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Beador Construction Company, Inc. - 2017-08-21 (10)
RECEIVED BY: (Name) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk C DATE: SUBJECT: Bond Acceptance I have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. Other No. g1forms/bond transmittal to treasurer (Company Name) s�lrV�oo7,��� Approved ,6�1v0. So (Council Approval Date) Agenda Item No. /0 City Clerk Vault No. &Uy SIRE System ID No. t3637 I 1iZG . FOB CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION DATE: 10/16/2018 TO: THOSE LISTED HEREON FROM: John Griffin, PW Contract Administrator�� SUBJECT: Retention Release Payment - PO #23279 OJ Supplier #101821 Co. #970 Brookhurst Bridge BPMP, Project # CC 1449 Contractor's Name: Beador Construction Company, Inc. Address: 26320 Lester Circle City, State and Zip Code: Corona CA 92883 Phone Number: (951) 674-7352 City Business License Number: A300565 Notice of Completion (Date by City Clerk): 9/11/2018 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. to Q D ---- Date Travis K. H I certify that there are no outstanding invoices on file. to (1-j 1t6 Date s, uirector of F uoiic vvorKs �),)P C,M(� Joyce 2acks, Dep City Treasurer I certify that no stop notices are on file, and that a guaranty bond has been filed with the City Clerk's Office. /a.-19-z J Date —6d', Robin Estanislau, City Clerk rb7/ 01• Attachments 1. Notice of Completion 2. Maintenance Bond 3. Certificate of Compliance with Prevailing Wage Laws 4. Contractor's Certificate 5. Certificate of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 6. Consent for Release letter from the Surety Company Document-593 3177-Page-1 Page 1 of 1 PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attn: John S. Griffin P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder II II II III I IIII II III II II II NO FEE * $ R 0 0 1 0 3 4 4 8 4 4$ 201800033392510:03 am 09/12118 47 NC-5 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY NOTICE OF COMPLETION NDTICE 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 Beador Construction Company, Inc., who was the company thereon for doing the following work to -wit: Brookhurst Bridge BPMP, Project # CC 1449 That said work was completed 09/05/2018 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 0910512018, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract Great American Insurance Company, was surety for the bond given by the said company as required by This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 27383 and should be recorded free of charge. 4D,P o sorCity EngineerDatetington Beach, California STATE OF CALIFORNIA) County of Orange 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. have read said NOTICE OF COMPLETION and know the contents thereof: the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. This document is solely the official business of the City of Huntington Beach, as contemplated under Government code section 27383 and should be recorded free of charge. 9/111-12 Director, of ublic s or ity Engineer ate City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) about:blank 9/12/2018 Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: CC-1449 Project: Brookhurst Bridge BPMP 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 21 st day of _STpmbeC , 2018 at Corona alifo nia. By: David Be (Contractor Name) Beador Construction�bompany, Inc. APPROVED SJO FOR Mi ael E. Gates City Attorney 1 I'M1. o I David beador , state and certify that: (Name of Declarant) 1. Beador Construction Company, Inc. is the general contractor to the City of Huntington Beach ("City") on Contract No. CC-1449 (the "Contract") for the construction of the public work of improvement entitled: Brookhurst Bridge BPMP, Project # CC-1449 (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). 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. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write `'NONE") None I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Corona, CA on this 21 ay of September 20 18 (SWnalu)-e of Declarant) APPROVED :�2 f'0RM_7 Michael�E. Gates City,A torney Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: CC-1449 Project: Brookhurst Bridge BPMP The undersigned contractor on the above -referenced project ("Project") hereby certifies that it has complied with title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 21 st day of September 201s , at Corona C lit rnia. David Bead (Contractor Name) Beador Construction Company, Inc. APPROVED NS TO F Mich6el E. Gates City Attorney 1 BOND NO. SNN4007227 PREMIUM: $2,240.00 Term: 09/05/2018 - 19/05/2019 MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: That BEADOR CONSTRUCTION COMPANY, INC. (contractors name) 26320 Lester Circle Corona CA 92983 (contractors street address, city and state and zip code) as Principal (hereinafter called Contractor), and: Nationwide Mutual Insurance Company (surety's name) 7 World Trade Center, 37th Floor, New York NY 10007-0033 (surety's street address, city and state and zip code) a corporation organized and existing under the laws of the State of Ohio with its principal office in the City of New York as Surety (hereinafter called Surety), are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of One Million Forty Five Thousand Eight One & 64/100 Dollars ($ 1,045,081.64--------------------- ), equivalent to the entire contract amount including all orders, for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents, WHEREAS, Surety is a duly admitted surety insurer under the laws of the State of California; and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and able to provide proof of bonding limitation shown in said circular is sufficient to provide bonds in the amount required by said Contract; and Surety has provided financial strength ratings from reputable companies, such as from A.M. Best, Moody's, Standard & Poor's, to validate that Surety has positive ratings of being secure or stable; and Surety is registered and listed with the California Department of Insurance; and Contractor has by written agreement dated , 20_, entered into a contract with Owner for the Rrnnkhi Jr5t Bridge RPMP, Prniart ftff 1 ddq with drawings and specifications prepared by reference made a part hereof (hereinafter referred to as the Contract); and in accordance which contract is by The Contract provides that the principal will guarantee, for a period of one year, the work performed as part of the Contract from and against all defects in materials and workmanship; and The Contract also provides that the Contractor shall secure Contractors obligations during the one-year period with a bond executed by a surety duly admitted in the state of California; and The Contract has been completed, and the Owner, Contractor and Surety agree that the commencement date for this Guarantee and Bond shall be September 5 20 1$ NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects 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) days following Owners 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. 15-4584/118138 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 as work progresses sufficient funds to pay the cost of. completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder, provided, however, that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to (a) remedy the default(s) of the Principal promptly, or (b) arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond. In said Notice of Election, the Surety shall state the date of commencement of its cure or remedy of the Principal's default(s) or its performance of the Contract. The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs 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 26th day of September , 20 18 Principal Raised Corporate Seal BEADORCONS RUCTION COMPANY, INC. [MUST BE AFFIXED] (Contractor Name) By: i (Seal) Principal Raised Corporate Seal T)k to�— [MUST BE AFFIXED] (Title) Nationwide Mutual Insurance Company (Surety Name) By: (Seal) Edw .rd N. Hackett, Attorney -in -Fact APPROVED AST `_- RM:,y.--; B NOTES: Michael E. Gates, City Attorney 1. Acknowledgments must be completed and returned I as part of the bond. 2. Raised Corporate Seals are mandatory. { 3. Please attach Power of Attorney, 15-4584/118138 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Riverside SS. On October 2, 2018 before me, R. Quezada Notary Public Date Name and Title of Officer Personally appeared David Beador Name(s) of Signer(s) F R. QUE?ADA Commission # 2100414 Notary Public California z Orange County My Comm. Expires Mar 19, 20191 Place Notary Seal Above OPTIONAL 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 seal, V= a2 of Votary ary Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Signer's Name: _Individual _Corporate Officer Title(s): _ _Partner- Limited _General —Attorney-in- Fact _Trustee _Guardian or Conservator Other: Signer is Representing: Top of thumb here Signer's Name: _Individual _Corporate Officer Title(s)_ —Partner--Limited—General .Attorney -in -Fact _Trustee _Guardian or Conservator Other: Signer is Representing:_ Top of thumb here , (, :� :l i , ', 1 1, ;, ;, ', :, "l , ,- ., CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California A notary public or other officer completing this certificate verified only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. County of ._.... .... Orange ._...___ ................_.,_._..,.......... Oil before me, ........_.........._. ............... Maestas, Now Public tl lerc iluer millic and title of rite officer) personally appeared ,� __._ Edward N. Hackett who proved to ine on the basis of satisfxtt teary evidence to be the person(si whose ntitne(s) is.Awe subscribed to the within instrument and acknowledged to the that heA-4+_-'1hey executed the saute in authorized capacityfies), and that by on the in5trurnetitthe per•son(s), or the entity upon behalf ofwhich the person(s) acted, executed the instrturnnt. l certify under PENALTY OF PERJURY under the laws of the State of Calif6mia that the foregoing paragraph is true and correct. 1 TI—NESS my hand and official seal St; u�tcr)rN ,'ryPublic C, MAESTAS commission 2117336 Notary Public California Orange County 24, 2013 My Comm. Expires Jul (Notary Sealj ADDITIONAL OPTIONAL INFORMATION l.)I S(.'Rt i'TIC)N OFT I lfa ArrAC'I IED DOCUMENT Maintenance Bond No. SNN4007227 f5tls:.ordce7piicii2,yfauaeiedtitu nCnti (Title or desc:ripti n or;el chcd docnr7ieni continue Number of Pages C)cx ulnent r)atc i.lttditional iaitoruarri<in} C'APAC FY CLAIMED BY TI1E• SIGNER. ra Individual (s) ("Orporate Officer ("bail 0 Partner(s) rX Attorney -in -Fact rl Trustce(s) 9 Other 2008 Version C's'iir.il 012,10,0 S004?3-4)Sr`)5 w%vli,Noll'gy0;asss5;coin INSTRIJCI•IC)NS FOR (:'{}MP1._41 i"1Nti "f1IIS FORM /lrr F!<'"�'rtfdri't£l�iyaY}Yirt :'(lnrtriel2'rl err %�rlllfriilaifl arPdtia L'trliifttfi 5ya tttlrrf k',Y.lY.;1lj' (Xw rltteexr ab< ; r in rile noted' scetitrrr in inuxt k, rrntietlrp roniplewd fain raraehed it; Burt dorurnew, The otriy ecceinion is ita al""llr wla is to tit' r`£rrr;r r/ei/ rrutxirt:t r;f Califurnio, lt= arntlr 16axfeIilc'es, arrY ;rhea rruth°e x. 