than$15 million 0 More than $15 mUlion - STYE 1� Name of Subcontractor's Firm: Phone: hi4) Oq3 L7byIT MomAddress: (4%q\ V.�1&,M&:{ (�r Fax: h►q 013 044 t5 WMMASTCY CA Type of work/services/materiah provided: Number of years In business: -1 Jr en Contact Person: Is the firm curr ntly certified as a DBE under 49 CFR Check the box below for the firm's Part 26? Nes 0 No annual eross receipts last year. ❑ Less than $1 million Lk L '�5,5 al� 0 Jess than $5 million Less than$10 million O�?,(05Ln �tr ❑ Less than$15 million TL�V 0 More than$15 million List Bidder's Information for each Subcontractor projects. including both DBEs obtain contracts. Name of Subcontractor's Firm: Phone: (1 9 843 V12, Address: 800 6. 1)PLA J r AVU Fax: h4 &43 514 flAkyt (\ C` R1,V5 1 Type of work/services/materials provided: Number of years in business: i5 Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes ❑ No annual gross receipts last year. Uc 44-l5 a ❑ Less than $1 million ❑ Less than $5 million re ss than $10 million $ 330 (�� ❑ Less than $15 million CO ❑ More than$15 million List Bidder's Information foi- each Subcontractor that bid or quote subcontracts on DOT-assisted projects. including both DBEs anti non-DBEs. i%liether successful or unsuccessful in. their attempts to obtain contracts. Name of§ubcontractortS Firm: Phone: fth) tA(op (P910 Address: 152p1 S'i TE r Fag: (qd) 4(qp OnO p n trr*_�0 C�* q l 1(0 l Type of viork/servic materials provided: Number of yvirs in business: to Ic c�A �6lSl Contact Person: bcs M Is the firm currently certified ��ss a DBE under 49 CFR Check the boa below for the firm's Part 26? 0 Yes UO annual gross receipts last year. ❑ than$1 million TM-ID Less than$5 million 0 Less than$10 million 4�0l0 Less than$15 million 0 More than$15 million v Name o ubcont actor's Firm: Phone: ( %`) (CIA 4550 CAWfLt SrOPIA(zh Address: �S;S Q. Fax: Nlt1 (c3a1 (OI O(W L1 Gi CA Q1,13A Type of work/services/materials provided: Number of years in business: 31 � mr;PI,n Contact Person: OtlU Ca O"W5 Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Pari 26? 0 Yes 9NO annual gross receipts last year. 0 Less than$1 million LAC 4-- ?A(MAS glessthan$5 million ❑ Less than$10 million Fin-r, 06 W1-1(50 ❑ Less than$15 million 0 More than$15 million i List Bidder's Information for each Subcontractor projects. including both i obtain contracts. Name of Subcontractor's Firm; Phone: (60 q O,& 50-) U)OcV,& STrAOin nn •• -- `` Address: \1'LZ. N. IA't,V SA C, y pn � Fax: (,bw W. COV►no-. 0111010 Type of work/services/materials provided: Number of years in business: flr i P1 Contact Person: Is the firm currently certified is a DBE under 49 CFR Check the boa below for the firm's Part 26? ❑ Yes No annual gross receipts last year. ❑ Less than $1 million L�L � 5� I q 71 ❑ ess than$5 million ess than$10 million F ^w * 045 ,1`'C l 13 ❑ Less than$15 million ❑ More than $15 million List I lidder's Inrormation for each Subcontractor that bid or quote subcontracts oil DOT-assisicd projects. including both DBEs anti non-DREs, ii liether %ticcessful or unsuccessful ill their attempts to obtain contracts. Name of Subc ntractor's Firm: Phone: AOJ 8l05 ?lt3 Address: Zl 9 TO(iq WA� Fax: Coi E 05 —1 D QNYI Uk 1"1 '1 Type ofwork/services/materials provided: Number of years in business: 21 t Contact Person: l,-L Is the firm currently certified a BE under 49 CFR Check the box below for the firm's Part 26? 0 Yes o annual gross receipts last year. ❑ Less than$1 minion LIL -� ?� �(��sSAm than$5 million 0 Less than$10 million CG f`eD .07 n15 �� Less than 0 L than$15 million "t 0 More than$15 minion Name of SU bcontractor's Firm: Phone: � $1q ?A33 Address: kt�<z P ,r t •• p Fax: �3j'� 3l QA Ar lac Type of work/services/materials provided: Number of years in business: Contact Person: S-1 E �l Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ("Yes 0 No annual gross receipts last year. ❑ Less than $1 million 0 Less than $5 million 33 WSW� 0 than 1 million J Less than $15 million ❑ More than$15 million List Biddcr's Infoi-niation for each Subcontractor projects. Itnon-DBEs. ii licther successful or unsuccessful in their aticnipts to obtain contracts. Name of Subcontractors Firm: Phone. 0504 Address: �O bob \Ukkb Fax: �%OL ?Ab 04,34 &A1M Ck 610,204 Type of work/services/materials provided: Number of years in business: `5 'SAY 1 9 � V Contact Person: 'b-A Is the firm currently certified as a DVE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes O No annual gross receipts last year. 0 Less than $1 million ❑ Less than $5 million ❑ Less than $10 million ess than $15 million ❑ More than$15 million List Bidder's Information for each Subcontractor that bid or quote subcontracts oil DOT-assisted projects. including both DBEs anti non-DBEs, whether successful or unsuccessful in. their attempts to obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes ❑ No annual gross receipts last year. 0 Less than$1 million ❑ Less than $5 million ❑ Less than $10 million ❑ Less than $15 million 0 More than$15 million _ V'(�LiTiCs REERIMMENUMMMENUMMUMMMMMEM Name of Subcontractor's Firm: Phone: (Z 55S bao S in Address: a M 9 jr�1 Fax: V3) 55� &� Q(w o(p Type of work/services/materials provided: Number of years in business: Z Contact Person: mkt Is the firm currently certified s a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes No annual gross receipts last year. 0 Less than $1 million ❑ Less than $S million `t ❑ Less than $10 million 0 Less than $15 million ore than$15 mUlion List Bidder's Information for each Subcontractor projects. including both i obtain contracts. Name of Subcontractors Firm: Phone. Address: �• sf�`iJ ' , �� Fax: ((s� 01(g-I � AA— CA CJ 1 V� Type of work/services/materials provided: Number of years in business: 10 Contact Person: Arr Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? DI'Ves ❑No annual gross receipts last ear. ❑Jess than $1 million Less than $5 million 0 Less than $10 million O,T ❑ Less than $15 million 0 More than$15 million 'i List Bidder's Information for each Subcontractor that bid or quote subcontracts oil DOT-assisted pr ects. including both DBEs anti non-DBEs, ii liether successful or unsuccessful ill. their attempts to Oi obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the boa below for the firm's Part 26? ❑ Yes 0 No annual gross receipts last year. 0 Less than $1 million 0 Less than $5 million 0 Less than $10 million 0 Less than $15 million 0 More than$15 million List Bidder's 1111,61-illation for each SlIbcolill-adol, Illat bid (it- quote slillcollfracts oll DOT-as%i%le(I Name of Subcontractor's Firm: Phone: ( 33%A 2�SS"1 - r Address: 103S W. Ga Ul SrMe ST- Fax: Pilo 33 351 A'LUSA, CA 411 OZ Type of work/services/materials provided: Number of years in business: to n Contact Person: �:t1111 kuis Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ©'Yes 0 No annual gross receipts last year. 0 Less than $1 million U L ���122, 0 Less than$5 million a5, ��� than S10 million ❑ Less than$15 million 0 More than$15 million projects.List Biddcr's Information for each Subcontractor that bid or quote subcontracts oil DOT-assisted both t obtain contracts. Name of Subcontractor's Firm: Phone: Address: �51 Wa�soa $T Fax: C.) , 4, C A- q_Ol3U � a5 �70 Q ?M _ _ Type of work/services/materials provided: Number of years in business: tor J Contact Person: `_ _ Is the firm currently certified a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes No annual gross receipts last year. ❑ Less than $1 million ❑ Less than $5 million 0 Less than$10 million FeD Vr- a5 2c���►a53Erless than $15 million 0 More than$15 million List Bidder's Information for each Subcontractor that bid or quote subcontracts on DOT-assisted projects. including both DBEs and non-DBEs, is liether successful or unsuccessful in their attempts to obtain contracts. Name of Subcontractor's Firm: Phone: 'A . Address: PO & 61Ll Fax: 100 -1226 6U 1N Vdt&l CA q (�53 Type of work/services/materials provided: Number of years in business: Contact Person: W11 Is the firm currently certified a DBE under 49 CFR Check the boa below for the firm's Part 26? ❑ Yes O'No annual gross receipts last year. 0 Less than $1 million 0 Less than$5 million l.1 0 Less than $10 million _ � �QG,� zp,,��� than$15 million` ✓�V 0 More than$15 million {/V Name ot..Su outractor's�'irg�:m Phone: (1►� 6110 ZUZ AOtA Address: 1A'8 !J. pop(GU^ s Fax: d►fV8 (A31 Type of work/services/materials provided: Number of years in business: 4o t Contact Person: 1 Is the firm currfntly certified as a DBE under 49 CFR Check the box below for the firm's Part 26? OYes 0 No annual gross receipts last year. l ❑ Less than $1 million than $5 million CC 0�8�� , 06_2A W3 ❑ Less than $10 million LA ❑ Less than$15 million 0 More than$15 million List Bidder'�-s Information for each Subcontractor projects. both DBEs and non-DBEs. iihether successful or unsuccessful in their attempts to obtain contracts. Name of Subcontractor's Firm: Phone: Cori h p aa2 2s�cj Address: PO &A 61001 Fax: (I aA bru Ct - Type of work/services/materials provided: Number of years in business: Mat Contact Person: flG�� J 0Ae S Is the firm currently certified As a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes YNo annual gross receipts last year. ❑ Less than $1 million 0 Less than $5 million (,(G " Ott Less than $10 million ❑ Less than $15 million ❑ More than $15 million List Bidder's Information ror each Subcontractor that bid or quote subcontracts oil DOT-assisted projects. including both DBEs and non-DBEs, it hether successful or unsuccessful ill.their attempts to Obtain Contracts. Name of Su ontractor s irm. Phon (OU, 2-15 J Address: lIA s g, eaSf r( heo Fax: ZZ S3 0(Y1MO', Ct Ll 11 w4 Type of work/services/materials provided: Number of years in business: I I Contact Person: OQ, �s Is the firm cur&ently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? i Ves ❑ No annual gross receipts last year. ILT ❑ Less than$1 million �� � � ❑ Less than $5 million s than $10 million TX J , 41001�_ ❑ Less than $15 million T ��Q 0 More than $15 million SIZE tonrOVEMOMIUMMMIMMMIR Name of Suhcontracto, 'a M. Phone: (11� Address: N. �GI'fl�r1ll� Fax: (11C ��D �9DS Type of work/services/materials provided: Number of years in business: IS �. f vew Contact Person: L-ky CA d, S F Is the firm currently certified jw a DBE under 49 CFR Check the box below for the firm's Part 26' 0 Yes dNo annual gross receipts last year. I 0 Less than$1 million (� P LS S`-C Ll 0 Less than S5 million than$10 million 0 Less than$15 million 0 More than$15 million List Bidder's Information for each Subcontractor projects. including both DBEs obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes ❑ No annual gross receipts last year. ❑ Less than $1 million 0 Less than $5 million 0 Less than $10 million 0 Less than $15 million ❑ More than$15 million List Bidder's Information for each Subcon(ractor that bid or quote subcontracts on DOT-assisted projects. including both DBEs and non-DBEs, ii hether successful or unsuccessful in their attempts to obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes 0 No annual gross receipts last year. 0 Less than $1 million 0 Less than $5 million 0 Less than $10 million 0 Less than $15 million 0 More than$15 million LA" S CAVE Name of Subcontractor's Fi Phone: ((Qje -101 (A1 I Ck Address: SS-10 E • B UT ST- Fax: QpJ 14qO1 Type of work/services/materials provided: �'1OSC Number of years in business: l.AA PL �" TYt(. WzX1C.. M I "A 25 ✓i Contact Person: Q1 =the currently certified as a DBE under 49 CFR Check the box below for the firm's 0 Yes n No annual gross receipts last year. I eu 1 0 than $1 million Less than $5 million ,, a�_ 3s �3 0 Less than $10 million 0 Less than $15 million ❑ More than$15 million List Bidd�i�'s Information for each Subcontractor projects. including both DBEs obtain contracts. Name of Subcontracto 's Firm: Phone: W"M V�PM ► 21 Address: Po 60A 5W 32 Fax: (9i1 61-1 l.W(>t CA Type of work/services/materials provided: Number of years in business: ' Contact Person: ?)t'U Is the firm currently certified AS a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes annual gross receipts last year. , L ❑ Less than $1 million U L IUC��I J2`'1 ess than $5 million ❑ Less than $10 million a ❑ Less than $15 million 0 More than$15 million List Bidder's Information for each Subcontractor that bid or quote subcontracts oil DOT-assisted projects. including both DBEs anti non-DREs, %%hellier successful or unsuccessful in.their attelil ohlain contracts. ills to Name of Subvntt ctor's Fi Phone: h►�) p��-1 NO C� Seyw t C� Address: PO 3Ilb0 Fax: W7n 4010 OrwC L (A p, Type of work/services/materials provided: Number of years in business: 10 r s Contact Person: Is the firm currently c rtified�as a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes 9 No annual gross receipts is last year. ❑Jess than$1 million Less than $5 million LAC. CoS�45aP 0 Less than$10 million 0 Less than $15 million 0 More than$15 million t�w XAZ�Ur- List Name of Subc tractor's Firm: Phone: (14) Z 1410 Address: l 11I�tAV i t.,Lj Fax: CA Type of work/services/materials provided: Number of years in business: Contact Person: AC G7 in Is the firm cuiy ently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes 0 No annual gross receipts last year. 0 Less than $1 million 0 Less than $5 million l�l Less than $10 million fX�LS?j�l $.gs- 1�� ❑ Less than S15 million ❑ More than$15 million List Bidder's Information for each Subcontractor projects. including both DBEs obtain contracts. Name of Subcontractor'§Firm: Phone: A-U NA LAf N D S Gt PC Address: �koo C "+ta . o<- Fax: An OZI /64 "!W S Type of work/services/materials provided: Number of years in bhWness: ,�,r C � , Contact Person: G t. Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes 0 No annual gross receipts last year. 0 Less than $1 million 0 Less than $5 million 0 !Ass than $10 million ess than $15 million ❑ More than$15 million List Bidder's Inrormation for each Subcontractor that hid or quote subcontracts oil DOT-assisted projects. including both DBEs and non-DBEs, %i hether successful of- unsuccessful in.their attempts to obtain contracts. Name of beontractor's Firm: Phone: 3 OO2'j 1 Address: l SOD 6 stile�h LJiul Fax: 1 a-A Type of work/services/materials provided: Number of years in b siness: 5 It Lan d 5 Contact Person: UA Sq l 2 Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? ❑ Yes VNo annual gross receipts last year. ❑ Less than $1 million �1 0 than $5 million LdLess than $10 million ❑ Less than $15 million 0 More than$15 million CA BIDDERS LIST PALP.INC.DU Bidder: r)(cr, pAyiNa cmPANY Firm Name: m Phon TaL Address:.- '3 5. N' � Fax: 09 Contact Person: No.of years in business Is the firm currently certified as a DBE under 49 CM Part 26? OYES ❑NO .Type of work/services/materials provided by firm? (lhA SCE 1 3$ k3 ❑ Less than$1 Million - 3•L—1 lP Cl Less than$5 Million CCA ❑ Less than$10 Million ❑ Less than$15 Million "1 W ❑ More than$15 Million Firm Name: Phone: Address: Fax: Contact Person: No.of years in business Is the firm currently certified as a DBE under 49 CFR Part 26? O YES ❑NO .Type of-work/services/materials provided by firm? ❑ Less than $1 Million ❑ Less than$5 Million ❑ Less than $10 Million ❑ Less than$15 Million ❑ More than$15 Million Firm Name: Phone: Address: Fax: Contact Person: No.of years in business Is the firm currently certified as a DBE under 49 CFR Part 26? ❑ YES ❑NO .Type of.work/services/materials provided by firm? ❑ Less than$1 Million ❑ Less than$5 Million ❑ Less,than$10 Million ❑ Less than$15 Million 11 More than$15 Million ollitAn contracts. Name of Sn ntnctor's Firm: Phones �pZ Address: �ZI1 a �d�M E%i t �''�c-- Fax: ( ) ga 2SZf�i ``L S (A '100D Type of work/services/materlah provided: Number of years in business: Contact Person: !w t rN Is the firm currently certifled,,�»-ss a!'CBE under 49 CER Check the box below for the firm Is Part 26? D Yes t�No annual gross receipts last year. 0 Less than $1 miWon UL �j�s ss than$5 million C6 41D� WA3 0 Less than$10 million 0 WS than$15 minion ore than$15 million List Bidder's Information Subcontractor obtain contracts. Name of ontractor'sElm: Phones •q03 6(0�0 RZLE Address: OAo I W(ALS 61 vd Fax: VA Type of work/services/materials provided: Number of years in buslue s: Contact Person: Is the firm currently certified�s a DBE under 49 CFR Check the box below for the firm's Part 267 ❑Yes td'No annual gross receipts is last year. D than$1 Million VA 6, than$5 ranlion D Less than$10 million AC — �QS�Z� D than$15 minion M_ Information Subcontractor projccts. inclailling both DBES anti lion-MIES, m helher successful or unsuccessfid ill.their attempts to oblain Contracts. Mine of gubcont ctor's Firm; Phone: ) Address. (Q3�� �11dU5 Fps LA i I 3 Type of work/services/materials provided, Number of years in business: I � Contact Person; Is the firm currently certified as a DBE under 40 CFR Check the box below for the firm's Part 267 ❑ Yes 0 No annual ross receipts last yeor. 0 Less than 1 million L� 0 Less than $5 million s than�10 Million 0 Less ,vt$15 million Name of bcontraetor's rm: Address: ,A A bay ell Fax: `r "/� Z3 Type of work/services/materials provided: Number of years business: Contact Person: h the firm currently certifiddpis s DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes o annual gross receipts last year. ❑)Less than$1 million a Less than$5 million v 0 Less than$10 million a5_�1 O5� O Less than$15 million ❑ More than$15 million List Bidder's hircirmation foi- cadi Subcontractor Onit bid or quote subcomnicts fill DOT-assisletL i Name of Su ontmet is Fi • Phones Address: 45�Qb en S f Fax: ) 1 -e to wtv' (A- °k 0_10Q 'Type of work/services/materials provided: Number of years in business: �- Contact Person: Is the arm currently certffled, a DBE under 49 CFR Check the box below for the firm's Part 267 O Yes 9No- annual gross receipts last year. D Less than$1 million than$5 million D Les$than$10 million ❑Less than$15 million r9 ILA......aL.... h 0__e...- Name of Subcont ctor's Firm; Phonp: ( ) 33 (�21 14 Address: 5 Fax, ) 305 .-(��3 �IAO 0 Type of work/services/materials provided: Number of years in business: \� Contact Person: Is the firm curr,eently certified as a DBE under 40 CFR Check the boa below for the firm's Part 267 Res 0 No annual aross receipts last year. L1 X�� D than 1 million 4 Less than $S Million 7<,o al 3 Less than 10 million 0 Less thin SIS mlMon r ? Bidder: PALP'ANC'WA nNgCWPANY BIDDERS LIST a Firm Name: S Phone: Address: Fax: 4 Ch Contact Person: No. of years in business Is the firm currently certified as a DBE under 49 CFR Part 26? ❑ YES ❑NO .Type of.work/services/materials provided by firm? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than$15 Million ❑ More than$15 Million Firm Name: Phone: Address: Fax: Contact Person: No.of years in business Is the firm currently certified as a DBE under 49 CFR Part 26? ❑ YES ❑NO .Type of-work/services/materials provided by firm? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than$15 Million ❑ More than$15 Million Firm Name: Phone: Address: Fax: Contact Person: No.of years in business Is the firm currently certified as a DBE under 49 CFR Part 26? 0 YES ❑NO .Type of-work/services/materials provided by firm? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less,than $10 Million ❑ Less than$15 Million ❑ More than$15 Million List Bidder's Information for each Subcowractor 1hat bill or quote subcontracts oil DOT-assist Cd projects. including both DBEs and iion-DIIEs. %%hullier successful or mmuccessfid in their -ItICIIII)IN Io obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years In business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes ❑ No annual gross receipts last year. ❑ Less than$1 million 0 Less than $5 million 0 Less than $10 million 0 Less than $15 million ❑ More than$15 million List Bidder's Information for each Subcontractor that bid or ; ute subcontracts (m DOT-assisted-1 projects. including both DBEs and non-DBEs. i%buther successful or unsuccessful in their allempts to obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years in business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the boa below for the firm's Part 26? 0 Yes 0 No annual gross receipts last year. ❑ Less than $1 million ❑ Less than $5 million 0 Less than $10 million ❑ Less than $15 million ❑ More than$15 million List Bidder's Information foi- each Subcontractor that hid or iltiote s it bcon(racls oil DOT-assisled projects. including both DBEs anti non-DBEs, ii hether successful oi- unsuccessful iii,their attempis to obtain contracts. Name of Subcontractor's Firm: Phone: ( ) Address: Fax: ( ) Type of work/services/materials provided: Number of years In business: Contact Person: Is the firm currently certified as a DBE under 49 CFR Check the box below for the firm's Part 26? 0 Yes ❑ No annual gross receipts last year. ❑ Less than $1 million 0 Less than $5 million 0 Less than$10 million ❑ Less than$15 million 0 More than$15 million L-40CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK 2005- To: se c f✓E L00A),A,4f�'�yl /,j G Enclosed please find your original bid bond issued by jk&-Y21CAN /!J S7-77y4-' OF &6#1 7Z—Z S for1)&" Joan L. Flynn City Clerk JF:pe Enclosure g:/fol lowup/cashcont/retumbidbond.doc (Telephone:714-536-5227) SEQUEL CONTRACTORS, INC 13W imperial Hwy. Santa Fe'Springs, CA 90670 ` ) cp A f 13546 Imperial Hwy.Santa Fe Springs,CA 90670 Clerk' 04P,6_0 ✓` � �ac C�j L Q�w i fin`nar+ Bond No. Bid Bond BID BOND The American Institute of Architects, AIA Document No. A310(February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS,that we Sequel Contractors, Inc. as Principal hereinafter called the Principal, and Federal Insurance Company a corporation duly organized under the laws of the state of Indiana as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten percent of the total amount of the bid Dollars ($ 10% ), for the payment of which sum well and truly to be made,the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for Gothard Street Rehabilitation 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 November 2004 Sequel Contracto , Witness Prr (Seal) B Went Name/Title Federal Insurance Company Surety (Seal) Witness By Douglas A.k6p Aitomey-in-Fact ORSC 21328(5/97) CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California County of Orange On NOV 0 3 2004 before me, A.P. Coats, Notary Public NAME,TITLE OF OFFICER personally appeared Douglas A. Rapp NAME OF SIGNERS) ® 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 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) A.P.COATS acted, executed the instrument. COMM. 1496145 10T R"` °1""'W WITNESS my and and official seal. (SIGNATURE OFNO RF) 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL/OWNER ❑ CORPORATE OFFICER TITLE(S) TITLE OR TYPE OF DOCUMENT ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL NUMBER OF PAGES ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S)OR ENTTI'Y(IES) Chubb POWER Federal Insurance Company Attn: Surety Department OF i/igilarit Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation, and PACIFIC INDEMNITY COMPANY,a Wisconsin corporation,do each hereby constitute and appoint Douglas A. Rapp Or Linda D. Coats of Laguna Hills , California---------------------------------- each as their true and lawful Attomey-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds) given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 2 2 nd day of January, 2004 Kenneth C.Wendel,Assistant Secretary f E.Robertson,Am Preterit STATE OF NEW JERSEY ss. County of Somerset On this 2 2 ndday of January, 2004 ,before me,a Notary Public of New Jersey,personally came Kenneth C.Wendel,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Kenneth C.Wendel being by me duly swan did depose and say that he is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof,that the seats affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By;Laws of said Companies;and thathe signed said Power of Attorney asAssistant Secretary of said Companies by like authority;and that he is acquainted with Frank E.Robertson,and knows him to be Vice President of said Companies;and that the signature of Frank E.Robertson, subscribed to said Power of Attorney is in the genuine handwriting of Frank E.Robertson,and was thereto subscribed by authority of said By-Laws and in deponents presence. Notarial Seal Karen A. i"ilue F PR�c l!y cry Rib(ic Siate of New Jersey , t�Oq Fz� No. L231647 Notary Public `L �° �G > n;. 