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Bannaoun Engineers Constructors, Corp. - 2010-12-20
t RECEIVED BY:� (Name) (Date) i 0 F TO:-,.-�Shari-Fireideni rich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. j 7c: MSC No f7.. (Company Name) Approved Z-. , /�o /6Agenda Item No. (Coup&Approval Date) City Clerk Vault No CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating #27 g1followup/bondletter.doc ® J City of Huntington Beach el�j INTER -DEPARTMENT COMMMUNICATION HUNTINGTON BEACH TO: THOSE LISTED HEREON FROM: John S. Griffin DATE: 10/12/11 SUBJECT: Retention Release Payment Company Name: Bannaoun Engineers Constructors Corp. Address: 9614 Cozycroft Ave. City, State and Zip Code: Chatsworth, CA 91311 Phone Number: (818) 775-40 Business License Number:A278879 Local Address: NSA Notice of Completion Date: 5/19/2011 Contract Purpose: Remaining retention release for Capital Improvement Project 1372 Garfield Avenue Rehabilitation 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 on the subject at this time. Ohq It D to v / Travis K. "op s, Public Works Director I certify that there are no outstanding invoices on file. h1 Date ``—"Jovice Zacks uty 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. ri Da a Joan Flynn Clerk Retention Release 3 signatue form 10/12/2011 9:54:00 AM PLEASE COMPLETE THIS INFORMATION This Document was electronically recorded by City of Huntington Beach RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH Attn: John Griffin P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 TITLE OF DOCUMENT Recorded in Official Records, Orange County Tom Daly, Clerk -Recorder 111111111111111111111111111111111111111111111111111111111111111 NO FEE 2011000249900 12:45pm 05/19/11 93 401 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to Bannaoun Engineers Constructors, Inc. who was the company thereon for doing the following work to -wit: GARFIELD AVENUE REHABILITATION, CONSTRUCTION CONTRACT-1372 That said work was completed May 16, 2011 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 May 16, 2011, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract First National Insurance Company was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. Dated at Huntington Beach, California, this May 16, 2011./ it ctor of Public W ks or City Engineer ity of Huntington Beach, California STATE OF CALIFORNIA) Z l! County of Orange ) ss: City of Huntington Beach ) I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof; the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. Dated at Huntington Beach, California, this May 16, 2011. /' rector of Public Works or City Engineer City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) RECEIVED BY: (Name) (Date) TO: - __h, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating w i iff - i, Tit, 0 Il �-IUA)40 tt-,10 (Company Name) Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. Z,3 7� MSC No. Approved /6Agenda item No. (Cou cil Approval Date) City Clerk Vault No 001 #27 g:/followup/bondletter.doc EXECUTED IN TRIPLICATE BOND NO. 6620345 PREMIUM INCLUDED IN PERFORMANCE BOND MAINTENANCE BOND KNOW ALL MEN BY THESE PRESENTS: That: BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION iconVactors name] 9614 COZYCROFT AVENUE, CHATSWORTH, CA 91311 [contractor's street address, city and state and zip code] as Principal (hereinafter called Contractor), and: FIRST NATIONAL INSURANCE COMPANY OF AMERICA name] [surety's street address, city and state and zip code] a corporation organized and existing under the laws of the State of WASHINGTON with its principal office in the City of SEATTLE as Surety (hereinafter called Surety), are held firmly bound unto EECITY ggggOFEgHNNUyNTIIgNGGGTON BEACH as Obligee (hereinafter called Owner), in the amount of HUNDREDUSIXTY SEVENTANDI6�IUOUSAND_SIX_ Dollars ($ 778,667..65 ) for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents, r WHEREAS, Contractor has by written agreement dated (Z-' lc Zm/0 entered into a contract with Owner for the GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. 1372 in accordance with drawings and specifications prepared by which contract is by reference made a part hereof (hereinafter referred to as the Contract); and ONE WHEREAS, the Contract provides that the principal will guarantee, for a period of = years, the work performed as part of the Contract from and against all defects in materials and workmanship; and WHEREAS, the Contract also provides that the Contractor shall secure Contractor's obligations during the two- year period with a bond executed by a surety duly admitted in the state of Califomia; and WHEREAS, the Contract has been completed, and the Owner, Contractor an Surety agree that the commencement date for this Guarantee and Bond shall be S /3 2011 , NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of two (2) years from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects arising in the Work, whether resulting from defective materials or defective workmanship, then this obligation shall be null and void; otherwise it will remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within thirty (30) following Owner's written notice of default, either: (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall save the Owner harmless from any claims, judgments, liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner. Whenever the Principal shall be, and declared by the Owner to be in default under the Contract, which shall include without limitation, any breach or default of the Contract , then, after written notice from the Owner to the Surety, as provided for below, the Surety shall either (a) remedy the default or breach by the Principal; or (b) shall promptly and faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a contractor other than the Principal, at its own expense, and make available 10-2567/50583 as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder; provided, however, that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to (a) remedy the default(s) of the Principal promptly, or (b) arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond. In said Notice of Election, the Surety shall state the date of commencement of its cure or remedy of the Principal's defaults) or its performance of the Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or failure to act; and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages caused by delayed performance or non- performance by the Principal). The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s) of its performance of the Contract. If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its performance of the Work within thirty (30) days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond, and the Owner shall be entitled to enforce any remedy available to Owner. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner named herein or the successors of Owner. Signed and sealed this 21ST day of JUNE 20 11 Principal Raised Corporate Seal BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION [MUST BEAFFIXED] (Contractor Name) By: (Seal) Principal Raised Corporate Seal [MUST BE AFFIXED] l ,e.,=- c Je4 (Title) FIRST NATIONAL INSURANCE COMPANY OF AMERICA (Surety Name) By: _xxtUy4� (Seal) MARK D. IATAROLA, ATTORNEY —IN —FACT NOTES: 1. Acknowledgments must be completed and returned as part of the bond. 2. Raised Corporate Seats are mandatory. 3. Please attach Power of Attorney. 2 10-2567/50583 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of SAN DIEGO On 6/21/2011 before me, MICHELLE M. BASUIL, NOTARY PUBLIC personally appeared MARK D . IATAROLA who proved to me on the basis of satisfactory evidence to be the personH whose name(.)) is/afa subscribed to the within instrument and acknowledged to me that he/s ef4ay executed the same in his44@.;/ t4* authorized capacity(i"), and that by his/task#" signature(s) on the instrument the person(o, or the entity upon behalf of which the person*) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of t Eux�xTNS MICHELLE M. BASUIL the State of California that the foregoing paragraph is N o COMM. #1862575 k g Y o NOTARY PUBLIC-CAUFORNIA cn true and correct. SAN DIEGO COUNTY N F A My Comm. Exp. AUG 24, 2013 WITNESS my hand and official seal. Signature of Notary OPTIONAL SECTION THIS CERTIFICATE MUST BE ATTACHED TO TITLE OR TYPE OF DOCUMENT THE DOCUMENT DESCRIBED AT RIGHT: Though the data requested here is not required by law, it could prevent fraudulent reattachment of this form. NUMBER OF PAGES ® OPTIONAL SECTION CAPACITY CLAIMED BY SIGNER Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the document. ❑ INDIVIDUAL ❑ CORPORATE OFFICER(S) TITLE(S) [:]PARTNER (S) ❑ LIMITED [:]GENERAL 0 ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. 4408368 N O Q O Yy n3 ,p C to y.+ L vtm d O W L ' d _ d� 3 2 .y 0 (D c)o O d C � caa) d L E� L d O LO Y•• L .C13 C O ` Zv This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. FIRST NATIONAL INSURANCE COMPANY OF AMERICA SEATTLE, WASHINGTON POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: That First National Insurance Company of America (the "Company), a Washington stock insurance company, pursuant to and by authority of the By-law and Authorization hereinafter set forth, does hereby name, constitute and appoint. JOHN G. MALONEY, HELEN MALONEY, MARK D. IATAROLA, DEBORAH D. DAVIS, MATTHEW C. GAYNOR, ALL OFTHE CITY OF ESCONDIDO, STATEOF CALIFORNIA............................................................................................................................................................................ .................................................................................................................................................................................................................... each individually if there be more than one named, its true and lawful attorney -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 TWENTY FIVE MILLION AND 00/100******* ***-**DOLLARS ($ 25,000,000.00***************** ******) each, and the execution of such undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents, shall be as binding upon the Company as If they had been duly signed by the president and attested by the secretary of the Company in their own proper persons. That this power is made and executed pursuant to and by authority of the following By-law and Authorization: ARTICLE IV - Execution of Contracts: Section 12. Surety Bonds and Undertakings. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitations as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.. Such attorneys -in - fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and executed, such instruments shall be as binding as if signed by the president and attested by the secretary. By the following instrument the chairman or the president has authorized the officer or other official named therein to appoint attorneys -in -fact: Pursuant to Article IV, Section 12 of the By-laws, Garnet W. Elliott, Assistant Secretary of First National Insurance Company of America, is authorized w to appoint such attorneys -in -fact as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety ? any and all undertakings, bonds, recognizances and other surety obligations. d That the By-law and the Authorization set forth above are true copies thereof and are now in full force and effect. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of First National Insurance Company of America has been affixed thereto in Plymouth Meeting, Pennsylvania this 16th day of February 2011 FIRST NATIONAL INSURANCE COMPANY OF AMERICA cg c g, s1.i.. By 19�- �✓- 3 797 Garnet W. Elliott, Assistant Secretary COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF MONTGOMERY On this 16th day of February , 2011 , before me, a Notary Public, personally came Garnet W. Elliott, to me known, and acknowledged that he is an Assistant Secretary of First National Insurance Company of America; that he knows the seal of said corporation; and that he executed the above Power of Attorney and affixed the corporate seal of First National Insurance Company of America thereto with the authority and at the direction of said corporation. IN TESTIMONY WHEREOF vgs to subscribed my name and affixed my notarial seal at Plymouth Meetin , Pennsylvania, on the day and year first above written. rb 4� C3MW �� Nrteria of f� Teresa Pa>?e3ia, ?tinwrr Pc;har. By _ u ?lymut" rwp.: Mon'°° n`y """ may Teresa Pastella, Notar Public OF Y:y Cosnrn ssiaf Ex# Tres R-�r, 28.2C"3 y CERTIFICATE €Ierber, Plemnsylva-11, mw,' r^ rf No"an A I, the undersigned, Ass rst National Insurance Company of America, do hereby certify that the original power of attorney of which the foregoing is a full, tru r y, 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 a is an Assistant Secretary specially authorized by the chairman or the president to appoint attorneys -in -fact as provided in Article IV, Section 12 of the By-laws of First National Insurance Company of America. 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 the board of directors of First National Insurance Company of America at a meeting duly called and held on the I Sth day of September, 2009. 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 attorney issued by the company in connection with surety bonds, 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 na 3 'xed the corporate seal of the said company, this 21ST day of JUNE 2011 Xz SEAT, 9 1926 re B David M. Carey, �stant Secretary ACKNOWLEDGMENT State of California County of Los Angeles ) On 24 June 2011 before me, Michele Etyemezian, Notary Public (insert name and title of the officer) personally appeared Omar Maloof who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me.that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official sea Signature (Seal) MICHELE ETYEMEZIAN Commission # 1790836 Notary Public - California Los Angeles County ti VCorrm80wF®b7.2012 Or EXECUTED IN TRIPLICATE OWNER ❑ CONSENT OF SURETYBOND NO. 6620345 ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ KA Conforms with the American Institute of SURETY Architects, AIA Document G707 OTHER ❑ TO OWNER: ARCHITECT'S PROJECT NO.: (Name andaddresti) CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 CONTRACT FOR: GARFIELD AVENUE REHABILITATION PROJECT: GARFIELD AVENUE REHABILITATION CONTRACT DATED: M-( ZJ , 0 1 � (Name and address) FROM NEWLAND STREET TO MAGNOLIA STREET In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address of Surety) FIRST NATIONAL INSURANCE COMPANY OF AMERICA ATTN: SURETY CLAIMS DEPARTMENT, 1001 4TH AVENUE, SUITE 1700 SEATTLE, WA 98154 ,SURETY, on bond of (Insert name and address q/ (7antrac or) BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION 9614 COZYCROFT AVENUE CHATSWORTH, CA 91311 ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Ownet) CITY OF HUNTINGTON BEACH 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 , OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: August 1 2011 (Insert in writing the month allowed by the numeric date and year.) FIRST NATIONAL INSURANCE COMPANY OF AMERICA (Surety) V "'- 1) K---- (Signature ofauthori=ed representative) Attest: (Seal): DEBORAH D. DAVIS, ATTORNEY -IN -FACT -_ (Printed name and title) fl- S-2134/GEEF 10/01 FRP CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No. 5193 State of California County of SAN DIEGO On 8/l/2011 before me, personally appeared MICHELLE M. BASUIL, NOTARY PUBLIC DEBORAH D. DAVIS who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/ their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. MIS Ci ELLE M. BASUIL N COMM. #1862575 NOTARY PUBLIC-CAUFORNIA cn SAN OIEGO COUNTY ro My Comm. Exp. AUG 24, 2013 THIS CERTIFICATE MUST BE ATTACHED TO THE DOCUMENT DESCRIBED AT RIGHT: Though the data requested here is not required by law, it could prevent fraudulent reattachment of this form. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signat re of Notary OPTIONAL SECTION CAPACITY CLAIMED BY SIGNER Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the document. ❑ INDIVIDUAL ❑ CORPORATE OFFICER(S) TITLE(S) ❑ PARTNER(S) ❑ LIMITED []GENERAL ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(ES) OPTIONAL SECTION TITLE OR TYPE OF DOCUMENT _ NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE A Q . THIBOWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. '440.0.3 82 This Power of Attorney limits the acts of those named herein, and they have no authority -to, bind heCompany-except in the:manner=and to_fhe extent e herein stated: - FIRST NATIONAL INSURANCE COMPANY OF.AMERICA SEATTLE; WASHINGTON POWER OF ATTORNEY- : KNOW ALL PERSONS BY THESE PRESENTS: That First National Insurance'Company of America (the."Company) a _Washington stock rnsurancecompany; pursuant to and by authority of the By-law and Authorization hereinafter set forth, does hereby name constitute and:appoint _JOHN G.MALONEY, -; HELEN MALONEY, MARK-D. IATAROLA; DEBORAH_D:=DAVIS,-MATTHEW-C. GAYNOR; ALL;O'FTHE CITY'OF ESCONDIDO; - STATEOF CALIFORNIA ......:.......:.:. ......... ......... ........: ...................... ......... .::...... ......................................................... ;each individually -if there be more:than :one:named, Its true and lawful attorney in fact to make; executeseal <acknowledge and deliver for acid on €fs behalf as _ - surety -and as its .act and deed,"any. and:. all.: undertakings, bonds, recognizances;and,:other:surety.obligat€ons,-€n the -penal _sum not exceeding. TWENTY FIVE MILLION AND 00/100******* ****** DOLLARS:($ 25;000;000:00********'******** *.*****) each, and:=the=ezecut€on =of -, such ._ undertakings, bonds, recognizances and other.surety obligat ons, in.pursuance of these presents ,shall be as;bind€ng upon the CompIa -as if th - h- been duly signed by the president and attested by the secretary.of the Company, in their own:proper:persons: Thatthispower is made and executed pursuant to and byautt0w of the•following By law and.Authonzation ARTICLE IV - Execution of Contracts: Section 12.-Surety Bonds and, Undertakings. `vy Any officer or other official.of the Corporation authorized forthat purposein writing by the Chairman_or the President and:sublect o such limitations Q as the Chairman or the President may prescribe; shall appointsuchattorneys in -fact; as,may be necessary to act in behalf:of the Corporation;to make,-: c� execute, seal; acknowledge and -deliver as surety any and all undertakings,. bonds, recognizances and other"surety obl,'igations.-_$uch a$orneys in- <3i Y fact, subject to the.limitations set -forth in their respective-powers.of attorney,-shall,have- full -power to bind the -Corporation by their signature and• - R D executed; such instruments shall be as binding as if signed -by the president and attested.by-the secretary - Co By the following instrument the chairman or the president has authorized the officer or:other:official named therein to appoint attorneys -in fact O d Pursuant to Article IV-Section-12-of the By-laws,-GarnetW. Elliott -A ssistant Secretary,, of "National]n'surance Company of Ame-ica;,is authorized .ea H _ .0. y d to appoint such attorneys -in -fact as maybe necessary to act:in-behalf of, the. Corporation to make;-execute,seal; acknowledge and deliver; as surety;W p? any and all undertakings, 6onds;tecognizances and other suretyobligations - _ as= Thatthe By-law and the_Authorization set forth above:are true copies thereof and are now.in full force and effect: - O"C -: d-3 - - %QM IN -WITNESS WHEREOF, this Power -of Attorney has been subscribed by- an authorized. -officer or -<off icial .6 the Company- and the; corporate seIal_of, ,� et d First:National Insurance Company, of America has been affixed thereto.in Plymouth Meeting :Rennsylvania this "-;16th day of - February: - 0 O '2011 .d=� O '_ C 4; FIRST NATIONAL INSURANCE COMPANY OF AMERICA< a c�a � C 1g2% W- Elliott:Assistant.Secreta Y pt , Garnet - ry COMMONWEALTH OFPENNSYLVANIA ss K':` .COUNTY OF_MONTGOMERY O. L..On this_16th _ day of February �2011 be a� Notary Public personally came Garnet W EII€ott to me known and ?_p 'acknowledged that. he is, of First,National-First an ofAmerca thkhe knows the seal of: said cot orat€on and that he= =� _�.ry P._ y P _. t.N '�-c executed the above .Power -of Attorney�and:affixed the corporate, of; First.National Insurance Company of-America�tliereto_with the authordy and at the= "'� L direction of said corporation.00 - � O" IN -TESTIMONY WHEREOF av e to sutiscnbed m name and affixed m notarial seal at PI mouth r, in Penns Ivania on he da and ear; C p Z -v Y Y Y. Y Y Y - first above written.IS - v r - r0 - _� yr iu h to z saw r r By 4 Terea Pastella Notary Public -CERTIFICATE. i R rvria.i,. u. r as I, the undersigned, Ass ta. Fr st`N'- nal Insurance Company of America do hereby certlfy.that the original power ofattorney of which.>: the foregoing is a full; true, r : y is:in full �force-and :effect on the date: -of this certificate --and 1 do-furthee certify that the officer or official wha - _ - _ - _. - executed .-the : said ower of a Js-an ,Assistant. Secrets s ,eciall authorized b ,;the chairman or=the resident to appoirit attorneys=in fact as R_ ry p Y- y P ,provided in_Article IV, Section-12.of the -By laws -of First Nationakinsurance Company of.Anienca Thin certificate and the above.:power -of attorney may be signed by facsimile o� mechanically reproduced signatures under and by_authority of the, _ 'following vote -of the board: of directors of First:National Insurance Company of Amencaat-ameeting duly called and"_held on the-18th-day of September;;- 2009:.: - -VOTED that the facsimile or mechanically reproduced signature of any assistant secretary of the company wherever app sting upon a,certfied: copy of any power of attorney -issued by the company in connection with surety bonds;' hallbe-valid-and-binding-upon:the company:with the same force.and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my narnan xed the corporate seal of the -said company .this 1 S-i >_day of AUGUST 2011- p c 3 - 1 S A1_ By David M.Carey,~A_stantSecretary- Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: 3� Z Project: 6 N-1r, G. _ 6 NJ;2 ��it� i V�i1�Z► f'mr" tJ't. S-1. mppr nl3 U nr S� The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor_ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 1� day of , 20� 1 , at ���%��� , California. (,C*) 3n nU�_77 �z % (Type Contractor Name) By_ Name: [Type Name] Title: [Type Title] QN`N_ ��� fRMRNiE4 -TLS 03- ab - cYlp Z<75a2., CONI`RACTOWS CERTMCA.TE I, �ANUVC�_' , state and certify that: {Name of Declarant) L�l-P is the general contractor to the City of Huntington Beach ("City') on Contract No. 1'3) Z (the "Contract") for the construction of the public work of improvement entitled: ��F 1 Cis �c�1�'L 1 ��'iP►�PJiI.��A'!��✓`-t � ��'Q�t�7M (�-�) 7. -_ (the "Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3. Except for the claims listed -below and the disputed claims listed in paragraph five (5), ail persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): �6NX 4. Attached hereto are the lien waivers required by the Contract Documents, which lien. waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at 0n-1� 0z),um on this t\J day of kq , 201( , (Signature of Declarant APPROVED AS TO FORM By: - �I 1 -71,01J_� 3. Zo-ocf Name: [Type Name] Title: [Type Title] 245914 1 08/02/2011 13:32 FAX 17145204027 TRAFFIC LOOPS CRACKFILLI 1�001 UNCONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT [ Califontia civil code 3262 (d) (4 ) The undersigned has been paid in Rill for all labor, services, equipment or material furnished to: Bannaoun Engineers Constructors on the job of City of Huntington Beach located at: Garfield Ave. Rehabilitation - CC 1372. and does hereby waive and release any right to a mechanic'c lien, stop notice, or any right against a labor and materials bond on the job, except for disputed claims for extra work in the amount of : 0.00. Date: August 02, 2011 Traffic Loops Crackfilling Inc. 946 S. Emerald St. Anaheim CA 92804 By: )Ui/ -- �7 MA -Lan Nguyen P ent NOTE: This form of release complies with the requirements of Civil Code Section 3262 (d)(4) CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT (Civil Code Section 3262(d)(1)) Upon receipt by the undersigned of a check from BANNAOUN ENGINEERING in the sum of $ 1,772.88 payable to J & S STRIPING COMPANY, INC. and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's lien, stop notice or bond right the undersigned has on . the job of CITY OF HUNTINGTON BEACH located at GARFIELD AVE PROJECT # 12- 1372 — HUNTINGTON BEACH. CA — INVOICE 7916RT- JOB# 3102-S AH This release covers a progress payment for labor, services, equipment, and or materials furnished to BANNAOUN ENGINEERING thru 07/21/2011 only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received, extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material was not compensated by the progress payment. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. Dated: JULY 21, 2011 J & S STRIPING COMPANY, INC. DY ARAGON — OFFICE MANAGER CONTRACTORS LICENCE # 538211 - C-32 HIGHWAY IMPROVEMENTS OUR NEW PHYSICAL ADDRESS &REMIT ADDRESS IS: 1544 S. VINEYARD AVENUE- ONTARIO, CA 91761 PHONE (909) 947- 8073 - FAX (909) 947-9489 08 02/2011 15:34 FAX 171497476Y3 "it -ill a��ul���a.�•.. Upon paid by the mechanics' final payment job, except for of this docume Dated: SS11-464 S(DIL S7'ASILIZATI:C )N & ASPHALT 17UL'VERIZA-FRDN CONDITIONAL WAIVER AND RELEASE UPON ]FINAL PAYMENT California Civil Code Section 3262 (d) (3) eipt by the undersigned of a check from BANNAOUN ENGINEERING ,RS CORP. in the sum of 57,789.1.6 payable to SOIL STABILIZATION & VERIZATION and when the check has been properly endorsed and has been upon, which it is drawn, this document shall become effective to release any stop notice, or bond right the undersigned has on the job of CITY di1H�F BLEACH' located at GARFIELD AVENUE RERAB (FROM NEWLAND AGNOLIA STREET), HUNTINGTON BEACH CA. This release covers the the undersigned for all labor, services, equipment, or material wished on the sputed claims for additional work ju the amount of S-0.00-. Before any recipient relies on it, the party should verify evidence of payment to the undersigned. Sail Stabilization & Asphalt Pulverization By: Charlotte -v ado, Office. Manager NOTE: CIVIL CODE 3262 (d) (3) PROVIDES: Where the claimant is required to execute a waiver sand release in exchange for or in order to induce payment of, a final payment and the claimant is not, in fact, paid in exchange for the waiver and release or a single payee check or joint check is given in exchange fr r theiwatver and release, the waiver and shall. follow substantially the form set forth above_ JCN# ALL AMERICAN ASPHALT ALL. AMERICAN AGGREGATES P,O, BOX 2229, CORONA, CA 92878-2229 STATE CONTRACTORS LICENSE #267073-A CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT Upon receipt by the undersigned of a check from BANNAOUN ENGNRS- CONSTRUCTORS in the sum of $45,988.89 payable to All American Asphalt and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanics' lien, stop notice, or bond right the undersigned has on the job of CITY OF HUNTINGTON BEACH located at GARFIELD AVE REHAB C#ESPL5181-168; MAGNOLIA & GARFIELD, HUNTINGTON BEACH, CA This release covers the final payment to the undersigned for all labor, services, equipment, or material furnished on the job, except for disputed claims for additional work in the amount of $0.00. Before any recipient of this document relies on it, the party should verify evidence of payment to the undersigned. Dated: 7/29/ 11 All American s halt By: Shirley R. Spenc — Credit ager TELEPHONE: 951-736-7600 - FAX: 951-739-4657 UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Civil Code Section 3262(d)(2) The undersigned has been paid and has received a progress payment in the sum of $ ice or labor, services, equipment or material furnished to n tl q i)yyl YOUR CUSTOMER on the job of NLh� _ cated at rfb-e 14 C m 3 -7 %- OWNER JOB DESCRIPTION and does hereby release any mechanic's lien, stop notice or bond right that the undersigned has on the above referenced job to the following extent. This release covers a progress payment for labor, services, equipment, or material furnished to air 4 ROOir through 11 YOUR CUSTOMER DATE only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recovar compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment, or material was not compensated by the progress payment. Dated: 19 1`2. 11 COMPANY NAME By: TITLE NOTICE: THIS DOCUMENT WAIVES RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID, USE A CONDITIONAL RELEASE FORM. NOTE: This form complies with the requirements of Civil Code Section 3262(d)(2). It is to be used to release claims to the extent that a progress payment has actually been received by the releasing party. Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O_ Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VIi of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: % F i GL Ali c N\j � vAi L4-7,pm z>� ` M kr3ft,' iD Z,-Z-T 1 > S'r+8,c� The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VU of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applit for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilitie.S at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct_ Executed this L �0 day of �� , 20 t � , at t* S �"�-�1 , California, (Type Contractor Name) ti� \ Name: [Type Name] 4 Title: [Type Title) E 1 IF � a t p CY- p c7RNEy DMNZ 1AAUDV. p pars 245911 1 1 , RECEIVED BY: (Name) J (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: _.Shar6Freidertr--ich, City Treasurer FROM: 191 DATE: SUBJECT: Bond Acceptance I have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. -- MSC No. Approved ) -� /,)/) l t� (Counc#'Approva) Date) Agenda Item No. City Clerk Vault No. ( Z)A #27 gAollowup/bondletter.doc FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND Bannaoun Engineers Constructors Corp. FOR Garfield Avenue Rehabilitation From Newland Street to Magnolia Street CC-1372 THIS AGREEMENT ("Agreement") made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and Bannaoun Engineers Constructors Corp, a [type of entity and State] California Corporation , hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as Garfield Avenue Rehabilitation From Newland Street to Magnolia Street CC-1372 in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not g/agree/ surfnet/federal const Page 1 of 27 5110 limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; g/agree/ surfnet/federal const Page 2 of 27 5/10 D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference), and the Federal Requirements from FHWA 1273 and additional requirements (which is attached hereto as Exhibit "B"); F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. g/agree/ surfnet/federal const Page 3 of 27 5/10 Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed Seven hundred and sixty six thousand, four hundred and fifty four dollars, Dollars ($ 766,454.50 ), as set forth in the and fifty cents. 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 Fifty 5o consecutive working days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/ surfnet/federal const Page 4 of 27 5110 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/ swfnet/federal const Page 5 of 27 5/10 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/ surfnet/federal const Page 6 of 27 5/10 secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of Five Hundred Dollars ($ 500.00 ) per day for each and every working day's delay in completing the work in excess of the number of working/calendar days set forth herein, which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. g/agree/ surfnet/federal const Page 7 of 27 5/10 CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall . be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DIFFERING SITE CONDITIONS A. Notice: CONTRACTOR shall promptly, and before such conditions are disturbed, notify DPW in writing of: (1) Subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents; or g/agree/ surfnet/federal const Page 8 of 27 5110 (2) Unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the character to be performed under this Agreement. DPW shall promptly investigate the conditions and if it finds that such conditions do materially so differ and cause an increase or decrease in the time required for performance of any part of the work under this Agreement, whether or not changed as a result of such conditions, an equitable adjustment shall be made and the agreement modified in writing accordingly. B. Time Extension: No claim of CONTRACTOR under this Section shall be allowed unless CONTRACTOR has given the notice required hereunder provided, however, the time prescribed therefor may be extended by CITY. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an g/agree/ swfnet/federal const Page 9 of 27 5110 increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, ten percent (10%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the Agreement price shall not be considered as a acceptance of any part of the work. g/agree/ surfneU£ederal const Page 10 of 27 5110 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by g/agree/ surfnet/federal const Page 11 of 27 5110 CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, g/agree/ surfnet/federal const Page 12 of 27 5110 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 without the prior written consent of CITY; however an insurance "deductible" of $5,000.00 or less is permitted. 21. CERTIFICATES OF INSURANCE• ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. g/agree/ surfnet/federal const Page 13 of 27 5110 CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten (10) days of receipt of such claim or claims. 23. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default g/agree/ surfnet/federal const Page 14 of 27 5/10 by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. g/agree/ surfnet/federal const Page 15 of 27 5110 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: g/agree/ surfnet/federal const Page 16 of 27 5110 TO CITY: City of Huntington Beach ATTN: John Gri f fin 2000 Main Street Huntington Beach, CA 92648 30. SECTION HEADINGS TO CONTRACTOR: Bannaoun Engineers Constructors Corp. 9614 Cozvcroft Chatsworth, CA. 91311 The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. g/agree/ surfnet/federal const Page 17 of 27 5110 33. ATTORNEY' S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 34. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 35. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. g/agree/ surfnet/federal const Page 18 of 27 5110 36. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 37. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 39. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of g/agree/ swfnet/federal const Page 19 of 27 5/10 Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 40. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty- five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is g/agree/ surfnet/federal const Page 20 of 27 5110 required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 42. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 43. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 44. FEDERAL PARTICIPATION The PROJECT pursuant to which the work covered by this Agreement is being executed is being assisted by the United States of America. Several Agreement provisions embodied herein are included in this Agreement in accordance with the provisions applicable to such federal assistance. As federal funds are financing all or part of this work, all of the statutes, g/agree/ surfnet/federal const Page 21 of 27 5/10 rules and regulations promulgated by the Federal Government and applicable to the work will apply, and CONTRACTOR agrees to comply therewith. Attached is FHWA Form 1273, known as Exhibit "B", which describes required contract provisions for federal -aid construction contracts. Additionally, the CONTRACTOR shall insert in each subcontract all of the stipulations contained in the Required Contract Provisions of Form 1273, and further require their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. Certain sections of Form 1273 may not be applicable depending upon the project and will be crossed out. 45. ADDITIONAL FEDERAL REQUIREMENTS CONTRACTOR agrees to abide by the additional requirements necessary for federal aid (see pgs. 12-14 of Exhibit "B"). The CONTRACTOR agrees to buy only steel and iron made in the United States for all federal -aid construction projects ("Buy America"). The CONTRACTOR also agrees to be subject to the legislative and regulatory Disadvantaged Business Enterprise (DBE) requirements (42 USC Section 2000d, et seq.). If the CONTRACTOR does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non -collusion certification. Select projects may also require "Federal Trainee" or "On -the -Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined g/agree/ surfnet/federal const Page 22 of 27 5110 by the Department of Labor (29 CFR part 5) in accordance with the Davis -Bacon Act (40 USC Section 276a to 276a-7) for each craft or type of worker needed to perform this Agreement. CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 47. DISCRIMINATION, MINORITIES, ALIENS The CONTRACTOR or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The CONTRACTOR shall carry out applicable requirements of 49 CFR, Part 26 in the award and administration of DOT -assisted contracts. Failure by the CONTRACTOR to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as recipient deems appropriate. 48. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled 'Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit "B") CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section. 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. g/agree/ surfnet/federal const Page 23 of 27 5110 Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 (38 USC Section 219 et seq.) prohibits job discrimination and requires affirmative action to comply and advance in employment (1) qualified Vietnam veterans during the first four (4) years after their discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 49. COPELAND "ANTI -KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations (29 CFR part 3), which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight (8) hours and standard workweek of forty (40) hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 times the basic rate of pay for all hours worked in excess of eight (8) hours in any calendar day or g/agree/ surfnet/federal const Page 24 of 27 5110 forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 306 of the Clean Air Act and section 508 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements g/agree/ surfnet/federal const Page 25 of 27 5/10 52. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 USC Section 6201, et seq.). 53. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 54. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 55. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, g/agree/ surfnet/federal const Page 26 of 27 5110 inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on �CG7 —�4 � 20/0 _ CONTRACTOR I kJ 1 BY: -- �N�Pc2.- print name ITS: (circle one) Chairma residen Vice President AND \ By: tr; eITS: (circle oncret Chief Financial Officer/Asst. Secretary - Treasurer CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California iayor INITIATED AND APPROVED: �( Director of Public rks REVIEAWjA(WD APPROVED: Administrator APPROV)DAS TO FORM: ,'�' t) City Attorney ��1 g/agree/ surfnet/federal const Page 27 of 27 5110 ACKNOWLEDGMENT State of Califcrnia County of Los Angeles ) On 22 December 2010 before me, Michele Etyemezian, Notary Public (insert name and title of the officer) personally appeared Omar G. Maloof who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and�yofficial sal. ft Cenwnlon # 117908" Los AnVONa C L%-r**XM9VWfQb7.2012 Signature (Seal) FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND Bannaoun Engineers Constructors Corp. FOR Garfield Avenue Rehabilitation From Newland Street to Magnolia Street CC-1372 TABLE OF CONTENTS Page No. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 4 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 5 7. NOTICE TO PROCEED 5 8. BONDS 6 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 7 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 11 17. WAIVER OF CLAIMS 11 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT & TERMINATION 14 24. TERMINATION FOR CONVENIENCE 15 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON -ASSIGNABILITY 16 27. CITY EMPLOYEES AND OFFICIALS 16 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 16 29. NOTICES 16 30. SECTION HEADINGS 17 31. IMMIGRATION 17 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 18 34. INTERPRETATION OF THIS AGREEMENT 18 35. GOVERNING LAW 18 36. DUPLICATE ORIGINAL 19 37. CONSENT 19 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 19 39. CALIFORNIA PREVAILING WAGE LAW 19 40. CALIFORNIA EIGHT -HOUR LAW 20 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 21 42. EMPLOYMENT OF APPRENTICES 21 43. PAYROLL RECORDS 21 44. FEDERAL PARTICIPATION 21 45. ADDITIONAL FEDERAL REQUIREMENTS 22 46. DAVIS-BACON ACT 22 47. DISCRIMINATION, MINORITIES, ALIENS 23 48. EQUAL EMPLOYMENT OPPORTUNITY 23 49. COPELAND "ANTI -KICKBACK" ACT 24 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 24 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 25 52. ENERGY CONSERVATION 26 53. HOUSING AND URBAN DEVELOPMENT 26 54. SIGNATORIES 26 55. ENTIRETY 26 11 I - SECTION C PROPOSAL. for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO.1372 FEDERAL AID PROJECT ESPL-5181 (168) 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 50-working days, starting fromthedate specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or .lump _sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 U Q r,'J in the amount of $ 1090 90 CYC60 which said amount is not Iess 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: [-0 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowledge receipt and review of Addendum Number One, dated November 1, Z" -.. 8 C, Company Name By ON VL, N N'JJ aWIYJi Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. PROJECT BID SCHEDULE - Garfield CG1372 SECTION C r j; ' ass.. -.�; E 1j&, CC NO. 1372 PROJECT BASE BID: GA.REIELD AVENUE — from Newland Street to Magnolia Street C-2.2 to C-2.4 11,1133311 C-2.1 PROJECT BID SCHEDULE - Garfield C4.1372 ..:..:::::.:......#: vith::104 rice::;:;;:::::::::`::::;;`::: ::; :.:.:.:.:::.:>:::: r >r tt t: a tr>E`d ::<::::::.....•.....::•::; :•:::X7u t• *'� e;>::::::: I 1 LS Mobilization 00 $ 3,00G— e • $ 3, 66®' 2 1 Traffic Control Plan LS $ 3, 56Q $ 6_ 3 1 LS Furnish Project Traffic Control oti o® 4 470 Unclassified Excavation (includes disposal of material and fabric) o0 CY $ D� $ /4 00 — Pulverize, Remove excess, Grade, Cement Treat, Microerack by 5 139890 FDR Process (includes disposal) pS Sro SF $ S If -I 04 6 55530 Surface Grind (0.1 T) (includes diposal of materal and fabric) p D, Oe /04 — SF $ $ //, 7 3265- Construct Asphalt Concrete (0.25' & 0.75' per plan) oti 67 e_ TN $ $e?lf%SS' 8 2560 Construct Asphalt Concrete (0.1 T ARHM Overlay) 80 TN $ tF OOP Remove & Reconstruct Curb& Gutter (CF=8", Includes AB) per 9 1845 LF Std Plan 202 b $ 10 370 Remove existing sidewalk (includes disposal) SF $ I $ 484 — Remove & Reconstruct Sidewalk per Std Plan 207 (includes 11 7000 SF disposal) $ 4 $3�,ss� Remove and Reconstruct Commercial Driveway per HB Std. Plan 211 (including all appurtenances but not limited to: onsite 12 500 improvements, retaining curb, slot pave, etc.) oft °° 40� SF $ $ C-2.2 PROJECT BID SCHEDULE Garfield CC-1372 Tte ri �stiAia e€1 ......: vi#1i: ii ...=...rice.......:....:..:< ::::::::::::::=.:: _ =aiteiiilcct:-<: t Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 1.3 2 slot pave, etc.) per Caltrans Std. A88A •o EA $ I G?o $ 3300 _ 7 Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 14 3 slot pave, etc.) per Fountain Valley Std. 204-3, Case "C" 60 o0 EA $ / S'SO $ 4, r0a i 15 1 Install Truncated Domes to existing access Ramp s o •o S 60 EA $ 660— $ 16 13 Adjust Sewer/Storm Drain Manhole to finished surface oo ®o EA $ 3 SO $ 4S SD 17 1 Adjust OCSD Sewer Manhole to finished surface es• $ 3S' O ao $ EA 18 11 EA Adjust City of HB Water Valve to finshed surface oo $ 7 S ve $_ 19 12 Adjust City of Fountain Valley Water Valve to finished surface EA $ C9 % $ 20 1 Adjust Monitoring Well to finished surface -7 -7 EA s $P 21 4 EA Raise Survey Monument Well to finished surface 8• $ -7 Ao $ 1 160 Sunuay�MenumenteOep-City to Provide Survey Monumentation 22 -4 4— (Not a Bid Item) EA $ $ Remove existing Tree and Roots; Grind Tree Stump and roots to 23 14 EA 24" below Top of Sidewalk/Grade oe $ 6S O —" $ OO Furnish & Plant 24" box trees (remove existing landscaping and a 00 24 14 EA irrigation to accommodate 24" box trees, replace irrigation in kind) $ 5o $ % f C-2.3 PROJECT BID SCHEDULE - Garrield CC-1372 ..................... #j ......... ............... I .... ........ ....... ....... .......... ....... ...... ........... .... ... . ...... ... * ...... . eic 25 RLS 1 1 Provide 90 Day Plant Establishment $ 26 1 LS Provide I Year Maintenance $ 27 1 LS Traffic Signing and Striping per plan 06 $ 960 $ /S",.SOO- 28 22 EA Install Traffic Loops 00 $ -)Io — so $ 46 29 1 LS Traffic Signal Pullbox and Relocation and Conduit Installation, $ V? 1, -560 ab $ .21, y0b 30 1 LS Median nose reduction and crosswalk modification per Appendix S in Specifications. $ ISO Total Amount Bid in Figures: $ '744, 4,54r Total Amount Bid in Words: %t4s! 4a, 6.-e. -404d.. f-w. _V.. .64,.q.j -1, .......................... ...... C-2.4 SECTION C In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. NDNC®LLUSI®N AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. Coftft+y o4� er-migo. Los (a rLc S OHAL �+�1-0. , being first duly sworn, deposes and says that he or she is of Oi;+�: Cam,► +� �atfie ���J party making p art the t g 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-ber 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. C7MPW- lAAt_oc)(-_ Name of Bidder (-01"—) S'Z TL J -' 7Z)f— S Signature of Bidder Address of Bidder Subscribed and sworn to before me this Z�l day of dL (( .�V , 201 0 . A CI Y- c M T'"% C-4 ACKNOWLEDGMENT State of California County of Los Angeles ) On 27 October 2010 before me, Michele Etyemezian, Notary Public (insert name and title of the officer) personally appeared Omar Maloof who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official eal.mM��TM MY I% Notary Public - California Loa Angola County 1 11*Cwnw 9FhXFeb 7. ZOtZ ww�r.�•rwrr�a■ Signature (Seal) NOTARY PUBLIC UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned- further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 2;`l 0 C --� 10 Cc)fr,e Contractor a By Title C-S 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 W! 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 Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 1`, 10 vj--�tjOftDo'f'-) ;(\)6-10 s Contractor e By C-7 BIDDER certifies that the following information is true and correct: Bidder Name Business Address City, State Zip �C� ) q q,, - ®5c,i Telephone Number z--13-zc:-% /Ir. . ('� State Contractor's License No. and Class - Original Date Issued Expiration Date The work site was inspected by ofour office on Z® ()c c0C `Yd.,2010 The -following are persons, firms, and corporations having a principal interest in this proposal: ©M►- M 0 0 b,1k0t0A,D c,J %QNL-, Z�5 C-s The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Company Naive 4 Signature of Bidder Printed or Typed Signature Subscribed and sworn to before me thisay of (--C , 201 O MICHELE EME"MEZiAN e, Commission # 1790836 Notary Public - California Los Angeles County NOTARY PUBLIC 3 l*Canm.E> %b7,2o12 �� �,�-�j.,� 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: r✓'®� 'r`� Dr Lz)'S A kXa r2-c-'� , � 8lwZ-TAI �-1 C-:r- PJbuL, v'U 'tom Name and Address of Public Agency Name and Telephone No. of Project Manager: J1 M Mkl S to��Pt-J . 10 4y� lejl �Oo- yyk*� Iyv1q�'li It., Zviv Contract Amount Type of Work Date Completed 2. VON ZS E on-r A J,':� , Name and Address of Public Agency Naive and Telephone No. of Project Manager: M M\/ !S VA kQN^--, yj � L � � -% (,0 ? � Sim( --� op, o ® C' 2,9 Contract Amount Type of Work Date Completed C t`- \/ a F Name and Address of Public Agency Name and Telephone No. of Project Manager: �AASCQD Cc H j(A�A Q = � � pl(OOD S-T-T l31 z— Contract Amount Type of Work Date Completed C-9 HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: �►7J�� �N�1� ���`1��k�� �+f Contact Person: 0 Rwz, MAD F Contact Phone: `1� -01016). Signed: . Date: 2'1 0 c--7 O 'kNote: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This formis intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalRepycle.ca.gov/Rep,ulations/Titlel4/ . Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: ! '-.,JAWr3 C3�40 AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: MAILING ADDRESS: gv"ky C As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Signature Date Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that maybe filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C-12 (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION Thebidder G}�-� G��' , 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 60-13(b)-(1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by.the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-1 4 Marcia 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has ,_,,,_, , has note"^been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1 101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder,, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No V if the answer is yes, explain the circumstances in the following space. C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-16 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section l l2 and Public Contract Code Section 7106) To the CITY / COUNTY of DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract ofanyoneinterested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the -contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E P5&E Checldist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: a Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; a Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; a Does not have a proposed debarment pending; and a Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily.result in -denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-18 ]March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) if any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all -lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-19 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G C0MPLE fF 'I'I'115 1;QKM 10 DISCLUSE LU13BY1N(j AC 11 V111tZ5 FUKJUAN I Iy i l U.0A( i J7< 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: P(la. contract Fol%a. bid/offer/application El a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year_ quarter_ f. loan insurance date of last report 4. Name and Address of Reporting; Entity 5. If Reporting Entity in No. 4 is Subawaroee, Prime Enter Name and Address of Prime: � Subawardee Tier , if known ri j Congressional District, if known G. Federal Department/Agency: 00 �WkJQ S. Federal Action Number, if known: Congressional District, if known 7. Federal Program Name/Deseription: �) Qwd)'> CFDA Number, if applicable 9. Award Amount, if known: U t' fV- ,{) IJ 10. a. Name and Address of Lobby Entity b. lndividuals Performing Services (including (If individual, last name, first name, MI) address if different from No. 10a) (last name, first name, MI) IJ 1r� �'✓-� P..' 