'rts'rr:lz%s� rnG�n1 r=6 r'/rieri t' (it hurl, he? lJrinlo dj m s"ch a rlacat treat .so ltia r+s the t.c°rl>in c< doev no! rejaire the +atria tri dry s.rnuwbiog thev is iifer;;nl f%ir a nnturtin (."IdI in nh-) ff-<e aert{f2'rnl; the allil orm?ei ec+litu`iry ra'rlx, signewl, pleil:se wrier, die � l t'ta;t'atric`trT r•ttrfjit?f> ; irirrrJtlzrrtr;ttrritr? �h'rndii,; eJnClttttucdt tilirT,t'rrt i{retlrrirMa a i Sulie and oitll y i:Iiili motion nnis2 he the Siatc, aoil t. ( n:y where ti::' docirmew ligiiel(s) roe son;:ily Irppc:ared be iue tho notary i;a6hc loracknoxvivdi nicni. note of'notarizxnion tllust li the dine that the sienir(st ricrximlly appe3ttd wiiish it5tret also hrc the lairs chic tree acitnzisr'rcti�.uicni is cr_xiilslctcd, • The notary public nuisi p6rit Fair on c�rrmiilc ¢is it appears .eithiii hi, of, her commission rothsived by ci cotnnw and thcu your brie irn tary ptihhe). . Prim ft:, imincty) rri'deelllllrIll sirzner(sj) Wlio ficrsotiany aplietir;il th,:` lime, of i3e)t;trizXt ior.. Indicate the correct s v,,ihir or plural fornis by crux inv. off mcmrect Brines ;i,e, 4Y@L$tiC*4e�lw is-fw ) or circ:luig the et}rre7et A)rrris. Fxihire to coaci;;ly intli ;ate erns, ir;fornaa€ion iliiiy Ic;ul to le eciizfr4tii`titxurtii.ul re ccrdin ,- The notary seal irnptcssioii must h, chair and pellet rn)yli:cait rgmyiucib€c. liupressirxa mull wit covcr text or hn S. if seal inipre;nion snaudgcs, rc-acne era sufficient an:,a perniit;, otherwv c completc a dilkrerit iicl:Iiowfadz;nisttl firin, Si ilmor.. or the notary public iitabt match the, sittnaiure on, 'file vitro the office or the courtly Clem(. CA- A d;htiorial infirmnation is not required trial c.rWd hc;p to ell"we this 1c.:kriot44cdz1ncut is not arustRscdvn atitanced to a dirRIcait dockalwall, z tnzliratc f lire ur tppc urunacl> d tern unac it, tiurttlAr ri# papa acid date, t->R ;nihrali,c ilia carlacity ;;blurted by the signor, If Ilic claimcd c3 miciry k a corp:rtnic officer. indicate the redo tiro, 0".0. (al? Sezf,=It ), Securely ;alladl this docuiuciii to the signed riru`nrri `tat Power of Attorney KNOW ALL MEN BY THESE PRESENTS THAT: Nationwide Mutual Insurance Company, an Ohio corporation AMCO Insurance Company, an Iowa corporation National Casualty Company, an Ohio corporation Allied Property and Casualty Insurance Company, an Iowa corporation hereinafter referred to severally as the 'Company" and collectively as `the Companies' does hereby make, constitute and appoint: EDWARD N. HACKETT IRVINE CA each In their individual capacity, Its true and lawful attomey-in•fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of FIVE MILLION AND NOJI00 DOLLARS S 5,000,000.00 and to bind the Company thereby, as fully and to the same extent as If such Instruments were signed by the duly authorized officers of the Company; and all acts of said Attorney pursuant to the authority given are hereby rattled and continued. This power of attorney Is made and executed pursuant to and by authority of the following resolution duty adopted by the board of directors of the Company, 'RESOLVED, that the president, or any vice president be, and each hereby Is, authorized and empowered to appoint attomeys-in-tad of the Company, and to authorize them to execute and deliver on behalf of the Company any and all bonds, fors, applications, memorandums, undertakings, recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other writings obligatory in nature that the business of the Company may require; and to modity or revoke, with or without cause, any such appointment or authority; provided, however, that the authority granted hereby shah in no way limit the authority of other duly authorized agents to sign and countersign any of said documents on behalf of the Company.' "RESOLVED FURTHER, that such attorneys -In -fact shall have full power and authority to execute and deliver any and all such documents and to bind the Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that said seal shall not be necessary for the validity of any such documents.' This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company, Execution of instruments. Any vice president, arty assistant secretary or any assistant treasurer shalt have the power and authority to sign or attest ail approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of the (ward, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or stamped on any approved document, contract, instrument, or other papers of the Company, IN WITNESS WHEREOF, the Company has caused this instrument o eated a uty attested by the signature of Its officer the I St day of May 2017 OWft Antonio Albanese, Vlce President of Nationwide Mutual Insurance Company, National 40�' Casualty ompany, AMCO Insurance Company, Allied Properly and Casualty Insurance Company �7JG1">�L � ACKNOWLEDGMENT / '�;=�0 ® ' Apr STATE OF NEW YORK COUNTY OF NEW YORK: ss *44 = I On this Ist day of May 2017 , before me came the above -named officer for the Company aforesaid, to me personalty known to be the officer described in and who executed the preceding instrument, and he acknowledged the execution of the same, and being by me duly Wuaj,. ♦tit0!!me�,, sworn, deposes and says, that he Is the officer of the Company aforesaid, that the seal affixed dyeoerTB hereto is the corporate seal of said Company, and the said corporate seal and his signature were ' dui affixed and subscribed to saki Instrument by the authority and direction of said Company. 1N3 .�+-+11i+'r BARRY T. BASSIS ,SDI * i •., r/ Notary Put�lic State New York �� ,�i spi r No. 02BA4656400 j") 4� r�� No. in New York County NWery Pubhe °i Commission Expires April 30. 2019 My Comminion Mom CERTIFICATE Apn130. 2019 1, Laura B. Guy, Assistant Secretary of the Company, do Hereby certify that it* foregoing is a full, true and correct copy of the original power of attorney issued by the Company; that the resolution included therein is a true and correct transcript tram the minutes of the meetings of the boards of directors and the same has not been revoked or amended in any manner, that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said Instrument by the authority of said board of directors; and the foregoing power of attorney is still in full force and offect. IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corpoZZL Company this 26th day of September 2018 G This power of attorney expires: Apn130, 2019 Assistant Secretary BDJ 1(05-17)00 47029 J J CONTRACTOR'S RECYCLABLE MATERIAL TRACKING SHEET �7 (FOR NON -HAZARDOUS MATERIAL) PLEASE TYPE OR PRINT LEGIBLY IN INK CONTRACTOR I COLLECTOR INFORMATION Business Name: Beador Construction Company, Inc. Address: 26320 Lester Circle, Corona, CA 92883 Phone: 951-674-7352 Fax: 951-674-7495 Contact Name: Roxana Quezada Quarter Reporting: 3rd Recycling Type of Tonnage Source Location Permit # ` Material Removed Destination/Disposition I I , I � J THIS FORM SHALL BE SUBMITTED QUARTERLY FOR EACH PERMIT ISSUED. Reports are due by the last day of the month following quarter end (1st Qtr.=April 30, 2"d Qtr.=July 31, 3rd Qtr.=October 31, 4th Qtr.=January 31). Please call (714) 374-5321 with questions. Please attach copy of weight ticket(s) from certified recycler and return completed form via mail or fax to: CITY OF HUNTINGTON BEACH DEPT. OF PUBLIC WORKS ATTN: RECYCLING COORDINATOR DEPT. OF PUBLIC WORKS -MAINTENANCE DIV. 2000 MAIN ST. HUNTINGTON BEACH, CA 92648 FAX: (714) 375-5099 CONSENT OF SURETY COMPANY TO FINAL PAYMENT PROJECT: Brookhurst Bridge BPMP (name, address) TO (Owner) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 CONTRACTOR: Beador Construction Co., Inc. 26320 Lester Circle Corona, CA 92883 Bond No. CA1844013 OWNER ❑ ARCHITECT ❑ CONTRACTOR ❑ SURETY KI OTHER ❑ CONTRACT FOR: Bridge Preventive Maintenance PROJECT NO.: CC 1449 CONTRACT DATE: 8/21/2017 FINAL CONTRACT PRICE: $1, 045, 081.64 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Co.) Great American Insurance Company 301 E. 4th Street, Cincinnati, OH 45202 , SURETY COMPANY, on bond of (here insert name and address of Contractor) Beador Construction Co., Inc. 26320 Lester Circle Corona, CA 92883 ,CONTRACTOR hereby approves of the final payment to the Contractor and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 OWNER, as set forth in the said Surety Company's Bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 20th day of septe 4018 eat Ame I su ce Company r any (SEAL) Sagnat e of Authorized Representative James W. Johns n, Attorney -In -Fact Title CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. I State of California County of Orange On SEP 2 0 2018 before me, Frances Lefler Notary Public, I personally appeared James W. Johnson who proved to me on the basis of satisfactory evidence to be the person(g) whose name(s) is/aft- subscribed to the within instrument and acknowledged to me that he/she%thc_y executed the same. in his/1i-r/14ieir authorized capacity(ic-s), and that by his/herhireir-signature(s) on the instrument a the person(-,), or the entity upon behalf of which the person(R) 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. f� WITNESS my hand, and official seal ( 9E'IOF, FRANCES LEFLER COMM. # 2150250 X " •� o NOTARY PUBLIC-CALIFORNIA X ' ORANGE COUNTY �gcsoaM`� MYCOMM.EXP. APRIL23,2020N OPTIONAL I Description of'attaehed document: 1 Document Title: { Date of Document: I Additional Signers Not Named Above: Number of Pages: (Seal) GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than SIX No. 0 15088 POWER OFATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREATAMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power ERIK JOHANSSON ELLEN BELL ALL OF ALL JENNIFER ANAYA FRAN LEFLER TUSTIN, $100,000,000.00 MELISSA LOPEZ JAMES W. JOHNSON CALIFORNIA This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 19TH day of SEPTEMBER 2017 Attest GREAT AMERICAN INSURANCE COMPANY 3"" �'Ugnsux,�rf (0"de- Assistant Secretary Dirisinnat Senior Vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C. KiTCHiN (877-377-2405) On this 19TH day of SEPTEMBER 2017 , before me personally appeared DAVID C. KITCHIN, to me known, being duly sworn, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorised, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof, to Prescribe their respective duties and the respective limits of their authority: and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Companv may be affixed by facsimile to any pou!er of attorney or certificate of either given for the execution of any bond. undertaking, contract of sureh ship, or other lvritten obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company lvith the same force and effect as though manually affixed. CERTIFICATION 1, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this day of SEP 2 Q 2018 , lay f AssistanrSecretary S1029AF (06/15) Document-5933177-Page-1 Page 1 of 1 PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attn: John S. Griffin P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder 11I II III I IIII II III I II II II NO FEE *$ R 0 0 1 0 3 4 4 8 4 4 $ * 201800033392510:03 am 09112118 47 NC-5 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.000.000.00 0.00 I THIS SPACE FOR RECORDER'S USE ONLY t_ TITLE OF DOCUMENT NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to Beador Construction Company, Inc., who was the company thereon for doing the following work to -wit: Brookhurst Bridge BPMP, Project # CC 1449 That said work was completed 09105/2018 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 09/0512018, per City i Council Resolution No. 2003-70 adopted October 6, 2003. i That upon said contract Great American Insurance Company, was surety for the bond given by the said company as required by This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 