'rq:+�.;- e'r Ri an (-• r-. 1. •,.CERTIFICATION ExtracC -y s of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY: It pow _ attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company,either by the Chairman or the President or a Vice President or an Assistant Vice President,jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved,printed or lithographed. The signature of each of the following officers: Chairman,President,any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attomeys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and bindng upon the Company with respect to any bond or undertaking to which it is attached" I,Kenneth C.Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the"Companies")do hereby certify that (i) the foregoing extract of the fay-Laws of the Companies is true and correct, (ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S.Treasury Department;further,Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands,and Federal is licensed in American Samoa,Guam,and each of the Provinces of Canada except Prince Edward Island;and (iii) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Warren,NJ this 3rd day of November 2004 9 g")=C. 11Nth Po ��otro+�G '� +•cv }3 DIANP �1Sco Kenneth C.Wendel,Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY,OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone(908)903-3485 Fax (908)903-3656 e-mail: surety@chubb.com Form 15-10-0225(Ed.4-99)CONSENT CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT r-.- -.cr-r- fir- fir- - - r- State of California County of LOS ANGELES ss. On '' U 3 20 , before me, MICHAEL ALLEN AMUNDSON,NOTARY PUBLIC Date Name and Title of Officer(e.g.,`Jane Doe,Notary Public") N personally appeared Thomas S.Pack,President r' ame(s)of Signer(s) ersonally known to me ❑ 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 MICHAELALL:NAMUNDSON acknowledged to me that he/she/they executed �ryl N COMM.#1483459 D the same in his/her/their authorized r Q : NOTARYSANUBUGCouNTY IA ca acit Ies and that b his/her/their LOS ANGELES COUNTY v P YC ), Y MY COrnm.6D.Awd II wm signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. ?� r WITNESS my hand and official seal. � Place Notary Seal Above Signature of Notary Public ` r5 �t r: OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document S �i and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: ?s Document Date: Number of Pages: Signer(s) Other Than Named Above: hh1 � Capacity(ies) Claimed by Signer ?� Signer's Name: ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General r ❑ Attorney in Fact r ❑ Trustee ❑ Guardian or Conservator ti ❑ Other: r s Signer Is Representing: ©1997 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder.Call Toll-Free 1-800.876.6827 SEQUEL CONTRACTORS, INC. SECTION C PR0P-O'SAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual-quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 C-1 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 R1nn'F-R'6 EinoRhFamount of$ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature G2 SEQUEL CONTFIACTORS, INC. SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: a� $ TOTAL AMOUNT LUMP SUM BID IN WORDS: �+ .S I f vS l C-2.1 SEQUEL CONTRACTORS, INC. GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 SEQUEL CONTRACTORS, INC. GOTHARD STREET (CC-1 154) PROJECT BID SCHEDULE 'UNITPRICEWRITTEWIN' ' "--,UNIT-'P,RICE:',I:�,EXT�,,N, P'' t.ITEM _EST.IMATED" -ITEM,WITH 7"­0UA AMOUNT,z ""A V 'T�TY 1 1 Mobilizpt'gn $ Z4 W9• $ 6/760 L.S. @ /7X ew 4,1416"al,15e,441.4,14 a Dollars .0- Cents 2 1 TrafficC t I Plar6 $ $2��0'00 L.S. (a-)- !�X"., A, .s"d Dollars _49- Cents 3 1 Furnish Proiect Traffic Control $ L.S. r&_1_'AJ4-44 4'w /4,�adrs Cents 4 188,917 Cold Milling & Header Cutting $ $ g?_2'm" S.F. @ Dollars Cents 5 471 Unclassified Exca tation $ -7-5-s- $ C.Y. @ :5'eV1e#.K -Dollars 4R" Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, $ ':M $ Ton Full Depth etc.) (a)- A120 Ilells- Dollars Cents 7 2,347 Pavement Reinforcement Fabric & Route and $ 430 $ S.Y. Seal of Cracks � 'p Dollars i . Cents 8 46 Adjust S 'er/Sto(m Dr Grade @ M Each X to G Dollars Cents 9 91 Adjust Wader Val e tp Graipe $2WO-0 Each C/ Dollars Cents 10 1 Traffic S $ 000 $ a ripi g L.S. .A.41 ,'or A-,-ow —Dollars .00, Cents Traffic Loop $ /70.e-& $-a Each z:24-c wz�clsalj -f/Y Dollars 49- Cents 12 8 Rem & Recpnstruct Access Rarpp $ 2�M. Each @ 60sq'.0.1 A&C 1Y4r;v4v Dollars -60-- Cents 13 3 Adjust Su ryay oge I to Grade $ 3001 $ 900, n W, e Each @ 101'e Dollars 4>- Cents 14 25 Survey nu nt $ ��avon $ eq Each Dollars Cents Sub Total Bid Amount, Bid in Figures: $ 6 eldl Sub Total Bid Amount, Bid in Words: 2�&L wto_ C-2.3 SEQUEL CONTRACTORS. INC. LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Portion: Name.;and Addr&ss4Subcontractor;:.: Siate.License :;Class of Work Number1-0 o • '7 La c�ih /AS•c,ales / O/o GS 770.7 GS . (O �i/�1..� Fo'odSr.•/ �i/�s�.viks��,/ '7S�Sv`� e'3.2- Y.S` 8 y49367 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Thomas S. Pack , being first duly sworn, deposes and says that he or she is Thomas S.Pack, President of SEQUEL CONTRACTOHS. 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. SEQUEL CONT TORS INC. ;ame rr�s P&,President RIAL HWY. SANTA FE SPRINGS, CALIF. 9%70 Address of Bidder Subscribed and sworn to before me this day of M' 16 Zej�,� , 200 NOTARY PUBLIC SEE ATSAGKEQ NOTARY SEAL C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT �I State of California , County of LOS ANGELES ss. On NOV 1 6 26 before me, MICHAELALLENAMUNDSON,NOTARY KSLIC I�I Date Name and Title of Officer(e.g.,"Jane Doe,Notary Public") �> personally appeared ThOMM S•Peck. Preside d X Name(s)of Signer(s) ersonally known to me ❑ proved to me on the basis of satisfactory I. evidence to be the person(s) whose name(s) is/are subscribed to the within instrument andI acknowledged to me that he/shelthey executed MICHAELALLLNAMUNDSON the same in his/her/their authorized l fV COM BLIC-C LIF D capacity(ies), and that by his/her/their NOTARY PUBLIC-CALIFORNIA LOS ANGELES COUNTY Go signature(s) on the instrument the person(s), or MYC— EXP.April I3,20M ~ the entity upon behalf of which the person(s) ? acted, executed the instrument. WITNESS my hand and official seal. Place Notary Seal Above Signature of Notary Public OPTIONAL r II Though the information below is not required by law, it may prove valuable to persons relying on the document o� and could prevent fraudulent removal and reattachment of this form to another document. h �I Description of Attached Document Title or Type of Document: Document Date: Number of Pages: 6 - Signer(s) Other Than Named Above: fi Q Capacity(ies) Claimed by Signer Signer's Name: _ (j ❑ Individual C, Top of thumb here =S ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑ General �y ❑ Attorney in Fact ❑ Trustee X ri ❑ Guardian or Conservator a ❑ Other: n ?� Signer Is Representing: ��•— —<._ —�.�- — — — — — —:-<.- �- _.Wit._ _ _ '�,�h,— — — — — — — — — — — — — — — — — — — — -_ J`� ©1997 National Notary Association-9350 De Soto Ave.P.O.Box 2402-Chatsworth,CA 91313-2402 Prod.No.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 IMPROVEMENTS, (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. SEQUEL CO RACTORS, INC. Contractor y Thomas S,Pack, President Title Date: Nov 1 6 C-5 SEOUEL CONTRACTORS, INC. DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who-has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes /No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. c-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. SEQUEL CO A-ACTOA . INC. Contractor y Thcoms S. Pwk, PmskW Title Date: to 1 6 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: SEQUEL CO RACTORS, INC. Contractor Y Of Thomas S.Peek,President Title Date: my 1 6 20 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: SEQUEL CONTR-ACT.ORS, INC. Bidder Name 13546 IMPERIAL HWY. SANTA FE SPRINGS, CALIF;90670 Business Address City, State Zip (562) 862=7227r; Telephone Number 6106MA State Contractor's License No. and Class Jartue�r 31. 19,9"1F Original Date Issued January 31,2M Expiration Date The work site was inspected by Ttwmss S.Paak.P of our office on Nov 1 0 M , 200_. The following are persons, firms, and corporations having a principal interest in this proposal: SEQUEL CONTRACTORS, INC. Thomas S.Pack,President Abel Magallanes,V.P.&Seen" MICHAEL A:MAHLER,ASST.SECRETARY C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. SEQUELRACT INC. .Ampany r .s S. Peck,President Printed or Typed Signature Subscribed and sworn to before me this_ day of , 200_ . NOTARY PUBLIC SSE NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. SEE Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type'of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: ; Contract Amount Type of Work ;- Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT I State of California County of LOS ANGELES ss. It I On NOV 1 6 MR before me, MICHAEL ALLEN AMUNDSON,NOTARY PMQ Date Name and Title of Officer(e.g.,"Jane Doe,Notary Public") personally appeared Thomas S. Pack. President Name(s)of Signer(s) C�personally known to me ❑ 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 MICHAEL ALL;N AMUNDSON C4 COMM.#1483459 D the same in his/her/their authorized hh NOTARY PUBUC-CAUFORNIA�o LOS ANGELES COUNTY capacity(ies), and that by his/her/their ; 2 Q to MY C—.Exp.April 13,2008 signature(s)on the instrument the person(s), or ' the entity upon behalf of which the person(s) acted, executed the instrument. T WITNESS my and and offic' seal. ,, ,(y Place Notary Seal Above Signature Notary Public OPTIONAL r' 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: <y t Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer ?� Signer's Name: = ❑ Individual Top of thumb here T ❑ Corporate Officer—Title(s): PPElPartner—ElLimited ❑ General ?� ElAttorney in Fact A P ❑ Trustee ❑ Guardian or Conservator r' ❑ Other: Signer Is Representing: ' ©1997 National Notary Association•9350 De Soto Ave..P.O.Box 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827 SEQUEL CONTRACTORS, INC. ST.LIC#610600A 13546 RAPERIAL'HIGHWAY SANTA FE SPRINGS, CA 9067Q FAX (562) 802-7499 OFFICE (562) 802-7227.'. STATEMENT OF EXPERIENCE 1. OWNER: CITY OF ANAHEIM ADDRESS: 200 S.ANAHEIM BLVD. ANAHEIM, CA 92805 PHONE NO: (714)765-5776 CONTACT: CHUCK SMITH PROJECT: KATELLA AVE BEAUTIFICATION PHASE 11 PROJECT AMOUNT: $ 17,500,600.00 COMPLETION DATE: MARCH 2O01 - - ---- 2. OWNER: CITY OF ANAHEIM ADDRESS: 200 S.ANAHEIM BLVD. ANAHEIM,CA 92805. PHONE NO: (714)765-5776 CONTACT: CHUCK SMITH PROJECT: KATELLA AVE BEAUTIFICATION PHASE I PROJECT AMOUNT: $19,941,735.00 COMPLETION DATE: JUNE 24,1999 3. OWNER: JOHN WAYNE AIRPORT ADDRESS: 3151 AIRWAY DRIVE COSTA MESA CA 92643 PHONE NO: (714)252-2570 CONTACT: DAVE Mc]MILLER PROJECT: ANNUAL MAINTENANCE PROJECT AMOUNT: $ 1,000,000.00 ANNUALLY COMPLETION DATE: JULY OF 1996, 1997, 1998, 19992 2001 4. OWNER: CITY OF BEVERLY HILLS#206: . ADDRESS: .. . . .; .45.5 RE30ORD DRIVE BEVERLY HILLS,CA 90210 PHONE NO: (310)285-2511 CONTACT: CHRIS THEISEN/ROB BESTE PROJECT: BURTON WAY PROJECT AMOUNT: $3,585,560:Q0 COMPLETION DATE: SEPTEMBER 1999 5. OWNER: PORT OF LOS ANGELES " ADDRESS: 425 S. PALOS VERDES ST SAN PEDRO CA 90733 PHONE NO: (310)732-3654 CONTACT: SAL ZAMBRANO PROJECT: ANNUAL PAVING CONTRCT PROJECT AMOUNT: $ 5,550,000.00+ COMPLETION DATE: ONGOING 6. OWNER: CITY OF LAGUNA HILLS ADDRESS: 25201 PASEO DE ALICIA LAGUNA HILLS, CA 92653 PHONE NO: (949)707-2655 CONTACT: KEN ROSENFIELD PROJECT: OSO PARKWAY RESURFACING _ &MEDIAN IMPROVEMENTS PROJECT AMOUNT: $ 1,714,973.00 COMPLETION DATE: MAY 5,2000 7. OWNER: CITY OF CULVER CITY ADDRESS: P.0 BOX 507 CULVER CITY, CA 90232 PHONE NO: (310)253-5760 CONTACT: MARGARET LIU PROJECT: WASHINGTON BLVD. PROJECT AMOUNT: $4,342,937.00 COMPLETION DATE: SEPTEMBER 1998 t 8. OWNER: - CITYOF SANTA ANA ADDRESS: 20 CIVIC CENTER PLAZA -:`,v': SANTA ANA,CA 92701 PHONE NO: (714)647-5045 CONTACT: TYRONE CHESANEK PROJECT: : SANDPOINTE NEIGHBORHOOD-" :' .-` PROJECT AMOUNT: $ 1,249,807,.00 COMPLETION DATE: , OCTOBER'�001` . 9. OWNER: LACDPW ADDRESS: 900 S. FREMONT AVE. ALHAMBRA,CA 91803 PHONE NO: (626)458-3197 CONTACT: SAM ASSOUM PROJECT: OLYMPIC BLVD. PROJECT AMOUNT: $2,242,000.00 COMPLETION DATE: APRIL 2002 10. OWNER: CITY OF BEVERLY HILLS ADDRESS: 455 N.REXFORD DRIVE BEVERLY HILLS,CA 90210 PHONE NO: (310)285-2511 CONTACT: CHRIS TYSON PROJECT: VARIOUS LOCATIONS PROJECT AMOUNT: $ 1, 150,000.00 COMPLETION DATE: JUNE 2002 11. OWNER: CITY OF SAN GABRIEL ADDRESS: 425 SOUTH MISSION DRIVE SAN GABRIEL,CA 91776 PHONE NO: (626) 308-2800 EXT. 715 . CONTACT: BRUCE MATTERN PROJECT: ROSES RD. PROJECT AMOUNT: $ 970,000.00 COMPLETION DATE: MAY 24,2002 12. OWNER: CITY OF HAWTHORNE ADDRESS: 4455 W 126 .. STREET HAWTHORNE,CA 90250 PHONE NO: (310) 970-7959 " CONTACT: AKBAR FAROKHI PROJECT: WASHINGTON AVE. PROJECT AMOUNT: $535,000.00 COMPELTION DATE: SEPTEMBER 2001 r y ` CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: SEQUEL CONTRACTORS, INC. Phone: (562) 802-7227 Address: Fax: (562) 802-7499 13546 IMPERIAL HWY, SANTA FE SPRINGS, CALIF. 90670 .Contact Person: Yhomm S.Pack,President No. of years.in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? 610600A What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million Vess than $15 Million More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 LOcal Assistance rruceuUS C3 lylanual i+/AXI"I1 1L-19 PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTEAN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS W19CHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMOENT OPPORTUNITY CERTIFICATION The bidder SEQUEL CONTRACTORS, INO. ,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. 12-"9 C-12 Page 12-45 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 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 quarter_ f. loan insurance date of last report , r 4. Na 71and Adress of Reporting Entity: 5. If keporting Ertitifirt'No.•41s Subawardee.Enter Prime Ei Subawardee Name and Address of Prime: Tier ,if known Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: • S 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual,last name,first name,MI): 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 n planned a. retainer 12. Form of Payment(check all that apply): b. one-time fee a. cash / c. commission �f 8 b. in-kind;specify: nature d. contingent fee e. deferred value f. other,specify: 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s), empioyee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Shee ) if necessary) 15. Continuation Sheet(s)attached: Yes No 16- Information requested through this form is authorized by Title 31 U.S.C.Section Sign re: 1352 This disclosure of lobbying activities is a material representation of fad upon which reliance was placed by the tier above when this transaction was P t N e: made or entered into.This disclosure is required pursuant to 31 U.S.C.1352 This information will be reported to the Congress semi-annually and will be itle: ThWr" P�CI(.IM1d d available for public inspection. Any person who fails to file the required disclosure to 1 .6 shall be subject to a civil penalty of not less than$10,000 and not more than Telephone NO.: $100,000 far each such failure. Federal Use Only: Authorized for LncalReproduction Standard m,.LLL Standard Farm LLL Rev.01-03-95 C-13 Page 12-55 February 1, 1998 EXIT 12-E Local Assistance Procedures Manual Attachment G 4" PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, SEQUEL CONTRACTORS, INC. 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 fast subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal (RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that,.apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made: 12. Check the appropriate box(es).:Check-all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXIEBIT 12-E, PS&E Checklist Instructions SEQUEL.CONTRACTORS, INC. Attachment G 14. Provide A specific,and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other-aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. C-15 Page 12-55 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment L LOCAL AGENCY BIDDER-DBE INFORMATION This information may be submitted with your bid proposal. If it is not,and you are the apparent low bidder or the second or third low bidder, it must be submitted and received by the administering agency no later than the timespecified in the special provisions. CO./RTE./P.M.: BIDDER'SNAME: SEQUEL CONTRACTORS. INC. CONTRACTNO.: ADDRESS: 13546 IMPERIAL HWY, BID AMOUNT: $ SANTA FE SPRINGS. CALIF 00670 BID'OPENING DATE: // /G D DBE GOAL FROM CONTRACT - 7 ITEM OF WORK AND DESCRIPTION NAME OF DBE** DOLLAR PERCENT CONTRACT OF WORK OR SERVICES TO BE (Name of DBEs,Certification Number, AMOUNT *** ITEM NO. SUBCONTRACTED OR MATERIALS and Telephone Number) *** DBE TO BE PROVIDED DBE T.�' = 40.140/ 9�l3 ,d�as�rhi..� rIA.H//�'i�c l°v-►ski.��bN 3�So• /� �C�o/OLLS �j�il�w� �ta.►Cc' SIo�/�� ��� Total Claimed $ $ Participation % % * If 100%of item is not to be performed or furnished by DBE,describe exact portion,including planned location of work to be performed,of item to be performed or furnished by DBE ** DBEs must be certified by Caltrans on the date bids are opened. Subcontractors and suppliers certified state-funded only cannot be used to meet goals on federally funded contracts. *** Credit for a DBE supplier,who is not a manufacturer is limited to 60%of the amount paid to the supplier. (See Section "Disadvantaged Business"(DBE)of the special provisions) IMPORTANT: DTames of DBE subcontractors and their respective item(s) of work listed above should be consistent the name and items of work in the "List of Subcontractors" submitted with your bid ursuant a Subco #r rs Listing Law. ow 16 M (5s2) 802-7227 i e er Date (Area Code)tel.No. Thomas-S. Pack,President Person to Contact (Please type or print) Distribution for NHS Projects: (1)Original-Caltrans DLAE for NHS Projects,(2)Copy-Local Agency project file Distribution for non-NHS Projects: (1)Original Local Agency project file DEPT.OF TRANSPORTATION (FED DBE)MODIFIED DC-OE-19(REV 09-18-95) C-16 Page 12-67 EXHIBIT 15-K Local Assistance Procedures Manual Report of DBE Awards s REPORT OF DBE AWARDS SEQUEL C4NTRACTQRS, INC, COMPLETE THIS FORM FOR EACH CONTRACT Locode: Agency: Project No. DBE Goal: Total.Contract Bid: Reimbursement Ratio: Federal Share: Award Date: Combined DBE Percent of Federal Share for this Project: DBE Subcontractors(excluding women Awarded by Ethinic Group and other Disadvanta ed Black Hispanic Native Asian- Asian- Other Total A Indian Pacific No. Total $ Fed$ DBE Subcontractors excludin men) Grand Total MWBE WWBE Total B Total A+B No. No. Total $ Total$ Fed$ Fed$ Number of subcontracts awarded by type of work: Professional and Consultant Services DBE MWBE WWBE (excluding women) 1. Engineering 2. Architectural 3. Right of Way 4. Other Construction 1. Grading/Drainage 2. Paving 3. Structures/Buildings 4. Materials 5. Equipment 6. Trucking 7. Traffic Control S. Landscaping 9. Other TOTALS: Note: For the purpose of this report,use the following definitions. • DBE=disadvantaged business enterprise • MWBE=minority women business enterprise • WWBE=white women business enterprise C-17 ;, CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK 200-5 To: 4Z-1-11,1VJC-467 S7�Q�oti,/�S Enclosed please find your original bid bond issued by �iL1Scc.�2�4.JG� mP � for (?& Joan L. Flynn City Clerk JF:pe Enclosure gJfollowup/cashcondretumbidbond.doc (Telephone: 714-536-5227) C1 ( ALLIANCE STREETWORKS, INC. ;' v i' .•l i l a t i J' 1 t..__i'i �i l��1 3873 E..Eagle Drive Anaheim,CA 92807 o� �Y� N�TotJ �Cty 2 o MAIN sTIEW' uNY1N6tYoM WV 6PTftT P.V11AS1(4TAMc&J 115+ t I.C.W."GROUP 0 INSURANCE COMPANY OF THE WEST ❑ EXPLORER INSURANCE COMPANY INDEPENDENCE CASUALTY AND SURETY COMPANY 11455 EL CAMINO REAL, SAN DIEGO,CA 92130-2045 PHONE:(858)350-2920 FAX:(858)350-2909 Bond Number: ICW-594 BID OR PROPOSAL BOND KNOW ALL MEN BY THESE PRESENTS: That we, Alliance Streetworks,Inc. ,(hereinafter called the Principal),and Insurance Company of the West a corporation organized and doing business under and by virtue of the laws of the State of California ,and duly licensed for the purpose of making,guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of California,as Surety,are held and firmly bound unto City of Huntington Beach (hereinafter called the obligee)in the just and full sum of Ten Percent of the Total Amount Bid Dollars ($ 10%of the Total Amount Bid)lawful money of the United States of America,for the payment of which,well and truly to be made,we hereby bind ourselves and our heirs,executors,administrators,successors and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS,the above bounden Principal as aforesaid,is about to hand in and submit to the obligee a bid or proposal dated 11/16/2004 forbid: Gothard Street Rehabilitation #CC1154 in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefor. NOW,THEREFORE,if the bid or proposal of said principal shall be accepted,and the contract for such work be awarded to the principal thereupon by the said obligee,and said principal shall enter into a contract and bond for the completion of said work as required by law,then this obligation to be null and void,otherwise to be and remain in full force and effect. IN WITNESS WHEREOF,said principal and Surety have caused these presents to be duly signed and sealed this 15th day of November ,2004. Alliance Streetworks,Inc. BY: aId P, 6ArAerp P".6iden� I ce Company of the West BY: Attorney-in-Fact aniel Huckabay CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 'State of California County of Ormig® ss. On J� , before me, CORDON D.KLINE,JR.,NOTARY PUBW"- , Dale Name and Title of Officer(e.g..