'QN4N3VO (attach Con ' uation Sheet(s) if n/aine li. Amount of Payment (check all that ly) 13. Tment {check all t apply} $ actual planned ner -time fee ,�y12. Form of Payment (ch all that apply): missi 1 V a. cash — d ent feeb. in-k' ;specify: nature redvalue El r, specify14. Brief seription of Services Performed or to be performed anf Service, including offic t {s), etnployee(s), or member{s) contacted, for Payment indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheets) attacbed: Yes F No 1 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made 1 or entered into. This disclosure is required pursuant to 3I Print Name: U U.S.C. 1352. This information will be reported to Congress 7� , semiannually and will be available for public inspection. Any Title: person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Telephone No.: 3 Federal Use Only: LLL Rev. 09-12-97 Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-20 March 15, 2001 EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known.- 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available.for the federal action identification in item I (e.g., Request for Proposal-(RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C 21 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-9NENDIF» Page 12-89 LPP 01-04 c-zz March 15, 2001 Local Assistance Procedures Manual EXHIBIT 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) EXHIBIT 15-G1 LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) NOT& PLEASE REFER TO INSTRUCTIONS ON THE �REVERSE SIDE OF THIS FORM LOCAL. AGENCY; GI (Y t�F� ��� ��` `)N LOCATION: PROJECT DESCRIPTION: ��Gli IAA Ir � TOTAL CONTRACTAMOUNT: $� 744 s 4 54 s O BID DATE: BIDDER'SNAME: CONTRACT UDBE GOAL:+ CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a UDBE) UDBE CERT NO. AND EXPIRATION DATE NAME OF EAC14 UDBE (Must be certified on the date bids are opened - include UDBE address and phone number) DOLLAR AMOUNT UDBE ra R 638033 raft x- (A'e w a(, 1.470 o. bs M„atd s . i Sao - SON. For Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all UDBE certifications have been verified and information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number: Total Claimed UDBE Participation & iao �1 3.4 % r.m Signature of Bidder Date (Area Code) Tel. No. CQ k�t Person to Contact (Please Type or Print) Local Agency Biddcr UDBE Commitment (Construction Cataracts) (Rev U26/09) Distribution: (1) Original —Local agency files Page 15-31 LPP 09-02 C-23 3uly 31, 2009 EXHIBIT 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) I ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1.) African Americans; 2) Asian -Pacific Americans; 3) Native Americans; 4) Women. This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the bid nonresponsive A UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: African Americans, Asian -Pacific Americans, Native Americans, or Women. The form requires specific information regarding the construction contract: Local Agency, Location., Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or -Materials to be provided by UDBEs. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces, if a UDBE. The UDBE shall provide a certification number to the Contractor and expiration date. Enter the UDBE prime's and subcontractors' certification numbers.The form has a column for the Names of-UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). IMPORTANT: Identify all UDBE firms participating in the project regardless of tier. Names of the First -Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the UDBE participation dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be -performed or - furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of UDBE firms. Exhibit 15-Gl must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-32 July 31, 2009 C 24 LPP 09-02 Local Assistance Procedures Manual EXHIBIT 15-G2 Local Agency Bidder DBE Information (Construction Contracts) EXHIBIT 15-,G2 LOCAL AGENCY BIDDER DBE INFORMATION (CONTRUCTION CONTRACTS) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCALAGENCY:Cni O1'r&iACtI LOCATION: PROJECT DESCRIPTION: TOTAL CONTRACT AMOUNT:. $ '61.4 L� S'4 �-0 BID DATE: BIDDER'S NAME:VJ(J�f ( J/ ii ��� `7J✓� C:.?� t1`° CONTRACT UDBE GOAL: CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE DBE CERT NO. AND EXPIRATION NAME OF EACH DBE (Must be certified on the date bids DOLLAR AMOUNT DBE SUBCONTRACTED OR MATERIALS DATE are opened - include DBE address O BE PROVIDED (or contracted ifthe and phone number) bidder is a DBE 449 jn!�^4!r L 3 re S' b 3 0 33 Tv-C;c tabes �iti` ?6T112a -� `7 sao —goat tmrC �e+ri �+'� a►[, a b 7 / _ S eye ks L ('rac.�: 39,000 t a . 6ko _ a O®tL-a CA 7 - 2sra -For Local Agency to Complete: Total Claimed DBE ._ Local Agency Contract Number: Participation Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certification have been verified and t Information is complete and accurate. Signature of Bidder Print Name Signature Date Local Agency Representative Z���-l•1 � �`2 <�—`� Date (Area Code)�^['el. No. (Area Codc) Telephone Number:` For Caltrans Review: Person to Contact (Please Type or Print) Print Name Signature Date Caltrans District Local Assistance Engineer Local Agency Bidder DBE Information (eonstniction Contarcts) (Rev 6/26109) Distribution: (1) Copy — Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days ofcontract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a LPP 09-02 C-25 July 31, 2009 EXHIBIT 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Local Agency, Location, Project Description; Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces, if a DBE.The DBE shall provide a certification number to the Contractor and expiration date. Enter DBE prime and subcontractors certification number. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15-GI), regardless of tier. Names of the First -Tier DBE subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars - and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed -or furnished by the DBE.) See Section ""Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts) to determine how to count the- participation of DBE firms. Exhibit 15-G2 must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Number, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and sending a copy of the -form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all informations is complete and accurate. Once the information has been verified, the District Local Assistance Engineer- signs and dates the farm. Page 15-32b July 31, 2009 C-26 LPP 09-02 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION —GOOD FAITH EFFORTS UDBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. - �� ���'� Bid Opening Date -11v-3C,-7 ¢ AC+1 The (City/county of) established an Underutilized Disadvantaged Business Enterprise (UDBE) goal of ',}A% for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder UDBE Commitment" forin indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed -by the Bidder (please attach copies of advertisements or proofs of publication): Publications N j � Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): I U• -17) - i-C O)Z� /�-[(/k-C;h �N Names of UDBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation LALA, 11 ?�I NiM zl = vho!�� ''( 'i � � If JG �J� c. �1-' 1p A.y� (v ll . Page 15-33 LPP 09-02 C-27 July 31, 2009 ENGINEERS CONSTRUCTORS Corporation GQVER Evc4qaRmGCoNmAcroRs Gu\ERAt_R-i DWGCoMRA(- oRs CONSULTING EN&4Egts License #: A, B, 827829 A Tradition of Excellence in Design and Construction 27 October 2010 Underutilized DBE Women/Minority/Disadvantaged Business Owners 9614 Cozycroft Avenue Chatsworth, CA 91311 Tel: 818.775.0040 Fax: 818.775.0050 RE: City of Huntington Beach - Garfield Avenue Rehabilitation (From Newland Street to Magnolia Street) - CC# 1372/ Federal Aid Project ESPL - 5181(168) Bid Date - Thursday, November 4, 2010 @ 2:OOPM Business Owners; Bannaoun Engineers Constructors Corporation is bidding the above mentioned project as a Prime Contractor. Being an Underutilized DBE, Women/Minority/Disadvantaged Owned Business, or a DBE, your support in this process is imperative to the overall goals and objectives for this project. Please forward your proposals to our office prior to bid date and time to allow for a proper review and incorporation into the final bid package. We are looking for all areas of expertise, category, trade and product to assist in the completion of this federally funded project. Bannaoun Engineers Constructors will assist as needed. Should you have any questions or concerns, please feel free to contact our office at 818.775.0040 and please fax your proposal to 818.775.0050. Please be aware that Bannaoun Engineers Constructors Corporation is looking forward to working with you on this project as well as other projects in the near future. Sincerely, Bannaoun Engineers Constructors Corporation An Equal Opportunity — Affirmative Action Employer Exhibit 15-H Local Assistance Procedures Manual UDBE Information -Good Faith Effort C. The items of work which the bidder made available to UDBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (QN) Contract ,�q g e s '�,���-F�� c to�+r�� �� I A0 3 .30 6 D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection .of the UDBEs: 0i_ CAN-xsl Y,3 —N�J PLiz�)wW Names, addresses and phone numbers of firms selected for the work above- E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: W rr e/ t This `T.im",_-- Page15-34 July 31, 2009 C-28 LPP 09-02 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: N'3Q = A—( It O 0 "c G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary):. NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-02 C-29 July 31, 2009 Local Assistance Procedures Manual. EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of th ode of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Phone/ . Annual rt Address/ Fax Gross. bescript>on of Portion of Work to be Performe` a f t x r Ci ,State, ZIP ecel is Name Phone ❑ < $1 million C1 < $5 million .•._-._.......----------- ---_._..•........ ... Address ❑ < $10 mullion „t Fax ❑ <$15 million' a i City State ZIP © > $15 million a Nance Phone ❑ <$1 million < $5 million Address < $10 mill ion Fax ❑ <$15 million City State ZIP > $15 million Name Phone U <$1 illion <$5 million Address < $10 million Fa.Y ❑ <$15 million City Stale ZIP ❑ > $15 million Name hone ❑ <$1 million ❑ <$5 million Address <$10 million Fax ❑ < $15 million City State ZIP ❑ > $15 million Distribution: 1) Original -Local Agency Pile Page 12-111 November 14, 2006 LPP 06-06 EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance Title an 0—:-- 14 nF+t,- O-A. n4 Fo ia.•ei Rannlntinnc Phntn�nnv thiC fnrm fnr ndrlitinnnl firm-. Firm Name/ !I Phone/ fflo,sbtt't.xs�. 't Address/ s�d..rt�r£Y lr s� Sd3Oil i'•,i'` r ev ' it - S ys i i �%. , 3tirs � `�' a �X I. L 1„ aa.h rrs,4KF Yi Y3X�`� ••� e t 4 , y� s St 1 jfl xtF F• t• ! •tt t 6 ^Yf�l W. t &. � f �• (` at�3 .1C t�iG� � r j J(n"- HER • i0 � f ut t I�i t t t �' Llt' J ait.*.�y 1SY1 �i"'n 5 i - �t t�'�� • ��'. ��K r ��1Tj��. �+�.�i}f r. 't H , 'I �slr ■ �,� lk t �`�, 3,� s �� f ! )f ty v �;�,�•V£��ti )�� �p SEIM £)S?!P k � )S (ti�S 7^ lr r � Distribution: 1) Original — Local Agency File Page ^ y n�` g (�(� V ,p /� � ,ten , November 14, 200G�� P �''U� t oo��—* LPP 06-06 .►\ 1 � 61M ENGINEERS CONSTRUCTORS Corporation GEvvERALENGwm?s GCONTRACToRs GENERAL BuILDNG CONTRACTCRS CovsuL-nNG EfvGz,Ea:Rs License #: A, B, 827829 A Tradition of Excellence in Design and Construction 27 October 2010 City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 9614 Cozycroft Avenue Chatsworth, CA 91311 Tel: 818.999.0394 Fax: 818.999.0395 RE: Garfield Avenue Rehabilitation (From Newland Street to Magnolia Street) CC#1372 To Whom It May Concern: In accordance with this proposal for the above mentioned project, Bannaoun Engineers Constructors Corporation, is driven to stand by and willing in a good faith effort to offer and to utilize Disadvantaged/Underutilized Minority Business Enterprises not just to meet but even exceed business standards and local and federal goals as well as the incorporation of any new qualified colleagues that fall under Section 3 criteria. Also, Bannaoun Engineers Constructors Corporation is a qualified Small Business and is certified with the State of California. Please be aware that any additional required documentation and information, for subcontractors as well as our company will be provided as soon as requested. Please feel free to contact us as soon as the apparent lowest bidder is established in order to complete the needed and necessary documentation to follow through with the award process. As always, Bannaoun Engineers Constructors Corporation is looking forward to work with your agency very soon with the above mentioned project or any project in the near future. Sincerely, Omar Maloof Bannaoun Engineers Constructors Corporation SAFECO Insurance Company ' PO Box 34526 Seattle, WA 98124-1526 FIRST NATIONAL SURETY BID BOND Conforms with The American Institute of Architects, A.I.A. Document No. A-310 KNOW ALL BY THESE PRESENTS, That we, BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION as Principal, hereinafter called the Principal, and the FIRST NATIONAL INSURANCE COMPANY OF AMERICA ATTN: SURETY CLAIMS DEPARTMENT of 1001 4TH AVENUE, SUITE 1700, SEATTLE, WA 98154 a corporation duly organized under the laws of the State of Washington , as Surety, hereinafter called the Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH as Obligee, hereinafter called the Obligee, in the sum of TEN PERCENT OF 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 GARFIELD AVENUE REHABILITATION (FROM NEWLAND STREET TO MAGNOLIA STREET) C.C. NO. 1372 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 26TH day of October 2010 BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION (Seal) 1 Principal Witness µme- lAF ; Q I? 1-05 , D`. s�-1 ` i itle FIRST NATIONAL INSURANCE COM ANY OF AMERICA Witness By / l () • ---- MARK D. IATAROLA, Attorney -in -Fact S-0054/FNEF 12/00 CA registered trademark of SAFECO Corporation FRP Lib �ry POWER First National Insurance Company of America 1001 4th Avenue OF ATTORNEY Suite 1700 Seattle, WA 98154 KNOW ALL BY THESE PRESENTS: No. 8062 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint *******HELEN MALONEY; JOHN G. MALONEY; MARK D. IATAROLA; KAREN JEAN HALL; MATTHEW C. GAYNOR; DEBORAH D. DAVIS; Escondido, its true and lawful attomey(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 21 st day of March , 2009 Dexter R. Legg, Secretary Timothy A. Mikolajewski, Vice President CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power -of -attorney appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." 1, Dexter R. Legg , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 26TH day of OCTOBER , 2010 SEAL s 1928 Dix* gkjj Dexter R. Legg, Secretary S-10491DF 3109 • 4 WEB PLIF .M A ■ R0-d k2%1L48 A A G ® ff%& 9@"1MAF%1rhK- A /+Y.IAA,#%'&& I 1ff-r%^RA1ff0L§ V --------- --»»-»1 State of California ) I� OPTIONAL SECTION SAN DIEGO ) CAPACITY CLAIMED BY SIGNER Coup 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. On 10/26/2010 before me, DEBORAH D. DAVIS, . NOTARY PUBLIC [1 INDIVIDUAL D ITRO Though the data requested here is not required by law, A could prevent fraudulent reattachment of this form. SIGNER(S) OTHER THAN NAMED ABOVE Bannaoun Engineers Constructors x z Corporation 9614 Cozycroft Avenue f Chatsworth CA 91311 1 pp(t? City of Huntington Beach City Clerk, Second Floor City Hall ` t 2000 Main Street Huntington Beach, CA 92648 tr Garfield Avenue Rehabilitation (From Newland Sc. to Magnolia St.) CC#1372 — Fed Aid #ESRL-5181(168) th Thursday, November 4 , 2010 @ 2:0OPM } g g TE `66 CERTIFICATE OF LIABILITY INSURANCE D2/16 ,DD010 � 12/16/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Rogers C nde RO NAME: y g Earl Insurance Corporation (A/C, NoNE , Ext):,,.��14) 637-0312 FAX (714)685-1880 888 S. Disneyland Dr., Ste 400 E-MAILADDREs: PRODUCER A0024022 CUSTOMER ID # Anaheim CA 92608 INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURERA:United National Insurance Co. '11445 INSURER B:Delo_S In_su_ranceCompany Bannaoun Engineers Constructors Corporation INSURERC: P O BOX 16352 INSURER D INSURER E Beverly Hills CA 90209 INSURERF: COVFRAGFS CERTIFICATG MI IMRPR•7r11 O/11 RRV MARTF.R A/T D'Ot/Icir%ki N11111Al2CR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PPOLICY EFF POLICY EXP _._T LTR TYPE OF INSURANCE INSR :i WVD '- POLICY NUMBER MM/DDlYYYY MM/DD/YYYY LIMITS GENERAL LIABILITY ;EACH OCCURRENCE ; _$ 1,000,000 X I COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED- - - - -- PREMISES (Ea occurrence)_ $_ 100, 000 A _ _ CLAIMS -MADE X_I OCCUR 11/4/2010 11/4/2011 X CBL0721788 MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 _ . GENERAL AGGREGATE i $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,000 I'! POLICY X IPE� LOC PER PROJECT AGGREGATE $ 5,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 X II. ANY AUTO ( a accident) BODILY INJURY (Per person) $ B DPA5504383 11/15/201011/15/2011 ALL OWNED AUTOS X BODILY INJURY (Per accident) $ X SCHEDULED AUTOS - PROPERTY DAMAGE $ HIRED AUTOS ,(�� �� A ! (Per accident) X t-1 -_. ._..._.._.._ _ _..._ .. ..--.._. ... _ NON -OWNED AUTOS ` FO ! Medical payments I S 1,000 Underinsured motorist S 1,000,000 j UMBRELLA LIAB; OCCUR k1KATH, '/,,,1 EACH OCCURRENCE I $ EXCESS LIAB I - _ CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ . RETENTION $ � ..... -_ $ _ WORKERS COMPENSATION : WC STATU- OTH-i AND EMPLOYERS'LIABILITY - Y/N TORY,LIMITS _ L..ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER nda ory n NH EXCLUDED? !NIA (Mandatory E.L. DISEASE - EA EMPLOYEE $ If yes, describe under ! .__.__... DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additiona{ Remarks Schedule, if more space is required) Certificate Holder(s) its officers, elected or appointed officials, employees, agents and volunteers are named as Additional Insured with respects General Liability per attached endorsement #CG2037 07/04 as required by written contract and primary coverage shall apply. Also named as Additional Insured with respects Auto Liability per endorsement #SACA0122 12/06 to be issued by the company and coverage shall be primary. Re: Resolution No. 2008-63 CITY OF HUNTINGTON BEACH 2000 Main St Huntington Beach, CA 92648 GANUtLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cynde Rogers/CLR sI `4o?- mwRu co Icuuuluta) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD r,Q� Cy NUM$F ClILD721788 COMMEROIAL GENERAL LIABILITY CG ZO 37 07 04 THIS ENDORSEMENT.CHANGES THE POLICY. PLEASE RED ff CAREFULLY, u-odifies iriaursnce provdW vnde-, thv f0owin,�j, COMMERCIAL GOJERAL UAOUTY CCNFRAGE. PART SCHEDULE Soction 11 � Wbo Is An linsumd i�� ansefljo� to ill(IlUde AS art addiiorlal irpsurexd the person(s) sur OQW,liza50'1(6) :-'hown in the Snhvdlulo' but oniv with' rft�,,aed tD 1iabffitv fw Ud, 'dam inivy" c� 'propem� - ap" "used. it wWe orm pal, t3y "y . our'wo*" at flan b:(,atiwl designated and doa-&bcd in the srhed- ule of lliw er-do-'sement performM for that additiom o imuf-ed ard inducted in operalions hazarc"' CG 20 37 0-2 04 prolw-r*'ies. Inn", M04 Page I at I k "The attaching clause need be completed only w hen this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 11/041.12010 at 12:01 A.M. standard time, forms a part of Policy No.: CBL0721788 Issued To: B-A-NNAOUN ENGINEERS CONSTRUCTORS CORPORATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LlBILITY 'COVERAGE PART If required under a written "insured contract" with you, the following is added to Subparagraph a. Primary Insurance of Paragraph 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: Notwithstanding the foregoing, the insurance afforded to any person or organization, who has been added to this policy as an automatic status additional insured is primary and non-contributing insurance, but only as respects " bodily injury" or " property damage" arising out of "your work" performed after the effective date of this policy under a written contract between you and such person or organization that requires you to maintain primary and non-contributing insurance and to include such person or organization as an additional insured under such insurance. EPA-! 4-18 (06/ 2009) Page 1 of 1 CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS ►bANN),nJ,3 FROM: (Contractor Name) (Street Address) C_l� c„3,� (City, State and Zip) TO: CITY OF HUNTINGTON BEACH PROJECT: RG 111a l S' 1 . 1 L. C� "* V3_- Z' DECLARATION Attached hereto is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement CG 2010 1185, which Certificate complies with the insurance requirements of the Contract by and between the City of Huntington Beach ("City' and the above -named Contractor ("Contractor's for the above -described project ("Project'). I declare under penalty of perjury under the laws of the State of California that the above statement is true and correct. D Signed on Cc, ,.5-r a �. 20l U ^ at C44-I/S.uvr A 44 (Date) (City, State) (Signature of Individual Wh is Making Declaration) Contractor hereby warrants and agrees to maintain Products and Completed Operations Insurance in compliance with the insurance requirements of the Contract for the Project. Said insurance shall be maintained through and until the expiration of all Warranties provided by Contractor. Said insurance shall contain Additional Insured Endorsement CG 2010 1185, naming City as an additional insured. Contractor shall supply to City, on at least an annual basis, a Certificate of Insurance and the aforementioned Endorsement evidencing continued coverage which meets the Contract requirements. Signed on neccoo4—y- --10, 20.1a at , ':-4 (Date) (City, State) CONTRACTOR: Name:(�,J��t�1 G�-P Jrt-ft—rio,�J 1 By Name: Title: P--r<5 I i 277621.2 POLICYHOLDER COPY SD P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-14-2010 CITY OF HUNTINGTON BEACH PUBLIC WORKS 2000 MAIN ST HUNTINGTON BEACH CA 92648-2702 GROUP: 000497 POLICY NUMBER: 0000900-2010 CERTIFICATE ID: 16 CERTIFICATE EXPIRES: 11-01-2011 11-01-2010/11-01-2011 SO JOB:GARFIELD AVENUE REHAB PROJECT #CC1372 (NEWLAND TO MAGNOLIA STREET) This is to certify that we have_ issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - MALOOF , OMAR P,S T - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 11-01-2010 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. AtFER El AS TO FORM Mc GRATH,, City Attomey EMPLOYER BANNAOUN ENGINEERS CONSTRUCTORS CORP PO BOX 16352 BEVERLY HILLS CA 90209 SO [DRS,CS] PRINTED : 12-14-2010 (REV.8.2010) City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK February 4, 2011 Bannaoun Engineers Constructors Corp. 9614 Cozycroft Chatsworth, CA 91311 Re: Garfield Avenue Rehabilitation from Newland St. to Magnolia St. — CC-1372 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title Vll of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the. City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5437. Sincerely, s" an 7Flynn, CIVIC City Clerk JF:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid Bond (original) Sister Ci4&l6+�a3 %aWpA41c'Ss c4iL4J.WecNew Zealand (Telephone: 7 1 4-536-5227 ) Certification of Compliance with 'Title VH of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with Title VH of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20, at , California. (Type Contractor Name) By: Name: [Type Name] - 1 Title: [Type Title] E , IF R a A7 4Y- A c7RNEY JL� 3-2�6-CP 245911 1 Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street(P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above -referenced project {"Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit -requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of 20, at (Type Contractor Name) By: _ Name: Title: [Type Name] [Type Title] California. -i-L-" 03. ar13 - 0-1-P 2<75<2A CONTRACTOR'S CERTIFICATE I, , state and certify that: (Name of Declarant) 1. is the general contractor to the City of Huntington Beach ("City") on Contract No. (the "Contract") for the construction of the public work of improvement entitled: (the "Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3_ Except for the claims listed.below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims; if none, write "NONE" ): 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"): 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at APPROVED AS TO FORM on this day of 120 By: M�� qI %t5 - U 3. ZD-©(p Name: [Type Name] Title: [Type Title] (Signature of Declarant) 1 245914 1 RECEIVED BY: (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's office after signing/dating • - • : - . .! TO: s' -*F ", City Treasurer FROM: =� DATE: / SUBJECT: Bond Acceptance I have received the bonds for Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved (ounci Approv t Date) (Company Name) �6A LO3 "� Agenda Item No. City Clerk Vault No. #27 g1followup/bondletter.doc EXECUTED IN TRIPLICATE Bond No. 6620345 PREMIUM: $11,165.00 PERFORMANCEBOND Premium Is For Contract Term And Is Subject To Adjustment Based On Final Contract Price KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereinafter referred to as'CV) has. by written agreement dated entered into a contract with BA NAOUN ENGINEERS CONSTRUCTORS CORPORATION, 9614 COZYCROFT AVENUE, CHATSWORTH, CA 91311 (name and address of Contractor) (hereinafter referred to as "Principal'), for performance of the work described as follows: GARFIELD AVENUE REHABILITATION FROM NET-1LAND STREET TO MAGNOLIA STREET, C.C. 1372 (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to fumish a bond guaranteeing the prompt, full and faithful performance of said Contract. NOW THEREFORE, we, the undersigned, as Principal, and FIRST NATIONAL INSURANCE COMPANY, ATTN: SURETY CLAM P-'pAp.TMPNT 1001 4TH AVENUE, SUITE 1700,'SEATTLE, WA 98154 (name and address of Surety) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as `Surety"), as Surely are held and firmly bound unto GJJ,VFli} the penal sum of SEVEN HUNDRED SIXTY SIX THOUSAIM FOUR HUNDRED _ FOUR AND 507100 Dollars ($ 7 6634 54.50 J this amount being not less than one -hundred percent of the price set forth in the Contract, in lawful money of the United States, for the payment of which sure, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION 1S SUCH THAT if the Principal shall promptly, fully and faithfully perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall indemnify and save harmless City and all of City's officers, agents and employees (hereinafter collectively referred to as "Obligees") from any and all losses, liability and damages, claims, judgments, stop notices, fees and costs of every description, whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract, including all alterations, amendments and modifications thereto, and any warranties or guarantees required thereunder; then this obligation shall be void; otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees, for value received, that no adjustment of the time or price in the Contract or any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety Under this Bond. Surety waives notice of any adjustment of contract time or contract price, and 277591.1 PERFORMANCE BOND Page 1 of 2 Bond No. 6620345 any other alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, and agrees to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations, changes, deletions, additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code §§ 2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution o" this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: DECEMBER 15, 2010 ATTEST BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION (Corporate Seal) (Principal Name) By: «; Name: O�Ji9� r��LooF Title:_ ATTEST FIRST NATIONAL INSURANCE COMPANY OF A-MER_ICA (Corporate Seal) (Surety Name) By: / w J - Name: MARK D. IATAROLA., ATTOPUNEY—IN—FACT (Signature of Attorney -in -Fact for Surety) (Attach Attorney -in -Fact Certificate) ( 949) _ 860-6620 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY 0 UNTINGTON BEACH By ennifer Mc ath :r4164 yAttoyme Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney -in -fact must be attached 277.59LI PERFORMANCE BOND Page 2 of 2 �" � POWER First National Insurance Company of America �'a 1001 4th Avenue ,ty j OF ATTORNEY Suite 1700 Seattle, WA 98154 KNOW ALL BY THESE PRESENTS: No. 8062 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint *******HELEN MALONEY; JOHN G. MALONEY; MARK D. IATAROLA; KAREN JEAN HALL; MATTHEW C. GAYNOR; DEBORAH D. DAVIS; Escondido, its true and lawful attorneys) -in -fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 21 st day of March 2009 Dexter R. Legg, Secretary Timothy A. Mikolajewski, Vice President CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, 0) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power-of-attomey appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, Dexter R. Legg , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 15TH SEAL 1928 day of DECEMBER p4wAkil Dexter R. Legg, Secretary 2010 S-1049/DF 3/09 WFB a`'DF P_AA 11Cf1tIOMIA AN 1 _®110DnQ= Af'_WUnIA11 =nf-"Ri1=1►11r 'ie�'`'`1\'`'`tt\LLL'�'�1'\'\•\�_\t1�'�1'\'��t\\•�1111'\1\11111'�1't11'\��'�`1�`l\1t\�1111t\111�'����»�•�����.1�� State of California ) COunt}f of SAN DIEGO } On 12/15/2010 before me, DEBORAH D. DAVIS, NOTARY PUBLIC IIARK D IATAROLA ® OPTIONAAI. SECTIONI CAPACITY CLAIMED BY SIGNER Through statute does not require the Notary to MI in the data below, doing so may prove invaluable to persons relying on the document. ❑ INDIVIDUAL ❑ CORPORATE OFFICERS) personally appeared ' who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are TITLE(S) PARTNER(S) F1 LIMITED subscribed to the within instrument and acknowledged GENERAL to me that he/she/they executed the same in his/her/ ©ATTORNEY -FACT -FACT their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity ❑ TRUSTEE(S) upon behalf of which the person(s) acted, executed the GUARDIAN/CONSERVATOR instrument. OTHER: I certify under PENALTY OF PERJURY under the laws of DEBORAH D. DAMS the State of California that the foregoing paragraph is COMM_ #1737411 w e • true and correct. SIGNER IS REPRESENTING: NOTARY DIEGOPUBLICOUNT RNIA N " JAtV t)IEGO COUNTY WITNESS m hand and official seal. Y NAME OF PERSON(S) OR ENTITY(IES) C',<1FOA��P 14,v Comm, Exp. APRIL 21, 2011 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 i. . PRM&M INCLUDED IN PRM1XAN= DMD EXECUTED IN TRIPLICATE Bond No. 6620345 R �i,o ,; Ii k'. KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS, the City of Huntington Beach (hereinafter referred to as "City") has awarded to BANNAOUN ENGINEERS CONSTRUCTORS CORPORATION,' 9614 COZYCROFT AVENUE CHATSWORTH, CA 91311 (name and address of Contractor) (hereinafter referred to as "Principal"), a contract ("Contract") for the work described as follows: GARFIELD AVENUE.REF.ABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. 1372 (project tide) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. FIRST NATIONAL INSURANCE NOW THEREFORE, we, the undersigned Principal, and COMPANY OF AMERICA, ATTN: SURETY CLAIMS DEPARTMENT, 1001 4TH AVENUE, SUITE 1700, SEATTLE, WA 98154 (name and address of Surety) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as "Surety"), as Surety, are held and firmly bound unto City in the penal sum of SEVEN HUNDRED HUNDRED SIXTY SIX THOUSAND FOUR HUNDRED FIFTY FOUR AND 50/100 --- ----------- dollars, ($ 766,454.50 ) this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code ("Claimants") for all labor, materials or services used or reasonably required for use in performance of the work described in the Contract or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, Withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. Surety stipulates and agrees, for value received, that no change, extension of time, alteration, addition or modification to the terms of the Contract, or any contract document or any work to be performed thereunder, whether made after notice or not, shall in any way affect, impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such change, 277599.1 - - - PAYMENT POND Page 1 of 2 Bond No. 6620345 extension of time, alteration, addition, or modification to the terms of the Contract, the contact documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEROF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such parry's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: DECEMBER 15, 2010 ATTEST (Corporate Seal) ATTEST (Corporate Seal) (Attach Attorney -in -Fact Certificate) BANNAOUN.ENCINEERS CONSTRUCTORS CORPORATION (Principal Name) By: -� Name: f2inAte Est d� its: ;d—�- FIRST NATIONAL INSURANCE COMPANY OF AMERICA (Surety Name) By: / ((ivl./ 0 Name:MRRK n.'TAT POL , ATTORNEY —IN —FACT (Signature of Attorney -in -Fact for Surety) - 0(�49) 860-6620 (Area Code & Telephone Number of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH By� J1 1 ► ennifer Mc rath 5/1-.1,6b ity Attorney Note. This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attorney-in4act must be attached. 277589.1 Page 2 of 2 PAYMENT BOND Lie POWER First National Insurance Company of America 1001 4th Avenue LyOF ATTORNEY Suite 1700 Seattle, WA 98154 KNOW ALL BY THESE PRESENTS: No. 8062 That FIRST NATIONAL INSURANCE COMPANY OF AMERICA, a Washington corporation, does hereby appoint *******HELEN MALONEY; JOHN G. MALONEY; MARK D. IATAROLA; KAREN JEAN HALL; MATTHEW C. GAYNOR; DEBORAH D. DAVIS; Escondido, its true and lawful attorney(s)-in-fact, with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar character issued by the company in the course of its business, and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such instruments had been duly executed by its regularly elected officers at its home office. IN WITNESS WHEREOF, FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents this 21 st day of March Dexter R. Legg, Secretary Timothy A. Mikolajewski, Vice President CERTIFICATE Extract from the By -Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA: 2009 "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as attorneys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970. "On any certificate executed by the Secretary or an assistant secretary of the Company setting out, (i) The provisions of Article V, Section 13 of the By -Laws, and (ii) A copy of the power -of -attorney appointment, executed pursuant thereto, and (iii) Certifying that said power -of -attorney appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, Dexter R. Legg , Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of this corporation, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this 15TH day of DECEMBER 2010 �s �P8m,9 ''Y,e� �� •' of SEt4I, s "P 1928 ar. _.��J Dexter R. Le ry f� m,, Legg, Secrets S-1049/DF 3/09 WEB PDF CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT � s,qs State of California } County of SAN DIEGO } m 12/15/2010 personally appeared before me, DEBORAH D. DAVIS, NOTARY PUBLIC MARK D IATAROLA OPTIONAL SECTION CAPACITY CLAIMED BY SIGNER Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the document ❑ INDIVIDUAL CORPORATE OFFICER(S) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are TITLEIS) PARTNER(S) LIMITED subscribed to the within instrument and acknowledged GENERAL to me that he/she/they executed the same in his/her/ ATTORNEY -IN -FACT their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity ❑ TRUSTEE(S) upon behalf of which the person(s) acted, executed the n GUARDIAN/CONSERVATOR .,. ;. DEB©RAH D. DAVIS instrument. OTHER: �� r 1 t. i+ COMM. #1737411 E BLIC N 1 certify under PENALTY OF PERJURY under the laws of &AN DierO COUNTOYRMA the State of California that the foregoing paragraph is �a. My Comm. Exp. APRIL 21, 2011 true and correct. 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 7 /9 Council/Agency Meeting Held: / d/O Deferred/Continued to: A pr ve) Conditional) A rov d ❑Denied C Clr 's Sign re Council Meeting Date: December 20, 2010 Department ID Number: PW 10-063 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Administrator PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Approve project plans and specifications and -award Construction Contract in the amount of $766,454.50 to Bannaoun Engineers Constructors Corp. for the Garfield Avenue Rehabilitation from Newland Street to Magnolia Street, CC-1372; and, authorize the Mayor and City Clerk to execute a contract in a form approved by the City Attorney Statement of Issue: On November 4, 2010, bids were publicly opened for the Garfield Avenue Rehabilitation from Newland Street to Magnolia Street, CC-1372, and Federal Aid Project ESPL-5181 (168). City Council action is requested to award the construction contract to Bannaoun Engineers Constructors Corp., the lowest responsive and responsible bidder. Financial Impact: The total estimated project cost is $900,000. Funds are available in the amount of $653,141 from the American Recovery and Reinvestment Act of 2009 (ARRA) federal grant which is budgeted in the Gas Tax Fund, Federal Funded Street Improvements Account No. 20790015.82300. The remaining balance between the ARRA funding and final cost will come from a reimbursement of $80,000 from the City of Fountain Valley, for its portion of Garfield Avenue, $20,000 from the rubberized asphalt concrete (RAC) grant, and $146,859 from Gas Tax, Arterial Rehabilitation, Account 20790008.82300. Recommended Action: Motion to: A) Approve the plans and specifications for the Garfield Avenue Rehabilitation Project, CC- 1372; and, B) Accept the lowest responsive and responsible bid submitted by Bannaoun Engineers Constructors Corp. in the amount of $766,454.50; and, C) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids, and provide staff with an alternative direction. HB -157- Item 8. - 1 REQUEST FOR COUNCIL ACTION MEETING DATE: 12/20/2010 DEPARTMENT ID NUMBER: PW 10-063 Analysis: The American Recovery and Reinvestment Act of 2009 (ARRA) provided $27.5 billion for highway infrastructure investment. California received approximately 101/6 of those funds and the share for the City of Huntington Beach was $1.7 million. Last year, the City of Huntington Beach constructed the Slater Avenue Rehabilitation project, CC-1359 with 84% ARRA funding (or $1,120,616). The remaining ARRA funding balance of $653,141 is being applied to this project and represents approximately 72% of the total anticipated costs. The City's objective is to replace the worn pavement on Garfield Avenue from Newland Street to Magnolia Street and replace the failed curb and gutter along selected segments on the south side of Garfield Avenue. Improvements primarily consist of full depth reclamation, rubberized asphalt (RAC) overlay, limited reconstruction of concrete curb and gutter, concrete sidewalk, curb access ramps, landscaping, and installing traffic loops with striping. The project utilizes RAC which contains crumb rubber derived from scrap tires. A two-inch layer of RAC uses over 2,000 waste tires per lane mile. The project will divert more than 3,000 waste tires, that otherwise would end up in a landfill. Including this project, the use of RAC in the rehabilitation of the City's arterial streets has resulted in the diversion of over 205,000 waste tires. Bids were opened publically on November 4, 2010. The verified bid amounts are listed below: H.:. SUBMITTED VERIFIED BIDDER_ 'S.:NAME tArri%ount Read,'t TOTAL; at Bid,'Opening)� M, UNT Bannaoun Engineers $766,454.50 $766,454.50 The RJ Noble Company $797,693.30 $797,693.30 EBS Inc. Elite Bobcat Service $819,014.40 $819,014.40 Hardy & Harper $822,000.00 $822,000.00 All American Asphalt, Inc. $824,824.00 $824,824.00 Sequel Contractors Inc. $856,381.35 $856,381.35 Excel Paving Company $858,786.80 $858,786.80 Terra Pave $882,521.70 $882,521.70 Staff recommends award of the contract to Bannaoun Engineers Constructors Corp. in the amount of $766,454.50. The reference check for the company provided acceptable response from past clients. The total project cost is estimated to be $900,000, which includes the construction contract, project management, construction contingency (10%), and supplementals (soils and materials testing, construction support services by outside firms, in- house inspection services and additional engineering support). Item 8. - 2 HB -158- REQUEST FOR COUNCIL ACTION MEETING DATE: 12/20/2010 DEPARTMENT ID NUMBER: PW 10-063 The contract with Bannaoun Engineers Constructors Corp will include street rehabilitation of one lane of Garfield Avenue that is reimbursable from the City of Fountain Valley under the Cooperative Agreement approved by the Huntington Beach City Council on May 17, 2010. The work includes surface grinding and asphalt concrete overlay of one street lane and replacing three curb ramps, all within the City of Fountain Valley. The reimbursement from the City of Fountain Valley is estimated to be $80,000. Public Works Commission Action: The Public Works Commission reviewed and recommended the project on April 21, 2010, with a vote of 4-0-3 (Kirkorn, Rivera, and Spencer absent). Environmental Status: The project is categorically exempt pursuant to Class 1, section 15031c of the California Environmental Quality Act and on June 3, 2009, the State determined that the project is a categorical exclusion under National Environmental Protection Act (NEPA) 23 CFR 771.117(d); activity Strategic Plan Goal: Maintain, improve and obtain funding for infrastructure and equipment Attachment(s): HB -159- Item 8. - 3 ATTACHMENT #1 Item 8. - 4 HB -160- tea. P�G�O s9� U) BOLSA AVE FC O Mc FADDEN AVE. U w J ~ Q Z (n o EDING R AVE. J 0 r:�dy)H �rQ AVE. m o w Q RER a Z AVE. w 0_ o � 0 SLATERw r"" AVE. I01TALBERT PACIFIC ,o 9 ELLIS GARFI ELD PROJECT LOCATION 10Garfield Avenue (Newland —Magnolia) LEGEND ® ARTERIAL STREET LOCATIONS NTS 405 X L. 1 1 AVE. v~i c~n c~n v~i 0 Q KTOW N AVE. 3 z ADAMS 3 AVE. �w Q Z J %NAPOLIS Z AVE. �- � o � _ < Q = ATLANTA AVE. N o _� °D m Of HAM I LTON AVE. m OCEAN REV 1/5/10 GARFIELD AVE ARTERIAL REHABILITATION, CC-1372 PROJECT LOCATION MAP CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS HB -161- e p 1 OF 1 ®Item 8. - 5 STATE OFCALIFORNIA) COUNTYF ORANGE I am a citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the notice published. I am a principal clerk of the HUNTINGTON BEACH INDEPENDENT, which was adjudged a newspaper of general circulation on August 24, 1994, case A50479, for the City of Huntington Beach, County of Orange,,.and the State of Calif orh ia.-t.Attached ,to -this -,Affidavit is a true and complete copy. as -was printed and published orr the. following: date(s): October 14, 21, 28, 2010 I certify (or declare) under penalty of perjury that the foregoing is true and correct. Executed on October 29, 2010 at Costa Mesa, California Signa e SE(TION'A- NOTIfE INVITING SEALED BIDS for. the construction of GARFIELD,AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 .. , FEDERAL AID PROJECT ESPL-5 181 (168), in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated project and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California' 92648, up to the hour. of .2:00 P.M...on Thursday, November,4, 2010. Bids will be publicly, open .in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from: the Office ,of the Director of Public Works; 2000 Main Street, Huntington Beach'; CA 92648, upon payment of,a_$45.00 nonrefundable fee if picked up, • or payment of a $70.00, nonrefundable fee if 'sent, by an overnight service provider (bidder shall pay additional costs for special delivery).' This is a'Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into, pursuant. to this notice will.,iricorporate the provisions of the Federal LAor`Standards,' which are'on•,file at the office of the Director of Public Works, 2000 ,Main Street, Huntington' Beach, CA 92648. The AGENCY will deduct a-10,% retention from `all' progress payments. The Contractor may substitute, an escrow holder surety of equal, value to the retention in accordance with the provisions of the. California. Government Code, Section 4590. The Contractor shall be beneficial owner' of the surety and shall receive -any interest thereon:. . The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit'bids' in response to this notice and will not be discriminated against on the basis of,race, color, national 0rigin,•ancestry, sex, or religion in any, consideration' leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as' determined by the AGENCY.' The bid must be. accompanied by a certified check„ cashier's check, or j bidder's bond made payable to the, AGENCY for, an amount no less than i 10-/ of the amount bid. The successful bidder shall be licensed, in accordance' with provisions of "the: Business and Professions' Code and shall possess a State. Contractor's License.Class A at the time of the bid opening. The successful Contractor andhis subcontractors will be,required to possess business licenses from the AGENCY: Project Description: The'project.consists primarily of full.depth reclamation (FDR) including pulverization of: the in-situs'distressed..pavement, blending with a predetermined depth of -in-situ granular base material, removing a predetermined amountof the pulverized mix, mixing of a smallpercentage of concrete cement for chemical, stabilization, then.curing in place,before overlaying with conventional asphalt, and surface rubberized. asphalt. The project also includes limited' removal andinstallation'of"concrete curb and gutter; driveway, concrete sidewalk, curb access ramps, adjusting manholes, monuments; and valves to grade, installing traffic .loops with striping,.'and removal of'a small portion of median strip-: • The contract allows the Contractor,.50 "working days to complete the contract. e 'The engineer's estimate for the work included in the base bid portion of this contract is $815,000'. • The Project Disadvantage Business Enterprises (DBE)"goal, is 8.34%, ❑ Race Conscious (UDBE) goal: 5.13% and.. O Race Neutral /DBE goal: 3.21%. The AGENCY reserves the, rightto reject any ,or all bids, to waive any irregularity and to take all`bids under advisement for a maximum',perioc of 60 days. BY ORDER of ,the, CITY COUNCIL of the CITY, OF ,HUNTINGTON BEACH, CALIFORNIA, the 20th day: of September 2010, by RESOLUTION 2010-69. Attest: (, loan L: Flynr CITY CLERK OF THE CITY OF, HUTTINGTON BEACF ' Published Huntington Beach Independent October 14, 21,, 8, 2010 010-095 CITY OF HUNTINGTON BEACH GARFIELD AVENUE REHABILITATION PROJECT C.C. NO. 1372. BID OPENING DATE: NOVEMBER 4,2010 TIME: 2:00 PM ENGINEER'S ESTIMATE: $815,000 BIDS SUBMITTEDI(AS READ':AT OPENING) . ...... . . . . . H . . . . . . . . . . .... ... - -11" DUN.-T." AMO All American Asphalt, Corona 7 B & Tworks, Wildo.mar ba nnaoun Engineers, Chatsworth 0 41 EBS Inc., Corona A/ Excel Paving, Co., Long. Beach stin Gass Construction Tustin Hardyand Harper; Santa Ana ...... ICE Engi ineerihg, Industry Sequel Contractors, Santa Fe Springs Silvia Contractors,, RanchoUcamonga Terra. Pave, Santa Fe Springs 'Zo The R.J. Noble Company, Orange 274 CC 1372 Bid Opening Worksheet 11/4/2010 12'.'03 PM -z 72-,--- Min 17 C-D OF HUNTINGTON BEACH 2000 Main Street P.O. Box 190 Huntington Beach, CA 92648 1-2- 1 VIA, MoTd—ffIXT179rai" Attention: Joan L. Flynn To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 Fax (714) 374-1673 Date: October 7, 2010 ProjectlC.C. No.: C.C. No. 1372 Regarding:_ Gafeld Avenue from Newland to Magnolia ❑ We are sending you: []!-,,'By Mail ❑icy 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 lnviiina Sealed Bids Item # Copies .:Pa es. ` - .. description 1 ? 1 Notice 1nvffin2 Sealed Bids for CC-1372 Garfield Avenue Rehabilitation From Newland Street to Magnolia Street These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other: Remarks: Per Resolution 2010-69 (adopted on 9/20/10), the City Council authorized the advertisement of the above listed arterial rehabilitation project. Please find attached the Notice Inviting Sealed Bids for advertisement on 10114/10, 10/21/10, and 10/28/10. The bid opening is scheduled for 11/04/10 at 2:00 PM. Please contact me at 536-5467 with any questions you may have. By: Jim Wagner, Senior Civil Engin c: file G:\CONSTRUCnoN CONTRACrs (CCs)\CC1372 GARFiEiA AVENuB REHABLLTAT[oN\NISB\NISB TRANsmuAL To CLERK-CC-1372.Doc /v/LO�/�J /,/ Lz`/,g SECTION A. NOTICE INVITING SEALED BIDS for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated project and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 P.M. on Thursday, November 4, 2010. Bids will be publicly open in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $45.00 nonrefundable fee if picked up, or payment of a $70.00 nonrefundable fee if sent by an overnight service provider (bidder shall pay additional costs for special delivery). This is a. Davis -Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 10% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the California Government Code, Section 4590. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: The project consists primarily of full depth reclamation (FDR) including pulverization of the in -situ distressed pavement, blending with a predetermined depth of in -situ granular base material, removing a predetermined amount of the pulverized mix, mixing of a small percentage of concrete cement for chemical stabilization, then curing in place before overlaying with conventional asphalt and surface rubberized asphalt. The project also includes limited removal and installation of concrete curb and gutter, driveway, concrete sidewalk, curb access ramps, adjusting manholes, monuments, and valves to grade, installing traffic loops with striping, and removal of a small portion of median strip. ® The contract allows the Contractor 50 working days to complete the contract. ® The engineer's estimate for the work included in the base bid portion of this contract is $815,000. ® The Project Disadvantage Business Enterprises (DBE) goal is 8.34%, o Race Conscious (UDBE) goal: 5.13% and o Race Neutral /DBE goal: 3.21%. The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 24th day of September 2010, by RE,SOLUTION 2010-69. Attest: Joan L.Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowledge receipt and review of Addendum Number One, dated November 1, 2010.. Company Name Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. 2"x4" WOOD Pi TREE BRA+ 2"x4" RWD. ST OPTION "B" L—U mom `VERIFY WITH CITY SECTION Lam.f-1 0=1 NOTES: 1 2"X4" WOOD BLOCK, NAIL TO FRAME. 