27383 and should be recorded free of charge. Di cto f P o s or City Engineer Date C Huntington Beach, California STATE OF CALIFORNIA) County of Orange ) ss: City of Huntington Beach ) I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof, the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. This document is solely the official business of 9 the City of Huntington Beach, as contemplated s�Lc L under Government code section 27383 and Director of ublic s or City Engineer ate City of kuntington Beach, California should be recorded free of charge. THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) about:blank 9/ 12/2018 h� ICE. City of Huntington Beach File #: 18-225 MEETING DATE: 8/6/2018 REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works Subject: Approve and authorize the Director of Public Works to implement Change Order No. 1 for the Brookhurst Street Bridge Preventive Maintenance project, CC-1449; and authorize an appropriation from the Gas Tax Fund of $212,000 Statement of Issue: On August 21, 2017, City Council awarded a contract to Beador Construction Company for the Brookhurst Street Bridge Preventive Maintenance project. One of the final stages of the project involves grinding the existing asphalt from the concrete deck of the bridge. During this process, deficiencies to the concrete structure underneath the asphalt were discovered. After further review and engineering analysis by the City's consultant, it was determined that additional construction work is required to create a structurally sound bridge deck. This work necessitates an additional expenditure of $160,000 and an appropriation from the Gas Tax Fund to cover this expenditure and an estimated $52,000 in additional inspection, material testing, and engineering/design costs. Financial Impact: Staff is requesting an appropriation of $212,000 from the Gas Tax Fund (207) undesignated fund balance. Recommended Action: Approve Change Order No. 1 and appropriate $212,000 from the Gas Tax undesignated fund balance to account 20790010.82800. Alternative Action(s): Do not authorize the additional expenditure and instruct staff on how to proceed. Analysis: The Brookhurst Street Bridge was constructed in 1958. In the mid 1980s the existing bridge was widened to its current dimensions. Parts of the bridge have deteriorated due to vehicular traffic and tidal flux necessitating the bridge to be rehabilitated. The Public Works Department was able to secure a Federal Grant under the Bridge Preventive Maintenance program to cover approximately 88% of the cost of construction and design. City Gas Tax funds were used for the local match. On City of Huntington Beach Page 1 of 2 Printed on 8/1/2018 povverE--I-k LeaistarTl File #: 18-225 MEETING DATE: 8/6/2018 August 21, 2017, City Council awarded a contract to Beador Construction Company for the project Construction began on December 18, 2017, and was scheduled to be completed in mid -July 2018. The Contractor was fulfilling all contractual obligations and was working well throughout all construction phases. During one of the last phases of construction, the contractor was to remove the asphalt on the bridge deck, apply a waterproof membrane and re -pave to match existing asphalt grades. During this process, it was discovered that there were deficiencies in the concrete bridge deck in areas constructed in the 1980s. Further discoveries identified excessively thin concrete in certain areas of the pre -cast concrete bridge deck panels. It cannot be determined why this condition exists. This is contrary to the as-builts from the project that were done almost 30 years ago which indicated a 3" thick layer of concrete in the structural section. When the asphalt was removed it was revealed that some areas were less than 1-inch thick. After review and engineering analysis by the City's design engineering consultant, it was concluded that the bridge deck needed additional thickness to create a structurally sound bridge deck. The project engineer identified all problem areas and proposed a method to fix these areas with a one -inch leveling course of polyester concrete overlay. The contractor and Public Works engineering obtained three competitive bids for the work. The cost of the overlay and the resulting delay is estimated at $160,000 over the contract amount previously approved by Council. Additional associated costs related to engineering, material testing, and inspections are estimated at $52,000. Staff will work with Caltrans and the federal government to explore obtaining additional grant funding to address this issue. The Director of Public Works is requesting approval for Change Order No. 1 to authorize these additional unanticipated costs above the original approved contract and contigency. Public Works Commission Action: An emergency meeting of the Public Works Commission will be held to address this issue. Environmental Status: A Categorical Exclusion was approved on September 15, 2015, in compliance with NEPA. Mitigated Negative Declaration No. 14-006 on April 15, 2015, in compliance with CEQA Strategic Plan Goal: Enhance and maintain infrastructure Attachment(s): 1. Emergency Repair Estimated Costs Summary City of Huntington Beach Page 2 of 2 Printed on 8/1/2018 powere4a:?/ Lepistar-1 BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE PROJECT CC-1449 EMERGENCY REPAIR ESTIMATED COST SUMMARY 06-19-18 During the eastside Brookhurst Street Bridge concrete deck inspection with Eric Pheifer (Biggs Cardosa Associates) a small hole or void was discovered 27' from the east bridge edge and 149" south of bent #3. BCA researched the original Brookhurst Street bridge construction plans and theorized that the concrete deck panels were ground during the original installation or construction of the bridge in the 1980's. It is theorized that the deck concrete was cold milled to meet the asphalt paving final elevations at that time. The thickness of the existing concrete deck was measured 3/8 -1/2" thick. The original Brookhurst Street plans show there should have been 3-4" of concrete cover with reinforcing rebar over 10" void sections in the precast bridge panels 06-19-18 2:00 pm it was determined that Beador should cancel the paving scheduled for tomorrow due to future discoveries. At this time Beador Construction is on delay time at the Brookhurst Street Bridge Project, CC1449 Beador Construction staff on hold and will perform all bridge repair activities on a time and material basis per Section 300 of the Green book. 06-21-18 BCA staff determined that Ground Pentrating Radar (GPR) would be the best method for nondestructive concrete deck thickness testing. 06-29-18 GPR testing was performed through Leighton and Associates. Beador Construction staff has assisted in the investigate phase of the deck repair and has performed detailed concrete bridge deck cleaning in preparation of receiving BCA deck repair recommendations and pending approval to proceed from the city of Huntington Beach Public Works Department. John Przybyszewski (Dudek) has been tracking all the repair cost on T&M 07-06-18 Beador was provided BCA repair scope of work and a cost proposal was requested by H3 staff 07-16-18 City of HBPW received three cost proposals through Beador Construction for Polyester Concrete repair on the Brookhurst Street Bridge Project CC1449. 07-17-18 City of HBPW received final scope of work recommendations from (Biggs Cardosa Associates) with estimated repair area square footages and materials specifications for the Brookhurst Street Bridge Project CC1449. Requested Additional Contract Monies Needed for YTD Grand Total Delay Penalties and Estimated Repair Costs Dates Additional Estimated Repair Costs 6/20/2018 8t7t2018 6/20/2018 817/2018 6/20/2018 81712018 6/20/2018 8/7/2018 Contract Delays Polyester Concrete Repair est. est. Additional Estimated Contract Cost Sub -Total Additional Contract Supplemental Costs Dudek Inspection Leighton Testing 6/20/2018 817/2018 BCA Engineering est. est. est. Additional Estimated Supplimental Cost Sub -Total $212,000.00 $ 26,000.00 $ 134,000.00 $ 160,000.00 $ 12,000.00 $ 20,000.00 $ 20,000.00 $ 52,000.00 263 IntelydepartmenW Memo TO: Honorable Mayor and City Council .Z FROM: Travis K. Hopkins PE, Director ofP`u—bfic Works DATE: August 6, 2018 SUBJECT: Brookhurst Bridge Public Works Commission Action In the staff report for item 22 in this evening's agenda (Approve and authorize the Director of Public Works to implement Change Order No. 1 for the Brookhurst Street Bridge Preventive Maintenance project, CC-1449 and authorize an appropriation from the Gas Tax Fund of $212,000) it is noted that the item would be taken to an emergency meeting of the Public Works Commission for approval. On August 2, 2018, the Public Works Commission received the change order and recommended approval of the item 5-0-2 (Larkin and Nguyen absent). Cc: Fred Wilson, City Manager Robin Estanislau, City Clerk SUPPLEMENTAL COMMUNICATION Meeting Date: O - 6 - Agenda Item No.. -1- 8/6/2018 i i RECEIVED BY - (Name) % v (Date) LDlam= CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: A)N//-7 d' SUBJECT: Bond Acceptance have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. Other No. g:/forms/bond transmittal to treasurer (Company Name) ZXV5043 Approved 1,,-IL611 (Counc Approovaal Date) Agenda Item No. w City Clerk Vault No. Q SIRE System ID No. J FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND BEADOR CONSTRUCTION COMPANY, INC. FOR BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, CC-1449 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 Beador Construction Company, Inc., a 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 Brookhurst Street Bridge Preventative Maintenance, CC- 1449 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, 1 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 including, but not limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public X SFF:17-5732/158097/CalTrans-Federal Contract 6/17 Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; D. The 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 as specified in the particular Plans, Specifications, Special Provisions and Addenda applicable to the Project; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (attached as Exhibit "A"), and, the Federal Requirements from FHWA 1273 (attached as Exhibit "B"); and 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 3 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed Eight Hundred Sixty -Six Thousand, Three Hundred Dollars ($866,300.00), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within one hundred thirty (130) consecutive working days from the day the Notice to Proceed is issued by CITY, 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 F SFF:I 7-5732/158097/CalTrans-Federal Contract 6/17 contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope 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. 5 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 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 ON SFF:17-5732/158097/CalTrans-Federal Contract 6/17 items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of One Thousand, Five Hundred Dollars ($1,500.00) per each calendar 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. 