*Jame Doe,Notary Pub[W) personally appeared ROMId P Gaid w , ame(s)of Signer(s) AN personally known to me 0 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 CORDON DALE KUNE JR N COMM.#I36M90 D acknowledged to me that he/she/they executed sn �� NOTARYPUBUGCAUFORNIA�p the same in his/her/their authorized ' % e LOS ANGELES COUNTY rA try Comm.Exp.ium9.2M capacity(ies), and that by his/her/their signatures)on the instrument the person(s),or the entity upon behalf of which the person(s) - aCto, executed the instrument. WITNESS my hand and official seal. Cod.,&— 2IL, LL==;;;9j Place Notary Seal Above Signature of Notfiry Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Numbef of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer Signer's Name: 0 Individual _ Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑Limited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 1997 National Notary Association•.9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder.Call Toll-Free 1-800-876-6827 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of orange On 11/15/04 before me, Arturo Ayala, Notary Public Date Name,Title of Officer—E.G."Jane Doe,NOTARY PUBLIC" personally appeared Daniel Huckabay NAME(S)OF SIGNER(S) 0 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 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. WITNESS my hand and official seal SIGNATURE OF N TARY 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 DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER Bid Bond TITLE OR TYPE OF DOCUMENT TITLE(S) ❑ PARTNER(S) ❑ LIMITED One ❑ GENERAL NUMBER OF PAGES 0 ATTORNEY-IN-FACT ❑ TRUSTEE(S) 11/15/04 ❑ GUARDIAN/CONSERVATOR DATE OF DOCUMENT ❑ OTHER: SIGNER IS REPRESENTING: SIGNER(S)OTHER THAN NAMED ABOVE NAME OF PERSON(S)OR ENTITY(IES) No. 0000654 ICW GROUP Power of Attorney Bond No. ICW-594 Insurance Company of the West The Explorer Insurance Company Independence Casualty and Surety Company KNOW ALL MEN BY THESE PRESENTS: That Insurance Company of the West,a Corporation duly organized under the laws of the State of California,The Explorer Insurance Company,a Corporation duly organized under the laws of the State of Arizona,and Independence Casualty and Surety Company,a Corporation duly organized under the laws of the State of Texas,(collectively referred to as the"Companies'),do hereby appoint RALPH EIDEM,JR.,DANIEL HUCKABAY,ARTURO AYALA,PATRICIA KNAPP their true and lawful Attomey(s)-in-Fact with authority to date,execute,sign,seal,and deliver on behalf of the Companies,fidelity and surety bonds,undertakings, and other similar contracts of suretyship,and any related documents. In witness whereof,the Companies have caused these presents to be executed by its duly authorized officers this 16th day of January,2001. ?4E�paPtwyo�r 0%148V94 o we�G INSURANCE COMPANY OF THE WEST opoapo%A Eo�g O���QPOA�t`�yi� u $ F THE EXPLORER INSURANCE COMPANY d SEAL m a INDEPENDENCE CASUALTY AND SURETY *4ft"I,Ate' y a��9�tpNA tom 2 COMPANY John H.Craig,Assistant Secretary John L.Barnum,Executive Vice President State of California } ss. County of San Diego On December 5,2003,before me,Mary Cobb,Notary Public,personally appeared John L.Hannum and John H.Craig,personally known to me to be the persons whose names are subscribed to the within instrument,and acknowledged to me that they executed the same in their authorized capacities,and that by their signatures on the instrument,the entity upon behalf of which the persons acted,executed the instrument. Witness my hand and official seal. M,aRY COBB1321 o nt341 OTARYPUBI.IC-CAUFOMIA.O SAN 01EG0 COUNTY i Myy.Commission Expires SEPTEMBER 20.:2005 Mary Cobb,Notary Public RESOLUTIONS This Power of Attorney is granted and is signed,sealed and notarized with facsimile signatures and seals under authority of the following resolutions adopted by the respective Boards of Directors of each of the Companies: "RESOLVED: That the President, an Executive or Senior Vice President of the Company,together with the Secretary or any Assistant Secretary,are hereby authorized to execute Powers of Attorney appointing the person(s)named as Attomey(s)-in-Fact to date,execute,sign, seal,and deliver on behalf of the Company,fidelity and surety bonds,undertakings,and other similar contracts of suretyship,and any related documents. RESOLVED FURTHER: That the signatures of the officers making the appointment,and the signature of any officer certifying the validity and current status of the appointment,may be facsimile representations of those signatures;and the signature and seal of any notary,and the seal of the Company,may be facsimile representations of those signatures and seals,and such facsimile representations shall have the same force and effect as if manually affixed. The facsimile representations referred to herein may be affixed by stamping,printing,typing,or photocopying." CERTIFICATE I,the undersigned,Assistant Secretary of Insurance Company of the West,The Explorer Insurance Company,and Independence Casualty and Surety Company,do hereby certify that the foregoing Power of Attorney is in full force and effect,and has not been revoked,and that the above resolutions were duly adopted by the respective Boards of Directors ofthe Companies,and are now in full force. IN WITNESS WHEREOF,I have set my hand this 15 th day of November 2004 John H.Craig,Assistant Secretary To verify the authenticity of this Fov:er of Attorney you may call 1-800-877-1 111 and ask for the Surety Division. Please refer to the Power of Attomey Number, the above named individual(s)and deh:ils of the bond to i Mich the power is attached. For information or filing claims,please contact Surety Claims,ICW Group, 11455 El Camino Real,San Diego,6-921_?41-2045.or call(858)350-2400. AUJMCE STREETWORKS, INC. SECTION C An hem,C Drive PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set'forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 C-1 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 61MO BOLPn the amount of$ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature C-2 ALLIANCE S MEETWOM% INC. SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: $ 7 76Z TOTAL AMOUNT LUMP SUM BID IN WORDS: izw� Alljol 'fv C-2.1 ALLIANCE STREETWORKS, INC. GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 ALUAMCE STREE ORKS, INC. GOTHARD STREET (CC-1154) PROJECT BID SCHEDULE 0 ITEM "'ESTI'MATED w I``TEIVI VVITH"�U;N';ITyy�I?R`I;CE WRtITfaTEN$lQ& UI,NIII�FR+IC;E� EX� ENDE® rN � � nQIJANI�T"Ys fi" 4 WORDS ."' AtMOUNw M r° T7c1& 1 1 Mobilization $ i I '�bp_ $ I I/too L.S. Qer\ThaQSa^J 341e�, VQAd(*\,J Dollars fro Cents 2 1 Traffic Cont�r(o' l-Plan $ l.s4 DDU' $ ISM pq L.S. @ f'�2n �1ok5an� Dollars 2epo Cents 3 1 Furnish Project Traffic Control $ L.S. @ %��� i Sr xs,on/o Dollars Cents 4 188,917 Cold Milling & Header Cutting $�_ $�?-11 -7 S3 3 No S.F. @ Dollars Tine„ Cents {� 5 471 Unclassified Excavation $ 50, $ Z_ l[, C.Y. @ F Dollars Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, Ton Full Depth etc.) (@' Dollars Cents 7 2,347 Pavement Reinforcement Fabric & Route and $ A10 S.Y. Seal of Cras ) @ <(!` t4" Dollars Cents 8 46 Adjust Sewer/Storm Drain Manhole to Grade $ Each @ 5iX f4g.,drej Dollars Zee : Cents 9 91 Adjust Water Valve to Grade $ OUP Wj,2 g,,3 Each @ Thtee 44u-dred Dollars T zero Cents 10 1 Traffic Striping D,DOtT $ yo�ocb L.S. @ t�r4s")-kyLl5 ano1 Dollars 2Bro Cents 11 80 Traffic Loop $ $ Each @ OAS Nujt-ed 3&,eJti ✓2 Dollars „ 70-0 1Cents 12 8 Remove Reconstruct Access Ramp $ ;DOc� $ ,On Each @ "Q-,Tk of s c>! Dollars 2-of-o Cents 13 3 Adjust Su ey Monument Well to Grade $ DO' $� Each @ 7h r e"_ WL"J -ark Dollars P" Cents 14 25 Survey Monumentation $ _ $ wo Each @ -Tt )0 Dollars Z2a`a Cents Sub Total Bid Amount, Bid in Figures: $ "7 Q Sub Total Bid Amount, Bid in Words: S4Vet4J c/rZ_aa1 C-2.3 LIST OF SUBCONTRACTORS AUJAMCE STREETWORKSD INC. In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. °Portion;: - Na and.Address of..:Subcontractor.,`: :.',`° State;License' of Work Number .. Cra [ G!o 1Oti l �-W 'S al Iv1 �,,,\,� jet ;Je�s�� C_, Y�-- 5t4r e nd;�, sa�� LEI 3 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 AL�,I�dCE: tEEY�1 ��. NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange Ronald P.Gardr , being first duly sworn, deposes and says th he r she is Presiders of ALLANCE MEETUV flee 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. Aid. MCE STREETWORKS, INC. Name of Bidder Signature of Bidder RonaldP.Gardw Presiderrrt 30-73 E. E�ULf- t>C. QA+IEIM GA gz$D7 Address of Bidder Subscribed and sworn to before me this lb+h day of NOVEM084 , 200 + . NOTARY PUBLIC GORDON D. K`INE,JR..NOTARY PUBLIC NOTARY SEAL SEE AITA{,ftM . C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of 0" ss. On (V 1200't, before me, GORDON D.KLWE,JR M�TAQy t Dale Nefne and Title of Officer(e.g.,'Jam Doe,Notary u c r— personally appeared Pmald P Gardner President Nam (s)of Signer(s) personally known to me ❑ proved to me on the basis of satisfactory evidence GORDON DAM KUNEiR to .be the person(s) whose name(s) is/are COMM.#1360290 > subscribed to the within instrument and NOTARY pUBUGCAUFORNUt acknowledged to me that he/she/they executed LOS ANGELB COUNTY Comm.Exp.June9,2�6 N the same in his/her/their authorized tollcapacity(ies), and that by his/her/their t signature(s) on the instrument the person(s), or I• i the entity upon behalf of which the person(s) ,. acted, executed the instrument. , WITNESS my hand and official seal. Place Notary Seal Above Signature of Nothry Public OPTIONAL i Though the infprmation below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Numbet of Pages: Signer(s) Other Than Named Above: i• 'I Capacity(ies) Claimed by Signer Signer's Name: _ ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): l ❑ Partner—❑ Limited ❑General ❑ Attorney in Fact 1 ❑ Trustee i I ❑ Guardian or Conservator i ❑ Other: i f Signer Is Representing: 0 1997 National Notary Association•9350 De Solo Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder.Call Toll-Free 1-800-876-6827 AU LANCE STREETWORK% 6NQ 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 IMPROVEMENTS, (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. SCE STRESWORKS, BNC. Contractor x By Ronald P.Ga*or Pr ant Title Date: (o— C-5 ALUANCE STREETWORKS9 INN DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under.penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who-has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes 4 No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 SCE S INM 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. ALLMCE STREETlWORKSa INC. Contractor, By RMId P.Ggtftr President Title Date: NoVEmk3C-K(Iv, 2-004 C-7 ALLIANCE STREETwoR ,% INC. UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: WILL PKOVlDE OoM AwA-Kb OF GoNTIQA T ALUANCE STREET) ORKSs INC. Contrac ems( By Ronald R Gardner President Title Date: NoVeW bM I(o,1004 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained f om the AGENCY upon request. C-8 ALLIANCE STRMWORK,% INN BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name ���• Business Address 3873 E.Eagle Drive. Anahelm�CA 92807 City, State Zip V14)688.7165 Telephone Number 812021 A State Contractor's License No. and Class Oq �v2. Original Date Issued dg10(v Expiration Date The work site was inspected by &WIM N K1,INE of our office on NOVErhW q , 200014 The following are persons, firms, and corporations having a principal interest in this proposal: Ronald P.Gardner Presldw* 1 Rick Ruch Sec/Treasurer C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Compan, a e y �ignature of Bidder PxmsW R GaMW PtssiW RorialdP.Gamier . Printed or Typed Signature Subscribed and sworn to before me this I&*day of tJ0VG1(Y1BEI2- , 20004 NOTARY PUBLIC NOTARY SEAL Y' Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: SEE A TAt,+4 El ) I. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount . Type of Work Date Completed 2. Name and Address of Public Agency Y Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Oran" .. ss. _ On tt"U ftW ko i 2,00 4, before me, GORDON D. KLWE,JR Dale Name eqd Title of Officer e.g., an o , t P Ronald P.Gardner Pramol t personally appeared , Name(s)of Slgne4s) personally known to me O proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are CORDON DALE KLJNEJIL subscribed to the within instrument and N COMM.#136M90 D acknowledged to me that he/she/they executed pp NOTARY PUBLIC-CAUFMIA .- LOS ANGELS COWM the same in his/her/their authorized Mr Comm.Exix19.2 capacity(ies), and that by his/her/their t signature(s) on the instrument the person(s), or I, tqq entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. t. Place Notary Seal Above Signature of Nothry Pubic t OPTIONAL I Though the infprmation 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. i 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 Signer's Name: _ i ❑ Individual Top of thumb here ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited ❑General ❑ Attorney in Fact ❑ Trustee i, ❑ Guardian or Conservator i ❑ Other: Signer Is Representing: 0 1997 National Notary Association••9350 De Soto Ave.,P.O.Box 2402•Chatsworul,CA 91313-2402 Prod.No.5907 Reorder.Call Toll-Free 1-800-876.6827 LLIAn C�c - __. 1 N C O R P YO `R A T E D 3873 E.Eagle Drive,Anaheim,CA 92807•Tel: (714)688-7165•Fax: (714)688-7195•Licl 812921 STATEMENT OF EXPERIENCE 1. Job: Pavement Resurfacing Value: $ 191,144.00 Completion Date: December 2002 Agency: City of Yorba Linda 4845 Casa Loma Ave Yorba Linda, CA 92886 Contact: Fernando Saldivar(714) 961-7170 2. Job: Left Turn Pockets Improvements Value: $ 167,800.00 Completion Date: April 2003 Agency: City of Laguna Niguel 27791 La Paz Rd. Laguna Niguel, CA 92677 Contact: Nicholas Renn(949) 362-4341 3. Job: Hacienda Blvd. Value: $ 336,784.00 Completion Date: May 2003 Agency: Los Angeles County Dept. of Public Works 900 S. Fremont Ave. Alhambra, CA 91803-1331 Contact: Joseph Rhyu (626) 300-4729 4. Job: Saturn Ave. Street Improvements Value: $ 199,500.00 Completion Date: May 2003 Agency: City of Huntington Park 6550 Miles Ave. Huntington Park, CA 90255 Contact: Pat Fu (323) 584-6253 5. Job: South Street Reconstruction Value: $716,123.00 Completion Date: August 2003 Agency: City of Cerritos 18125 Bloomfield Ave. Cerritos, CA 90703 Contact: Hal Arbogast (562) 916-1219 1 6. Job: Rehabilitation of Denni St. &Moody St. Value: $ 221.437.00 Completion Date: September 2003 Agency: City of Cypress 5275 Orange Ave. Cypress, CA 90630 Contact: Kamran Dadbeh (714) 229-6756 7. Job: City Street Repairs 2002-2003 Value: $ 265,100.00 Completion Date: October 2003 Agency: City of San Juan Capistrano 32400 PAseo Adelanto San Juan Capistrano, CA 92675 Contact: Brian Perry(949) 443-6353 8. Job: Street Improvements 1951h St. Value: $ 638,386.00 Completion Date: October 2003 Agency: City of Cerritos 18125 Bloomfield Ave. Cerritos, CA 90703 Contact: Hal Arbogast(562) 916-1219 9. Job: Peck Ave. Improvement Value: 84,487.00 Completion Date: January 2004 Agency: City.of Manhattan Beach 1400 Highland Ave. Manhattan Beach, CA 90266 Contact: Edward Kao (310) 802-5358 10..Job: Improvement of Santa Fe Ave. Value: $ 159,250.00 Completion Date: April 2004 Agency: City of Long Beach 333 W. Ocean Blvd. Long Beach, CA 90802 Contact: Carlos Segui (562) 570-5160 2 11. Job: Local Street Overlay with Curb & Gutter Value: 1,077,610.00 Completion Date: April 2004 Agency: City of Norwalk 12700Norwalk Blvd. Norwalk, CA 90650 Contact: Randy Hillman(562) 929-5719 12. Job: Glassell St. Reconstruction Value: $ 444,104.00 Completion Date: April 2004 Agency: City of Orange 300 E. Chapman Ave. Orange, CA 92866 Contact: Alan Truong(714) 744-5568 13. Job: Pioneer Blvd. Medians Ph II Value: $ 675,500.00 Completion Date: May 2004 Agency: City of Artesia 18747 Clarkdale Ave. Artesia, CA 90701 Contact: Carlos A. Alba(949) 766-2686 14. Job: Fountain Installation Pioneer Medians Value: $ 394,838.00 Completion Date: May 2004 Agency: City of Artesia 18747 Clarkdale Ave. Artesia, CA 90701 Contact: Carlos A. Alba(949) 766-2686 3 AU" CE STREETWORK,% ONG, CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the-following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: Phone:(714)6U-7165 3873E , INC. Address: Anaheim. 9 7 (7t4) 688-7t85 Fax: Ronald P.Gardner Proskkr* .Contact Person: No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? V%Zl a CONT12A01c"o— What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 LUCal Abb1514U%:C 1-1 U%;U UA c4 AIAo Q —+ AXauai 1.4-JM PS&E Checklist Instructions Attachment C (THE BIDDER'S F.XE'CUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SMLL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROAff&CE67MEMOMMINC. EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder AUJAWCE STREETWORKS, INC. —,proposed subcontractor ,hereby certifies that he has), has not .participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering 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. 12-4-89 C-12 Page 12-45 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑ a contract ❑ a. bidiofTedapplicadon ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement r- post-award d. loan . For Material Change Only: f. loan guarantee date of last re ear quarter_ f. loan insurance Po 4. Name and Adress of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee.Enter Prime ci Subawardee Name and Address of Prime: Tier , if known Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known. 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual,last name,first name,Mi): different from No. 10a) (last name,first name,MI): N On►E N ��- (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 12. Form of Payment(check all that apply): b. one-time fee a. cash c. commission 8 ec nature d. contingent fee b. in-kind;s p �� e. 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 Sheets)attached: Yes No / 16• Information requested through this form is authorized by Title 31 U.S.C.Section Signature: 1352 This disclosure of lobbying activities is a material representation of fact Ronald P Gardner upon which reliance was placed by the tier above when this transaction was Print Name: made or entered into.This disclosure is required pursuant to 31 U.S.C.1352 b,,,.Ua.,p This information will be reported to the Congress semFannually and will be Title: P mk" available for public inspection. Any person who fails to file the required disclosure I� shall be subject to a civil penalty of not less than$10,000 and nat more than Telephone No.4 14r1 N-7165 Date: 11 l 64 $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction a nn LLL - Standard Form LLL Rev.01-03.95 C-13 Page 12-55 February 1, 1998 •. EX MIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, AUJANCE STREETW DISCLOSURE OF LOBBYING ACTIVITIES ���o 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 fling of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of. Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number,for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number;grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official-shall sign and date the form,print his/her name title and,telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing iiist=uotion,.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. C-15 Page 12-55 Local Assistance Procedures Manual tits l tlNV@'IN�y Blt9�s° EXFIIBIT 12=E PS&E Checklist Instructions Attachment L LOCAL AGENCY BIDDER-DBE INFORMATION This information may be submitted with your bid proposal. If it is not,and you are the apparent low bidder or the second or third low bidder, it must be submitted and received by the administering agency no later than the timespecified in the special provisions. ,,.,_ALLIANCE STREETWORKS, INC. CO./RTEJP.M.: BIDDER'SN e�z.Ee9'"n.;.,e CONTRACT NO.: ADDRESS:—T�iE.Eagle 911VO BID AMOUNT: $ -7-7 f �3 0 1 , L 807 BID'OPENING DATE: ('- l '�. - d �( DBE GOAL FROM CONTRACT - -7 % ITEM OF WORK AND DESCRIPTION NAME OF DBE** DOLLAR PERCENT CONTRACT OF WORK OR SERVICES TO BE (Name of DBEs,Certification Number, AMOUNT *** TTEM NO. SUBCONTRACTED OR MATERIALS and Telephone Number) *** DBE TO BE PROVIDED DBE RaM�`rgZ Cons��c�h°av� yq�oZ60' �00 7 G'(-03y6ss (6a6) Cru J;-SP�I, Goop S (,l�ba l � Se�li�-I I �, I oo — too 1) cT- 03d1�-6 �v2 !M'o't �q [�w� 6R3� 09yS - �✓��1 `7R,u� �t Goa l�'h awc cs Al, 137, 6070 P c l ©o C71-J2 37-/'SSS_0 Total Claimed S 7/,Z97 $ Participation * If 100%of item is not to be performed or furnished by DBE,describe exact portion,including planned location of work to be performed,of item to be performed or furnished by DBE ** DBEs must be certified by Caltrans on the date bids are opened. Subcontractors and suppliers certified state-funded only cannot be used to meet goals on federally funded contracts. *** Credit for a DBE supplier,who is not a manufacturer is limited to 60%of the amount paid to the supplier. (See Section "Disadvantaged Business"(DBE)of the special provisions) IMTORTANT: Names of DBE subcontractors and their respective item(s) of work listed above should be co ' tent with the name and items of work in the "List of Subcontractors" submitted with your bid urs a tote b ontractors Listing Law. 0+ (714)688.7165 Signature of Bidder Date (Area Code)tel.No. Ronald P.GardnerPreWOM Ronald P.Gardner President Person to Contact (Please type or print) Distribution for NHS Projects: (1)Original-Caltrans DLAE for NHS Projects,(2)Copy-Local Agency project file Distribution for non-NHS Projects: (1)Original Local Agency project file DEPT.OF TRANSPORTATION (FED DBE)MODIFIED DC-OE-19(REV 09-18-95) C-16 Page 12-67 CITY OF HUNTINGTON BEACH 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK 200 S To: 4,5&eg-,,i �aod Y44-C-47-. ", - 7n-- 4rJ,4 (34 Enclosed please find your original bid bond issued by � 7�5/i 0 PAr1 for Joan L. Flynn City Clerk JF:pe Enclosure g:/fol lowup/cashcont/returnbidbond.doc 1 Telephone:714-536-5227) i.. 1 ell, I.r 705/ C7C70 ASPHALT, INC. 2200 S. Yale Street Tel: 714-540-1700 Santa Ana, CA 92704 Fax: 714-540-1709 n�. Sealed Bid For Gothard Street Rehabiltation-CC 1154 From Ellis Ave. to Heil Avenue 1 Bond No.-,AU 92-54 Fidelityand Deposit Com"p"affi"y POST OFFICE BOK 1227 OF MARYLAND BALTIMORE. MO 21203 BID BOND KNOW ALL MEN BY THESE PRESENTS: That Svc, ._ _ _ ,. BEN'S ASPHALT, INC. _--- ----- ------ ----- -------I....... . .. .....-----------. - --------- ... --. _------ -------- -------------- -------------------- ---------- ------------------------------- ----- ---------- - ---- -- -------- -------------------------_..._..................-__-___-.-_._.._-_- as Principal, (hereinafter called the "Principal"), and,thc FIDELITY AND DEPOSIT COMPANY OF MARYLAND, P.O. Box 1227, Baltimore, Maryland 2t203, a corporation duly .organized under Lite laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto-------__ CITY OF HUNTINGTON BEACH ------------------------ --------------------------------------------------------------------------------------------- - --------------------------- - -------------------------------------------------------------------------------------------------------------------------------- ----------------- ------------....