2"X4" WOOD BLOCK, NAIL TO BRACE & STAKE. O 2"X8" WOOD FRAME WITH CARPET ON SIDE FACING PALM. CARPET CUSHION: STAPLE TO INSIDE OF FRAME STEEL TREE BOX BANDING STRAP (2 BANDS). ,LM TRUNK PLAN VIEW UNK PALM QUA® POD pas APPROVED: CITY OF H UWNGT®N BEACH STANDARD p DEPARTMENT OF PUBLIC WORKS 713 - 2009 1 OF 1 CALL THE CITY OF HB LANDSCAPE INSPECTOR AT (714) 536-5431 FOR TREE SPECIES, SIZE, SPACING, NURSERY SOURCES AND/OR FIELD ADJUSTMENTS BEFORE PLANTING. STAKES 2" DIAMETER LODGE POLE PINE (2) EACH. COPPER NAPTHANATE TREATED AND DRIVEN 12" BELOW THE BOTTOM OF PLANT HOLE. STAKES TO BE DRIVEN INTO THE GROUND WITH A STAKE POUNDER OR A METHOD APPROVED BY THE LANDSCAPE INSPECTOR. (USE OF SLEDGE HAMMERS, HAMMERS OR AUGURING TOOLS WILL NOT BE PERMITTED). STAKES ARE TO BE PLUMB. ADJUST STAKE LENGTH PER TREE VARIETY OR AS DIRECTED BY THE LANDSCAPE INSPECTOR. STAKES ARE TO BE PARALLEL WITH THE ROADWAY. A THIRD STAKE AND TWO EXTRA TIES MAY BE REQUIRED IN SPECIAL CONDITIONS. TIES 32" LONG (MIN) 'CINCH TIES' (4EA PER TREE). ATTACH WITH 4D GALVANIZED ROOFING NAILS BENT OVER BACK OF STAKES (ONE NAIL PER CINCH TIE). PRE DRILL ALL HOLES. TREE PLANTING PLANT HOLE SIZE TO BE A MINIMUM OF (2) TIMES LARGER THAN THE CONTAINER. DUST ENTIRE HOLE WITH GYPSUM BEFORE BACKFILLING, PLANT THE TREE CROWN 1 1/2" ABOVE FINISH SOIL GRADE. BACKFILL 2 PARTS CLASS A TOPSOIL TO BE THOROUGHLY MIXED WITH (1) PART NITROLIZED SAWDUST. ROOTBARRIER FOR TREES WITHIN 6' OF HARDSCAPE OR LOW WALLS, SEE STD PLAN 718 (LINEAR ROOT BARRIER). WATER BASIN 3" HIGH WATER BASIN IN GROUNDCOVER AREAS. IN LAWN AREAS USE A 24" DIAMETER OF 3" SHREDDED BARK (NO BASIN). 07 - SUMP SEE STD PLAN 716 (TREE/PALM . SUMP) OR 716A. TREES IN LAWN AREAS SHALL HAVE A 36" DIA. AREA CLEAR OF LAWN, CENTERED AROUND THE TREE TRUNK, AND MULCHED WITH 3" OF "MEDIUM GRIND MULCH" FROM RECYCLED WOOD PRODUCTS (626) 727-7211. TREE PLANTING AND STAKING O I!!ii? APPROVED: CITY OF HUNTINGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 714 ,.,T„ 1 2009 1 OF 1 SET CROWN OF ROOTBALL 1 1 /2 INCHES ABOVE 30" I FINISH GRADE MIN. SIDEWALK e a' NOTE: SINGLE STAKE PALM UPWIND WITH ONE 10 FOOT LODGEPOL£ PINE STAKE DRIVEN 24 INCHES INTO UNDISTURBED SUBGADE WITH TWO 'CINCH TIES' NAILED THRU STAKE AND BENT OVER. 4" DIA. BLACK SDR 55 (PEA GRAVEL FILLED) PERFORATED DRAIN PIPE (2 REO D) (ONE INCH FROM BOTTOM OF PLANT PIT) CURB AND GUTTER WHERE OCCUR 1 1/2"BASE MATERIAL 1 /2rr +.'. .... COMPACTED SAND BACKFILL w ows \/� \ `PLACE on!! (2-cn ��\ TWO PIECES OF #70 MIL FILTER OF THEAUGERED WITHEMESHEATOP HOLE WITH ARGHTANGLE THE MESH OF THE FABRIC BELOW o BACKFILL AUGERED HOLE o�� WITH 3/4" CRUSHED ROCK xamo � oo� 12 INCH DIAMETER AUGERED HOLE �zCL an � z EO DRAIN PIPE w 0 o w � STAKE LOCATION r�ov UPWIND FROM EQ PALM o PLAN VIEW PALM ROOTBALY • NOTE: AUGER THE HOLE TO THE MAXIMUM DEPTH OF 10 FEET UNLESS GROUNDWATER OR A POROURS MATERIAL IS ENCOUNTERED AND APPROVED AS POROUS BY THE CITY INSPECTOR ® NOTE: REFER TO SPEC'S ON STANDARD PLAN 715, 3 OF 3 APPROVED: CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS CITY ENGINEER 1 2009 pos- STANDARD PLAN 715 1 OF 3 SET CROWN OF ROOTBALL 1 1/2 INCHES ABOVE FINISH GRADE \ SIDEWALK d d . LL J 0XM J Q LO w0wa 0or_ a.0 TREE STAKING SEE STD 714 4" DIA. BLACK SDR 55 (PEA GRAVEL FILLED PERFORATED DRAIN PIPE (2 RE4 D) (ONE INCH FROM BOTTOM OF PLANT PIT) 24" DEEP CONTINUOUS ROOT BARRIER 08" THICK PLACED ADJACENT TO 301, CURB/WALK MIN. CURB AND GUTTER WHERE OCCUR 1 1 /2"BASE MATERIAL <• 1 /2" ♦ s a ♦ + •a♦♦♦..,.,a+♦+♦ ll a ♦ s + ♦ ♦.+ . a ♦ ♦ . ♦ .�r a PLACE TWO PIECES OF #70 MIL FILTER FABRIC OVER THE TOP OF THE AUGERED HOLE WITH MESH AT A RIGHT ANGLE TO THE MESH OF THE FABRIC BELOW BACKFILL AUGERED HOLE WITH 3/4" CRUSHED ROCK 12 INCH DIAMETER AUGERED HOLE DRAIN PIPE -ROOT BARRIER CONTINUOUS TREE STAKING SEE STD 714 VIEW TREE ROOTBALL ® NOTE: AUGER THE HOLE TO THE MAXIMUM DEPTH OF 10 FEET UNLESS GROUNDWATER OR A POROURS MATERIAL IS ENCOUNTERED AND APPROVED AS POROUS BY THE CITY INSPECTOR ® NOTE: REFER TO SPEC'S ON STANDARD PLAN 715, 3 OF 3 APPROVED: CFTY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS 2009 ® . STANDARD PLAN 715 2 OF 3 PLANTING SPECIFICATIONS (D PRIOR TO EXCAVATING OR BORING, NOTIFY DIG ALERT TO FIELD MARK EXISTING UTILITIES. PROTECT IN PLACE. IF FIELD CONFLICT EXISTS, NOTIFY THE LANDSCAPE ARCHITECT/INSPECTOR. PROCEED WITH WORK ONLY AFTER NEW DIRECTIONS HAVE BEEN GIVEN BY THE LANDSCAPE ARCHITECT/INSPECTOR. Q EXCAVATE PLANT HOLE TO SIZE AND DEPTH SHOWN. Q EXCAVATE AND CONSTRUCT DRAINAGE SUMP PER 'TREE/PALM SUMP' STANDARD PLAN NO. 716. ® CONNECT EACH 2' LONG X 2' WIDE PIECE OF 'DEEP ROOT' ROOT BARRIER PANELING TO ANOTHER 2' LONG X 2' WIDE PIECE WITH THE MANUFACTURERS JOINER STRIP TO FORM ONE CONTINUOUS 10' LENGTH. BEND 10 ' LENGTH OF ROOT BARRIER TOGETHER INTO CONFIGURATION AS SHOWN AROUND ROOTBALL AND CONNECT ENDS USING ANOTHER JOINER STRIP. DEEP ROOT BARRIER SHALL BE FLUSH WITH THE EDGE OF CONCRETE PAVING. DO NOT USE ROOT BARRIER WITH PALMS UNLESS DIRECTED BY THE LANDSCAPE INSPECTOR. a INSTALL 6" PERFORATED ABS PLASTIC SDR 35 DRAIN PIPE IN ALTERNATE CORNERS VERTICALLY AND FILL WITH 3/4" CRUSHED DRAIN ROCK. PERFORATIONS SHALL BE A MINIMUM OF 1 /2" IN DIAMETER IN THREE LOCATIONS AROUND THE CIRCUMFERENCE. FOR TREES, BACKFILL PLANT HOLE APPROXIMATELY 6" TO 12" DEEP WITH PREPARED BACKFILL AS SPECIFIED IN THE CITY OF HUNTINGTON BEACH LANDSCAPE SPECIFICATIONS. FILL THE REMAINDER OF THE HOLE WITH WATER TO SETTLE. FOR PALMS, BACKFILL WITH PURE CLEAN COARSE SAND. COMPACT SAND WITH A 'BUSHWACKER' AND WATER TO CREATE A SOLID BASE FOR THE PALM. 0 AFTER BACKFILL HAS SUFFICIENTLY SETTLED AND DRIED AS DIRECTED BY THE LANDSCAPE INSPECTOR, INSTALL THE TREE ROOTBALL WITH THE TOP LEVEL AND 1" ABOVE THE BOTTOM OF THE ADJACENT SIDEWALK. FOR PALMS, BACKFILL WITH CLEAN, COARSE SAND AND COMPACT WITH 'BUSHWACKER' AND WATER TO THE SATISFACTION OF THE LANDSCAPE INSPECTOR. ® BACKFILL THE REMAINING TREE WELL VOIDS WITH SPECIFIED BACKFILL AND WATER TO SETTLE. ® STAKE TREE PER STANDARD PLAN NO. 714. ALL PALMS IN MEDIAN ISLANDS AND PALMS WITH 10' OF BROWN TRUNK OR GREATER TO BE STAKE ANCHORED WITH PALM QUAD PODS PER STANDARD PLAN NO. 713. PALMS WITH LESS THAN 10' OF BROWN TRUCK AND NOT IN MEDIAN ISLANDS SHALL BE STAKED WITH A 10' LONG, 2" DIAMETER COPPER NAPHANATE TREATED LODGE POLE PINE STAKE, DRIVEN A MINIMUM OF 3' INTO THE GROUND AND 12" BELOW THE BOTTOM OF THE PLANT HOLE. TIE TO PALM WITH 'GRO-STRAIGHT' RUBBER TIRE TEES (24" TO 36" LONG) SIZE AS REQUIRED TO ENCIRCLE STAKE AND PALM LOOSELY. ATTACH TO STAKE WITH A 16D NAIL AND BEND NAIL ON BACK OF STAKE. 10 AFTER BACKFILL HAS SUFFICIENTLY SETTLED AND DRIED, BRING BACKFILL TO GRADE SH OWN. ARTERIAL - PLANTING 8PECIFICAT11ONS. APPROVED: CITY 1 OF 1— UN 1 eNGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 715 ��T� CAI!_IAICC'G 2009 3 OF 3 0 rr,v oQ x �c v �v w w� c� c 0c �a APPROVED: PLACE TWO PIECES OF #70 MIL FILTER FABRIC OVER THE TOP OF THE AUGERED HOLE WITH MESH AT A RIGHT ANGLE TO THE MESH OF THE FABRIC BELOW UGERED HOLE CRUSHED ROCK ,METER DLE NOTE: AUGER THE HOLE TO THE MAXIMUM DEPTH OF 10 FEET UNLESS GROUNDWATER OR A POROUR MATERIAL IS ENCOUNTERED AND APPROVED AS POROUS BY THE CITY INSPECTOR s � TREE AND PALM SUMP-® w CITY OF HUNT NGT®N BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 716 2009 1 OF 1 TREE: ONE, FIVE, FIFTEEN GALLON OR BOXED TREE. CONCRETE CURB OR SIDEWALK WHERE OCCURS. 3a- HARDSCAPE WHERE OCCURS 4&- EDGE OF MASONRY WALL UNDER 4' IN HEIGHT. 24" DEEP X .08" THICK X 12' LONG PVC ROOT BARRIER CENTERED ON THE TREE. LOCATE FLUSH WITH TOP OF CURB OR HARDSCAPE. WHERE ROOT BARRIER OCCURS IN MEDIANS WITH STAMPED CONCRETE, PLACE FLUSH WITH THE TOP OF STAMPED CONCRETE. ffi L NEAR ROOT BARRIER a APPROVED: CITY ®F FIU�MNG-TON BEACH STANDARD CITY 1 PLAN DEPARTMENT OF PUBLIC WORKS 718 riTV rKiraMUCO 2009 1 OF 1 BASE OF HEART LEAF c� w z J171 J � � Q w `w r o z w w 30 I c=� w jLi w = CL oa I Y I- Z z BOTTOM OF 1ST Zu r VIABLE PETIOLE 1 Z Of (nm Z 5 o xws Z Nc m V1 FINISH GRADE BROWN TRUNK HEIGHT (B.T.H.) BROWN TRUNK HEIGHT (B.T.H.) IS THE MEASUREMENT REFERENCED IN AND REQUIRED BY THE CITY OF HUNTINGTON BEACH ORDINANCE CODE. NOTES: AMERICAN STANDARD FOR NURSERY STOCK —HEIGHT MEASUREMENT CRITERIA DIFFERS O1 FROM BROWN TRUNK HEIGHT —WHICH IS MEASURED FROM FINISH GRADE TO THE BOTTOM OF THE FIRST VIABLE PETIOLE. NOTE: NURSERIES SELL PALMS WITH ONE OF THESE TWO MEASUREMENTS. PALM HEIGHT MEASUREMENT Ims APPROVED: CITY OF HUNTINGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 719 NTY FNr:iNFF7R 2009 1 OF 1 l 1► AN A CC-13 i2 CITY OF HUNTINGTON BEACH GARFIELD AVENUE REHABILITATION PROJECT C.C. NO. 1372 BID OPENING DATE: NOVEMBER 4, 2010 TIME: 2:00 PM ENGINEER'S ESTIMATE:. $815,000 BIDSSUBMITTED (AS READ AT OPENING) ::::::RACK::::::AP.:P 'BIDi�R.S ....APSE:::::::::::::::::::::::::::::::::.............. R-EMTSID AM Q1I IT::: ........................................................ All American Asphalt, Corona B &.T Works, Wild'omar Bannaoun Engineers, Chatsworth �;,` %�6! �{ • �� EBS Inc., Corona ic Excel ,Paving Co., Long Beach, .. %a Gass Construction, Tustin Hardy and Harper, Santa Ana. 40f - a IC_ E Engineering, Industry Sequel,Contractors, Santa Fe Springs Silvia Contractors; Rancho Cucamonga . Terra Pave, Santa Fe S:prmgs 70 The R J. Noble Company;;. range'� ^ 7�7 �; 9`3 • . CC 1372 Bid Opening Worksheet 11/4/201012:03 PM 11/9/2010 Garfield Avenue Rehabilitation Project, Newland to Magnolia Owner: City of Huntington Beach Bid Opening: 11/04/10 ` marks an allowance Engineer's Estimate Bannaoun Engineers Constructors RJ Noble EBS, Inc. Hardy & Harper, Inc. All American Asphalt Sequel Contractors Inc Excel Paving Company Terra Pave 9614 Cozycroft Ave Chatswroth, CA 91311 15505 E Lincoln Ave Orange, CA 92865-1015 Us 1320 E Sixth Street Ste H100 Corona, CA 928791700 US 1312 East Warner Avenue Santa Ana, CA 92705 US 400 E 6th St Corona, CA 92878 13546 Imperial Hwy Santa Fe Springs, CA 90670 2230 Lemon Avenue Long Beach, CA 908065195 US 11925 Los Nietos Rd Santa Fe Springs, CA 90670 CC-1372, Garfield Bid Items Item # Item Descripti on Quantity Unit of Measur a Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total Unit Price Item Total 1 TION 1 LS $0.00 $0.00 $3,000.00 $3,000.00 $24,000.00 $24,000.00 $18,000.00 $18,000.00 $24,000.00 $24,000.00 $13,750.00 $13,750.00 $25,000.00 $25,000.00 $50,000.00 $50,000.00 $14,000.00 $14,000.00 21 ICONTROL 11 LS $0.001 $0.00 $3,500.00 $3,500.001 $770.00 $770.00 $3,800.00 $3,800.00 $6,000.00 $6,000.00 $3,300.001 $3,300.00 $6,000.00 $6,000.00 $3,000.00 $3,000.00 $2,500.00 $2,500.00 3 PROJECT 1 LS $0.00 $0.00 $9,500.00 $9,500.00 $12,500.00 $12,500.00 $9,600.00 $9,600.00 $24,000.00 $24,000.00 $33,740.90 $33,740.90 $50,000.00 $50,000.00 $30,000.00 $30,000.00 $8,500.00 $8,500.00 4 FIED 470 CY $0.00 $0.00 $30.00 $14,100.00 $53.60 $25,192.00 $64.00 $30,080.00 $30.30 $14,241.00 $53.00 $24,910.00 $50.00 $23,500.00 $56.00 $26,320.00 $97.00 $45,590.00 5 E, 139890 SF $0.00 $0.00 $0.85 $118,906.50 $1.12 $156,676.80 $1.06 $148,283.40 $1.06 $148,283.40 $0.97 $135,693.30 $0.95 $132,895.50 $1.10 $153,879.00 $1.30 $181,857.00 6 GRIND 55530 SF $0.00 $0.00 $0.20 $11,106.00 $0.20 $11,106.00 $0.20 $11,106.00 $0.22 $12,216.60 $0.16 $8,884.80 $0.22 $12,216.60 $0.26 $14,437.80 $0.24 $13,327.20 7 CT 3265 TN $0.00 $0.00 $67.00 $218,755.00 $63.00 $205,695.00 $65.00 $212,225.00 $61.16 $199,687.40 $71.00 $231,815.00 $65.45 $213,694.25 $63.00 $205,695.00 $64.00 $208,960.00 8 CT 2560 TN $0.001 $0.00 $80.00 $204,800.00 $71.00 $181,760.00 $76.00 $194,560.00 $75.57 $193,459.20 $75.00 $192,000.00 $78.00 $199,680.00 $76.00 $194,560.00 $83.00 $212,480.00 9 & 1845 LF $0.00 $0.00 $28.50 $52,582.50 $28.70 $52,951.50 $28.00 $51,660.00 $21.12 $38,966.40 $32.00 $59,040.00 $25.00 $46,125.00 $28.00 $51,660.00 $31.00 $57,195.00 10 EXISTING 370 SF $0.00 $0.00 $1.85 $684.50 $1.10 $407.00 $2.50 $925.00 $3.00 $1,110.00 $1.40 $518.00 $1.00 $370.00 $1.50 $555.00 $1.25 $462.50 11 & 7000 SF $0.00 $0.00 $4.65 $32,550.00 $4.10 $28,700.00 $4.95 $34,650.00 $4.74 $33,180.00 $4.75 $33,250.00 $4.00 $28,000.00 $4.00 $28,000.00 $4.75 $33,250.00 12 AND 5001 SF $0.00 $0.00 $8.00 $4,000.00 $14.55 $7,275.00 $12.00 $6,000.00 $9.00 $4,500.00 $12.50 $6,250.00 $5.00 $2,500.00 $16.00 $8,000.00 $7.80 $3,900.00 13 AND 2 EA $0.00 $0.00 $1,650.00 $3,300.00 $2,765.00 $5,530.00 $2,300.00 $4,600.00 $2,555.00 $5,110.00 $2,000.00 $4,000.00 $2,000.00 $4,000.00 $2,000.00 $4,000.00 $1,900.00 $3,800.00 14 JAND 3 EA $0.00 $0.00 $1,500.00 $4,500.00 $2,565.00 $7,695.00 $2,300.00 $6,900.00 $2,555.00 $7,665.00 $2,000.00 $6,000.00 $2,000.00 $6,000.00 $2,500.00 $7,500.00 $1,900.00 $5,700.00 15 TRUNCAT 1 EA $0.00 $0.00 $500.00 $500.001 $275.00 $275.00 $530.00 $530.00 $800.00 $800.00 $400.00 $400.00 $500.00 $500.00 $300.00 $300.00 $650.00 $650.00 16 SEWER/ST 13 EA $0.00 $0.00 $350.00 $4,550.00 $276.00 $3,588.00 $610.00 $7,930.00 $700.00 $9,100.00 $560.00 $7,280.00 $400.00 $5,200.00 $380.00 $4,940.00 $735.00 $9,555.00 17 OCSD 1 EA $0.00 $0.00 $350.00 $350.00 $276.00 $276.00 $765.00 $765.00 $900.00 $900.00 $560.00 $560.00 $400.00 $400.00 $380.00 $380.00 $735.00 $735.00 18 CITY OF 11 EA $0.00 $0.00 $275.00 $3,025.00 $295.00 $3,245.00 $500.00 $5,500.00 $575.00 $6,325.00 $525.00 $5,775.00 $400.00 $4,400.00 $220.00 $2,420.00 $550.00 $6,050.00 19 CITY OF 12 EA $0.00 $0.00 $275.00 $3,300.00 $300.00 $3,600.00 $500.00 $6,000.00 $575.00 $6,900.00 $525.00 $6,300.001 $400.00 $4,800.00 $220.00 $2,640.00 $550.00 $6,600.00 20 IMONITOR. 1 EA $0.00 $0.00 $275.00 $275.00 $260.00 $260.00 $610.00 $610.00 $750.00 $750.00 $525.00 $525.00 $400.00 $400.00 $220.00 $220.00 $1,000.00 $1,000.00 21 SURVEY 4 EA $0.00 $0.00 $275.00 $1,100.00 $260.00 $1,040.00 $500.00 $2,000.00 $575.00 $2,300.00 $325.00 $1,300.00 $400.00 $1,600.00 $220.00 $880.00 $850.00 $3,400.00 22 MONUME 11 EA $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 23 EXISTING 14 EA $0.00 $0.00 $650.00 $9,100.00 $590.00 $8,260.00 $355.00 $4,970.00 $1,000.00 $14,000.00 $375.00 $5,250.00 $900.00 $12,600.00 $800.00 $11,200.00 $675.00 $9,450.00 24 & PLANT 14 EA $0.00 $0.00 $850.00 $11,900.00 $475.00 $6,650.00 $575.00 $8,050.00 $500.00 $7,000.00 $500.00 $7,000.00 $600.00 $8,400.00 $500.00 $7,000.00 $900.00 $12,600.00 25 90 DAY 1 LS $0.00 $0.00 $3,500.00 $3,500.00 $1,850.00 $1,850.00 $2,200.00 $2,200.00 $2,200.00 $2,200.00 $300.00 $300.00 $2,500.00 $2,500.00 $1,800.00 $1,800.00 $500.00 $500.00 26 1 YEAR 1 LS $0.00 $0.00 $5,000.00 $5,000.00 $8,200.00 $8,200.00 $9,600.00 $9,600.00 $10,000.00 $10,000.00 $1,750.00 $1,750.00 $10,000.00 $10,000.00 $7,000.00 $7,000.00 $2,000.00 $2,000.00 27 SIGNING 1 LS $0.00 $0.00 $15,500.00 $15,500.00 $16,000,00 $16,000.00 $12,600.00 $12,600.00 $16,000.00 $16,000.00 $14,400.00 $14,400.00 $18,000.00 $18,000.00 $15,000.00 $15,000.00 $15,000.00 $15,000.00 28 TRAFFIC 22 EA $0.00 $0.00 $210.00 $4,620.00 $188.00 $4,136.00 $185.00 $4,070.00 $191.00 $4,202.00 $200.00 $4,400.00 $300.00 $6,600.00 $200.00 $4,400.00 $230.00 $5,060.00 29 SIGNAL 1 LS $0.00 $0.00 $21,500.00 $21,500.00 $18,500.00 $18,500.00 $17,000.00 $17,000.00 $24,000.00 $24,000.00 $15,300.00 $15,300.00 $28,000.00 $28,000.00 $20,000.00 $20,000.00 $17,850.00 $17,850.00 30 NOSE 1 LS $0.00 $0.00 $950.00 $950.00 $1,560.00 $1,560.00 $4,800.00 $4,800.00 $5,104.00 $5,104.00 $1,132.00 $1,132.00 $3,000.00 $3,000.00 $3,000.00 $3,000.00 $550.00 $550.00 List $0.00 $766,454.50 $797,698.30 $819,014.40 $822,000.00 $824,824.00 $856,381.35 $858,786.80 $882,521.70 Total Bid Amount $0.00 $766,454.50'1 $797,698.301 $819,014.40 $822,000.001 $824,824.00 $856,381.351 $858,786.80 $882,521.70 Total Bid Amount with 0% Preference i 1 $766,454.00 n/a n/a n/a n/a n/a n/a I n/a Listed Subs G:\Construction Contracts (CCs)\CC1372 Garfield Avenue Rehablitation\pre award\Bid Opening and Award\CC-1372 Bid Results SECTION C LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. ,._:..�:•�-::_. :_..cP............ 117rxrre,....ntl_........_.Qs..:_._.......o.,....:.ato...........:.. c...... .. ...:.::.::.:. -ami ........:... e7-t �BaC�°1 r� $ Cr•�c.leM C-10 4, /6, /7,/8 aC9f a?l 7 0 71 s s-a-oc. s U,k%,v.'®vi 8,66 -784 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 City ®f (Huntington Beach 2000 Main Street • Huntington Beach, CA 92646 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK March 7, 2011 All American Asphalt P. O. Box 2229 Corona, CA 92878-2229 RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, I � 6 P�- lj� � Joan L. Flynn, CIVIC City Clerk JF: pe enclosure Sister Citipf6&apicA AVretAbi g%New Zealand (Telephone: 714-536-5227 ) City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowledge receipt and review of Addendum Number One, dated November 1, 2010.. 14G1 AyaL6,ai n Company Name By (r Y` Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. OPTION "A" 2"x4" WOOD PALM TREE BRACE 2"x4" RWD. STAK 2'- 0" (ERIFY WITH CITY SECTION 07, OPTION "B" PALM TRUNK UNK NOTES: 2"X4" WOOD BLOCK, NAIL TO FRAME. 2� O 2"X4" 2"X8" 4 WOOD BLOCK, NAIL TO BRACE & STAKE. WOOD FRAME WITH CARPET ON SIDE 5 2 FACING PALM. ® CARPET CUSHION: STAPLE TO INSIDE OF FRAME. PLAN VIEW O STEEL TREE BOX BANDING STRAP (2 BANDS). PALM QUA® POD � APPROVED: CITY OF HU NQTQN BEACH I STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 713 fHTV CAI/`IKICCO 2009 1 OF 1 CALL THE CITY OF HB LANDSCAPE INSPECTOR AT (714) 536-5431 FOR TREE SPECIES, SIZE, SPACING, NURSERY SOURCES AND/OR FIELD ADJUSTMENTS BEFORE PLANTING, STAKES 2" DIAMETER LODGE POLE PINE (2) EACH. COPPER NAPTHANATE TREATED AND DRIVEN 12" BELOW THE BOTTOM OF PLANT HOLE. STAKES TO BE DRIVEN INTO THE GROUND WITH A STAKE POUNDER OR A METHOD APPROVED BY THE LANDSCAPE INSPECTOR. (USE OF SLEDGE HAMMERS, HAMMERS OR AUGURING TOOLS WILL NOT BE PERMITTED). STAKES ARE TO BE PLUMB. ADJUST STAKE LENGTH PER TREE VARIETY OR AS DIRECTED BY THE LANDSCAPE INSPECTOR. STAKES ARE TO BE PARALLEL WITH THE ROADWAY. A THIRD STAKE AND TWO EXTRA TIES MAY BE REQUIRED IN SPECIAL CONDITIONS. TIES 32" LONG (MIN) 'CINCH TIES' (4EA PER TREE). ATTACH WITH 4D GALVANIZED ROOFING NAILS BENT OVER BACK OF STAKES (ONE NAIL PER CINCH TIE). PRE DRILL ALL HOLES. TREE PLANTING PLANT HOLE SIZE TO BE A MINIMUM OF (2) TIMES LARGER THAN THE CONTAINER. DUST ENTIRE HOLE WITH GYPSUM BEFORE BACKF€LLING. PLANT THE TREE CROWN 1 1/2" ABOVE FINISH SOIL GRADE. BACKFILL 2 PARTS CLASS A TOPSOIL TO BE THOROUGHLY MIXED WITH (1) PART NITROLIZED SAWDUST. ROOTBARRIER FOR TREES WITHIN 6' OF HANDSCAPE OR LOW WALLS, SEE STD PLAN 718 (LINEAR ROOT BARRIER). WATER BASIN 3" HIGH WATER BASIN IN GROUNDCOVER AREAS. IN LAWN AREAS USE A 24" DIAMETER OF 3" SHREDDED BARK (NO BASIN). SUMP SEE STD PLAN 716 (TREE/PALM SUMP) OR 716A. &- TREES IN LAWN AREAS SHALL HAVE A 36" DIA. AREA CLEAR OF LAWN, CENTERED AROUND THE TREE TRUNK, AND MULCHED WITH 3" OF "MEDIUM GRIND MULCH" FROM RECYCLED WOOD PRODUCTS (626) 727-7211. TREE PLANTING AND STAKING I reLsl APPROVED: CITY OF HUNTINGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 714 rrry C'KicihirrD 2009 1 OF 1 SET CROWN OF ROOTBALL 1 1 /2 INCHES ABOVE 30" FINISH GRADE I MIN. SIDEWALK a. .a O b yl/ w O w a- o w oQ}� Q_mo �ooLa zn u j:D ry�> d a_ 0 U r APPROVED: NOTE: SINGLE STAKE PALM UPWIND WITH ONE 10 FOOT LODGEPOLE PINE STAKE DRIVEN 24 INCHES INTO UNDISTURBED SUBGADE WITH TWO 'CINCH TIES' NAILED THRU STAKE AND BENT OVER. 4" DIA. BLACK SDR 55 (PEA GRAVEL FILLED) PERFORATED DRAIN PIPE (2 REO D) (ONE INCH FROM BOTTOM OF PLANT PIT) CURB AND GUTTER WHERE OCCUR i 1/2,'BASE MATERIAL COMPACTED SAND BACKFILL \ PLACE TWO PIECES OF #70 MIL FILTER HOBLEINTTHEMESHEATOP OF A RIGHT ANGLE AUGERED ANGLETO THE MESH OF THE FABRIC BELOW BACKFILL AUGERED HOLE WITH 3/4" CRUSHED ROCK 12 INCH DIAMETER I AUGERED HOLE EQ -DRAIN PIPE STAKE LOCATION UPWIND FROM EQ PALM 0 PLA V]EW PALM ROOTBALL/ ® NOTE: AUGER THE HOLE TO THE MAXIMUM DEPTH OF 10 FEET UNLESS GROUNDWATER OR A POROURS MATERIAL IS ENCOUNTERED AND APPROVED AS POROUS BY THE CITY INSPECTOR ® NOTE: REFER TO SPEC'S ON STANDARD PLAN 715, 3 OF 3 ARTERIAL PALMWELL PLANTING pas - CITY OF HUNTINGTON REACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 715 CITY ENGINEER 2009 1 OF 3- SET CROWN OF ROOTBALL 1 1/2 INCHES ABOVE FINISH GRADE \ SIDEWALK LL-i OQ m V) U Q— O W L,..I wowa afyd(1) 0 f- w x�F- OQr� ¢-'mo �000 zCL Q orz w� Qcr Ow� I/ TREE STAKING SEE STD 714 4" DIA. BLACK SDR 55 (PEA GRAVEL FILLED PERFORATED DRAIN PIPE (2 RE4 D) (ONE INCH FROM BOTTOM OF PLANT PIT) 24" DEEP CONTINUOUS ROOT BARRIER .08" THICK PLACED ADJACENT TO 30" CURB/WALK MIN. CURB AND GUTTER WHERE OCCUR 1 1 /2"BASE MATERIAL "d ` .'.`. PLACE TWO PIECES OF #70 MIL FILTER FABRIC OVER THE TOP OF THE AUGERED HOLE WITH MESH AT A RIGHT ANGLE TO THE MESH OF THE FABRIC BELOW BACKFILL AUGERED HOLE WITH 3/4" CRUSHED ROCK -12 INCH DIAMETER AUGERED HOLE op 0-4 DRAIN PIPE Q ROOT BARRIER CONTINUOUS EO TREE STAKING SEE STD 714 PLAN VIEW TREE ROOTBALL • NOTE: AUGER THE HOLE TO THE MAXIMUM DEPTH OF 10 FEET UNLESS GROUNDWATER OR A POROURS MATERIAL IS ENCOUNTERED AND APPROVED AS POROUS BY THE CITY INSPECTOR • NOTE: REFER TO SPEC'S ON STANDARD PLAN 715, 3 OF 3 ARTERIAL TREEWELL PLANTING e APPROVED: C+� OF HUNTINGTON BEACH STANDARD I !� PLAN DEPARTMENT OF PUBLIC WORKS 715 CITY ENGINEER 2009 2 OF 3 PLANTING SPECIFICATIONS 1� PRIOR TO EXCAVATING OR BORING, NOTIFY DIG ALERT TO FIELD MARK EXISTING UTILITIES. PROTECT IN PLACE. IF FIELD CONFLICT EXISTS, NOTIFY THE LANDSCAPE ARCHITECT/INSPECTOR. PROCEED WITH WORK ONLY AFTER NEW DIRECTIONS HAVE BEEN GIVEN BY THE LANDSCAPE ARCHITECT/INSPECTOR. Q2 EXCAVATE PLANT HOLE TO SIZE AND DEPTH SHOWN. O EXCAVATE AND CONSTRUCT DRAINAGE SUMP PER 'TREE/PALM SUMP' STANDARD PLAN NO. 716. ® CONNECT EACH 2' LONG X 2' WIDE PIECE OF 'DEEP ROOT' ROOT BARRIER PANELING TO ANOTHER 2' LONG X 2' WIDE PIECE WITH THE MANUFACTURERS JOINER STRIP TO FORM ONE CONTINUOUS 10' LENGTH. BEND 10 ' LENGTH OF ROOT BARRIER TOGETHER INTO CONFIGURATION AS SHOWN AROUND ROOTBALL AND CONNECT ENDS USING ANOTHER JOINER STRIP. DEEP ROOT BARRIER SHALL BE FLUSH WITH THE EDGE OF CONCRETE PAVING. DO NOT USE ROOT BARRIER WITH PALMS UNLESS DIRECTED BY THE LANDSCAPE INSPECTOR. 0 INSTALL 6" PERFORATED ABS PLASTIC SDR 35 DRAIN PIPE IN ALTERNATE CORNERS VERTICALLY AND FILL WITH 3/4" CRUSHED DRAIN ROCK. PERFORATIONS SHALL BE A MINIMUM OF 1/2" IN DIAMETER IN THREE LOCATIONS AROUND THE CIRCUMFERENCE. ® FOR TREES, BACKFILL PLANT HOLE APPROXIMATELY 6" TO 12" DEEP WITH PREPARED BACKFILL AS SPECIFIED IN THE CITY OF HUNTINGTON BEACH LANDSCAPE SPECIFICATIONS. FILL THE REMAINDER OF THE HOLE WITH WATER TO SETTLE. FOR PALMS, BACKFILL WITH PURE CLEAN COARSE SAND. COMPACT SAND WITH A 'BUSHWACKER' AND WATER TO CREATE A SOLID BASE FOR THE PALM. �7 AFTER BACKFILL HAS SUFFICIENTLY SETTLED AND DRIED AS DIRECTED BY THE LANDSCAPE INSPECTOR, INSTALL THE TREE ROOTBALL WITH THE TOP LEVEL AND 1" ABOVE THE BOTTOM OF THE ADJACENT SIDEWALK. FOR PALMS, BACKFILL WITH CLEAN, COARSE SAND AND COMPACT WITH 'BUSHWACKER' AND WATER TO THE SATISFACTION OF THE LANDSCAPE INSPECTOR. ® BACKFILL THE REMAINING TREE WELL VOIDS WITH SPECIFIED BACKFILL AND WATER TO SETTLE. ® STAKE TREE PER STANDARD PLAN NO. 714. ALL PALMS IN MEDIAN ISLANDS AND PALMS WITH 10' OF BROWN TRUNK OR GREATER TO BE STAKE ANCHORED WITH PALM QUAD PODS PER STANDARD PLAN NO. 713, PALMS WITH LESS THAN 10' OF BROWN TRUCK AND NOT IN MEDIAN ISLANDS SHALL BE STAKED WITH A 10' LONG, 2" DIAMETER COPPER NAPHANATE TREATED LODGE POLE PINE STAKE, DRIVEN A MINIMUM OF 3' INTO THE GROUND AND 12" BELOW THE BOTTOM OF THE PLANT HOLE. TIE TO PALM WITH 'GRO-STRAIGHT' RUBBER TIRE TIES (24" TO 36" LONG) SIZE AS REQUIRED TO ENCIRCLE STAKE AND PALM LOOSELY. ATTACH TO STAKE WITH A 16D NAIL AND BEND NAIL ON BACK OF STAKE. 10 AFTER BACKFILL HAS SUFFICIENTLY SETTLED AND DRIED, BRING BACKFILL TO GRADE SHOWN. � ARTERIAL - REEWELL I Imo' -. �- . - SPECIFICATIONS _. APPROVED: CITY OF HUNTINGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 715 , w 2009 3 OF 3 PLACE TWO PIECES OF #70 MIL FILTER FABRIC OVER THE TOP OF THE AUGERED HOLE WITH MESH AT A RIGHT ANGLE TO THE MESH OF THE FABRIC BELOW UGERED HOLE CRUSHED ROCK ,METER DLE NOTE: AUGER THE HOLE TO THE MAXIMUM DEPTH OF 10 FEET UNLESS GROUNDWATER OR A POROUR MATERIAL IS ENCOUNTERED AND APPROVED AS POROUS BY THE CITY INSPECTOR 109 TREE AND PALM SUMS APPROVED: CITY ®F I,,,11 [NMNGTON BEACH STANDARD t 1 r9`!9� i 9 BEACH E PLAN DEPARTMENT OF PUBLIC WORKS 716 /lETV CAIMAiCCO 2009 1 OF 1 D z_ Mt R N 4 1 2 I I I 3 i I I I WITHIN 6' OF CURBS, WALKS OR LOW WALLS A ROOTBARRIER IS REQ'D TREE: ONE, FIVE, FIFTEEN GALLON OR BOXED TREE. CONCRETE CURB OR SIDEWALK WHERE OCCURS. 3Q- HARDSCAPE WHERE OCCURS EDGE OF MASONRY WALL UNDER 4' IN HEIGHT. 24" DEEP X .08" THICK X 12' LONG PVC ROOT BARRIER CENTERED ON THE TREE. LOCATE FLUSH WITH TOP OF CURB OR HARDSCAPE. WHERE ROOT BARRIER OCCURS IN MEDIANS WITH STAMPED CONCRETE, PLACE FLUSH WITH THE TOP OF STAMPED CONCRETE. LINEAR ROOT BARRIER � APPROVED: CITY OF HUNTINGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 718 ,,,, , �,, ,,,,��� 2009 1 OF 1 w a z �0 IN BROWN TRUNK HEIGHT (B.T.H.) BROWN TRUNK HEIGHT (B.T.H.) IS THE MEASUREMENT REFERENCED IN AND REQUIRED BY THE CITY OF HUNTINGTON BEACH ORDINANCE CODE. NOTES: AMERICAN STANDARD FOR NURSERY STOCK -HEIGHT MEASUREMENT CRITERIA DIFFERS FROM BROWN TRUNK HEIGHT -WHICH IS MEASURED FROM FINISH GRADE TO THE BOTTOM OF THE FIRST VIABLE PETIOLE. NOTE: NURSERIES SELL PALMS WITH ONE OF THESE TWO MEASUREMENTS. PALM HEIGHT MEASUREMENT to . APPROVED: CITY OF HUNTINGTON BEACH STANDARD PLAN DEPARTMENT OF PUBLIC WORKS 719 CITY ENGINEER 2009 1 OF 1 PROPOSAL for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181(168) 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 50 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices -set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 'n the amount of $jb�o which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 PROJECT DID SCHEDULE - Garfield CC-1372 SECTION C GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET CC NO.1372 FEDERAL AID PROJECT ESPL-5181 (168) PROJECT BASE BID: GARFIELD AVENUE — from Newland Street to Magnolia Street C-2.2 to C-2.4 BASE BID TOTAL AMOUNT LUMP SLIM BID IN FIGURES: s %D,H,%A14"C)(-'� C-2.1 PROJECT BID SCHEDULE - Garfield CC-1372 1 11 LS 2 1 LS min 4 1470 CY 5 1139890 SF #eiirt:�vy th:....ft ..... e::::::::::::::::::::::.. ::::::::.... ::::::::::::E ten ie :::;:: ;:.;. #� .....:P ..... ::: A l at i�it;:::::: bilization �,• Control Plan Furnish Project Traffic Control $ � �� . - C`` I $ ,.-' $ nclassified Excavation (includes disposal of material and fabric) c $ 00 1 $ 2�.q its :rize, Remove excess, Grade, Cement Treat, Microcrack by Process (includes disposal) 6 55530 Surface Grind (0.1 T) (includes diposal of materal and fabric) SF $ 7 3265 Construct Asphalt Concrete (0.25' & 0.75' per plan) TN $ 1 1 OG $ ;D)k�\ l� i 8 2560 Construct Asphalt Concrete (0.17' ARHM Overlay) c TN $ S . C o $ , OW Remove & Reconstruct: Curb & Gutter (CF=8", Includes AB) per 9 1845 Std Plan 202 LF $ 32oc) $ �t,ULAO� 10 370 Remove existing sidewalk (includes disposal) SF $ $`J\is•00 Remove & Reconstruct Sidewalk per Std Plan 207 (includes 11 7000 SF disposal) $ �5 — cc $ ? X-3-6 Remove and Reconstruct Commercial Driveway per H13 Std. Plan 211 (including all appurtenances but not limited to: onsite 12 500 improvements, retaining curb, slot pave, etc.) C _ $ USCG �e SF $ So v C-2.2 PROJECT BID SCHEDULE - Garfield CC-1372 Tteri �stitiia ed.::::::::::::::::: tctn:vvi#}i:iinit:rice:::<:::`>.::::::::::;:::::::::::::;:;`.:::::;:.:,:::;:_:,:;:.:;:,:,:::;::<.::::]Kx~feai P. M... :•..•.:•::..•.:•::•:•:::::• :.�0,...•.�lil�14f1...• ..........:..•.•:.... •.•.•.•.:•.•.•.�.•.•.•.•.•.•.•.•.W .•.•.•...•.•. x -i o s:.:.:.:.:.:.:.:..:.:.:..:.:.:.:.:..:.:.::: : ..�4'�,-I�•�..�1+.......................... ..•. . €:.'race:=:. .�.��Tl?.. �'....... .•.•.•� ..0>x ..... . Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 13 2 EA slot pave, etc.) per Caltrans Std. A88A $Ci'`' $ 4C;G6 Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 14 3 EA slot pave, etc.) per Fountain Valley Std. 204-3, Case "C $ o0o $ 6.006 15 1 EA Install Truncated Domes to existing access Ramp $ LA CG .L 6 $OC �U 16 13 EA Adjust Sewer/Storm Drain Manhole to finished surface $'S (Do • 0o $ 17 1 EA Adjust OCSD Sewer Manhole to finished surface $5L26' .co $ 18 11 EA Adjust City of HB Water Valve to finshed surface $S2.s-o) $ 5715.C) I 19 12 EA Adjust City of Fountain Valley Water Valve to finished surface $ 2 5 - $ (OR 20 1 EA Adjust Monitoring Well to finished surface $ . 2 W $ S LS c° 21 4 EA Raise Survey Monument Well to finished surface $R)25 -oc) $ l30G.0C, SurveynMonumet ien-City to Provide Survey Monumentation 22 EA Remove existing Tree and Roots; Grind Tree Stump and roots to 23 14 EA 24" below Top of Sidewalk/Grade _ $1J $ Furnish & Plant 24" box trees (remove existing landscaping and 24 14 EA irrigation to accommodate 24" box trees, replace irrigation in kind) $ JGC: CC bCI $ �,t1 C-2.3 PROJECT BID SCHEDULE - Garfield CC-1372 :Ifeigi; ....... ::E:siinai . ....... ::::::: Zterii:�pitii:_iiiit:';�riee:::::::;:::;:::;:::::;:::;:;::::::::::;:;:::::::•:•::;:;:;:;::::•:•:•:;:;:.... i'. . :.QitCj?':�:: .>rFtt t. �... Bilk .1i1�. . :•:A mcti> Ott .. . 25 1 Provide 90 Day Plant Establishment LS $ AO(,.00 $ :1CC),00 26 1 LS Provide 1 Year Maintenance j $ i 15O ©` $ 1-7 S 6 0 `. 27 1 Traffic Signing and Striping per plan LS $ ILL 4 0 0 $ G O 28 22 EA Install Traffic Loops $ BOG .d© $ L-i,(Aoo 24 1 LS Traffic Signal Pullbox and Relocation and Conduit Installation. $ ©` 30 1 Median nose reduction and crosswalk modification per Appendix $2. UL LS S in Specifications. Total Amount Bid in Figures: $ qa(4,SDLL4,00 Total Amount Bid in Words: ,c��e�t_� :e-Cuvw'--_K' s�``G ----- -�{�,,� _ ` 6 wee �� r ck�tl t u nd,re� --t- I-S C-2.4 SECTION C LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. �Portivn: iVtame and Address of S�rbcontractor :Sta% Lccens Class Nuarttber_;..-': l.. k� txxUNCA �dc,��s ca'�Ckl �Gy�c Cec►n "?�3Ga� A° -lG a C. L%u.1 i t,rf �z�r C_ C'(J,(N An c,�)6 ro /D 44 4 5 GfY1 r ►O 'A4S `ate TS i -32 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of ®fie 4e JGW- e being first duly sworn, dep ses and says that he orb is of i4�d� 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. #v _ X*WZA_0AJ#tF Name of Bidder Signature of Bidder i V'' �• I 7,o, ;c� z�aaq, Address of Bidder Subscribed and sworn to be of �91 . day of , 201 C-4 CALIFORNIA .BURAT State of California County of Riverside BRENOA L. ROVSTER Art Commission #t 1908379 = Notary Public - California Riverside County M Comm. Ex iras Oct 26 2014 Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 3rd day of November, 2010, Date Month By (1) Robert Bradley Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) (,) (2) (and Name of Signer Prove to' me on the basis of satisfactory evidence be a person who appeared before me.) Signature Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document Noncollusion Affidavit Document Date: 11-3-10 Number of Pages: 1 Signer(s) Other Than Named Above: None S" 12]AM UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (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 S, California Administrative Code, Section 2700, as follows: "(qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: AIQ �Wmlt� Contractor V�wwxOF .® Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? Yes 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. 1 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 X will comply with such provisions before commencing the performance of the work of this contract. Date: kc. 3+ 216 l () ka AN AyAkr Contractor Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: W Bidder Name P'0 k ;� 'a;` Business Address City, State Zip (�-1)Z%-?(0rs0 Telephone Number *- Ao7673 47 z State Contractor's License No. and Class —(l'7 1 Original Date Issued -3t-1Z Expiration Date The work site was inspected by (2f our office on �� . 2.._, 2010 The following are persons, firms, and corporations having a principal interest in this proposal: C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Comnanv Name Printed or Typed Signature Subscribed and sworn to before y of , 201_ NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. , 2. 0 Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public 70ject Name and Telephone No. ofManager: Contract Amount ark Type of Work Name and Addpbss of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Date Completed Date Completed C-9 CALIFORNIA J I1 'A State of California County of Riverside BRENOA L. ROYSTER COmmiaaion # 1908379 Notary Public - California Riverside County Mv Comm. Ex fires Oct 26, 2014 Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 3rd day of November, 2010, Date Month By (1) Robert Bradley Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) (,) (2) Signature (a Name of Signer F to me on the basis of satisfactory evidence person who appeared before me.) OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document Bidder's Information Document Date: 11-3-10 Number of Pages: 3 Signer(s) Other Than Named Above: None Signature of Notary Public Top of thumb here Top of thumb here "2010" PAST WORK REFERENCES City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 Contact: Edward Torres, (714) 647-5018 City of Chino 13220 Central Avenue Chino, CA 91790 Contact: Emani Naghmeh, (909) 464-8367 City of Costa Mesa 77 Fair Drive Costa Mesa, CA 92628-1200 Contact: Thomas Banks, (714) 754-5222 City of Westminster 8200 Westminster Boulevard Westminster, CA 92683 Contact: Tuan Pham, (714) 898-3311 ext. 209 City of Paramount 16400 Colorado Avenue Paramount, CA 90723-5012 Contact: Ed Cox, (562) 908-6205 City of Cerritos 18125 Bloomfield Avenue Cerritos, CA 90703-3130 Contact: Rash Syed, (562) 916-1221 City of Anaheim 200 South Anaheim Boulevard Anaheim, CA 92805 Contact: Sean Ramsey, (714) 765-5059 City of Garden Grove 11222 Acacia Parkway Garden Grove, CA 92842 Contact: (714) 741-5180 Segerstrom Avenue Rehabilitation Contract Amount: $2,094,618.00 Start: 11 /2009 Completed: 3/30/2010 Street Rehabilitation Project FY 08/09 Contract Amount: $2,127,501.00 Start: 11/2009 Completed: 5/31/2010 Rehabilitation of Vanguard Way Contract Amount: $517,646.00 Start: 12/2009 Completed: 2/30/2010 City-wide Overlay 09-10 St. Improvement Project Contract Amount: $1,171.416.00 Start: 2/1/2010 Completed: 5/30/2010 Resurfacing in Rosecrans Avenue Contract Amount: $572,209.00 Start: 10/1/2009 Completed: 5/30/2010 Bloomfield Avenue Improvements Contract Amount: $1,103,000.00 Start: 3/1/2010 Completed: 6/20/2010 Magnolia Avenue Street Improvements Contract Amount: $868,000.00 Start: 4/1/2010 Completed: 7/20/2010 Harbor Boulevard Street Rehabilitation Contract Amount: $919,000.00 Start: 3/1/2010 Completed: 6/30/2010 "2009" PAST WORK REFERENCES City of Costa Mesa 77 Fair Drive P.O. Box 1200 Costa Mesa, CA 92628-1200 Contact: Tom Banks, (714) 536-5431 City of Dana Point 33282 Golden Lantern Dana Point, CA 92628 Contact: Archie Rempher, (949) 248-3500 City of Beverly Hills 345 Foothill Road Beverly Hills, CA 90210 Contact: Juan Martinez, (310) 285-2521 County of San Bernardino 825 East Third Street San Bernardino, CA 92415-0835 Contact: Sri Srirajan, (909)387-7935 City of Redondo Beach 415 Diamond Street Redondo Beach, CA 90277 Contact: Javier Urista, (310) 318-0661 City of Westlake Village 31200 Oak Crest Drive Westlake Village, CA 91361 Contact: Roxanne Hughes, (805) 653-6597 Department of Transportation 12975 Culver Blvd. Los Angeles, CA 90066 Contact: Sixto Ramin, (213) 216-4406 City of Rialto 150 South Palm Avenue Rialto, CA 92376 Contact: Eddie Chan, (909) 820-2651 Prop 1 B Street Maintenance Contract Amount: $993,993.00 Start: 7/2009 On -going — not completed yet Annual Roadway Resurfacing Project Contract Amount: $3,982,982.00 Start: 4/2009 On -going — not completed yet 2008-09 Street Resurfacing Contract Amount: $4,085,000.00 Start: 1/2009 Completed: 8/2009 Arrow Route Contract Amount: $1,980,000.00 Start: 2/2009 Completed: 7/2009 Public Improvement Package Contract Amount: $1,678,000.00 Start: 9/2009 Completed: 1 /2009 Joint Cities Pavement Rehab. Project Contract Amount: $1,242,241.11 Start: 6/2009 Completed: 9/2009 Route 27, Contract No. 07-2Y4904 Contract Amount: $915,511.00 Start: 6/2009 Completed: 9/2009 Route 210 Detour Contract Amount: $1,983,548.00 Start: 6/2009 Completed: 9/2009 HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 RELIABLE CONTRACTOR DECLARATION (page 1 of 3) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of fiends to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalReocle.ca.gov/Regulations/Titlel4/. Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: 2W ASP AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: MAILING ADDRESS: y� As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Signature2z� Date )JO f � Oto C-11 RELIABLE CONTRACTOR DECLARATION (page 2 of 3) Title 14 CCR, (Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the -bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or -federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a'waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C-12 RELIABLE CONTRACTOR DECLARATION (page 3 of 3) (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) The bidder subcontrMvi EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION proposed hereby certifies that he has, lids '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 1.00 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-14 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidderhas= , has not been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Cade Section 10162_Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the -bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes, explain the circumstances in the following space. C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-16 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit {Title 23 United States Code Section 1 l2 and Public Contract Code Section 7106) To the CITY J C -0, f � A (LT u(T70—) &WA+ DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checidist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; 0 Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and ® Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. H Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP O1-04 C-18 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E NONLO BBYINC CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. - The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 G19 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DISCLOSURE OF LOBBYING ACTIVITIES EXHIBIT 12-E Attachment G COMPLETETMS YORM TO DISCLOSE M313YINU AU11VllltS PUKD(JANi IV SI tJ.J.0 . t,i,)/ 1. Type of Federal Action: 2Ela. . Status of Federal Action: 3. Report Type: Fla. contract bid/offer/application ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Cha a Only: e. loan guarantee year _ uarter £ loan insurance date of I report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 ' Subawardee, Enter Name and Address Prime: Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: Congress' nal District, if known 7. Feder Prograin Name/Description: FDA Number, if applicable &. Federal Action Number, if known: /4�( Award Amount, if known: y 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI address if different from No. I oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (eh all that apply) 13. Type of Payment (cheek all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payme (check all that apply): c. commission 8 a. m d. contingent fee b. i -kind; specify: nature e deferred value f. other, specify 14. Brief escription of Services Performed or to be performed and Date(s) of Service, including offi r(s), employee(s), or member(s) contacted, for Payment Indicated in Item I I - (attach Continuation Sheet(s) if necessary) Continuation Sheet(s) attached: Yes No El 16. Information requested through this forin is authori2cd by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject Title: V to a civil penalty ofnless than $10,000 and not more than A � $100,000 for each such r failure. Telephone No.: ��j( / Bate: Federal Use Only: Standard Donn LLt, Rev. U9-I L-Nt Authorized for Local Reproduction Standard Forin - LLL Page 12-87 LPP 01-04 C-20 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full narnes 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 (itern 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C 21 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-instructions Rev.06-04-90«ENDIN Page12-89 LPP 01-04 G22 March 15, 2001 ON Brenda Royster Distribution List Flame: 1-Electrical Members: C.T.&F., Inc. (Business Fax) C.T.&F., Inc.@+1 (562) 927-4171 California Engineering & Contracting, Inc. (Business Fax) California Engineering & Contracting, lnc.@+1 (714) 708-3581 California Professioanl Engineering Inc. (Business Fax) California Professioanl Engineering Inc.@+1 (626) 810-1322 Comet Electric, Inc. (Business Fax) Comet Electric, Inc.@+1 (818) 340-4033 Competitive Edge Electric (Business Fax) Competitive Edge Electric@+1 (909) 649-0233 CSI Electrical Contractors (Business Fax) CSI Electrical Contractors@+1 (562) 236-9499 Dynalectric-Los Angeles (Business Fax) Dynalectric-Los Angeles@+1 (714) 484-2389 F.J. Johnson Inc. (Business Fax) F.J. Johnson Inc.@+1 (714) 632-8569 Global Road Sealing, Inc. (Business Fax) Global Road Sealing, Inc.@+1 (714) 893-0945 High Light Electric (Business Fax) High Light Electric@+1 (951) 352-2497 L A Signal Inc. (Business Fax) L A Signal Inc.@+1 (626) 968-5720 Lincoln Pacific (Business Fax) Lincoln Pacific@+1 (626) 960-7739 Loop Masters, Inc. (Business Fax) Loop Masters, Inc.@+1 (714) 630-1783 Los Angeles Signal Construction, Inc. (Business Fax) Los Angeles Signal Construction, Inc.@+1 (909) 599-0376 MBE Electric, Inc. (Business Fax) MBE Electric, Inc.@+1 (951) 352-2498 Moore Electrical Contracting (Business Fax) Moore Electrical Contracting@+1 (951) 371-4296 Moore Signals & Lighting (Business Fax) Scott Hambright (Business Fax) Sierra Pacific (Business Fax) Smith & Son (Business Fax) Smithson Electric (Business Fax) Steiny & Company, Inc. (Business Fax) Moore Signals & Lighting@+1 (714) 693-4838 Scott Hambright@+1 (951) 681-5920 - Sierra Pacific@+1 (951) 784-4489 Smith & Son@+1 (760) 728-4157 Smithson Electric@+1 (714) 997-9559 Steinty & Company, Inc.@+1 (626) 338-8343 Traffic Loops Crackfilling Inc. (Business Fax) Traffic Loops Crackfilling Inc.@+1 (714) 520-4027 it A tl Brenda Royster Distribution List Name: 1-Landscape Members: Brumad Inc. (Business Fax) Brumad Inc.@+1 (310) 324-9589 Buena Vista Landscape Inc. (Business Fax) Buena Vista Landscape Inc.@+1 (714) 779-1406 Clarke Contracting Corporation (Business Fax) Clarke Contracting Corporation@+1 (310) 542-2188 Kato Landscape (Business Fax) Kato Landscape@+1 (714) 963-6424 Landscape F/X (Business Fax) Landscape F/X@+1 (310) 329-6756 Marina Landscape (Business Fax) Marina Landscape@+1 (714) 935-1199 Midori Landscape (Business Fax) Midori Landscape@+1 (714) 751-4167 Phoenix Landscape, Inc. (Business Fax) Phoenix Landscape, Inc.@+1 (714) 572-1412 Pierre Sprinkler and Landscape, Inc. (Business Fax) Pierre Sprinkler and Landscape, Inc.@+1 (626) 214-9328 Rivera Irrigation Inc. (Business Fax) Rivera Irrigation Inc.@+1 (714) 639-7523 S&M Landscape, Inc. (Business Fax) S&M Landscape, Inc.@+1 (626) 812-0902 Valley Crest Landscaping (Business Fax) Valley Crest Landscaping@+1 (714) 546-9524 e� Brenda Royster Distribution List Name: 1-Asphalt Pulverizaton, Soil Stabilization, Dust Control Members: Arrow Asphalt Recycling ArrowAsphaltRecycling@+1951-328-8453 Pavement Recycling System (Business Fax) Pavement Recycling System@+1 (951) 682-1094 United Soil Stabilization (Business Fax) United Soil Stabilization@+ 1661-298-5878 Brenda Royster Distribution List Name: 1-Tree Removals/Root Pruning Members: Chris's Tree Service (Business Fax) Chris's Tree Service@+1 (310) 517-9923 Stevens Tree Experts (Business Fax) Stevens Tree Experts@+1 (626) 449-7464 Treesmith Enterprises (Business Fax) TreeSmith Enterprises@+1 (714) 996-6057 Treesmith Enterprises (Business Fax) Treesmith Enterprises@+1 (714) 996-0778 V and E Tree Service, Inc. (Business Fax) V and E Tree Service, Inc.@+1 (714) 637-4070 Brenda Royster Distribution List Name: 1-Traffic Control Devices/Barricades Members: American Barricade Inc. (Business Fax) American Barricade Inc.@+1 (714) 634-2666 >H � Brenda Royster Distribution List Name: 1-Plans Members: ET Designs (Business Fax) ET Designs@+1 (800) 774-9896 Traffic Control Engineering (Business Fax) Traffic Control Engineering@+1 (714) 447-6081 N �1 Brenda Royster Distribution List Name: 1-Striping Members: ABC Resources, Inc. (Business Fax) ABC Resources, Inc.@+1 (909) 988-6201 C-18 (Business Fax) C-18@+1 (951) 845-4983 Cal Stripe Inc. (Business Fax) Cal Stripe Inc.@+1 (909) 884-7106 Chrisp Company (Business Fax) Chrisp Company@+1 (909) 820-1311 J and S Sign Company, Inc. (Business Fax) J and S Sign Company, Inc.@+1 (562) 777-2499 Orange County Striping Service, Inc. (Business Fax) Orange County Striping Service, Inc.@+1 (714) 639-6353 PCI (Business Fax) PCI@+1 (562) 218-0634 Pro -Line Striping (Business Fax) Pro -Line Striping@+1 (805) 671-9903 Ranch Rock Corp/SCI Pavement Services (Business Fax) Sudhakar Company Inc.@+1 (909) 546-1030 Schaefer R. E. Ent. (Business Fax) Schaefer R. E. Ent.@+1 (909) 460-0220 Statewide Safety & Sign (Business Fax) Statewide Safety & Sign@+1 (805) 929-5786 Sterndahl Enterprises (Business Fax) Sterndahl Enterprises@+1 (818) 834-8618 Super Seal & Stripe (Business Fax) Super Seal & Stripe@+1 (805) 524-7428 Superior Pavement Markings (Business Fax) Superior Pavement Markings@+1 (714) 562-9400 Traffic Operations Inc. (Business Fax) Traffic Operations Inc.@+1 (909) 865-7140 1 Exhibit 15-H Local Assistance Procedures Manual UDBE Information -Good Faith Effort C. The items of work which the bidder made available to UDBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: E. Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection ,of the UDBEs: Names, addresses and phone numbers of firms selected for the work above: Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: Page 15-34 July 31, 2009 C-28 LPP 09-02 .j All American Asphalt -1 Sub -contracting & Vendor Opportunities Z Phone (951) 736-7600 Public Works Fax (951) 736-7646 Project: GARFIELD AVE NEWLAND TO MAGNOLIA ST. Owner: CITY OF HUNTINGTON BEACH Bid Date & Time: 11-4-10 a1S 2:00 PM (Bid should be Wed to the above number 1 hr. prior to Bid Time) Subcontracting Opportunities In the following areas ; Underground Miscellaneous Water Improvements Landscaping & Irrigation- Street Trees XXXX Sewer Improvements Fencing and/or Railing Storm Drain Improvements Mass Grading / Earthwork Underground Linings and/or Coatings Pulverizing and/or Cement Treat, Lime Treat XXXX Adjust Utilities to Grade / Install Monuments Crack Filling / Joint Sealing Cast -in -Place Structures & V-Ditches Heater Re -Mix and/or Cold Recycling Electdcal Tree Removals and/or Root Pruning XXXX Traffic Detector Loops XXXX Base Material Traffic Signal Improvements XXXX Street and/or Parking Lot Lighting Engineering/Testing Dry Utilities Testing and/or Inspection Misc. Electrical / Video Detection Survey Concrete Traffic Control Devices and/or Plans XXXX Masonry Wall (Grouted River Rock) Specialty Wail Finishes Stamped Concrete Striping & Markings & Removals XXXX Specialty Concrete / Monument Wall Monument Signs Steel Placement Slurry Seal Grinding / Grooving Painting and/or Finishes Interlocking Pavers Chip Seal All American Asphalt is an Equal Opportunity Employer and encourages the participation of Certified DBEIMBENVBE/DVBE Subcontractors and/or Vendors. Subcontractors may be required to submit Payment & Performance Bond equal to 100 % of their bid at a maximum additional cost of 1 1/2% of total bid amount. Subcontractor will be required to fully execute All American Asphalt standard subcontract. PLANS & SPECS ARE AVAILABLE FOR REVIEW AT THE OFFICE OF ALL AMERICAN ASPHALT AT 400 E. SIXTH ST., CORONA, CA. 92879 TELE: 951-736-7600 Local Assistance Procedures Manual F. Exhibit 15-H UDBE Information - Good Faith Effort Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization _ Method/Date of Contact Results NJA— H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-02 C-Z9 July 31, 2009 n w Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LOST OF SUBCONTRACTORS (DBE and VON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: t) Ongmal - Local agency Pile rage i4-xx� LPP 06-06 November 14, 2006 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local agency Pile Page 12-111 LPP 06-06 November 14, 2006 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ fihone/. �tYlil) Pill t���1#�}liryi�rl !' S� l i� Address/ Fax In ♦ City, State, 4 iid i LJiGS•'f4) S : G�iu'! I:C tY • ♦ �� ■ �ryf ilii IE itl�if",-fk. {ll,. e!�'LYs�l`1t� ��T"i?j} � � yRl't i•s�j7-�v}'t`7 z:,.fwl �h;�g5i?l,°! i 3 ° 7� R ♦ ♦ r.. w : 1: ,; � - .n, �iy�.•iCtiSiL:Lii�f:�''-'.)»;:fiv �'.i._t'_Y.,,�t"�Yi fa +i'Sr f FT ��`3���.,� r-�;"•n ��-�szt3k; i i ri, tl—r�jtA`S �t4'13t�S�if r;?< n±lilit • ♦ 1 (l(!Id+' .,::cuut,..uv"yff:�: Y�C=..yj���ni iiK�il f C) i 1 - .7ui ! { ! ♦ � ♦ � ���J3�� Sj� ��><�&,i=)�f,.-trlS� � 11r7,4'�i���8 f�� t t tT•� 3i�✓f 71 �i �jKP) e`er-~"�k"1� ♦ � .... � _ ) � w ,/^;�Z�s� YN r r7�[F(��T'!{Sith h sl++' Sri ts>�' �nt4 ftr y,tfn 'E � 1 . Pl hsd }ti��"•S� �.����';=�iw�#��'P;�,���i�ll1p ��:. 7 3�� h�e5� }.�i�(A)i W(f�41 •1'�SS�l�fl'1. X�r �Tf?'I� StateCin ,TIM , `} �`{ , t ♦ ♦ _. _-_1 .__ _____ _ _. _ _ _... _ _— _ __.._ _ __ _. ___—._.— —. _. - - __ _ ___—___. { 9 ©4 I4 l.,itS.a1%��xikl�.Y! x fait;j ,r:1iiG✓ a�i' n Fi ii° '� s fi lY i � a l l��i���IPI,� ,li ����((� S5;I�••,il�sl.:ttl� i;3Ef ys rsErf ff'n^1?t {�utl4Cj1� �I� dlt'�li\F"r it?i�.:�atilf.f Distribution: 1) Original - Local Agency Pile Page 12-111 LPP 06-06 November 14, 2006 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST 4F SUBCONTRACTORS (DBE and NON -DBE)- FART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title R..wLtLjJ nnq Phnfnnnnv Y i r additional firms Name/Firm � � 1 r City, State, i7' 3�'YF 1� Y .c 1 2�F ttI-ti • v y.�tx is s£��a� 2�F��� ' F I _. ■ _.... y`ij ,tl K } rxs Fry � i } "� y�M—y`t='. 1 ai .- IRk h fi {.a�i}11 �t ■ ! • 7�v3rmAa } kU _ ( in ■ ! ! Gt r L.� 81 l�r���� �''r l t�J�.