7 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless CITY shall grant a further period of time), notify CITY 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 CITY 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. SFF:17-5732/158097/CalTrans-Federal Contract 6/17 12. DEMANDS FOR ADDITIONAL TIME OR MONEY A. Definitions. (1) "Change Order" means a document signed by the CONTRACTOR and CITY which authorizes an addition, deletion or revision in the work, or an adjustment in the Compensation under Section 3, or the Completion Time specified at Section 4. (2) "Demand" means a written demand for a Change Order by the CONTRACTOR for any of the following: (a) A time extension; (b) Payment of money or damages arising from work done by, or on behalf of, the CONTRACTOR pursuant to this Agreement and payment of which is not expressly permitted pursuant to Section 3 of this Agreement; (c) Payment of an amount the CITY disputes; (d) Any disputes and other matters relating to the acceptability of the work performed or the interpretation of the Contract Documents; (e) A request for a time extension or additional payment based upon differing site conditions, such as subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents, or 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 PROJECT; or (f) A request for a time extension or additional payment based upon acts of neglect by CITY or due to fires, floods, labor disputes, epidemics, abnormal weather conditions or acts of God. 0 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 B. A Demand for a time extension or payment of money or damages may only be granted by a Change Order. C. No Change Order may be granted except where the Contractor has submitted a Demand to the DPW (or its written designee). All Demands shall be submitted promptly, but in no event later than thirty (30) days after the occurrence of the event giving rise to the Demand. The Demand shall be in writing and include all documents necessary to substantiate the Demand. The DPW shall act on the Demand within fifteen (15) days after receipt, including by requesting additional information from the CONTRACTOR to determine whether to approve the Change Order the Demand seeks. The DPW shall act on the Demand within fifteen (15) days after receipt of the additional information or within a period of time no greater than the time the CONTRACTOR took to produce the additional information requested, whichever is greater. D. Notwithstanding the thirty (30) days to submit a Demand under Subparagraph C, in the case of differing or unknown site conditions, immediately upon encountering the conditions, CONTRACTOR shall notify the DPW in writing of the conditions, so that the DPW may promptly investigate the conditions. E. If the CONTRACTOR disputes the DPW's written response on the Demand, or the DPW fails to respond within the time prescribed, the CONTRACTOR may so notify the DPW, in writing, either within fifteen (15) days of receipt of the DPW's response or within fifteen (15) days of the DPW's failure to respond within the time prescribed, respectively, and request an informal conference to meet and confer for settlement of the Demand. Upon the CONTRACTOR's request, the DPW shall schedule a meet and confer conference within thirty (30) days to seek to resolve. 10 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 F. CITY and CONTRACTOR shall execute appropriate Change Orders covering changes to the time or price by executing the Change Order by mutual agreement. If the CITY and CONTRACTOR are unable to reach a mutual agreement, then the City Engineer shall issue a written decision on the claim within a reasonable time. G. Following the meet and confer conference, if the Demand remains in dispute, the CONTRACTOR may file a claim with the CITY as provided in Chapter 1 (commencing with Section 900) and Chapter 2 (commencing with Section 910) of Part 3 of Division 3.6 of Title 1 of the Government Code. For purposes of those provisions, the running of the period of time within which a claim must be filed shall be tolled from the time the time the CONTRACTOR submits his or her Demand until the Demand is denied as a result of the meet and confer process, including any period of time utilized by the meet and confer process. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an increase in the time necessary for completion, DPW shall 11 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof From each progress estimate, five percent (5%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. 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. Provided, however, that in the event of a dispute between CITY and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the contract price shall not be considered as an acceptance of any part of the work. 12 SFF:17-5732/158097/Ca]Trans-Federal Contract 6/17 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 CITY 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 13 SFF:17-5732/158097/Cal'rrans-Federal Contract 6/17 CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY, its officers, elected or appointed officials, employees, agents, and volunteers. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 14 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to defend, hold harmless and indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as (the "Additionally Insured Parties") 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 and non-contributory with any other valid and collectible insurance or self-insurance available to the Additionally Insured Parties. Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties. All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties. Under no circumstances shall said above -mentioned insurance contain a self -insured retention without the express written consent of CITY; however, an insurance policy "deductible" of $5,000.00 is permitted. 15 SFF:17-5732/l 58097/CalTrans-Federal Contract 6/17 CONTRACTOR shall be responsible for causing all Subcontractors to maintain the same types and limits of insurance coverage as that required of CONTRACTOR by this Agreement. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. CONTRACTOR shall maintain the foregoing insurance coverages in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverages shall not derogate from the provisions for indemnification of CITY by CONTRACTOR under the Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of all the 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. 16 SFF:17-5732/158097/Ca]Trans-Federal Contract 6/17 22. DISADVANTAGED BUSINESS ENTERPRISES. CONTRACTOR shall not discriminate on the basis of race, color, national origin, or sex in the performance of this Agreement. CONTRACTOR shall carry out applicable requirements of Part 26 of Title 49 of the Code of Federal Regulations in the award and administration of this Agreement, which has received funding assistance from the United States Department of Transportation. Failure by CONTRACTOR to carry out these requirements is a material breach of this Agreement, which may result in the termination of this Agreement or such other remedy as the CITY deems appropriate. 23. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 17 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 24. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty-five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 25. 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. 26. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 18 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 27. 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. 28. FEDERAL PARTICIPATION Because the United States of America is providing funding for the PROJECT, CONTRACTOR shall comply with the following Federal Statutes and Regulations: A. Attached at Exhibit "B" is FHWA Form 1273, which describes required Federal contract provisions which CONTRACTOR shall perform. Additionally, CONTRACTOR shall incorporate Form 1273 into each of CONTRACTOR's subcontracts for the PROJECT, and further require each subcontractor to incorporate Form 1273 in any lower tier subcontract or purchase order. B. Pursuant to the Federal Cargo Preference Act (46 CFR Part 381), the CONTRACTOR agrees: (1) To utilize privately owned United States -flag commercial vessels to ship at least 50 percent of the gross tonnage (computed separately for dry bulk carriers, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or commodities 19 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 pursuant to this Agreement, to the extent such vessels are available at fair and reasonable rates for United States -flag commercial vessels. (2) To furnish within 20 days following the date of loading for shipments originating within the United States or within 30 working days following the date of loading for shipments originating outside the United States, a legible copy of a rated, `on -board' commercial ocean bill -of -lading in English for each shipment of cargo described in paragraph (B) (1) of this Section to both the Contracting Officer (through the prime contractor in the case of subcontractor bills -of -lading) and to the Division of National Cargo, Office of Market Development, Maritime Administration, Washington, DC 20590. CONTRACTOR shall incorporate Section 28(B) of this Agreement into each subcontract, and further require each subcontractor to incorporate Section 27(B) of this Agreement in in any lower tier subcontract or purchase order. C. Pursuant to the Buy America Act, CONTRACTOR agrees: (1) Furnish steel and iron materials to be incorporated in the PROJECT that was melted and manufactured in the United States except: a. Foreign pig iron and processed, pelletized, and reduced iron ore may be used in the domestic production of the steel and iron materials b. If the total combined cost of the materials does not exceed the greater of 0.1 percent of the total bid or $2,500, materials produced outside the United States may be used if authorized (2) Furnish steel and iron materials to be incorporated into the work with certificates of compliance and certified mill test reports. Mill test reports must indicate where the steel and iron were melted and manufactured. 20 SFF:I 7-5732/158097/CalTrans-Federal Contract 6/17 (3) To incorporate Section 28(C) of this Agreement into each subcontract and further require each subcontractor to incorporate Section 28(C) into any lower tier subcontract or purchase order. D. Pursuant to Section 402 of the Vietnam Era Veterans Readjustment Act of 1974 (38 USC Section 219 et seq.), CONTRACTOR agrees: (1) To prohibit job discrimination and require affirmative action to comply and advance in employment to (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. (2) To incorporate Section 28(D) of this Agreement into each subcontract and further require each subcontractor to incorporate Section 28(C) into any lower tier subcontract or purchase order. 29. 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 21 SFF: I 7-5732/158097/CalTrans-Federal Contract 6/17 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. 30. 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. 31. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. 22 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 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 32 and any damages shall be assessed as set forth in Section 32. 32. 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. 33. 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. 