----------------------------as Obligee, (hereinafter called the "Obligee''), in tic suns of.. _TEN._PERCENT...OF AMOUNT_ BID - ---------- ----------------- ..... --Dollars (S------ 107 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.....GOTHARD STREET REHABILITATION - CC1154 FROM ELLIS AVE. TO HEIL AVE ------------------ -- - ----------------------------------------------------------------------------------------- --------------------------------------------------- --------- ------------ --------- - --------------------------------- ------------------------------------------------------------------ -------------------------------------------- ------- -------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------ NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof,or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect_ ND NOVEMBER Signed and scaled this.......... Z 20 04 --------------------- -- ------- ---day of......... ---------- - . ------------- ------- A D BEN'S ASPHALT, INC. (SEAL ) -- -------------------- --------------------- Principal Witness BYI. Skiington, - J CFO Title F(DEL[TY ANO NY OF MARYLAND re y !� Witness DAVID L. CULBERTSON, ATTORNEY-IN-FACT 7itic C.12Vr O'l. 19j „r.... .......... .a .e..., rwc ,,K 1,0 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California SS. County of Orange r� Barbara L. Russell, Notary Public On � J before me, _ Date -Mama and We of OHloer(a.%,'Jane Doe,Notary PubW) personally appeared John W. Skeffington Nama(a)of Slgner(s) ®personally known to me ❑ 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 BARBARA L.-RUSSELL capacity(ies), and that by his/her/their Comm #ission 1513390 1 signature(s)on the instrument the person(s), or -�► Notary Public — California the entity upon behalf of which the person(s) Orange County WComm.E)Oes Oct 122008 acted,*executed the instrument. WiTN S my hand and o cial seal. Place Notary Seat Above Stgnafine of Note4 Pubis OPTIONAL Tlloughlhe Information below 1a.mot required bylaw,It may prove valuable to persons re/ying..on the document and could prevent fraudulen[r emovat and reattachment of this form to another 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 Signer's Name: John W. Skeffington ❑ Individual 10 Corporate Officer—Thle(s): CFO Top of thumb here ❑ Partner—❑Umited ❑General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing- 0 1997 National Notary Assoclatlon•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder.Call To&Free 1-800-876-6927 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF ORANGE On 11-02-2004 before me, LEXIE SHERWOOD - NOTARY PUBLIC personally appeared DAVID L. CULBERTSON personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person or the entity upon behalf of which the person acted, executed the instrument. 11 E�:F .. LEXIE COMM. �ER3WOOD3 WITNESS my hand a d official seal . Q NOTARYPUBLIC13113ORNIA D ORANGE COUNTY n 1UFOp' COMM:€XP:JULY 27,2005-� Si a e of 3Kotary Public 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. DESCRIPTION OF ATTACHED DOCUMENT BID BOND TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES 1 DATE OF DOCUMENT 11-02-2004 CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLES) ❑ PARTNER (S) ® ATTORNEY-IN-FACT ❑ TRUSTEE (S) ❑ OTHER: SIGNER IS REPRESENTING: FIDELITY AND DEPOSIT COMPANY OF MARYLAND NAME OF PERSON(S) OR ENTITY(S) Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS:That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,a corporation of the State of Maryland,by PAUL C.ROGERS,Vice President,and T.E. SMITH,Assistant Secretary,in, pursuance of authority granted by Article VI,Section 2,of the By-Laws of said Company, w t set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,�d s 6j nate,constitute and appoint David L.CULBERTSON,of Anaheim,California, its true__,r '1*Aiet�Att n-Fact,to make, execute,seal and deliver,for,and on its behalf as surety,and ���`a aqA;� p d undertakings and the execution of such bonds or undertakings in purs p �ent g upon said Company,as fully and amply,to all intents and purposes,as i 'IF, 11�duly e ,e0 �IkniRwledged by the regularly elected officers of the Company at its office in n ie' p p} 0 This power of attorney revokes that issued on behalf of David L. O Md_Au� �� The said Assistant's �1 hat the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2,of the By- ° C�any,and is now in force. IN WITNESS WI41�' OF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 24th day of July,A.D. 2003. ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND 'gyp DEPp's�r ine o 0 W v By: T. E. Smith Assistant Secretary Paul C. Rogers Vice President State of Maryland �ss: City of Baltimore On this 24th day of July, A.D. 2003, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came PAUL C. ROGERS, Vice President, and T. E. SMITH, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn,severally and each for himself deposeth and saith,that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Mwo.00�.n+ iuwn,wo Ry Dennis R. Hayden Notary Public My Commission Expires: February 1,2005 POA-F 012-4150E EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI,Section 2. The Chairman of the Board,or the President,or any Executive Vice-President,or any of the Senior Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto." CERTIFICATE I,the undersigned,Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seal of the said Company, this 2ND day of NOVEMBER 2004 Assistant Secretary SECTION C PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 C-1 r proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find in the amount of$ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature C-2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: $ imclz TOTAL AMOUNT LUMP SUM BID IN WORDS: 7:y�A� C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 GOTHARD STREET (CC-1 154) PROJECT BID SCHEDULE ITEM ESTIMATED"=, ITEM 1N:ITH{UNIT PRICE 1NRITTEN:IN' T INIT. PRI'GE,,,!,,i,"EXTE�NEiE,Ei ,' 4 tlTY��: AMOUNT"' WORDS �QUAN 1 Mobiliza ion $J420.0100 $ ff'Zov.00 L.S. a MAW i9&5A§fZ YLO 11"Alhollars Cents 2 1 Traffic Control Plan $—WOO.60 $ 4?14 0. L.S. @04,w YJ6,As#Ad6yA -Dollars Cents 3 1 Furnish Project Traffic Control $eug'd L.S. @�_ C.- le L Dollars Cents 4 188,917 Cold Milling & Header Cutting jfI5A;1_e_eIA1 -,CVA'"73 $ 0 $ U.2.2& S.F. 5 471 Unclassjfied'Excavation .01 C.Y. FdCC ZA 6 10,134 Construct Asphalt Concrete (Latex �ver� $ A/d',041 $ 1655 7 . - A Ton Full Depth etc.)i5w X .4 0, S 7 2,347 Pavement Reinforcemenf'�b.6,ic�o te and $2U25,00 S.Y. Seal of Cracks Q 0 8 46 ,Adjust Se r/Storm Drain Manhole to Grade $ 3.5-41 Each V-4 'IT a 9 91 Adjust Water Valve to Grade 41,eAx AN M ess-3010 $.2;z - "4- - , 3maedt Aff __­QECE� Each Pd .0a 10 1 Traffic Striping $JjLG70, L.S. r-n' ..Ir-4'�� Y71 's-Ao"WS4"Met� Dollars Ma 11 80 Traffic Loop $_74y, Each 9eva 114 - '7 Aw_Y2&g!w�AO64m� esoll e6<:5 12 8 R move & Reconsl;uct Accecp Ramp $ 3C2 2 Each 13 3 Adjust Survey Monumeqt Well to Grade $ -?A $ Each 14 25 Survey Monumentation $ Ad oO $ Each @ Dollars J_ Cents Sub Total Bid Amount, Bid in Figures: $ Sub Total Bid Amount, Bid inWords: C-2.3 i LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one_percent of the total bid and the portion of the work to be done by such subcontractor. Portion Name and Address,of Subcontractor J State License Class of:Work Number TRAP) ;�_' .4Ao eooea ? P��ort-l Pve, lylo 3.2 Cowen 20 t'o r,T dV1ti�Qt'.z aivsiZ'uCTin� 3oZ�1l C'(o/ / r rie s Z 5 1 .�GtNtJiN ��sso�i�oT By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange John W. Skeffington , being first duly sworn, deposes and says that he or she is CFO of Ben's Asphalt 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. Ben's asphalt Inc. - _ - Name of Bidder Signat r i BARBARA L. RUSSELL Joh W. k ington, CFO Commission# 1513390 Notary Public — California i1.Orange County 2200 S. le Street, Santa Ana, CA 92704 W Comm.Expires Oct 122008 Address of Bidder Subscribed and sworn to before me this 3rd day of November , 2004 NOTARY PUBLIC Barbara L. Russell NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the IMPROVEMENTS, (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. Ben's Asphalt Inc. Contractor By John W Igton, CFO Title Date: November 3, 2004 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who.has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes *No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Ben's Asphalt Inc. Contractor By John W. Skeffington, CFO Title Date: November 3, 2004 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: (-FO �)IrL CotZgA-ir AwAfLO) Ben's Asphalt Inc. Contractor By John S effington, CFO Title Date: November 3, 2004 Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Ben's Asphalt Inc. Bidder Name 2200 S. Yale Street Business Address Santa Ana, CA 92704 a C. State Zip fy (714 ) 540-1700 Telephone Number 668417 Class A State Contractor's License No. and Class 3-31-1993 Original Date Issued 3=31-2005 Expiration Date The work site was inspected by Steve Marquez of our office on , 200_. The following are persons, firms, and corporations having a principal interest in this proposal: William J, Skeffington, President John W. Skeffington, CFO, Secretary C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Ben's Asphalt Inc. Company Name Signatu e i John . Ske fington, CFO Printed or Ned Signature BARBARA L. RUSSELL Commission# 1- ---- Subscribed and sworn to before me this 3rd day of November , 2004 - ix jem Notary Public — CaliforniaZ Orange County W Comm.Expires Oct 12.200E NOTARY PUBLIC ar ara L. RusseliNOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. See Attached Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-10 i ASPHALT, INC. LICENSE#668417 CITY REFERENCE LIST City of Santa Ana City of Anaheim 1 S1& 51h Street/ Shelton Street Broadway Street Improvements 20 Civic Center Plaza 200 S. Anaheim Blvd. Santa Ana, CA 92702 Anaheim, CA 92805 Edward Torres(714) 647-5018 Mike Woods (714) 765-5176 City of La Puente City of Santa Ana Temple Ave. Reconstruction Shelton Street 15900 E. Main Street 200 Civic Center Plaza, La Puente, CA 91744 Santa Ana, CA 92702 Joe Boada(626) 855-1500 Edward Torres (714) 647-5018 City of Huntington Beach City of Santa Ana Warner/Newland Improvements Fairview/Edinger Ave. Intersection Widing 2000 Main Street 20 Civic Center Plaza Huntington Beach, CA 92648 Santa Ana, CA 92702 Eric Charlonne (714) 536-5430 Ed Torres (714) 647-5018 City of Anaheim City of Placentia Anaheim Blvd. Placentia Ave Rehabilitation 200 S. Anaheim Blvd. 401 E. Chapman Avenue Anaheim, CA 92805 Placentia, CA 92870 Mike Woods (714) 765-5176 Art Burgner(714) 9934245 City of Santa Ana City of Tustin Warner Avenue Improvements Tustin Ranch Road 200 Civic Center Drive 300 Centennial Way Santa Ana, CA 92702 Tustin, CA 92780 Ed Torres (714) 647-5018 Benny Tenkean (714) 573-3161 City of Westminster City of Anaheim Bushard Street Improvements La Palma Avenue Street Improvements 8200 Westminster Blvd. 200 S. Anaheim Blvd. Westminster, CA 92683 Anaheim, CA 92805 Kevin Sin(714) 898-3311 Daryl Lopez(714) 765-5126 City of Santa Ana City of Lynwood Fairview Street Rehabilitation San Jose , Platt& Carlin 20 Civic Center Plaza 11330 Bullis Road Santa Ana, CA 92702 Lynwood, CA 90262 Ed Torres (714) 647-5018 Elias Saikaly(310) 603-0220 2200 S. Yale Street, Santa Ana, CA 92704 Phone 714-540-1700 fax 714-540-1709 o ee® ASPHALT, INC. LICENSE#668417 SCHOOL DISTRICT REFERENCE LIST Bassett Unified School District Long Beach Community College District 904 North Willow Avenue 4901 East Carson Street La Puente, CA 91746-1696 Long Beach, CA 90808 Bob Cornell (626) 918-3487 Steve Wheeler(562) 938-4111 Burbank Unified School District Long Beach Unified School District 330 North Buena Vista Street 1515 Hughs Way Burbank, CA 91505 Long Beach, CA 90801 Ali A. Kiafar(818) 558-4600 (562) 997-8000 x 1504 Claremont Unified School District North Orange County Comm. College Dist. 2080 North Mountain Avenue 1000 North Lemon Street Claremont, CA 91711-2697 Fullerton, CA 92832-1351 Steve Lowe (909) 398-0609 Linda York(714) 578-8463 Fullerton Union High School Dist. Mt. San Antonio Community College Dist. 1027 South Leslie Street 1100 North Grand Avenue La Habra, CA 90631 Walnut, CA 91789-1399 Bill Nance& Fred Diamon(714) 680-5601 Susan Rosas (909) 594-5611 ext 4245 Fountain Valley Unified School Dist. Placentia Yorba Linda Unified School Dist. 17210 Oak Street 1301 East Orange Thorpe Avenue Fountain Valley, CA 92708 Placentia, CA 92670 Ken/Ian (714) 843-3201 Pete 9714) 985-8440 Garden Grove Unified School Dist. Redondo Beach Unified School district 8211 lampson 1401 Inglewood Avenue Garden Grove, CA 92641 Redondo Beach, CA 90277 Phone (714) 663-6390 (310) 379-5449 Glendale Unified School Dist. Saddleback Valley Unified School Dist. 223 North Jackson 25631 Diseno Drive. Glendale, CA 91206 Mission Viejo, CA 92691 Steve Vartanyan (818) 241-3111 x 470 Charles Butler(949) 580-3270 Hemet Unified School Dist. Torrance Unified School Dist. 2350 West Latham Avenue 2335 Plaza Del Amo Hemet, CA 92545 Torrance, CA 90509 (909) 765-5100 Patrick(31) 533-4212 Huntington Beach Unified School Dist. Westminster School District 10251 Yorktown Avenue 14121 Cedarwood Avenue Huntington Beach, CA 92646 Westminster, CA 92683-4482 Ed Baker(714) 964-3338 Kenneth A Fiolka(714) 894-7311 2200 S. Yale Street, Santa Ana, CA 92704 Phone 714-540-1700 fax 714-540-1709 e 777-11 ASPHALT, INC. LICENSE#668417 TRADE JOB REFERENCE LIST Diffenbaugh Const. Inc------------------------------ Jurupa Valley Spectrum 2375 Chicago Avenue $318,356.00 Riverside, CA 92507 Completed December- 1999 (909) 684-2820 Oltman's Construction Inc.------------------------- University Research 10005 Mission Mill Road Phase 8 & 10 Whittier, CA 90608 $501,343.00 Jim Woodside (562) 948-4242 Completed January—2000 Camp Pendleton-------------------------------------- IQ AC Repair Public Works Department' $9,000,000.00 Oceanside, CA Completed September—2002 (760) 725-8239 Grant General Contractors-------------------------- Lowe's Santa Clarita PO Box 979 $375,000.00 Carlsbad, CA 92018-0979 Completed February—2002 Snyder Langston------------------------------------- Seacliff Village 17962 Cowan $839,964.00 Irvine, CA 92714 Completed March—2002 Don Rudd (949) 863-9200 Diffenbaugh Const. Inc.---------------------------- Lowe's Distribution Center 2375 Chicago Avenue $2,785,698.00 Riverside, CA 92507 Completed March—2001 Russell W. North(909) 684-2820 Lusardi Construction Company Berry Construction Scott Staley(760) 744-3133 Lance Berry (909) 985-9677 Mercer Construction Company Port of Long Beach Bob Erickson(909) 695-6222 Dennis Nielan (562) 590-4172 Fullmer Const. Gentosi Brothers Louie Anderson(909) 947-9467 Charlie Young (949) 474-2333 Kajima Construction Ken Kwok(323) 881-2591 2200 S. Yale Street, Santa Ana, CA 92704 Phone 714-540-1700 fax 714-540-1709 ASPHALT, INC. LICENSE#668417 ARCHITECTS REFERENCE LIST EKN Engineering 4770 Campus Drive. #240 Newport Beach, CA 92660 (714) 263-1925 Ninyo & Moore 9272 Jeronimo Road# 123-A Irvine, CA 92618 (714)472-5444 Paragon Project Resources 10 Corporate Park 3 310 Irvine, CA 92606 (949)477-4948 2200 S. Yale Street, Santa Ana;CA 92704 Phone 714-540-1700 fax 714-540-1709 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name:(%µ'S 06 Phone: 6(L( 5t(O -l o O Address: 'LL-00 . 4AU- 6 K- Fax: 6(q) 540 — I-I.a�'( 011- - 91-10q .Contact Person: 6-%.tF- VjkMjWG Z-- No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? 66LA(W4, 0,V rA What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 Local Assistance Procedures manual PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder S 'S ,proposed subcontractor ,hereby certifies that he 14 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. 12-489 C-12 Page 12-45 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 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 u b. material change c.cooperative agreement c. post-award d, loan . For Material Change Only: e. loan guarantee date of laear -st re q rt rter f. loan insurance po 4. Name and Adress of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee.Enter Prime o Subawardee Name and Address of Prime: Tier , if known Congressional District, ffknown: Congressional District, ifknown: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable 8. Federal Action Number, ifknown: 9. Award Amount, if known: 10, a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual,last name,first name,MI): 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 12. Form of Payment(check all that apply): . b. one-time fee a, cash c. commission 8 specify: nature d. contingent fee b. in-kind;s p �' t e. deferred value f. other,sp ecify: 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 Rem 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 Signature: 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was Print Name: made or entered Into.This disclosure is required pursuant to 31 U.S.C.1352 This information will be reported to the Congress semi-annually and will be Title: 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 Telephone No.: Date: $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Standard Farm LLL Rev.01-03.95 C-13 Page 12-55 February 1, 1998 EXIRBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address,city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1.). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number.for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal (RFP)number,Invitation for Bid(IFB)number;-grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the.lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MU). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and.telephone number. Public reporting burden for this collection of information is estimated to average 3 0 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. C-15 Page 12-55 CITY OF HUNTINGTON BEACH BU)DERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide,a proposal, bid, quote, or were contracted by the proposed prima. This information, is also required ftom the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huniington Beach will use this information to maintain and update' a "Bidder's"list to assist in the annual DBE goal-setting process. Firm Name:. ) Address: I� Fax �1 ' ��� �J 67 ,Contact person: ez—>-v No. of years,in business Is the firm currently certif ed as DBE under 49 CFR Part 267• 'YES 0 Type of work/services/materials provided by What was your firm's Gross Annual receipt's for last ear? u Less than $1 Million Less than$5 Million o Less than$10 Million o Less than $15 Million ❑ More than $1 5 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. i C-11 , 11- 4-04; 10:42AM;Bens ASDnaIt ;714S40t709 0 3/ ■ i. CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contfactors,who provide a proposal,bid, quote, or were contracted by the proposed prune. This information is also required from the proposed prune contractor, and must be submitted with their bid/propgsal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: se- LAas D ufty�4,�.�,Luc Phone: (7iU) y4 Address: 101 o AJ , �j„;,c v i A ST Pax: K-714) 6,;L8 - "05 D Aj 4. C.a J.2-Kb-7--- _Contact Person: �,�R_Q�,r �i s� No. of years,in business 1 Is the firm currently certified as DBE under 49 CFR Part 26? YES C�0) Type of work/services/materials provided by firm? Su9_V e—Al l-j ca z5 rr-r-8 What was your firm's Gross Annual receipt's for last ? o Less than$1 Million v4,d-Less than$5 Million ❑ Less than$10 Million a Less than $15 Million ❑ More than$15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. I I , 1 C-11 I I g d S06B-BZ9-�TL SWIA3ANns aWU-1 3St10 dSt' :t'0 b0 ZT now - -- —• 7r..v GF!1-i,y in.5 P1'1C 11 7 .1•:. ..l_��i a .� CITY OF 1-WNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for al1.DBE and non- DBE conrfactors,who provide a,proposal, bid, quote,or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/ptoposal.The City of Huntington Reach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Namc::IA OVAPV �I;TIr-S Phone.,�1 1 Address: 07W E *10AC104-4 _e4k�F-F73 Fax:. OIL4 � f A0A ,4A CA 'IZv 040 .Contact Person:Cl� Ste_ e-c q No. of years.in business Ls the firm currently certified as DBE under 49 CFR Part 26? 6�i) NO Type of work/services/materials provided by firm.?_01)(5orEa`T1,-,6 What was your firm's Gross Annual receipfs for last ycar? ❑/Leas than$1 Million Less than$5 Million ❑ Lass than$10 Million ❑ Less than$15 Million o More than $1S Million This form can be duplicated if necessary to report all bidders(DBEs and non DBEs) information. C-1 1 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors,who provide.a proposal,bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, andrdust be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a`Bidder's"list to assist in the annual DBE goal setting process. Firm Name:Wor ks S+r;n ,ua 41A � P'hone:_ Address: I/Za Alo. 42 Fax: r�2�o,g I.4 " 2gCkS— W"� avV AJA�c 'Contact Person:s+e- rkS No. of years,in business Is the firm currently certified as DBE under 49 CFR Part 26?' YES NO Type of work/services/materials provided by firm? K emu, + Aim What was your firm's Gross Annual receipt's for last ear? o Less than$1 Million X Less than$5 Million ❑ Less than$10 Million ❑ Less than$15 Million o More than $1S Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. I I I C-11 i CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DSE and non- DBE contractors,who provide a proposal,bid,quote, cr were contracted by the proposed p::ime. This information is also required from tho proposed prime contractor, and must be submitted with their bi&<)ropcsal. The City of Htm ington Beach wilt use this information to maintain and update a`Bidder's"list to assist in the annual DBE goal sexing process. FirmNeme: � (�v,nr�c _ Phone: J-9 E-344-7_&51 Address; Contact person: C.1:1a\t LQ No. of years.in business Is the firm currently certified as DDE under 49 CFR Part 26? YES NO Type of worWservices/materials provided by firm? �514f Crirt car "a i4 e What was your fam's Gross,Rnnual receipt's for last year? ❑ Less than$1 Million Lees thmi$5 Million ❑ Less than$10 Million ❑ Less thmi$15 Million ❑ More than$1'5 Million This form can be duplicated if necessary to report all bidden(DEF.s and non DBEs)info:Lrnation_ C-11 Ed Wd90:0T b00Z ST 'SON iZSOV=E9 'ON 9NOHd 3i3doNoo 1 3 WOdA 11/'115/2004 11: 18 71463O1783 LOOP MASTERS INC PAGE 02 02 M10: 3oM;Bens 501i2, I L CITY GI'HUNTINGTON BEACN BIDDERS L1ST- �0J, Bidders/prol 3sers are required to provided the following informatjon for all DBE a, d noR- Df iE contractor! who provide a proposal,bid, quote,or were contracted by the propoA .1 prime 'I'h.s information is also required from the proposed prime contractor, and must be subn fitted wi h -clie it bidlpropos; l_ The City of Huniington Beach will use this information to maintain :I ad upda to a "Bidder's"'ist -.0 assist in the annual DBE goal setting process. _ F u m Name:_I_ M�✓T� i NC- Phone: r7j��_;a,D-- A dress: ON !J?T Fax: �YK/r►�iMF��g„Z Apr/' - . �:c ntact Persc.n: B►NDPaC"A NOPer* T No. of years,in !