{��+; r}if t y etat $�� Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 Local Assistance Procedures Manual SSE and Non-DBJ BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I! The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART O6 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: t) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 ®U Fidelity and Deposit Company of Maryland 9 Home Office: P.O. Box 1227. Baltimore. MD 21203-1227 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ALL AMERICAN ASPHALT BOND NO.085 97 423 , as Principal, (hereinafter called the "Principal"), and FIDELITY AND DEPOSIT COMPANY OF MARYLAND P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto City of Huntington Beach as Obligee, (hereinafter called the "Obligee"), in the sum of TEN PERCENT OF THE TOTAL BID PRICE IN ------ Dollars ($ 10% OF TOTAL BID PRICE ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Garfield Avenue Rehabilitation - C.C. No. 1372 Federal Aid Project No. ESPL-5181(168) Bid Date: November 4, 2010 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and seated this 22nd Witness day of October A.D., 2010 ALL AMERICAN ASPHALT (SEAL) �Pr_ P Title �� FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety By KMO_ (SEAL) Barbara J. Bender Witness Rebecca Haas -Bates Attorney-im-Pact 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 ACKNOWLEDGEMENT State of California County of Riverside On November 3, 2010 before me, Brenda L. Royster, Notary Public , Date Here Insert name and Title of the Officer personally appeared Robert Bradley Name(*_�-ef Signer who proved to me on the basis of satisfactory evidence to be the BRENDA L. ROySTER person(s) whose name(s) is/are subscribed to the within instrument Commission # IOM79 and acknowledged to me that he/she" executed the same in Notary Public - California hisA;ertth& authorized capacity(ies), and that by his/herAheir Rlverside County signature(s) on the instrument the person(s), or the entity upon behalf M Comm.Expires Oct 26.2014 r of which the person(s) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State. of California that the forgoing paragraph is true and correct. WITNESS mand and official seal. Signature 7 Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Bidder's Bond — City of Huntington Beach Document Date: October 22, 2010 Number of Pages: 3 Signer(s) Other Than Named Above: Rebecca Haas -Bates, Attorney -In -Fact, Barbara J. Bender, Notary Capacity(ies) Claimed by Signer(s) Signer's Name: Robert Bradley ❑ Individual X Corporate Officer — Title(s): Vice President ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact RIGHT. ❑ Trustee Top of thumb here ❑ Other: Signer is Representing: Signer's Name ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Attorney in Fact j Top of thu ❑ Trustee ❑ Other: ®' I Signer is Representing: CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 4�,• �c, �..at.�> .�;t�±�c��S.:�.�n.L%��..�...a..adzt;siv_=�5��!T3,sjc�,r�.�c:> S 5..3',c�L S:�t,: �a,.sav']�'r.',.�va.,. �':s��,.��G�.,.�c�.�.'.�... �c..3e,� �� State of California County of Orange On 10-22-10 before me, Barbara J. Bender, Notary Public Date Here Insert Name and Title of the Officer personally appeared Rebecca Haas -Bates Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that -he/she/tl`iey executed the same in +dslher/their authorized capacity(ies), and that by WilherMeif signatures} on the instrument the person(*, or the entity upon behalf of which the persons} acted, executed the instrument. BARBARAJ.BENDER Commission # 1801899 1 certify under PENALTY OF PERJURY under the laws 2 . Notary Public - California z of the State of California that the foregoing paragraph is Orange County true and correc My Comm. Expires Jul 13, 2012 WITNESS m h an ificial al. Signature Place Notary Seal Above Signature of Wary Public OPTIONAL Though the information below is not required by taw, it may prove valuable to persons retying 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: 10-22-10 Number of Pages: One (1) _ Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas -Bates Individual Corporate Officer — Title(s): _ Partner — ❑ Limited 0 General E] Attorney in Fact El Trustee Guardian or Conservator Other: Signer Is Representing: _ Fidelity and Deposit Company of Maryland Top of thumb here Signer's Name: Individual ❑ Corporate Officer — Title(s): Partner —13 Limited ` General �] Attorney in Fact L Trustee L Guardian or Conservator 0 Other: Signer Is Representing: WMN Top of thumb here 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • w .NationalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 Power of Aftorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the. FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by WILLIAM J. MILLS, Vice President, and GREGORY E. MURRAY, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said y, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the dase 1J=ereby nominate, constitute and appoint William SYRKIN, Rebecca HAAS-BATES an f Irvine, California, EACH its true and lawful agent and Attomey-in-Fact, to mak { e v 9 behalf as surety, and as its act and deed: any and all bonds and undert a ecu ' or undertakings in pursuance of these presents, shall be as binding upon s " 1 yu d� 1 i ents and purposes, as if they had been duly executed and acknowled y ele ompany at its office in Baltimore, Md., in their own proper persons er a on behalf of William SYRKIN, Rebecca HAAS-BATES, Sergio D. BECHA and ed April 8, 2008. The said Assistant ie by certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By- s said Company, and is now in force. IN WITNESS WHEREOF, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 25th day of September, A.D. 2009. ATTEST: '�a Divvy./i a P, ISIf ? t 4 "una State of Maryland I ss: City of Baltimore FIDELITY AND DEPOSIT COMPANY OF MARYLAND J `J Gregory E_ Murray Assistant Secretary By: William J. Mills Vice President Or,- this 25th day of September, A.D. 2009, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came WILLIAM J. MILLS, Vice President, and GREGORY E. MURRAY, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ItCit/ :Y 1 a � 'riiii ltlll��` Maria D. Adamski Notary Public My Commission Expires: July 8, 2011 POA-F 012-0033 City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92646 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK March 7, 2011 Elite Bobcat Service, Inc. 1320 E. Sixth, Ste. 100 Corona, CA 92879, RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, Joan L. Flynn, CIVIC City Clerk JF: pe enclosure Sister Citiq.lfo6%I kkfik 4R/tet iA@k&&OcNew Zealand {Telephone: 714-536-5227 ) �DSERVICE ELITE BOBCATGENERAL ENG 1320 E. SIXTH, SUITE 100 ® CORONA, CA 92879 Tel: (951) 279-6869 s FAX: (951) 279-6832 City of Huntington Beach City Clerk 2000 Main St, 2nd FL Huntington Beach, CA 92646 SEA -ED BI® �®�® Garfield Avenue Rehabilitation Project No. 1372 Due: 11/04/10 a@ 2:00 PM SECTION C PROPOSAL for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) 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 fiunish 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 50 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 M proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount of $ 10% of amount bid which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 PROJECT BID SCHEDULE - Garfield CC-1372 SECTION C CC NO.1372 FEDERAL AID PROJECT ESPL-5181(168) PROJECT BASE BID: G IELD AVENUE -- from Newland Street to Magnolia Street C-2.2 to C-2.4 BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: pAV ►, ►° 7., , .� � ,., �1° ���� � : .; i�., • � � a C-2.1 PROJECT BID SCHEDULE _ Garfield CC-1372 .•. 1 .. 11lRt 1 1 LS Mobilization $ �� � $ It WA 2 1 LS Traffic Control Plan $ 3, 2 % $ '3 3 1 LS Furnish Project Traffic Control $ �� $ —�—"- 4 470 CY Unclassified Excavation (includes disposal of material and fabric) $ $ 3—— Pulverize, Remove excess, Grade, Cement Treat, Microcrack by S 139890 SF FDR Process (includes disposal) ��( $yl7 $ 6 55530 SF Surface Grind (0.17) (includes diposal of materal and fabric) p� $ �, V $ �Ip,OD 7 3265 TN$a Construct Asphalt Concrete (0.25' & 0.75' per plan) $Z�Z{22s 8 2560 Construct Asphalt Concrete (0.1 T ARHM Overlay) TN $ 76 $ / 50 �© Remove & Reconstruct Curb & Gutter (CF=8", Includes AB) per 9 1845 LF Std Plan 202 D 2 Si '0 $ D $ 10 370 Remove existing sidewalk (includes disposal) 2 9Z - °-4' SF $ $ 11 0 Remove & Reconstruct Sidewalk per Std Plan 207 (includes disposal) 9� sF $ y $ Remove and Reconstruct Commercial Driveway per HB Std. Plan 211 (including all appurtenances but not limited to: onsite 12 500 improvements, retaining curb, slot pave, etc.) rip f 1. 'r � D0— SF $ $ C-2.2 PROJECT BED SCHEDULE - Garfield CC-1372 :gCetti Esti #e em :ii ' ;:fit t ,p-f. ....:.: .:� #eBi.e : Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 13 22 slot pave, etc.) per Caltrans Std. A88AEA $ 21300 $ { Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 14 3 EA slot pave, eta) per Fountain Valley Std. 204-3, Case "C" 21300i0 Q`l (�1960 $ $ 15 1 EA Install Truncated Domes to existing access Ramp $ 3,00� .; $ !�-30 16 113 EA Adjust Sewer/Storm Drain Manhole to finished surface $ 0. 17 11 Adjust OCSD Sewer Manhole to finished surface $ 1 45.00EA $ b 18 11 EA Adjust City of I-IB Water Valve to finihed surface $ $ 19 12 EA Adjust City of Fountain Valley Water Valve to finished surface $ $ "0a 20 1 Adjust Monitoring Well to finished surfaceEA $ $ . 21 4 EA Raise Survey Monument Well to finished surface $ U ,`v� 4D $ tU Suwv ennmaataiewdCity to Provide Survey Monumentation 22 (Not a Bid Item) r $ $ Remove existing Tree and Roots; Grind Tree Stump and roots to 23 14 EA 24" below Top of Sidewalk/Grade $ 3.Vb $ y 7D.Ob Furnish & Plant 24" box trees (remove existing landscaping and 24 14 EA irrigation to accommodate 24" box trees, replace irrigation in kind) $ 5-6-OD $ 036.0 C-23 PROJECT DID SCHEDULE - Garfield cc-1372 :fit .r??::`• > FP . .. >q .:. 7�jj�Aataaii -'QI1�1Fi� :.•. 25 1 LS Provide 90 Day Plant Establishment 26 1 LS Provide I Year Maintenance 27 1 LS Traffic Signing and Striping per plan 28 E�2 Install Traffic Loops $ 29 � Traffic Signal Pullbox and Relocation and Conduit Installation. $ , ,.., _ � , , $ e -7. 0000 30 1 LS Median nose reduction and crosswalk modification per Appendix S in Specifications. $Q� ilk, $ Total Amount Bid in Figures: $'214.614.40 Total Amount Bid in Words:__ : `_ :. uw -"JtJ _ ;fie �- - _F_ - -..try✓ �.. _____ C-2.4 , SECTION C (LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. r, ........:..... re.�s..._..:�,u . o.. . .... .. - ..::. ........:...: ...; ...............:.:.:. �611 , STI � G�iD a "M . v �.� n � 3-5al1 ai0I}9oN• �cQ ZA TrceSn� i�� �5 ► `M� I� goano5 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. NONCO]LL USION AFFIDAVIT TO BE EXECUTED BY BIDDEN AND SUBMITTED WITH BID State of California ss. County of Orange Joseph Nanci , being first duly sworn, deposes and says that he or she is President of Elite Bobcat Service, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any, other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the, bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Joseph Nanci Name of Bidder Signature of Bidder 1320 E. 6th St #100, Corona, CA 92879 Address of Bidder Subscribed and sworn to before me this day of , 201 ^ . C4 State of California County of Riverside On November 3, 2010 before me, Jeff Lee, a notary public, personally appeared Joseph Nanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my h d and official seal. Signature glbN 1" NO (Seal) Go�J��� S,o `G Go Q�o\�e �byy NOTARY PUBLIC UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGI'ON BEACH, CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title S, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Elite Bobcat Service, Inc. Contractor By Joseph Nanci President Title Date: 11/03/2010 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 X No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 11/03/2010 C-7 Elite Bobcat Service, Inc. Contractor 1AJj By Joseph Nanci President Title BIDDEWS INFOR AA'I'ION BIDDER certifies that the following information is true and correct: Elite Bobcat Service, Inc. Bidder Name 1320 E 6th St #100 Business Address Corona City, 951 ) 279-6869 Telephone Number 720016A State Contractor's License No. and Class 03/1994 Original Date Issued. 03/31/2012 Expiration Date CA 92879 State Zip The work site was inspected by Joe Nanci of our office on October 29 ) 2010 . The following are persons, firms, and corporations having a principal interest in this proposal: Elite Bobcat Service, Inc. Joseph anci, President C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Elite Bobcat Service, Inc. Company Name Signature of Bidder Joseph Nanci Printed or Typed Signature Subscribed and sworn to before me this , day of , 201 ` NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1, City of Riverside 3900 Main Street, Riverside, CA 92522 Name and Address of Public Agency Name and Telephone No. of Project Manager: Danny Cwiak (951) 826-5852 $6,900,000 Street Improvements 06/2010 Contract Amount Type of Work Date Completed 2 City of Long Beach 333 W Ocean Blvd, Long Beach, CA 90802 Name and Address of Public Agency Name and Telephone No. of Project Manager: Charles Ramey (562) 570-6200 $2,782,164 Street Improvements 06/2010 Contract Amount Type of Work Date Completed 3. City of Redondo Beach 415 Diamond Street, Door E, Redondo Beach, CA 90277 Name and Address of Public Agency Name and Telephone No. of Project Manager: Steven Huang $820,000 Contract Amount Street Improvements Type of Work C-9 (310)318-0661 03/2010 Date Completed State of California County of Riverside On November 3, 2010 before me, Jeff Lee, a notary public, personally appeared Joseph Nanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. Witness my hand and official seal. Signature \X. ,a`'l�o " (Seal) Go` X� GO��JQ JpS`�� � S dyi` BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or _ Will hire no new employees in conjunction with Us project. Will award 101/o of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Elite Bobcat Service, Inc. Contact Person: Joseph Nanci Contact Phone: (951) 279-6869 Signed: Date: November 3, 2010 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). ]Previous non-compliance with Section 3 could result in disqualification. C-10 RELIABLE CONTRACTOR DECLARATION (page 1 of 3) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CaIRWycle.ca.pov/RegWations/Titlel . Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: Joseph Nanci CONTRACTOR INFORMATION CONTRACTOR NAME: Elite Bobcat Service, Inc. AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Joe Nanci MAILING ADDRESS: 1320 E 6th St #100, Corona, CA 92879 ,4s the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Signature Date 11/03/2010 C-11 RELIABLE CONTRACTOR DECLARATION (page 2 of 3) Title 14 CM Division 7, Cbapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on -the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the-CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CaiRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 6) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List; C-12 RELIABLE CONTRACTOR DECLARATION (page 3 of 3) (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a per -son or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Elite Bobcat Service, Inc. subcontractor ,proposed hereby certifies that he has _X has notes participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed -subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-I4 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has , has not -&been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No --2L If the answer is yes, explain the circumstances in the following space. C-15 Public Contmct Code 10232 Statement 1n conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-16 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the -bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 EXHIBIT 12•E Attachment E The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: C Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and e Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-53 LPP 01-04 C-18 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-55 LPP 01-04 C-19 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES 1. Type of Federal Action; ❑ a. contract b. grant a. cooperative agreement d. loan e. loan guarantee f. loan insurance TU U16t;LUSr. LV1313Y INU At;11 V I J 2. Status of Federal Action: a. bidleffer/application b. initial award c. post -award 4. Name and Address of Reporting Entity QPrime ® Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: S. Federal Action Number, if known: 10. a. Name and Address -of Lobby Entity (If individual, last name, first name, MI) i YU "UAIV 1 IV 3I U.b.U. "3Z 33.. Report Type: ! —1 a. initial b. material change For Material Change Only: year_ quarter date of last report_ . 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known, 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, ifknown: b. Individuals Performing Services (including address if different from No. 10a) (last name, first name, Ml) (attach Continuation Sheet(s) ifnecessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission Ba. cash d. contingent fee b. in kind; specify: nature a deferred value U 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 I I: (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 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: Joseph Nanci U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: President person who fails to file the required disclosure shall be subject to a civil penalty of not less than S 10.000 and not more than 951 279-6869 11/03/10 S100,000 for each such failure. Telephone No.: ( Date: Federal Use Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-20 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to Iobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., 'RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. if other, specify nature. Page 12-88 March 15, 2001 C-21 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Itev.06-04-9WENDIN Page I Z-39 LPP 01-04 C-22 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) EXHIBIT 15-G1 LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: City of Huntington Beach LOCATION: Huntington Beach, CA PROJECT DESCRIPTION: Garfield Avenue Rehabilitation TOTAL CONTRACT AMOUNT. $ GO, V I l , BID DATE: November 4, 2010 BIDDERS NAME: Elite Bobcat Service, Inc. CONTRACT UDBE COAL: 5.13 % CONTRACT ITEM NO, TEM OF WORK AND DESCRIPTION R SERVICES TO BE U13CONTRACTFD OR MATERIALS O BE PROVIDED (or contracted if the idder is a UDBE) UDBE CERT NO, AND EXPIRATION DATE NAME OF EACH UDBE (Must be certified on the date bids are, opened - include UDBE address and phone number) DOLLAR AMOUNT UDBE For Local Agency to Complete-, Local Agency Contract Number: Federal -aid Project Number: Federal Share: Total Claimed UDBE Participation Contract Award Date: Local Agency certifies that all UDBE certifications have been verified and information is complete and accurate. Print Name Signature Dale Local Agency Representative (Area Code) Telephone Number. Signature of Bidder 11/03/10 (951) 279-6869 Date (Area Code) Tel, No. Joe Nanci Person to Contact (Please Type or Print) Local Agency Bidder UDBE Cowninnent (Consttaaion Contracts) (Rev 6t26109) Distribution: (1) Original —Local agency files Page 15-31 LPP 09-02 C-23 July 31, 2009 �� EXHIBIT 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE CO1VJ(1V117I'iV1EN1: (CONSTRUCTION CONTRACTS) ALL ]BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) African Americans; 2) Asian -Pacific Americans; 3) Native Americans; 4) Women. This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the bid nonresponsive 1 A UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: African Americans, Asian -Pacific Americans, Native Americans, or Women. The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces, if a UDBE. The UDBE shall provide a certification number to the Contractor and expiration date. Enter the UDBE prime's and subcontractors' certification numbers.The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). IMPORTANT: Identify all UDBE firms participating in the project regardless of tier. Names of the First -Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the UDBE participation dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of UDBE firms. Exhibit 15-G1 must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-32 July 31, 2009 C-24 LPP 09-02 Local Assistance Procedures Manual EXHIBIT 15-G2 Local Agency Bidder DBE Information (Construction Contracts) EXHIBIT 15-G2 LOCAL AGENCY BIDDER DBE INFORMATION (CONTRUCTION CONTRACTS) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: City of Huntington Beach LOCATION: Huntington Beach, CA PROJECT DESCRIPTION: Garfield Avenue Rehabilitation TOTAL CONTRACT AMOUNT: S. It 19 1 O I�- G BID DATE: November 4, 2010 BIDDER'S NAME: Elite Bobcat Service, Inc. CONTRACT UDBE GOAL: 5.13% CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE DBE CERT NO. AND EXPIRATION NAME OF EACH DBE (Must be certi Fled on the date bids DOLLAR AMOUNT DOE SUBCONTRACTED OR MATERIALS DATE are opened - include DBE address O BE PROVIDED (or contracted if the and phone number) idder is a DBE P i SIL q For Local Agency to Complete: Total Claimed DBE / $U� Local Agency Contract Number: Participation Federal -aid Project Number. Federal Share:% Contract Award Date: Local Agency certifies that all DBE certification have been verified and Information is complete and accurate. Signature of Bidder � 11/03/2010 (951)279-6869 Print Name Signature Date Local Agency Representative Date (Area Code) Tel. No. (Area Code Tel hone Number: Joe Nanci Person to Contact (Please Type or Print) For Caltrans Review: Print Name Signature pate Caltrans District Local Assistance Engineer L omt Agency Bidder DBE Wbt nation (ConsirwAioo Contacts) (Rev W26109) Distribution: (1) Copy —Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAB) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a LPP 09-02 C-25 duly 31, 2009 EXHIBIT 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER 128E INFOR1VdATION (CONSTRUCTION CONTRACTS) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces, if a DBE.The DBE shall provide a certification' number to the Contractor and expiration date. Enter DBE prime and subcontractors certification number. The DBE contractors should notify the Contractor in writing with the date ofthe decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15-G I), regardless of tier. Names of the First -Tier DBE subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 1001/o of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section ""Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts) to determine how to count the participation of DBE firms. Exhibit 15-G2 must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Number, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all informations is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b July 31, 2009 LPP 09-02 C-26 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION --GOOD FAITH EFFORTS UDBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. ESPL-5181 (168) Bid Opening Date 11/04/2010 City of Huntington Beach The (City/Coin of) established an Underutilized Disadvantaged Business Enterprise (UDBE) goal of 5.13 % for this project. The information provided herein shows that a good faith effort was made, Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation California Professional Electrical Eng. 11/01/2010 Phone - 11/04/2010 Cultural Research Association 11/02/2010 Phone - 11/04/2010 Astro Construction 11/02/2010 Phone - 11/04/2010 So Cal Tree Care, Inc. 11/02/2010 Phone - 11/04/2010 Payco Specialties Inc. 11/02/2010 Phone - 11/04/2010 Super Seal & Stri e Inc. 11/02/2010 - 4 Loop Masters Inc. - Global Road Sealing, Inc. 11/02/2010 Phone - 11/04/2010 Page 15-33 LPP 09-02 C-27 July 31, 2009 Exhibit 15-H Local Assistance Procedures Manual UDBE Information -Good Faith Effort C. The items of work which the bidder made available to UDBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Performs Item Items Amount Percentage M Of Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: J Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs; Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: Page 15-34 July 31, 2009 C-28 LPP 09-02 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the UDBB subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-02 C-29 July 31, 2009 Monday, November 01, 2010 Dear California Professional Electrical Engineering: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St 4100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Monday, November 01, 2010 5:53 PM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT38097.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. van(@cpeneineeringinc.com i Tuesday, November 02, 2010 Dear CULTURAL RESEARCHASSOC: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee -PV EBS 1320 E. 6th St #100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX Elite Bobcat Service, Inc. 1320 E 6th St #100 Corona, CA 92879 (951) 279-6869 (951) 279-9112 OWNER: City of Huntington Beach DBE/UDBE FORM JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTII.E TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIA4MING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 8:18 AM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00178.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. cra lori(asbcglobal.net 1 Tuesday, November 02, 2010 Dear Astro Construction: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St #100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE I SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 8:54 AM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00350.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. astroconst(asbcglobal.net 1 Tuesday, November 02, 2010 Dear So Cal Tree Care, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St 9100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 8:57 AM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00383.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. info(@socaltreecare.com Tuesday, November 02, 2010 Dear Payco Specialties, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St #100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX Elite Bobcat Service, Inc. 1320 E 6th St #100 Corona, CA 92879 (951) 279-6869 (951) 279-9112 OWNER: City of Huntington Beach JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 9:02 AM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00411.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. llewellyn44360msn.com 1 Tuesday, November 02, 2010 Dear Super Seal & Stripe, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St #100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 9:03 AM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00440.txt This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. brenda(@supersealandstripe.com 1 Tuesday, November 02, 2010 Dear Loop Masters, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St #100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 9:07 AM To: Jeff R. Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00485.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. andreanorth@loopmastersinc.com 1 Tuesday, November 02, 2010 Dear Global Road Sealing, Inc.: Elite Bobcat Service, Inc. will be a prime bidder in the City of Huntington Beach, "Garfield Avenue Rehabilitation" bid that takes place on November 4, 2010 @ 2:00 PM. We would be interested in receiving a quote from you in the categories on the following page along with a description of your company's details and work experience as a certified Disadvantaged Business Enterprise (DBE) business or Underutilized Disadvantaged Business Enterprise (UDBE) business. If you have any other Caltrans Minority Certifications, please list below. Please indicate if you will be interested in bidding this project by noting below, "YES" or "NO" and listing your company's name and faxing a copy back to us at (951) 279-9112. YES NO COMPANY NAME Thank you, Jeff Lee EBS 1320 E. 6th St #100 Corona, CA 92879 (951)279-6869 (951) 279-9112 FAX JOB NAME: Garfield Avenue Rehabilitation BID DATE: November 4, 2010 BID TIME: 2: 00 PM PLEASE FAX ALL SUB QUOTES TO THE ESTIMATOR AT (951) 279-9112 ADJUST SEWER MANHOLES ADJUST SEWER / MANHOLE TO GRADE ADJUST MANHOLES & VALVES ADJUST WATER VALVE TO GRADE AGGREGATE BASE MASONRY BAR REINFORCED STEEL MISCELLANEOUS IRON & STEEL BARRICADES MOBILIZATION BOLLARDS PARKING LOT LIGHTING BRICK PAVER PAVEMENT MARKERS BRIDGE REMOVAL PAVEMENT REINFORCE FABRIC CATCH BASIN PORTABLE CHANGEABLE MESSAGE SIGN CHAIN LINK FENCE RENTAL EQUIPMENT CONSTRUCTION CATCH BASIN RETAINING WALL CLEARING & GRUBBING ROADWAY EXCAVATION COLD PLANE / COLD MILLING ROOT PRUNE / BARRIER STAMPED / COLORED CONCRETE SHORING CMB SIGNAL & LIGHTING CONCRETE PIPE REINFORCEMENT SIGNS XXXX CONCRETE BARRIER SOUND WALL CONCRETE IMPROVEMENTS STEEL & CONCRETE PILING CONSTRUCTION AREA SIGNS STORM DRAIN IMPROVEMENTS CRACK SEAL STREET LIGHTING CURB & GUTTER STRIPING & MARKING XXXX EDISON / TELEPHONE SURVEY & STAKING XXXX ELECTRICAL SURVEY / SURVEY MONUMENTS XXXX EXCAVATION SILT FENCE REMOVE & REPLACE FENCING SLURRY SEAL FILTER FABRIC FENCE SWPPP GEOTEXTILE TRAFFIC CONTROL GROOVE & GRINDING CONCRETE TRAFFIC SIGNAL GUARD RAIL TREE PLANTING XXXX HYDROSEED TREE REMOVAL XXXX HAZARDOUS WASTE SOIL REMOVAL TREE TRIMMING IRON GATES TREE WELLS JOINT SEAL TRUCKING JUNCTION STRUCTURES UNDERGROUND LEAD COMPLIANCE PLAN TRUNCATED DOMES LANDSCAPING & IRRIGATION XXXX UNCLASSIFIED EXCAVATION LEGENDS UNDERGROUND CONDUIT LOOP DETECTORS XXXX VIDEO WATER POLLUTION CONTROL PROGRAM Jeff R. Lee From: Administrator Sent: Tuesday, November 02, 2010 9:11 AM To: Jeff R.Lee Subject: Delivery Status Notification (Relay) Attachments: ATT00534.txt; CITY OF HUNTINGTON BEACH - GARFIELD AVE REHABILITATION This is an automatically generated Delivery Status Notification. Your message has been successfully relayed to the following recipients, but the requested delivery status notifications may not be generated by the destination. lalatri0yahoo.com 1 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Phone/ AinuW C Pbrtio�orktPreFax �mAddress/ Ci ,State, ZIP iZece is Name � k Phone / 1��1�_ <$] million _� pu 10 <$Smillion -- — —� _ $10 million Address< � $g ?',�r�i.i��.Gfx?.{� Fax 1 1 ❑<$15million > $15 million��A t�.,�s�`�3.�ri:��i, _ - ---_ �__.--__.. �— Ciry State ZIP ae\a� 6� V I Name Phone ❑ <$1 million f' �� I �aa l Fax <$10 mdlioa Lj<sl5million Address .� � � � ►9 ! t%�.. _� Chy State ZIP ����� —�� > $15 mi0ton �0—ko:t t 1-5 g .a . « `: � —__--� _ �_-- Tr y ;AXP; Nonce ' Phone ❑<$I million <$5 million 0 <$10million Address Fax ❑ <$15 million CJ > $15 million � ltg ! Yid a tl ar Ciry State ZIP Nome Phone ❑<$I million l] <$5 million , qgg Address El <$10 million ,...Fit ..tf � z a1tl. h � _•[ � i Ciry' Scare ZIP p3 ❑ > $15 million — 9i'. Xi?4313% t Distribution'. 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14, 2006 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Phone! Ai►nual Address/ Fax Gross Desert Lion of Por ioadf Workto be Performed; Ci ,State, ZIP 1Zece is (�ft� x Name Phan <$I million ❑ < $5 0 < $10 million — ------ .. _ ------ Address Fax ❑ <$15 miliian 0 > $15 million F City State ZIP Nmne Phone 0 <$1 million t1a �a <$Slnlfltan a ( t l Aress dd Q < $10 milhon Fax <$15 million —� iRIM Crn- State ZIP > $ 15 mlhon ` Name Phone ❑ <$1 million ----`���! T N7,17—RTsi <$5million <$10million Address Fax ❑< $$15 million > $15 million x CitvSrate ZIP Nane ' Phone ❑ <$1 million ❑ <$5 million t +fir �r Address CirvStateZIP LO >$15million nf8. 1 2 fir.«y 1 f` Fl.e�+S+�: Sd 4��e .. Distribution: 1) Original - Local Agency rile Page 12-111 LPP 06-06 November 14, 2006 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS {DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected co parcicibate as a subcontractor on this project. This is required for compliance with Title _v.t_ t^..,1.,..., 1 ae..,. 1—;—OkM-- tl,ic fnrm fnr nrlriitinnal firms 47, Jecuun au vl u,c —1 v, .u..��� .�..:..+..+..�.•..• Firm Name/ ••„•..-.. Phone/ - Ariltu 'I oiePmer bseP tonofporton I tt r1'# a Address/ Fax Cas niRork ' City, State, ZIP Re.ei is Nance Phone ❑ <$l million �WW� Fax <$5 million < $10 million ❑ <$l5 mi[Itan£� t � Address ❑ > $ l5 million C!ry we 71P R¢rjF..•1 WA �T I����� k i1}°rg� M i l��}<'f a y' k Nance Phone 0 <$I million 0 < $5 million ❑<$10 million -��T — ,�_— — -- Address Fax ❑ <$i5 million ❑ > $15 million __—. —�—_s' Ciry Stare ZIP ,h p��y ,fq,j• ` IS4 cif �r p � m'�` Name Phone Fax El <$1 million < $5 million ❑ <$f0 million <SlSnullion >$15million i n Wt� �4f Address Ciry StareZlP �tlfa, Name Phone ❑<$Imillion $5 million .__ t _'°- all 0 �fi .'• Address Fax ❑ < $15 million ❑ > $15 million [ Ciry Scare ZIP Distribution: t)Original- LocalAgencyFile Page 12-112 LPP 06-06 November 14, 2006 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowledge receipt and review of Addendum Number One, dated November 1, 2010- Elite Bobcat Service, Inc. Company Name By Joseph Nanci 11/03/2010 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. e E Bond #3-B Premium Nil k4w KNOW ALL MEN BY THESE PRESENTS, that we E1 i to . Bobcat Service, Inc. as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 9737 Great Hills Trail, Suite 320, Austin, Tx 78759, as surety, hereinafter called the "Surety," are held and firmly bound unto City of Huntington Beach as obligee, hereinafter called the Obligee, in the sum of ten percent of amount bid 10% of the Amount Bid by Principal for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the principal has submitted a bid for Garfield _Avenue Rehabilitation #137.2 NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specked in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract. shall .furnish evidence of financing in a .manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 60 days of the date hereof. SIGNED, sealed and dated this 2nd day of November .20 10 Elite Bobcat Service, Inc. (Principal) BY: TITLE: SureTecJasuranceLomvanv BY: 7. r,4 V, Charles L. F e Attorney -in -Fact suretec bid bond file.doc Rev 1.1.06 CALIFORNIA ALL-PURPOSE STATE OF CALIFORNIA County of Orange } On 11-2-10 before me, Lexie Sherwood, Notary Public Date Here Insert Name and Title of the Officer personally appeared Charles L. Flake LEXIE SHERWOOD COMM. #1856389 3 NOTARY PUBUC • CAUFORNIA n ORANGE COUNTY Comm_ Exp. JULY 27, 2013 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. l certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and o icial seal. Signature Place Notary Seal Above Signature of Notary ubfic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s):_ ❑ Partner— ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other. Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02007 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 - www.NationaiNcytary.org Item #5907 Reorder. Call Toll -Free 1-800-876-6827 POA ?i. 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Alen by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Richard A. Coon its true and lawful Attorney -in -fact, with fitll power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety, providing the bond penalty does not exceed Five Million Dollars and no/100 ($5,000,000.00) and to bind the Company thereby as fatly and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming allthat the said Attorneys) -in -Fact may do in the premises. Said appointment shall continue in force until _ 10/31/2012 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistan[ Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys) -in -Fact to represent and act for and on behalf of the Company subject to the Allowing provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances; contracts„ agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shali be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Re it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting field on 20, of'April, 1999. ). In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 25th day of October, A.D. 2008. SURETECIN A 'CE COMPANY J y. � 1 .'� B.J. Ki , resident ,r ✓,.• State of Texas ss: > County of Harris t .. . On this 28h day of October, 2008 before me personally came B.J. King; to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE CO&VANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate. seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. Michelle Denny � memo State Texas g , f ,n� )_ ' -- sntr ar, eta t ` _ Michelle Denny, Notary F 11c My commission expires August 27, 2012 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Powe4of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 2ND_ day of NOV ER , 20_10 , A.D. 1tI. Brent e>zty, Assis ant Secretary Any instrument issued In excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may tali (713) 812-0800 any business day between 8:00 am and 5.00 pm CST. State of California County of Riverside On November 3, 2010 before me, Jeff Lee, a notary public, personally appeared Joseph Nanci, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing is true and correct. qha `p ryti9> Witness my h and o icial seal. ` •c Signature - (Seal s City of Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK March 7, 2011 Hardy and Harper, Inc. 1312 E. Warner Ave. Santa Ana, CA 92705 RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister CitiN&r p/CJ &retAgi �W&IcNew Zealand (Telephone: 714-536-5227) PROPOSAL for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO.1<372 FEDERAL AID PROJECT ESPL-5181(168) 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 50 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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. Bidder's Accompanying this proposal of bid, find Ron j in the amount of $ 10 o which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 PROJECT BID SCHEDULE - Garfield CC-1372 SECTION C PROJECT BID SCHEDULE GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET CC NO.1372 FEDERAL AID PROJECT ESPL-5181 (158) PROJECT BASE BID: GARFIELD AVENUE -- from Newland Street to Magnolia Street C-2.2 to C-2.4 BASE BID TOTAL AMOUNT LUMP SUM BID IN BASE BID WILL BE THE BASIS OF AWARD C-2.1 PROJECT BID SCHEDULE - Garfield CC-1372 . ............. ........... .......... ................. ........... ....... ............. .. ............ U ft:phl . U LS Mobilization $ $ Z-9 1 LS Tral'flic Control Plan $ lV $ 3 1 LS Famish Project Traffic Control $ 11Wv$ilti 4 470 Unclassified Excavation (includes disposal of material and fabric)CY o,-'30 $ Pulverize, Remove. excess, Grade, Cement Treat, Microcrack by 5 139890 9F FDR Process (includes disposal) $ 6 55530 SF Surface Grind (0.17) (includes diposal of materal and fabric) $ $ 7 3265 TN Construct Asphalt Concrete (0.25 & 0.75'per plan) $ $ 8 2560 TN Construct Asphalt Concrete (0.17ARHM Overlay) $ $ I'S '9' 9 1845 Remove & Reconstruct Curb & Gutter (CF=8", Includes AB) per Std Plan 202 C1 LF $ 10 370 SF Remove existing sidewalk (includes disposal) 11 7000 Remove & Reconstruct Sidewalk per Std Plan 207 (includes disposal) $ SF Remove and Reconstruct Commercial Driveway per HB Std. Plan 12 500 211 (including all appurtenances but not limited to: onsite improvements, retaining curb, slot pave, etc.) SF $ 5.90 , bo �.q 'q "-Zc) 6d— C-2.2 PROJECT DID SCMDULE - Garfield CC-1372 #eAt :stited ..... ..1� :::::::::. . .�:�'lri•::�: Remove and reconstruct ADA access ramp (including all 13 2 EA appurtenances but not limited to: sidewalk, domes, retaining curb, slot pave, etc.) per Caltrans Std. A88A $ $ tD Tr 0 Remove and reconstruct ADA access ramp (including all 14 3 EA appurtenances but not limited to: sidewalk, domes, retaining curb, slot pave, etc.) per Fountain Valley Std. 204-3, Case "C" $ t 15 1 EA Install Truncated Domes to existing access Ramp $ ff 16 13 EA Adjust Sewer/Storm Drain Manhole to finished surface (� tr11 $ 1 V ~ $ 17, 1 EA Adjust QCSD Sewer Manhole to finished surface $ $ 18 11 EA Adjust City of HB Water Valve to finshed surface $ 57�JC� 19 12 EA Adjust City of Fountain Valley Water Valve to finished surface $ $ 20 1 EA Adjust Monitoring Well to finished surface .— $� $ 21 4 EA Raise Survey Monument Well to finished surface $ onunentatiepCity to Provide Survey Monumentation 22 (Not a Bid item) EA $ $ 23 14 EA Remove existing Tree and Roots; Grind Tree Stump and roots to 24" below Top of Sidewalk/Gmde $ 24 14 EA Furnish & Plant 24" box trees (remove existing landscaping and irrigation to accommodate 24" box trees, replace irrigation in kind) N\ C-2.3 PROJECT BID SCHEDULE - Garfield CC-1372 XOX Q 25 1 Provide 90 Day Plant Establishment $ $ iI toc 26 1 LS Provide 1 Year Maintenance $ � � $ 0 .o oo 27 LS Traffic Signing and Striping per plan 28 22 EA Install Traffic Loops $ )Od- 29 1 LS Traffic Signal Pullbox and Relocation and Conduit Installation. $ `— $ 30 1 LS Median nose reduction and crosswalk modification per Appendix S in Specifications. $� .- $ Total Amount Bid in Fi m $ 2 �, ,.._'Total Amount Bid in Words...................................... ..... �?_��til;�rPr� ............ C-2.4 SECTION C LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Poruh .l. !•......... _. lYrtme,d AId�es,�Subcon#raFto'r' i I � ...1.... ._ �.. », t Iii..,{..v' i.. C 4:.t- SYu�te License: 1 .�Vk�etlS.er, .,_... Class _......: ._•., ,..,. (�.i j .r s 54-w-ifr c.3 Z 665 �. e%%S 4 - 6le. o.. �- By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. 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 Signature ofBidder Steve Kirschner Vice President 1312 E. Warner Ave.; Santa Ana, CA Address of Bidder Subscribed and sworn to before me this day of , 201 _ C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California Orange f County of November 3, 2010 Jo -Ann Lyons, Notary Public On before me, }�[e Date Steve Kir-91 If1ICIt Name and Title of the Officer personally appeared Names) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(o whose name(,q is/a4v subscribed to the within instrument and acknowledged to me that he/s#e/tltmy executed the same in his/Mr/ O& authorized capacity(io), and that by his/tvr/titer signature(o on the instrument the person(&), or the entity upon behalf of Ja ANN 1YONS I which the person(p) acted, executed the instrument. CC)NI V #184i32,3 Notary °"'llc Californ a I certifyunder PENALTY OF PERJURY under the laws ORANGE COUNTY — 1y Conlm. Expires Apr 17, 2013 If of the State of California that the foregoing paragraph is true and correct. WITNESS y nd and of ial Signature seal4pu� Place Notary Seal Above Signature of Notar 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 NonCollusion Affidavit Title or Type of Document: November 11 2010 1 Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by S �sc$rSTeves) Signer's Name: ❑ Individual W Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ° ❑ Trustee Top of thumb here ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT' " `OFSIGNER, ... _I ©2007 National Notary Association • 9350 De Sato Ave., P.0. Box 2402 • Chatsworth, CA 91313-2402 • www.NadonalNotary.org Item #5907 Reorder: Cail Toll -Free 1-800-876.6827 NOTARY PUBLIC UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (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 Califomia Cal -OSHA requirements. The undersigned finiher 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. C&,aclor By Steve Kirschner Vice President Title Date: 11 / 1 / 10 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ® No. If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a. signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public ,works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: i i/ j/ j o Hard Harper, Inc. Con tor' By Steve Kirschner Vice President Title C-7 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 A,C8,C12 State Contractor's License No. and Class 3/13/63 Original Date Issued 12/31/11 Expiration Date The work site was inspected by Corey xi rs chnerof our office on 10 / 2 8 , 2010 . The following are persons, firms, and corporations having a principal interest in this proposal: See Attachment A C-8 Attachment A Yfardy c0farper, Inc. Corporate Officers Fred T. Maas, Jr., President, Treasurer, 1312 E. Warner Avenue Managing Officer Santa Ana, CA 92705 hone: 714) 444-1851 Dan T. Maas, CEO 1312 E. Warner Avenue hone: (714) 444-1851 Santa Ana, CA 92705 Steve Kirschner, Vice President 1312 E. Warner Avenue hone: (714) 444-1851 Santa Ana, CA 92705 Kristen S. Paulino, Corporate Secretary 1312 E. Warner Avenue hone: (714) 444-1851 Santa Ana, CA 92705 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. Steve Kirschner, Vice President Printed or Typed Signature Subscribed and sworn to before me this _ day of , 201_ NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. See Attachment B Name.and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount 2. Name and Address of Public Agency 3. Type of Work Name and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Date Completed Date Completed Contract Amount Type of Work Date Completed C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California Orange County of November 3, 2010 Jo -Ann Lyons, Notary Public On before me, , Date Steve Klrg�fir'S@r Name and Title of the Officer personally appeared Name(s) of Signer(s) JO-ANN LYONS C0N1M. n1.841329 Notary: Pubic -California _ } ° ORANGE COUNTY My Comm. Expires Apr. 17. 201 T: Place Notary Seat Above who proved to me on the basis of satisfactory evidence to be the person(tv) whose name( is/ate subscribed to the within instrument and acknowledged to me that heliaae/tMy executed the same in his/her/tk�i authorized capacity(iia), and that by his/M/tKMRr signature(g) on the instrument the person(M, or the entity upon behalf of which the person(d) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNES hand and of ial seal. Signature Signature of Notary 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 Bidders Information Title or Type of Document: Nnvpmhpr 3 2010 2 Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed WSWRO) Signer's Name: Vice President ❑ Individual QC Corporate Officer—Title(s): — ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT OF SIGNER, Number of Pages: Signer's Nat ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing RIGHTTHUMSPRINT OF SIGNER .. 02007 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 -Chatsworth, CA 91313-2402 - www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1-800-876-6827 Attachment B Yfardy cz Yfarper, Inc. Owner/Agency Contact Project (Amount & End Date) City of Diamond Bar Kimberly Molina, PE Preventive Street 21825 E. Copley Drive (909)839-7000 Maintenance Program Diamond Bar, CA 91765 f. (909)861-3117 $ 1,521,000.00 5/10 City of Irvine Darrell Hartman, PE Redhill Ave. Rehabilitation One Civic Center Plaza (949)724-7546 $ 1,715,000.00 4/10 Irvine, CA 92623-9575 f. (949)724-6187 City of Glendora Jason Roehrborn, PE Grand Ave. Grind & Overlay 116 E. Foothill Blvd. (626)914-8253 $ 1,276,000.00 3/10 Glendora, CA 91741-0338 f. (949)455-2589 Anaheim Union High John Oskoui, PE Magnolia High School School District (714)999-5456 Paving Project 501 Crescent Way f. (714)956-1954 $ 826,000.00 12/09 Anaheim, CA 92803 City of Temecula John Salazar, PE De Portola Road Pavement 43200 Business Park Dr. (951)694-6411 Rehabilitation Temecula, CA 92589-9033 f. (951)694-1999 $ 1,374,000.00 12/09 BIDDER'S CER'I MCATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or X Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Hardy & Harper, Inc . Contact Pelson: Corey Kirschner Contact Phone; Signed: Date: ice President *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 RELIABLE CONTRACTOR DECLARATION (page 1 of 3) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalRe2ycle.ca.goy/RegglationL/Titlel . Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: Hardy & Harper, Inc. AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Corey Kirschner MAILING ADDRESS: 1312 E . Warner Ave. Santa Ana, CA 92705 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to th ;'above ' entifi contractor. n Signature Date 11 / 1 / 10 Steve Kirschner Vi C,p Praci riPrn i-_ C-11 RELIABLE CONTRACTOR DECLARATION (page 2 of 3) Tide 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on -the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104. for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud; bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste fire hauler registration; or, (in) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C-12 RELIABLE CONTRACTOR DECLARATION (page 3 of. 3) (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Local Assistance Procedures Manual EXHIBIT 12-B PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL. EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc.- . proposed subcontractor hereby certifies that he has X has not_, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-14 March 15, 2001 PUBLIC COlit'I'RACI' CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing ofcer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of violation of law or a safety regulation? Yes No X If the answer is yes, explain the circumstances in the following space. C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. r$IP Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Af idavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section H 2 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing.this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual PS&E Checklist Instructions DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 EXHIBIT 12-E Attachment E The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: • Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-18 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist instructions Attachment F NONL®EI$YING CERTIFICATION FOR IFEIDERAL,-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Farm-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or -she shall require that the language of this certification be included in all lower tier subcontracts,.which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Pnge 12-85 LPP 01-04 C-19 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES 1. Type of Federal Action: a a. contract b, grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: Ela. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity L :1 Prime ® Subawardce Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: N/A 7U31 U.s.t:. IJU 3. Report Type: Ela. initial b. material change For Material Change Only: year_ quarter_ date of last resort 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: N/A Congressional District, if known 7. Federal Program NamelDescription: CFDA Number, if applicable 9. Award Amount, ifknown: N/A 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (if individual, last name, first name, MI) address if different from No. IOa) (lest 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 El actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee b. in -kind; specify: nature a deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: Hardy & Harper has not paid funds to anyone in regards to this project. (attach Continuation Sheets) if necessa 15. Continuation Shcel(s) attached: Yes No 16. Information requested through this form is authorized by Tide 31 U.&C, Section 1352. This disclosure of lobbying reliance Signature: (((rrr was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: Steve Kirschner U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: Vice President person who fails to file the required disclosure shall be subject to a civil penalty ofnot less than $10,000 and not more than SI00,000 for each such failure. Telephone No.: 714 - 4 4 4 -1 S S 1 Date: l l / l /1 Federal Use Only: LLL Rev. M12.97 Authorized for Local Reproduction Standard Form - LLL Page 12-87 LPP 01-04 C-20 March 15, 2001 EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making.the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item l (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. if payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-21 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLUnstructions Rev.06-0490uENDIF» Page 12-89 LPP 01-04 C-22 March is, 2001 Local Assistance Procedures Manual EXHIBIT 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) EXHIBIT 15-G1 LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: City of Huntington BeactbCATION: Huntington Beach, CA PROJECT DESCRIPTION: GarfieldAve. Rehabilitation TOTAL CONTRACT AMOUNT: $ _ al'Z -Z BID DATE. 11 / 4 10 - BIDDEWSNAME: Hardy & Harper, Inc. CONTRACT UDBE GOAL: 5 . 