23 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 34. 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. 35. 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. 36. 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. 37. 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 24 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: City of Huntington Beach ATTN: John Griffin 2000 Main Street Huntington Beach, CA 92648 38. SECTION HEADINGS TO CONTRACTOR: David A. Beador Beador Construction, Inc. 26320 Lester Circle Corona, CA 92883 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. 39. 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. 40. 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 25 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 41. 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 attomey's fees from the nonprevailing party. 42. 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. 26 SFF:17-5732/158097/Cal'rrans-Federal Contract 6/17 43. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 44. 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. 45. 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. 46. 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. 47. 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. 48. 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 27 SFF:17-5732/158097/Ca]Trans-Federal Contract 6/17 unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on4v&J,5, 2017. CONTRACT print names 1 ITS: (circle one) Chairrrian/President/Vice President CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California LA Ax M^ayoi Nty Cre'rk _ r �� l Io :A,ND INITIATED AND APPROVED: By: Director of Aublic Works print name� ITS: (circle one)' ecretary.,/Chief Financial Officer/Asst. Secretary - Treasurer 28 REVIE 1 D APPROVED: city Manager SFF:17-5732/158097/Cal"Trans-Federal Contract 6/17 EXHIBIT A (Contractor's Proposal) 29 SFF:17-5 732/ 1 58097/Call'rans-Federal Contract 6/ 17 z-'_-X/�L/,&/T SECTION C PROPOSAL for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guarantee 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 completed to the satisfaction of the AGENCY. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the contract, the undersigned agrees that in the event of the BIDDER's default in executing the required contract and filing the necessary bonds and' insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find OpegzS Q in the amount of $ which said amount is not less than 10% of the Total Amount Bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond fortD% ", as the case may be). Any standard Surety Bid Bond form is acceptable. BIDDER shall signify receipt of all Addenda here, if any: 11 Addenda No. I Date Received Bidder's Signature . C-2 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item No. Contract Quantity Unit Description Unit Price : Extended '- Amount 1 1 LS Mobilization $ ALL)— d $ ;L' h,r 2 1 LS Prepare Storm Water Pollution Prevention Plan $ �c x>> .. $ _S2CV�- 3 1 LS Water Pollution Control $. 4 3 EA Emergency Evacuation $ ICr:v r $ '3Cc t , 5 1 LS Traffic Control $��a-$v 27,030 SF Saw Cut, Grind and Remove AC Pavement 7 63 TN Asphalt Tack Coat and AC Leveling Course Pavement $ I $10t -710 8 340 TN ARHM Finish Course Pavement $ $ 611fh_ C-2.1 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item No. Contract Quantity Unit Description Unit Price Extended Amount 9 240 LF Install 4' High Environmental Protection Fence $ iS $ 1 LS Install Striping and Pavement Markings 11 135,000 SF SlurrySeal $ 12 34 CF Remove Unsound Concrete $ We > $ 2-;3 13 317 LF Remove Concrete Barrier $ (}Ga $ 14 317 LF Remove Chain Link Railing $ $ 5-7 C 6 15 34 CF Portland Cement Concrete (Patch) $ �`�?� ` $ 16 317 LF Concrete Barrier (Type 26 Modified) $ �s'i'<J $ 2 =3 60L) C-2.2 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item No. Contract Quantity Unit Description Unit Price Extended Amount 17 317 LF Wildlife Protection Railing 18 16,874 SF Seal Concrete Bridge Deck $ 1 $Z��il� 19 65 LF Chain Link Fence $ 17' � a, $ i-A Sv Total Amount Bid in Figures: $ Total Amount Bid in Words: e` ..... ................. .............o......L.....h......�rid. .c.c.. ....................e..Y.7f'�..J....�..5.a.....r....c C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the Bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Name.andAddress of State Class DIR Dollar. % of Item(s) Subcontractor License Number Amount Contract Number T �, ^ 00o0 / �D/Z 1%,H Ce✓N C-e (00000 1996 /1Yyy 4. 7 S Q par I 00000 b2 1-7-7 5r..1111*-( 5f� I urn D By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of Califomia Ss. County of' OrzK( 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed onah9*-L , at. CA - Date city State being first duly sworn, deposes and says that he or she is of 3i6vcc U5;v-i-I (lul- re-+ 1.1_ [he 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. _Z63-d b: n?� Address of Bidder c-1 4,ec ,c 6vvo &P+ Subscribed and sworn to before me this I day of _Ajja=;1 _ , 201 _T µ . R. OUEZAOA ? . Commission # 2100414 7 im Notary Public - California z Orange County v M Comm. Expires Mar 19, 2019 NOTARY PUBLIC NOTARY SEAL C:-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Orange SS. On August 1, 2017 before me, R. Quezada, Notary Public Date Name and Title of Officer Personally appeared David A. Beador R. OUEZA0A Commission # 2100414 Notary Public - California z Z Orange County My Comm. Expires Mar 19, 2019 Place Nowt' seal Above Name(s.) of Signer(s) OPTIONAL Who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) islare subscribed to the within instrument and acknowledged to me that helshe/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 seal. Signature of oiaw Public Though the inforaratioti below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document. Document Date: Number of Pages, Signer(s) Other Than Named Above: Signer's Name -individual -Corporate Officer Title(s)i Partner- Limited General -Attorney-in-Fact -Trustee Guardian or Conservator --Other Signer is Representing: Signer's Name, -Individual _Corporate porate Officer Title(s) -partner--l-imited-General Attornev- in- Fact Top of thumb - Trustee .. here - Guardian or Conservator -Other:. Signer is Representing: Top of thumb here UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449, (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 promises and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: A '�3 1. 1 C-5 Contracto C�Q iU BY Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes O-No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-b COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a Public Works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: �'� — 1 % C-7 Contractor By Title BIDDER'S INFORMATION Bidder certifies that the following information is true and correct: Bidder Name Business Address City, State Zip () �74.--% 2 Telephone Number `-12-c4 .- " / i ' State Contractor's License No. and Class Original Date Issued Expiration Date The work site was inspected by of our office on`> , 2011 . The following are persons, firms, and corporations having a principal interest in this proposal: �`../ i l._J�s'pflJ,.�f • .�z9'�i �%-✓ J`- j�`ty!}S.it } VVr�1-�Gz✓� G8 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. Signai&TBNcler Printed or Typed Signature Subscribed and sworn to before me this \--- day of _/ J.JA ; 201 . A notary public or other officer completing this certificate verities only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of C",. County of 0qC,! e- —.- -- ) On,')�-t 1 , a uti before me, -- 2zIL__�_N� Month, Day, and Year insert Name and Title of Notary personally appeared Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose namc(s) is/are subscribed to the within instrument and acknowledged to me that he/shc/they executed the same in his/her/their authorized capacity(ics), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the R.OUEZADA foregoing paragraph is true and correct. A _ � . — A Commission # 2100414 a •-as Notary Public - California z WITNESS my hand and official seal. z Orange County M Comm. Expires Mar 19, 2019 FIWIqWGIk Signature _ l` Signature of Notary Public (PLACE; NOTARY SEAL ABOVE) C-v CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Orange SS. On August 1, 2017 before me, R. Quezada, Notary Public Date Name and Title of Officer Personally appeared David A. Beador R.OUEZADA _ a Commission # 2100414 _ Notary Public - California i Orange County D My Comm. Expires Mar 19, 2019 Place Notary Seal Above Name(s) of Signer(s) OPTIONAL 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 seal, Signature of gotafy Public Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Description of Attached Document Title or Type of Document: Document Date Number of Pages: Signer(s) Other Than Named Above: Signer's Name: _Individual _Corporate Officer Titie(s): _ _Partner- _Limited _General _Attorney -In -Fact _Trustee _Guardian or Conservator Other Signer is Representing: Top of thumb here Signer's Name: _Individual _Corporate Officer Title(s)_ —Partner--Limited—General _Attorney -in -Fact _Trustee _Guardian or Conservator Other Signer is Representing: Top of thumb here BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The Bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449. Bidders may submit additional sheets, using the format shown, t em strate his/her historry -o �milar work experience. Listed btow e ani and ephone numbers for three public agencies for which the Bidder has performed similar work within the past five years: 2. a Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: C-10 Beador Construction Company, Inc MAJOR CONSTRUCTION PROJECTS / COMPLETED Attachment "A" PHONE NUMBER PROJECTMGR PROJECTSUPT CONTRACT DATE PROJECTNAME OWNER CONTACTPERSON PHONENUMBER PHONENUMBER AMOUNT COMPLETION 210 FWY-CCTV 07-129934 562-755-9218 951-674-7352 949-279-3676 Tustin Caltrans Hessam Mansouri David Beador John Brink $213,027 00 Oct-07 5 FWY & 55 FWY 12-OH3704 949-598-3587 951-674-7352 949-279-3676 Costa Mesa Caltrans Kupan Ramanathan David Beador John Brink $309,148.00 Oct-07 Paularion Avenue 12-OG1904 714-567-6172 951-674-7352 949-279-3676 Laguna Coast Wilderness Park County of Orange Chns Kubasek David Beador John Brink $598,965.00 Nov-08 Mull, -Use Trad 714-448-6251 951-674-7352 949-279-3676 Fountain Valley Caltrans Malid Javahernashan David Beador John Brink $876,273 00 Jan-09 Brockhurst & 405 Freeway 12-OH5404 949-279-8743 951-674-7352 949-279-3676 City of Corona City of Corona Reza Zolghadr David Beador John Brink $1.762,710.00 Jul-08 El Cerrito Interchange Improvements-1-15 951-736-2441 951-674-7352 949-279-36715 City of Costa Mesa City of Costa Mesa Raja Sethurarman David Beador Ramuo Acevedo $3.582 420 00 Apr-09 Harbor Boulevard Improvements - 405 714-754-5032 951-674-7352 949-279-0057 Corona Caltrans Imad Abughafeeh David Beador John Brmk $13,773,532.00 Oct 09 Widen Bnd a/Interchange Improvments 08-452204 951-232-3610 951-674-7352 949-279-3676 Los Angeles CalTrans Darrell McKenzie David Beador John Brink $507. 