>usiness �P l> he firm curre Ay certified as DBE under 49 CFR Part 26? 1'y?e of work/se viceshnaterials provided by firm?�r� L , .,,�� 12 1 W iat was your: rm's Gross Annual receipt's for Last year? n Less than $1 Million Tess than $5 Million ❑ Less than$10 Million ❑ Less than $15 Million ❑ More than $15 Million -;'his form c an duplicated if necessary to report all bidders(DBE: and non DBEs) i iformat on. I Glf Nov' 15 04 11 : 10a p . 2 r. CITY OF HUNTINGTON BEACH tBIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors,who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal.The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: E � "a ��( — Phone: Address: ax - ! .Contact Person: '`c— kj(?\_ uN No. of years.in business Is the fum currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? � What was your firm's Gross Annual receipt's for lastyear? o Less than$1 Million `)% Less than$5 Million ❑ Less than 510 Million i ❑ Less than$15 Million ❑ More than$15 Million This form can be duplicated if necessary to report all bidders(DBEs and non DBEs) information. J I C-11 11/1a/4uu'2 1J.JJ 1'AA 11/15/2004 10:14 19494928324 ORION CONTRACTING PAGE 01 CITY OF pIUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal- The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Finn Name 1 d o h,�, ��:�! � „i--c Phone (7 Address:! `� „%c.,cjljfcl Fax: .Contact person: C?/`L No. of years in business ' 2— Is the firm curtently certified as DBE under 49 CFR Part 26? YES SN �,\ Type'of work/services/rriaterials provided by firm? I o a 3 4211-4, What was your firm's Gross Annual recet is for last ear? . a A Less than$1 Million a Less than$5 Million mess than$10 Million a Less than$15 Million ❑ More than $15 Million Ibis form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. , II , I CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors,who provide.a proposal,bid, quote, or were conxacted by the proposed prime. This information ie also required from the proposed prime contractor, and'must be submitted with their bid/proposaL The City of Hwi ington Beach will use this information to maintain and update a"Biddef s"list to assist in the annual DBE goal setting process. Firth Name: -Phone: 2,tk 44-7 6 6 7? Address:_____ 1 , U .Contact Person: m No. of years.in business 'Is the fvm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm? a�1L Wbxt was your fern's Gross Annual receipt's for last ear? Less than$1 Million a. Less than$S Million o Less than$10 Million a Less than$15 Million o More than$IS Million This form can be duplicated if necessary to report all bidders(DBEs and non DBEs)information_ C-11 Zd Wd2-S:E0 baOZ ST 'noN T8092-bbbT2-: 'ON Xdd 'ONd -10aiN00 OIddHdl: W0dld i 1 -1 S-04 11 ::RAflI; 71d54017O9 1 CITY OF 14UNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal,bid, quote, or were contracted by the proposed prime. This information is also requited from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Hun'tington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process, Firm Name- Phone: l 7 1 Y 110 '115 S' Address: 7,-U C Uf1"[1°ti bt! I�"!" y Fax:— -5a V L N two Ce, 9 220-6 .Contact Person:_RAV, � �l'SL'S No. of years,in business Is the firm currently certified as DBE under 49 CFR Part 26? YES Type of worldserviceslmaterials provided by firm? CS}QC R.C-TC, 'What was our firm's Gross Annual receipt's for last,year? Tess than$1 Million ci Less than$5 Million ❑ Less than$IO Wlion o Less than$15 Million o More than $15 Milliou This form can be duplicated if necessary to report all bidders(DBEs and non DBEs)information. I T C-.l L i 11-16-2004 08:29 M C STRIPING 190998861-1 PAGE2 11-1G-UA; /: IUAM;Ron.% A%nnalr r l 4! 401 L)5 CITY OF HUNTINOTON BEACH BIDDERS LIST All Bidders/proposers are mquiisd to provided the following information for all DUE and non- DBE contractors,who provide.a proposal,bid, quote,or were contracted by the proposed prime. This infonriation is also required from the proposed prime contractor,and must be submitted with their bid/proposal.The City of Huntington Beach will use this information to maintain and update a`Bidder's''list to assist in the annual DBE goal setting process. Firm Name: Phone: Address: L� Fax: ,Contact Person: (I((()e&WI 5r No. of years.in business Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/serviccs/materials provided by firm? What was your firm's Gross Annual rece" is for last ar? Less than$1 Million o. Less than$5 Million o Less than$10 Million ❑ Less than$15 Million o More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 nnnt•� 1 Uuv-1 (—leuliq 12 :5'J RM r. P. 01 U11/16/2004 10:54 19494929924 ORION CONTRACTING PACE 01 CITY Of HUNTINGT©N BEACH BE)PER9 LIB-' All Biddere/propossre are required to provided the following inforrtladOn for all DBE and non- DBE cWtjactor9,who provide a proposk,4 bid,quota,or were contracted by.the proposed pfte. This information is&too required from the proposed prime contractor,'snd must be mbmi"d with their bid/propow L The City of ILmtington Beach will use this infm=tion 119 maintain and update a"Bid&t's"list to assist in the annual IDBL 9081 Settinj PTOMS. Firm Name. L'alol P/"i n I Phone gQ '�L./ - -2 S"9 Address-40", o -e: - <,/O h Pax: l T,m . , ell- z .Contact Person L No. of years in business-1,_� Is the fum currently emtiPied as DBE under 49 CFR Pert 26? YES CN IType of work/setviaea/materials provided by flan? C Q`d ��� n �14 Whet was YOUT 's Gross A.ndual i t'e,for t ar'? Less tWW$:I Million a Lass then$9 Million o Lmes than$10 Million u Lest ffm$l5 Million a More loan$15 Million TW9 tbrm can be duplicated if necessary to report all bidders(DBEs and mote DM) btforrnataan. Post-Its ax We "?i i1° ► WE) 11:11 9092799112 EBS INC PAGE 03!'03 CITY OF HUNTINGTON BEACH } BIDDERS LIST f j jJA11 Bidders/proposers are required to provided the following information for all DBE and .non- '//DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed pnme. This .information is also required from the proposed prime contractor, and must be submitted with Jr� their bi 3/proposal. The City of Huntington Beach will use this information to maintain and update r a"Side.er's" list to assist in the annual.DBE goal setting process. 1 �I r %f Firm Name: �, /� •- i���/,�,�'. Phone: Z 79— �G z� i Address:,: /'1Zo �- .Sint»�- STZ `rl oc� Fax: 2-753 " `U2 any�4-f C'•g- q��i79^�'70[� .. .Contact Person::t_ No. of years in business Is the film currently certified as DBE under 49 CFR Part 26? YES O Type of'wo,rk/services/materials provided by firm? What w;Ls your firrn's Gross Annual receipt's for last year? o Less than,$1 Million ❑ Less than $5 Million co Less than $1.0 Million ❑ Less than $15 Million More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 NOV-1*6-04 12:08PM F ROM-TM I 562-424 0266 T-452 P.003/003 F-802 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors,who provide.a.proposal,bid, quote,or were contracted by the proposed prime. This information is also required from the proposed prime contractor, andmust be submitted with their bid/proposal.The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: % /'�<�'�+�[r..e��. �,s Phone: 561 -05'- YZ-7 B Address: Fax: 41 _Contact Person: G /2 No. of years,_in business /O Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by What was your fum's Gross Annual receipt's for last ear? ❑ Less than$1 Million `#, Less than $5 Million ❑ Less than$10 Million v Less than$15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs)information. y I C-11 ;,"iff CITY OF HUNTINGTON BEACH okjr 2000 MAIN STREET CALIFORNIA 92648 OFFICE OF THE CITY CLERK / , 2006' 9gNrP�� Enclosed please find your original bid bond issued by /jj a=/72;f 2EPOS!7- C a . 0c /11*tY,WZ for ( Je Joan L. Flynn City Clerk JF:pe Enclosure g:/followup/cashcont/retumbidbond.doc (Telephone:714-536-5227) ►S � s I r k^ 'fix r=+ f l 1r M r''• �-y'`;�t '� yy.,: �yw ,tt „�i.� yr�`M-WN, i&.w•'"f,r yt '�t'�+, aa`a:� I p' 4x ��'�t � �:kx��ih-�,+�k' °}�� �`+ n ft� •v F t aeier. MA Nq ,F '�f ^ ,; vx#�m-Xty r uF, .;,v.�'"v+.� 4 �f t r 1 i. .a "4 ,^�i.ta'�' �`.t .'d, „ •,",�r r y`�n ,. a*., yt� ct ^y�'rr s" �' "s, t"va �'�«j �k"'`�d m ✓ �-4. `v�r`°,�,`a _ Luse • • "� u l^ q .sn.R - +.,,�rt�-,`�nq��� dS�F.�.E �Ly'' N ��' k, � i n,„{fir h aw� ",je +�' x T � 'fi" a `; y a w"+•��r''� ",.li` 4,.1�' �J,� 't,eS eC • S P�� �.e �p�6M," y"��'§�¢¢`.., rt has}� jd t,o tie 3 f- .,J ,,�. ki' q. Q, .Jd,?ytlrl ``71^y4 �u �� i,ar r � s �'��'•" 3 �4 "S e �i, 7 � ( '� ��r $� f "sN� �u..� �Y n�. 'ca ' 1 t 42 }"b ,Q'�r 3 r,t•• � � �t t�. v • - �z� - 4P�z a x- s Y 4 7'e xi i r s� • • �' v'#C '4 f x�r i"S �.��f�•.a' C�'s f'�� a { �t °�t`'i'rd r��9 y�1 �s� '£ .�.� � '� 1 a_. _;c'�r�_" �r'`"�, - rps,s, �. •Ay`:. ��..�: sM,�;,- e: r�'!'�,y„, y ,-w h'.n,,�s�i-^ �y-.��;. � ,N�- a o Fidelity and Deposit Company of Maryland Home Office:P.O.Box 1227.Baltimore.MD 21203-1227 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ALL AMERICAN ASPHALT BOND NO.085 97 423 as Principal,(hereinafter called the"Principal"), and FIDELITY AND DEPOSIT COMPANY OF MARYLAND P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of the State of Maryland, as Surety,(hereinafter called the"Surety"),are held and firmly bound unto City of Huntington Beach as Obligee,(hereinafter called the"Obligee"),in the sum of TEN PERCENT OF THE TOTAL BID PRICE IN-------- Dollars($ 100/o OF TOTAL BID PRICE ),for the payment of which sum well and truly to be made,the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has submitted a bid for Gothard Street Rehabilitation from Ellis Avenue to Heil Avenue,Project No.CC 1154 Bid Date: November 16,2004 NOW,THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid,then this obligation shall be null and void,otherwise to remain in full force and effect. Signed and sealed this 12th day of November A.D., 2004 ALL AMERICAN ASPHALT (SEAL) L"L. plti� Principal Witness Robert Bradl�le Vice P ent FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety r /f By (SEAL) Witness M.BROWN Attorney-in-Fact Printed in cooperation with the American Institute of Architects(AIA)by Fidelity and Deposit Company of Maryland. Fidelity and Deposit Company of Maryland vouches that the language in the document conforms exactly to the language used in AIA Document A-310,February 1970 Edition. BID70000ZZ0701f CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Riverside ss. On November 15, 2004 before me, Debbie A. Matsen, Notary Public, Date Name and Title of Officer Personally appeared Robert Bradley Name of Signer(p X personally known to me to be the personSx)whose name) is/ace-subscribed to the within instrument and acknowledged to me that he/&heAher 46 0executed the same in hisfheA4eifauthorized DEBBIE A MATSEN capacity(iesj-and that by his/heritheir- _ Commisslon#1452589 signature)on the instrument the person() -® Notary Public-Califomla or,the entity upon behalf of which the persono) Riverside County I acted,executed the instrument. My Comm.Expires Nov22,2007P WITNESS my hand and official seal, 7_ Signature of Notary Public OPTIONAL Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Bid Bond, City of Hunting Beach Document Date: November 12, 2004 Number of Pages: 1 Signer($) Other Than Named Above: Owen M. Brown Signer's Name: Robert Bradley _Individual XCorporate Officer Title(,: Vice President _Partner-_Limited_General r� _Attorney-in-Fact Top of thumb here _Trustee _Guardian or Conservator Other: Signer is Representing: All American Asphalt )-rLCIrtr uti t� Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS:That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,a corporation of the State of Maryland,by M. P.HAMMOND,Vice President,and L.L.GOUCHER,Assistant Secretary, in pursuance of authority granted by Article VI,Section 2,of the By-Laws of said Company, wh' set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof d s S* mate,constitute and appoint Owen M.BROWN,of Anaheim,California, its true and lawf ey-i - to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and o ngs,and the execution of such bonds or undertakings in pursuan ° s on said Company,as fully and amply,to all intents and purposes,as if th xec �. l� ged by the regularly elected officers of the Company at its office in Bal ' r15 h it �r This power of attorney revokes that issued on behalf of Owen M. at y 2 The said Assistant hat the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2,of the By- C any,and is now in force. IN WITNESS W 1 OF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this I I th day of February, A.D.2003. ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND '�9 9EPOs�i _ o ION ��yy � T v 1 V 4'w Rl By: L. L. Goucher Assistant Secretary M. A Hammond Vice President State of Maryland I ss: City of Baltimore On this I I th day of February, A.D. 2003, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came M. P. HAMMOND, Vice President, and L. L. GOUCHER, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn,severally and each for himself deposeth and saith,that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Sandra Lynn Mooney Notary Public My Commission Expires: January 1,2004 POA-F 012-4160 EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI, Section 2.The Chairman of the Board,or the President,or any Executive Vice-President, or any of the Senior Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto." CERTIFICATE I,the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 1 Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company, this 12th day of November 2004 . Assistant Secretary .r, �-«��:.... '`�.'.'�ti-v{�.!c.'�-��..'i•<4`?�%5:::;v=q. z'_'�"�� .'-_`r4:S."t"rS:"t:':G��G,:�u'';��5�.`�.`.-�eG'{'v-. �%�'s=�..-.�r,:l''�_ ' ':��-�;.::r'•`,'`�..�''�..:.ra`?_,';�, . �a State of Camomfa �S ss. _ County of ORANGE . On ]-12-n4 Wore no, BARBARA J- BENDER NaareadTrOadOfSrsr(a9.'taneDneGMat"Pd6? peppy appeamd OWEN M. BROWN 2"personaly lawn to me t P ' to to the perso (s) whose name(sk isfam - subscribed to the within instrument and t r adatowledged tome that the same in h� authorized BAftBAM J.BENDER capadtaw), and that by WwMak ' COmmisdO►#1494946 t _CconMa sttre(a)on the the persorr(�,or Wokwythe upon behaff� the person(s)Orange county acWd gkiecuted the # W Cornm.E*hes.�13. LIP d HMW PdAC {' Y OPT90MAL 7hougn ow bdvrm am bebwv is not requindbyhK a umy prove vekaft m parsers r 6ft w ft d=WlWW wW cmW prevent baudv�ea# end mtertt�tt+tz porm to anotherdbrxur�errt �, DemAption of Attadled Document Tale or Type of Document BID BOND x } !?orxarartt Oaie: 11�-12:�4 Number of Pages:L ZZE ALL AMERICAN -ASPHALT Soter(s)Other Than Named Above. � r Capaci4QW)Ck*ned by SkjW SigrWs Name: OWEN M. BROWN ` x� ❑ hnd>V� . Top d tlnnnb here, ❑ Corporate Officer--TAfe(s). :x ❑ Partner--❑United ❑Genera! XXX Aaomey-in-Fad ❑ Tnatee ' ❑ GuanJan or Conservator ❑ Other: signer is RepmsenuW,FIDELITY AND DEPOSIT COMPANY OF ,MARYLAND - _ - -- -.,r ,.�'yV�r �-.Y_'�F.m-•F�,:in:-- "4`-,:M1 t. -��. .Ic_F;. .�.... i{'.��..- � . +.,'-� 1+�; 44:F>ti';� rv,�y.:{s,Y;�_�:�:�r=ey` . . -�''�t _:. .✓`v:;*�`.�`.:v'-;t;�.'"'�.fC"Z',:;`4'/::`�:i;:-,��:�=/-,�:�-C,K'..;,i.;t`✓,::.,; i.'•'�°):J:: O1 N-a MMwyAmoda**-9CWDoSMPAM.P.a&xS -CAWMkCA9130-MM•rwunWMWMW*M Pmd.N&W? CdTa&rwe1A*%W W 5Z V RICH THIS IMPORTANT DISCLOSURE NOTICE IS PART OF YOUR BOND Fidelity and Deposit Company of Maryland,Colonial American Casualty and Surety Company,Zurich American Insurance Company,and American Guarantee and Liability Insurance Company are making the following informational disclosures in compliance.with The Terrorism Risk Insurance Act of 2002. No action is required on your part. Disclosure of Terrorism Premium The premium charge for risk of loss resulting from acts of terrorism(as defined in the Act)under this bond is $ waived_. This amount is reflected in the total premium for this bond. Disclosure of Availability of Coverage for Terrorism Losses As required by the Terrorism Risk Insurance Act of 2002,we have made available to you coverage for losses resulting from acts of terrorism(as defined in the Act)with terms,amounts,and limitations that do not differ materially as those for losses arising from events other than acts of terrorism. Disclosure of Federal Share of Insurance Company's Terrorism Losses The Terrorism Risk Insurance Act of 2002 establishes a mechanism by which the United States government will share in insurance company losses resulting from acts of terrorism (as defined in the Act)after a insurance company has paid losses in excess of an annual aggregate deductible. For 2002,the insurance company deductible is 1%of direct earned premium in the prior year; for 2003, 7%of direct earned premium in the prior year;for 2004, 10%of direct earned premium in the prior year;and for 2005, 15%of direct earned premium in the prior year. The federal share of an insurance company's losses above its deductible is 90%.In the event the United States government participates in losses,the United States government may direct insurance companies to collect a terrorism surcharge from policyholders. The Act does not currently provide for insurance industry or United States government participation in terrorism losses that exceed$100 billion in any one calendar year. Definition of Act of Terrorism The Terrorism Risk Insurance Act defines "act of terrorism"as any act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States: l. to be an act of terrorism; 2. to be a violent act or an act that is dangerous to human life,property or infrastructure; 3. to have resulted in damage within the United States,or outside of the United States in the case of an air carrier (as defined in section 40102 of title 49, United 17 States Code)or a United States flag vessel (or a vessel based principally in the United States,on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), or the premises of a United States mission; and 4. to have been committed by an individual or individuals acting on behalf of any foreign person or foreign interest as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. But, no act shall be certified by the Secretary as an act of terrorism if the act is committed as part of the course of a war declared by Congress(except for workers' compensation)or property and casualty insurance losses resulting from the act, in the aggregate,do not exceed$5,000,000. These disclosures are informational only and do not modify your bond or affect your rights under the bond. Copyright Zurich American Insurance Company 2003 SECTION C PROPOSAL for the construction of I. GOTHARD STREET REHABILITATION - CC 1154 FROM ELLIS AVENUE TO HEIL AVENUE 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 85 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 C-1 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?,x D gf�, iZp in the amount of which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature 9 G2 SECTION C PROJECT BID SCHEDULE Gothard Street, CC-1154, STPL - 5181 (141) PROJECT BID: TOTAL AMOUNT LUMP SUM BID IN FIGURES: 61,10,Zsg• d TOTAL�AMOUNT LUMP SUM B `ID IN WORDS: f /� 5T ["�"a Pa* 'rk.L- GW.0 u10 eJ 1 k (Gl Vd is ao-4 C-2.1 GOTHARD STREET REHABILITATION IMPROVEMENTS CC NO. 1154 STPL - 5181 (141) C-2.2 GOTHARD STREET (CC-1 154) PROJECT BID SCHEDULE ITEM 6,' ,`�4ESTI TED," ITEMVI T H,'�U N FERRI C E,'W,R I TT EN�,,l C,E �'%,EXT.E N D E D:- QUAN-TIT 0 '�M U,N Tiu,1 1 Mobilization gob 3,C-0 Z 2 L.S. @w�d Dollars Cents 2 1 Traffic Control Plan $ 6 1 Aoo $ 64;t oz> L.S. "IX Syf-A� rwo Ate, Dollars zeleb Cents 3 1 Furnish Pr-p-ro M0644ject.-�ffntrol $ 4,boo $ tY ,600 L.S. @ 91,x AAA�I� Dollars rIew-0 Cents 4 -188,917 Cold Milling & Header Cutting $ O. $ Zip S.F. @ ZRII(V Dollars e7p_ Cents 5 471 Unclassified Excavation $_GAfL $Z C.Y. @ F-:,� Dollars 7le-Ary Cents 6 10,134 Construct Asphalt Concrete (Latex Overlay, $_Y.3-310 $If W-g-'Cs- Ton Full Depth etc.) @ F;'L4 I Dollars a V ot'-_ Cents Y P 7 2,347 Pavement Reinforcement Fabric & Route and $Lfi�0 $ S.Y. Seal of Cracks @ f=0 Dollars PL.9LO 511 t,.3.q o :EYInAg Cents 8 46 Adjust Sewer/Storm Drain Manhole to Grade $ q?vsp $-7/'9,0V Each @ Po"r 14-yJ reA Seoowf 14 rft4- Dollars Z-ey-n / . . Cents 9 91 Adjust Water Valve to Grade $ ir? $ Y69 Each @O^e- 6:M4� Gi V Dollars 7_e n5 Cents 10 1 Traffi,,S ri *,& .$ Y0410 $.-Ye' L.S. —Dollars Zcva Cents 11 80 Traffic Loop co-e P-4ced C' AM.&6410"f $ Each '-0.0 -Dollars I r aeo­ Ift Cents 13 q-?z � Ree 12 8 Remove & Reconstruct Access Ramp $ZI W? Each @Tw_ * 16negel6j oeeAoe4qq I;wtZ ve.Dollars 7 Pala Cents 13 3 Adjust Survey Monument Well to Grade $ 151 op Each V%� -Dollars Cents 14 25 Survey Monumentation $ Each @ Ow- #t4reS Al,,-e& !Q< Dollars Z!1 0 Cents T Sub Total Bid Amount, Bid in Figures: $ Sub Total Bid Amount, Bid in Words:54-A I— .5">e Y—JMJ For+( A-34VJ - C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. P...ortio.n Name a,nd Address:of Subcontractor State_License Class of Work Number 6 0/0 L (,orj �eo�oftG �-� 6 v.-K1( D Soy,-fE� °(/0 Cad;4rhia t M-'W- By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of44rarrge kiv"ide 96??E T T9,AQL=" , being first duly sworn, deposes and says that he or she is of Aw- AM MCA.A ASP-, A -1 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. TA\\ Au►�.�c�1 Q��L� Name of Bidder DEBBIE A.MATSEN Commission#1452589 S��gnature of Bidder Notary Public-California lv- 2 T -j12ADl��f ,V ���A r®.. Riverside County My Comm.Expires Nov 22,2007 VP ���2�2G ,GoRhN�.t��l °12�s'(Sr-222� Address of Bidder Subscribed and sworn to before me this J�Jl}day of Y", 200 0 . NOTARY PUBLIC NOTARY SEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the IMPROVEMENTS, (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. eLy tmfN��v a cLkA Contractor By `) k Itq y ICt Title Date: 5 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who-has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes RfNo 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. A\\ &ub6= AnOna.l� Contractor By 1?bVJ) r VCd Title Date: 11 0 C-7 UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER (To be completed only by the awarded Contractor prior to excavation) No excavation will be permitted until this form is completed and returned to the AGENCY. Section 4216/4217 of the Government Code requires a Dig Alert Identification Number be issued before a Permit to Excavate will be valid. To obtain a Dig Alert Identification Number, call Underground Service Alert at 1-800-422-4133 a minimum of two working days before scheduled excavation. Dig Alert Identification Number: Contractor By Title Date: Note: This form is required for every Dig Alert Identification Number issued by U.S.A. during the course of the Work. Additional forms may be obtained from the AGENCY upon request. C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Akk Amb(icnn &OMU Bidder Name tA = Business Address City, State Zip Telephone Number State Contractor's License No. and Class Original Date Issued A,AN U Ae-\.I L\4i Expiration Date ' The work site was inspected by 3 C1 i't: �1(� of our office on t , 200p�` The following are persons, firms, and corporations having a principal interest in this proposal: C-9 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name Signature of Bidder k � Printed or Typed Si ature DEBBIE A.MATSEN Subscribed and sworn to before me this L!