13 0 CONTRACT M OF WORK AND DESCRIPTION DBE CERT NO. NAME OF EACH UDBE DOLLAR AMOUNT REM NO. SERVICES TO BE ND EXPIRATION (Must be certified on the date bids BE CONTRACTED OR MATERIALS DATE opened - include UDBE BE PROVIDED (or contracted if the PR 3ddrws and phone number) er is a UDBE) a1 ,✓ r For ]Local Agency to Complete: Local Agency Contract Number: Toss) Claimed UDBE Participation Federal -aid Project Number. % Federal Share: Contract Award Date: 0a ve Kirs Local Agency ceniftes that all UDBE certifications have been verified and Slgnatrue of B�dqr Vice P r e s i 1 information is complete and accurate. 11/1/10 714-444-1851 Date (Area Code) Tel. No. Print Name Signature Date Corey Kirschner Local Agency Representative Person to Contact (Please Type or Print) (Area Code) Telephone Number. Local Agency Diddar UODE Commimicnt (Conoruction Contrads) (tter 6/26109) Distribution: (1) Original —Local agency files Page 15-31 LPP 09-02 C-23 July 31, 2009 !finer lent EXHIBIT 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE CO NT (CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) African Americans; 2) Asian -Pacific Americans; 3) Native Americans; 4) Women. This Information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the bid nonresponsive IA UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: African Americans, Asian -Pacific Americans, Native Americans, or Women. The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces, if a UDBE: The UDBE shall provide a certification number to the Contractor and expiration date. Enter the UDBE prime's and subcontractors' certification numbers.The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). IMPORTANT: Identify all UDBE firms participating in the project regardless of tier. Names of the First -Tier UDBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the UDBE participation dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (if 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of UDBE firms. Exhibit 15-G1 must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-32 July 31, 2009 C-24 LPP 09-02 Local Assistance Procedures Manual EXHIBIT 15-G2 Local Agency Bidder DBE Information (Construction Contracts) EXHIBIT 15-G2 LOCAL AGENCY BIDDER DBE INFORMATION (CONTRUCTION CONTRACTS) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM City Of Huntington Beach LOCAL AGENCY;LOCATION: Huntington Beach, CA PROJECTDESCRIPTiON: Garfield Ave. Rehabilitation TOTAL CONTRACT AMOUNT: S / 1 L �) ~ BID DATE: 11 / 4 / 10 BiDDER'SNAME: Hardy & Harper, Inc. CONTRACT UDBE GOAL: 5 13 CONTRACT ITEM OF WORK AND DESCRIPTION DBE CERT NO. NAME OF EACH DBE DOLLAR AMOUNT ITEM NO. R SERVICES TO BE UBCONTRACTED OR MATERIALS AND EXPIRATION DATE (Must be certified on the date bids me opened - include DBE address DOE O BE PROVIDED (or contracted irthe and phone number) idder is a DBE For ]Local Agency to Complete: Local Agency Contract Number: Federal -aid ProjectNumber. Total Claimed DBE Participation Q $ 0 % Federal Share: Contract Award Date: r7L - HI'vEl 4 Local Agency certifies that all DBE certification have been verified and Information is complete and accurate. S eve Ki Signattue of Bidder Vice P r e Print Name Signature Date Local Agency Representative 11 / 1 / 10 714 — 4 4 4 —18 51 Dale (Area Code) Tel. No. (Area Code) TelcphorieNumber Corey Kirschner Person to Contact (Please Type or Print) For Caltrans Review: Print Name Signature Dale Caltrans District Local Assistance Engineer Local Agency Bidder DBE tnfomalion (Construction Contarcts) (Rev 6%10% Distribution: (1) Copy —Fax or scan a copy to the Caltrans District Loral Assistance Engineer (DLAE) within 15 days of contact execution. Failure to send a copy to the DI.AE within 15 days of contract execution may result in de -obligation of funds for this project. (2)Copy— Include in award package to Caltrans District Local Assistance (3) Original — Local agency riles -chner Ldemc Page15-32a LPP 09-02 C-25 July 31, 2009 EXHIBIT 15-G2 Local Assistance Procedures Manual Local Agency Bidder. DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL, AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) SUCCESSFUL BIDDER The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces, if a DBE.The DBE shall provide a certification number to the Contractor and expiration date. Enter DBE prime and subcontractors certification number. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15-G1), regardless of tier. Names of the First -Tier DBE subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts) to determine how to count the participation of DBE firms. Exhibit 15-G2 must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Number, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator- should verify that all informations is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b July 31, 2009 C-26 LPP 09-02 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H VDBE INFORMATION --GOOD FAITH EFFORTS UDBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. E S PL - 5181 (168L Bid Opening Date 11 / 4 / 10 The (City,/County of) established an Underutilized Disadvantaged Business Enterprise (UDBE) goal of 53% for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement DBEGoodfaith.com 10/28/10 B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation See accompanying DBE Goodfaith documentation. Page15-33 LPP 09-02 C-27 July 3l, 2009 Exhibit I5-H UDBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to UDBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Amount Performs Item Items M Percentage Of Contract See accompanying DBE No 100o UDBE See Bid >5.130 Goodfaith documentation Subcontractor Schedule D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection.of the UDBEs: See accompanying DBEGoodfaith documentation. If bidder was not selected, either they did__ne�tsubmit a quote, they were not a Union company, or theirsxuote was not the lowest for the portion of work indicated. Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: Plans and s-pecs were made available to interested UDBE firms. Page15-34 July 31, 2009 C-28 LPP 09-02 Local Assistance Procedures Manual Exhibit 15•H UDBE Information - Good Faith Effort F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: Plans and specs were made available ro i ntP..]"P-,fiPrl TMRF_. f; rm-- G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results See accompanying DBE Goodfaith documentation. H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): See accompanying DBE Goodfaith documentation. NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-02 C-29 July 31, 2009 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (OBE and NON -DBE)- DART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 44, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14, 2006 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 Distribuilou: I) Original —Local Agency File Page 12-112 LPP 06-06 November 14, 2006 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. 0 This is to acknowledge receipt and review of Addendum Numb r_ n ; dated Nove 1, 1 .. s Hardy & Harper, Inc. Company Name BY Steve Kim chner Vice President 11/2/11 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. DBE Goodfaith Inc. Company Name Department Address g� Suite # city State Zip Phone # Fax # Email # Good Faith Transaction ..o�...,w_ s g i Company Details Hardy & Harper, Inc. Contracts 1312 E. Warner Ave. Santa Ana California 92705 714-444-1851 714-444-2801 cKirschner@hardyandharper.com Solicitation Transaction Log (STL) Bid # C.C. No. 1372 } Bid Date 11 /04/2010 j Bid Description Hardy & Harper, Inc. is seeking qualified UDBE I subcontractors and suppliers for the Garfield Avenue Rehabilitation from Newland Street to Magnolia Street I project for the City of Huntington Beach in Orange County. We are soliciting quotes for the following: TRAFFIC CONTROL, EXCAVATION, ADJUST UTILITIES, ROOT CONTROL, LANDSCAPING, SIGN & STRIPING, TRAFFIC LOOPS, AND ELECTRICAL. I This document contains all information pertaining with solicitations made on behalf of/for Hardy & Harper, Inc. of g Santa Ana, California by DBE Goodfaith Inc. (a California -based Corporation). These solicitations have been done in good faith. DBE Goodfaith has participated with Hardy & Harper, Inc. in communicating with selected UDBE firms. DBE Goodfaith has contacted the California Department of Transportation (Office of Civil Rights) on 10/28/2010 on your behalf. Please write this information on the appropriate forms if required. Page t / 6 DBE Goodfaith Inc. Good Faith Transaction Log Total Companies Solicited The following information is a summary of the different types of Business that have been solicited by DBE Good IB Faith Inc. on behalf of Hardy & Harper, Inc. DVBE (Disadvantaged Veteran Business Enterprises) 0 DBE (Disadvantaged Business Enterprises) 0 UDBE (Underutilized Disadvantaged Business Enterprise) 25 MBE (Minority Owned Business Enterprises) 0 WBE (Women Owned Business Enterprises) 0 SBE (Small Business Enterprises) 0 �w Total - 25 r Page 2 / 6 DBE Goodfaith Inc. Good Faith Transaction Log Minority Focus Journal Ad posted to website www.dbegoodfaith.com on 10/2812010 at 3:19PM :.:.Focus Ad M VAC Hardy & Harper, Inc. is Seeking Qualified UDBE Bid Due .Date :: 11/014/2 010 a t 2: 00 P: M Bid No -C. C. No: 13 1 72 Z Contact;Estirnatpr,: Corey,.Kirschn,er Project Name Garfield Avenue Rehabilitation from Newland Street to Magnolia Street Agency Name City of Huntington Beach Project City Huntington Beach Project County Orange Project State California Project Details Had &'' Harper; Inc., i eeking qualified �,ppiiers for�the, P S�s UDBE subcontractlorsand E Garfield Avenue Rehabilitation d'Street to,Magnol -Street proibct,fo' from Newlan ia r,-the ,City, of,Huntington'Beach in Orange 'County. We are soliciting quotes for the following: TRAFFIC CONTROL, EXCAVATION, ADJUST UTILITIES, ROOT CONTROL, LANDSCAPING', 'SIGN &STRIPING,: TRAFFIC LOOPS; AND ELECTRICAL. Contact Details Corey Kirschner 1312 E. Warner Ave. Santa Ana, California 92705 714-444-1851 714-444-2801 We are, an equal opportunity:ernployery The�plans and specs are,available for your,,review,at our oiice� or W� can fax you the proposal'schedule. Bonds' will not be required from qualified subcontractors' Page 3 / 6 DBE Goodfaith Inc. Good Faith Transaction Log Minority Trade Journal Ad posted to website trade.dbegoodfaith.com on 10/28/2010 at 3:19PM Trade Journal Ad Hardy & Harper, Inc. is Seeking Qualified UDBE Bid Due Date : 11/04/2010 at 2:00 P.M Bid No: C.C. No. 1372 Contact Estimator : Corey Kirschner Project Name Garfield Avenue Rehabilitation from Newland Street to Magnolia Street Agency Name City of Huntington Beach Project City Huntington Beach Project County Orange Project State California Project Details Hardy & Harper, Inc. is seeking qualified, UDBE subcontractors and suppliers for the Garfield Avenue Rehabilitation from Newland Street'to<Magnolia-Street project for the,City of Huntington Beach in Orange County. We are.soliciting quotes for,the following: TRAFFIC CONTROL, EXCAVATION; ADJUST UTILITIES, ROOT CONTROL, LANDSCAPING, SIGN & STRIPING, TRAFFIC LOOPS, AND ELECTRICAL. " Contact Details Corey Kirschner 1312 E. Warner Ave. Santa Ana, California 92705 714-444-1851 714-444-2801 We are an equal opportunity employer. The plans and specs•are available for your review at our office or we can -fax you the proposal schedule. Bonds will not be required from qualified subcontractors. Page 4 / 6 DBE Goodfaith Inc. Good Faith Transaction Log Recipient List (Fax/Email) coNameiSpecialt Fax Date Email Date `"Log Page#"- CONE ZONE INC,CORONA,CA,Construction Zone Traffic Control J Contractor 10/28/2010 10/28/2010 Address - 1128 QUARRY STREET Phone - 9517349535, Fax - 9517342887, Email - elaine@aconezone.com CONTRACTING SERVICES,ALISO VIEJO,CA,Highway, Street, and 10/28/2010 10/28/2010 Construction �s - 43 ELDERWOOD - 9498311393, Fax - 8662308468, Email - aero.contracting@yahoo.com ORNIA PROFESSIONAL ELECTRICAL ENGINEERING,SOUTH EL 10/28/2010 10/28/2010 FE,CA,Electrical Contractor ss - 9316AVENUE - 62681681013381338, Fax - 6264480470, Email -van@cpengineeringinc.com 'ARINI TRACTOR,FALLBROOK,CA,Earthwork and Paving Contractor 10/28/2010 No Mail ss - 427 YUCCA ROAD - 7604279292, Fax - 7607289641, Email - u \11 ', V'� V\ LINGER CONSTRUCTION INC,DEVORE HEIGHTS,CA,Earthwork and 10/28/2010 10/28/2010 ng Contractor ess - 15924 NORTH CAJON BLVD ie - 9098806200, Fax - 9098806262, Email - sooners7@wildblue.net ,f �/ ID ECILIA'S SAFETY SERVICE, INC.,SOLANA BEACH, CA, Construction Zone 10/28/2010 10/28/2010 ,affic Control Contractor ddress - 525 STEVENS AVENUE, SUITE 200 \ . Y'1 O `� hone - 8587934465, Fax - 8587934495, Email - cecilias@pacbell.net iX O'S TRAFFIC CONTROL, INC,DEL MAR,CA,Construction Zone Traffic 10/28/2010 10/28/2010 ontrol Contractor ddress - 2201 SAN DIEGUITO DRIVE hone - 8582590300, Fax - 8582590357, Email - co@costraffic.com REATIVE INNOVTIONS LANDSCAPE & DESIGN,SANTA FE 10/28/2010 10/28/2010 PRINGS,CA,Landscaping Contractor ddress - PO BOX 2397 hone - 5626960803, Fax - 5626960804, Email - debbie@cilandscaping.com� in J1 &R TRAFFIC CONTROL SERVICES,GARDEN GROVE,CA,Construction 10/28/2010 10/28/2010 one Traffic Control Contractor ddress - 12031 NIETA DRIVE hone - 7144036814, Fax - 7145343679, Email - dandrtcs@gmail.com"{ `� CN CORPORATION,SAN MARCOS,CA,Landscaping Contractor 10/28/2010 10/28/2010 ddress - 2123 SEA ISLAND PLACE hone - 6192534247, Fax - 7605987226, Email - dcneonstruction@yahoo.com INNOVATIONS INC.,LONG BEACH, CA, Construction Zone Traffic I Contractor s - 3513 MAINE AVENUE - 3105136209, Fax - 3105136299, Email - ronnie@enortraffic.com PAVING & GRADING, INC.,ROWLAND HEIGHTS,CA,Earthwork and Contractor s - 1905 CALLE BOGOTA - 6269650703, Fax - 8056505208, Email - -IX ELECTRICAL AND CONSTRUCTION SERVICE,LOS GELES,CA,Electrical Contractor tress - 5302 S. ST. ANDREWS PLACE one - 3232952680, Fax - 3232951365, Email - felix5302@aol.com IE GRADE EQUIPMENT, INC.,PALMDALE,CA, Earthwork and Paving ddress - 41729 CIELO VISTA DRIVE hone - 6619498788, Fax - 6619451183, Email - finegradeeq@aol.com !ITAT WEST, INC.,ESCONDIDO,CA,Landscaping Contractor ress - 2067 WINERIDGE PLACE, SUITE B ne - 7607359378, Fax - 7607359351, Email - email@habitatwest.com L HAYS CONSTRUCTION, INC,RIVERSIDE,CA,Earthwork and Paving ntractor dress : 1835 CHICAGO AVE, SUITE C one - 9517880703, Fax - 9517881517, Email - hhaysconst@aol.com V 10/28/2010 10/28/2010 cam^ V ` c � I 10/28/2010 No Mail Jj 10/28/2010 10/28/2010 10/28/2010 10/28/2010 10/28/2010 10/28/2010 10/28/2010 10/28/2010 \ 1' S I DBE Goodfaith Inc. Good Faith Transaction Log IDIAN CONSTRUCTION INC,DEVORE HEIGHTS,CA,Earthwork and Paving 10/28/2010 10/28/2010 ontractor ddress - 15924 N CAJON BLVD hone - 9098806244, Fax - 9098806262, Email - sooners7@wildblue.net L ( fv\ ATO LANDSCAPE INCORPORATED, FOU NTAI N VALLEY,CA,Landscaping 10/28/2010 10/28/2010 ontractor ddress - 18182 BUSHARD ST hone - 7149646396, Fax - 7149636424, Email - kato.lands@verizon.net DOP MASTERS INC.,ANAHEIM,CA,Highway, Street, and Bridge 10/28/2010 10l28/2010 onstruction ddress - 4740 EAST BRYSON ST hone - 7149203353, Fax - 7146301783, Email - andreanorth@loopmastersinc.com AYCO SPECIALTIES, INCORPORATED,CHULA VISTA,CA,Parking and 10/28/2010 10/28/2010 ighway Improvement Contractor ddress - 120 NORTH SECOND AVE. y t V hone - 6194229204, Fax - 6194271620, Email - Ilewellyn4436@msn.com�pll ta�� OWER GRADE, INC, NORCO,CA,Highway, Street, and Bridge Construction 10/28/2010 10/28/2010 ddress - 2277 NORCO DRIVE 1(( hone - 9517129668, Fax - 9096731885, Email - tammie@thepgicompanies.com31� j\ _, 1t\ (� ,11\ ti �} (U UKAN, INC.,ROWLAND HEIGHTS,CA,Highway, Street, and Bridge 10/28/2010 10/28/2010 J) onstruction `t ddress - 18412 FARJARDO STREET hone - 6268549467, Fax - 6268549469, Email - suzanne@sukaninc.com UPER SEAL & STRIPE, INC, FILLMORE,CA,Parking and Highway 10/28/2010 10/28/2010 nprovement Contractor ddress - 310 A STREET hone - 8055247345, Fax - 8055247428, Email - brenda@supersealandstripe.com RAFFIC LOOPS CRACKFILLING, INC,ANAHEIM,CA,Parking and Highway 10/28/2010 10/28/2010 nprovement Contractor ddress - 1915 W BALL RD. hone - 7145204026, Fax - 7145204027, Email - trafficloop@sbcglobal.net JEAVER ELECTRIC, INC,ANAHEIM,CA,Electrical Contractor 10/28/2010 10/28/2010 ddress - 4210 E LA PALMA AVE(0��I hone - 7149171165, Fax - 7149173011, Email - dweaver@weaverinc.neti IV, 1L Page 6 / 6 Sy�3°�ds�l9o4��tt One Newark Center International Fidelity Newark, New Jersey 07102 N S U R A N C E C O M P A N Y (973) 624-7200 Bond No. HARHA-145 KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Hardy & Harper, Inc. as Principal, and THE INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation of the State of New Jersey, as Surety, are hereby held and firmly bound unto City of Huntington Beach in the penal SUM of Ten Percent of the Total Amount Bid ($100------- for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors and assigns. Signed, this 28th day of October 20 10 The condition of the above obligation is such that whereas the Principal has submitted to City of Huntington Beach a certain bid, attached hereto and hereby made a part hereof, to enter into a contract in writing for Garfield Avenue Rehabilitation from Newland to Magnolia Street NOW, THEREFORE, (a) If said bid shall be rejected, or in the alternate (b) If said bid shall be accepted and the Principal shall execute and deliver a contract in the form of contract attached hereto, properly completed in accordance with said bid, and shall furnish a bond for the faithful performance of said Contract, and for the payment of the persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the agreement created by the acceptance of said bid; THEN, THIS OBLIGATION SHALL BE VOID, otherwise the same shall remain in force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligation of said Surety and its bond shall be in no way impaired or affected by any extension of time within which the said bid may be accepted; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety have hereto set their hands and seals, and such of them as are corporations have caused their corporate seals, to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. Signed, sealed and delivered in the presence of. ATTEST: ATTEST: ar�iI c Principal Steve Kirschner, Vice Pres. INTERNATIONAL FIDELITY INSURANCE CO. By: / v �-- Dwight Reilly, Bid Bond Date 10 / 2 8 / 10 Attorney -In -Fact CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California Orange County of November 3, 2010 Jo -Ann Lyons, Notary Public On before me, Date Steve Klrht �f� h ICf��se�t Name and Title of the Officer - - personally appeared Name(s) of Signer(s) - who proved to me on the basis of satisfactory evidence to be the person(f) whose name(s) is/am subscribed to the within instrument and acknowledged to me that he/sM/y executed the same in his/MVr/tr authorized capacity(i4e), and that by his/tW/t43mtr signature(" on the instrument the person(@), or the entity upon behalf of which the person(dj acted, executed the instrument. JO_ANN LYONS !E COMM. #1841329 1 certify under PENALTY OF PERJURY under the laws w N°vary"'°° of the State of California that the foregoing paragraph is a ' ` ORANGE COUNTY - N1yConmi.Expires Apr. 17.2013 (( true and Correct. u WITNESS my h d and offi seal. Signature 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 Bid Bond Title or Type of Document: OntabPr 28 2010 1 Document Date: Dwight Reilly Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) ClaimedAmmm) Signer's Name: Vice President-- 0 Individual Corporate Officer — Title(s): _ Partner — ❑ Limited ❑ General Cl Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: IRIGHTiTHUNIBPAINT' F SIGNER'.• I Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: FIGHTTHUNI_BPAfNT aF:SIGNEA" of thLimb here '✓S'✓ `=S'0."'-�. � �y� `y5C✓6�✓4`'✓,.'✓ti.C✓ ��'.�'✓Tv."�:'sy�y.'�✓�✓.5"y'�"✓.:L✓."�✓ y "si ✓S ✓.v'✓.�✓ "y:'✓6L.v4�✓.6C✓.5�y.:',✓3V. yi.`✓,�✓�✓ti t 41 1 �• 'i •1 •i •/ :/1 ACKNOWLEDGMENT State of California County of Orange ) On October.28th, 2010 before me, Allison Ritto, Notary Public (insert name and title of the officer) personally appeared Dwight Reilly , who proved to me on the basis of satisfactory evidence to be the personm whose name(s) is/X subscribed to the within instrument and acknowledged to me that he/ executed the same in his/ ii-authorized capacity(, and that by hisft tfTeEi;F signaturef on the instrument the person}, or the entity upon behalf of which the personM acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. l ALLISON RITTO WITNESS my hand and official seal. L�.�— My Commission # 15249324_,x Notar Public - California z Y Oran a Count 9 Y Comm. Expires Dec 23, 2012 Signature494 (Seal) Allison Ritto City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK March 7, 2011 Palp, Inc. dba Excel Paving Co. 2230 Lemon Ave. Long Beach, CA 90806 RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, 1 _1 Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Zealand (Telephone: 714536-5227 ) PALP,'INC. Dr ' I �OMPAW 2230 MMON;,, � , LONG BEACH, CA : 6606 SED SEALED I CIA 2url City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 716, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknpw ipt and review of Addendum Number One, dated November 1, 2010.. L Company Name By , NOV - 4 2010 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. SECT10N C PROPOSAL for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181(168) 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 theworktherein-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 50 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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. ;-TEN PERCENT -OF AMOUNT 8100 Accompanying this proposal of bid, find 91D � 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 an *. C-2 PROJECT BUD SCHEDULE - Garfield CC-9372 SECTION.0 PROJECT BID SCHEDULE GARFIELD AVENUE REHABILITATION FROM NEW'LAND STREET TO MAGNOLIA STREET CC NO.1372 FEDERAL, AID PR-OJECT _ESPL-5181 (168) PROJECT BASE BID. GARFIELD AVENUE - from Newland Street to Magnolia Street C-2.2 to C-2.4 BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: W40 - g° C-2.1 PROJECT BID SCHEDULE - Garfield CC-1372 #ern w th uif::rice::::::::.:.:.:.::::::::::::::::::::::::::::::::::::::teideii:::: =:No:;:; :::: t tull>EZ . . ::W.A toi Pik;t�4�`-cls....::=::•:•:;:;:::;:;:::::;:::;::.....::::-'UWt'. . 1 I LS M�QwIization U9 -Dm f� G0- rt FT I TNb �D S $ S0-o ," $ 50000 !" 2 1 LS Traffic Control Plan THOW—T*US4APO DVu-AYZ-.5 $ 3oi7o °O $ ;OW .°' 3 1 Furnish Project Traffic Control LS Tth P-w TWoUS.gAND -DOU-Ae 5 $1wo•°° $ 3p000 m' 4 470 CY Unclassified Excavation (includes disposal of material and fabric) 00 5G. tsn vow Fi+Irk S/X DOS (Z5 $ $ Pulverize, Remove excess, Grade, Cement Treat, Microcrack by 5 139890 SF FDR Process (includes disposal) $ .�._ OWE �t.L� T� a4-n5 6 55530 SF Surface Grind (0.1 T) (includes diposal of materal and fabric) Z, f� Tla/E-0T`1 Si x CATS $ O • $ 7 3265 TN Construct Asphalt Concrete (0.25' & 0.75' per plan) Sl qT1 TNtQV6-'bo t,.LA-e-S 8 2560 TN Construct Asphalt Concrete (0.17' ARHM Overlay) %!o• $1g1g547o " $ Remove & Reconstruct Curb & Gutter (CF=8",Includes AB) per 9 1845 LF Std-Plan 202 -DoLLA-,ta -r►a1C-ll-liTI r1_1 16W 5 10 370 SF Remove existing sidewalk (includes disposal) • 50 I ao $55�• 0�'QpLL. nm, �-5 $ Remove & Reconstruct Sidewalk per Std Plan 207 (includes 11 7000 SF disposal) 5LAe -DO"-5 $ y •°� $ z�000 •� Remove and Reconstruct Commercial Driveway per 1-113 Std, Plan 211 (including all appurtenances but not limited to: onsite 12 500 SF improvements, retaining curb, slot pave, etc.) $ S►�rttt� ^Do1� 5 C-2.2 PROJECT BED SCHEDULE _ Garfield CC-1372 ei stiaite: :::::::::::::::::::::::Ytein:wi: :::::::::::::::::lEaltea�e:: .................................. . � ....��i.iu.�Q��.:.:.:.:<:"::`«:::�:�:�:`�`:��`�:�:�:� <`��iilx...'iciiice:.:.� .``:.;�;�iviat```: Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 13 2 slot pave, etc.) per Caltrans Std. A88A EA $ 20000 $ `'lobo .60 TvZ -rH-D4&A-9,M DouAP5 Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 14 3 EA slot pave, etc.) per Fountain Valley Std. 204-3, Case "C" -T N0l2bo Ov $ Z�OD $ 1 Soo 00 WO 1' {f OL 4� h \W t4-Ut k 17pLCJk2S 15 1 EA install Truncated Domes to existing access Ramp $ 3b D '� $ 30 0 -i ({Ckr- t- u NoVZW T-)ou-A-Yt 5 16 13 EA Adjust Sewer/Storm Drain Manhole to finished surface -TfVW- !fup--Vf2t-o Ei4��� y JULAYZ 5 $ 3FO $ gq`io•°° 17 1 Adjust OCSD Sewer Manhole to finished surface �p 60 EA TV C-r- 41id "A36 616 4-11 -k5 $ 390 • $ ?90 - 18 11 EA Adjust City of HB Water Valve to finshed surface TINa f. TIA/&JT�{ :Ov 4f-S $ ZW .Q0 19 12 Adjust City of Fountain Valley Water Valve to finished surface -Tt�l�r� EA TVJO 4fu lApto ,Q S $ ZZ 0 •°� $2&40 •°� 20 1 EA Adjust Monitoring Well to finished surface TuUD WU lA9,66 Tvi" iOL A-d2-5 $ -2,u $yw av 21 4 EA Raise Survey Monument Well to finished surface $ 220 . w $ ,E8 0 - wo w%A ,--012L-o TOLL� DakAa 5 .ey-Menuma"en-City to Provide Survey Monumentation 22 (Not a Bid Item) ilk Remove existing Tree and Roots; Grind Tree Stump and roots to 23 14 EA 24" below Top of Sidewalk/Grade 1 C FH'l Ik1A o�J R� �OLLA'Y� S CFO $ � 66 $ (l z b 0. Furnish & Plant 24" box trees (remove existing landscaping and 24 14 irrigation to accommodate 24" box trees, replace irrigation in kind) EA f l v t K*t P�O IoUAA5 C-2.3 PROJECT BID SCHEDULE - Gafield CC-1372 :Tteiii Esli>triafei:: : Zterit:vvitli: unit'a ie®::::: .•.•.•..•..........•.•..•.•.•...... . ..:...:.:....::::;:; :Erfeiitecl �::::..._;:•:•:•:-:-:;;::::< .:.::..:....:::...::..:.:..::.: ..:::<-.-::-s:;s:•:::.=;;Vv•'.' •:•:.. :: -:-:.:::•:•:•:-:.:;:... .•. rt� .:•:- 25 1 LS Provide 90 Day Plant Establishment oKc— -r ous Atip F,-l64i HtA PxO-64 $ 1'�00 ` T 6D 10u S 26 1 Ls Provide I Year Maintenance $ 00b �' t� Oow, 27 1 LS Traffic Signing and Striping per plan -rO -ZUA-2S $1 00 $ 600 Kt -&A USA NA-3 28 22 EA Install Traffic Loops TWD E1(A6 wa-W lf�A �S $ 00 $4tt 29 1 LS Traffic Signal Pullbox and Relocation and Conduit Installation. OV $ 000. T 1"TA 30 1 Median nose reduction and crosswalk modification per Appendix �e LS S in Specifications. TEE - No fit- -S Total Amount Bid in Figures: $ 8'6 g % %o Total Amount Bid in Words: E l >+? _ ru �l-i� . r=f__ .T�t. ............................................. .. .. SE/6,1 ifla NVP-Z-D EFl E *1,Rise -Pt)q-*as C-2.4 SECTION C LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater; and the portion of the work to be done by such subcontractor. S6'o-S1AatU2A-l�C6� �a7fq 195 N • E-WAA S+jJ U m*-S CA cs C- Z7 4 S Maim 6?Wq'73 P-i LDS t5t-iN s. \n NV A** A4c- . By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Orange C• P. BROWN , being fire-st d lye, ssw� , deposes and says that he or she is PRES10' of�pA..the party making the foregoing bid that the bid is not made in the 1riterest`` �ol~;° '� o c 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. NJ U MEL P94aING COMFAW Name of Bidder C.P. BROWN f—� PRESIDENT Signature of Bidder 2230 LEMON AVENUE LONG BEACH, CA 90806 Address of Bidder Subscribed and sworn to before me this day of NOV ' 3 201) 201 _ C-4 NOTARY PUBLIC UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH CALIFORNIA Gentlemen: C. F'HILLIPS GOM Mt. #.ZN097g Mbfer;+alif:m N L08 �6,NG LES COUN"ry LL My CGffl n, irea Aug.16, 2012 K __..r.._... NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (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 andagreesthat the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: FALP HCOBA Contractor By Title C-5 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Los Angeles On NOV - 3 2010 before me, C. PHILLIPS, NOTARY PUBLIC (Nero insert name and tide of the officer) personally appeared PALP DBA EXCEL PAVING COMPANY BY C.P. BROWN, PRESIDENT who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/tltes subscribed to the within instrument and acknowledged to me that he7 litsy executed the same in hisAtWOWDc authorized capacity(ies), and that by hisfixt tkei signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. C. PHILLIPS t< WITNESS my hand and official seal. COMM, 1 € 007s r� Notary PubII t JIN�trnlrJ LOS ANOF.'LES COUNT-Y � i fora of Notary Public (Notary ) , My Comm,FxplrasAug,16,2 ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Tide or description of attached dmument) (Tide or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer ❑ Ptutner(s) 1-1 Attorney -in -Pact ❑ TrLlStee(S) ❑ other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of Cal(fo•nta in such instances, any alternative acknorr/edgmerut verbiage at may be printed on arch o dacumerd so long as the verbiage does not require the notary to do something that is dlegat for a notary In California (i.e. cerWing the authorized cqpadry of the signer). please check the document carefully for proper notarial wording and attach the form ifrequdred • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personally appeared which must also be the same date the acknowledgment Is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your tide (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e, hdshe/0*5— is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording.- • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form • Signature of tlx notary public must match the signature on file wide the office of the county clerk. Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document Indicate title or type of attached document, number of pages and date Indicate the capacity claimed by the signer If the claimed capacity is a corporate officer, indicate the dde (i.e, CEO, CFO, Secretary). • Securely attach this document to tlu signed document 2008 Vcrsion CAI',1 c12, 1007 800-873-9865 www NotaryClasses.com 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 YNo If the answer is yes, explain the circumstances in the space provided. Note; This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: NOV - 3 2010 F 1ACA XEA PXVNIG COMPANY Contractor C/ 4t". By Title ; P. MINN, PRESIMENT C-7 BIDDERrS INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name `PALE, ?SIC. ULA EXCEL PAVING COMP 2230 LEIViCN AVENUE i nNt' REACH, CA 80806 Business Address City, ) ism 599-5841 Telephone Number State Zip SIKE LIC. 688659 W State Contractor's License No. and Class 5-\�- �A Original Date Issued Expiration Date '`N v\ Gvo The work site was inspected by e of our office on ��a-��lt� , 201Q. The following are persons, firms, and corporations having a principal interest in this proposal: curb P Brown President and Chief Executive 09oer Curtis P. Brown III Vice President and Cwef Operating Offs cer BruceE. E aFlatt Vice President and Chief Financial Officer 23 LEMONAVENUE George R. McRae Vice President_ "' NG BEACH r:a aogna MSMW S. Miller Secretary Michele E. Drakulich Assistant Secx�et��r C -8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. FAAFAALP IMOBA PAVING CORM Company Name Signature of Bi deer %,?. MOM, PRESiCENT Printed or Typed Signature Subscribed and sworn to before me this day of NOV - 3 2010 2pl_ . C, PHILLIPS COMM. #1809758 M Notary PUVC•Callfornla LOS ANGELr_5 COUNTY iL NOTARY PUBLIC My COMM. EVI(U Ao6, 16, 2,612 NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. 2. 3. Name and Address of Public Agency Name and T-eephone No. of Project Manager: Contract Amount Type of Work Name and Address of Public Agency - Naive and Telephone No. of Project Manager: Contract Amount Name and Address of Public Agency Type of Work Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Date Completed Date Completed C-9 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this -project. R A i X.8 Contractor: EXCEL �bRIMI0 COMPANY Contact Person: 1� _h Contact Phone: (562) Signed: Date: NOV - 3 2010 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 RELIABLE CONTRACTOR DECLARATION (page 1 of 3) - This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of fiends to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalReUcle.ca.pov/Reizulations/Titlel4/. Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.Q. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: -CONTRACTOR INFORMATION CONTRACTOR NAME: i A LP NUBA �+ OMPANY OXEL � COMPANY AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: MAILING ADDRESS: i a I W vG ONG BEACH, CA 90806 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Signature ;ft 1f�r �,�� Date PRESIDENT C-11 RELIABLE CONTRACTOR DECLARATION (page 2 of 3) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable Last The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that -the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C-12 RELIABLE CONTRACTOR DECLARATION (page 3 of 3) (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. 1s on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (b) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 - Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL. EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder E -" P. WG C® , proposed subcontractor hereby certifies that he has V , 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 fled with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be -submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders -or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-14 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not 3.g/ convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. -Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of -the -bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No �1 if the answer is yes, explain the circumstances in the following space. C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shalt also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-1 G Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY I COUNTY of WSANWLES DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged -information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Cheeldist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: ® Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and ® Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. 0" Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP Q1_04 C-18 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checldist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal -that he or she shall require that the language of this -certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-1 9 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES LUNIYLb I t 11-115 YUKM 1 V WbULUSh LU1313Y 1NU At; 11 V11ILS YUKJUAN 1 1 V S 1 U.b.U. 13:3L 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a. contract ®a. bid/offer/application � a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime FISubawardee XCEL PAVING C+OMRAa W Tier , if known NUE 90806 Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, ifknown: b. Individuals Performing Services (including address if different from No. I0a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in -kind; specify: nature a deferred value El f. other, specify 14. Brief Description of Services Pea -formed 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 Sbeet(s) attached: Yes1:1 No 16. Information requested through this form is authorised by Title r1 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name: C.P. W l la E�l3F 1 f��itli U.S.C. 1352. This information will be reported to Congress — semiannually and will be available for public inspection. Any Title: person who fails to file the required disclosure shall be subject to a civil penalty ofnot less than $10,000 and not more than (56c) 599-5841 �Ov _ 4 91r $100,000 for each such failure. 'Telephone No.: Fate: LU Authorized for Local Reproduction Federal Use Only: Standard Form - LLL LPP 01-04 Sramlard r.". 1.1.1_ Rev C-20 Page 12-87 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 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 l (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RIP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-21 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LU-Instructions Rev.06-04-90«ENDIN Page 12-89 LPP 01-04 C-22 March 15, 2001 n W O Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. . 1� 1 A• a 1? a ' 1 1! 1 1 1 1• �. 1 • � ,} r ��F 3ltr��!I�� r� t n" d1? *� RIM Wt W.�,4�� 3iy. 0�r� Il= N Y�a4n..,�F'- �r1� �e it< "Z' 1 r $r'��ttF+"�t�?7' � i � �✓ I t:47�A:E+i:� ` a� r''t•''':f:�g?'i • 25s'p3+;f / y '' Address r1. j 1 i • � ' . :. I v t s'f;;i33 t{filiu fI ajF;+t ' ANi a>s � � .. ' G' i 7k��RiF;_�,• ;IYY.ais!,�'�,''� S' itlz-?c'rP h y^lys r'r.S _� • 1 . . i,11111N OEM Tel f $ �9 d v�,���•�:=,,,PVV��������.k?r�f�-, $S':`;•I.>ifn�.�, 14 LA&Mrdl 9a3� Fy 66.7�y�v7.T:`' � 34!2+ 34is'' �i?f �;• ciui_ 'S:s'•'i li�ii:e;ix{�yvt3s3utS'n, ry�m D#piku, t Ori nal - Local ency File C�T S-'r',q I PJ 7- t544 S- VIN64A Page 12-111 LPP 06-06 November 14, 2006 (04 0 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Name/ Phone/ ttlsx tl �i i'd dt Address/Fax1 A r l 1 ' 0 1 i r I r I r f GAYPdi } .}'r� r 3 s`� 1 �€14-`i rgiJll a City, State, •%iG ■ ' .Qi�ii �*ri��? 14 3# a� f�;cszt.�,�,�- f ie r� 1 • , �.�, �' , lY ttffif 3 flt.ii �u �A _ . _j�� . 4 :: *pY•t�"'r`�Ctrd ff�` :31G1'i�:i. n'�s:;$%,,3u_ I,.. �hj � ,.YY4 ■ 1®. • � •at j f'�it "'��t��i. z t ,�}e, ��,,p�'ra�,�tw•3di�� .1i4.�� rh:xil �f���{p/,j�3�+g�{f�.itrs',Yt��,yv�.j�' • ■ • �j}i� { •t t•'{A. T�'(:�{e}'#.t3�I)atY���32+ i•� 3 ' • r t3 1 t i t i yR ti tf trf 3?,ttr=i�lj ( •�E 7��:x��Tu��� _ _.. _.• _ iAt}�;*�5#�4�t ,�"'K _ - • •_.-. iIt�27! t$ x� t�' ,E��a,11ff�c tx lE> �st�33''7f s r is tax f ; Y Y t t£�N•11e,r.a,jJa4f`�. 1? Al:C'ti � �d�c�X E� 7wi��f �?Mils 5iai ■ • ■ �. I� �t•1� � in`^ deal � {,r r �J S�s�, ' 1` � -1, C y.'� f t dr K,�',� S�f'`r 3 Safi. s� ■ ' ■ • t .'!' � i � � �fS`D� �.�'tt, SY�Jr J,'ai"U.i1F�iia^ice --rt', _.. • ,n• ■ Y ®. s �r;t%s ��3f , � 7Js<i�„t - f l� �� ' J �Y�'S��Y 4� tehi ;�1;,9£P'i ■ I , �� Y t kf7 � ..f{?{�r'! ��t�itj �Sil ni:3J (:{�f� f 17: � 3 li'�1.4 i�a.<Twltit� CfAi1T.Fn7t1,. ■ • •c[ Distribution: 1) Original - Local Agency Pile rage iz-iii LPP 06-06 November 14, 2006 EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title d9 Centinn 26 of the Code. of Federal Regulations- Photoconv this form for additional firms. Name/ Address/ CityIP Ph.6ne/ Fax 1 __ _t�� I v of 6- fa l? t' iyi l T' #Firm 1''i4tt1�2, i q t• rK`# r t i; .ril v. _. __ _.. I.. _. _. _. ■ • •� a/ /i,!- imL�j����n.�a�ii�i' �g �c t.a �nif 4 , a .rz 1 tines . l ' ;s5 ll 3�^�'�^�'� r • ■ 1 .tt ,^ r ty2t<{t�1�'�{jr'��f''r�fi=s t iri 6'11it11,'�f t a}'s:'Si I�rO.r�a!tt)9aY��i•%'�r�:kLLI't�i;a. • ,� , • c � I 1 II i.} +'=1v N . tM� �S .;F�..'lr.� rYe `t I�n�:yi IJ 3t3 i$t �(IS{t'�Jl SRi��� _ )� If 3(� Ali t( t t t:.j - __ r t • / � ■ A • ►i • � � . � u � %, �5 r t;..tr I v , i �i�J21 Z���I,d,rr[r"1'P {fir' ,ta�.�rr'Itr � F� �I 1 " � * it�t�'�i �fr�-i•� 5 Z:.;1 zj 2 Y n ; ,t. as vs 1 s'fir„ 01�v State ZIP i I ♦ -4vtNl / ♦ � ■ {l�f (R � fs� [ S tR4 ,� �IF�rtiJ t �:in� 7 �t•�`t Y3 �. t'{�a��� �.f�.1r� ��i3t£i. )' tip , t(�{"',�ty'{;7�•q` iy'. Gt Z<�s•�i1i'LfF:� P• y 4 :i '-in�n� flfl Iifivlitj:Mt�3�" )�f�iN lir�s��21�?�� �Fti"fii Y (' [F i, T 1 ^ t cz Hu tm i � ,>�., , �� } ��r [ vas )" ,af .• $': a .`c;-" `�fi • • • � ♦ , ; 1���"� 01.• . _. Ysa, py `• #�' L;.���j•x��1ljg+� � � l#i�3tX)t'fj13¢t `Itt SS ri Distribution: 1) Original— Local Agency File Page 17,112 November 14, 2006 LPP 06-0� EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LISP OF SUBCONTRACTORS (DBE and NON -DBE)- PART ID The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Firm Name/ ' I 1 rt 1 (F v "'! s r� G{� t'4r�I 1 E �y� it f 1 3 t'>�I 11 Address/ oil t it s City, State, ZIP 1 I i4 R$ia• .1':sliti3�'al,i, :: j� Kn'NI tt�4 dlF�Tas' Ytn�'L« ■rnillion a. t'x a ii`+i iP ;U7ip'7 t 8 ..1 t t`rQi! �y���t� •a!q `3 {�4aS .' I� 7 ryJy,1•rs j 7�J3 4 D C Yjy� A . ■ 1 . li � 7 f ``L'� '���/�i �� Y�s jja 4Ss, <�3', y',x(i,��, � 1 r.,i ig � 'f u� a�s?'�,1} 3� �`'j�'f>�k?if. ■ . •l a'��F'�°{"1�� `^ `i. ' .ayl':^�t �� �f� �yF3 3 ir1 •Li'-, � ����� 4 q1 t f �R1Y•) 1R 2 ■ ' • ; 9 Ft }`,,at�a:?y 145 00"T MAIN ;' " yj } ti�$y1¢y� �Aty�{,.1 'l>J'1� j�{ '3 ;v.37° tfTt • N � { �+�p ,i }+ fir i�-j SiA 'R Y 3'"� 1 y. i Yt e 01, 'tµ`erll t !(j' lt`a`•�'"'A Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP Ob-06 k A GENERAL ENGINEERING CONTRACTOR STATE LICENSE NO. 688659A P.O. 130X 1641 LONG BEACH, CA 908p6-S14 (562) .599-58, FAX (562) 591.741 C. P. Brown, President: 30+ years experience working for other general contractors with the past 24 years being self employed in own general engineering contracting business. PALP, INC. DBA EXCEL PAVING COMPANY A GENERAL ENGINEERING CONTRACTOR STATE LICENSE NO. 688659A Description of Operations P.O. BOX P641 LONG BEACH, CA 90806-51' (562) 599-S& FAX (562) 591-7.41 Excel Paving Company is a general engineering and paving contractor that has been in business for the past 30+ years. The company is a corporation owned by C.P. Brown, Jr. Their operations include street and road construction, widening, and repairs; related sidewalk, curb and gutter construction; paving of school yards and parking lots; and excavation and grading of "pads" for building sites. On approximately 80% of their jobs the company will operate as a general contractor, responsible for all off -site improvements, grading, removal, etc. but will subcontract any work, which is not specifically within their domain. Occasionally the company will perform work at airports. They also may occasionally perform work in the "THUMS" area of Long Beach Harbor, requiring them to transport their equipment and personnel by barge to these Islands, approximately '/2 mile from the harbor. The company estimates 2009 gross revenues of 50 million, $33 million of which is subcontractor and material costs. All work is performed in Southern California, with most in Los Angeles and Orange County. A great deal of work is done for public entities, repairing/widening existing surface streets and roads (75% public entities and 25% private entities), pipe work, concrete, landscaping, electrical, cold milling, highway, bridge, or overpass work is subcontracted out to other firms. Excel Paving Company also repairs a great number of paved schoolyards and parking lots (30%) and usually has a small amount of on going work at the Los Angeles, Burbank and Long Beach Airports. INCUMBENCY AND SIGNATURE CERTIFICATE OF PALP, INC. The undersigned, Marcia S. Miller, being the duly elected and Incumbent Secretary of Palp, Inc., dba Excel Paving Company, a California corporation (the "Corporation"), hereby cerdfles that the persons named below are, on and as 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 s , in the nacre of and on behalf of the Corporation. Curtis P. Brown President and Chief Executive Officer Curtis P. Brown III Vice President and Chief Operating Officer Bruce E. Platt Vice President and Chief Financial Officer George R. McRae Vice President Marcia S. Miller Secretary Michele E. Drakullch Assistant Secretary IN WITNESS WHEREOF, the undersigned has executed this Certificate as of the date set forth below. Date: January 27, 2010 PALP, INC. DBA EXCEL PAVING COMPANY A GENERAL ENGINEERING CONTRACTOR STATE LICENSE NO. 688659A Excel Paving Company 2230 Lemon Avenue Long Beach, CA 90806 Telephone: 562/599-5841 Type of Business: Contractors License # Fed I.D. # CREDIT APPLICATION Fax: 562/599-3679 General Engineering Contractors 688659A 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#0161 U.S. Bank: Account Representative: Phone #: Fax #: Account #: TRADE REFERENCES: Company Vulcan Materials R.E.H. Trucking Blue Diamond Materials Savala Equipment 4100 Newport Pl. # 130 Newport Beach, CA 92660 Robin Woods 949/863-2462 949/863-2336 153491958689 Phone Fax 626/334-4913 626/334-4161 909/591-0871 909/591-0506 714/578-9600 714/449-2295 800/223-2473 949/552-8597 P.O. BOX-16 LONG BEACH, CA 90806-5 (562) 599-5 FAX (562) 591-7 Contact Bill Watt Gina Mendiola Rich Shoan Yoganda Ellis I certify that the above information is true and correct, and that we can and will comply with your terms. C.P. Brown - President Bonding Agent: Rapp Surety Services 23461 South Pointe Drive Suite 346 Laguna Hills CA 92653 Of s: (949) 457-1060 Fax: (949) 457-1070 Contact: Douglas A. Rapp Surety: Federal Insurance Company C/O Surety Department 801 South Figueroa Street 23" Floor Los Angeles CA 90017 P.O. Box 30127 Los Angeles CA 90030-0127 Insurance Carrier: The Wooditch Company One Paris Plaza Suite 400 Irvine CA 92614 Contact: William Wooditch Office: (949) 553-9800 Fax: (949) 553-0670 PREVIOUS J013 RE 11HRENCES 41 Contractor's Name: Palp Inc. DBA Excel Paving Co. Project Name: Jefferson Blvd. Widening Project Description: Street widening, infrastructure reconstruction, street lighting, traffic signals, landscape &.irrigation, storm drain improvements, and sewer Location: Jefferson Blvd., Playa Vista, Los Angeles Construction Value: $6,306,687.00 Date of Completion: 12/08 General Contractor Information: Palp Inc. DBA Excel Paving Co. Contact: Phone: Fax: Owner Information Contact: Phone: David Cook 562/599-5841 Ext.239 562/591-7485 Playa Capitol Company, LLC Cliff Ritz 310/448-4678 Fax: 310/822-5336 Contractor's Name PREVIOUS JOB REFERENCES #2 Palp Inc. DBA Excel Paving Co. Project Name: Slauson Ave./SR-90 Impvts. Project Description: On ramp & off ramp widening on SR90, Traffic Mitigation Added left turn on Slauson Signalization & Signing & Storm Drain Impvts. Location: Slauson Ave. @ SR90 Culver City, Los Angeles Construction Value: $2,136,269.00 Date of Completion: 4/09 General Contractor Information: Palp Inc. DBA Excel Paving Company Contact: David Cook Phone: 562/599-5841 Ext.239 Fax: 562/591-7485 Owner Information: Contact: Phone: Playa Capitol Company LLC Cliff Ritz 310/448-4678 Fax: 310/822-5336 PRF V1Ot_iS .IUB REI:FRLNC1:S # 3 Contractor's Name: Palp Inc. DBA Excel Paving Co. Project Name: Santa Monica Transit Parkway Project Project Description: Underground, Retaining Walls, Fwy. On Ramps, A/C Pave, Sidewalk, Curb & Gutter, Signalization, Landscaping, Storm Drain Impvts. Sewer, Water And Retaining Wall Location: From 405 Fwy. To Beverly Hills City Limit, Los Angeles Construction Value: $34,455,152.00 Date of Completion: 11105 General Contractor Information: Palp Inc. DBA Excel Paving Company Contact: Bruce Flatt Phone: 562/599-5841 Fax: 562/591-7485 Owner Information: City of Los Angeles Contact: Carl Nelson Phone: 213/485-4474 Fax: 213/485-4836 Contractor's Name Project Name: Project Description PREVIOUS JOB RI:I-ERENCES #4 Palp Inc. DBA Excel Paving Company Alameda Street Redesign of Arterial Streets and Storm Drain Impvts. Location: Intersection of Alameda Street and N. Spring St., L.A. Construction Value: $3,197,043.00 Date of Completion: 11/09 General Contractor Information: Palp Inc. DBA Excel Paving Company Contact: Bruce Flatt Phone: 562/599-5841 Fax: 562/591-7485 Owner Information: City of Los Angeles Contact: Steve Chen Phone: 213/485-4516 Fax: 213/485-4838 PRI':VIOUS .1011 RI EERENCES 45 Contractor's Name: Palp Inc. DBA Excel Paving Co. Project Name: Phase 3 Container Yard Expansion, Pier T Project Description: Container Yard Parking Lot Expansion, Storm Drain Impvts. Sewer and Water Location: Pier T, Long Beach, CA Construction Value: $21,703,834.00 Date of Completion: 10/07 General Contractor Information: Palp Inc. DBA Excel Paving Company Contact: Phone: Fax: Owner Information Bruce Flatt 562/599-5841 562/591-7485 The Port of Long Beach Contact: Gary Cardemone Phone: 562/590-4172 Fax: 562/901-1732 PREVIOUS JOB REFERENCES 46 Contractor's Narne: Palp Inc. DBA Excel Paving Company Project Name: Pier E Berths E24-326 Project Description: Asphalt Utility Removals, Grade, New Asphalt Paving and New Concrete RTG Runways, Storm Drain Impvts., Sewer and Water Location: Pier E, Long Beach, CA Construction Value: $5,251,800.00 Date of Completion: 1/08 General Contractor Information: Palp Inc. DBA Excel Paving Co. Contact: Bruce Flatt Phone: 562/599-5841 Fax. 562/591-7485 Owner Information: The Port of Long Beach Contact: Gary Cardemone Phone: 562/590-4172 Fax: 562/901-1732 PREVIOUS JOB REFERENCES 47 Contractor's Name: Palp Inc. DBA Excel Paving Co. Project Name: Highland Avenue Widening Project Description: Redesign of Highland Ave. and Adjacent Streets, And Storm Drain Impvts. Location: Highland Ave. @a Franklin Ave., City of Los Angeles Construction Value: $2,754,889.00 Date of Completion: 11/09 General Contractor Information: Palp Inc. DBA Excel Paving Company Contact: Bruce Flatt Phone: Fax: Owner Information: Contact: Phone: Fax: 562/599-5841 562/591-7485 City of Los Angeles Steve Chen 213/485-4516 213/485-4838 PR1 VIOUS .10B RI-I-IIZENCIS 48 Contractor's Name: Palp Inc. DBA Excel Paving Project Name: North Maclay Ave. Project Description: Street Beautification and Improvement of North Maclay Avenue Location: North Maclay Ave. from 1" Street to Eighth Street Construction Value: $3,682,624.00 Date of Completion: 7/08 General Contractor Information: Palp Inc. DBA Excel Paving Co. Contact: Bruce Flatt Phone: 562/599-5841 Fax: 562/591-7485 Owner Information: City of San Fernando Contact: Ron Ruiz Phone: 818/898-1237 Fax: 818/361-6728 EXCEL PAVING CO. 10-23-09 JOB NO 4295 4458 4483 4492 4499 4505 4507 4522 4524 4568 4590 4593 4596 4625 4631 4635 4646 4653 4654 4657 4660 4666 4671 4672 4674 WORK EXPERIENCE MAY 31, 2009 CLOSED JOBS 2ND QUARTER 2008-2009 CULVER BLV/VISTA DEL MAR: TAPO CYN/ALAMO ST:SIMI VALLEY BOB HOPE AIRPRT:BURBANK E06-53 TIERRA REJADA RD/2ND ST:MORPRK KAISER CANTARA ST.:PANORAMA TOPANGA h V7CTORY:WESTFIELD N. BRAND BLVD:GLENDALE BELMONT PIER PLAZA:LB R6660 VERDUGO/BARRINGTON:GLENDALE NUEVA VISTA E/S:BELL 07-08 ROYAL AVE:SIMI SV08-02 LOWELL EL SCH:LONG BCH USD MAT ARRESTING SYS:BURBANK ARPT EL PRESIDIO ST.:CARSON 4TH ST SAN BERNARDINO:REMPREX JOHN WAYNE AIRPORT:BALI CALIFORNIA BLVD.:PASADENA GETTY CENTER:LOS ANGELES WESTERN AVE:TORRANCE SO. FREMONT ST.:ALHAMBRA GOODE AVE.GLENDALE 5TH ST. :MANHATTAN BEACH R ST/FIGUEROA:KAISER:WILMINGTN 5901 7TH ST VA HOSP:LONG BEACH OLDEN ST.:SYLMAR PROJECT NAME PLAYA CAPITAL CO CITY OF SIMI VALLEY BURBANK/GLENDALE/PASADENA CITY OF MOORPARK KAISER FOUNDATION HEALTH PLAN WESTFIELD DESIGN 6 CONSTRUCTIO HATHAWAY DINWIDDIE CONSTRUCTIO CITY OF LONG BEACH CITY OF GLENDALE PREMIER WEST CITY OF SIMI VALLEY LONG BEACH UNIFIED SCHOOL DIST BURBANK/GLENDALE/PASADENA LANE AIRE MANUFACTURING REMPREX, LLC BALI CONSTRUCTION HATHAWAY DINWIDDIE CONSTRUCTIO HATHAWAY DINWIDDIE CONSTRUCTIO MOOG AIRCRAFT GROUP INTERSCAPE CONSTRUCTION, INC DINWIDDIE CONSTRUCTION COMPANY BEARDSLEY CONSTRUCTION KAISER PERMANENTE (USE) MOTORCYCLE SYSTEMS TUTOR SALIBA PERINI, JV FINAL CONTRACT AMOUNT 1,601,060 2,957,391 13,177,103 3, 167,306 91, 879 2, 597, S i2 217,460 514,419 585,432 206,362 1,816,110 541, 572 3,642,247 13,122 1,438,337 15,536 37,708 6,700 7,240 4, 600 256,760 1, 500 8,450 5,445 36,710 WORK EXPERIENCE MAY 31, 2009 • OPEN JOBS 2ND QUARTER 2009 EXCEL PAVING CO. EST. FINAL WORK WORK 8-6-409 CONTRACT COMPL. BACKLOG. 