733 00 Sep-08 Various 07-246704 818-637-2506 951-674-7352 949-279-3676 San Diego CalTrans Greg McClendan David Beador John Brink $517,031 00 Oct-08 Ranip Rehabdnatmn 11-284004 760-355-8666 951-674-7352 949-279-3676 Los Angeles Caltrans Hassan Azima David Beador John Brink $259,503 00 Sep-08 Paving & Slope Paving 07-4S7404 323-981-1795 951-674-7352 949-279-3676 Mira Loma City of Loma Linda Ivan Benaviclez David Beador Bob Ortega $3,947,214 00 Jan-10 Mountain View Avenue Bridge Widening 909-350-2144 951-674-7352 949-678-2041 Vista Point CalTrans Sera Parbul David Beador John Bunk $442,690 00 Auq-08 Paving 08-005004 909-381-1939 951-674-7352 949-279-3676 Hesperia & 15 FWY CalTrans Ehab Mina David Beador John Brink $222,359,00 Sep-08 Paving 08-OH1204 951-232-6415 951-674-7352 949-279-3676 San Diego CalTrans Carlos Cortez David Beador John Brink $457,544 00 Apr-09 Ramp Rehab & Widening 11-285904 619-697-0217 951-674-7352 949-279-3676 San Bernardino CalTrans Alfonso Gonzales David Beador John Brink $1,821,655 00 Jul-08 Emerge icy Jobs 08-OL7604/08-OL7704 760-843-5844 951-674-7352 949-279-3676 Ventura CalTrans Joseph Tehram David Beador Jahn Brink $394,576 00 Sep-08 Cold plane & hot mix asphalat overlay 07-2Y6604 805-375-9247 951-674-7352 949-279-3676 Monterey Park CalTmis, Miguel Rodriguez David Beador John Brink $523,297.00 Sep-08 Cold plane & hot mix asphalat overlay 07-1X2404 323-981-1795 951-674-7352 949-279-3676 Long Beach Port of Lonq Beach Alex Reus David Beador Bob Ortega $555,170 00 Jan 09 Straighten Bridge Girder 0 1 Oth Street 562-590-4172 951-674-7352 949-678-2041 Los Angeles CalTrans Sam Gallardo David Beador Jeff Bari $9,998,043,00 Mar-10 Sepulveda Ramp & Bridge Widening 07-178504 310-609-0264 951-674-7352 949-337-0543 San Bernardino SANBAG Mario Alarcon David Beador Ramiro Acevedo $1.15041600 SR 210 Muscoy Underpass Seismic C08-191 909-795-1003 951-674-7352 949-279-0057 Newport Beach -Crystal Heights Dove CalTrans Fred Hamim David Beador John Brink $707,545 00 Mar-10 Drainage, Cold Plane, Paving, Planting 12-OG5304 949-279-8486 951-674-7352 949-279-3676 Riverside LNR Riverside, LLC John Schaefer David Beador Jeff Barglowskr $1,860,621.00 Sep-09 Cactus Ave & 215 Bridge Widening 949-885-8500 951-674-7352 949-337-0543 Beaumont CalTrans Mahfual Alam David Beador John Brink $44,234,240 00 Start Feb 2009 Construct Bridge & Street Works 08-472304 951-276-1938 951-674-7352 949-279-3676 Santa Ana City of Santa Ana - 5th William Albright David Beador Jeff Barglowskr $2,415,273.00 Mar-10 Construct Bridge & Street Works 5th St & McFadden Bridge 714-647-5029 951-674-7352 949-337-0543 Barstow CalTrans Taghreed AI-Khateeb David Beador Bob Ortega $477,254 00 Sep-09 Rehabilitate Bridge Decks 08-492904 951-232-7793 951-674-7352 949-678-2041 0nlario'Rancho Cucamonga CalTrans Elvira Lenart David Beador Bob Ortega $473.773 00 Sep-09 Rehabrldate Bridge Decks 08-OG7404 951-232-8949 951-674-7352 949-678-2041 Anaheim 55/91 CalTrans Sam Khabbr David Beador Bob Ortega $189.668 00 Ju1-09 Replace Concrete Slabs 12-OH3904 949-279-8416 951-674-7352 949-678-2041 County of Los Angeles County of Los Angeles Victor Bermudez David Beador Jeff Barglowskr $250,300 00 Oct-09 Carson/1232-Lme A FCC0001099 626-688-8275 951-674-7352 949-337-0543 County of Los Angeles County of Los Angeles Salman Khan David Beador Bob Ortega $197.120 00 Start Sept 2010 Anaheim Street Over LB Freeway RDC0011234 6264584956 951-674-7352 949-678-2041 Complete Feb 2011 County of Orange County of Orange Hamid Abedzadeh David Beador Ramiro Acevedo $4,776.212 00 Start Apr 2010 Moulton Parkway Widening ER08402 714-567-7800 951-674-7352 949-279-0057 Complete Dec 2011 County of Los Angeles County of Los Angeles Alex Carlos David Beador Bob Ortega $1,595,361 00 Start May 2010 Valley Blvd over Old Valley Rd & UPRR RDC0012368 626-786-5813 951-674-7352 949-678-2041 Complete 2012 Irvne CalTrans Steve Kinaly David Beador Ricardo Covarrubtas $309,122.00 Auq-10 Rid 133- Hot Mix Asphalt Overlay 12-OK2704 949-279-8800 951-674-7352 951-453-3378 Moreno Valley CalTrans Miguel Cal,do David Beador Evan Burden $4,433,631 00 Start July 2010 Rid 60 - Rubbenzed HMA Ovedaly 08-ON3004 951-232-8957 951-674-7352 909-721-1642 Dec-!() San Juan Capistrano CalTrans Maid Javaherneshan David Beador Ramiro Acevedo $8,404,700 00 Start June 2011 Rte 5 - Widen Roadway and Bndges 12-OE5704 949-289-3551 951-674-7352 949-279-0057 Complete June 2013 Irvine City of Irvine Steve Sherwood David Beador Larry Coleman $248,567 00 Start Nov 2010 Macarthur Median Drainage Imprvmnts 314120 949-724-6000 951-674-7352 949-279-0386 Complete Sept 2011 Irwindale - Bridge County of Los Angeles Salman Khan David Beador Bob Ortega $1,929,786 00 Start May 2011 Foothill Blvd over San Gabriel River RDC0011613 626-458-4956 951-674-7352 949-678-2041 Complete April 2012 Long Beach - Road Improvements Port of Long Beach PK Wang David Beador Bob Ortega $428,822 00 Start Oct 2010 710- Ninth and Shoemaker Bridge HD-S2339 562-901-1759 951-674-7352 949-678-2041 Complete 2012 Long Beach - Bridge Girder Repair Port of Long Beach PK Wang David Beador Bob Ortega $439,371 00 Start Oct 2010 SR 710 - Anaheim Street Bridge HD-S2320A 562-901-1759 951-6744352 949-678-2041 Complete 2012 Newport Beach Seismic Retrofit City of Newport Beach Thomas Sandefur David Beador Ramiro Acevedo $780,759 00 Start Dec 2010 Bridge Seismic Retrofit #3531 949-644-3312 951-674-7352 949-279-0057 Complete Aug 2011 57 FWY CalTrans Adrian Wu David Beador Jeff B & Bob Ortega $28,581.800,00 Start Feb 2011 Rte 57 in Placentia & Fullerton 12-OF0314 949-279-8488 951-674-7352 951-674-7352 Complete 7-2014 1-10 WB Lane addition SANBAG Ken Lonchanch David Beador Ramiro Acevedo $16.083,300 00 Start Feb 2011 Rte 10 in Redlands & Yucaipa C10190 STPLN 6053(088) 949-283-0854 951-674-7352 949-279-0057 Complete 2013 City of Newport Beach City of Newport Beach AB Fakhoun David Beador Ramiro Acevedo $3,522,723 00 Start May 2011 Jamboree Road over SR-73 #3724 949-644-3312 951-674-7352 949-279-0057 Complete 2012 County of Orange County of Orange Hiram Downard David Beador Ramiro Acevedo $20,053,300.00 Start June 2011 Antonia Parkway #ER08990 714-567-7838 951-674-7352 949-279-0057 Complete 2013 City of Moreno Valley City of Moreno Valley Vnen Shah David Beador Bob Ortega $229,000 00 Start April 2011 2011 Citywide Bridge Maintenance Program 11-22679828 951-314-2288 951-674-7352 949-678-2041 Complete June 2011 County of San Bernardino County of San Bernardino David Beador Bob Ortega $360,422 00 Start May 2012 Hwy 330 08-OJ8004 951-674-7352 949-678-2041 County of Riverside City of Corona/Murneta David Beador Bob Ortega $726,521 00 Completed 15/215/91 08-002104 951-674-7352 949-6/6-2041 County of Riverside County of Riverside David Beador Bob Ortega $11,870 00 Completed Blythe Emergency Repair 08-007004 951-674-7352 949-678-2041 County of Los Angeles County of Los Angeles David Beador Bob Ortega $1,169,693 00 Completed PCH Bridge 07-3X4604 951-674-7352 949-678-2041 County of Orange County of Orange David Beador Ramiro Acevedo $235,551 00 Completed 91 Freeway Emer ency 12-OM1904 951-674-7352 949-279-0057 City of Carlsbad C1N of Carlsbad Casey Arndt David Beador Ramiro Acevedo $660,000 00 Start Jan 2015 Carlsbad Blvd OH RailingImprovements 6016/3557 (760) 602-278o x7320 951-674-7352 949-279-0057 Complete Au ust 2015 City of Tustin City of Tustin Jon Draugelrs David Beador Ramiro Acevedo $1,560,000 00 Start August 2015 Install Bicfiltration Units 50041 714 573 3164 951-674-7352 949-279-0057 Complete March 2016 Beador Construction Company, Inc MAJOR CONSTRUCTION PROJECTS / COMPLETED Attachment "A" PHONE NUMBER PROJECTMGR PROJECTSUPT CONTRACT DATE PROJECTNAME OWNER CONTACTPERSON PHONE NUMBER PHONE NUMBER AMOUNT COMPLETION Palos Verdes Estates City of Palos Verdes Wendy Farce David Beador John Brink $1,010,000.00 Sep-02 Construct Storm Dram #3 310 378-0383 951-674-7352 949-279-3676 Beaumont - Marshall Creek City of Beaumont John Wilder David Beador John Brink $672,000 00 Mar-02 Flood Control Channel 909 769-8520 951-674-7352 949-279-3676 Laguna Hills City of Laguna Hills Ken Rosenfeld David Beador Ramiro Acevedo $489,205 00 Apr-03 Turtle Mitigation Plan 949 707-2655 951-674-7352 949-279-0057 Los Angeles CalTrans Simon Wang David Beador John Brink $377,000 00 Sep-02 Slope Repair & Irrigation 07-4H5404 213 620-2039 x209 951-674-7352 949-279-3676 Downey CalTrans Wale Alone David Beador Ramiro Acevedo $203,000 00 Oct-02 Install Bridge Deck Storm Drains 07-4G3804 562 401-3333 x261 951-674-7352 949-279-0057 Southgate City of Southgate A B Fakhoun David Beador Ramiro Acevedo $2,427,249 00 Jun-04 Reconstruct 710/Firestone Inter change 310-592-1829 951-674-7352 949-279-0057 Oceanside City of Oceanside Gary Kel6son David Beador John Brink $150,000 00 May-03 Install Storm Drain 760435-5112 951-674-7352 949-279-3676 Corona Cal -Frans Ali Fathr David Beador John Brink $171 000 00 Aug-03 Drainage Improvements 08-467104 909232-7259 951-674-7352 949-279-3676 County of L. A. L A County Chandra McCloud David Beador John Brink $108,000 00 Sep-03 Box Replacement Line A FCC0000892 626 4584967 951-674-7352 949 279-3676 Temecula Eastern Municipal Water Arlen Nielson David Beador John Brink $512,016 00 Sep-04 First Street Sewer District Pralect 8675 909 298-3777 951-674-7352 1 949 279-3676 Long Beach Port of Long Beach Alex Reus David Beador Ramiro Acevedo $173,592 00 Jun-04 Storm Dram Pump Station 28 562 590-4173 951-674-7352 949 279-0057 San Juan Capistrano CalTrans Andy MyDounig David Beador Ramiro Acevedo $1,391,750 00 Nov-03 Slonehill Drive median barrier 12-OA4004 714 556-1334 951-674-7352 949 279-0057 Laguna Nigel CalTrans Krfah Ramadan David Beador John Brink $291,832 00 Apr-04 Repair slope erosion & modify drainage 12-OF3804 714 418-5004 951-674-7352 949 279-3676 LA I Redondo Beach CalTrans Wendell Davidson David Beador John Brink $341,651 00 Feb-04 Install metal beam guard rail 07-4G5004 213 798-6048 951-674-7352 949 279-3676 Highland CalTrano Imad Abu-Gharbieh David Beador John Brink $421,281.00 Dec-03 Remove & reconstruct bridge rafting 08-437204 909 390-4503 951-674-7352 949 279-3676 Live Oak Spreading Ground Three Valleys Municipal Thomas Bayles David Beador John Brink $336,568 00 Jan-05 Imported water connection Water District 626 357-0588 951-674-7352 949 279-3676 Riverside County of Riverside Hugh Smith David Beador John B ink $331,300.00 Mar-04 Traffic signal @ Van Boren & Jmupa 909 955-6885 951-674-7352 949 279-3676 Torrance City of Torrance Steve Fnton David Beador John Brink $1,016,068 00 Nov-03 234 Sheet channel improvements 310 618-2975 951-674-7352 949 279-3676 Fullerton CalTrans James Decker David Beador John Brink $207,300 00 Jan-04 Euclid Street Undercrossing 12-OF8304 714 688-1951 951-674-7352 949 279-3676 city of Carlsbad City of Carlsbad Grant Clavier David Beador Jahn Brink $423,698 00 Dec-04 EI Camino Real Sewer Line Contract # 38911 760-602-2780 951-674-7352 1 949 279-3676 County of Orange County of Orange Mil Thornton David Beador John Brink $1,863,859 00 Oct-06 Tustin Avenue Widening ER 08930 714-567-7834 951-674-7352 949-279-3676 Playa Vista Playa Vista Cliff Ritz David Beador Ramero Acevedo $2,500,000.00 Jun-04 Riparian Corridor 310-345-6941 951-674-7352 949-279-0057 Moreno Valley CalTrans Ali AI-Saadoon David Beador John Brink $602,700 00 Mar-05 Widen 60 Freeway Exit Ramp 08-486204 951-276-1945 951-674-7352 949-279-3676 Fontana City of Fontana Paul Lemoine David Beador John Brink $618,700 00 Aug-05 Catawba & Cuffs Avenue Storm Drain 951-686-1070 951-674-7352 949-279-3676 Oceanside City of Oceanside/ Danielle Maxwell David Beador John Brink $3,119,640 00 Oct-06 Douglas Avenue Storm Drain D R Horton Homes 760-929-1600 951-674-7352 949-279-3676 Costa Mesa CalTrans Kdah Ramadan David Beador John Brink $420,272 00 Dec-05 