�h day of 111)rArly►— , 200j@,My Commission#1452589 Notary Public-California Riverside County Comm.Expires Nov 22,2007 NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: Name and A dress of Public Agency Name and Telephone No. of Project Manager:'G)b�Qx'ans-nr ,-ii�.6-&� .59-,0 Contract Amount Type of Work Date Completed 2. C1 n��a� ►r►'i��tc ,i_ �1� CPC-tF��Avg �aLDw�►��a MCA ���►c� Name and Address of Public Agency Name and Telephone No. of Project Manager: qg jA�► 1 DAN� �Lnu.°��v.L4nk\ 43G3,Lt Contract Amount Type of ork Date Completed 3. C.ik\i_ nF�ce1wAUV-j 121DU N w n2AN Y,� w D 15 .�T-4 AXx SI�,bN CMt0 Name and Address of Public Agency Name and Telephone No. of Project Manager: 1pNt�u NILLMIR�► , p2.Q?A.5-723 r bo shotx�cy�,l�.rAvr �Fr. 'P�rk to. t o 20�� Contract Amount Type of Work Date Completed C-10 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name:,a11 P�kC Phone:qDq.`I3lo.1 Address:rVh l =ck Fax: °lbGt.1?,q. 4(„11 .Contact Person:'26bb(-V bm tfi No. of years in business 5. Is the firm currently certified as DBE under 49 CFR Part 26? YES NO Type of work/services/materials provided by firm?'pAv IN,( Q.►E�, (`D�C�r r� What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 LOCaI Assistance rruceuul cJ 1►iauua7 r�J.M I nl1 1!i-li PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CER77FICATI01VS YFHICHAMA PART OF=S PROPOSAL) EQUAL.EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Q 6Y�CLur) j Y�t\\ ,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. 12-4-99 C-12 Page I2-45 Local Assistance Procedures Manual EX WIT 12-E PS&E Checklist Instructions Attachment-G DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a contract ❑ a• bidioffer/application �I a. initial grant b. initial award u b. material change c. perative agreement r. post-award d. I n . For Material Change Only: e. loa uarantee year quarter f. loan in rice date of last report 4. Name and Ad\District, ff y: 5. If Reporting Entity in N/SubawardEnter Primedee Name and Address of , if known Congression Congressional District, 6. Federal Department/Agency: 7. Federal Program/NaelDescription: CFDA Numb if applicable 8. Federal Action Number, ifknown: 9. Award unt, if known: 10. a. Name and Address of Lobbying Entity b. Ind' iduals Performing Services (including address if (if individual,last name,first name,Ml): Idifferent from No. 10a) (last name,first name,MI): (attach Con)atio Sheet(s)if nece ary) 11. Amount of Payment(check all that apply): 13. Type of Pay nt(check all that apply) $ actual tanned a. retainer 12. Form of Payment(check all that apply): b. one-time f 8 a. cash c. commission b. in-kind;specify: nature d. contingent fee p e. deferred value f. other,specify: 14. Brief Description of Services Pe ormed or to be performed and Date(s)of Service,including officer( employee(s),or members)c tacted,for Payment Indicated In ftem 11: (attach Continuation Sheet(s) if necessary) 15. Continuation eegs)attached: Yes No .011 /lable n re ested through this form is authorized by Title 31 U.S.C.Section Signature:is sdosure of lobbying activities is a material representation of fadreliance was placed by the ter above when this transaction was Print Name: rentered into.This disclosure is required pursuant to 31 U.S.C.1352mation will be reported to the Congress semi-annually and will be Title:for public inspection. Any person who fails to file the required disclosure ubject to a civ0 penalty of rat less than E10,000 and not more than Telephone No.: •13�."1lotDate:for each such failure. Federal Use Only: Authorized for Local Reproduction Form LLL - Standard Faun LLl Rev.01-03-95 C-13 Page 12-55 February 1, 1998 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is. inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name,address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number,for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number;grant announcement number,the contract grant. or loan award number,the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-54 C-14 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s) contacted or the officer(s)employees)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. C-15 Page 12-55 II l CITY OF HUNTINGTON BEACH I.. BIDDERS LIST i All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with i their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: . r Co, Phone: 7-45— Address: KK l IV, 6c,,4m AC k UA Fax: Av-,-,�.e� cA -trsnoz- .Contact Person: Parer, ye l-t• . No. of years in business 6 l: Is the firm currently certified as DBE under 49 CFR Part 26? NO Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million Less than $15 Million ❑ More than S15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 i CITY OF HUNTINGTON BEACH I` BIDDERS LIST I li All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name:S rK ik�sov. C��le�fri� �w e . Phone: Address: 11t-?9 Ka 4e%, Ave - Fax: 7-11(— ` — 4ss- Ora A Q Z V 7- .Contact Person No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YESO Type of work/services/materials provided by firm? 1PeAr,1ors What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 i II �I it CITY OF HUNTINGTON BEACH BIDDERS LIST i All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. i Firm Name:6,t(,Z rv%;R 'een y Phone: 06-q5S -09C-r Address: 013( 6 M a d e( Ave- Fax: b z 6— yyg'- o V:F-a .Contact Person: av'. 01 K ye h No. of years in business 3 Is the firm currently certified as DBE under 49 CFR Part 26? d!R NO Type of work/services/materials provided by firm? Lype 19e4eeAc , What was your firm's Gross Annual receipt's for last year? Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 11/10/LUU4 1J:J1 C.i.l 610 8J4 SO12f 5'1LKINVAHL tm LokU �lfUVl/UVl 11/15/2004 10:14 19434928324 ORION CONTRACTING PAGE 01 CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposer, are required to provided the following information for all DBE and non- DBE contractors,who provide a proposal,bid,quote, or were contracted by the proposed prime. This information i3 also required from the proposed prune contractor, and must he submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update La"Bidder's"list to assist in the annual DBE goal setting process. f Firm Name J LO_d c!h :r7.f7, L?" Phone: _ ;� c = � f'Xc;trTc'Ca - Fax: ! Qa Contact Person: ,'�`/ No. of years in business C Is the firm currently certified as DBE under 49 CFR Part 26? YES NOS,` Type of work./services/materials provided by firm? Gi. l •r'Yi.c That was your firm's Gross Armual receipt's for last year? II' Q less than$1 Million 1 va Less than$5 Million � than $10 Milbotl � 4 o Less than $15 Million o More than$15 Million. This form can be duplicated ifueeessary to report all bidders (DBEs and nCn DBEs) information. I`RJV. 11.CUiJ4 :G•l✓Jrl'I WUMN� :D[KirlIYiz. kwt-) IYV.a-vo CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following infonnatioa for all,DBE and non- DBE contractors, who provide a proposal,bid,quote,or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bidiproposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE Loal setting process. Firm Name:Wor r' a .t'iPr,?i4:;Phone: & -161 P- - 0� Address: 1122 it/o, f�2vsA �Ay 6, Fax: Wes� G'ov ,Contact Person:3' e idlerkcs No. of years.in business rs Is the firm currently certified.as DBE under 49 CFR Part 26?' YES NO Type of worklserviceshnaterials provided by firm'? What was y2ur E m's Gross Annual receipt's for last sr? o Less than$1 Million Less than$5 Million o Less than$10 Million o Less than$15 Million o More than SIS Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs)information. I C-II ALL AMERICAN AbVHAL I 11/16/2004 12:06 19097394671 `v, , V, :-NV LU cr+ uca• i t CITY OF HUNTtNGTON BEACH BIDDERS LIST i All Biddcraiproposers are required to provided the following information for oil DBLE"and non- I=18B coattaotm,who provide a proposal,bid,quote,or were contracted by the propwe d prime. T"lis int ormatibu is also,required trot the proposed prune contractor, and mu:r be sutq-.n1 ted with I their bid'propaW.The City of Huntington Scub will use this information to update �a ` iddcr'e el it to assist in the annual DBE goal whingproccss. > i rm Name: I.GbPS CRItGK �G rUE it�photte: .5- -- l A414row_q"C._CMrz&jty.D f Fax: _3 tUro CLmtact Person;' -_&Ate —Yf N No.of years in business_ l.C...� ..-.- ` 1s 1te firm currently certified as DBE under 49 CFR Part 26? YES 'N 0 I� Type of work/servi=simatcrials provided by;firm? S•A1n&1_ L OO P�CT_FCMK.._ voumss Annualrece r�'s G ipt's fbor last nar? 3 Less than$1 Million I Less than.$5 Million :t Less that Sl0 Million o Less than S I s Minion a More than$15 Mi Uioa -_.._.. ..._ Ties form can be duplicawd if necessary to report all bidders(DBEs and non.CBEs)intbrmation. i i t C•11 11/16/2004 12:06 19097394671 ALL HMtK1UHry H5F'Y1H1..1 emu` V6 CITY OF HUNTINOTON BEACH BIDDERS LIST rAll Bidderelpropoaers as�d to provided the Wowing info moeiop for all DBE aad no� n-1. DDE conftotom wko provide a proposal.bid.4uot,or ware ecatraeted by the propoe ed pruina This inforrdadon is also required bmm the pra mW prim contractor, aad'must be submitted with their bidlproposal.The City of Huntington Beech will use this information to maintain and upd*m a"Bidder'4"fiat to assist in the annual DBE Roll setting procem. Firm Nalml. Phone: 6e7 l Address:._.. # J-- •--�-y-== No.of years.in buaaiinesR�_„_. Is the Cum cwrr4atly certified as DBE under 49 CFR Pent 261 (YES NO Type of worklaerviees/mmeiials provided by 1�Vhx t was cur Srm's C3ro6w Aaaual rnet's for Iwt Year? '"` „Less than$1 Million o Loess 1km$S million o Mesa tl►aoa$10 Mllli= � L,esa tbati$1 S Million . o More tium$13 Million This fo►TQ can be duplicated if neeos! "to report all bidder&(AB&and noon DBEs)inibimmden. 611 Gd wHcS:LT ME 91 ''�N I$GJ9LbbbLZ: 'ON X .4 TN3 'JQalAI03 a tjj�jNl: woad 11/16/2004 12:06 19097394671 ALL PMtKlkRIV w3rnH"i 11-16-04 11 :41 J 5 SIGN CO ID-714 5382779 P@1 GPTy OF HuNT'iNGTON BEACH BIMMS LIST All.Wderslproposm are requized to provided the Mowaag idt=dOm faoc all DBE and nan- DB;:contractors,Who provide a proposal,bid.quote,or were car#ttaetsd by the proposed prime. Thi:;kformadon is also required from the proposed prune cm ctor.and must be submitwd with dWr bid/pr�.The City of Huntington Beach will use this iaf wafm to maintain and+apdaw a"Biddeef list to assist i6ft ennusl DU e!1 setostg process. _ ��-r +ten+ Finn Name: Adiirm: 6,Z�3n wo, 404rf Fax: 21j -5-?eo�ZT Co�atact Person: lY�--&`;-�Cff" No. of years in business,.. Is tho fum mureutfy certified as DBE under 49 CPR Part 264 YES • v / Tyl?e of work/servieWmawrWr.provided by&m? _ What was your&m's Grose MAW roeeipt's�r fast yeax? D Less then$1 Million 4"%than$5 Million o Less than$10 Million o Less than$15 MilUou • 4 Mo1m than$15 Million � -11his Forma can be'dupUcatcd if necessary to rtport ail bidders(DBEs and non DBEs)information. C-11 11-16-64 1A:02 TO:J SIGN CO FROM: �61 • 11/16/2004 12:06 19097394671 ALL AMtKIUAN Har-r"4L-1 ---------- .... . CITY OF HUNT040TON BEACH BIDDERS LIST i, All 9idders/prvpaaata an requ'ued to provides!the Wowing infammtion for all Dab and now D8B oom actmm.who provide a proposal,bid.quote,or were cottttaded by the proposed prirhe. This i nfbimation is sled required im the proposed prime caspt uft,=4 stunt be submitted with ` their b WpmpmL The City of B=dngtn Bench will use ibis kdWmadon to maktaia and updm a"Bidder's"list to swig is the so"DOR Lod senk4 a ! pig NOT" CO_LA 5; w� Pbone_ t �vz�a 9b�� Address: %�I<PL , 1�L% Fex: .Cmam Person: 4Lk Ll" tjcj2ZjQ�6 No.ofyean in business-5 4 Is the firm cumatly certified as DH$under 40 CM Pert 26? YES �A►D' Type of workiservicerdmateriBb provided by fine? What was our arm's Owes Annual is ta8t im7 I a Less than 31 Million o Lena than$5 Minion leas that$10 Miltton a Leis than S15 Million • o More than 315•Million This form eaa W dupiieated if necessary to report all bidders(DOEis and nos DHEs)inf9rcwtion. C-11 2 11/16/2804 12:06 19097394671 ALL AMLK'IUAN HSrrwLI T-Ht] I. CITY OF HUNTI NGTON REACH BU)DBRS LIST 1 All Bidderatprcposm arc mquifcd to provided the following latt rttmtimt for aU DBE and non- DBE eottaucton,who provide a proposal.bid,quat4 or were eonttseted by the proposed ptirne. � This it►f mnsdom is alto required f m tba pmposed prig"costr'actar,sad erwt be subtmittad with their bWptgwul,7be City of Huntington 9mb will rise:this infbrmerlets to mWamin and updame a"awder'a"hat to wrist in the amoral DBE sa. l� i Firm' ame. .•.nr_ic ex 6tatr ry�~o punt: 7#'y -r71 Address. "7 i,V 76w�c,e_ elf Fax: 7r y- 7 7r Contact 9ersoA: �E71',Zv M it t1" No.of years ie business j 7 to the firm carmdy catifled as DOE under 49 CFR peat 26? YES i Type aWorwSarvim3 taeitetiala provided by firm?—,re �r What was VOW fiat►'$G Atu�u+al m is fit lost Less dtan St M1Gon o Less.than SS Millioa o Lass dm S10 Million o Less tban SIS Million o More tire+a Sl S'MiWao This form ern be dup licated if oemstaty to report an bidde6(DBEs an4 iron DBEs)kfbymsltioa. C-11 � d 6tEe-SLL fbTL) $111W Augaa R90% lt 00 St noW 11/16/2004 12:06 19097394671 ALL AMLKiL4 r47.jrnr4L i 1•VY -L' WW t •�•�• 1 IOW I'1 V♦ yyVt�� V.� IV•J1 Jr111JV1 V•1V 1 L'L �f 1 CITY OF HVN'l•INGTON REACH BEDDIMS LIST Pal Bidder9lp*opoears are requited to provided the following infbmutioa br dl DSS sad eao• DW coammmm wbo previde a propmL bid.quos%or were coaf:eoted by On proposed prize*. nix inhwmadon is also tequmd fim The proposed prime coaftusur,and must be ntbmitted with Vmk bid"opml TOa MY of Mnati opm Beach wiU use Chia iz,,fomo6on UP tzudtttWz end update "sidax'a"list to=Wst is the aaa m Dom' 17irm Name:� _ -- _, Pfaane�; L��S.a5 d %Z7 Z t lin 10_0 .Cantata Pman: ►�Cnle No.of yam in business i La*c fam am tdy certified as DBE uAtber 49 CFI!Part 261 YES N Type of woWservieesl namiab provided by firth? l L Wbat w"your firm'&COM nmtualnftfs for kst Yew a Las rhea$i Million Mellen than 35 MOM o Le31 then S10 MHUon o C.m than S15 MUIlm a n More than SIS bouion 'Mis tbrm can be'dupUtcd if memary to mpott all bidders(DBEs and non DBEs)intlittoakm. C•I i 11/16/2004 12:06 19097394671 ALL AMEMiGAN AbtHAL1 r- ur- v I CITY OF HUNTINGTON BEACH j BIDDERS LIST i I' All Bidders/proposers are required to provided the following information for aU DBE and non- DBE contractors,who provide a proposal,bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's''list to assist in the annual DBE goal setting process. Firm Name: UmjA&z 4 dy::194—, Phone: Yilm By D 3 Address: Fax: .Contact Person: �� /�/wJ��_ No. of years in business � Is the ;um currently certified as DBE under 49 CFR Part 26? YES Type of work/services/materials provided by firm? What was your f m's Gross_Annual receipt's for last year? M/Less than $1 Million a Less than$5 Million A Less than$10 Million ❑ Less than$15 Million a More than $15 Million This form can be duplicated if necessary to report all bidders(DBEs and non,DBEs) information. C-11 ALL AMLKIUAN A5r-'HAL 1 r-Huc uv 11/16/2004 12:06 19097394671 11j:HLLRMERICAN R:2�2 1 v.;v J:-c6�cn A:7 co riwri-wrKrn•rac WUNIT bIKlrl r14 Day bJ73 1 i I Cay OF HL>r IUCrrON SBACH UMISRS LIST i All B Iddare/proposers ar+e requit+nd to peavided tsbe><bilowi>a8 ise> ei4a for all DB8 and Dan. DOE emmictorl,who provide a proppsaL bid.qw*6 or w M eon&WW by the proposed prime This intbrmatilon is also Mquimd&OM 41C parapMd pry oonttMM end must be submitted with their bid/proposdL'The City of Htaotiagton Beady will wn this iafon m*q to m9wain and update e"Bidder's"list to wilt in Rto awwdl i I Firm Name, ORANGE COUNTY STRIPING ph 18$ N.PIXLE1l STREET �►-� Adclyd0=; ORANGE- CAA 02960-22a", Contact Person: No.of years in busiaess �./ + Ls the f M ca adY ctMed as DOE turder 49 CFK Part 261" YES NO Typo!of work/services/tttUwftls provided by fim? n V-\�&I apt wy Ur 6M'9&;S Aapual ! t's for lastyela o Lisa im$I Minim v Lm than$5 Million xd L IM t�$10 MHUM a+ Less qua$15 WHIM o More than$1 S Million This farm can be duplicated if wnsazy to nVort all bidders(DBEs and uen J,BES) infa:ntation. C.t I hL 15-2004 MC1hl Q8 2� TEL r ezq 639 S= NAMF:nRi NCsF rry Mry arvfeTwr. o e Nov 16 04 08:33a CASE LAND SURVEYING, 714-628-890t P. ? i • i i I . i ` vogetu u!( on uoa Pm a3H(10 ew"!9 Ile nodal q tiessasaas�paaea!ldnp aq I=I=J snly f noKioq it's Wm WHl a 1 UWJNSIS'Mson m GOOM OIS MO S'I o ff UDRm. S$an%son 1 UD!MIS19M WIrl c `--pug A paptAwd q L=A=/4wMJo aad,(l + `O� 53A l9l�%d�60�P�38Q� ��•��3?q3$[ '—` ssami"ur'sm t 10-o)l s 8WT.uo=d tommo. S�bA' J riG :meg CZ v ,z• •rf :ssa ppy Y�`77 `15's—�":awaN wK wzwwnpi l9a RHO loomm a*a!W.M o1 OR..B.nmfl..a . I 2PPdD Pm ttn uW=o;aopsucwJm T"P.m IPIA 110=8 ao;liaRnH JO 413 OL'lHeOdwd/P!q s!*T ip!m►pawwgns oq;snut pue`Iow4mo vmud paeoda:d eip utmg puplw osle sq noatta wjuq qq.L •atq!.rd pa5odatd aig A pex►apaoo aiaen io'eionb`p!q`Modwd»op".sd ogta Vgmm=aW -aoa pug HHQ nit.o;uogautaaJrn Sea,eoaas aqi pap!eoid m pwff bu an=odouimvp!H QH l t isn macm6 i dHH t�O1rJ11LLNttH dO=0 • C ,It c so4lQvsv%z a �uOQv Cue®:vJvrLr:O :vO-o -i. IL906EL6061 90:ZZ b00Z/91/11 li CITY OF HUNTINGTON BEACH . I BIDDERS LIST j ii All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name:C-i Aoakea-h'% Phone: Address: 6.7ttl N,,~4k Or. Fax: .Contact Person: l ri No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? Y51 NO Type of work/services/materials provided by firm? L oap be,4-e P-6r What was your firm's Gross Annual receipt's for last year? ❑ Less than $1 Million Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 909-73R-7600 ExtV2021 FAX:909-736-7646 CELL 90�„322-81l5 b CAL.STATE LIC.4267073-A / ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES 400 E.Sixth St. JOHN PETERSON P.O.Box 2229 PROJECT MANAGER CORONA,CA 92878-2229 I I L: Local Assistance Procedures Manual EDIT 12-E PS&E Checklist Instructions Attachment L LOCAL AGENCY BIDDER-DBE INFORMATION This information may be submitted with your bid proposal. If it is not,and you are the apparent low bidder or the second or third low bidder,it must be submitted and received by the administering agency no later than the times specified in the special provisions. CO./RTE./P.M.: r=ra-rl. k;tO yT BIDDER'SNAME: A\ V LtL1CUU\ t"lA CONTRACT NO.: cc 11 S �I BI Ill) ADDRESS: 90 Z� 222a BID AMOUNT: $ D Cbmf)a A CL 1-6' 2.929 BID'OPENING DATE: , 1 `2 ova DBE GOAL FROM CONTRACT % ITEM OF WORK AND DESCRIPTION NAME OF DBE** DOLLAR PERCENT CONTRACT OF WORK OR SERVICES TO BE (Name of DBEs,Certification Number, AMOUNT *** ITEM NO. SUBCONTRACTED OR MATERIALS and Telephone Number) *** DBE TO BE PROVIDED DBE Al 4SIll-Akre dill foe-61,v S l37,3oo.so Gr aV�z� x6a�a �•�i. �(047 gy���,30 Total CIaimed $ Participation 17-. * If 100%of item is not to be performed or furnished by DBE,describe exact portion,including planned location of work to be performed,of item to be performed or furnished by DBE ** DBEs must be certified by Caltrans on the date bids are opened. Subcontractors and suppliers certified state-funded only cannot be used to meet goals on federally funded contracts. *** Credit for a DBE supplier,who is not a manufacturer is limited to 60%of the amount paid to the supplier. (See Section "Disadvantaged Business"(DBE)of the special provisions) EWFORTANT: Names of DBE subcontractors and their respective item(s) of work listed above should be consistent with the name and items of work in the "List of Subcontractors" submitted with your bid pursuant to the Subcontractors Listing Law. ITC 5{ Signature of Bidder' Date (Area Code)tel.No. �v�e�k '�Gra1Qy. Person to Contact (Please type or print) Distribution for NHS Projects: (1)Original-Calt mis DLAE for NHS Projects,(2)Copy-Local Agency project file Distribution for non-NHS Projects: (1)Original Local Agency project file DEPT.OF TRANSPORTATION (FED DBE)MODIFIED DC-OE-19(REV 09-18-95) C-16 Page 12-67 E?UMIT,15-K Local Assistance Procedures Manual Report of DBE Awards REPORT OF DBE AWARDS COMPLETE THIS FORM FOR EACH CONTRACT Locode: Agency: G/o Punir��UE�iDA/ Cl�— Project No. 6Z //S7V DBE Goal: Total_Contract Bid: 107, Reimbursement Ratio: Federal Share: Award Date: Combined DBE Percent of Federal Share for this Project: /2•`1 DBE Subcontractors excludin women Awarded by Ethinic Group and other Disadvantaged Black Hispanic Native Asian- Asian- Other Total A Indian Pacific No. Total $ -B� Fed$ �— DBE Subcontractors excludin men) Grand Total MWBE WWBE I Total B Total A+B No. No. Total $ OW.`P 3a Total$ 30 Fed$ v.-39 5v,3o Fed $ Z 3 -3;9 Number of subcontracts awarded by type of work: Professional and Consultant Services DBE MWBE WWBE (excluding women) 1. Engineering 2. Architectural 3. Right of Way 4. Other Construction I. Grading/Drainage 2. Paving _ 3. Structures/Buildings 4. Materials 5. Equipment 6. Trucking 7. Traffic Control S. Landscaping 9. Other TOTALS: Note: For the purpose of this report,use the following definitions. • DBE=disadvantaged business enterprise • MWBE=minority women business enterprise • WWBE=white women business enterprise C-17 Local Assistance Procedures Manual Ert 15-$ Good Faith Effort Statement of DBE Participation DBE INFORMATION--GOOD FAITS EFFORTS Federal-aid Project No. STPL 5181 (141) . )Bid Opening Date Cityof Huntington Beach The established a Disadvantaged Business Enterprise (DBE)goal of 7 ON for this project. The information provided herein shows that a good faith effort was made. 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 A/&a1F 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 Date of Follow Up DBEs Initial Methods and Solicited Solicitation Dates . .II 1 I 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 440 1 made available to DBE fums. Items of Work Breakdown of Items g!