40A2 TUDOR WEST/UCLA JOBS ?, 339, 610 100.0% 1,020 00 4093 FLIf r; VLT LA 1 , 4 73 , 9.13 100.0% 4232 VALENCIA MESA FULLERTON 930, 000 99.9% 1,145.00 4240 LINCOLN BLVD. CALTRANS 12,138,000 98.4% 231,084.00 4242 CHANDLER/LANKERSHIM LOS ANGELES 5,421,529 100.0% 4245 LINNIE CANAL LOS ANGELES 351,920 100.0% 4266 CENTINELA AVE. LOS ANGELES 2,880,145 100.0% 4295 CULVER BLVD VISTA DEL MAR 1, 601, 060 100.0% 4302 VERMONT AVE. LOS ANGELES 1,392,670 100.0% 4324 USC, FIGUEROA & JEFFERSON 1,584,799 100.0% 4328 HIGHLAND AVE. LOS ANGELES 3, 449, 332 99.8% 6,582.00 4329 SUNSET BLVD. LOS ANGELES 2,062,587 100.0% 4330 HARBOR GATE.: ;Y LOS A14GELES 2,744,039 99.8% 3,679.00 4340 SLAUSON AVE. CULVER CITY 2, 570, 504 97.3% 60,893.00 4348 PH 3-PIER T LONG BEACH 23,538,665 100.0% 4370 ALAMEDA ST. LOS ANGELES 2, 687, 109 97.2% 50,216.00 4408 HOLLYWOOD WAY BURBANK 23,710 82.7% 2,900.00 4413 VERMONT LOS ANGELES 182, 915 99.4% 1,000.00 4425 FIRST ST-LOS ANGELES 255,000 69.6% 53,211.00 4442 SEPULVEDA BLVD. LA/CC 594, 814 86.4% 80,015.00 4454 UCI IRVINE 59,976 100.0% 4458 TAPO CYN SIMI VLY 2, 957, 391 100.0% 4466 FIGUEROA/SEPULVEDA LACO SANI 2,453,930 100.0% 4481 CERRITOS/EL RITO GLENDALE 1,197,605 100.0% 4482 ALAMITOS RODGE LONG BEACH 408,474 100.0% 4483 BOB HOPE AIRPORT BURBANK 13,177,103 99.4% 66,346.00 4492 TIERRA REJADA RD MOORPARK 3,167,306 100.0% 4497 CALIFORNIA BLVD. CSI ELECT 14,892 100.0% 4499 CANTARA KAISER FOUND 100,078 81.6% 14,190.00 4502 GARDEN GROVE SANI 1,964,738 100.0% 4505 TOPANGA/VICTORY WESTFIELD 2,597,572 99.9% 1,488.00 4507 BRAND BLVD. HATHAWAY 217,460 100.0% 4508 ALVARDO TRANSIT LACRA 2,140,870 72.6% 523,426.00 4522 BELMONT PLAZA LONG BEACH 514,419 100.0% 4523 BESS/LEORETTA KAISER 347,000 100.0% 4524 VERDUGO/BARRINGTON GLENDALE 585,432 100.0% 4526 LAKEWOOD BLVD. DOWNEY 2,047,150 99.2% 18,801,00 4534 7TH/CATALINA HENSEL PHELPS 73,954 100.0% 4535 SHENANDOAH EIS LAUSD 744,408 100.0% 4549 RAMIREZ CANYON TORRES 400,835 99.5% 2,080.00 4552 JOHN WAYNE AIRPORT ORANGE CO 1 , 538,269 90.7% 126,667.00 4553 PACIFIC OCAST HWY DANA POINT 5, 973, 934 68.0% 2,114,492.00 4566 CLEVELAND H/ S LAUSD 1, 304, 212 98.9% 16, 024.00 4567 NO HOLLYWOOD ST LACRA 1 , 143 , 779 8.5% 934, 049.00 4568 NUEVA VISTA ES BELL 206,362 100.0% 4573 ATHERTON ST. LONG BEACH 1 , 308', 318 95.5% 56,457.00 4585 VARIOUS LOC WESTLAKE VILLAGE 2,125,397 100.0% 4586 7TH ST. LONG BEACH 1,782,650 100.0% 4588 EAGLE ROCK HS LAUSD 1,145,867 99.4% 6,158.00 4590 ROYAL AVE . SIMI VLY 1 , -i 91 , 856 98.50% 24,569,00 4592 MADERA RD. SIMI VLY 711,565 100.0% 4593 LOWELL EIS LBUSD 541,572 100.0% Page 1 of 4 WORK EXPERIENCE MAY 31, 2009 ' OPEN JOBS 2ND QUARTER 2009 ° EXCEL PAVING CO. EST. FINAL WORK WORK - 8-6-09 CONTRACT COMPL. BACKLOG 4595 MARINA HIS HBUHSD 3 , 305, 000 99 5% 14,887.00 4596 FMAS SYS BURBANK ARPRT G•; 2 , < t - 100 001� 1.358.00 4597 WILSHIRE/FAIRFAX MATT CONST 1,125,815 76.6% 207,466.00 4598 CHEVIOT HILLS LOS ANGELES 777, 869 55.0% 312,655.00 4603 INGLEWOOD/CULVER PLAYA CAP 386,070 92.6% 28,623.00 4604 MADISON EIS REDONDO BEACH USD 45,000 85.5% 5,698.00 4605 MWD WATERLINE RUDOLPF/SLET 1, 809, 170 27.2% 1,097,224.00 4607 LACC CHILD DEV CTR CA CONSTR 36, 549 100.0% 4608 TAXIWAI D LON BEACH 816,228 100.0% 4609 JUVENILE HALL ALCORN FENCE 476,412 78.1% 65,652.00 4611 USC ST IMPRV Usc 1, 800,000 75.2% 414,662.00 4613 STORM DRAIN POL POLB 4,127,471 27.8% 2,783,997.00 4615 PIER A WEST TUTOR SALIBA 121,70G 22.1% 41,302.00 4616 PIER A WEST TUTDOR SALIBA 327,832 28.1% 235,691.00 4618 FED EX RAMP FEX EX BURB ARPRT 3,949,667 8.3% 3,210,502.00 4619 SO REGION ES LAUSD 415,870 98.4% 4,961.00 4620 EAST LA HS TUCKER ENGR 175,225 79.0% 32,499.00 4621 VARIOUS LOC DANA POINT 60, 527 70.4% 18,050.00 4623 CANDLEBERRY AVE SEAL BEACH 1,508,369 2.3% 1,344,057.00 4624 WASHINGTON/IND BNSF JOJMSPM CONTROLS 152,759 59.0% 45,180.00 4625 EL PRESIDO LAINE AIRE 13,122 100.0% 4628 LIMECREST DR. LACPW 220,002 99.5% 1,119.00 4629 WASHINGTON BLVD PCL CONST 129,305 72.2% 32,476.00 4631 4TH ST. REMPREX 1,438,337 99.0% 9,478.00 4632 LACMA PH I I MATT CONST 431,836 22.3% 291, 350.00 4635 JOHN WAYNE AIRPORT BALI CONS 15,536 100.0% 4636 VARIOUS STS ROLLING HILLS EST 178,414 100.0% 4637 DISNEYLAND TRENCH BALI CONS 9,985 100.0% 4638 DICKSON, ENT, FOSTER COMPTON USD 89,200 85.9% 11,941.00 4639 VARIOUS INTER BOEING CO. 1,475,312 44.9% 732, 546.00 4640 BERTH 73/191 POLA 237,765 9.6% 192,277.00 4641 PUENTE HILLS LANDFILL LACO SANI 474,349 99.2% 3,700.00 4643 CAMPUS CAP PLAYA VISTA 443,335 1.6% 423,216.00 4646 CALIFORNIA HATHAWAY 37,708 100.0% 4647 WOOD AVE. FULLERTON 1,075,000 10.6% 880, 962.00 4648 BANDINI BNSF 454,993 0.6% 421,809.00 4649 SUNNYMEAD BLVD. MORENO VLY 2,456,972 0.7% 2,214,886.00 4651 BALBOA/VICTORY LOS ANGELES 1,397,499 2.9% 1, 233, 522.00 4652 LA AIR FORCE BASE RMA LAND 10,890 100.0% 4653 GETTY CENTER HATHAWAY 6,700 100.0% 4654 WESTERN AVE MOOG, INC 7,240 92.6% 444.00 4655 ARTESIA PILAR SANTA ANA 1, 676, 293 2.1% 1,509,603.00 4656 RTE 23/118 SIMI VLY 31,998 100.0% 4657 FREMONT ST ALHAMBRA 4, 617 4.6% 2,199.00 4658 LA PALMA AVE PCL CONT 723,223 0.0% 592,186.00 4659 VARIOUS STS PV EST 204, 212 1.3% 183,842.00 4660 GOODE AVE HATHAWAY 262,440 22.1 % 132, 477.00 4661 BIKE ROUTES LONG BEACH 277, 703 0.6% 258,334.00 4662 VARIOUS ACHOOLS COMPTON 127,142 1.8% 105,600.00 Page 2 of 4 WORK EXPERIENCE FEBRUARY 28, 2009 CLOSED JOBS 1ST QUARTER 2008-2009 EXCEL PAVING CO. 8-6-09 FINAL CONTRACT JOB NO. PROJECT NAME AMOUNT 3 84 3 LAUREL CYN BLVD. LOS ANGELES 807,100 4103 HOWLAND CNL CRT LA 299,025 4129 MT. SAC WALNUT 910,385 4211 VARIOUS LOC LONG BEACH 306,515 4282 LOOP & PARK PL. IRVINE 1,112,969 4319 REDONDO AVE. LONG BEACH 221,979 4339 VARIOUS LOCATIONS LONG BEACH 1,353,277 4415 CASE AVE. LOS ANGELES 186,308 4416 STIMSON AVE. LA PUENTE 396,099 4434 IMPERIAL HW'i DOWNEY 2,427,816 4443 INGLEWOOD AVE. REDONDO BCH 540,525 4468 LACC LOS ANGELES 6,085 4490 VARIOUS LOC LB TRANSIT 879,832 4515 GRAND AVE. MT. SAC 224,919 4516 TUSTIN & 1ST ST MCCARTHY 233,937 4530 VARIOUS LOCATIONS CULVER CITY 801,667 4531 LONG BEACH CALCARTAGE 18,500 4541 CAMINO REAL REDONDO BCH 444,555 4545 BERTHS 261-267 CONNELLY-PACIFIC 174,979 4548 NORMANDIE KAISER 58,823 4558 LA PALMA AVE. PENNER 15,895 4559 BERTH 302-305 POLA 0 4569 MIDWAY/39TH PL LONG BEACH 6,353 4571 AVE. 45 HUNTINGTON PARK 76,100 4572 VARIOUS LOC LONG BEACH 147,364 4574 SOUTHERN/GARFIELD SO GATE 27,300 4577 SLAUSON OVERPASS BELL 74,614 4578 PACOIMA MS TORRES 13,892 4582 ST IMROV INGLEWOOD 548,259 4583 OLYMPIC/CENTINELLA SANTA MONICA 1,961,558 4584 VARIOUS LOC SANTA ANA 3,570,920 4587 COLUMBUS E/S PANKOW 224,715 4591 LAS BRISAS SIGNAL HILL 146,749 4594 ALDRICH PARK UCI 907,704 4599 VARIOUS SCHOOLS 837,133 4600 ANCHORAGE/SHOR RE SCHAFER 7,710 4606 PERRY LINDSEY ACADEMY LBUSD 1,074,447 4612 KAISER VENTURA BLV KAISER PERM 43,997 4626 VAN NESS BUNTICH 4,850 4627 SHEILA ST. ELECTRO 2,698 4630 LAMAR/MAIN ELECTRO 33,320 4633 DISNEYLAND BAKERY BALI CONS 16,876 4642 JA14ES WOOD AVE FED OF LABOR 8,388 4645 USC SCH ARTS HATHAWAY 19,130 4650 SPEED HUMPS PASADENA 38,130 Page 3 of 4 WORK EXPERIENCE NOVEMBER 30, 2008 CLOSED JOBS 4TH QUARTER 2008 EXCEL PAVING CO. ' 8-6-09 FINAL CONTRACT JOB NO. PROJECT NAME AMOUNT 4240 CMB QTY/PLAYA VISTA 8,938 4247 7TH/710 FRWY LONG BEACH 606,153 4296 GLENDALE BLVD LOS ANGELES 597,309 4359 MICHELSON BLVD. IRVINE 2,909,722 4359 LOOP ROAD 0 4359 MICHELSON DR. 0 4367 GRANADA AVE. LA MIRADA 564,180 4377 PIER E PORT LB 5,295,408 4393 JEFFERSON BLVD. PLAYA VISTA 7,938,248 4417 PROSPECT TUSTIN 941,017 4421 LB TAXIWAY LONG BEACH 59,379 4427 05-'06 ST. REHAB LAGUNA BCH 3,848,764 4448 MARYMOUNT HS 856,482 4452 GLENCOE LOS ANGELES 309,434 4463 SERVICE MOD EL CAMINO COLLEGE 147,800 4464 WASHINGTING/GRANDE BNSF 1,122,915 4467 VALLYHEART ST. FRANCIS 135,875 4469 HALDEMAN RD. RUSTIC CYN HOA 58,395 4470 LATIMER RD. RUSTIC CYN HOA 66,500 4480 EAST OLIVE AVE BURBANK 313,6S6 4500 CAMPUS/ARTISAN CSI ELECT 0 4501 GAGE AVE BELL 25,375 4504 BERENDO M.S. TORRES CONST 207,053 4506 VARIOUS LOC CO OF ORANGE 32,744 4509 ROSCOE BLVD. KAISER FOUND 100,937 4518 NORMANDIE ARB STRUCTURES 94,545 4521 ZANE GREY HIS TORRES 75,326 4525 TAPER AVE SCH TORRES 108,842 4527 SUNNY BRAE SCH TORRES 15,345 4528 GETTY CENTER HATHAWAY 37,887 4529 NORTHRIDGE MIS TORRES 6,542 4532 SAN MIGUEAL EIS TORRES 315,091 4536 W. 4TH ST BNSF 265,323 4538 PERSHING DR CSI ELECT 76,194 4547 WRIGHT MIS TORRES 99,389 4554 BLUFF CREEK FINVEST 91,269 4555 VICTORY BLVD. NO. HOLLYWOOD 429,749 4557 DACOTAH EARLY ED TORRES 159,273 4561 BESS/LEORITA BALDWIN PARK 15,866 4563 NICHOLS/BELSITO BALI CONST 405,647 4579 KAISER/NORMANDIE KAISER 8,225 4580 CAL ST NORTHRIDGE 6,200 4581 E. 26THST BNSF 296,935 4601 SHEILA/INDIANA ELECTRO CONST 8,784 4610 SEPULVEDA BLVD B & D CONST 8,939 4617 SEPULVEDA BLVD B & D CONST 16,600 4634 RIVERA RD. SPRKLR UNION 27,441 4644 MGM DR. HATHAWAY 47,068 Page 4 of 4 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter Job No. PROJECT NAME 3843 LAUREL CYN BLVD. 4042 TUDOR WEST/UCLA JOBS 4093 SAN FERN VLY 4103 HOWLAND CNL CRT 4126 UNIVERSITY AVE 4129 MT. SAC 4165 EL TORO RD 4211 VARIOUS LOC 4232 VALENCIA MESA 4240 LINCOLN BLVD. 4240 CMB QTY/PLAYA VISTA 4242 CHANDLER/LANKERSHIM 4245 LINNIE CANAL 4247 7TH/710 FRWY 4266 CENTINELA AVE. 4282 LOOP & PARK PL. 4295 CULVER BLVD 4296 GLENDALE BLVD 4302 VERMONT AVE. 4319 REDONDO AVE. 4324 USC, FIGUEROA & JEFFERSON 4328 HIGHLAND AVE. 4329 SUNSET BLVD. 4330 HARBOR GATEWAY 4339 VARIOUS LOCATIONS 4340 SLAUSON AVE. 4348 PH 3-PIER T 4359 MICHELSON BLVD. 4367 GRANADA AVE. 4370 ALAMEDA ST. 4377 PIER E 4393 JEFFERSON BLVD. 4408 HOLLYWOOD WAY 4413 VERMONT 4415 CASE AVE. 4416 STIMSON AVE. 4417 PROSPECT 4421 LB TAXIWAY 4425 FIRST ST-LOS ANGELES 4427 0546 ST. REHAB 4434 IMPERIAL HWY 4442 SEPULVEDA BLVD. 4443 INGLEWOOD AVE. 4448 MARYMOUNT HS 11-30-08 WIPS 12-14-2008 - Open Jobs LOS ANGELES LA LA RIVERSIDE WALNUT LK FOREST LONG BEACH FULLERTON CALTRANS LOS ANGELES LOS ANGELES LONG BEACH LOS ANGELES IRVINE VISTA DEL MAR LOS ANGELES LOS ANGELES LONG BEACH LOS ANGELES LOS ANGELES LOS ANGELES LONG BEACH CULVER CITY LONG BEACH IRVINE LA MIRADA LOS ANGELES PORT LB PLAYA VISTA BURBANK LOS ANGELES LOS ANGELES LA PUENTE TUSTIN LONG BEACH LAGUNA BCH DOWNEY LA/CC REDONDOBCH ESTYINAL CONTRACT AMOUNT 807,100 2,339,610 1,473, 973 299,925 2,067,233 910,385 11,091,333 306,515 930.000 11, 970,000 8,938 5,421,529 351,920 606,153 2,880,145 1,112.969 1,601,060 597,309 1,392,670 221,979 1,585,000 3,582,540 2,062, 587 2,722,826 1,353,277 2,550,397 23,552,507 2,909,722 564,180 3,163,392 5,295,408 7,938,248 23,710 182,915 186,308 397,215 938,817 59,379 230,000 3,848,764 2,427,816 596,857 540,525 856,482 % WORK WORK BACKLOG COMPL. 100.0% 100.0% 100.0% 100.0% 99.9% 2,486 100.0% 99.6% 41,984 99.8% 92.8% 66.955 100.0% 0.0% 8,938 100.0% 100.0% 99.9% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 96.0% 142,898 99.9% 1,291 100.0% 100.0% 90.2% 249,935 100.0% 2,291 99.7% 8,529 100.0% 90.3% 308,049 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 99.6% 3,312 100.0% 58.4% 95,597 100.0% 99.7% 8,309 100.0% 100.0% 100.0% Page 1 of 14 1-21-09 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 : 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG 4452 GLENCOE LOS ANGELES 309,434 100.0% 4454 UCI IRVINE 59,976 100.0% 4458 TAPO CYN SIMI VLY 2,957,391 100.0% 758 4463 SERVICE MOD EL CAMINO COLLEGE 147,800 100.0% 4464 WASHINGTING/GRANDE BNSF 1.122,915 100.0% 4466 FIGUEROA/SEPULVEDA LACO SANI 2,463,930 100.0% 4467 VALLYHEART ST. FRANCIS 135,875 100.0% 4468 LACC LOS ANGELES . 6,085 100.0% 4469 HALDEMAN RD. RUSTIC CYN HOA 58.395 100.0% 4470 LATIMER RD. RUSTIC CYN HOA 66,500 100.0% 4480 EAST OLIVE AVE BURBANK 313,656 100.0% 4481 CERRITOS/EL RITO GLENDALE 1,197,605 100.0% 4482 20TH/REDONDO LONG BEACH 408,474 100.0% 4483 BOB HOPE AIRPORT BURBANK 13,177,103 99.3% 91,795 4490 VARIOUS LOC LB TRANSIT 879,832 100.0% 4492 TIERRA REJADA RD MOORPARK 3,167,306 100.0% 4497 CALIFORNIA BLVD. CSI ELECT 14,982 100.0% 4499 CANTARA KAISER FOUND 82,000 21.2% 64,631 4500 CAMPUS/ARTISAN CSI ELECT 4,200 0.0% 4,200 4501 GAGE AVE BELL 25,375 100.0% 4502 GARDEN GROVE SANI 1,967,739 100.0% 4504 BERENDO M.S. TORRES CONST 207,053 100.0% 4505 TOPANGA/VICTORY WESTFIELD 2,520,000 98.9% 27,394 4506 VARIOUS LOC CO OF ORANGE 32,744 99.9% 4507 BRAND BLVD. HATHAWAY 217,460 96.7% 7,193 4508 ALVARDO TRANSIT LACRA 2,140,870 69.0% 663,657 4509 ROSCOE BLVD. KAISER FOUND 100,937 100.0% 4515 GRAND AVE. MT. SAC 224,919 100.0% 4516 TUSTIN & 1ST ST MCCARTHY 233,937 100.0% 4518 NORMANDIE ARB STRUCTURES 94,545 100.0% 4521 ZANE GREY H/S TORRES 75,326 100.0% 4522 BELMONT PLAZA LONG BEACH 427,634 100.0% 4523 BESS/LEORETTA KAISER 251,657 100.0% 4524 VERDUGO/BARRINGTON GLENDALE 577,656 99.9% 4525 TAPER AVE SCH TORRES 108,842 100.0% 4526 LAKEWOOD BLVD. DOWNEY 2,047,150 92.0% 164,456 4527 SUNNY BRAE SCH TORRES 15,345 100.0% 4528 GETTY CENTER HATHAWAY 37,887 100.0% 4529 NORTHRIDGE M/S TORRES 6,542 100.0% 4530 VARIOUS LOCATIONS CULVER CITY 801,667 100.0% 4531 LONG BEACH CALCARTAGE 13,577 100.0% 4532 SAN MIGUEAL E/S TORRES 315,091 100.0% 4534 7TH/CATALINA HENSEL PHELPS 73,954 100.0% 4535 SHENANDOAH E/S LAUSD 744,408 99.8% 1,585 11.30.08 W IPS 12-14-2008 - Open Jobe Page 2 of 14 1-21-09 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12i14i08 Open Jobs 4th. Quarter _ EST.FINAL % WORK CONTRACT WORK BACKLOG 4536 W. 4TH ST BNSF 265,323 100.0% 4538 PERSHING DR CSI ELECT 76,194 100.0% 4541 CAMINO REAL REDONDO BCH 444,555 100.0% 4545 BERTHS 261-267 CONNELLY-PACIFIC 174,979 99.9% 4547 WRIGHT M/S TORRES 99,389 100.0% 4548 NORMANDIE KAISER 58,500 83.7% 9,559 4549 RAMIREZ CANYON TORRES 400,836 99.5% 2,001 4552 JOHN WAYNE AIRPORT ORANGE CO 1,538,269 90.7% 143.001 4553 PACIFIC OCAST HWY DANA POINT 5,792,241 46.6% 3,095,493 4554 BLUFF CREEK FINVEST 91,269 100.0% 4555 VICTORY BLVD. NO. HOLLYWOOD 429.749 100.0% 4557 DACOTAH EARLY ED TORRES 159,273 100.0% 4558 LA PALMA AVE. PENNER 15,895 100.0% 4559 BERTH 302-305 POLA 35,000 3.5% 33,773 4561 BESS/LEORITA BALDWIN PARK 15,866 100.0% 4563 NICHOLS/BELSITO BALI CONST 405,647 100.0% 4566 CLEVELAND H/S LAUSD 1,269,712 95.2% 60,824 4567 NO HOLLYWOOD ST LACRA 1,143,779 8.5% 1,046,619 4568 NUEVA VISTA ES BELL 206,362 100.0% 4569 MIDWAY/39TH PL LONG BEACH 6,853 100.0% 4571 AVE. 45 HUNTINGTON PARK 76,100 100.0% 4572 VARIOUS LOC LONG BEACH 153,371 37.8% 95,447 4573 ATHERTON ST. LONG BEACH 1,322,726 92.3% 102,324 4574 SOUTH ERN/GARFIELD SO GATE 27,300 100.0% 4577 SLAUSON OVERPASS BELL 74,614 100.0% 4578 PACOIMA MS TORRES 13,894 100.0% 4579 KAISER/NORMANDIE KAISER 8,225 100.0% 4580 CAL ST NORTHRIDGE 6,200 100.0% 4581 E.26THST BNSF 296,935 100.0% 4582 ST IMROV INGLEWOOD 548,259 100.0% 4583 OLYMPIC/CENTINELLA SANTA MONICA 1,961,558 98.9% 21,525 4584 VARIOUS LOC SANTA ANA 3,636,816 99.9% 5,446 4585 VARIOUS LOC WESTLAKE VILLAGE 2,125,397 100.0% 4586 7TH ST. LONG BEACH 1,713,347 99.9% 927 4587 COLUMBUS E/S PANKOW 225,945 94.6% 12,270 4588 EAGLE ROCK HS LAUSD 991,991 92.3% 76,168 4590 ROYAL AVE. SIMI VLY 1,791,856 93.6% 113,798 4591 LAS BRISAS SIGNAL HILL 142,749 99.5% 4592 MADERA RD, SIMI VLY 711,585 100.0% 4593 LOWELL E/S LBUSD 541,662 100.0% 4594 ALDRICH PARK UCI 907,704 100.0% Page 3 of 14 1-21-09 11.30.08 WIPS 12-14-2008 - Opan Jobs Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG 4595 MARINA H/S HBUHSD 3,215,000 86.6% 432,035 4596 EMAS SYS BURBANK ARPRT 3,642,247 99.9% 1,957 4597 WILSHIRE/FAIRFAX MATT CONST 1,071,699 46.5% 572,826 4598 CHEVIOT HILLS LOS ANGELES 777,869 54.2% 356,169 4599 VARIOUS SCHOOLS 837,132 100.0% 4600 ANCHORAGE/SHOR RE SCHAFER 7,710 100.0% 4601 SHEILA/INDIANA ELECTRO CONST 8,784 100.0% 4603 INGLEWOOD/CULVER PLAYA CAP 374,797 86.4% 51,113 4604 MADISON E/S REDONDO BEACH US 39,300 100.0% 4605 MWD WATERLINE RUDOLPF/SLET 1,809,170 1.9% 1,774,728 4606 PERRY LINDSEY ACADEMY LBUSD 1,034,834 99.9% 1,516 4607 LACC CHILD DEV CTR CA CONSTR 29,079 71.2% 8,389 4608 TAXIWAI D LON BEACH 816,228 100.0% 4609 JUVENILE HALL ALCORN FENCE 452,834 10.4% 405,839 4610 SEPULVEDA BLVD B & D CONST 8,939 100.0% 4611 USC ST IMPRV USC 1,717,400 34.9% 1,118,308 4612 KAISER VENTURA BLV KAISER PERM 43,997 98.2% 807 4613 STORM DRAIN POL POLB 4,688,404 12.1% 4,119,191 4615 PIER A WEST TUTOR SALIBA 121,706 12.3% 106,720 4616 PIER A WEST TUTDOR SALIBA 327,832 28.1% 235,691 4617 SEPULVEDA BLVD B & D CONST 16,600 91.0% 1,489 461.8 FED EX RAMP FEX EX BURB ARPRT 3,493,821 2.8% 3,395,388 4619 SO REGION ES LAUSD 590,518 9.7% 533,215 4620 EAST LA HS TUCKER ENGR 57,000 100.0% 4621 VARIOUS LOC DANA POINT 94,600 17.5% 78,040 4622 D & E YARD CROSSINS LA JUNC RR 44,041 100.0% 4623 CANDLEBERRY AVE SEAL BEACH 1,415,869 1.7% 1,391,826 4624 WASHINGTON/IND BNSF JOJMSPM CONTROLS 74,988 91.6% 6,326 4625 EL PRESIDO LAINE AIRE 13,500 100.0% 4626 VAN NESS BUNTICH 4,850 100.0% 4627 SHEILA ST. ELECTRO 2,698 100.0% 4628 LIMECREST DR. LACPW 228,859 0.7% 227,325 4629 WASHINGTON BLVD PCL CONST 124,000 35.0% 80,638 11-30-06 WIPS 12-14-2008 - Open Jobs Page 4 of 14 1-21-09 Work Experience Report November 30, 2008 Excel Paving Co. Open Jobs 2008 12/14/08 Open Jobs 4th. Quarter EST.FINAL % WORK CONTRACT WORK BACKLOG 4630 LAMAR/MAIN ELECTRO 31,900 100.0% 4631 4TH ST. REMPREX 1,420,000 49.4% 719,049 4632 LACMA PH II MATT CONST 352,051 17.6% 290,001 4633 DISNEYLAND BAKERY BALI CONS 16,876 100.0% 4634 RIVERA RD. SPRKLR UNION 27,441 100.0% 4635 JOHN WAYNE AIRPORT BALI CONS 15,536 100.0% 4636 VARIOUS STS ROLLING HILLS EST 178,414 82.3% 31,653 4637 DISNEYLAND TRENCH BALI CONS 9,985 100.0% 4638 DICKSON, ENT,FOSTER COMPTON USD 94,603 1.4% 93,299 4639 VARIOUS INTER BOEING CO. 1,303,476 0.1% 1,301.812 4640 BERTH 73/191 POLA 237,765 0.0% 237,765 4641 PUENTE HILLS LANDFILL LACO SANI 447,645 2.8% 435,270 4642 JAMES WOOD AVE FED OF LABOR 8,388 100.0% 4643 CAMPUS CAP PLAYA VISTA 336,600 1.0% 333,330 4644 MGM DR. HATHAWAY 47,068 57.1% 20,196 4645 USC SCH ARTS HATHAWAY 19,130 19.4% 15,417 4646 CALIFORNIA HATHAWAY 37,426 0.0% 37,426 4647 WOOD AVE. FULLERTON 1,090,322 0.8% 1,081,204 4648 BANDINI BNSF 454,993 0.0% 454.993 11.30-08 WIPS 12-14-2008-Open Jobs - -... _..-_ - Pape 5 of 14 1-21-09 Work Experience August 31, 2008 Excel Paving CO. D1 /20/09 Closed Jobs 3rd. Quarter 2008 JOB NO. PROJECT NAME 3947 TUSTIN AVE., ANAHEIM 3959 SANTA MONICA BLVD., LOS ANGELES 4062 SANTA MONICA/MWD 4164 KENNEDY HS ANAHEIM 4316 MONTROSE AVE. LACPW 4332 SO. BRAND BLVD GLENDALE 4336 VERMONT AVE. GARDENA 4337 MCFADDEN AVE. 4374 WOODRANCH PKWY SIMI VALLEY 4401 NO. MCLAY ST SAN FERNANDO 4414 TOPANGANICTORY LOS ANGELES 4420 VERMONT AVE. LOS ANGELES 4429 RANDALL ST. ORANGE CO. 4435 NATIONAL BLVD. CAL TRANS 4440 226TH ST HAWTHORNE 4451 OVERLAY SANTA CLARITA 4471 ANAHEIM ST. LB TRANSIT 4474 NO. LOOP RD. HATHAWAY 4479 UNION AVE SNYDER LANGSTON 4486 BLUFF CREEK DR COUCH & SONS 4491 WESTFIELD CENTER ARCADIA 4493 FREEMAN DR. CALABASAS 4495 PORT OF LB RYAN CO. 4498 VAGABOND STRM DRN MONTEREY PARK 4514 FOOTHILL BLVD. BERNARDS 4520 AMBLER AVE SCH TORRES 4537 26TH ST.NERNON CBRE 4540 EVEWARD RD. DLSB 4544 BURBANK AIRPORT BURBANK AIRPORT 4551 GEPRGE BURNS AVE. WEST HOLLYWOOD 4556 GARVEY AVE. REYES CONST 4565 AVE OF STARS HATHAWAY 4575 DOUGLAS/EL SEGUNDO EL SEGUNDO 4589 WILSHIRE DR PSOMAS 4602 CALSTATE HATHAWAY DIN 4614 LOMITA BLVD ELECTRO CONST FINAL CONTRACT AMOUNT 4,370,876 49,757,848 7,739,622 1,037,004 2,447,026 2,011,346 1,204,230 1,121,382 1,982,642 4,981,426 2,166, 954 915,500 824,976 90,524 92,155 5,503,565 244,032 2,996,158 55,297 207,560 29,118 82,619 16,091 89,325 81,317 134,849 52,143 47,967 16,585 39,219 38,218 9,375 4,300 32,190 9,386 3,486 Ord Atr. 8-91-2008 WIPS. Closed Jobs - Sorted 1-20.2009 Page 6 of 14 1-21-09 Work Experience May 31, 2008 Excel Paving CO. Closed Jobs 2nd. Quarter 2008 01/20/09 FINAL CONTRACT JOB NO. PROJECT NAME AMOUNT 4123 ANAHEIM ST LONG BEACH 3,249,006 4365 WEIDLAKE IMPRV LOS ANGELES 465,183 4373 CENTURY PKG LOT E. LOS ANGELES 736,152 4404 UCI IRVINE 22,443 4444 ALLEN AVE. GLENDALE 279,890 4453 ST. IMPRV INGLEWOOD 479,793 4456 EL DORADO HS LAUSD 794,632 4462 VIRGINIA ST. EL SEGUNDO 92,774 4489 ENT PKG LOT BURBANK AIRPORT 380,925 4503 GRANADA HILLS TORRES CONST 50,496 4510 LIGGETT E.S. TORRES CONST 84,479 4513 LEAPWOOD E.S. TORRES CONST 142,331 4519 MOORPARK HIGHLANDS CHAPARRAL 616,202 4533 USC CINEMATIC HATHAWAY 2,134 4539 W. BURBANK LOT BURBANK AIRPORT 63,382 4542 PASEO DEL MAR VAL VERDE 13,374 4546 ORCHARD ST. BELL 19,375 4550 4TH ST. CHLS KING 18,527 4560 ROSCOE BLVD WEST HILLS 2,200 4562 J PAUL GETTY LOS ANGELES 17,079 4564 SPAZIER BURBANK 1,600 4570 LOST E BURBANK AIRPORT 37,158 4576 VARIOUS LOC DANA POINT 94,080 2nd. Qtr. S31.OB WIPS- Closed Jobs Only -Soded 1.20.2009 - Page 7 of 1-21-09 Work Experience February 28, 2008 Excel Paving Co. CLOSED JOBS 2007- 2008 07/08/08 JOB SALES NO. PROJECT NAME AMOUNT 3704 TAXIWAY D L.B. AIRPORT 3,720,722 3865 2627 HOLLYWOOD, BURB/GLEN/AIRP 377,031 4084 SAND CANYON IRVINE 720,447 4088 ANNUAL RD RESURF DANA POINT 1,490,592 4099 03 ST IMPRV INGLEWOOD 593,520 4144 CASE AVE LA 432,963 4157 YL/PLACENTIA FULLERTON 137,338 4176 SILVER LAKE LOS ANGELES 1,317.464 4182 UCLA LOS ANGELES 38,066 4182 UCLA CAMPUS LOS ANGELES 103,828 4218 ASHCROFT/ROBERTSON LOS ANGELES 52,900 4233 VAN BUREN VLD. CO RIVERSIDE 2,461,429 4237 S/W AREA LAX 4,876,048 4253 S.A. STADIUM SANTA ANA 397,289 4257 MIRAMONTE ES LOS ANGELES 677,111 4269 KINNELOA DEBRIS BASIN LOS ANGELES 237,063 4274 HARBOR BLVD LOS ANGELES 1,249,459 4275 CLAY MS LOS ANGELES 620,819 4281 HILLCREST ES LOS ANGELES 903,237 4306 10TH ST. LONG BEACH 1,192,729 4307 NEWPORT SHORES NEWPORT BEACH 1,584,279 4309 KING MS LOS ANGELES 985,753 4314 PARK PLACE IRVINE 998,231 4314 PARK PL PKG 76,267 4317 BERTHS 226-236 POLA 2,811,047 4334 710 FRWY CALTRANS 700,680 4344 PKG LOT PH 1 RANCHO SANTIAGO CC 896,694 4346 DAMON, CONSTELL OF STARS 202,454 4347 HAMILTON HS LOS ANGELES 603,569 4349 FIRESTONE BLVD. SEPULVEDA DEV 325,075 4353 FOUNTAIN VLY HS HUNT BCH UHSD 1,074,427 4354 LA BREA AVE. WEST HOLLYWOOD 496,890 4361 ORANGE AVE LAWNDALE 209,832 4362 ST. REHAB LEISURE VILLAGE 799,326 4366 ANNUAL ST. ALHAMBRA 651,988 4371 VARIOUS STS REDONDO BCH 960,788 4372 WALNUT ST. SIMI VALLEY 412,988 4380 POINT FERMIN PASCHEN 359,607 4383 VERMONT AVE. KAISER FOUND 117,035 4384 VERMONT AVE KAISER FOUND 182,820 HISTORY REPORT 2-2&200&780 S L—MPS CI—IJoO-.1—OTRS. NOT 6 IN. OTR. 200E Page 8 of 14 1-21-09 Work Experience February 28, 2008 Excel Paving Co. CLOSED JOBS 2007- 2008 07/08/08 SALES AMOUNT 4385 VARIOUS STS INGLEWOOD 379,574 4387 PALOS VERDES DR. PV EST 95,060 4394 CLARA ST. CUDAHY 556,434 4395 E. LOOP RD. IRVINE 363,771 4407 ORANGETHORPE BUENA PARK 1,038,513 4412 TRUNK SEWER REHAB CARSON 16,824 4418 PCH WILMINGTIN 22,830 4419 MICHELSON DR. IRVINE 460,419 4424 BNSF-TRACK 114 VERNON 1,108,470 4426 BNSF-SHEILA AVE. COMMERCE 528,245 4430 BNSF-ESPARANZA YORBA LINDA 352,990 4431 HAVEN AVE. RANCHO CUCUMONGA 155,069 4433 TRADE MARK IRVINE 29,025 4436 FULLER/GARNER WEST HOLLYWOOD 235,383 4439 DESOTO CHATSWORTH 9,437 4445 RAYMOND ST. PASADENA 25,155 4446 EASTERN/BANDINI BNSF 73,995 4449 WILLOW LANE WESTMINSTER 132,524 4450 ST, IMPRV LYNWOOD 766,795 4455 MAIN ST. NT2 PRODUCTIONS 2,700 4457 ACCESS RD. LOS ANGELES 499,954 4459 CLARK/SPRING LONG BEACH 70,775 4460 WASHINGTON/IND BNSF 171,668 4461 CDR 233 UPGRADE 374,942 4465 CANTERA ST. KAISER PERM 106,978 4472 BALUHARBOR CHLS KING 16,626 4473 FIRST/BOYLE LOS ANGELES 60,771 4475 6TH/PCH BOVIS 10,886 4476 SLAUSON/VAN NESS MLADEN BUNTICH 23,570 4477 WEST LA COLLEGE LOS ANGELES 186,054 4478 VALLEY BLVD. INDUSTRY 7,900 4484 UNIVERSITY HS TORRES CONST 88,537 4485 FLINTRIDGE HS LA CANADA/FL 1,400 4487 ROSEMEAD/SLAUSON BNSF 96,849 4488 GETTY CENTER GETTY TR 3,020 4494 SPAZIER ENVIRON 25,977 4496 POL SHOOTING LAGUNA BCH 51,837 4511 PIER F-POLB B & D 3,100 4512 L ST-WILLMINGTON BNSF 146,806 4517 18TH ST. SANTA MONICA 15,198 4543 AMELIA AVE, ROYAL ELECT 21,950 HISTORY REPORT 7-2&I008 /SO&S lase WIPS CbseC JoW ]rG.dYf,.OTRS. 7pp7 6 IM, OTR, 7pOg Page 9 of 14 1-21-09 Excel Paving Co. Work Experience May 31, 2007 ` JOB Closed Jobs 2006 SALES " NO PROJECT NAME AMOUNT 3716 710 FWY PCH TO 405 21,510,942 3990 OCEAN BLVD LONG BEACH 1,196,229 4004 GREEN VALLY CIRCLE CULVER CITY 1,173,791 4024 UCLA KINROSS 2,329,669 4045 5 FRWY, OR. CO 180,290 4057 PALO VERDE HSG 611,836 4061 PANKOW BLDRS M.B. 720,917 4064 WALGROVE E.S. L.A. 767,069 4083 HARBOR BLVD FULLERTON 214,172 4098 BLEND E.S LA 273,966 4102 DENA E.S. LA 177,306 4104 MOULTON PKWY CO OF ORANGE 478,612 4106 PIER S BRTH S102-S110 LONG BEACH 4,077,253 4109 VARIOUS STS REDONDO BEACH 761,751 4115 WASHINGTON BLVD CULVER CITY 741,069 4117 VANUYS AIRPORT VAN NUYS 620,336 4120 SOUTHGATE HS LOS ANGELES 681,858 4142 ROSECRANS LAWNDALE 233,216 4143 CALLE MIRAMAR REDONDO BCH 536,987 4156 STERRY E.S. LA 223,520 4160 WARNER ES LA 988,639 4161 ST OVERLAY SIMI VLY 704,970 4168 MARINA DEL REY LA 459,915 4169 CEN PK WEST LA 50,550 4174 SHERMAN OAKS CNTR RESEDA 1,044,265 4175 GLEDHILL ES NO HILLS 506,079 4181 STATE ST ES LAUSD 334,787 4185 WHITTIER/PRESBY WHITTIER 7,400 4186 GETTY TRUST LOS ANGELES 850 4191 HARVARD AVE. IRVINE 329,938 4192 COMPTON/61 ST LOS ANGELES 17,722 4195 NEW JOB SAN CLEMENTE 10,966 4196 MWD/SEARL HEMET 9,109,427 4197 LYNOOD USD LYNWOOD 1,520,919 4198 AGOURA BIKE AGOURA HILLS 1,032,236 4209 PCH/CATALINA LONG BEACH 657,469 4210 GLENDALE BLVD LOS ANGELES 36,630 4212 GLENDORA/HILL LA PUENTE 11,833 �JW W flies 20 2W7 C "I.2W7. A OI/.2= Page 10 of 1-21-09 Excel Paving Co. Work Experience May 31, 2007 JOB Closed Jobs 2006 SALES NO, PROJECT NAME AMOUNT 4213 ALDAMA ST SCH 19,097 4214 PCH/ZUMIREZ MALIBU 453,886 4215 THE TOLEDO LONG BEACH 7,449 4216 REEVES/NAVY PORT OF LB 268,611 4217 KANAN RD/101 FRWY 13,589 4220 SO CENTRAL HS LOS ANGELES 54,026 4222 PKG LOT 6 MONROVIA 406,899 4224 SUNSET BLVD. W. HOLLWOOD 166,602 4227 SEWER REHAB REDONDO BCH 550,196 4229 BLDG 10 & 28 24,697 4230 VARIOUS LOC LOS ANGELES 441,551 4235 VICTORY BLVD. CANOGA PARK 687,374 4243 ANDASOL ES NORTHRIDGE 131,502 4246 SOUTH ST. ANAHEIM 492,994 4248 MANHATTAN & AVIATION REDONDO BEACH 49,589 4249 CAL TECH PKG PASADENA 39,406 4250 2 FRWY GLENDALE 13,200 4261 5M FRWY CAL TRANS 188,210 4254 PCH CAL TRANS 1,204,048 4256 GARDENA HS GARDENA 1,009,381 4258 N/E INTER SEWER LOS ANGELES 360,460 4259 LOMA VISTA ES LOS ANGELES 277,404 4261 MULHOLLAND DR. LOS ANGELES 17,598 4263 BEVERLY VISTA ES BEVERLY HILLS 734,246 4265 INDIANA/WASH BNSF 15,290 4271 GETTY CENTER DR. CENT. CITY 28,907 4276 GETTY CENTER DR. CENT. CITY 262,399 4277 GETTY CENTER DR, CENT. CITY 4,384 4278 CLARK AVE. LONG BEACH 517,203 4279 41 ST ST. LOS ANGELES 440,218 4280 VIA ROSA/PV BLVD, PV ESTATES 504,157 4264 CENT/LINC CULVER CITY 263,999 4286 WESTERN AVE. TORRANCE 28,640 4287 GRAND AVE. EL SEGUNDO 144,403 4289 LUGO E.S. LYNWOOD 15,435 4291 05-06 St.Maint AGOURA HILLS 831,113 4292 PICO BLVD. LOS ANGELES 67,308 4293 HOLLYWOOD WAY BURBANK ARPRT 38,800 4294 5 FRWY MISSION VIEJO 3,359 HW"FMn W0&2W MN "I7A&27,20 Page 11 of 1-31-09 Excel Paving Co. Work Experience May 31, 2007 JOB Closed Jobs 2006 SALES NO. PROJECT NAME AMOUNT 4297 VICTORY/TOPNGA LOS ANGELES 606,202 4298 ST. JOSEPH'S SCH LONG BEACH 2,000 4300 PV LANDFILL LA SANI DIST 19,650 4301 MICHELSON IRVINE 201,698 4304 MEDIA STUDIOS BURBANK 18,700 4310 VAIL/CLEVELAND MONTEBELLO 10,790 4311 PLAYA VISTA LOS ANGELES 16,854 4312 INDIANA/WASHINGTON BNSF 147,323 4315 190TH/GREENLANE REDONDO BEACH 2,000 4318 RON REAGON FRWY SYLMAR 16,304 4321 SO. EAST HS SOUTH GATE 12,000 4322 E. PCH WILMINGTON 14,216 4325 BLUFF CREEK PLAYA VISTA 50,310 4326 BNSF, IND & WASH COMMERCE 334,616 4327 UNION STATION LOS ANGELES 10,000 4331 OLIVE & LAKE BURBANK 12,876 4333 VINEYARD & SATURN LOS ANGELES 8,545 4335 CSI/BOEING-BOLSA HUNT. BCH 101,500 4338 BNSF, WASH & IND NERVON 37,840 4341 FIRE STATION BURBANK 0 4342 MOOG, WESTERN WAY TORRANCE 37,031 4345 3355 EMPIRE BURBANK 79,193 4351 LAX -SO VAULT LOS ANGELES 26,514 4355 HAWTHORNE BLVD TORRANCE 4,000 4356 LAAFB RMA LAND 3,858 4357 PICO BLVD, LOS ANGELEWS 20,400 4363 DUESLER LANE DUESLER ASSOC 36,000 4364 WASHINGTON BLVD. PICO RIVERA 23,265 4375 VAN NUYS BLVD. ARLETA 6,140 4376 OBSERVATORY RD. LOS ANGELES 13,151 4379 E. SOUTH ST. MARKET RECYCLE 1,885 4382 FIGUEROA/JEFF LOS ANGELES 5,995 4386 INDIANA/WASH BNSF 83,456 HeMFlb 2 2N7 M� 5.31 -20C.A 677.2007 Page 12 of 14 1-31-09 Excel Paving Co. Work Experience May 31, 2007 = JOB CLOSED JOBS 2007 SALES NO. PROJECT NAME AMOUNT 3876 PARTHENIA, LA 1,153,774 4067 DEL AMO BLVD LONG BEACH 393,459 4076 JESSE OWENS PK INGLEWOOD 562,447 4077 CHAPMAN/ST COLL FULLERTON 135.411 4112 BELMONT PIER LONG BEACH 479,513 4113 NO LONG BEACH LONG BEACH 1,673,247 4127 UNION STATION LOS ANGELES 429,149 4154 STS & ALLEYS W. HOLLYWOOD 205,131 4177 COLD CANYON LOS ANGELES 481,211 4179 PE BIKE TRAIL UPLAND 2,418,540 4183 CAHUENGA LOS ANGELES 33,205 4189 AVE OF STARS CENT CITY 465,184 4205 DREW MID SCH LOS ANGELES 1,097,527 4206 107TH ST ES LOS ANGELES 400,544 4207 93RD ST ES LOS ANGELES 348,165 4226 MONTANOSO DR. MISSION VIEJO 163,838 4236 THOMAS EDISON MS LAUSD 814,878 4241 BRACKETT ARFLD POMONA 373,977 4252 W. PICO BLVD. LOS ANGELES 518,766 4255 ROMOLAND CALTRANS 200,540 4260 WESTLAKE VILLAGE 958,888 4264 BELLA TERRA MALL HUNT. BCH 3,166,715 4268 RANCHO CUCAMONGA RANCHO CUCAMONG. 234,424 4272 CHIQUITA BLDG PORTOF LB 6,922,874 4273 UCLA CAMPUS LOS ANGELES 71,597 4281 PALISADES HS 1,942 4285 MARLTON ES LOS ANGELES 278,427 4305 JEFF/CENTINELLA LOS ANGELES 1,486,623 4308 LAX AA MAINT AMERICAN AIRLINES 57,975 4313 SSA PKG LOT CO ORANGE 189,508 4320 CERRITOS PARK GLENDALE 305,537 4323 6TH & PCH HUNTINGTON BCH 16,092 4350 SHEILA ST. BNSF 256,660 4352 PREY MAINT REDONDO BEACH 254,596 4358 EL MODENA ALLEY ORANGE 97,222 4360 BESS/LEORITA KAISER FOUND 300,107 4368 SCHOOLWOOD DR. LA HABRA 170,908 4369 SHERMAN OAKS CNTR KBR SRV 39,323 4378 E. SLAUSON AVE. MARMOL RADZINER 60,718 4381 E. 7TH ST. INTERSCAPE 16,995 4388 PICO BLVD LOS ANGELES 22,255 wYay Flb, 2008.2X71hN "I.2M7 -A 6 77-2M Page 13 of 14 Excel Paving Co. JOB NO. 4389 4390 4391 4392 4396 4397 4398 4399 4400 4402 4403 4405 4406 4409 4410 4411 4422 4423 4428 4432 4441 4447 CLOSED JOBS 2007 PROJECT NAME Work Experience May 31, 2007 UPPER CLOVERLEAF RD MONROVIA COLDWATER CYN NO. HOLLYWOOD U OF WEST ROSEMEAD OLDEN ST. SYLMAR BURBANK AIRPORT BURBANK DURFEE/MICHAEL HUNT DIEMER PLANT MWD WARDLOW/CHERRY BOEING ELSMERE CARSON MOORPARK COLLEGE BNSFIWASH VERNON HAALAND DR THOU OAKS TROY H/S FULLERTON MAARKET ST SWR CHLS KING LOT A BURBANK ARPRT BRAVO BASE REPAIR LOS ANGELES PUENTE HILLS LACO SANI PIER J-BERTH 247 LONG BEACH SIXTH ST. SAN PEDRO BURBANK AIRPORT BURBANK INDIANA/3RD BNSF PIER F LONG BEACH SALES AMOUNT 178,395 10,855 351,139 92,684 18,283 17,989 116,205 156,900 7.780 91.578 506,615 148,500 321,451 5,270 47,124 17,390 12,500 8,200 3,200 43,500 3,900 8,300 liW.y FM 2006-2DV71 63120U/-A &21-2007 Page 14 of 14 1-21-09 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 Compan 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 Garfield Avenue Rehabilitation (CC#1372) 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 29th day of October 2010 PALP Inc. dba Excel Paving Company Witness Principal (Seal) By: C ��'� n�� ' . r>R s € - 0 Name(ritle Witness ORSC 21328 (5197) Federal Insurance Company ure (Seal) Timothy D. p ttomey-in-Fact ARM OR At INSIST - State of California County of orange On 10/29/2010 before me, Debra Swanson, Notary Public , (Here insert nacre and tide of the officer) personally appeared Timothy D. Rapp who proved to me on the basis of satisfactory evidence to be the person(&) whose name(*) is/aft subscribed to the within instrument and acknowledged to me that helsheAhey executed the same in his/4ffAhe4F authorized capaciry(io&), and that by hisAwA signature(4) on the instrument the person(.&), or the entity upon behalf of which the person(.) acted, executed the -instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature of Notary Public DESCRIPTION OF THE ATTACHED DOCUMENT (ritk or description of attached document) (Titk or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER O Individual (s) O Corporate Officer (Tide) O Partner(s) O Attomey-in-Fact O Trustee(s) O Other ��5gu Ocry�e DEBRA SWANSON d COMM. * 1822117 X a NOTARY PU8UUA1JF0RNIA X c '< ORANGE COUN-rY CA (Nosy sew) ? Comm, Earns f4Y 10, 2012 INSTRUCTIONS FOR COMPLETING THIS FORM Arty ackreowls4wN -completed In California must contain verbiage exactly ar appeari above In tha notary aaaion or a mporou acknowledgment farm must N properly eootplotad and auaehtd to that document. Tree only exception a if o document is to bs recorded out Ak of California In .such instances, any alternariw ocknowledpxsrrt verbiage as may be printed on such a document so long as the verbiage doer not require the notary to do sotnsthtng that a illegal for a notary in Cal( nda (tot. carr(fying the authorized capacity of the -signer). Please check the doeutaent cargfullyfor proper notarial wording and attach this form jf required • State and County information must be the State and County where the document signos(s) personally appeared before the notary public for acknowledgment • Data of ttooriratioa wig be the data that the signer(s) personally appeared which must also be the sane dew the aokrwwtorgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your tide (notary public)- • Print the namc(s) of document signers) who personally appear at the time of tmtarixatioa. • Indicate the omed singular or plural forms by crossing off mcorroet forms (i.e. is lore ) or circling the correct forms. Failure to correctly indicate this information may Wed to miectron of document rocordirtg. • The notary seal impression must be clear and photographically reproducible. Impression malt not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county deck. ® Additional information is not required but . could help to «cure dus wknowledgamo t is not misused or attached to a different document O indicate We or" of attached document number of pages and date • Indicate this capacity claimed by the signer. If the claimed capacity a a Corporate officer, indicate the tide (ix- CEO, CFO, secretary). • securely attach this document to the signed document 200E Version CAPA vl2.10.07 300-973-996S www.NowyCksm.com Chubb POWER Federal Insurance 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 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 Linda D. Coats, Matthew J. Coats, Douglas A. Rapp and Timothy D. Rapp of Laguna Hills, California --------- earth as their true aril fawful Attorney- In- Fact to execute under such designation in their names and bu 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 16th day of November, 2009.. d- Z Z (/r7— enneth C. en� Assistant Secretary . Norris, Jr., Vice Pjam6ent STATE OF NEW JERSEY ss. County of Somerset On this 16th day of November, 2009 before tile, 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 duty 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 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 that he signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that he is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies: and that the signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr-, and was thereto subscnbed by authority of said By - Laws and in deponents presence. Notarial Seat KATiiERINE J. ADELAAR 1t NOTARY PUBLIC OF NEW JERMY 4TAR fv® pni J 5 Gf�J�C— �o-� �-Esmrvriatiion ExPrros July 1fi, i07A PUBL1r+ Notary Public ER9 CERTIFICATION Extract from the By- La vra of I-EDEtIAL INCunANCE COMPANY, VIGILANT INMUrtANCC COMPANY, and PACIIIC INDEMNITY COMPANY: "All powers 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 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 Asslstarii Vice President, any secretary, ary Assisram Secretary and me seal, of the Company may be afixed by facsimile to any power or auomey 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:' 1, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies') do hereby certify that (1) the foregoing extract of the By- Laws of the Companies is true and correct, (it) tire Companies are duly ficensed and aunxnnzed to transact surety business in all 50 of the united States of America and the Dismct of Columbia and are authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and ttte U.S. Virgin Islands, and Federal is licensed in American Samoa, Guam, and each of the Provinces of Canada except Prince Edward [stand; and (ill) 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 October 29, 2010 e '� ,mat, �' , { • +aE�, ��„' 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- 3493 Fax (908) 903- 3656 e-mail. surety0chubb.com Fufm l f3-10- 0225B- U (Ed. 5- 03) CONSENT State of California County of Los Angeles On NOV before me, C. PHILLIPS, NOTARY PUBLIC (lfem insert name and title of the officer) personally appeared PALP DBA EXCEL PAVING COMPANY BY C.P. BROWN, PRESIDENT who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/srls subscribed to the within instrument and acknowledged to me that heASMgy executed the same in hisAtbWOMY authorized capacity(ies), and that by his/hedrAh* signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. •<<. r+,• C. PHILLIPS WITNESS m hand and official seal. COMM. #1809758 M a Notary Public-Callfornia Ir LOS ANGELES C©UNFY u. My Comm; Luffm Aug, 16� 2012 (Notary seat) -_._:: _. __ . _ Stre of Notary Public DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Nwnber of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) Attorney -in -Fact Trustee(s) O Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be property completed and attached to that document. The only exception is (f a document is to be recorded outside of California In such Instances. any alternative acknowledgment verblgge as may be printed on such a document so" long as the verbiage does nm require the notary to do something shot it illegal for a notary to California r.e_ eeriWng de audwrized nVocity of the signer). Please check the document carefully for proper notarial wording and attach rhos form if required • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment Is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your tide (notary public). • Print the name($) of document signer(s) who personally appear at the time of notarization- • Indicate the, correct singular or plural fors by crossing off incorrect forms (i.e. halsheldmey; is /ere) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording.- • The notary seal impression must be clear and photographically reproducible Impression must not cover text or lines. If seal impression smudges, re-seal'if a sufficient area permits, otherwise complete a different acknowledgment for. • Signature of the notary public must match the signature on file with the office of the county clerk. Additional information is not required but could help to ensure this ac.knowtodgment is not misused or attached to a different document Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer If the claimed capacity is a corporate officer, indicate the Iitle(i.c. CEO, CFO, Secretary). Securely attach this document to the signed document 2008 Vcrsion CAPA v 12. 10.07 800-873-9865 cyvw NotaryClasses com City ®f Huntington Beach 2000 Main Street • Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK March 7, 2011 R. J. Noble Company 15505 E. Lincoln Ave. P. O. Box 620 Orange, CA 92856 RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, Joan L. Flynn, CIVIC City Clerk J F: pe Enclosure Sister Citiy.WO600�,cl AA/retWggt r& New Zealand ( Telephone: 714-536-5227 ) 2019 N i." -4 F" I : 53 •,,e., s� r•,tt City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowledge receipt and review of Addendum Number One, dated November 1, 2010.. R.J. NOBLE COMPANY Company Name 11-04-2010 Date All bidders must acknowledge the receipt of this Addendum v Should you have any questions regarding this Addendum, pl( for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) 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 50 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 PROJECT BID SCHEDULE - Garfield CC-1372 SECTION C PROJECT BID SCHEDULE GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET CC NO.1372 FEDERAL AID PROJECT ESPL-5181 (168) PROJECT BASE BID: GARFIELD AVENUE — from Newland Street to Magnolia Street C-2.2 to C-2.4 BASE BID WILL BE THE BASIS OF AWARD C-2.1 PROJECT. BID SCHEDULE - Garfield CC-1372 : to :: stiff a to ii:.vvitli::pjr�e .feiiiteil: ... :: :iii' it ' E :=^VP . tk riti> lic i' �i i...............:.::. < :::=:::.::... ; A 1 1 1 LS Mobilization / j 7-Ve b' Q r` � 1b ((// �f $ 2 Y' ®0!� j t/�o4 •*f/` 4 � q 61 o no 2 1 Traffic Control Plan LS seven hundred seventy dollars $ 770.00 $ 770.00 3 1 Furnish Project Traffic Control LS $ 12,500.0 $ 12,500.0 TWELVE THOUSAND FIVE HUNDRED DOLLARS 4 470 Unclassified Excavation (includes disposal of material and fabric)' 53.60 25,192.0 Ci, fifty three dollars and sixty cents $ $ Pulverize, Remove excess, Grade, Cement Treat, Microcrack by 5 139890 FDR Process fincludes disposal) Ay- 'Af%W $ 6 55530 Surface Grind (0.1 T) (includes diposal of materal and fabric) SF $ 0.20 $ 11.106.0 zero dollars and twenty cents 7 3265 TN Construct Asphalt Concrete (0.25' & 0.75' per plan) �, ! Pee �6�j�r-f 4,11J $ �3. °- $ Z n b c® elt4 i 8 2560 Construct Asphalt Concrete ^/(0.1 TT AR/JJH QMOverlayy)TN big ce,,v Remove & Reconstruct Curb & Gutter (CF=8", Includes AB) per 9 1845 Std Plan 202 LF twenty eight dollars and seventy ceIILL $ 28.70 $52,951.5 10 370 Remove existing sidewalk (includes disposal) 1. 10 407.00 SF one dollar and ten cents $ $ Remove & Reconstruct Sidewalk per Std Plan 207 (includes 11 7000 disposal) 4.10 28,700. SF four dollars and ten cents $ $ Remove and Reconstruct Commercial Driveway per HB Std. Plan 211(including all appurtenances but not limited to: onsite 12 500 improvements, retaining curb, slot pave, etc.) SF fourteen dollars and $ 14.55 $ 7,275.0 fifty five cents 1-1 p5V 0 C-2.2 PROJECT BID SCHEDULE - Garfield CC-1372 :lteri Estiaiited ::r#€fi.''aiie:;:;:;:::;:;: p . ::utcirrlei:> Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 13 2 slot pave, etc.) per Caltrans Std. A88A EA two thousand seven hundred $2,765.00 $5,530.00 sixty five dollars Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 14 3 slot pave, etc.) per Fountain Valley Std. 204.3, Case "C" EA 2 , 565.00 $ 7,695.00 $ two thousand five hundred sixty five dollars 15 1 Install Truncated Domes to existing access Ramp EA s275.00 $ 275.00 two hundred seventy five dollars 16 13 Adjust Sewer/Storm Drain Manhole to finished surface EA two hundred seventy six dollars $276.00 $ 3,588.0 17 1 Adjust OCSD Sewer Manhole to finished surface EA two hundred seventy six dollars $ 276.00 $276.00 18 11 Adjust City of RB Water Valve to finshed surface EA two hundred ninty five dollars $ 295.00 $3,245.00 19 12 Adjust City of Fountain Valley Water Valve to finished surface EA three hundred dollars $ 300-00 $ 3,600.0 20 1 Adjust Monitoring Well to finished surface EA two hundred sixty dollars $ 260.00 $ 260.00 21 4 Raise Survey Monument Well to finished surface gq $ 260.00 $ 1,040.00 two hundred sixty dollars Sumoy-Menumwoti(w-City to Provide Survey Monumcntation 22 4 -- (Not a Bid Item) -EA $ $ Remove existing Tree and Roots; Grind Tree Stump and roots to 23 14 24" below Top of Sidewalk/Grade EA five hundred ninty dollars $ 590.00 $ 8,260.0 Furnish & Plant 24" box trees (remove existing landscaping and 24 14 irrigation to accommodate 24" box trees, replace irrigation in kind) EA four hundred seventy five dollars $ 475.00 $ 6,650.00 C-2.3 PROJECT BID SCHEDULE - Garfield CC-1372 -Iteiir•:_eiri::...::..•.::::::::;:;:::::::::::;::::::::::::::::::::::::;:;;:;:::::::::::::::::::::::... jf..:::.. _•.:-::.:......:.. :.:........:.:....... ..lt;>sC•;: ..•: 1 17�ilErt ::. 25 t Provide 90 Day Plant Establishment LS one thousand eight hundred $1,850.00 $ 1,850.0 fifty dollars 26 1 Provide 1 Year Maintenance LS eight thousand two hundred $-,200.00 $ 8,200.00 dollars 27 1 LS Traffic Si ;g:d;ping per plane / �l� D�t.Ger r (���c11kfA 28 22 Install Traffic Loops EA one hundred eighty eight dollars $ 188.00 $ 4,136.00 29 1 Traffic Signal Pullbox and Relocation and Conduit Installation. LS eightteen thousand five hundred $ 18,500.0 $ 18,500.0 dollars 30 1 Median nose reduction and crosswalk modification per Appendix LS S in Specifications. $ . 1, 560.00 $ 1,560.00 one thousand five hundred sixty Total Amount Bid in Figures: $ "7 -) , ........ Total Amount t Bid in Words: syQet4i IF ..di'6 onnC 7' � . z - C-2.4 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 10°//o BID BOND in the amount of $ -------------------- which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 SECTION C In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. PANY T P.O. , LOOPS/ MSL ELECTRIC, INC. ELECTRI 4580 E. EISENHOWER CIR., ANAHEIM, 92807 822450 C10 ADJUST RAMIREZ CONSTRUCTION UTILITIES 656 E. SAN BERNARDINO RD., COVINA 91723 683241 C61 S & M LANDSCAPE LANDSCA E 346 S. MOTOR AVE., AZUSA, CA 91702 638473 C27 CEMENT SOIL STABILIZATION TREAT 2290 N. BATAVIA ST., ORANGE, CA 92865 866784 A V & E TREE SERVICE CLEARING P.O. BOX 3280, ORANGE, CA 92857 654506 STRIPING J & S STRIPING C-61 1544 S. VINEYARD AVE, ONTARIO CA 91761 538211 C-32 D-42 By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished 'by subcontractor for this project. 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 x Sign re o Bidder MI AEL J. CARVER, PRESIDENT 15505 E. LINCOLN AVE. ORANGE CA 92865 Address of Bidder Subscribed and sworn to before me this 4 day of NOVEMBER , 2010 C-4 JENNIFER DE IONGH �' Commisslon # 1771186 Nora;;+ Public - Colifnmin z NOTARY Del AGREEMENT ]HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (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 X By MICHAEL J. CARVER, PRESIDENT Title Date: NOVEMBER 4, 2010 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 M No If the answer is yes, explain the circumstances in the space provided. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 Pursuant to Section 1861 of the State Labor Code, each Contractor to whore a public works contract has been awarded shall sign the following certificate. I axe aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: NOVEMBER 4, 2010 C-7 R.J. NOBLE COMPANY Contractor X By MICHAEL J. CARVER, PRESIDENT Title BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: R.J. NOBLE COMPANY Bidder Name 15505 E. LINCOLN AVE. Business Address ORANGE, CA 92865 City, State Zip ( 714 ) 637-1550 Telephone Number A-782908• CLASS A State Contractor's License No. and Class AUGUST 14, 2000 Original Date Issued AUGUST 31, 2012 Expiration Date The work site was inspected by STEVE MENDOZA of our office on OCTOBER 22 )2010, The following are persons, firms, and corporations having a principal interest in this proposal: MICHAEL J. CARVER, PRESIDENT CRAIG PORTER, VICE PRESIDENT STEVE MENDOZA. SECRETARY JAMES N. DUCOTE, TREASURER C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. R.J. NOBLE COMPANY Company Name X of MICHAEL J. CARVER, PRESIDENT Printed or Typed Signature JENNIFER DE IONGH Commission # 1771186 "wcb; Notary Public - California 4 NOVEMBER 201 0 Z ' o : Orange County Subscribed and sworn to before me this J day of � n',�, Comm. Expires Oct 2s, 2011 NOTARY PUB NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has perfo-r-med. similar work within the past two years: 1. _COUNTY OF RIVERSIDE, P.O. BOX 1090 RIVERSIDE, CA 92502 Name and Address of Public Agency Name and Telephone. No. of Project Manager: STAN DERY (951) 955-6742 $4,628,247.70 STREET IMPROVEMENTS 02/08 - 10/08 Contract Amount Type of Work Date Completed 2. CITY OF HUNTINGTON BEACH, P.O. BOX 784, HUNTINGTON BEACH, CA 92648_ Name and Address of Public Agency Name and Telephone No. of Project Manager: DAVE VERONE (714) 536-5221 $3,875,549.75 ARTERIAL REHAB. 12/07 - 06/09 Contract Amount Type of Work Date Completed 3. CITY OF ORANGE, P.O. BOX 449, ORANGE, CA 92868-0449 Name and Address of Public Agency Name and Telephone No. of Project Manager: ALAN TRUONG (714) 744-5544 $1,212,702.00 AHRP PROJ. REHAB. 09/09 - 03/10 Contract Amount Type of Work Date Completed C-9 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, fart 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or """ Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: R.J. NOBLE COMPANY Contact Person: STEVE MENDOZA, SECRETARY Contact Phone: 714-637-1550 Signed: x a 0JV_ Date: NOVEMB R 4, 2010 ;kNote: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the eontractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalRecycle.ca. ov/Regulations/Titlel4/ . Please return the completed forms) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn:lVame of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 -GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: STEVE MENDOZA, SECRETARY CONTRACTOR INFORMATION CONTRACTOR NAME: R.J. NOBLE COMPANY AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: MICHAEL J. CARVER, PRESIDENT MAILING ADDRESS: 15505 E. LINCOLN AVE., ORANGE, CA 92865 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of 'California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. MICHAEL J. CARVER, SI NT Signature X Date NOVEMBER 4, 2010 Z C-11 RELIABLE CONTRACTOR DECLARATION (page 2 of 3) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on. -the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (e) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous Ca7Recycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grantor loan by the CalRecycle-or prime contractor; or (g) Placement on the CalReeycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of Rinds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C-12 RELIAJBLE CONTRACTOR DECLARATION (page 3 of 3) (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Focal Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder 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 I00 (EEO-1) is the only report required by the Executive Orders or their. implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-14 BRarch 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 101.62 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No X- If the answer is yes, explain the circumstances in the following space. N/A C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-16 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of HUNTINGTON BEACH/ORANGE DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;. that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulgedinformation or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 e 17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checldist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: i Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; 0 Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. N/A Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is pail of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page12-83 LPP 01-04 C-I8 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Cheeldist Instructions Attachment F NONLOBBXING CERTIFICATION FOR FEDERAL-AIID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-19 March 15, 2001 n Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES C:UMFLL I 1 1115 1'U1,CM I U llISC;l.,USh LUl3t3Y1NCi AC; ItVI IIE6 FUKSUAN I 1 U 31 U.S.C;. 