Repair Joint Seal 12-OG8304 949-279-8625 951-674-7352 949-279-3676 Tushn CalTrans Kugan Ramananthan David Beador John Brink $2,449,368 00 Mar-06 (17th & 55) AC Pavement 12-OF2604 949-279-8495 951-674-7352 949-279-3676 Hunnington Beach CalTrans Issac Tabar David Beador John Brink $2,191,183 00 Dct-06 (405 & Beach) Add Offramp Lane 12-OA7614 949-279-8411 951-674-7352 949-279-3676 Santa Ana CalTrans Gassem Zi teian David Beador John Brink $162,945 00 Jul-06 (SB 55 & Einger) 12-OF3604 949-279-8468 951-674-7352 949-279-3676 Hagador Canyon CreeklDrchard Glen Centex Homes Glen Land David Beador John Brink $6,250,665 00 Nov-06 Centex Homes 949-453-0113 951-674-7352 949-279-3676 Dana Point Dana Pond/Sewer Repairs Tom Townsend David Beador John Brink $32,000 00 Dec-05 Sewer Repair/Dana Point Harbor Dana Pont Harbor 949-923-3795 951-674-7352 949-279-3676 City of Corona SE Corporation Hamid Soroosh David Beador John Brink $2,554,198 00 Oct-06 Dos Logosfremescal Canyon/Bedford Wash Channel 213-926-2640 951-674-7352 949-279-3676 City of Oceanside PBS&J Jeff Moody David Beador John Bank $1,243,125 00 Jun-06 Douglas Drive Street Improvement 760-525-8647 951-674-7352 949-279-3676 Tushn County of Orange Octavio Rivas David Beador John Brink $1,611,976 00 Jan-06 Skyline Drrve/Stonn Sewer 714-567-7814 951-674-7352 949-279-3676 Huntington Beach Caltrans James Yii David Beador Jahn Book 5458,056.00 Aug-06 405&SB Edinger Avenue On -Ramp 12-OG3804 714-556-8202 951-674-7352 949-279-3676 San Diego Caltrans Con Kontaxis David Beador John Brink $370,100 00 Nov-06 State Hwy Modify Existing Drainage 11-091604 619-397-6254 951-674-7352 949-279-3676 Los Angeles Caltrans Reds, Karout David Beador John Brink $532,368 00 Oct-06 Reconstruct Drainage Invert 07-4G7004 626-338-3340 951-674-7352 949-279-3676 Colton Caltrans Ali Fathi David Beador Ramiro Acevedo $159 405 00 Jun-06 Repair Drainage Girder 08-OF2704 951-276-1945 951-674-7352 949-279-0057 City of Oceanside City of Oceanside Gary Bodman David Beador John Brink $508,596 00 Jan-07 Hoover Street Sewer Line improvement 760-435-5908 951-674-7352 949-279-3676 Laguna Coast Wilderness Park County of Orange W.P. Niemann David Beador John Brink $370,909 00 Jum07 SCE Bridge 714-834-7801 951-674-7352 1 949-279-3676 Irvine Caltrans Kifah Ramadan David Beador John Brink $9,184,704 00 Jul-07 5/133/Barranca 12-OF9504 949-279-8625 951-674-7352 949-279-3676 Irvine Caltrans James Yu David Beador John Brink 52,104,600 00 Apr-07 73/Bonita Canyon/El Toro 12-OC9834 949-279-8743 051-674-7352 949-279-3676 Colton Caltrans Nahro Saoud David Beador John Brink $4,400,720 00 Apr-07 215 08-OC1804 951-232-9778 951-674-7352 949-279-3676 Cily of Temecula City of Temecula Scott Harvey David Beador John Brink $4,956,168c0 Feb-07 79 South 951-694-6411 951-674-7352 949-279-3676 City of Newport Beach City of Newport Beach Michael Snacon David Beador John Brink $4,555,025.00 Apr-07 Big Canyon 949-644-3311 951-674-7352 949-279-3676 Corona SE Corporation Hamid Soroosh David Beador John Brink $1,258,500 00 Oct-06 Wemck Road & 15 213-926-26640 951-674-7352 949-279-3676 Huntington Beach Caltrans Jose Berries David Beador John Brink $422,006.00 Jun-07 Westminster B Edinger 12-OH0014 949-279-8502 951-674-7352 949-279-3676 Anaheim Caltrans Jose Berries David Beador John Brink $1,063,311 00 Jul-08 Gene Autry 12-OF9404 949-279-8502 951-674-7352 949-279-3676 Orange & Anaheim Caltrans Kfah Ramadan David Beador John Brink $634,227 00 Aug-07 57 FWY 12-OH2484 949-279-8625 951-674-7352 949-279-3676 Corona County of Riverside Ivan Mendoza David Beador John Brink $1,507,457 00 Jul-07 Calalco/Harle Road 562-254-9351 951-674-7352 949-279-3676 Irvine City of Irvine Steve 0II0 David Beador John Brink $22,983,169 00 Dec-09 McArthur& Redhill 949-724-6000 951-674-7352 949-279-3676 Yorba Linda County of Orange Daren Shappet David Beador John Brink $1,697,571 00 Sep -OS Santa Ana River Bike Trail 714-567-7837 951-674-7352 949-279-3676 South Gate City of South Gate Jim Hannigan David Beador Bob Ortega $11,160 875.00 Oct-08 Firestone Bnd e Widening -Rio Hondo 585-205-7730 951-674-7352 949-678-2041 San Diego Caltrans Rahim 858-688-1318 David Beador John Bonk $119,700 00 Jun-07 Route 52 11-280604 Akhoncincindeh 951-674-7352 949-279-3676 Lucerne Valley Caltrans Mohsen Parvinlah David Beador John Brink $489,016 00 Aug-07 Route 247 08-OH6404 951-232-7755 951-674-7352 949-279-3676 )Various (Caltrans I Warren Yut I David Beador I John Brink 1 $10,400,23800 1 Jan-10 Beador Construction Company, Inc Attachment "A" MAJOR CONSTRUCTION PROJECTS / COMPLETED PHONENUMBER PROJECT MGR PROJECTSUPT CONTRACT DATE PROJECTNAME OWNER CONTACTPERSON PHONENUMBER PHONE NUMBER AMOUNT COMPLETION Orange - Chapman Ave. Countyof Orange Stan VanderMay David Beador Robert Hinojosa $175,00000 May-98 Seismic Retiofl 714 567-7832 951-674-7352 951-674-7352 Los Angeles - 10 CalTrans David Nloya David Beador Robert Wnolosa $635,000 00 May-98 Approach & Departure Slabs 310 577-9605 951-674-7352 951-674-7352 Long Beach CalTians Dar Pham David Beador Robert Hinojosa $146,000 00 Jun-98 Treat Bridge Decks 714 556-1746 951-674-7352 951-674-7352 Long Beach -Westminster Ave L A County - DPW Neil Munaweera David Beador Robert Hinojosa $380,00000 Dec-97 Rein/Rep Overhang Sidewalk 626458-3122 951-674-7352 951-674-7352 Baldwin Park - Merced Ave. City of Baldwin Park Anne Garvey David Beador Robert Hinojosa $460,000 00 Sep-97 Bridge Widening 626 960-4011 951-674-7352 951-674-7352 Irwindale - Irwindale Ave. CalTrans Ernie Ardales David Beador Robert Hinojosa $250,000 00 Aug-97 Pavement Rehab 909 305-1250 g51-674-7352 951-674-7352 Long Beach - DelAmo Blvd. L A County - DPW Neil Munaweera David Beador Robert Hinojosa $750,000 00 Sep-98 Seismic Retrofit 626 458-3122 951-674-7352 951-674-7352 Carson -213lh Street LA County - DPW Neil Munawfera David Beador Robert Hinojosa $160,00000 Sep-98 Bridge Seismic Retrofit 626 458-3122 951-674-7352 951-674-7352 Downey - Firestone Blvd. CalTnans Jahn Vassilrades David Beador Robert Hmolosa $180,000 00 Sep-98 Modify 0N-Ramp 5624or-3333 951-674-7352 951-674-7352 San Juan Capistrano City of San Juan Cap Bnen Perry David Beador Robert Hmolosa $119,000 00 Oct-98 City Bridge Repairs 949 443-6353 951-674-7352 951-674-7352 Garden Grove - Beach Blvd. CeITnans Leda Nerdecker David Beador Robert Hmolosa $370 000 00 Feb-99 On -Ramp Improvements 714 556-8202 951-674-7352 951-674-7352 Irvine - Michelle Drive Griffith Company Allen Perkovich David Beador Robert Hmolosa $260,000 00 Feb-99 Bridge Widening 714 549-2291 951-674-7352 951-674-7352 Newport Beach County of Orange Raymond Douglass David Beador Robert Hmolosa $90 000.00 Aug-99 Ccycle Basin Repairs 949-262-2427 951-674-7352 951-674-7352 Spring Valley -Bancroft Drive CelTnans Gustavo Dallarda David Beador Robert Hmolosa $930 000 00 Sep-99 Bridge Widening 619-462-0662 951-674-7352 951-674-7352 Dceanside CelTnans Jeff Brown David Beador Robert Hmolosa $129,00000 Oct-99 Slope Erosion Control 858-467-4088 951-674-7352 951-674-7352 San Gunfire State Park California Department of Greg Kama David Beador Robert Hmolosa $85,000 00 Oct-99 Outlet Repairs Parks & Recreation 949-366-8598 951-674-7352 951-674-7352 Carson - Avalon Avenue CalTrans Massod Akbanan David Beador Robert Hinojosa $200 000 00 Nov-99 Replace Approach Slabs 310-516-4140 951-674-7352 951-674-7352 Long Beach -Trinidad Lane County of Orange Mike Reetz David Beador Robert Hinojosa $180 000 00 Oct-99 Bridge Seismic Retrofit 714-567-7821 951-674-7352 951-674-7352 Colton Avenue CalTnens Manny Yagaralah David Beador Robert Wnolosa $160,00000 May-99 Repair Steel Girders 909-949-3095 951-674-7352 1 951-674-7352 Cerritos CzlTrans Kelvin Train David Beador Robert Hmolosa $268 000 00 May-99 Construct lnfltra6an Basin 562-940-4276 951-674-7352 951-674-7352 San Bernardino Department of Water Both Ross David Beador Robert Hmolosa $106,000 00 Jul-99 Surge Chamber Seismic Retrofit Resources 805-946-1024 951-674-7352 951-674-7352 Los Angeles CalTmns Reza Jahromi David Beador Robert Hmolosa $498,000 00 Mar-99 Replace PCC 310-609-0264 951-674-7352 951-674-7352 Ontario City of Ontario Farm Boulos David Beador Robert Hmolosa $308 000 00 Sep-99 Seismic Retrofit-3 Bridges 909-931-9331 951-674-7352 951-674-7352 Anaheim - Krae-091 California Private Fehun Boulos David Beador Robert Wnolosa $612,000 00 Jan-00 Bridge Widening Transportation Company 909 931-9331 951-674-7352 951-674-7352 Los Angeles - Century Blvd. CalTnans Mahamad Pasebani David Beador Robert Wnolosa $175,000 00 Mar-00 Bridge Repair 310 609-0272 951-674-7352 951-674-7352 Pomona CalTnans Billy Rojas David Beador Robert Wnolosa $618,00000 Jun-00 Median Barrier 909305-1284 951-674-7352 951-674-7352 Riverside CalTrans Ray Stokes David Beador Robert Hinojosa $169,00000 Jun-00 Bridge Repair 08-493104 909 275-0211 951-674-7352 951-674-7352 Los Angeles CeITnans Joseph Tehrani David Beador Robert Hinojosa $173 000 00 Jun-00 Glare Screens 310 768-1704 951-674-7352 951-674-7352 Route 60 - Repl PCC Pave CalTrans Kelvin Train David Beador Robert Wnolosa $530 000 00 Nov-00 Atlantic Blvd 07-4G7304 562401-3333x239 951-674-7352 951-674-7352 Irvine CalTrans Nahrd Baq hbanran David Beador Robert Hinojosa $191000 00 Nov-00 Construct Check Dam 12-071304 7146 2-2535 951-674-7352 951-674-7352 Long Beach CalTrans Mashun Ali David Beador Robert Hinojosa $920,000 00 Nov-00 Reel PCC Pave 310 609-0264 951-674-7352 951-674-7352 Long Beach CalTre- Amlad Obeid David Beador Robert Hmolosa $1,515,000 00 Mar-01 Callector Road & Bridge 07-185004 562 401-3333 951-674-7352 951-674-7352 Downey Ortiz Tom Meyer David Beador Robert Wnolosa $56,250 00 Mar-01 Construct Barrier 07-195704 949753-1414 951-674-7352 951-674-7352 Vernon ACTA Paul Buckley David Beador Robert Hmolosa $4,343,000 00 Jun02 Bridge Widening C0099 323526-7051 951-674-7352 951-674-7352 Fountain Valley CaMans Dal Pham David Beador Ramiro Acevedo $560,000 00 Jun-Oi Widen Ramp 12-OA5204 714 556-9425 951-674-7352 949-279-0057 Long Beach & Signal Hill CalTrans Massod Akbanan David Beador John Brink $333,000 00 Apr-01 Hwy & Apo Slabs Replaced 07-144614 310-516-4140 951-674-7352 949-279-3676 Garden Grove CalTrans Xavier Avila David Beador Ramiro Acevedo $405,00000 Dec-00 Widen Ramp at Valley View 12-OA5004 714632-2539 951-674-7352 949-279-0057 Rancho Cucamonga So Cal Underground Jim Jackson David Beador Ramiro Acevedo $305,000 00 Apr-01 Deer Creek Bridge Widening 310639-2257 951-674-7352 949-279-0057 San Diego Hazard Construction / David Beador Ramiro Acevedo $24,408.00 Jun-Oi Median Bar net CslTraus 858587-3600 951-674-7352 949-279-0057 710 Freeway Excel Pavinq Will Harris David Beador Ramiro Acevedo $1.713 951 00 Feb-04 Banner Rai 562 599-5841 951-674-7352 949-279-0057 Costa Mesa GO I Tom Taylor David Beador Ramiro Acevedo $133,000 00 Sep-02 Calvary Chapel Bridge 714 957-0233 x22 951-674-7352 949-279-0057 Ludlow CalTrans Frank Lozano David Beador John Brink $700 000 00 Feb-02 Repair Earthquake Damage to Bridge 08-496004 760 256-7316 951-674-7352 949-279-3676 Colton CalTrans Mario Savala David Beador Robert Hmolosa $180,000 00 May-02 Mt Vernon Traffic Signal 08-427204 909 519-2422 951-674-7352 951-674-7352 San Diego Can- ans Hassan Muslafe David Beador John Brink $220 000 00 Dec-01 Install CDS Unn 11-172864 619957-4604 951-674-7352 949-279-3676 Riverside County of Riverside Dick Cleland David Beador John Brink $1,300,000 00 Feb-02 Median Barrier on Van Buren Blvd 909 826-5889 951-674-7352 