&r' AI ram Okl- '/N a w� names., addresses and hone numbers the reasons for the bidders i D. The ham �, p of rejected DBE firms, j rejection of the DBEs, and the firms selected for that work (please attach copies of quotes from the firms involved): EXHIBIT 15-H Local Assistance Procedures Manual �N Good Faith Effort Statement of DBE Participation Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: J i 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: P ., A/0/l/(-'F- :s 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: A/B2V 6E i � 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.): f Name of Method/Date Results i Agency/Organization of Contact H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): �(1o1V� Page 15-34 March 15,2001 LPP 01-04 All American Asphalt 400 E.Sixth Street Corona,CA 91718-2M All American Asphalt' (909)736-7600 Telephone (909)736-7646 Facsimile VerW TO: John Peterson Fronc W.C.Goolsby, Inc. Faw Pages Phones 800.839.9697 Dates November 16,2004 Verbal Quote Re: Asphalt Oil CC: City of Huntington Beach Project:Gothard St. Bid Date:Tuesday, November 16,2004 ❑Urgent ❑ For Review ❑Please Comment ❑Please Reply ❑Please Recycle See attached. Thank you. a i W. C. GOOLSBY, INC. 970 N. TUSTIN AVE., SUITE 102 ANAHEIM, CA 92807 CT-002822 (800) 839-9697 DBE OIL CALCULATION GOAL AMOUNT $82,380.30 OIL CONTENT 0.050 PRICE $250.00 TN HAUL $16.97 TN ADDITL HAUL $4.00 TN SUB TOTAL $270.97 TN TONS AC 10,134 TN TONS OIL 507 TN TOTAL PURCHASE $137,300.50 ASPHALT OIL MATERIAL TOTAL I f CITY OF HUNTINGTON BEACH BIDDERS LIST I All Bidders/proposers are required to provided the following information for all DBE and non- j DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. i l 'I Firm Name: /,c 4 f1/- Phone: -op (23�9/„� i Address: &971).Al 774,3 %IA-14Y& fT Fax: I "i I .Contact Person: No. of years in business II �i Is the firm currently certified as DBE under 49 CFR Part 26? YE NO �I Type of work/services/materials provided by firm? I What was your firm's Gross Annual receipt's for last year? Q�CV !` I ❑ Less than $1 Million ❑ Less than $5 Million i ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. ii i I C-11 ,f J • 1_/_=123N _:07 PM FACM: Fax T6: 195_73�1 4J FACE: DOI CF NY GLOBAL ROAD SEALING INC (Union signatories, DBE and MBE certified CT#-031176) 6341 Klamath Dr. Westminster, Ca 92683 LIC. #757584 Class C-32 Ph: (714) 893-0845 Fax: (714) 893-0945 Subcontract Quotation Project: Gothard Street Rehab Location: City of Huntington beach Bid Date/Time: 11-16-04 Al 2:00 p.m . Item Desch tion Quantity t"nit erice Extension Crack Sealing 2,347 SY L.S. $ 3,900.00 Loop Detector type E 80 $ 1 65.00 S 13,200.00 ---------------- Total : $ 17,100.00 PRICES ARE'GOOD FUR 45 DAYS OF THE DATE OF THIS PROPOSAL Inclusions: 1. Clean cracks Y4"and greater with high compressed air and seal with hotmelt rubberized sealant. 2. Traffic control for crack sealing operation 3. ****One mobilization per location. At your request additional shift @ 2,700.00 ea.*** Ia. Saw cut loop 2a. Clean and seal with hotmelt rubberized sealant 3a. Install conductor 4a. Splice conductor to existing DLC 5a. Traffic control Exclusions: Bond premium, utility permits and fees, Inspection fees, advance sign posting of any kinds, weekend work, notify resident(flyer), and any Items not specifically included under INCLUSIONS section. ***Replacing pull box and stubout will be extra. Estimator. Tri La (Vote: Crack sealing item does not include Reinforcement Fabric REVISED 4• CITY OF HUNTINGTON BEACH i BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- . � DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. �I i ' �I Firm Name: ���'y/�-c _ /J�y ��7a2IiVC-� Phone: '?W �G� 3 OOL- S Address: ,(3cl/ Z,04-wi/M1— ,&44 , Fax: al/S' .Contact Person: �� (,(I� No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? ES NO Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last year? ! I' ❑ Less than $1 Million I, Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. i ' i I ' i C-11 `�l I 11/16/2004 12:53 6264480470 CP ENGINEERING INC PAGE 01 LLii CALIFORNIA PROFESSIONAL ENGINEERING INC. T] . PHONE FAX (626) 452-8658 9316 MABEL AVE. (626)448-0470 SOT ITH EL MONTE, CA 91733 A&C-10 793907 CERTIFIED DBE/SMBE CT-031277 EXPRIRE 04-01-2005 PROJECT NAME. GOTI;><ARD STREET RE,HAD PROJECT No.: CC-11.54 CITY, STATE: HUNTINGTON BEACH BID DATE: NOV. 16, 2004 BID TIME: 2:00 PM Wc',74m(W, cv4,m444,a n!�ixo�4oaca�lb i9ouel l�a��ax .A,sMrrris�m'ax�o'rramo».�'»000Nlwe��n�na!/ili/i/liofi�lor.r,r:.rnq i/i �n�innsrv. ITEMS QUANTITY UNIT DESCRIPTION UNIT i TOTAL PRICE 11 so EA. TRAYFIC LOOP 1.85.00 $14,800.00 I i I� I I 1 TOTAL: $ 14,800.00 NOTE:PLEASE NOTIFY 7 DAYS PRIOR TO JOB STARTING. CONDUIT STUB-OUT&PULL BOX MUST BE EXIST, EXCLUDES:DOND PREMIUM,ALL PERMITS,AND INSPECTION FEES. 11/16/2004 12:53 6264480470 CP ENGINEERING INC PAGE 02 CITY. 1FlC3N'i a_GTON BEACH B LIST.;i', All Sidders/proposets ere requlmd To pxo-ija cl't�tb`$a1lcWving in ormatioa'for PI]DBE and non- DBE contractors,who provide,a propl,bid,qua%or were coutmaed by the propoged prime. This i nfcm3ation is also require osa d From the'prcp prime contractor.and.mug be suhmiited with their bidlpropos4 The City of Mzdtingtoa Bewh**M uae tlxis in�ioa to maintain a d update a"Aidder'x"list to aWst in the snnual DBE 9w settins process: FirmNeme: C ✓ Phone: .S ' Addrew: t6 _ F'ax• .Cantact Porson: � - k Np, of years,in busiaess____, h die fum curreudy oextified as DBE under 49-CM.Part 269' YES NO Type of worViecvice lmaterials provided b� firm .. f Z What was Em's Gross AA�wual race' is fort . Less*on$t Million o Las than$5'Mllioa o Laus than$IO I�iIIioa o Law than$15 A+Iiilim o More*=$15 m Lm- : This farm tea be duplWaxe+d if nocca uy to mport:all bidders(DBEs and non DBEs)information. i 4 JQ'd. 1f, 2 0 D 4 1,2, 0 PN NO, 4CL P. 1;`1 ` Smithson Electric, Inc. 19381.K&WIs Am Orange,Ca.92867 Contradan I. ewe 0 614516 MOM 714-991.9556 Fay 714.997-93H Bid_to: QUOTE# Project Name: DATES November 12,2004 Gothard Street Rehabilitation All American Asphalt ATTN: JohnCity of Huntington Beach Did Date: November 16,2004 Estimator: Tom Smithson Bid Item# Amount Description Unit price Total I 1 80 LoOR detectors 190.00 ea. A 15 00.00 I i I I Total ♦ a CITY OF HUNTINGTON BEACH I Ii BIDDERS LIST 4 i All Bidders/proposers are required to provided the following information for all DBE and non- f DBE contractors, who provide a proposal, bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. 4I Firm Name: Phone: '7t 4 q,17 q Sk i Address: kATz, Fax: i' rOrrL�'Jy6E — 27- 2 .Contact Person: T� jrA4-r��i.1 No. of years in business �l Is the firm currently certified as DBE under 49 CFR Part 26? YES O Type of work/services/materials provided by firm? What was your firm's Gross Annual receipt's for last year? I I ❑ Less than $1 Million ria111"Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million I ❑ More than $15 Million ' I li This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. ' I. I I . I1. i , � i j �i C-11 i �I 11/15t1_004 23:07 5632702 SUDHAKAR COMP41Y I14T PAGE 01/02 Cal Teraina CeetiNed(SMBE/DBE) #CT 028984 City of Lw Angeles(MBE/DBE) *CCA-9"8 Sudhakar Company, Int. Laborers Local 11841 Lic.9 752367 A,B.Har.,ADS 1441 N. Central Park Ave Unit A Anaheim, CA 92802 Phone. (714) 563-2765 Ext 13 Fax- (714)$83-2702 ESTIMATOR, Darren Velht November 15,2004 SUBCONTRACT QUOTATION Project Name: Gothard Street, Huntington Beach CLARIFICATIONS: 1. Contractor to provide montlily proles payments for all completed work in accordance with the bid pricing schedule.Monthly progress payments must be received in full by Sudhakar no later than 10 calendar days after the Contra=receives payment from Owner for our completed woeK. Delinquent payamA.ts will be subject to the highest interest rate allowed by law. 2. Rctaivage parernagc on monthly progress payments to be no greater than the percentage retained by the Owner on its payments to the Contractor. If Owner reduces the retainage percentages on payments to the Contractor, the Contractor shall likewisc rrduce the mUt brags pert eritage on payrowts to Sudialcar. Full retention to be released no later than thirty(30)days alter completion of Sudhaker's work. Excessive or delinquent retainage will be subject to the highest interest rate allowed by law. 3. Any roquired Testing,Entueering,Design,Permits,Licenses or Applications,and the like to be provided by othm. 4. Prices are based on Plans&Specilio Lions available at bid time,including all addenda. Any request for wurk(post bid)under conditions d0cxintt firm those represented by the,Prime Contsvo Documents,including but not limited to;altered phasing or surging dWiKn charges modified layout Imululla f1 LlIIfk;LtaTM or inaccurate d igas.will require payment for additional work to be made to Sudhakar Company at an amount agreed upon priot to performing this work. if an amiotmt cannot be.agreed upon prior to performing the additional work the amount will be determined using Caltws Fora Account Rates or unit prices established in the bid pricing schedule,or a combinatiou thowif.whichever method results in a higher overall payraient. 5. Sudhakar is rot responsible for delays caused by and or resulting from activities or non activities of others,includinx but not limited to,owner, contractor, %=dons, suppliers, other subcontractors and other factors not in direct control of Sudhakar. For the delays caused by the aforenremioued,Sudbak&-will be reimbursed For all direct and indirect costs plus a manic up of forty percent(40%),or as specified mud allowed by the Frvne Contract if the dalays are caused by the Owner. Sudhakar will be gratltod an extension of time to perform its work tantamount to the delays. 6. Sudhakar requires thirty (30)days notice prior to commencetlrettt of any production activity. 1f any of Sudhakar's work will be a controlling operation on the czidcal path of this project. Sudhakar must be notified in writing prior to execution of the Subcontract Agreement and provided with a CPM schedule which details this wont- Uluro to provide thi6 hnfo1r=tlon will waive the Contractor's right to recover tiquidated damages from Sudhakar for this work, 7. All changes to the original scope of work or proposed extra work must be directed by tie Contactor in writing prior to Sudhakar performing this work, S.. For the purpose of this Subcontract Quotation one(1)move-in is considered to be:a period of consecutive eight(8)!tour days of continuous work, not.including weekends and holidays. Any disoontinuities in this period,other than weekends and holidays,or for our own convenience,will be charged as wt additional move-ion at the Addition Move-in Charge as quoted herein. 9. Sudhakar must receive a letter of uncut to award us the subcontract no later dm(20)cakudar days after bid datr or this Subcontract Quotation becomes Trull and void. If Contractor requires a Bond,for Prime Contractor sbati pay cost of the Bood. Revised 919"V IN IMAY MUMIM MI=10 T a 11/15/2004 23:07 5632702 SUDHAKAR COMPANY DIT PAGE 02/02 cwpjff,off. a"21 111182004 PR03Wr NAME: Gothwd Stviet, HuntingWn beach DID DATE: November 16, ZW ITEM 0 QVY UNITS DESCRIPTION UNITS TOTAL Ellis Avenue To Heil Ave 10 1 is Traffici��tripin� 45,411.00 II n $ $ $ ........... $ TOTAL BASE BID, $ 45,411.00 Options ........... TOTAL OPTIONS, A. A MkWnwn Of 15 working days prior notification is required for each move-in for Striping. B. The following materials and services are included in this quote for striping:Thermoplastic[NO)Faint[YES) Marken(YES) Signs-Per striping Plans only MS I Temp tab removal[NO I Paint/nermo Removal[NO I Marker rernovaj [NO Channelizm-install and removal only-no up keep[No I C. (I I Total move-ias included in this quote for permanent strilpiug.Additional move in charge.S 530.00 D. [0)Total move iris included in this quote for temporary sft*W& F- Traffic control(IS)included in this quote.Tr4fflc control when included in this quote is o*for Sudbakar's operations. F. If general contractor or any of its sub-contactom work widdn Sudhaka's UzMc control,the expense will be shared accordingly at Sudh"'s discretion. No advance posting,signing,or CMS is included fbr Sudbakar's buffic control G. Fyc-striping Pavement preparation,including sweeping,to be provided by others. H, This quote excludes the painting of any curb addresses. CHAKOES OR DELETING OF ANY ITEM MUST BE APPROVED PWOR TO BID TIME. ESTIMATOR;DARREN VELTZA7A4j§gLZ7f 5 L Paip 2 FROM FAX HO, Feb. 26 2003 02:45FM P2 A Y CV Y 4F HUWINGTCN BEACH ems LIST AR.Dskkr**-cpv=s=a nVued to.plrovkkd the*Sowing ia&mnm6W ft all,M mud WM- DUE cxaaM.►rbonx*ho pwide a proposal,bid.quote,or vie cun"eted by the pry pr4ne- Tha atm is a60 Mquind fimm Oe pro d prm contrwbx,and mot,be submit VA with dW:jr bd*upoW, ple City of Mmungma b*ili use d&hAmulian tD mvi�end+modiste a-8 'iF'bra to mist is,*c 000 UBIE;M S!!ftz ..., Firm.Name:S &f. 71 Awmw;14N t d AA v�tT11'Fax•. L-7 t o S t�,7Z o .�PeranaraSZfL a 1 is the mart cwv=tiy cettifvA os DBE under 40)M.Pw 26? NO 7 �Svait� ry'y�c�f rawart�s+rr'�'ix�?tYl�t�s .by�:— rT� ���LylUb,�•.� � WW was gout 6m'.s Gmss,&aftW mmipt's ftr'last °'' --- :a tea,+tin St milfin x u Less tlw$5 Nfilea t o Less t $10 IhMan '9W.)rm raa be.dupfimled if necammy to tcpw.ail bidden(ems aid nm DBEs) ar.•tmWt a. C-i.t r�,�aE al 11/16/2004 12:13 7769016 Tr&Mc Loops Crac ill'p ing, _Inc. "6 S.EWW%d St.Awheim CA 92904 Tel.#(714)520.4026 Fax(714)520.4027 StW Liamae #632936 Class C-10 A C-32, CT Cent.#012886 7W Inc.is a mamba-of BBB and an Eqt al Opportunity Empl%w Nov. is,2* ArM : >Eltimator Praject : lE iWtingtoln Bosch/Gothard Street Rehabibtation CC-1154 Bid Date : 1It 16.04 @) 2:OOPM -� Qualift IOU NO Unnd Price 11 Install Loop Detector type E s0 Ea, 183.00 Ea. S 14,,800.00 (]ir<r quote idea 1- Layout, saw calf,wash, blow,dry, seal, and nwgg 2- Loop sawcut shall be 8U with Hotmelt Sealant 3- One move on 4- Traffic oo*ml -u�quote eclhtdet I- Bond fee,lit fa, utilities fee,advance sign posting of any kirud or notify residents 2- Stub- out,conduit Alt inclsision rand aclasion are to be Incorporated into our contract.Heither party becomes invoMe is 11flptim or arbitration arising out of this contract the court or arbitration p"el aball award attomey 's fees aad costa to the prevailing party Traffic Loops Cmackf l tA, Inc. meets all of the requirements for t he Federal dt State of Califo ie►and( tti&d as Iviityarity by Cal-Tram(Certification#Cf-012886 EXp- 12/01/05) MW by the Dep* ofGettarab service of California as IMBE/DBE. We are also Union Signatories Please call If you pave any questions or more information. sincerely, Mai,[.an Tlguyte V.Presidwt 287 P01 hlOV 16 '04 00:37 s CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders;proposers are required to provided the following information for e.11 DBE ami non- DOE contraatoirs, who provide a proposal,bid, quote, or were contracted by the propoied prime. 9iis informatibr, is also required ffom the proposed prime contractor, and mu,t be subr- ucd with } their b.idrpropo�al. The City of Huntington Beach will use this information to M aic.tam ;arid update a `"l3iddrr'b"bit to assist in the annual DBE goal setup process. Firm Name: ��4.00 S °U kt,-K1--1441V(-hone: 1 , _.., -�-- Fax: ) .7..._...._ , lot ?& Contact Person; N J1KrUYl� No. of years in busitress�„ ! ._ w Is the firm eurrontly certified as DIRE under 49 CFR Part 26? Y`ES ) N } Tape of worleA$rvicesimaterials provided by fzrTn"_ k) FU 7P ba vour�'s Gross Annual �.1.,,_.�t as --� Less than $1 Million ' ( Less Haan.$5 Million :�j Less than $10 Million c Less t}san .$l 5 Million a More than $15 Million _..... ....__.__�... ...._ _._—.. This form can;be duplicated if necessary to report all bidders (DBEs and non OBEs} information_ i i C-l 1 TRAFFIC ^^ Cwi rA' INC. November 15, 2004 Re: Gothard St. f in City of Huntington Beach Bid Date: 11/16/04 Traffic Control Design Traffic Control Engineering, Inc . is a certified MBE firm by Caltrans/City of LA (Certification File No. 1339 ) and a recommended engineering firm by City of Huntington Beach for preparing traffic control/detour plans . The following is the cost estimate of preparing traffic control plans for the above project : street Locaxon Gothard St . Heil - warner Gothard St . @ Heil Gothard St . @ Warner Gothard' St . Warner - Cedar Gothard St . Cedar - Ellis Gothard St . Slater GotbArd St . _ @ Talbert Estimated. fee 6, 000 .00 Please call :f we can be of any help. TRAFFIC CONTROL ENGINEERING, INC. Lan,Kuan P.E. 231 E. Imperial Hwy., Suite 241 TEL(714) 447.6077 Fullerton, CA 92835 FAX (714) 447-6081 Id wHgc:11 tOOZ 9L t8092-t7btITZ: 'ON XHd 'ON8 10diNO3 OIddH`dl: WONA CITY OF HUNTINGTON BEACH BIDDERS LIST All Bidders;proposers are required to provided the fallowing info rr, dap for ali OSE and non- �. DBE contractors,who provide a proposal,bid, quota, or were matracted by the proposred otirne. This information is also required from the proN:sed prince contractor, and'must be submitted with their bUlproposal, The City of Huntington Beach will use this information to mairtain and update a"Bidder',"list to assist in the annual DBE foal setting proce%. Firrrt Nauru. Phone• 44 6677 Address: ._— �J :_.. ...�1U�4?� ..w I ,Contact Person: No.of years,in business ... Is the firm currently certified as pBl✓under 49 CFR Part 26? yEs NO _Type of wor'K/sorviees/materials provided by firm? What was your firm's Grohs Annual receit's for last year't Less than$1 Million o Less than$5 Million Q Less that$10 Million o Less thaw$15 Million a More than$15 Million This form can be duplicated if necessary to report all bidders(DBFs and non DBEs)informutioa. �d Wt�ZS:1 i bOOE 9b ''ON L8092 bbbSL: 'ON Xt1d r '.JN3 IOb1N0D Wpad CASELAND SURV/EYIN6, INC. 1010 N. Batavia Street, Suite D Orange, CA 92867 (71 l)6.--8-8948 fay: (714)628-8905 BID SHEET TO: ALL BIDDERS BID DATE: 11/16!2004 SITE: GOTHARD STREET REHABILITATION HUNTINGTON BEACH The following is the surveying scope of work for the above site. Any work performed outside the described scope of work, will be provided at our standard hourly rate and will be billed,per our union agreement, in segments of 4, 6 or 8 hours. This bid is valid for 6 months. RESET CENTERLINE MONUMENTS, CENTERLINE TIES & FILE CORNER RECORDS APPROXIMATELY 25 @ $275.00 EACH..............................................$6,875.00 TOTAL..............................$6,875.00 (Bid excludes the adjusting of survey well monuments) The above bid is predicated upon Owner/Agency providing a minimum of 2 Horizontal control points, i Vertical control point and an AutoCAD file of the project plan. Please contact us if you have any questions. Thauk you for the opportunity to bid this project. SURVEYM6 *MAPPING *6PS d 615 SERVICES Larry V. Case,P.L.S. License No.L 5411 I 'd SD6B-8Z9-biG 9WIA3Amns QWtl1 3SU3 e2e=80 bD 91 ^oW 1- 4-04:10:42AM.S CrIe Asoneit . 7:4540170& tt 3/ 3 I• CITY OF HUNTINGTON BEACH 1 BIDDERS LIST Bidders/proposersi r vided the fo -All are requited to provided following information for all DBE and non DBE contractors,who provide a proposal,bid,quote,or were contracted by the proposed prime. This information is also required from the proposed prime contractor,and must be submitted with their bidiproposal.The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: 1-v00,b crRv „�4�/.ue Phone: (7iy) 6-S- ffj 8' _ Address: !D l o A 7-A uLn .Ccntact Person: L bg&w r►se— _ No.of years.in business / S' Is the firm currently certified as DBE wader 49 CFR Part 26? YES i 1 Type of work/services./materials provided by firm? What was your firm's Gross Annual receipt's for last year? a Less than$1 When gam..Less than$5 MilCion o Less than$10 Million a Less than$15 Million o More than$1$Million . � II This form can be duplicated is necessary to report all bidders(DBEs and non DBEs)information. 1 1 ' tl. i I C-11 _ J z •d 5068-8?9-biG 9NIA3Aans QNHI 3SHo ece :eo to 9i mow John Peterson Full Name: Betty Mills Last Name: Mills First Name: Betty Job Title: P.L.S. Company: Mills Surveying Business Address: 16714 Spruce Circle Fontain Valley, CA 92708 Business: (714) 531-5082 Mobile: (714) 742-9476 Business Fax: (714) 775-8319 Categories: Survey �.I CLTY OF HUNTINGTON BEACH BIDDERS LIST I. I. All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors,who provide a proposal,bid,quote,or were contracted by the proposed prime. This infomtation is also required&orn the proposed prime contractor,and must be submitted with their bid/proposal.J%e City of Huntington Beach will use this information to maintain and Update a"bidder's"list to assist in the annual DBE 12LI stttin ass. (. t: Firm Name: •+ter it-eX :2n .,ry e r Phone: 7/ Address: Fax: 7/Y 77f Contact Person; 4�5cz2ze ivr < ex No. of years io business 17 Is the firm currently terrified as DBE under 49 CFR Pact 26? YES Q: Type of work/services1materials provided by firm? What was ur fmn's Gross Annual rccei is for lastLear? l i Less than$1 Million o Less thw$5 Million • Less d=S10 Million o Less than$15 Million o More than S15 Million , This form can be duplicated if necessary to report all bidders(DBEs and non DBEs)information. C-11 Z 'd 61E8-SGL fb1G) sib W 914%as e90: 11 00 91 AOW Jaime Vulegas ]G A_L,VvIL�1GAN.ASF'HALI mete: I.'IDAA im=: AM "tige 1 of 1 PV I P.O.BOX 16118,LONG BEACH.CA.90806.PH.(562)218-0504, FAX(562)218-0634(LIC NO.823802) QUOTATION AGENCY' CITY OF HUNTINGTON BEACH PROJECT: GOTHARD ST. REHABILITATION -CC 1154 FROM ELLIS AV. TO HEIL AVE. STPL 5181 (141) BID DATE: 11/16/04 ITEM UNIT EXTENDED NO. ITEM DESCRIPTION QUANT, PRICE PRICE 10) TRAFFIC STRIPING 1 LS $ 39,975.00 EXCLUDES TEMPORARY STRIPING AND REMOVALS IF ANY $ TOTAL BID : $ 39,976.00 Union Contractor. Includes traffic control for PCI forces. Based on (1) move-in(s). Additional move-ins to be charged at$860. each. Require ten working days notice prior to each move-in. This proposal includes Monday through Friday day work only. Work performed outside those days and hours may be subject to premium time rates. Excludes special insurance requirements, I.e. increased General Liability, Railroad Insurance, etc. We require acceptance in writing of this proposal with-in ninety(90) calendar days. Proposals not accepted with-in ninety days are subject to pricing review by PCI. If bonding is required, add 2%to PCI's bid. Per agency and reference plans and specifications unless otherwise noted. Addenda no.(s) none are noted. All retention monies due to PCI will be paid in full with-in ninety(90)calendar days of completion of PCI's contract work. A!I terms and conditions stated herein become a binding part of any contract or agreement between buyer and seller Submitted By, Accepted by' Customer: JAMIE VILLEGAS P C I Date: s N00-16-2004 11:11 FROM:PCI 5622188021 TO:919517367696 P:212 i 1 CITY OF HUNTINGTON.BEACH BIDDEXi LIST i All Bidders(proposers are required to provided the following information for aU DBE and non- DBE colvtractors,who provide a proposal,bid,quot.