1 j5Z 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract 1�1 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, nly: e. loan guarantee year quarter f. loan insurance date of lastport 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Sdbawardee, Enter Name and Address of Piime: Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, ifknown: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award'Amount, ifknown: 10. a. Name and Address of Lobby Entity b/ Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. I On) \ (last name, first name, MI) (attach Contin ation Sheets) if necessary) 11. Amount of Payment (check all that applaancd / 13. Type of Payment (check all that apply) $ actual p#a. retainer % b. one-time fee 12. Form of Payment (check all that ap'pty): c. commission 8 a, cash d. contingent fee b. in -kind; specify: nature a deferred ZePerformed alue f. other, specify 14. Brief Description of Se or to be performed and Date(s) of Service, including officer(s), etnployce(s),%r member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) ifnecessary) 15. Continuation Sheet(s) attached: Yes n No 16. Information requested through this form is authori'/.ed by Title 3 (U.S.C. S.�tion 1352. This disclosure of lobbying reliance Signature: X was placed by the tier above when his transaction was made or entereXnto. This disclosure is required pursuant to 31 print Name: ICHAEL J. CARVER U.S.C. 1352. This information will be reported to Congress J scmiaWulally and will be available for public inspection. Any Title: PRESIDENT person who fails to rile the required disclosure shall be subject -- — to,a civil penalty of not less than $10,000 and not more than 5900,000 for each such failure. Telephone No.:(714) 637-1550 pate: 11/4/10 Federal Use Only: LPP 01-04 C-20 RTC Authorized for Local Reproduction Standard Form - LLL Page 12-87 March 15, 2001 EXHIBIT 12-E Attachment G Local Assistance Procedures Manual PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 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 I (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10), Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. if payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C 2I LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90«ENDIN Page12-89 LPP O1-04 C-22 March 15, 2001 t7 a Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE). PART 1 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per "Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. • • i f • !MAM FMI a 1P t n�5��'•�.(�i�'��filY i�.,`'r,�z 1�l� ''.6h T 4l?iswQ'�FP{S jL 3 a5 ttTi SS{#it l� a Pl't t <tu, i�;i:i vi,. / �� � � s Res,,JCS,t7e=.3..,,;i;3,,°!`'¢f� V 77 YPi }yx�°,.lii 1. �R y rrc3,s�=i�. r�,�lt;.'�uii�tk?,3+1�'rl�. ■ 1 • l� • •j��j{tZu:yi,ryryS��i�.�rlsa-i�f'1:3 �'; ,�,�'�' / / i °f `�� �, �'.�,:� "/ /� i •filIq � �� /� � 1 I, `� / /_ ����t )hry �C1r1E i=1{7Y�c^��t�S"��i,�l t1iS�+i'S'q b �j,� 6��A�S�J)tljl�l;,ay 3ti�.� E�t`ti.: �`L33�� _ 4':i: �3�3�a��. }FiiT�1TiJ)z�t=.ty�..t�ii � 1 • • /� �� `� /'! �- • �jCi2f�f 7•.ia [s: • o • i _ �' 1 ! 1 S , / ' /�. r � " u . t" / � f /'f / ,� lEllLst �v �' it'll 91•7F 1�r'JI�,�c (t .f- �1+� , � tyyl li� I. 3 'r Po la l.� � J tiS�' 1 �.T .-,II' ;}- 12ii1A:tl.ny.� 7 3 m s .t • •i.:ce r• � 1 • • S.= BMW .1„ t ' r 9r.n i�4`'. Cm.- State ZIP t si„ I� sl MR, n?l; f p°{ ��•'f• f3�t'�i'A 13 �t y%iJ �1 3 i3 (i�lf� �i�j , '°, d 4= � jII,ISi =.} Y,•t,l:n�tft"' {� `�°� Ss`(t7 ht nit3t L;��,sEu�.i',i1:�k'c } ' � I � / � ■`�j • ' � � • '0l' U Distribution: i) Original - Local Agency Pile Page 12-111 LPP 06-06 November 14, 2006 Local assistance Procedures Manual EXHIT31T 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LOST OF SUBCONTRACTORS (DBE and NON -DBE). PART 9 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. 'This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. ; � �It' ' 1 1 ! • ! 1 1 i 1 1 • " i ' ! n t "�j�riT 2 s� hl"ta NO8 v/��� Fe �� 1 tE � • [ a • ti.3 .1 ) �i, :l]S�k•` 9; �b9j J • 1 • z �,� r� �� �[ik3 ;y��7. {fit(,-ti�qq I' J / _~ $r„ic. E�r i�{� :5 t �Y{a tE>e� �`���8 a G SYs)�j i.at I tkS 5 ,2 � s' ,may 77; � r� a • � �� � R'��lRIR■ Phone • 1f11E51 t t ,l,�NC lii� t! '.. r ( •'_ ��JZui i�IlA&§ ��.e),�.Fi�iFi iti+2L[s.'i'i.�i✓ • 1 �� • � , �Sa•* 4@ihT�x �, }iii� _.._ --. _,_. -.—_— _-. —_ ___. ...Jbit�. - / I '/ �. • _..__- - �q, 41 y` !� p4' AA �`� I� NG�SEY ��.SjC���N�Z�` �nt�st{F�,,33k('$".1i:S"j �Ei1F v=i� 2[%50 pp `y �y?':!j;,�53 f=l iSZ`ii�1) 51.4')°..''S',?r�-77 r ! • . • Distribution: 1) Original - Local Agency Pile Page 12-111 LPP 06-06 November 14, 2006 w Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS tDBE and NON -DBE)- PART 9 The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listins DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. • ' • � £ r rrt , h �, �iL 1 1 � ' ! ! ! • ! 1 ! / ! ! � • . ! • ! 3 � Yti w� �� u'�y� aArraF i �£�.,�-1:liit��< PtTt�� �'a+,t'31��ds! • • ! G.� � S{'it f:£c. . I•t e e1ut,'7':vi:?i�y ,s��>i{ A "M ll M . , s{t t• • : ��9 e � II' t ti f� rrtl� l fs r�i�: I�• i9 E°e �If Rb �i�x'�rq�t)i ( si' U 4: City State ZIP ■ 3;�kf" i3� •©� 7 .,i u; xu�a'L•.lai7:i{i�,�t�v�f;�°' ,.] 3 2 f z*t i'� i tr f �ii �'2u '. � � � L3It ,..s.�.> �� ♦ ■ � �°a � s£�'��i L 111j4,.�o i altEi 1°�� i� • 'l, 9S�z� r��15,F�r) E' �i 1 � z a5'ii�'s� f�f i tJ,i{l', i �ri..1�t Taz� t �I✓n�i a f�. r t� bill. ' • - --- ,, � -- — — _ _ - ,; •tl,�t�` f �� A,00,99 p ]. St `tti.. �z° rtt�,lSyV'�i�! �'.li'tP fllf�41.4i':t+«�iiii[>';ici123t;� ■ . Citv Stare ZIP k3a'{£�A Distribution: {) Original - Local Agency rile Page 12-111 LPP 06-06 November 14, 2006 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PARS' B The bidder shall fist all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. • l� .sis i < it ��WJA �I;ay S '� A^.s�rt.3vetii cin a te r ■ • _ - .. • ■ . f It1U.,! � L4t �S��h' SIYSY14 �'S`����Y;VY'JIU'�. �} .•. � '� pis {���. r vA MIO ' • �� r}� r3�� ����'Se H t f li�y LLD Yr 7} Distribution: 1) Original - Local Agency file rage a-111 LPP 06-06 November 14, 2006 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Mon -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART If The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49. Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Firm Name/ Address/ • State, ' 1t FAXCity, f . • 1 ► 1 1 i 1 1 1 1' 1 1 :Illy `lx� ; l i� 1, f J��tN ?� jttY l�f 1 3ixli�.-s�t�*�t•1 "� Su..li�+lY.ik�YS� $,• 5 nx'trt#'"7' %`+ )! r rt ire{n`'r • • �� � �. � -/ x � ' .' t � ..Iti �in� �� '��f'stt isRV S 'ts i� K..•r'x� �Lx �n h,Q t • , :II `���� n,t't< AM, "A� i ' • • i`� �■�� `- • � 1 • � • • g g f' i .'� r y .r} /slt itl tli x tl.hzg ii. y, S ��"�.�1'�fA ' `xe:+it.4�•H.�7b���� IS :� r .,.t 1 •, E � • + ,( r �l�l �� /. - ... 1 � t _ f• . i � i • - / � i. • / .._ ,l / � s_�` / r' �/% / � ;' / % : >I/ /!'x� /_ I / - _. ti���t Ix X��,��i,'z���1"T�ti ��IF� �I f l:Iz3i: HOW G`�k!,�,{' t'f�+�t3 �7i51�s�"�,. qp Nat$ 11��11j }C:) tt3�.ltySt7F_fs1 tt •i ftc S E P lI it�t .� • 1 • 1. • Cjl�- State ZIP '� .xt' / I b t l ��i^&.t{� • , � . • . � • �, ' ,/ � � '� � ��' . ��.• l �. r'" � ` / j 'N'}� �,a.i � � �1 S �� `CIA �� 1 it � jtj;l` a � a �rrS��F �z�.�`i%�z �'� 1 � �a � ! �t�!" t�����Tt .���iFS�f�73 t 1 n�y����,.x'� . � Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART of The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49. Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms, Firm Name/ Address/ 1 1 t 1 • 1 t t 1 t 1' 1 ' f .� s�s'C.t71'h' 3�"tjfs*lr"'rsEa'=-titri City, State, ZIP, t rd, S f ; = ■ 1 s a p4{,, R`:�^ J �'tr1 41Y r }:: `il�� { 3[Z '6 Al�.��''�F>ti.��v:.� 5V, , l�' � F,��gsi3 Rstt,: :r,r 4 - ! s„r / <� / • �,. i ` s _ _�� � r 1:.. • , •. �� // a�.29 ti . ° '� i t Lti i 1�3"`� FR'� l�i i �. �r �* � •. ' • UVj� La Nj �f LL�`}�.jrl �. Yir �frY .2{rr (}.��r. 51�15 I' 4♦; Fa "}-t Lx�7�'• �. ,(. ' • / /� .� I �� /. /.1%fSrxt i [� t';4 1f•[•r t i• y •c.' W, Sig.; ';-5}t"' .1. / • '� . jjjjfr3, �'1}# P�y�++tj-r art � r!<=l ORR.„ r �'tt r Y � (fit �� _ ■ • X}'�yy7 �7i`[�, 'Syru � {�u S-R`Ft' �tt tf �� ri: '� ' aZ i;3 ' 3 - ■ _.. _... _.. _ it• t % `�j`9,7 sltl }Tt L�r$ ��lC�1 �17.-G f t ��:•• ' , ■ _. • 1 L f t a, �i'1mm;;}?iS�ki;i 1.i 3tr t`.. s.&IME I�Z Y., - t � // / - i�.,� i J/,y �3: i��a� GSidp79,H4� 8< r�•'c�f t� r sf£k '.tixjt. Ji .,(ia i rf=p .J ,�i Yt iJ l�y �tY I3YIt 951�y y Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 n W EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and PION -DBE)- PART 11 The bidder shall list all subcontractors Nvho provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49, Section 26 of the Code of Federal Retrulations. Photocopy this form for additional firms. Firm Name/ Address/ State, •MAP: • f Fax • • t)±u.. trY �'llb {f]W"�ill� rFf76r�'� 1 3� Sit'}r,({'yy+;is59' 3� jr2�"z T'aCity, � I - �' � �� , • ., ! • l a5 � , f �p 't'}"i3 �l' 79 �r .7 @ �(}^i-Tij'�'?t y s�Py�tf[��.7�7yi�£�' :r��7Qlf `7�(J`J ' ME / // , , .i `a.(ia ■ i g^i3f, 1'+,sc?!;`;as?Y3.tN .. tfu^*n� 1=55t hlitt9i�.t9L. 6 il£i�14 AN.++.F?f�'.ti�Ut.x+- F , >' 1 i� 71£'4'� t'r;i d 'WIN .. , • : �- . !% ��1 I�� � • ( • ti .i •,I . � i � • � 1 • .1�, ri� ,it � { �C fai1 s! 1 • )'c;lfl1i j � '� j ,r / �/ � � 'r'/ !.lid % '�� -" %y/ ",/l � .� /__.. .� te'_ !/� '� t�sz}�clwr•f�s�- t hi9 �I� u�A � � £ �� �T�I���i�ri ���) $ y, q g''t� � �I*�� z�r3�. t�ul �i��� y �:+as� `flit ��Ei i jtb ���, j`N:�� �� �u�E 1� J E No!/�/ / / ,. , ' �� — / �/, !� ./ '' u � � � i �j � � 1 I • _.. ___ _— - _ -. �WM,7 1.; A,7 • � 7�� �"'��3`ta��s��v��r'S 'S 1 - Nfy�z ���i 1t }Lis 7� 11 �t y r . J� s tt �' � �T �i3,. Sr Pj� s ;t,?,.�k, c�1�i r /, E• s - ✓1 , � *,./ / . / 1'�.t'"k taS!'i.4'i� {, ;fix{ . • _.. _._. '.!✓i /l / ' � '/y //- � � / j.. - *j• i .� G gig "tY I jtt iA1' ��ifi36J['f xi iF7 1 i 1� sr5 rti {si CiS,�''ys}i Distribution: 1) Original — Local Agency File Page12-112 November 14, 2006 LPP 06-06 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART If The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49. Section 26 of the Code of Federal Regulations. Photocopy this Firm Namel Phone/ Address/ FilixCity, 1 d' 1 t 1 f 1 1 f 1!•. 1 . !iA_i W{�,..Su...triiiI I State, ZIP ^.. ■ • { ! � ::�� fit/ I/ �/ / ' 1 ,'d @ 1("}��,�3��1'����tt��,��j / - ■ • i '1s x, i ^ti; `?ii �rJ� A i`! /' / • � �r �i?C13"a�a� '-1.eit��3 ,sr>+af�*`� "uC�� � fi S rp F fb�rIle ^'S.f�ht"'l�'s.Yi 12.,_+ry Mr t %} 3� �'j�) >`�.ias� Xy • .// '�' _ si].i �j?• .i7 3���, • _..i} - _ } � �',� , /.� :. ./ ■ •. _ _ ■ 1 • __ � � �� � ��i ,, r � �/ � � � , � � _� y i�;t;iS��ii�j•f�Y t:1� y a is NMI � 1 � W�=�'it��ij�'MY3 Xi�i15x.�i�� �{ �' ' , � � � / � ' ,�%.r • 50 ■ � • ■ • i`';_ � ��; s �/ 1 -,�� /t / l �. .% ^'/� t:;�y��' �!�:1`i4 iF�34°�7i�i �' SIa ,'l1'z,'- „i '' i��;,,.y�• � _ l i' , � � � "I /%� % /- , .sir , - - - - _- - - - - - II:Si ,�� - ,... _ /� � � � /� I• �� • , . • fri�i ��' S�iif�i'� a �i.--?p'�f�ff�t '{j � [t�S,r 4.4 21 "y3 i J i ♦♦, • ■ • � / Vwy' ��� i;Yi' y S�f�-:S"�y3`iinj`k����i'�ijt3jf �.5 in /. i' � I'.i • / ■ • /� 1' 0 t! ';jS �14j i� yS1 �y�I'j {{i111M tp Xll � / �Si�,dq>1�,�ILsi P E.- ERR ! t F di i s rtv ii i33�3 � '!% �• � . "/ � -- ..- _ — �il�b iJ a. P �� y ! { 3 a �i}ia�;.5� � AiS�d'3y Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 A EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART II The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49. Section 26 of the Code of Federal Regulations. Photocopy this form for additional firms. Firm Name/ • 1 1 f 1' 1 1 1 • f 1 1 1 1 1' •' i6iified 3'jis* F' f+t�i} Cit State, ZIP ,Y�(szf'6.Lty'•}'7>s;`nz • y � t _ • , ■ • , [ � ti kT'IP�#'{��' S �r }"jtk j f L A. ,' �y.Sl�'A { r €.f�t Uix r •� !1 I 1 _ • • li, `�'.'"s'd ..� 3fl �r' 1 'W i3��pp`�J � k a �J"d��L. � � a �{]i� �� � EJ<$10 million i�� jai � jr✓ r_ rrJ��A�'E,{!y#'}rl'� b li s n%'i?+a r a3�7%ss . • • • �-..�{.� [.y 5i ' e €}•s�,lis £,.,fry S .\ � • �. � I �� _ � �'�i�l�a�t�`���r-r��i_#..a3fr#'aa� 9 b F __ #� � a t���� S� f j + )1f �l}U l�ul fe�_F.a E�l7i!��}�7j Oil ■ ��.. .rr jt t-s E•` ' 1 ■ • is [ ++r f PM 11 i 141I y?}Ilj4(•1+# 1 l:i chF� c� i•[�,;�,>~�'i',E1 2f'`,.nu i:4.7��"'�� ZI' Ili '� � 01): State ZIP 17Yr r�q}a'�e��i •la*' - ,<,3? _._ - - �# J y,Ff. .j i2?+ }��`.? Distribution: 1) Original — Local Agency File Page 12-112 November 14, 2006 LPP 06-06 EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title �����.rN•[•71l�iziltt•R:��LiI1}'d � . , 1df rC•i9j+�t Firm Name/ II j�aarZFrri �?r~1.�.� Address/1 b 1 • 1 ' 1 1 1 r 1•' 1 ► y�;"'�� 1'r> t z o-is! . City, tate, ZIP / �tz� i ?2 .• r a r • � � • [ t FF'�v � � SrPrr S� Itn iI ) �•� •�3 dl pgfflu �`� P }Yid ���' � SS, >a ,.,(."R3 fyI'�.�,}�iiC�yL�F• L1 S Ra, ��3"'' f 3r .• €*'1?i' ! y� i �tij aL.') 1� 71�S� S „'1.�'1`S F ■ , ■ •�1{j(tt:lf � i5 A� ,(i�{e�'�QoSA r 1 • � ytr � � � ��� `t �' i'?tUs �a c ; m}k�.s���� ll�i�� � t � - JI _ _ � 9 t � � a �[-1 � �4 EI�� ' , • , e u ftii}Zr� i I lt3 1� }}�{�(i£p` �rrl15�F}FjlIt'.} �, '�7jj( 4E, 1�7 l tf�I�'. • •,�' • `f�f m of ''J i� I u t3� i �1 #�;,t tjlt slk• `vli �xr � � ty��e .� � '+'u' mt3'.. 'ram. i t� sir. ;tsn�:3•�7'' F t ������ ' • ■ • n �S ��C `�� �� L'ItI� S�� ( • r � "fie ��rF SS I �t� Distribution: l) Original — Local Agency Pile Page 12-112 LPP 06-06 November 14, 2006 FedEx Ship Manager - Print Your Label(s) Page 1 of 1 From: Origin ID: FULA (714) 637-1550 Jennifer De longh ec • R J Noble Company Elmss 15505 E. Lincoln Ave. Orange, CA 92865 [E] rmmawams SHIP TO: (714) 53&5431 BILL SENDER Jim Wagner City of Huntington Beach 2000 MAIN ST HUNTINGTON BEACH, CA 92648 Ship Date: 08NOV10 ActWgt 1.0 LB CAD: 5293310ANET3090 IIII�IIINII�IIIIII�YMIIN Invoice # Dept # r2g, 001 7964 2702 5820 TUE - 09 NOV Al STANDARD OVERNIGHT 92648 CA -US SNA After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim.Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic valueof the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $500, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. Global Home I Small Business Center ( Service Guide I About FedEx I Investor Relations I Careers I fedex.com Terms of Use I Security & Privacy Site M- This site is protected by copyright and trademark laws under US and International law. All rights reserved.© 1995- 2010 FedEx IdOv 2010 DEIP https://www.fedex.comlshippinglshipmentConfirmationAction.handle?method=doContinue 11/8/2010 Local Assistance Procedures Manual EXHIBIT 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) EXHIBIT 15-GI LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: CITY OF HUNTINGTON BEACH LOCATION: GARFIELD AVE. PROJECT DESCRIPTION: GARFIELD AVE. REHAB. FROM NEWLAND TO MAGNOLIA ST. _ TOTAL CONTRACT AMOUNT: $ 797,698.30 BID DATE: NOVEMBER 4, 2010 BIDDERS NAME: R.J. NOBLE COMPANY CONTRACT UDBE GOAL: 5.31 % CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a UDBE) UDBE CERT NO. AND EXPIRATION DATE NAME OF EACH UDBE (Must be certified on the date bids are opened - include UDBC address and phone number) DOLLAR AMOUNT UDBE TVI. I ranspo �- $71,5U6.0 xtbj0%� 08/02/2010 1145 S. Taylor Avenue _=$42,900.00 Montebello, Ca 90640 323-722-9088 For Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number. Federal Share: Total Claimed UDBE Participation $ 42,900.00 5.37 % Contract Award Date: Local Agency certifies that all UDBE certifications have been verified and information is complete and accurate. Print Name Signature Dalc Local Agency Representative (Area Code) Telephone Number: X Signature of Byder St a Mendoza, Secretary NOVEMBER 4, 2010 (714) 637-1550 Date (Area Code) Tel. No. MICHAEL J. CARVER, PRESIDENT Person to Contact (Please Type or Print) Local Agency Bidder UDBE Connnilmenr (Construction Conbacts) (Rev 6n6/09) Distribution: (1) Original — Local agency files Page 15-31 LPP 09-02 C-23 July 31, 2009 EXHIBIT 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) African Americans; 2) Asian -Pacific Americans; 3) Native Americans; 4) Women. This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the bid nonresponsive A UDBE is a firm meeting the definition of a DBE as specified in 49 CPR and is one of the following groups: African Americans, Asian -Pacific Americans, Native Americans, or Women. The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work —performed by its own forces, if a UDBE. The UDBE shall provide a certification number to the Contractor and expiration date. Enter the UDBE prime's and subcontractors' certification numbers.The form has a column for the Names of UDBE contractors to perform the work (who must be certified on the date bids are opened and include the UDBE address and phone number). IMPORTAN'T': Identify all UDBE firms participating in the project regardless of tier. Names of the First -Tier UDBE Subcontractors and their respective items) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the UDBE participation dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of UDBE firms. Exhibit 15-G1 must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-32 July 31, 2009 C-24 LPP 09-02 Local Assistance Procedures Manual EXHIBIT 15-G2 Local Agency Bidder DBE Information (Construction Contracts) EXHIBIT 15-G2 LOCAL AGENCY BIDDER DBE INFORMATION (CONTRUCTION CONTRACTS) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: CITY OF HUNTINGTON BEACH LOCATION: GARFIELD AVE. PROJECT DESCRIPTION: GARFIELD AVE. REHAB. FROM NEWLAND TO MAGNOLIA ST. TOTAL CONTRACT AMOUNT: $ 797,698.30 BID DATE: NOVEMBER 4, 2010 BIDDERS NAME: R.J. NOBLE COMPANY CONTRACT UDBE GOAL: 5.31 % CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS 0 BE PROVIDED (or contracted if the bidder is a DBE DBE CERT NO, AND EXPIRA710N DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT D8F 7 Portion of Asnhalt Oil CT-10447 E.M. 01L Trans'p_ort $11r5U0 z 60% 08/02/2010 1145 S. Taylor -Ave — =$42,,UUU.UU-- Montebello, Ca 90640 - For Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number. Federal Share: Contract Award Date: Local Agency certifies that all DBE certification have been verified and Information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code) Telephone Number: Total Claimed DBE Participation $ 42,900.00 5.37-- X signature of>✓ derSt6he Mendoza, Secretary NOVEMBER 4, 2010 (714) Q7-1550 Date (Area Codc) Tel. No. MICHAEL J. CARVER PRESIDENT Person to Contact (Please Type or Print) Local Agency Bidder DBE Infornuttion (Construction Contarcts) (Rov 6126/09) For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Distribution: (1) Copy —Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds I'or this proiect. (2) Copy— Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a LPP 09-02 C-25 July 31, 2009 E.M. Oil Transport Inc® M BE[WBE/DBE[UDBE Certified Caltrans # 10447 State License # 838893, C-12 1145 S. Taylor Ave. Montebello, Ca 90640 TEL (323)722-9088 FAX (323)722-5459 E-MAIL: EMOILTRANSP®RT@SBCGL®BAL.NET Date 11 /4/ 10 Steve Mendoza C/o R.J. Noble Company From: Cristina Rodriguez Proposal Re: Garfield Ave Rehab ESPL-5181(168) Bid Rate: 11/4/10 2:00pm Job Description: Bulk Liquid Asphalt Est. Liquid Tons Item Price per ton Refinery 130 PG64-10 $550.00 Paramount Refinery All transportation not included in per ton price. If any questions please give me a call. EXHIBIT 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) SUCCESSFUL. BIDDER: The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces, if a DBE.The DBE shall provide a certification number to the Contractor and expiration date. Enter DBE prime and subcontractors certification number. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit I5-GI), regardless of tier. Names of the First -Tier DBE subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "'Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts) to determine how to count the participation of DBE firms. Exhibit 15-G2 must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Focal agencies should complete the Local Agency Contract Number, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 1,5-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all informations is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b July 31, 2009 C-26 LPP 09-02 0 Eeme 11 Transport Inc. MBE/WBE/DBE/UDDE Certified Ca➢trans # 10447 State License # 838893, C-12 1145 S. Taylor Ave. Montebello, Ca 90640 TEL (323)722-9088 FAX (323)722-5459 E-MAIL: EMOILTRANSP®RT@SBCGL®BAL.NET Date 11 /4/ 10 Steve Mendoza C/o R.J. Noble Company From: Cristina Rodriguez Proposal Re: Garfield Ave Rehab ESPL-5181(168) Bid Date: 11/4/10 2:00pm Job Description: Bulk Liquid Asphalt Est. Liquid Tons Item Price per ton Refinery 130 PG64-10 $550.00 Paramount Refinery All transportation not included in per ton price. If any questions please give me a call. PUBLICATION AFFIDAVIT POLE COPY DECLARATION OF PUBLICATION STATE OF CALIFORNIA Surte Davidson /Art Director The unde RjNOBLE 15S(lS e. lincolrl 0A 620 � p.o. box G20 orange, ca 92856 company 714-637- 321 fax 7I4-t37-fi32i R.J. NOI3.LJ5 COMPANY IS ;r.:(EQUESTING PARTICIPATjON FROM -ALL QUALIFIED WDEI UDBE SUBCONTRACTORS AND/OR SUPPLIERS FOR THE FOLL OW).NG: GARFIELO AVE NUE REHABILITATION FROM NEWLAND ST. TO MAGNOLIA ST. CC 1372 PROJECT NO. ESPL-5I81(168) HUNTINGTON BEACH CA BID DATE/TIME: NOVEMBER 4, 2010 AT 2:00 PM Please respond by November 4, 2010 REQUEST FOR DBVUDBE SUBCONTRACTORS FOR THE FOLLOWING: CONC.R1 TE, ADJ_ UTILITIES. SIGNING c& STRIPING, TREE SERVICE, TRAFFIC LOOPS, ELECTRICAL, arcs: Please call if you .b..a.ve any questions. R,J- NOBLE COMPANY CONTACT: STEVE MEN.DOZA 7.1 4-037- 1 550 - Fax 7 14-637-6321 CQUAL OPPORTUNITY EMPLOVER I am over the age of 18 years and a citizen of the United -States, I am not a party to and have no irtezest in this matter. I am principal cleric of the publisher of the Construction Up -Date, Inc, and Minority Bidders Bulletin, a trade/ focus publication in the City of San Diego, the County of San Diego, and the State of California. This notice,'a true copy hereon, was published on the below date(s): I declare under penality of perjury that the foregoing is true and correct. 2 1 Executed at San Diego, California v � signature CONST*0 �d . RU : � w TRADE PUBLICATION FOCUS PUBLICATION ALSO DISPLAYED ON WEB, SITE @ http://ivwip.gooc?faitheffort,coni 16885 W. Bernardo Dr., Suite 335, San l3lego, CA 92127 Phone Number (858) 487-2600 Fax Number (858) 467-3500 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION —GOOD FAITH EFFORTS UDBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. ESPL-5181(168) Bid Opening Date NOVEMBER 4, 2010 The (City1county of) established an Underutilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation Page 15-33 LPP 09-02 C-27 July 31, 2009 Exhibit 15-H Local Assistance Procedures Manual UDBE Information -Good Faith Effort C. The items of work which the bidder made available to UDBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (Y/N) Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection.of the UDBEs: Names, addresses and phone numbers of firms selected for the work above- E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: Page 15-34 July 31, 2009 C-28 LPP 09-02 " . Local Assistance Procedures Manual Exhibit I5-H UDBE Information - Good Faith Effort F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results I-1. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. 9 01 4 � i LPP 09-02 C-29 i ..July.31, s TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Hartford, Connecticut 06193 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 as Oblinee, hereinafter called the Obfigee, in the sum of TEN PERCENT OF THE AMOUNT OF THE BID Dollars ($ 10% OF BID ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AND PROJECT ESPL-5181 (168) IN THE CITY OF HUNTINGTON BEACH NOW, THEREFORE, if the Obligee shalt accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terns 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 tabor 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, it 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 good1aith contract vAth another party to perform the Wort: covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 22nd day of OCTOBER, 2010 R.J. NOBLE COMPM (Witness) (Principal) (seal) MICHA J. CARVER, PRESIDENT ��k) TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA (Witness) By � k"-O. MI T EL D . S 0 (Att =ur Printed 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. �i it54 G ,0?-97) CALIFORNIAALL-PURPOSE ACKNOWLEDGMENT �,• S i '� r-�S;ZS S,y�S�5�„s�.'A 5,.�i,.-�.'.v!::g • .v.7.!�:��a3S.c�ax�G..S g..�.;-saC�S>S.n�.�g S,a>.�� S:�iS.�,:aC.g.�,:�',5.4�:;�� 4;�4,•\.'�` State of California County of ORANGE On 10/25/10 before me, JENNIFER DE IONGH, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MICHAEL J . CARVER JENN- IFER �E 10NG Commission # 1771186 Notary Public - California v Z ` -.. Orange County ,Vt,r "omm. Expires Oct 28, 2011 Place Notary Seat Above who proved to me on the basis of satisfactory evidence to be the persono) whose namek8) War& subscribed to the within instrument and acknowledged to me that he/may executed the same in his/ge#their authorized capacity(i&5), and that by his/ha;4 w signatureW on the instrument the personA, or the entity upon behalf of which the person(,a°j acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Signature OPTIONAL and official of Noted Public Though the information below is not required by law, it may prove valuable to persons relykg on e document and could prevent fraudulent removal and reattachment of this form to another ddo6wfent. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT+, OF SIGNER Signer's Name: O Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBP OFSIGNElkRINT, ; .. . 0 2007 National Notary Association • 9350 De Soto Ave.. P.O. Box 2402 • Chatsworth. CA 91313-2402 • www.NatanalNotaryorg Item #5907 Reorder. Call Toll -Free 1-800-876 6827 Jl� CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of RIVERSIDE On�- l before me, R. NAPPI "NOTARY PUBLIC" (Here insert name and title ofthe officer) personally appeared MICHAEL D. STONG who proved to me on the basis of satisfactory evidence to be the persogWwhose nameWls/are- subscribed to the within instrument and acknowledged to me that he/sheAhey executed the same in his/Uerkltek authorized capacity(.it:4 and that by his/HerAboir signatureWon the instrument the persons or the entity upon behalf of which the persongacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNE S my)d and official seal. Signature of Notary Public R.APPI #1791 �, F . COMM.. #1796916 s '"° NOTARYPU8W-CAUFMNIA C RIVERSIDECOIJNTY (Notary Seal) AAy Comm. Expires )tine 7,201 ADDITIONAL, OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM 4i0 acknowledgment completed in Calijorma must contain verbiage exactly as appears above in tine notary section or a separate acknorledgment form must be properly completed and attached to that document. The only exception is tf a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be primed on such a document so long as the verbiage does not require doe notary to do something that is !!legal for a notary in California (U. certifying the authorized capacity of the signer). Please check the document canefutl3, forproper notarial wording aril attach this form if required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forts (i.e. Ire/shddwh . is /are ) or circling the correct forms. Failure to coffrctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear ami photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. v Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. 4- Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document 2008 Version CAPA vl2.10.07 800-873-9865 -.vww.NotaryClasses-corn WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER POWER OF ATTORNEY TRAVELERSFarmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 222079 Certificate No. 003471396 KNOW ALL MEN BY THESE PRESENTS: 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, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, 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 Michael D. Stong, Rosemary Nappi, and Jeremy Pendergast of the City of RiVerside , State of California , their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory 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 undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrurnont to be signed �and their corporate seals to be hereto affixed, this day of February 2010 State of Connecticut City of Hartford ss. I St Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Iusurance Company _ Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company 9. µ N4CE".y',��S,a„�€� c��<�C�Ii ♦a;*.RNv�oIRNqSG>U -f'iZ !om t t1IFW.a4itP;''•p!+aN SEASE—POA$N_VqL,'=a6-* i tno't 'a a�ca. JHPACR1OTY fNqONryR, ODs, `9rmo<e g�• `uqaF pi�♦t%j s9Y9 'W6 p d-•-.....:�a �vJ.•-... , �d bb +a . v9 1•i/ By: 14� Georg Thompson, enior ice President On this the 1 St day of February 2010 , before me personally appeared George W. Thompson, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 000A In Witness Whereof, I hereunto set my hand and official seal.My Commission expires the 30th day of June, 2011. `Mane C. Tetreault, Notary Public 58440-4-09 Printed in U.S.A. City ®f Huntington Beach 2000 Main Street ® Huntington Beach, CA 92648 OFFICE OF THE CITY CLERIC JOAN L. FLYNN CITY CLERK March 7, 2011 Sequel Contractors, Inc. 13546 Imperial Hwy. Santa Fe Springs, CA 90670 RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Citi(gs#o lc6pa vtet ta6w.eocNew Zealand (Telephone: 71 4-536-5227 ) k. 3. 5Is61: f$dl H . Solta R 5 �' igs, A i70 2010 NM'., 7 -15 ��.11� 5/ s City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowle ge receipt and review of Addendur Com ny N me Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. t SEQUEL CONTRACTORS, INC. SECTION C e _i S el [/� P �Ji�E`L.O PROPOSAL for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO.1372 FEDERAL AID PROJECT ESPL-5181(168) 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 50 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enterinto a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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 SEQUEL GONTRACTORs, INC proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. BIDDER'S BOND Accompanying this proposal of bid, find in the amount of $ 10'4 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). LM 1 11 .r _. I _1-_11 A 77___9_1_---- _'D_.__.. C-2 PROJECT BID SCHEDULE - GarFeid CC-1372 SEQUEL CONTRACTORS. INC SECTION C PROJECT BID SCHEDULE GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET CC NO.1372 FEDERAL AID PROJECT ESPL-5181(168) PROJECT BASE BID: GARFIELD AVENUE — from Newland Street to Magnolia Street C-2.2 t® C-2.4 BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: r�51�,343\.js BASE BID WILL BE THE BASIS OF AWARD C-2.1 PROJECT BID SCHEDULE - Gafeld GG-1372 DUEL CONTRACTORSO INC ":;` teiti: vitii:-uiaif'''ir ce::;::` ::::::::::::::::<:::?::'::;::: <:::::::=;:::::>.::::?<:::.... .•...........•.•.•.•.•..•.•...•.-.•...-....•.•..•.•.:..•:•:•..•:•..• .. :-:.:E tieiideil::.:_: .................... . .. . rit>€' ........... 1 1 LS Mobilization EP7 i —lv %M®�sSy4N� $ZS0 00. 2 1 LS Traffic Control PI 6 ix 3 1 Ls Furnish Project Traffic Control "ice t V $ 4 470 CY Unclassified Excavation (includes disposal of material and fabric) /11;" lle6 4Z $ $� S 139890 SF Pulverize, Remove excess, Grade, Cement Treat, Microcrack by FDR Process (includes di osal) $ $ ' /1// V G x , v� / v 6 55530 SF Surface Grind (0.17) (includes diposal of materal and fabric) /� e $ $ " 7 3265 T1•1 Construct Asphalt Concrete 0.25' & 0.75' per plan) s 1 XT`'i I J VF _LA PC%ti� $ F1 V q C,E7/i i s 8 2560 TN Construct Asphalt Concrete (0.17' ARHM Overlay) S�V EN '� C. i HT D(3 L �R.S $-7 $ 191 (0 9 1845 LF Remove & Reconstruct rb & Gutter (CF=8", Includes AB) per Std Plan 202 /� '// /, $ QC! $ 10 370 Remove existing sidewalk (includ s disposal)SF ,1,1,5 -a Ile 11 7000 Remove & Reconstruct Sidewalk per Std Plan 207 (includes disposal) D Remove and Reconstruct Commercial Driveway per HI3 Std. Plan 12 500 SF 211 (including all appurtenances but not limited to: onsite improvements, retaining cur , lot pave, etc.) $ —14 r� i ®n C-2.2 PRO.IT,C'T RID CC:URDUI R _ Garfield CC-1372 SWUEL TO AI ;gym n a a ::::::::: >:::=:::::::::item.whiiii a: -Ate':;:;:,:::;:::::::.:::.:::::.::::::::::::::::.:::.:::::::::.:.:::.::::>:::> ...•.•...•P.-.....-.•.•...•.•.•.•.-.•.•.•..•..•.•..•..... . 1i ; aid:.::: .•...•......•.•.•..•............•.:. ��:1`+�a,:;� :,:!Q?tia�#i.: •.; ,...:.:...........•................................ :�>::>:::�:�:::�`:�:vvrit��'<t:=���'�Yo�'�s:.:.:::.:::.:.::::::::.::::::.:.::: :::::::�: . U�.. �'. r..... ... � ..�� . t... . 13 2 EA Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, slot pave, etc.) Cllx9�1-6altrans td. A88A $� $ �/O 14 3 EA Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, slot pave, etc.) per Foun 'n Valley Std. 204.3, Case' _� .4204 $ i $ lab _2ft 15 1 EA Install Truncated Domes to existing access R L 16 13 EA Adjust rrm�ain Manhole to finished surf U�'ItVYj�cl/ ���� ✓ x 17 1 EA Adjust OCSD SewerManhole to finished surface r-evir $ � $ 18 11 EA Adjust City of HIi Fater Valve to finshed surface / d $ $ 19 112 EA Adjust Ci of-Fou ta�inn�V%alley Water Valve to finish surface 20 1 EA Adjust Monitoring Wel to finished surface 21 4 EA Raise Survey Mo ument Well to finished surface / A—/^$ w' $ � 22 Suuyey�Menume"ea-City to Provide Survey Monumentation (Not a Bid Item) _ EA $ $ 23 14 Remove existing Tree and Roots; Grind Tree Stump and roots to 24" below Top of dewalklGrade �%jylj� $ 1(2J 24 14 EA Furnish & Plant 24" box trees (remove existing landscaping and irrigation to accommodate 24" box trees, re l irrigation in kind) ,y )LIZ IIK lit ORS, INC 9 C-2.3 PROJECT BIND SCHEDULE - Garfield CC-1372 Tteiri ES#iirnai i :::::: , :]�terii: vit i:'mitt:..a ice ::::::::::::::::........... ... . ...........::::� :�Fo::�::=:Q>lE�titkC�:::=:�:�:�:•:•:•:;:�:::• :::::::::::::Vie>r�tteltt�iu;�fr�'c�9�:;:�:�: ::::::;:::;:::::=:�.. ::.......:..:::::::::::::.>: . ' ' '�. .. .....•.;1 d1i2 25 1 LS Provide 94 Day Plant tablish ent $ $ 26 LS Provide 1 Year Maintenan $ 27 1 Traffic Sig ing and Striping p plan 28 22 EA lns T is Loops �jy�� $ 30 $ f 29 1 LS Traffic Si al P llbox and el cati d Conduit Tnstallat' f: /� $ $ �— 30 1 LS Median nose reduc "on and cross aIk modification per Appendix S in Speciflcati . v $ (�� $ — Total Amount Bid in Figures: $ S(9 3 a ----- Total Amount Bid in Words: E_l�''N.7'._ yND ?:`_1..51_K. .......... 1 VN Ao�-t�stRS- r'� ri vC c-C-1j ma's C-2.4 SEQUEL CONTRACTORS, INQ, SECTION C In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Potiari Name find AddYess of Snlicortractor. Si o ,Work. Via RkC'TRI C AAAW ek" PPaS Mi24 (.. PER IvR ,e License �Ll,filllCP ;. �� l/twg I-rstzc A&A H L )v" I 1 II By submission of this proposal, the Bidder certifies: That he is able to and will perforrn the balance of all work which is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. 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 President of SEQUEL CONTRACTORS. INC 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 conferencewith 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. thomas S. • ck President 13546 IMPERIAL HWY. SANTA FE SPRINGS, CALIF. 90-570 Address of Bidder Subscribed and sworn to before me this day of .`: p~, 201 C-4 �.> ,�s�.�S�.a.'.,.:�>•,�T. �.,: aS .,,: �> C�>,?�>,s�.,�. H.., v, :a c�.S>•,?a.,�U�.C�e�.•,�v .,�,,a.wa4�.�ax..ca.a ,z�s,.ca .�a. .c�R,. » 0,3 State of California County of LOS ANGELES On INOv o 4 2010 before me, Daniel Eustarnanter Notary Public Date Here Insert Name and Title of the Officer personally appeared Thomas S. Pack President Name(s) of Signer(s) 0000@OOOOAA00AOAOA0000000000A000000A@@00000 DANIEL BUSTAMANTE o `- f A- �m 0 4 COMNi. #1825827 �.' NOTARY PUBLIC - CALIFORNIA C) �LOS ANGLLE:S COUNTY iA0@AOA0AA000040A0@00A00000000000A@r0@G@0144� who proved to me on the basis of satisfactory evidence to be the person(A whose name(x) is/Am subscribed to the within instrument and acknowledged to me that he/sbe/4ep executed the same in his/he#ftir authorized capacity(ies), and that by his/heOtheir signatureX on the instrument the person(, or the entity upon behalf of which the personoo acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official se Signature _PL�0451 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: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer— Title(s): — El Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER 17 Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in_ Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT' OF SIGNER 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationaiNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 NOTARY PUBLIC UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL, CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall -be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: SEQUEL NTPACT RS, INC r*B Thomas S. Pack President Title C-5 SEQUEL 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. Date: NOV 0 4 2010 SEQUEL CONTRACTORS, INC Thomas S. Pack Presid Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: �SEQ1JEL. CONTRAC TOSS. INn Bidder Name 13546 IMPERIAL HVW. SANTA FE SPRINGS, CALIF, ,�.�T) Business Address 13546 IMPERIAL HVVV. SANTA FE SPRINGS, CALIF. 67f) City, State Zip ( (552) S02 7227 Telephone Number State Contractor's License No. and Class ) /-3 jjq I Original Date Issued Expiration Date The work site was inspected by Thomas S. Pack of our office on d Z , 2010 . The following are persons, firms, and corporations leaving a principal interest in this proposal: Thomas S. Pack President Abe! Magee, V.P. & rOtM- ; 1 . , Lam, . SEarr-um SEQUEL CONTRACTORS, INC C-s The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. SEQUEL C RACi _ thin SiVaturd'of Bidder Thomas S. Pack President Printed or Typed Signature Subscribed and sworn to before me this ____ day of , 201_ . NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. 9 Name and -Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Name and Address of Public Agency 10 Name and Telephone No. of Project Manager: Date Completed Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENTsa. A State of California County of LOS ANGELES On N OV o 4 2010 before me, Daniel Rustamante, Notary Public Date Here Insert Name and Title of the Officer personally appeared Thomas S. Pack President Name(s) of Signer(s) A0000000000000000@00A0000000A0000000000000A DANIEL BUSTAMAN I E 0 COMM, #1825827 .. 7 NOTARY PUBLIC - CALIFORNIA p LOS ANGELES COUNTY My Commission Expires December 20, 2012 4 ♦00000A000AAA000000000000000000000000000000 who proved to me on the basis of satisfactory evidence to be the personA whose name(i is/W subscribed to the within instrument and acknowledged to me that he/sheAbep executed the same in his/he#"ir authorized capacity(ies), and that by his/efr signature(,) on the instrument the personX, or the entity upon behalf of which the personlo acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my h d and official se Signature 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: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): — El Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing RIGHTTHUMBPRIN7 OF`SIGNER .. of thumb here Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in_ Fact -❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNERS _ 02007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 • www.NationalNotaryorg Item #5907 Reorder: Call Toll -Free 1-800-876-6827 SEQUEL CONTRACTORS9 INC. ST. LIC #610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 502-7499 (562) 802-7227 Office ACTION BY UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTOS OF SEQUEL CONTRACTORS, INC. The undersigned being all of the Directors of SEQUEL CONTRATORS, INC. a California Corporation, do hereby take the following action by this written consent at a meeting of the Board of Directors held on April 4, 2004 in accordance with the Bylaws of the Corporation and the California Corporation Code. WHEREAS, the Board of Directors deems it advisable to authorize the officers of the Corporation, Abel Magallanes, Thomas S. Pack and Michael A. Mahler, respectively, to execute bid bonds on behalf of the Corporation with any agency, person, company or municipality; RESOVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler are authorized to execute labor, material, and faithful performance bonds in connection with contracts to be entered into with any agency, person, company or municipality; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler are authorized and directed to execute and deliver street improvement contracts and related agreements with any agency, person, company or municipality on such terms conditions as they deem advisable in their sole discretion; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler be, and they hereby are authorized by their sole signatures on any document to bind this corporation to contract, bids, bonds, etc.; RESOLVED FURTHER, that Abel Magallanes, Thomas S. Pack and Michael A. Mahler be, and they hereby are authorized and directed to take any and all such other actions and execute such other documents as may be necessary or appropriate to carry out the purposes of the foregoing authorizations. In witness thereof, the undersigned Directors have executed this unanimous written consent to indicate this adoption of the consent of the foregoing resolution and the action set forth therein. Dated: AnfiL84.2004 & President Michael A. Mahler Assistant Secretary Abel MigaiWfies Director, Vice President & Secretary SEQUEL CONTRACTORS9 INC. ST. LIC #610600A 13546 IMPERIAL HWY SANTA F'E SPRINGS, CA 90670 Fax (562) 502-7499 (562) 802-7227 Office 2 3 4 5 STATEMENT OF EXPERIENCE OWNER: CITY OF ANAHEIM ADDRESS: 200 S ANAHEIM BLVD ANAHEIM, CA 92805 PHONE NO.: (714) 765-5285 CONTACT: ROBERT PALAEOLOGUS PROJECT: KATELLA AVE SMART STREET PROJECT AMOUNT: $4,087,034.75 COMPLETION DATE FEBRUARY 2010 OWNER: CITY OF GLENDALE ADDRESS: 633 E. BROADWAY GLENDALE, CA 91206 PHONE NO.: (818) 937-8250 CONTACT: ARMOND SIMONIAN PROJECT: COLORADO STREET WIDENING PROJECT AMOUNT: $1,926,471.00 COMPLETION DATE DECEMBER 2009 OWNER: PORT OF LOS ANGELES ADDRESS: 925 S. PALOS VERDES STREET SAN PEDRO, CA 90731 PHONE NO.: (310) 732-7634 CONTACT: JILL SHIMAMOTO / BRIAN CHUC PROJECT: SAN PEDRO WATERFRONT ENHANCEMENTS PROJECT AMOUNT: $6,636,700.00 COMPLETION DATE DECEMBER 2009 OWNER: CITY OF SANTA MONICA ADDRESS: 1437 4TH STREET SANTA MONICA, CA 90401 PHONE NO.: (310) 458-8732 CONTACT: ALLAN SHETH PROJECT: ANNUAL STREET, SIDEWALK MAINTENANCE PROJECT AMOUNT: $8,259,040.00 COMPLETION DATE SEPTEMBER 2009 OWNER: CITY OF HAWTHORNE ADDRESS: 4455 W. 126TH STREET HAWTHORNE, CA 90250 PHONE NO.: (310) 349-2997 CONTACT: ALAN LEUNG PROJECT 135T" STREET RECONSTRUCTION PROJECT AMOUNT: $803,068.00 COMPLETION DATE SEPTEMBER 2009 SEQUEL CONTRACTORS9 INC. ST. LIC #610600A 13546 IMPERIAL HWY SANTA FE SPRINGS, CA 90670 Fax (562) 502-7499 (562) 802-7227 Office STATEMENT OF EXPERIENCE 6. OWNER: CITY OF INDUSTRY ADDRESS: 255 NORTH HACIENDA BLVD. INDUSTRY, CA 91744 PHONE NO.: (626) 333-0336 CONTACT: GERRY PEREZ PROJECT: AZUSA AVE / RAILROAD STREET. WIDENING PROJECT AMOUNT: $3,884,998.75 COMPLETION DATE SEPTEMBER 2008 7 8 9 OWNER: CITY OF WESTMINSTER ADDRESS: 8200 WESTMINSTER BLVD. WESTMINSTER, CA 92683 PHONE NO.: (714) 898-3311 CONTACT: JAKE NGO PROJECT: WESTMINSTER BLVD. MEDINA ISLANDS PROJECT AMOUNT: $2,157,180.00 COMPLETION DATE FEBRUARY 2008 OWNER: CITY OF COSTA MESA ADDRESS: 77 FAIR DRIVE COSTA MESA, CA 92628 PHONE NO.: (714) 754-5223 CONTACT: TOM BANKS PROJECT: 17T" STREET BEAUTIFICATION PROJECT AMOUNT: $2,801,689.75 COMPLETION DATE OCTOBER 2007 OWNER: CITY OF RANCHO PALOS VERDES ADDRESS: 30940 HAWTHORNE BLVD. RANCH PALOS VERDES, CA 90275 PHONE NO.: (310) 544-5252 CONTACT: BINDU VAISH PROJECT: ANNUAL STREET MAINTENANCE PROJECT AMOUNT: $1,500,000.00 COMPLETION DATE DECEMBER 2005, 2006, 2007 10, OWNER: ADDRESS: PHONE NO.: CONTACT: PROJECT PROJECT AMOUNT: COMPLETION DATE CITY OF DOWNEY 11111 BROOKSHIRE AVE. DOWNEY, CA 90241 (562)904-7118 NOE NEGRETE LAKEWOOD BLVD. IMPROVEMENTS PHASE 1 A $6,274,630.00 AUGUST 2006 SEQUEL CONTRACTORS9 INC. ST. LIC #610600A 13546 IMPERIAL. HWY SANTA FE SPRINGS, CA 90670 Fax (562) 802-7499 (562) 802-7227 Office II 12 13 14 15 STATEMENT OF EXPERIENCE OWNER: PORT OF LONG BEACH ADDRESS: 925 HARBOR PLAZA LONG BEACH, CA 90802 PHONE NO.: (562) 590-4172 CONTACT: GARY CARDAMONE PROJECT: PIER E BERTH D28-E27 NEW GATE PROJECT AMOUNT: $6,279,157.00 COMPLETION DATE APRIL 2006 OWNER: CITY OF TUSTIN ADDRESS: 300 CENTENNIAL WAY TUSTIN, CA 92780 PHONE NO.: (714) 573-3030 CONTACT: DENNIS JUE PROJECT: IRVINE & NEWPORT INTERSECTION PROJECT AMOUNT: $4,034,000.00 COMPLETION DATE APRIL 2006 OWNER: CITY OF SEAL BEACH ADDRESS: 211 EIGHTH STREET SEAL BEACH, CA 90740 PHONE NO.: (714) 431-2527 CONTACT: RAYMOND VELASCO PROJECT: VARIOUS STREET IMPROVEMENTS PROJECT AMOUNT:- $917,329.50 COMPLETION DATE AUGUST 2006 OWNER: CITY OF LAGUNA BEACH ADDRESS: 505 FOREST AVE. LAGUNA BEACH, CA 92805 PHONE NO.: (949) 497-0345 CONTACT: FRED SHAHIDI PROJECT: VARIOUS DOWNTOWN STREET IMPROVEMENTS PROJECT AMOUNT: $791,357.15 COMPLETION DATE JANUARY 2006 OWNER: CITY OF ANAHIEM ADDRESS: 200 S. ANAHIEM BLVD. ANAHIEM, CA 92805 PHONE NO.: (714) 765-5776 CONTACT: CHUCK SMITH PROJECT: LINCOLN & STATE COLLEGE. INTERSECTION PROJECT AMOUNT: $1,757,836.00 COMPLETION DATE AUGUST 2005 SEQUEL CONTRACTORS. INC BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of S tion 3 of CFR Part 135 of the HUD Act of 1968; or rll hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: SEQUEL CONTRACTORS, INC. Contact Person: Thomas S. P; k President Contact Phone: Signed: Date: S. Pack President ','Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 RELIABLE CONTRACTOR DECLARATION (page 1 of 3) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalReeycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of fiends to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalReacle.ca.gov/RegLilations/Titlel4/. Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: GRANT NUMBER: PRIMARY CONTACT NAME: CONTRACTOR INFORMATION CONTRACTOR NAME: ,�"+ � (1 ` 0g`i'\ ,.` , .: "+'a.k.��V+s•, � �,.i'a!d a aA aka? 16.ri AUTHORIZED CONTRACTOR REPRESENTATIVE NAME:Thomas S. Pack MAILING ADDRESS: As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the abavqidentfed contractor. Sign tureMin U. C-11 ...;: il: .a� ;sI, w-UYt RELIABLE CONTRACTOR DECLARATION (page 2 of 3) x, Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, -that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, -any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by -the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 19304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C-12 (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXEC UTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder 59QUEL CONTRACT01 . 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 mustbesubmitted by bidders and proposed subcontractors only in connection -with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts - and subcontracts which are exempt from the equal opportunity clause -are set forth in 41 CFR 60-1-5.._ (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is -the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-14 March 15, 2001 PUBLIC CONTRACT COTE Public Contract Cade Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has ,has not be convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract -Code Section 10162 (questionnaire to conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of pei jury, the following questionnaire: Has the bidder, any officer of the -bidder, or any employee of the bidder -who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes No _,V_/ If the answer is yes, explain the circumstances in the following space. C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shalt also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-16 SEQUEL CONTRACTORS 1 Local Assistance Procedures Manual HIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of LOS ANGELES DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bird are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP Oi-04 C-17 March 15, 2001 $EQUE.°® CONTRACTORS, INC Local Assistance Procedures Manual EXHIBIT 12-E PS&E Cheeldist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: ® Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page12-83 LPP 01-04 C-18 March 15, 2001 $.EQUEL CONTRACTORS, INC Local Assistance Procedures Manual EXHIBIT 12-E PS&E Cheeldist Instructions Attachment F NONLrOBBYING CERTIFICATION FOR FEDERAL. -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-19 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: Ea. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 3. Report Type: a. initial b. material change For Material Change Only: year_ quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, -last name, first name, MI) address if different from No. 10a) // (last name, first name, MI) r 0� Al1A- (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) 5 actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission 8 a. cash d. contingent fee b. in -kind; specify: nature a deferred value ET 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 I I- J(/ove- (attach Continuation Sheet(s) if nece ry) 15. Continuation Sheet(s) attached: Yes No 16. Information requested through this form is authorimd by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance SignatL was placed by the tier above when his transaction was made k or entered into. This disclosure is required pursuant to 31 Prit Nam a " U.S.C. 1352. This information will be reported to Congress — semiannually and will be available for public inspection. Any Title: 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 F�a��� $100,000 for each such failure. telephone No.: � ate: WIN 1 Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Form LLL Rev. 09-I2-97 2njo Page 12-87 LPP 01-04 C-20 March 15, 2001 SEQUEL CONTRACTORS, INC EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB)-number,grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check ail boxes that apply. if payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. Page 12-88 March 15, 2001 C-21 LPP 01-04 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-UL-Instructions Rev.06-04-90«ENDIF» Page 12-89 LPP 01-04 C-22 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 15-GI Local Agency Bidder UDBE Commitment (Construction Contracts) EXHIBIT 15-GI LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) NOTE:: 'PLEASE REEFER TO /INSTRUCTIONS ON THE REVERSE SIDE OF THIIS -FORM LOCAL AGENCY; N � �� /�/11M7 . lnn. LOCATION: dr<j�Y�r� /J�"`' 7-1 PROJECT DESCRIPTION: /G 1 / �/', 6�/��/ / TOTAL CONTRACT AMOUNT: $ BID DATE: NOV 0 4 2010 BIDDER'S NAME: QUE'LrCON RA`p-s �T R' o INC CONTRACT UDBE GOAL: J 0 ao/O CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a UDBE) UDBE CERT NO. AND EXPIRATION DATE NAME OF EACH UDBE (Must be certified on the date bids are opened - include UDBE address and phone number) DOLLAR AMOUNT UDBE For ]Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all UDBE certifications have been verified and information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code)'felepltone Number: Total Claimed UDBE Participation goo S q5,'�2 �---_ �. ig e e i V 1 4 MO 5e 21 _ 0nGv7 Date (Area Code) Tel. No, Thomas S. Park silo Person to Contact . (Please Type or Print) Local Agency Biddcr UDBG Commitment(Constraction Contracts) (Rcv 6t26/09) Distribution: (I) Original —Local agency files Page 15-31 LPP 09-02 C-23 July 31, 2009 EEQUE CONTI CTORS, pjG . EXHIBIT 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER UDBE COMMITMENT (CONSTRUCTION CONTRACTS) I ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1) African Americans; 2) Asian -Pacific Americans; 3) Native Americans; 4) Women. This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the bid nonresponsive A UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: African Americans, Asian -Pacific Americans, Native Americans, or Women. The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract Item Number and item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. Prime contractors shall indicate all work to be performed by UDBEs including, if the prime is a UDBE, work performed by its own forces, if a UDBE. The. UDBE shall provide a certification number to the Contractor and expiration date. Enter the UDBE prime's and subcontractors' certification numbers.The form has a column for the Names of UDBE contractors to perform the work -(who must - be certified on the date bids are opened and include the UDBE address and phone number). IMPORTANT: Identify all UDBE firms participating in the project regardless of tier. Names of the First -Tier UDBE Subcontractors and their respective items) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the UDBE participation dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished -by -the UDBE, describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of UDBE firms. Exhibit 15-G1 must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. Page 15-32 July 31, 2009 C-24 LPP 09-02 Local Assistance Procedures Manual EXHIBIT 15-G2 Local Agency Bidder DBE Information (Construction Contracts) EXHIBIT I5-G2 LOCAL AGENCY BIDDER DBE INFORMATION (CONTRUCTION CONTRACTS) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER %TO (INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: 6X ONM!/`I�i 'e"I _ LOCATION: :�// PROJECT DESCRIPTION: TOTAL CONTRACT AMO BID DATE: ''yyOV (( O 4 2010 pp� qua BIDDER'S NAME: e)r-QUE" CON i RACTURS, INN CONTRACT UDBE GOAL: e. 37 ('P CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if a idde 's a DBE DBE CERT NO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT DBE For Local Agency to Complete: Local Agency Contract Number: Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certification have been verified and Information is complete and accurate. Print Name Signature Date Local Agency Representative (Area Code Telephone Number: Total Claimed DBE Participation $ qA5 052, • Z s— o /o ature of dder N 0 2010 4�s�� ��2- TgaDa}t�e t1� (Area Code) Tel. No. S omas s. Pack" Pmlderg For Caltrans Review: Print Name Signature Date Caltrans District Local Assistance Engineer Person to Contact (Please Type or Print) Local Agency Bidder DBE information (Constmction Contarcts) (Rev WN09) Distribution: (I) Copy —Fax or scan a copy to the Caltrans District Local Assistance Engineer (DLAE) within 15 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de -obligation of funds for this project. (2) Copy — Include in award package to Caltrans District Local Assistance (3) Original — Local agency files Page 15-32a LPP 09-02 C-25 July 31, 2009 EXHIBIT 15-G2 Local. Assistance Procedures Manual Local Agency Bidder DBE Information (Construction Contracts) INSTRUCTIONS - LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract UDBE Goal. The form has a column for the Contract item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces, if a DBE.The DBE shall provide a certification number to the Contractor and expiration date. Enter DBE prime and subcontractors certification number. The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work (must be certified on the date bids are opened and include DBE address and phone number. IMPORTANT: Identify all DBE firms participating in the project --including all UDBEs listed on the UDBE Commitment form (Exhibit 15-GI), regardless of tier. Names of the First -Tier DBE subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar --amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section ""Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts) to determine how to count the participation of DBE firms. Exhibit 15-G2 must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Number, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within- 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de -obligation of funds on this project. District DBE Coordinator should verify that all informations is complete and accurate. Once the information has been verified, the District Local Assistance Engineer signs and dates the form. Page 15-32b July 31, 2009 C-26 LPP 09-02 Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort EXHIBIT 15-H UDBE INFORMATION --GOOD FAITH EFFORTS UDBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. SOL �S/ /�/Gp� Bid Opening Date NOV® 4 2010 The (City/County of) established an Underutilized Disadvantaged Business Enterprise (UDBE) goal of _C13% for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder UDBE Commitment" form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a UDBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications k Dates we e h to. gid /0%7JT//0 B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of UDBEs Solicited Date of initial Follow Up Methods and Dates Solicitation 16VATAWS Page 15-33 LPP 09-02 C-27 July 31, 2009 Exhibit 15-H UDBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to UDBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Performs Item Items Amount Percentage M Of Contract D. The names, addresses and phone numbers of rejected UDBE firms, the reasons for the bidder's rejection of the UDBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection .of the UDBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: �t OV 'stu...-4 40 /t u.1 Page 15-34 July 31, 2009 C-28 LPP 09-02 S&EQUEL CONTRAC 013a, IN Local Assistance Procedures Manual Exhibit 15-H UDBE Information - Good Faith Effort F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: See o�� ��/�e-c o icy K G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-02 C-29 July 31, 2009 SEQUEL CQUI � Whoa*,, Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LOST" OF SUBCONTRACTORS (DBE and NON -DBE)- PART 1 The bidder shalt list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency Pile ragV'LL-111 LPP 06-06 November 14, 2006 SEQUEL GQN1 (,Ah4��., Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency Pile Page 12-111 LPP 06-06 November 14, 2006 SEQUEL GONTMGTOR% INC, n W N EXHIBIT 12-C Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART If The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title en n__.:__ 11E ..F.U- n„de ..Fte.7e..nl Uomilnrinr.c AhnMnnnv this fnrm fnr neiditinnal firma. iii�►1�+r=9�N11f•�i�i�I��na-i•L.�7 ���Z riii! Name/ City, State, ZIP _ MI _ _ N �� ' 1 1 1 � 1 1 1 1 l t ' ',}�ng7d)71h ?� {9 'Firm iCl,?t"�n 17jjri 7!*7r"� i-t �Gsu{' I II } .l �� AF�fl�i l{]�li t fIS f#1 K �;i}",gSsrt` Itl«°l�a:'lirri?..av rISP.t.i`s1 iu''' 1 • t� (� ��TVPlfr•31��3i�iS�� ��r ni'. '@ i I J,;, iatS fM1 �r'+ ;if 10 r t sty zsIr .. Snfr / ,rft�rl+}snl 11111111111111151 j�{K; ;I ! is �} d r s ��, t, t+ 3 WINid rn•'f' a4 >� ' 'ti,�aa�'}. S J+ s'a�s�tr((r�rF t � .�� �,,rz ��(�7N � jjii{f�,�'>���{�3$�Ys�j, {{#jj(��}}l�1(jj'',, �itFFlttti!]]�; �V12e'ratarh�'It]�1Y J.....`"iL? is kF,� Wi a7�n 3to;i ti r Fi` S 3 °er ,tti s t,4 �icfa ,�h srb+a ii' f`iG� 'n+l6itr'`i. +��M 'it RTi'a�O c�l+� f B", t tN,.U`i !E {I!_ ( i SiJi�t 1„ ��0t Ub '� 7 �r f r���h4-r Yi frig � j <g r,•. 4`iy J� 1p ,hF1Ld1�7cU>�#lIi[i$414ii ' �} i«7(7G3s{i .. - - � - - f I citl>Y t. 7 ��rl }i . +f Distribution: 1) Onginal —Local Agency File Page 12-112 LPP 06-06 November 14, 2006 SEQUEL WWRAG-folia. INC, EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART If The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Firm Name/ Address/ "Afifitial.. .���r'Yiti�^11.51 Cit Weeipts a�[trv%�' �eY9Jn311 11<%u ,,pp�u'Sp - ^tiyy'1`.,;..tc....s.,. - ; 1+�2ti'1'�' •'{'i t,{k is 4ti,i2, OF• _ _ ' 2 ''• ' a t 1 I • i , 1�j�S L,} �9 hA^iiYai ?- • . � ryrye�``;; f21'{i a"l 4{;¢� ti4 1 tSI .{!S ■ 2 s �'lutF4 zz14�`�t" ' �Yk }�T�•l,�S{, i�21y�.St`Z"p�R�l2tjl:�1�7?f��i�:y I a a'. �� 1 � d ef�tt ''3`t i`2il�it{ii i• } � j y tU�l j S�sa � )t m�t y5'v'°fili p� . I � � , 'il Distribution: 1) Onginal — Local Agency File Page 12-112 LPP 06-06 November 14, 2006 Page 1 of 2 Mike Mahler From: The Weekly Bid Flash [support@theweeklybidflash.com] Sent: Friday, October 29, 2010 4:30 PM To: Mike Mahler Subject: Weekly Bid Flash DBE Ad Affidavit - Garfield Avenue Rehabilitation Project, Newland to Magnolia Proof ®f Publishing Affidavit To Whom It May Concern: Be it known that this is a sworn affidavit that Sequel Contractors did place an advertisement we published on 10/30/2010 in our nationwide publications, Construction Star, Inc. and The Weekly Bid Flash, seeking Certified Disadvantaged subcontractors and/or material suppliers for the project Garfield Avenue Rehabilitation Project, Newland to Magnolia. A copy of the advertisement is below: Date Of Advertisement Placement: 10/29/2010 4:29:33 PM Sequel Contractors An Equal Opportunity Employer, is requesting quotations from all qualified DBE,UDBE,MBE,WBE sub -contractors and material suppliers for the following project: Garfield Avenue Rehabilitation Project, Newland to Magnolia City/Location: Huntington Beach County: Orange Owner: City of Huntington Beach Bid Date: Thursday 11/4/2010 at 2:00 PM We are requesting bids for the following trades and/or supplies: SUB -BIDS AND SUPPLIERS FOR BUT NOT LIMITED TO: ELECTRICAUSTREET LIGHTING, EARTHWORK, ASPHALT CONCRETE, CRUSHED MISCELLANEOUS/AGGREGATE BASE, STRIPING, EQUIP. RENTAL, TRUCKING, LANDSCAPE & IRRIGATION, SITE CONCRETE (CURB, GUTTER, SIDEWALK), SOIL STABILIZATION, UTILITY ADJUSTMENTS NAICS Classifications Sector 23--Construction Sector 81--Other Services (except Public • All Other Specialty Trade Contractors Administration) • Electrical Contractors • Professional Organizations • Highway, Street, and Bridge Construction • Other Heavy and Civil Engineering Construction CSI Classifications DIVISION 1 - GENERAL DIVISION 2 - SITE WORK • CONSTRUCTION EQPT- SALES LEASE RENTAL • ASPHALT CONCRETE PAVEMENT AND REPAIR BASE • MARKETING/PUBLIC RELATIONS • ASPHALT PAVING • TRUCKS -- DUMP/TRAILERS • CEMENT SOIL STABILIZATION • CONCRETE CURBS/GUTTERS • CONCRETE REMOVAL e DEMOLITION • EARTHWORK • IRRIGATION SYSTEMS e LANDSCAPING e PAVEMENT MARKING • PAVING/SURFACING • TRAFFIC SIGNALS Bid documents can be viewed at or obtained from: 11/4/2010 Page 2 of 2 SEQUEL CONTRACTORS, INC. 13546 IMPERIAL HWY. SANTA FE SPRINGS, CA 90670 (562) 802-7227 FAX (562) 802-7499 CONTACT: MIKE MAHLER CALL FOR APPOINTMENT Sequel Contractors 13546 Imperial Hwy Santa Fe Springs, CA 90670 Phone: (562) 802-7227 Fax: (562) 802-7499 Mike Mahler mmahler@sequel.mpowermail.com Published on 10/30/2010 5:00:00 PM by The Weekly Bid Flash and The Construction Star Trade and Focus Publications located at www.theweeklybidflash.com and www.constarl.com Phone:1.800.479.5314 Fax:1.619.688.0585 This solicitation Ad will run until the bid date Our publication is a listed approved source by the State of CA , Dept. of General Services, Office of Small Business Certification & Resources, in its Resource Packet. Since, 1989 our firm has been proud to help businesses reach Certified Disadvantaged firms statewide. If you should need any further information, please do not hesitate to contact us at 858-777-6889. Thank you again! The Weekly Bid Flash 4420 Hotel Circle Court #215 San Diego, CA 92108 www.theweeklybidflash.com 858-777-6889 V° " 11/4/2010 Page 1 of 3 Date: 10/29/10 - 4:45:41 PM From: "Sequel Contractors, `Mike Mahler Related To: Garfield:Avenue'Rehabilitation'Project,""Newland to Magnolia Subject: REQUEST SUB BIDS"FOR Message: Recipients . " Phone Method Fax - ; Date°Sent Number -Number �=:.Status 1 "-A W ELECTRIC - ANDRE WHITMORE Fax (323) 751- (323) 751; " Fax 10/29/2010, 1717 0717" Sent 4:45:40-PM 2 ACCU Construction, Inc:"- Dennis Yum Email (951) 657- 10/29/2010 8200 4:45:40 PM 3 AJK Communications- Kiran"Kaur Fax (562-) 942- ;(562)'94.2- . Fax 10/29/2010 1400 1800 -Sent 4:45:41 PM.""' 4 AJK"Communications -.-Kiran Kaur Email (562):942=" 10/29/2010 1400 4:45:40 PM 5 Baja"Tr-ucking, Inc. - Ana Diaz Fax (951) 488-- (951) 2477 Fax 10/29/2010 0012 9616 Sent 4:45,41-PM 6 "Baja Trucking, Inc. - AnazDiaz Email (951) 488- 10/29/2010 0012 4:45:40 PM 7 CALMEX ENGINEERING, INC"- RICHARD MONTIEL Fax (951.) 686- (951)-686-" Fax 10/29/2010 8613 °"8532 Sent- 4:45:40 PM- 8 CALMEX ENGINEERING, INC - RICHARD MONTIEL Fax (909) 686- (909)686- Fax 10/29/2010 4981 8532 Sent 4:45:40"PM 9 CALMEX ENGINEERING, INC - RICHARD MONTIEL Fax, (951) 686- (951) 686- ""Fax 10/29/2010 8613 9011 Sent 4:45:41 PM 10 "CALMEX ENGINEERING, INC RICHARD MONTIEL Fax (909)" 686- (909)-686- Fax' 10/29/2010. 8613 8532 Sent 4:45:41 PM 11 CALMEX ENGINEERING; INC - RICHARD MONTIEL Tax:" (951) 686- (951) 686- Fax A0/29/2010 8613 8532 Sent 4:45:41 PM 12 CALMEX ENGINEERING, INC" - .RICHARD MONTIEL Fax (909) 686- (909) 686- Fax 10/29/2010 " '8613 8532 Sent "4:45:41 PM` 13 CALMEX ENGINEERING, INC - RICHARD MONTIEL, Fax (909)"686- (909) 686- Fax 10/29/2010 8613 8532 Sent 4:45:40 PM 14 CALMEX ENGINEERING, INC - "RICHARD MONTIEL Fax, (909) 686- (909) 686- Fax 10/29/2010 8613 8532-" Sent 4:45:40=PM 15 CALMEX ENGINEERING, INC - Edward Valenzuela Fax (951) 686- (951) 686- Fax `10/29/2010 8613 x1l 8532 1 Sent 4:45:40 PM 16 CivilSource - amy amirani Email (949) 585=' 10/29/2010 0477 4:45:40 PM 17 DOR-SAN ELECTRIC - FRED EDWARDS Fax (909) 869- (909) 869"-" Fax 10/29/2010 6024 6584 Sent 4:45:41 PM 18 E.A. MENDOZA, INC. - Paul MENDOZA Fax (949) 789- (949) 789- Fax "Sent 10/29/2010 9100 :9109 4:45:41 PM 19 EAGLE ASPHALT CONSTRUCTION, INC. - Estimator Fax (909) 444- (909) 444- Fax 10/29/2010 5566 8311 Sent •4.45:40 PM 20 EAGLE ASPHALT CONSTRUCTION, INC. - Fax (909) 444- (909)"444- Fax 10/29/2010 WILLIAM RAMIREZ 5566 8311 Sent 4:45:41 PM 21 -EAGLE ASPHALT CONSTRUCTION, INC. - Fax (909) 444- (909) 444- Fax '10/29/2010 WILLIAM RAMIREZ 5566 8311 Sent 4:45:41 PM 22 EDT ENGINEERING - DAVEST ADAMS Fax (949) 598- "(949) 598- " Fax 10/29/2010 1900 1919 Sent 4:45:40 PM 23 Fine Grade Equipment, Inc. - John Baron Fax (661) 949- (661) 722- Fax 10/29/2010 8788 8900 Sent 4:45:40 PM 24 Fine Grade Equipment, Inc. - John Baron Email (661) 949- 10/29/2010 8788 4:45:40 PM http://www.ebidboard.com/reports/message_ detail. asp?routeguid= {E7C4177A-5F6B-4813... 11 /4/2010 Page 2 of 3 25 FITE CORPORATION - KATHLEEN FITE Fax (909) 623- (909) 623- Fax 10/29/2010 4133 0645 Sent 4:45:40 PM 26 FITE CORPORATION - KATHLEEN•FITE Fax (909) 623- (909) 623- Fax 10/29/2010 °4133 0645 Sent 4:45:41 PM 27 jfl :electric - jose torres Fax (323) 581- -(323) 581- Fax 10/29/2010 4400 4404 Sent 4:45:41 PM 28 jfl,electric - Jose Torres Fax (323) 581- (323)'581- Fax 10/29/2010 4400 4404 Sent 4:45:41 PM 29 jfl electric - Jose Torres Email (323) 581- 10/29/2010 4400 4:45:40 PM 30 jfl electric - -jose1orres Fax (323) 581- (323) 581- Fax 10/29/2010 -4400 4404 Sent 4:45:40 PM 31 jfl electric - jose torres fax (323) 581- (323) 581- Fax 10/29/2010 4400 4404 ;Sent 4:45:41 PM 32 jfl electric - jose torres Email (323).581- SO/29/201Q 4400 4:45:39 PM . 33 -jfl electric = jose torres Email -(323) 581- 10/29/2010 4400 4:45:40 PM 34 jfl-electric - jose torres Email '(323) 581- 10/29/20,10 4400 4:45:40 PM 35 jfl electric -_ dose torres Fax (323) 581- (323)-581- Fa,x 10/29/2010 4400 -4404 Sent 4:45:40:PM. 36 jfl electric - jose torres Email (323) 581- 10/29/2010 4400 4:45:39 PM 37 Lincoln Pacific Builders, Inc: - John Wong Email (626) 960- 10/29/2010 7738 4:45:40 PM . 38 Lincoln Pacific -Builders, Inc. - John Wong .Fax; (626) 960- ,(626) 960- Fax 10/29/2010 7738 7739, Sent 4:45:41-PM 39 MIRAMONTES -CONSTRUCTION COMPANY, INC - Fax (626) 330- (626) 330-: Fax'- 10/29/2010 MIRIAM MIRAMONTES 1043 5463 Sent 4:45:41 PM' 40 MIRAMONTES CONSTRUCTION COMPANY, INC - Fax (626) 330- (626) 330- Fax 10/29/2010' MIRIAM MIRAMONTES 1043 5463 Sent,- 4:45:40. PM, MIRAMONTES:CONSTRUCTION.COMPANY, INC - Fax (626) 330- (626) 330- Fax 10/29/2010 YVETTE MIRAMONTES 1043 5463 Sent 4:45:41'PM 42 -RMA Group - Ed Lyon Fax (909) 989- (909) 989- Fax 10/29/2010, 1751 4287 Sent 4:45:41 PM 43 RMA Group-- Ed Lyon Email (909) 989- 10/29/2010 1751 4:45:40 PM 44 RMA Group - Ed Lyon Email (909) 989- 10/29/2010_ , 1751 4:45:40 PM 45 SDR SURVEYING INC - Steve Richardson -Email (949) 554= `10/29/2010 4085 4:45:40 PM 46 SDR SURVEYING INC - Steve Richardson Fax (949) 554- (949) 542- 'Fax 10/29/2010 4085 - 7140; Sent '4:45:40 PM - 47 SDR SURVEYING INC - Steve Richardson Email (949) 554- 10/29/2010 4085 4:45:39 PM 48 SDR SURVEYING INC - Steve Richardson Fax -(949) 554- (949) 542- Fax 10/29/2010 4085 7.140 'Sent 4:45:40 PM 49 SDR SURVEYING INC - Steve Richardson Fax (949) 554- (949) 542- Fax '10/29/2010 4085 7140 Sent 4:45:40 PM 50 SDR SURVEYING INC - Steve Richardson Email (949) 554- 10/29/2010 `PM 4085 4:45:40 51 Triumph Geo-Synthetics, Inc - Maria Flores Fax (714)-237- -(714) 237- Fax 10/29/2010 . 1550 1549 Sent 4:45:40 PM 52 Triumph Geo-Synthetics, Inc - Maria Flores Email (714)-237' 10/29/2010 1550 4:45:39 PM 53 Triumph Geo-Synthetics, -Inc - Cissy McCaa Fax (714) 237- (714) 237- Fax 10/29/2010 1550 1549 'Sent 4:45:41'PM 54 Triumph Geo-Synthetics, Inc - Cissy McCaa Email (714) 237- 10/29/2010 1550 4:45:40 PM 55 TriumphGeo-Synthetics, Inc - Cissy McCaa Email (714) 237- 10/29/2010 1550 -4:45:40,PM 56 Triumph Geo-Synthetics, Inc - Cissy McCaa Email (714) 237- 10/29/2010 1550 4:45:40 PM 57 Triumph Geo-Synthetics, Inc - Cissy McCaa Fax (714) 237- (714) 237- Fax 10/29/2010 1550 1549 Sent 4:45:41 PM 58 WESTERN PAVING CONTRACTORS, INC - Estimator Fax (626) 338- (626) 338- Fax 10/29/2010 7889 3799 , Sent 4:45:41 PM 59 WESTERN PAVING CONTRACTORS, INC - Fax (626) 338- (626) 338- Fax 10/29/2010 Sean Huges 7889 3799 Sent 4:45:41 PM 60 WESTERN •PAVING CONTRACTORS, INC - Fax (626) 338- (626) 338- Fax '10/29/2010 http://www.ebidboard.comlreportslmessage_detail.asp?routeguid= { E7C4177A-5F6B-4813... 11 /4/2010 Page 3 of 3 Shawn Hughes 7889 3799 Sent 4:45:41 PM WESTERN PAVING CONTRACTORS, INC - 61 (626) 338- Fax (626) "338- Fax 10/29/2010 Shawn Hughes 7889 3799 Sent 4:45:41 PM WESTERN PAVING CONTRACTORS, INC-- 62 (626) 338- Fax (626) 338- Fax 1'0/29/2010 Jim Nelson 7889 3799 Sent 4:45:40 PM http://www.ebidboard.comlreportslmessage_detail.asp?routeguid=IE7C4177A-5F6B-4813... 11 /4/2010 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 Vigilant Insurance Company a corporation duly organized under the laws of the state of NeNv York 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 (S 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WITEREAS, the Principal has submitted a bid for Garfield Avenue 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 famished 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 1 st day of November , 2010 Witness (Seal) Name/Title Thomas S. Pack PresideM t\ Vigilant Insurance Company Surety (Seal) c Witness By. Timothy D. Rapp mey-in Fact ORSC 21328 (5/97) CALIFORNBA ALL-PURPOSE ACKN tO_Da .,%T> State of California County of LOS ANGELES On NOV 012010 before me, Dan►ef Rustamante, Notary Publlc Date Here Insert Name and Title of the Officer personally appeared Thomas S. Pack PreeWlent Name(s) of Signer(s) arse®a®c®?��o®sdP��gvm�en����e�m�rE.aac���� 4 DANIEL p comm. #i 827 NOTARY PUBLIC - CAUPOR:,IA t G'<t,ESCCUNlY Njy Ccmmissicn Esc:res ^ecer ler 2E 2D12 who proved to me on the basis of satisfactory evidence to be the personae(( whose name(x) is/�%m subscribed to the within instrument and acknowledged to me that he/sfa@Ahey executed the same in his/hefAheir authorized capacity(ies), and that by his/be64heir signatureM on the instrument the personal, or the entity upon behalf of which the personoj acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my and and officials I. Signature � 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, Descriptionof Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: =RIGHTaFTHUMBFRINT'. _ SIGNER Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in,Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT THUMBPRINT OF SIGNER •v:�:�4�✓.ti✓6�.'ai.�✓:<✓a�:�✓.�✓'.,�ri..'✓.p:✓'s�.'✓.:�.'.•ri•v -sr4'ri'�s'✓i-er.'y '✓a'ri:'✓.'✓:�';:�:C✓:-✓,n✓ '✓.<✓:'✓'.�✓.:�'+�'✓.:�:�✓.'.v '.r.'y -y.�✓ y P. s- -•�. •. :..: CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On 11 /01 /2010 before me, Debra Swanson, Notary Public (Here inset name and tide of the officer) personally appeared - Timothy D . Rapp who proved to me on the basis of satisfactory evidence to be the person(4) whose name(o) is/a subscribed to the within instrument and acknowledged to me that he/sW4hey executed the same in his/4"A4e4 authorized capacity(4@s), and that by his/h#r/ signature(4) on the instrument the person(.&), or the entity upon behalf of which the person(.&) acted, executed the* instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. SSffA OR ThF DEB SWANSON w a'r COMM. # 1822117 X ® o NOTARY P' UC CAI.IFORNIA ORANGE COUNTY (Notary Seed) My Corn. Expires NOY 10, 2012 ADDITIONAL. OPTIONAL. INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (ride or description of attached document) (Title or description of attached doa new continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Office . (fide) ❑ Paruier(s) ❑ Attorney -in -Fact O Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM AMY aebsowledgmerd .completed in Cd&wia must eoruain verbiage exactly as opp#ara above In the notary section or a separate acbwwtedgmew farm must be properly cotgplsW and attached to that document 77be only exception is if a docanrent is to be recorded outride of CaVornria. In such instances. any alternasrn acbsowtsdgment verbiage as may be printed on such a document so long as the verblago doss rot require the notary to do something that is illegal for a rotary in Cal(jornla (Le. cerr6ft the authorized cap -try of the signer). Please check the document cargfidly for proper notarial wording and anach this form j f required • State and County information must be the State and County where the document :ignor(o) personally appeared before the notary public for acknowledgment. • Date of notarizatim must be the data that the sigrner(s) personally appeared which must also be the name date the acicnowtedgamt is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your tide (notary public). • Print the name(s) of document signer(s) who personally appear at the time of • Indicate the correct singular or plural forms by crming off incorrect forms (1-c. hOWwAlwyr is Am) or circling the coned forms. Failure to correctly indicate this iaformadw may lead to rejection of document recording. • The notary seal impression must be elm and photographically reproducible. Impmaion must not cover text or lines. If seal impression smudges, re -scat if a suffncitat area permits, otherwise complete a different acknowledgment form. • signature of the notary public must match the signature on rile with the office of die county craft. s ` o Additional information is not roquired but could help to ensure this acknowledgment is not misused or attacbod to a diffaunt docwnent. O Indicate tide or type of attached document, number of pages and date O Indicate the capacity claimed by the signer. If the claimed capacity Ls a corporate officer, indicate the tide (i.e. CEO, CFO, secretary). • Scmmly attach this document to the signed document 2008 Version CAPA 02.10.07 $00473-9$65 www_NotaryClaamcom allow Chubb POWER Federal Insurance 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 FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each herebyconstitute and appoint Linda D. Coats, Matthew J. Coats, Douglas A. Rapp and Timothy D. Rapp of Laguna Hills, California-------- each as their true and lawful Attorney- 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 bad 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 16th day of November, 2009. I L Lila 17enneth C.Wend-el, Assistant Secretary STATE OF NEW JERSEY ss. County of Somerset Norris�P��nt On this 16th day of November, 2009 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 swom, 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 that he signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that he is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr., and was thereto subscribed by authority of said By - Laws and in deponent's presence. Notarial Seat KATHERINE J. ADElAAR niots';Z0 NOTAPY I�UBLIC OF NEW JERSEY85 on xpinac ulLiilNlHitision Expires July 16, 20inNotary Public CERTIFICATION Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: "All powers 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 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 ofrtcerv. Chairman, President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be amxeo 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 shalt 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." 1, 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 By- Laws of the Companies is true and correct, (n) 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 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 (tit) 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 November 01, 2010 0 Kenneth C. Wendel, AssistaT nt 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- 3493 Fax (908) 903- 3656 e-mail; 3urety@chubb.com Form I5-10- 02258- U (Ed. 5- 03) CONSENT City ®f Huntington Beach 2000 Main Street Huntington Beach, CA 92648 OFFICE OF THE CITY CLERK JOAN L. FLYNN CITY CLERK March 7, 2011 Terra Pave 11925 Los Nietos Rd. Santa Fe Springs, CA 90670 RE: CC-1372 — Garfield Avenue Rehabilitation Project Enclosed please find your original bid bond for CC-1372. Sincerely, Joan L. Flynn, CIVIC City Clerk JF:pe Enclosure Sister Citig,5todw t*iciapi�brwktVV*iaakwevcNew Zealand ( Telephone: 714-536-5227 ) apwn for the construction of GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO.13"72 FEDERAL AID PROJECT ESPL-5181 (168) 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 perforin all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Flans 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 50working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit price figures shall govern over extended amounts, and words shall govern over figures. 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, he considered null and void. BIDDER'S BOND 10% OF BID AMOUNT Accompanying this proposal of bid, find in the amount of $ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: C-2 PROJECT BED SCHEDULE - Garfield CC-1372 SECTION C PROJECT BID SCHEDULE GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET CC NO.1372 FEDERAL AID PROJECT ESPL-5181 (168) PROTECT BASE BID: GARFIELD AVENUE -- from Newland Street to Magnolia Street C-2.2 to C-2.4 BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: g19z 5 2-1 - --� BASE BID WILL BE THE BASIS OF AWARD PROJECT BID SCHEDULE _ Garfield CC-1372 :liem :; i..:. .; sti�tia i ' ::=: >:-::::::: >::: ieii t:vvi#fi:=iiuit: 'rice:::::: >:::< :::::< :::: >::::.::::::: ::::::::::: to . ded- ::: :::.:..:.:.. 1.17 .:.:::.:.:.:......:::::.:::.;:.:.:.:;:::::::..:: =:•:•:•:.:.:,:::::::::;:_:;:•:.:-:-:=: ;•:•:•Uat�-. :; =:.,; i. . ::::0ii1t1 �*r'ac.•.,... . 1 1 LS Mobilization $ ,fJ�7 $ j 2 1 Traffic Control Plan LS $ 'LS OL) $ 3 1 Furnish Project Traffic Control $ '6i5rfJ $ LS 4 470 Unclassified Excavation (includes disposal of material and fabric) 11.5 CY $ $ q o Pulverize, Remove excess, Grade, Cement Treat, Microcrack by 5 139890 SF FDR Process (includes disposal) $ 6 55530 Surface Grind (0.1 T) (includes diposal of materal and fabric) d.Z`i 3 SF $ $ 7 3265 Construct Asphalt Concrete (0.25' & 0.75' per plan) b TN $ $ 2a i 8 2560 Construct Asphalt Concrete (0.17' ARHM Overlay) TN $ Remove & Reconstruct Curb & Gutter (CF=8", Includes AB) per 9 1845 LF Std Plan 202 $ 10 370 SF Remove existing sidewalk (includes disposal) $ 2 5 $ 7. 50 , Remove & Reconstruct Sidewalk per Std Plan 207 (includes 11 o SF disposal) Remove and Reconstruct Commercial Driveway per HB Std. Plan 211 (including all appurtenances but not limited to: onsite 12 500 improvements, retaining curb, slot pave, etc.) —1•10 SF $ $� G2,2 PROJECT BID SCHEDULE - Garfield CC-1 372 ............. ......... .................. ............ ......... ............. ........ .... ........ . ...... Remove and reconstruct ADA access ramp (including all appurtenances but not limited to: sidewalk, domes, retaining curb, 13 2 EA slot pave, etc.) per Caltrans Std. A88A $ '0104 40 CD Remove and reconstruct ADA access ramp (including all appurtenances but not limited to; sidewalk, domes, retaining curb, 14 3 EA slot pave, etc,) per Fountain Valley Std. 204-3, Case "C" $ 15 1 EA Install Truncated Domes to existing access Ramp $ b50 $ 16 1 13 EA Adjust Sewer/Storm Drain Manhole to finished surface 17 1 EA Adjust OCSD Sewer Manhole to finished surface '7 $55 $ 18 11 IEA Adjust City of HB Water Valve to finshed surface $ 5 5 v $ 60050 19 12 EA Adjust City of Fountain Valley Water Valve to finished surface $ 5 -,o $ 6 boo 20 1 EA I Adjust Monitoring Well to finished Surface $ i (00-0 $ r 0-00 21 4 EA Raise Survey Monument Well to finished surface $ $ L100 S-ur,v.oynMonumentefieriCity to Provide Survey Monurnentation 22 44— (Not a Bid Item) EA $ Remove existing Tree and Roots; Grind Tree Stump and roots to 23 14 EA 24" below Top of Sidewalk/Grade $ $ 4-t5 L) Furnish & Plant 24" box trees (remove existing landscaping and 24 14 EA irrigation to accommodate 24" box trees, replace irrigation in kind) $ -1 7T boa C-2.3 PROJECT BIB SCHEDULE - Garrield CC-1372 ': ' iait:..irice:: x;;.:..::.:.:.:.:.;=:=:.:::::::::: ................te, ..... #k� u....•.l?..�......:,:.:.:..,,......,.,,,.............•.•.•.•......•. <.. vw :' tee it wvti i : > = ::.:::,`:::::::: >:=`::........ ::.` .. .@.........titi#ll... 3€ ........ :::Etenited .......... . .. . . 25 1 LS Provide 90 Day Plant Establishment $ Jr ®� $ 50,0 26 1 LS Provide 1 Year Maintenance $ "2-- 00 D $-7- j C'0 0 27 1 LS Traffic Signing and Striping per plan $ 5 nCI�> $ LT 0 28 22 EA Install Traffic Loops $ $ 50 60 29 1 LS Traffic Signal Pullbox and Relocation and Conduit Installation. $ 7,5,0 $ (_-1 1350 30 I LS Median nose reduction and crosswalk modification per Appendix S in Specifications. $ $ c7 50 Total Amount Bid in Figures: $ 9 521 . "7 0 Total Amount Bid in Words: ,�- }� wr`�i r �,i _ _ ----------- ----- ---cad----. ---------_...- ------....._..--------------- - - _.. ---- -----•--- o -r� ►� G-2.4 SECTION C In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. X'otinri Ncxme iirtd Address of �ulicoritrac or fate, Zcense um ,er , Class By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which; is not covered in the above subcontractors listing. C-3 That the AGENCY will be furnished copies of all subcontracts entered into and bonds t furnished by subcontractor for this project. NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of QWW LOS ANGELES JOHN TERRY , being first duly sworn, deposes and says that he NIQM is PRESIDENT of TERRA PAVE, 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. TERRA PAVE, INC. JOHN TERRY Name of Bidder 4jeat_f Bidder 11925 LOS NIETOS ROAD, SANTA FE SPRINGS Address of Bidder Subscribed and sworn to before me this day of , 201 _ , By JOHN TERRY, proved to me on the basis of satisfactory evidence to be the person who appeared before me. C-4 State of California ) County of LOS ANGELES ) of Subscribed and sworn to (or affirmed) before me on this _ NOVEMBER 10 20 , by JOHN TERRY 3RD day proved to me on the basis of satisfactory evidence to be the persons - who appeared before me. Signature NICHOL R. GRANER , NOTARY PUBLIC NICE H 3L R GRANERO Comm. S1 SO Poo NOTARY PtgKX • GUPORIHA '. LOS ANGELES COUNTY + Comm. Exp. JULY 26, 201i Seal OPTIONAL INFORMATION Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this juror to an unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document This certificate is attached to a document titled/for the purpose of Method of Affiant Identification containing pages, and dated Iopyright 7,007-2009 Notary Rotary, Inc PO Box dl a ;7, Des IvI mes, 1A 50311-0507 All Rights Reserved Form JUR01 12107 Please contact your Authorized neseuer io purcnase c.-p— o, -i, --- 0 V,. NOTARY PUBLIC UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH CALIFORNIA Gentlemen: NOTARY SEAL The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the GARFIELD AVENUE REHABILITATION PROJECT, C.C. NO. 1372, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title S, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that -the -provisions herein shall -be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 11/03/10 TERRA PAVE, INC. Contractor PRESIDENT Title C-5 State of California County of LOS ANGELES CALIFORNIA JURAT 3RD Subscribed and sworn to (or affirmed) before me on this day NOVEMBER 10 of _ 20 , by JOHN TERRY proved to me on the basis of satisfactory evidence to be the person�s)' who appeared before me. Signature NICHO'L- GRANERO, NOTARY PUBLIC OPTIONAL INFORMATION ii.... NICHOL (3RAtN�RO Comm. A1807850 NOTARY PUBLIC 0 CALIFORIM LOS ANGELES COUNTY e° Comm. Exp. JUL11,29. 20`11 Seal Although the information in this section is not required by law, it could prevent fraudulent removal and reattachment of this iurot to on unauthorized document and may prove useful to persons relying on the attached document. Description of Attached Document This certificate is attached to a document titled/for the purpose of �y�CV Ltd 171." containing _ pages, and dated Method of Affiant Identification Proved to me on the basis of satisfactory evidence: Lo form(s) of identification O credible witness(es) Notarial event is detailed in notaryjournal on: Page # Entry # Notary contact: Other Affiant(s) Thumbprint(s) ❑ Describe: Copyright 2007 2009 Not ary Rotary, Inc PO Box 41400, Des Moines, IA 50311-0507. All Rights Reserved. Form JUR01. 12I07 Please contact your Authorized Reseller to purchase copies or MIS rorm. 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 ]E1 No If the answer is yes, explain the circumstances in the space provided. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. 11/03/10 Date: TERRA PAVE, INC. Contractor PRESIDENT Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: TERRA PAVE, INC. Bidder Name 11925 LOS NIETOS ROAD Business Address SANTA FE SPRINGS, CA 90670 City, State Zip ( 562 ) 693=7283 Telephone Number 456836 A, C12 State Contractor's License No. and Class 05/21/84 Original Date Issued 05/31/12 Expiration Date The work site was inspected by VICTOR RAMIREZ of our office on NOVEMBER 1 2010. The following are persons, firms, and corporations having a principal interest in this proposal: TERRA PAVE, INC. JOHN TERRY, PRESIDENT KEN SCHRADER, VICE PRESIDENT CHRISTINE SANTOS, SECRETARY C-8 - The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. TERRA PAVE, INC. Printed or Typed Signature Subscribed and sworn to before me this _ day of , 201_ . 1 NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1 CITY OF COSTA MESA, 77 FAIR DR., 2ND FL., COSTA MESA, CA 92626 Name and Address of Public Agency Name and Telephone No. of Project Manager: THOMAS BANKS (714) 754-5235 $ 3579694 ASPHALT PAVING/GENERAL ENGINEERING 2010 Contract Amount Type of Work Date Completed 2. CITY OF LAWNDALE, 14717 BURIN AVENUE, LAWNDALE, CA 90260 Naive and Address of Public Agency Naive and Telephone No. of Project Manager: ALBERT MEDNOZA (310)973-3200 $ 2991798 ASPHALT PAVING/GENERAL ENGINEERING 2009 Contract Amount Type of Work Date Completed 3 CITY OF SOUTH EL MONTE, 1415 N. SANTA ANITA AVE. SOUTH EL MONTE, CA 91733 Name and Address of Public Agency Name and Telephone No. of Project Manager: SERGIO TOPETE (626)579-6540 $93,426 ASPHALT PAVING/GENERAL ENGINEERING Contract Amount Type of Work 2009 Date Completed C-9 Oki State of California ) County of LOS ANGELES ) CALIFORNIA JURAT of Subscribed and sworn to (or affirmed) before me on this _ NOVEMBER 10 20 , by JOHN TERRY 3RD proved to me on the basis of satisfactory evidence to be the personk!�' who appeared before me. Signature NICHOL R. GRANERO, NOTARY PUBLIC OPTIONAL INFORMATION day NI'CHOL R. GRA►NERO COMM. 01807850 NOTARY PUBLIC • CALIP0WA LOS ANGELES COUNTY a. Comm. Exp. JULY 28. 2011 Seal 0 Although the information in thi.; section is not required by law, it could prevent fraudulent removal and reattachment of this jurnt to an unauthorized docum,nt and may prove useful to persons relying on the attached document. Description of Attached Document This certificate is attached to a document titled/for the purpose of Method of Affiant Identification__ containing pages, and dated CDpynoht 2007-2009 Notary Rotary, Inc. PG Box 41400, Des Moines, 1A 50311-0507 All Rights Reserved. Form JUR01. 12107 Please contact your Authorized Reseller to purchase copies of this form BIDDEWS CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project: Contractor: TERRA PAVE, INC. Contact Person: _ CHRISTINE SANT ,S Contact Phone: (562) 693-7283 Signed: cyoi�_ Date: 11/03 0 'Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalReeycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalReeycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page for a listing of events, or refer to www.CalReUcle.ca.p_ov/Rmiations/Titlef 4/ . Please return the completed form(s) to: Department of Resources Recycling and Recovery Name of your Grant Program Attn: Name of your Grant Manager P.O. Box 4025 Sacramento, CA 95812-4025 GRANTEE INFORMATION GRANTEE NAME: `r gD GRANT NUMBER: Tp�p PRIMARY CONTACT NAME: T I7 CONTRACTOR INFORMATION CONTRACTOR NAME:-r4,,Croq AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: MAILING ADDRESS: f-405 . Job �-C 5 C i (` CA O �>O As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to ove identified contractor. Signa re Date 3 10 C-11 Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (e) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalReeycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: C -12 RELIABLE CONTRACTOR DECLARATION (page 3 of 3) (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-13 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN ENDORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE APART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder TERRA PAVE, INC. subcontractor proposed hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)),. and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts, which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 12-79 LPP 01-04 C-14 March 15, 2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1. Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of pei jury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of -the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? X Yes No if the answer is yes, explain the circumstances in the following space. C-15 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-1 G Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of SANTA FE SPRINGS/LOS ANGELES DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price -or any breakdown thereof, or the contents_ thereof, or divulged information -or data relative -thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-17 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Cheeldist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, and manager: Y Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any federal agency within the past 3 years; Does not have a proposed debarment pending; and • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award,.but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-s3 LPP 01-04 C-18 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F N®NL®BBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than.$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-19 March 15, 2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES C;V1WrLh I t 11-ilJ 1. Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance I(ti] 2. Status of Federal Action: Fl bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: UNK S. Federal Action Number, if known: UNK 10. a. Name and Address of Lobby Entity (If individual, last name, -first name, MI) N/A (NO LOBBY) i rUKJUAN 1 1 V S I U.J.L. I SQL 3. Report Type: IDa. initial b. material change For Material Change Only: year_ quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: UNK CFDA Number, if applicable 9. Award Amount, if known: UNK b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment S t-) O r-L actual planned Q amer b. one-time fee 12. Form of Payment (check all that apply): Q.. c. commission 8 a. cash d. contingent fee b. in -kind; specify: e e deferred value f. other, specify 14. Brief Dese ' Ion of Services Performed or to be performed and Date(s) of Service, including I is , empioyee(s), or members) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sbeet(s) attached: Yes No 16. Information requested through this fonn is authorised by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Si ature: was placed by the tier above when his transaction was made JOHNR or entered into. This disclosure is required pursuant to 31 print Name: U.S.C. 1352. This information will be reported to Congress PRESIDENT semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be sub.icct Title: apply) to a civil penalty ofnot less than $10,000 and not more than 562/693-7283 11/3/1( $100,000 for each such failure. Telephone No.: hate: Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Standard Fonn LLL Rev.09-12-97 Page12-87 LPP 01-04 C-20 March 15, 2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. if the organization filing the report in Item 4 checks "subawardee" then enter the full name, address, city, State and zip code of the prime federal recipient. Include Congressi-oval District, if known. 6. Enter the name of -the federal agency making the award or loan commitment. Include -at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g., Request for Proposal (RFP) number, Invitation for Bid.(IFB)-number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. if payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box(es). Check all boxes that apply. if other, specify nature. Page 12-88 March 15, 2001 C-21 LPP 01-04 Local Assistance Procedures Manual PS&E Checklist Instructions EXHIBIT 12-E Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90<(ENDIF)) Page12-89 LPP 01-04 C-22 March 15, 2001 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For GARFIELD AVENUE REHABILITATION FROM NEWLAND STREET TO MAGNOLIA STREET, C.C. NO. 1372 FEDERAL AID PROJECT ESPL-5181 (168) in the CITY OF HUNTINGTON BEACH November 1, 2010 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) INCLUDE LANDSCAPE STANDARD PLANS 713, 714, 715, 716, 718, AND 719 IN AGENCY SPECIFICATIONS (APPENDIX K) Insert Additional Agency Standard Plans 713, 714, 715, 716, 718 and 719 which are discussed in construction Note 22 on the Construction Drawings. Bidders shall submit bids based on the Landscape Agency Standard Plans. This is to acknowledge receipt and review of Addendum Number One, /dated November 1, 2010- TERRA PAVE INC. C�------- Company Name By 11/2/10 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jim Wagner at (714) 536-5431. Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1,054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File Page 12-111 LPP 06-06 November 14, 2006 Local Assistance Procedures Manual EXHIBIT 12-G Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART I The bidder shall list all subcontractors (both DBE and non -DBE) in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Distribution: 1) Original - Local Agency File ragc a-A.LX November 14, 2006 LPP 06-06 EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S (LIST OF SUBCONTRACTORS (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title .1_ _rr_a_—1 01—+n°,. —, tt— 4, -m fnr a.Mitinnnl firms ag i s, a S' . 7 a3 ♦ ij,2ry-. z?�t�v �£♦ �t F�,.�'i,ff�.sl�� '�,�, /e�t7 s� • f f• 1 1 •! F 1 1 1!' '' 1 • � r f 5{}'�.c s-��ii�Jdr t ��iLar r ��� • • 1 �� ���{£I iitf F��r�'i "tii' tz� f�z�;;}�53 tr li�"i / • — � 3 . CV 1>�SI )•iti� � ��j�nfrT.1j � � ■ ! • ^'r1 :r<�.,iSa,li�k�l.s"� y nh F�S2.2�1 �' ' � / y • t � � rt�� r-�"�� t a��* 3���t2s � �isf{iiaiV fi :L£i�i'� �>�1�E�u4 tom• .. a . F t�I t �� ST �ir i�� i � q x m It � 7�S } ■ • ■ • I . . I • � w 'tti i& c-Clt1r7�n �`�!� a 3,i �4. �S7r�..1(�.i.°. - �'». � '�' u�i.,.�.xy rSw.:4 ■ t� t� y`.,vr'z"{ia'I��1Yt�:r,+?�7 tF • ♦ 2. y lip . rli ■ ■ tiyaSYl,,It4"^ a N ■ � • 3, MT1; 1 KiAJ: � � � � r�yi�li��,t�,�..if I t�t�itif rY� 1,yl�ry'k s ' / � ; ��, (-{`i�. L�FI y��j . Isiiiii t�.S£�. 3`(� S'i 1 fi uif skJi(` Ems; Jki �:t .5 Y r l2KR �r�_ �I� zi ♦ ■ • >=.�7 �>! I��{ � t �, � -" � C�: i � •_ t1111t > � . ,..- _. — ___ -- - ,... _. ■ " •1 __ _. __ .. .." -_ _. _ r m t trio-i3k�t�i��k7 5����t S�j�3,�;��3 "'z" ..tP.�Ni. �'a�^ s?i .,�'♦Cis .cisYtylN,� ' 7'r{j({i"*�'�isrs�J���Nd�3 ti H-111. f/r 01); State •WIN, ■ • h.5'Y'Sis f��r1j�(s E2n�7^s �i' yM7 Distribution: i) Original — Local Agency File Page 12-112 UP 06-06 November 14, 2006 EXHIBIT 12-G Local Assistance Procedures Manual Bidder's List of Subcontractors (DBE and Non -DBE) BIDDER'S LIST OF SUBCONTRACTORS' (DBE and NON -DBE)- PART 11 The bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title Distribution: 1) Original — Local Agency File Page 12-112 LPP 06-06 November 14, 2006 Fidelity and Deposit Company of Maryland BiD BoND KNOW ALL NIEN BY TIEFSE PRESENn that we TERRA PAVE, INC. as Principal, hereinafter called the Principal, and Fidelity and Deposit Company of Maryland, a corporation duly organized under the laws of the State of Maryland, as Surety, hereinafter called Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH as Obligee, hereinafter called Obligee, in the sum of *TEN PERCENT OF AMOUNT BID* Dollars ( I or (10 %) percent of the amount bid, whichever is less, for the payment of which sum well and truly to be made, the said Principal and the said Surntty, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents- WEW-RFAS, the Principal has submitted a bid for 11GARFIELD AVENUE REHABILITATION, NO. C.C. 1372, ESPL-5181(168)" NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contractwith the Obligee in - accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding m:Comtract Documents with good and sufficient surety for the faithfi l performance of such Contract and for the It payment of labor and material fiumisbed in the prosecution thereof; or in the event of the fail= of the Prnacipal to eater such Contract and give such bond or bonds, if the Prhx*A shall pay to the Obligee the difference -not to exceed the penalty hereofbetweea the amount specified in said bid and such larger amo=t %rwhicr the Obligee may is good faith contract with another party to perform the Work covered by said bid, then this obiigadon, shall be null and void, otherwise to remain in full farce and effect. Signed and sealed this 27th day of OCTOBER > 2010 (Sol) (Wihtess) r . J Y, PRE IDEN'I' (title} COMPANY OF MARYLAND (�) Y: Michael A At�raey-hrFact) 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 THEODORE G. MARTINEZ, Vice President, and GREGORY E. MURRAY, Assistant Secretary, in pursuance of authority granted by Article Vl, Section 2, of the By -Law id Company, which are set forth on the reverse side hereof and are hereby certified to be in full force and eff t reof, does hereby nominate, constitute and appoint Michael A. QUIGLEY, of Laguna N' , ' s lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and y t� 0 eed: any and all bonds and undertakings, and the execution of sue p n ese presents, shall be as binding upon said Company, as fully an is a t ey had been duly executed and acknowledged by the regularl e t 't ice in Baltimore, Md., in their own proper persons. This power of attorWy=th e" A. QUIGLEY, dated March 17, 2005. The said Assistant Section 2, of the By-. &xtffy' at the extract set forth on the reverse side hereof is a true copy of Article VI, , and is now in force. IN WITNESS WI1P_Rr0F, the said Vice -President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Sea] of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 4th day of March, A.D. 2008. ATTEST: 'gyp OfPps�t t +cPfOjof o o c State of Maryland ss: Baltimore County FIDELITY AND DEPOSIT COMPANY OF MARYLAND i Gregory E. Murray Assistant Secretary In L 7 Theodore G. Martinez On this 4th day of March, A.D. 2008, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came THEODORE G. MARTINEZ, Vice President, and GREGORY E. MURRAY, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Dennis R. Hayden Notary Public My Commission Expires: February 15, 2013 POA-F 012-0626 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of ORANGE On October 27, 2010 before me, MEG QUIGLEY, NOTARY PUBLIC , Date Here Insert Name and Title of the Officer personally appeared MICHAEL A. QUIGLEY Name(s) of Signers) m MEG QUIGLEY m COMM ... 1786547 n NOTARY PUBLIC-CAUFORNIA -i m tip ORANGE COUNTY W M Term Exp. Janua 10, 2012 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(o whose name(s) istam subscribed to the within instrument and acknowledged to me that he/sbedkRK executed the same in his/bDddxEkr authorized capacity(im), and that by his/signature( on the instrument the person(, or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true andticorrect. -=7r-,\ Signature OPTIONAL Though the information below is not required by law, it may prove valuable and could prevent fraudulent removal and reattachment of this fi Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s): _ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHT.jHUIVISPRINT OF SIGNER _ Top of thumb here nWA dd officidl seal. / ASS- re tary •o person rely' o the c m to an ther oc m It. Number of Pages: — Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): — ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT OFjSIGNER' ___ CALIFORNIA '...ri` - ALL-PURPOSE -iice, :_• e.. ACKNOWLEDGMENT .�,!s�S.��.e�.-�.'.v!�S;a�s�e�.-�.'S�S!a�S�S SASS.-�.'c�.-�.'e;:�. S�> :�.c�.'g,�c .�.-�.'. e�.--�.'.�. S�S�S�c!s�:�,.�.'>,�.-�.'t�,.-�.'.�S;:�c.',��..�C�.,�c,��.•„�.�.-'.S;a�c,:� State of California 1 County of f6 On C before me,'/ Date / �/ Here rme and personally appeared 1/''/ who proved to me on the basis of satisfactory evidence to be the persons) whose name(4 is/MR subscribed to the within instrument and acknowledged to me that _ _ _ _ _ _ he/914XViay<.executed the same in his/! / authorized JEANNIE TERRY capacity0eiC and that by his/W~ signatureN) on the Commission # 1743187 1 instrument the person}, or the entity upon behalf of -� Notary Public - California > which the person(` acted, executed the instrument. a Los Angeles County MVCcmm "'2011 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNES and and official seal. Signature Place Notary Seal Above gn ure of Notary Publ' OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): — ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: !RIGHT THUMBPRINTr OF SIGNER i Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: RIGHTTHUMBPRINT OF:SIGNER .�c:�.•ac��.�.:s..�<�s:-�'s:-�c:�.:� � �.�.�.:�s:�c� �s.�_cs:�c:� �s.� ems.-ems.=%n�sc-Ss�.�s:_%a:�.:�s.•�c� o r. ..• • : r r r :rr