-,or were contracted by the proposed prime. "Chia information is also required from the proposed prkne contractor,slid must be subtnittod with { their bid/proposal.The City of k;uutington Beach will use tills information to maintain and update { a"Bidder's"list to assist in the annual DBE goal sefing process. First Name- Phone<k L.) � 1� ^D5�"� Address: I WsS E_, Fax: ,Contact Pearson: VC,'-k No.of years is business l Is the firm cu=osttty certified as ME under 49 CER Part 26? YES N� Typc of work/scrviccs/materials provided by firm?Jar i SD, W hat was our firm's gross Annual rcc ' is for last car? o Lms than$1 Million w ''Less than$5 Million a Less than S10 Million a Lo"than$15 Million a Mire than$l5 Million This form can be duplicated if necessary to report all bidders(DBEs and non DBEs) information. C•l l 11115I2004 18:05 7146301793 LOOP MASTERS INC PAGE 01/01 LOOP MAS'TER S INC. 4740 E. Bryson St. •Anaheim - CA • 92807 - (714) 630-8894 • Fax#(714)630-1783 License#755319 DBEISMBE/SWBE CT 032041 Union Signatory: 1BEW and LIUNA I BID PROPOSAL All American Asphalt Estimator November 14, 2004 COMPANY NAME ATTENTION DATE City of Huntington Beach; Oothard Street Rehab CC 1154 PROJECT NAME - ITEM: Eighty (80)6' round asphalt loops $189.00 each= $15,720.00 Total Bid; $15,720.00 STIPULATIONS: 1.. Bid excludes sEecial provisions not Tested on bid request, and A permit and inspection fees 2. Bid is based upon all stub-outs to be located and functional 3. Quote valid for thirty (39)days. _ 4. Unless otherwise stated, bid is priced for asphalt loops. Andrea J. North President NUV-16-2UU4 TUE 139,29 AM FAX NO. 909 988 6201 P. 02 A B C Resources, Incorporated phone: 909.988.0390 Proposal#: JD-704 1527 West State Street Fax: 909.988.6201 Page 2 of 2 Ontario, Ca. 91762 License#538680 Date: 11/16/2004 James Duncan Cell#(909)772-5565 E-Mail:ASCresources@earthlink.net CUSTOMER PROJEC All American Asphalt Gothard Street 400 East eth St. Huntington Beach,Ca. Corona,Ca.91718-2229 (909)736-7600 Fax: (909)736-7646 Attention.Estimating De rtment All areas must be dean and free of obstacles and debris prior to crews arriving on-site.This proposal good for 30 days from date.The work Quantity described below and ABC terns and conditions must be included in any and all contracts. Notes: Owner to accept ABC Insurance Limits All Engineering, Permits and Fees NIC Priced for 2 coats striping at prevailing wage rates. 2nd Coat Striping to be Completed No Sooner Than 24 Hours After First Coat All Pavement Markers To Be Installed With Bituminous Adhesive Work to be completed in week-day moves. Work to be cat-tracked and striped the same day 1 move for 1 st coat striping and signs,2nd move for 2nd coat striping and marker installation Extra moves at$450.00 ea, Traffic control for ABC work areas during work hours only All change orders will be processed and paid within 30 days from date of completion of said work Excluding custom signs unless specifically stated in proposal All striping removal NIC All work not listed NIC No thermoplastic included Two weeks notice required for start of work This bid excludes hazardous removal and abatement Overhead/mastArm Signs Not Included All Signs High Intensity with 3M Anti-Graffiti Sheeting/Overlay Signs Mounted on Unistrut Posts with Anchors Signs Mounted on Light and Or Signal Poles Whenever Possible .lames Duncan Cell# (909) 772-5565 Total Bid Price: $59,890.00 NOV-16-2'04 TUE 09:28 AM FAX NO. 909 988 6201. a. 01 A B C Resources Incotpo rated Phone: 909,986.0390 Proposal#: JD-704 ►, 1527 West State Street Fax:909.988.6201 Page 1 of 2 Ontario, Ca. 91762 License#538680 Date: 11/16/2004 James Duncan Cell#(909)772-5565 E-Mail: ARCresourcesCoearthlink.net CUSTOMER PROTECT All American Asphalt Gothard Street 400 East 6th St. Huntington Beach,Ca. Corona,Ca.91718-2229 (909)736-7600 Fax: (909)736-7646 Attention: Estimating Department All areas must be clean and free of obstacles and debris prior to crews arriving on-site.This proposal good for 30 days from date.The work Quantity described below and ABC terms and conditions must be included in any and all contracts. 2 Coats Striping and Markers: 700 Type A Raised Pavement Marker for 4" Lead Lines 16018 L.F. Detail 16018 L.F. Detail 10 2492 L.F. Detail 21 2492 L.F. Detail 23 215 L.,F. Detail 27B 200 L.F. Detail 28 200 LY, Detail 30 6869 L.F. Detail31 6869 L.F. Detail33 1630 L.F. Detail 38A 1630 L.F. Detail 38C 16857 L.F, Detail 39 2625 L.F.Detail 39A 100 L.F. Detail40 2800 L.F. Lead Line 17347 L.F, Painted Curb 22 Lane Legend 22 Bike Legend 22 Bike lane arrow 25 Type 4 arrow 2429 L.F, 12" X-walk Furnish and Install Signs: 4 Remove sign and post 2 Relocate Sign and Post 2 W65-1 2 SR4 James Duncan Cell It (909) 772-5565 Total Bid Price: $59,890.00 FROM :DLA*DMS FAX NO. :714-740-8842 Nov. 16 2004 08:2SaM P1 L 3Cn q_ aces Survey Q u otc` - FAX 25446 Morningstar Rd Date El Toro, CA 92630 9/28/2004 Name/Address All American 951-739-4671 city Bid Date Project Huntington Beach 11/10/2004 Gothard Str- ct Description Total Tie-out,reset,trod prepare corner records for 28 each survey monuments 5,320.00 Any additional survey can be performed on a T&M basis at$135/hr(straight time), Contractor to provide arrow boards if roquired by the City, Contractor to provide 41 least 2'working day notice prior to start of work. As-built plans not included. a ` Good Luck With Your Bid Total $5,320.00 Licenses CA PLS 7707 CA RCE 44453 Phone# Fax# E-mail 949-594-0388 949-586-474L3 ` wlundin495@aol.com �I II I I CITY OF HUNTINGTON BEACH I BIDDERS LIST i �i All Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal,bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist in the annual DBE goal setting process. Firm Name: UAJ-41t1'E *gOC. Phone: Address: ��"7 AiL��2A//.G�' � L��A. Fax: 4,47 V3 .Contact Person: 44?d" No. of years in business Is the firm currently certified as DBE under 49 CFR Part 26? YES Type of work/services/materials provided by firm? �S7.frly✓�, / ,��5 �CJ fz�Z�JlCc3 What was your firm's Gross Annual receipt's for last year? Y/Less than $1 Million ❑ Less than $5 Million ❑ Less than $10 Million ❑ Less than $15 Million ❑ More than $15 Million This form can be duplicated if necessary to report all bidders (DBEs and non DBEs) information. C-11 Frofn:Clint Rieber 714-538-2779 To:Estimating Date: 1/4/80 Time:7:49:48 AM Page 1 of J and S SIGN COMPANY INC. .# Tel: 71��-63S -4921 Fax: 71��-53E -2 79 a .. To: Estimating From: Clint Rieber Fax #: 19517394671 Fax #: 714-538-2779 Company: All American I ITel #: 714-639-4921 Subject: Huntington Beach Sent: 1/4/80 at 7:47:58 AM Pages: 2 (including cover) MESSAGE: Gothard a ` s ` Froon:Clint Rieber 714-538-2779 To:Estimating Date: 1/4/80 Time:7:49:48 AM Page 2 of J and S Sign Company Inc. 822 W Katella Ave., Orange, CA. 92867 BID PRIOP03"AL 714-639-4921 Fax: 714-638-2779 Lic.#538211 / Union Contractor PROJECT: Street Rehabilitation (CC-1164) BID DATE: Tue 11/16/04 LOCATION: Gothard (Ellis to Heil) TIME: 2:00 PM CITY: Huntington Beach BID NO.: PUB- 1115.04A ITEM QTY UNIT DESCRIPTION UNIT PRICE TO -AL 10 1 LS Traffic Striping 44360.00 44,360.00 CONSTRUCTION NOTES 1 The above unit price was figured for one move-in. If this project requires additional moves,an additional charge of$350 for each move will be added to the final invoice. 2 J&S Sign Co.will need(10)working days notice prior to scheduling. 3 Includes(2)coats of water based paint. 4 Prices for signs/barricades includes installation in dirt only. Core-dri Ili ng/saw-cutting in concrete will be an additional charge of$100 per location. 5 Price does not include sandblasting or cleaning of painted curbs. 6 Price does not include sandblasting or removals due to overlay. 7 Based on striping plan sheets 1 through 5 of 5. d ` The above unit price will remain in effect for 60 days from the date of this proposal. Contract invoice shall be paid at 95%of each invoice as submitted;5%retention to be paid by within 35 days after final accepatnce or 6 months from date of each invoice, whichever occurs first. No retention will be held on a purchase order. TOTAL $41,360.00 Accepted: By: //S// PRINT NAME CLINT RIEBER,E:STIMATOF By: By. Authorized Signature(Buyer) 4 ` 11-16-d4 11 :41 J S SIGN CO ID=714 5382779 PS CITY OF HUNTINGTON BEACH BIDDEPS LIST All Bidders/proposers are required to provided the following information for all DBE and nan- DBE contractors,who provide a proposal,bid, quote, or were conU=ted by the proposed prime- This information is also required from the proposed prime contractor, and must be subrr hwt with their biftroposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's"list to assist i*tM annual DBE oal setting process. Firm Naxno: (, ih. Phone: op Address: —5-7r— ,Contact person: (/lam ���- No. of years in business, 1Q�� Is the firm aimrutly certified as DBE under 49 CFR Fart 26? YES N0 ) Type of work/services/materials provided by firm? 'VI!'hat was your firm's Caoss AnAual receipt's for last year? f � © Less than$l Million XJess than $5 Whou Q Less than $10 Million o Less than$15 Milhou U More fl= S15 Million � This form can be duplicated if necessary to report all bidders(DBEs and non DDEs)information. C-11 11-16-04 10:02 TO:J S SIGN CO FROM: poi' NOU-14-2004 23: 17 FROM:ORANGE COUNTY STRIPI 714 639 6353 TO:RL.LAMERICAN P:1/2 ORANGE COUNTY STRIPING SERVICE, INC. CONTRACTOR'S LIC. 4346095 C-32 183 N, PIXLEY STREET, ORANGE, CALIF. 92868 (714) 639-4550 FAX (714) 639-6353 PROJECT: GOTHARD STREET REHABILITATION-CC1154 ELLIS AVE. TO HEIL AVE, HUNTINGTON BEACH JOB BIDS: 11116iO4 @ 2:00 PM ARCHITECT: CITY OF HUNTINGTON BEACH SHEET 1.5 OF 5 9/l/04 APPROVFD 912104 We h�abY submit ao esfirnatefor-. ITEM DESCRIPTION ESTIMATED UNIT UNIT EXTENDED QUANTITY PRICE AMOUNT 10,TRAFFIC STRIPING LUMP SUM $45,8$5-00 "ORANGE COUNTY STRIPING SERVICE, INC. DOE: NOT WARRANT ADHESION OF ANY OF ITS PAINT,APPLICATION TO ANY NEWLY POURED CONCRETE SURFACE NOR TO ANY CONCRETE SURFACE TREATED WITH A CURING COMPOUND NOR TO A CONCRETE SURFACE ON WHICH A CURING COMPOUND HAS BEEN APPLIED, THIS DISCLAIMER APPLIES TO ALL IMPLIED AND EXPRESS WARRANTIES." ATTACHMENT: O.C.S.S.TERMS AND CONDITIONS INCLUDES: 1 MOVE-IN 1$600,00 EACH ADDITIONAL EXCLUDES: TEMPORARY $TRIPING/MARKERS REMOVALS ESTIMATOR; ROBERT LITCHFIELD OATS: 11115104 NOV-14-2004 23:1 7 FROM:ORANGE COUNTY STRIPI 714 635 6353 TO:ALL PMERICRN P:2'2 _ Orange Comy Striping St:rvice,Inc. Vedcrai I.D.No, 95.3077158 183 North Pixley Strut Contractors License Nc.346095—C3-: %)range,Culif 9:865 Phone: 714 v39-4550 Fax 7)4-639.6353 TOMIs and Conditions of fled or PlronosM I. Orange County Striping Service,Inc.is signatory to the Laborers Union,Local 1184 2,. Orango County Striping Service, Inc,requires a rriilnimum of 10 working days notjce prior io scheduling work 3 Total bidiproposal package must be accepted in fill unless Orange Count} Striping Set-vice,hic.has ngreed to changes prior to bid time. 4. Prices good for 45 days from the Gate of bid unless otherwise ngrced upon. 5. Orange County Striping Service,Inc. wi!l not be held liable for any backcharges unless prior mutual agreement, Ili writtrtg,is made. 6. Referencing or staking of existing striping is not hiciudcd un!ess otherwise stated. Shop d-awings or traffic control plans are also net atcludcd. 7. lasurnnce included with bid: Commercial Liability Limits $1,000,000 per occurrence/$2,000,000 Aggregate S2,000,000 Products&Completed Operatioat Aggregate $1,000,000 Personal&Advertisement Injury $100,000 Fire Damage(my one frre) $5,000 Medical Payments(any one pers or) ,$2500 Deduntible Per Occurrence including Loss Expense Additional Insured On CC201010/93 only, .with up to 2 Additiwiai Insureds(Owner/Contractor) .into,Liability Limits S!,000,000 Combitied Single Limit—includes owned,non-owned, and hired 'fork-Comp Limits as required by Statutory Provisions of the State of California Waiver of Subrogation NOTIncbaded Acceptance of bid/Proposal rieceptc these insurance limits regardlw of requirements by owner, S. Thiv bid!proposnl and all its Terms and conditions shall become a binding part cf any sube.ontract, pwchase order,o:other agreement made with Orange County Striping Service, Inc. NOO-15-2004 19:29 FROM:ORANGE COUNTY STRIFI 714 639 6353 TO:ALLAMERICAh! P:2/2 i CITY OF HUNIINGTON BEACH BIDDERS UST t All Bidderelproposers are required to provided the following information far aH DBE end non• DBE connectors,who provide a Proposal,bid,quote,or were contmc,w by the proposed prit7te, This information is also required firm the proposed prone contractor, and must be submittod with their bid/proposal, The City of Huntington Beth will use this information to maintain and update ' a"Bidder's"last to assist in the annual DBE pal sening proom. i. Firm Name, ORANGE COUNTY STRIPING PhonC� 183 N. PIXLEY STREET Address: ORANGE Ca 92964 Fax: Lf�,�� ��contact Person; �1 r�� No. of years in business Is the fum currently certified as DOE wider 49 CPR Pert 26?' YES _--� Type of work/serviceVMaterials provided by firm? �ka6� J What wag ur firm's Gross Annual recei is for last ear? o Ws than$1 Million o tess than$S Million Less than$10 Million Less than$1 S Million o More than$1 S Million This form can be duplicated if necessary to report all bidders(DBEs and non DBEs) information. C-11 NRNF:f�2Qtl(+r= �rqu�ry �TRTPTr+r NCV-15-2004 MON 02:2T TEL.?14 639 6353 v n it/10/ZUU4 14:64 YR3 616 664 db18 SiM(NU9HL NA''L 1PG wjuu.L/UU2 11861 Branford Street Sun Valley, CA. 91352 . Phone(818) 834--1e39 Fax (818) 834-8618 License No. 421823 A, C31, &C32 TO, ESTIMATING: From Denny Stemdahi Fax: Pagoe: 2 Phones Date: 11-16-04 ice: GOTHARD ST.ELLIS TO HEAL.AVE. CC: Stemdahl Job File CITY OF HUNTINGTON BEACH 11 Urgent ®For Review 13 Please Con moat ❑Please Reply O Please Recycle o Gor wao is, SEI BID NO 04-8TS ITEM DESCRIPTION UNIT EST. QTY PRICE TOTAL TRAFFIC STRIPING LS 1 $57,500.00 $ 57,500.00 GRAND TOTAL $ 57,500,O0 Stamdalhl Enteripresea,Inc.TERMS AND CONDITIONS to follow. Page 1 of 2 L1/1D/ILL)U4 13:33 I'Al 010 8J4 0015 3111KINDAiL KiNI 11M1- tj-7.JUUL/UUZ BID 04.875 GOTHARD ST. HUNTINGTON BEACH 11-16-04-doc November 10, 2004 STERN®AHL ENTERPRISES, INC. Terms and Londi4lons 1. Sterndahl Enterprises,Inc. is signatory to the Laborers Unior,Local No 1184. 2. Unless otherwise noted or agreed to in writing by Sterndahl Enterprises,Inc., prior to bid time,the total bid must be accepted. If you need revised pricing fix only a portion of the work,please contact the Estimator. 3. Sterndahl Enterprises,Inc.requires a written contract,purchase order or signed quote prior to the start of work. 4, Lump sum items are based on"working days"listed in the Special Provisions for this project.. Additional compensation will be required if working days are exceeded. 5. Stemdahl Enterprises,Inc. requests'invitation to all pre-job conferences. 6. This quote shall remain valid for 30 days from the date of this notice unless otherwise agreed upon. 7• Sterndahl Enterprises,Inc.Contractors License 4 421823,A,C31,&C32. Exp.04/30/2006 8• 18AtXCHARGES: Customer acknowledges that Steradakil Enterprises,Inc. will not accept any beck-charges witless prior mutual agreement is made in writing. 9. The price of bonding is not included in the bid. Our bond rate is 1.54%. 10. Removal includes clean up,however,the Contractor must provide the sweeper with a dump site on the project. 11.. Referencing of the pavement delineation_ _will_X_will not be included, We require 10 working days notice before obliterating any existing pavement delineation to reestablish alignment and location of pavement delineation,including the limits or changes in striping patterns. On seal coat jobs,alignment is to be established by the Contractor by placement of temporary markers per Special Provisions. 12. Bid ,X _includes does not include traffic control for our work only. 13. Sterndahl Enterprises,Inc. requires 15 worming days notice prior to commencement of our work. This time is necessary to reference,when applicable,order material and schedule the project. 14. Price includes_1__move-in(s). Additional moves will be charged at$2000,00 15. Special Conditions as follows: 16. Force Account work will be paid at the following:Labor+ 19%surcharge+33%markup. Materials and Equipment+ 15%markup. 17. Bid_X_includes —does not include temp. tab removal. 18, Bid excludes any and all items related to handling hazardous materials including,but not limited to removal, testing,containment,hauling and disposal,unless specifically noted elsewhere on this bid, [Nd—Fit LS. BID INCLUDES SIGNS AND RED CUR®.������____ I have read,and understand,the above"Terms and Conditions",and agree that our Quote and these Teems and Conditions wi!1 become a part of the agreement,in the event that the contract is awarded to Sterndabl Enterprises, Inc. General Contractor: Signature _— Title !Name(Type or Print) Bate ?age 2 of 2 11/1�lLUV4 ld:dl NH.� 2'S1Z5 iS34 nbltS �'.lL;K1V.V.'tIL L'IV'1' Ll�(: IQ�UI)1/Ulll •11115;2004 10:14 19494928324 ORION CONTRACTING PAGE 01 CITY Of HUNTINGTON BEACH BIDDERS LIST All Bidders/proposers are required to provided the following information for all DBE and non- 1 DBE contractors,who provide a proposal,bid, quote, or were contracted by the proposed prime. This information is also required from the proposed prime contractor, and must be sub mitted with I their bid/proposal.The City of Huntington Beach will use this information to maintain and update I La"Bidder's" list to assist in the annual DBE goal setting process. i Firm Name��t� r� �1� -�� ���� Phone: Add:ess:����• I ct�T�Ctd�`?�' Fax: .Contact Person:Z. 1ji �� No. of years in businessT G- Is the firm currently certified as DBE under 49 CFR Part 26? YES Type of work/services/materials provided by filter? 0. What was your firm's Gross Annual receipt's for last year? A Less than$1 Million i u 'Less than$5 Million �..i,css than $lO Million 4 o Less than $15 Million u More than$15 Million nis form can be duplicated if necessary to report all bidders(DBEs and non DBEs) information. N[JV-11.eUU4 1e;U':JFM WUWKS 51 K1Y1NG (W(_;) NO.�y8 P. i/6 -Works Striping & Marking Service, Inc . Design & Installation 1122 No. Azusa Canyon Rd. - West Covina, CA 91790-1001 (626) 962-5074 - Fax (626) 814-2805 - EST-1-MATE - Date: Address: Bid Date; Contract/Project No; CC \ 1 5 q Job Descr: 'zt`i c �.VJ, � `wv��^i v� � - _ I C_ , TFRMS: Per Public Comma Code("PCC") 10261.5(Ne )8nd 10262.5(New). 8usmess&Profemions Code("B&PC")7108.E Ammende4 And Civil Code "CC" 3260(New). Item No Quantity U/D+i Description Unit Price Amount LICENSE NO. 511977 (Terns and Conditions of this Esti mate Enclosed) (PLEASE NOTE CHANGE IN ITEM#3 &#8 ON PG 2) BY: I OF 2 TOTAL$ �' "" NOV.11.2004 12:10PM WORKS STRIPING (WC) NO.29e P.2/6 s ( r Works Striping & Marking Service, Inc. Estimate Con't.... Contract No: 5C4 /or Description of Job: GZYA -- TERMS & CONDITIONS— 1) Works Striping & Marking Service, Inc. is signatory to Laborers Local Union 1184. 2) We agree to provide insurance coverage for our portion of work only. 1f Addi uft,l Insured is rgggira Eerm CG 201010 Ol will Ise uced and n4 of r Q d'tional insured endarcement can be issued tEdM=04 Nbn-Cantrib=a"warding. if required, will be subAct to a-charge of$2.50M not included in our Eniw=&U&e. 3) Our Bond rate is 2.0%. Our price does not include a bond premium. 4) Portable Changeable Message Signs, when required, are to be furnished by the General Contractor. 5) All Special Ramp Notification Signs and all Detour Signing shall be furnished by the General Contractoz, 6) Our price does not include referencing and/or staking of the existing Striping or Pavement Markings. 6a) Referencing and furnishing drawings of existing Striping &pavement Markings will be an additional $1,500.00 per job. 7) Our price includes removal of Temporary Pavement Markers (Flip-ups). 8) Two (2) weeks advance notice to us is required for each move in. ALL NOTIFICATIONS WTrH LESS THAN THE REQUIRED NOTICE ARE SUBJECT TO AN ADDITIONAL CHARGE OF$2So.00. 9) This estimate is good for 30 days from the contract bid date. Written acceptance from the General Contractor is required within the 30 day period. 10) Our Traffic Control is included. 10a) Our Traffic control is not included. 10b) Our Traffic Control is included for Permanent Striping &Marking only. 10c) The General Contractor is required to furnish all Traffic Control. 11). No Move-In Charges. 1la)—* Priced for Move-In(s) Extra Moves @ $ 1 Z, CrJ Each PLEASE MOTE: This Estimate and all of its Terms K Conditions must become a BONDING PA MEN of all subcontracts issued to us. esdmacemvpd ft 2 Rev 1/8/0443&#8) 2 OF 2 11Vv. I.r_UVJ14 ;c•1t71'I'I WVKND .DIKII-111lo lWI,J Ili .c7d u ( r CITY OF HUNTINGTON BEACH BIDDERS LIST AU Bidders/proposers are required to provided the following information for all DBE and non- DBE contractors, who provide a proposal,bid,quote,or were contracted by the propos; d prime. This information is also required from the proposed prime contractor, and must be submitted with their bid/proposal. The City of Huntington Beach will use this information to maintain and update a"Bidder's" list to assist in the annual DBE goal setting process. Firm Name: ors S�•r.4'igg 1'11_ r_ �G�S'�r, rP'hone: 10 9 ;•5� 7r1 - Address: UR it/, QzvsA&44(aa , Fax: W CA. q IngD ,Contact Person: Pu. W rkS No. of years.in business, Is the fine currently certified as DBE under 49 CFR Part 26?' YES NO Type of work/services/materials provided by firm? K t*1 STr 'What was Xour firm's Gross Annual receipt's for lastyear? o Less than$1 Million Less than$5 Million o Less then$10 Million a Less than$15 Million o More than S IS Million i This form can be duplicated if necessary to report all bidders(DBEs and non DBEs)information. I C-II 11/16/2e04 11:51 6269688590 RCM JR ELECT PAGE 01 D A S E ELECTRIC DBA 1 L.A. Signal QUOTATION 15100 E.NELSON, IDUSTRY, CA,91745 Prone: (626) 968-3771 Fax: (626)965-5720 License #: 749255 C1.0, Exp. 5/31/2006 •T'rn!'fxc Signal Date: 1 I/16/04 •Loop Detectors •Street Lighting To: Prime Bidders Attn: Estimating Department INSTALLATION & RELOCATION Speclahzing in Round Loops From.: Rocky Morales/Lauren Fclber 1 Regarding. City of Huntington Beach Gothard St. Rehab BID DATE-NOVEMBER 16,2004 Disadvantaged Business ; ;.' Enterprise Certification Currently Pending TTEM DESCRIPTTON QTY UNITS AMOUNT 11 Traffic Loops 80 $199.00 $15,920.00 *Traffic Control Included "Includes One MobilizationPer Bid Item. Additional mobilization, if required, $1000. ***No Retention Withheld On Subcontracts/PO's under$20,000. PLEASE CALL IF YOU HAVE ANY QUESTIONS Grand Total: $18 920.00 Our Quote Excludes: 1. Inspection, Permit and Utility Fees. 2. Payment & Performance Bonds. DOE/MO , Certification 3. All Signing and Striping. Cat-Tracking To Be Performed By Stripers. Currently Pending 4. Insurance Coverage Over$1 Million(Available at additional cost) 5, New Detector Lead I,n Cable,New Stubouts and New Pullboxes, 6. Waiver of Subrogation& Umbrella Insurance Coverage SIGNATORY TO THE LABORERS INTERNATIONAL THANK YOU ROCKY MORALES UNION OF N.AMERICA 11./16/2e04 12:25 6269688590 RCM JR ELECT PAGE 02 i M CM OF H><JNTINGTON BEACH � I' t BIDDERS LIST I; All Bidders/proposers are required to provided the following information for all DBE and non. i DBE contractors,who provide a proposal,bid.quote,or were contracted by the proposed prime. This information is also required frm the proposed prime contractor,and must be submitted with their bid/propoW.The City of Huntington Beach will use this information to maintain and update a"Bidder's"last to assist in the annual DBE goal setting ocess. � Firm Name: 12 co Lot I Phone: �C�z�a 9(�, 7`7 Address: I' Fax: �L��' �5 72X2 741'f .Contact Person: -�G'7� �12 ,,t 1N No. of years in business 1s the firm cuxreutly certified as DBE under 49 CFR Part 26?' YES r2 Type of work/services/materials provided by firm? �,C�-�'/4'/L .i'J�^�✓ f� I What was your Erm's Gross Annual receipt's for last year7 I a Less than $1 Million a Less than $3 Million p1 Less than $10 Million J�a— Tess than $15 Milliou o More than$15 MiWon 'Phis form can be duplicated if necessary to report all bidders(DBEs And non DBEs) information. C-11 2