949-279-3676 Los Angeles County of Los Angeles Tony Hu, David Beador Robert Hmolosa $638,302 00 Feb-02 Sierra Madre Dam Bridge Replacement 626 458-4954 951-674-7352 949-279-0402 Walnut City of Walnut Jason Welday David Beador John Blink $133,000 00 Dec-03 Lemon Creek Outlet Structure 909 594-9702 951-674-7352 949-279-3676 San Bernardino Yeager Construction At Artega David Beador Ramiio Acevedo $483,000 00 Dec-02 Barnet rail an 30 Freeway 909 721-9746 951-674-7352 949-279-0057 Santa Ana City of Santa Ana Tyrone Chesanaek David Beador Ramiro Acevedo $2,946,017 00 May-03 Bnstar Street Bridge Widening 714 647-5045 or 29 951-674-7352 949-279-0057 Playa Vista Playa Capital Cliff Ritz David Beador Ramiro Acevedo $2,860,403 00 Feb-04 Perimeter Landscape & Retaining Wall 714-345-6941 951-674-7352 949-279-0057 LaJolla CzlTraus Gary Le Vine David Beador Terry Brown $1,798,002 00 Jun-03 Construct Medan Barrier 11-243704 760 738-6021 951-674-7352 949 279-0385 710 Freeway Excel Paving Will Hams David Beador Ramiro Acevedo $1,738.700 00 Fe6-04 Construct median barrier 07-1384U4 562 591-7485 951-674-7352 949-279-0057 Rainbow Rainbow Water Dist Ken O'Connor David Beador John Bunk $346,000 00 Jan-03 Construct water main 760 942-0366 Xl 58 951-674-7352 949-279-3676 San Bernardino County CalTrans Ali At Saadoon David Beador John Brink S1,269,319 00 Feb-03 Metal Beam Guard Far 08-477904 909 682-1715 949-724-0264 949-279-3676 BIDDER'S CRITICAL STAFF The Bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the Bidder at the time the referenced projects were completed. l ` �AoG-,Z- Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work 2. ��L ;10 A7_ti %A el-17'� Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: Date Completed Date Completed CA, Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic. Opportunities for Low and Very Low -Income Persons The Bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HLID 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: >F -��"% 3 Signed: Date: (— *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.go-,,/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link — Call (844) 522-6734 https://efiling.dir.ca. gov/PWCR/ActionServlet?action=displayP WCRegistrationFonn DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.actioii I am aware and will comply with the provisions of Labor Code Section 1771.1(a) which states: "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. Date:-� —� DIR #: 100-b) "9 C-13 Contractor By Title Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION r� 7 The bidder �z � �,r J4�-t llpl-1 proposed subcontractor hereby certifies that he has , has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 6 of 22 C-14 October2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has ,,,_,_ , has not 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 1 100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes 1] No LLJ If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-15 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 8 of 22 C-16 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of t4c^_t DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shal I 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 Non -collusion Affidavit is pail of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 9 of 22 C-17 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 10 of 22 C-1 S October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 11 of 22 C-19 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACI M LIES PUKSUAN I IU 3I U.Q.U. t »t 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 yo. 4 is Subawardee, Enter Name and Ad Tess of Prime: Prime F-ISubawardee Tier if known Congressional District, if k� n 6. Federal Department/, ge y 8. Federal Action Numb\ t wn: o 10. a. Name and Address of Lobby Entity (If individual, last name(first name, M1) �(' ongressional District, if known Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. 10a) (fast name, first name, MI) (attach Continuation Sheet(s) if necessary) IL Amoent (check all that apply) 13. Type of Payment (check all that apply) $untpf PaymU ❑ actual Elplanned a. retainer b. one-time fee 12. F 4m of Payment (check all that apply): c, commission I✓8 a, cash d. contingent fee b, in -kind; specify: nature e deferred value f other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheets) if necessary) ] 15. Continuation Sheet(s) attached: Yes ❑ No 16. Information requested through this form is authorized by Title 31 U.S C. Section 1352. This disclosure oflobbying Signature. _ reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required �F(/lltf Print Name: pursuant to 31 U.S C. 1352. This information will be 1 reported to Congress semiannually and will be available for public inspection Any person who fails to file the required Title: farc�t disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 I'or each such failure. Telephone No.: �57� �� �7sZ Date: �� 1 Federal Use On Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C_20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred, Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if' known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6, Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid ([FB) 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 Nanie, First Name and Middle initial (MI). It. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box. Check all boxes that apply. If other, specify nature. i4. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employees) contacted or the officer(s) 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-bsvuction Rev 06-04.90aENDiF» Page 13 of 22 C-21 October 2016 Local Assistance Procedures Manual Exhibit 12-B Bidder's Lest of Subcontractors (DBE and NON -DBE) Exhibit 12-B Bidder's List of subcontractor (DBE and Non -DBE) Part 1 As of March 1, 2015 Contractors (and sub -contractors) wishing to bid on public works contracts shall be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at: https://efiiing.dir.ca.gov/PWCR/ActionServlet?action=displayPWCRegistrationForm In accordance with Title 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 of the Public Contract Code of the State of California, as amended, the following information is reauired for each sub -contractor who will perform work amounting to more than one half of one percent (0.5%) of the Total Base Bid or $10,000 wnicnever isgreater). rnotocopy tnis Corm for aacacionai arms. Subcontractor Name and Line Item & Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number contracted DIR Reg Number Name: dtr Q �4 Y < million b -%I (`<$5 millionl10fiS�5 City, State: <$10 million <$15 million j Age of Firm: _ yrs. Name: <$1 million I C9 trn l ZZ 5 t'i <$5 million City, State:<$10 million `( ( Q <$15 million �j.i Vl V4�1�( �j� • �fi►�C1 Vt ���G� ��06 Age of Firm: _ yrs. Name: PUT— <$1 million l' g 23$i12 <$5 million City, State: * 1 6/ o/ <$10 million p (Q CC ..? EA <$15 million f t �g o SOS Age of Firm: _ yrs. Name: t <$1 million .� �•�% 1/1 !i 1 (� 03%0 <$5 million City, State: �`w C _L�I^�y o I �p2� (0.4 o � <$10 million C tInC• u 7 1010000 <$15miilian Suq=�GL(le rt S1-1-76 Age of Firm: _,,yrs. Na e: <$I million p /7! ien (( 372 <$5 million City, te: 100000 O o tl <$10 million Ca T) Ct /Ift S 1 1 (�S. Age of Firm: millia Yrs. Name: <$1 million <$5 million City, State: <$10 million LJ <$15 million Age of Firm: _ yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package G27 Page 1 of 2 September 2016 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 12-B Bidder's List of subcontractor (DBE and Non -DBE) Part 2 In accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provide a quote or bid but were not selected to participate as a subcontractor on this project. Photocopy this form for additional firms. Subcontractor Name and Line Item & Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number contracted DIR Reg Number Name: <$1 million LJ <$5 million City, State: ❑ <$10 million LJ <$15 million Age of Firm: _ yrs. Name: <$1 million [] <$5 million_ City, State; [] <$10 millionT ❑ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million c$5 million City, State: <$10 million ❑ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million ❑ <$5 million City, State: <$10 million <$15 million Age of Firm: _ yrs. Name: EJ <$1 million L___<$5 million City, State: <$10 million LJ <$15 million Age of Firm: yrs. Name: <$1 million ❑ <$5 million City, State: ❑ <$10 million LJ <$15 million Age of Firm: yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package Page 2 of 2 C-28 September 2016 Vil I Document A310 TM - 2010 CONTRACTOR: (Name, legal status and address) Beador Construction Company, Inc. 26320 Lester Circle Corona, CA 92883 OWNER: (Name, leegal status and address) City of Huntington Beach 2000 Main Street SURETY: (Name, legal status and principal place of business) Great American Insurance Company 301 E. 4th Street Cincinnati, OH 45202 Huntington, Beach, CA 92648 BOND AMOUNT: Ten Percent of Amount Bid (--10%--) PROJECT: (Name, location or address, and Project number, if any) Brookhurst Street Bridge Preventive Maintenance (Over Talbert Channel), C.C. No. 1449 This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. Project Number, if any: The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material famished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and seated this 27th day of July, 2017 (Witness) �.-& &&C-. Xx4' (Witness) Frances Lefter BeAr Lis , truction Comnanv. Inc (Pi.l�l WfCtt�sl f'x-'� (Seal) (TiTi e) Great American Insurance Company (Surety) j (Seal) �l.tr (Title) Erik Johansson, Attorney -In -Fact AIA Document A310TM — 2010. Copyright© 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AleInit. Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This / document was created on 01/27/2012 07:23.12 under the terms of AIA Documents -on -Demand TM' order no. 2008397483 , and is net for resale. This document is licensed by The American Institute of Architects for one-time use only, and may not be reproduced prior to its completion. ociiio CALIFORNIA-. . . .. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On JUL 2 7 2017 before me, Date personally appeared E. M. Bell, Notary Public Here Insert Name and Title of the Officer Erik Johansson Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/XX subscribed to the within instrument and acknowledged to me that he/dWI executed the same in his/,% authorized capacity(ies), and that by his/D signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. -- E. M. BELL C\j COMM. # 2151184 g NOTARY PUBLIC CALIFORNIA o 's LOS.ANGELES COUNTY ro My comm. expires Apr. 29, 2020 C I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ('� Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): • Partner — El Limited El General • Individual El Attorney in Fact • Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: I] Corporate Officer — Title(s): 71 Partner — 71 Limited I] General I] Individual -D Attorney in Fact I] Trustee ❑ Guardian or Conservator I] Other: Signer Is Representing: ©2014 National Notary Association - www.NationaiNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET 0 CINCINNATI, OHIO 45202 0 513-369-5000 0 FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FIVE POWER OF ATTORNEY No.0 15055 KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attomey-in-fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof, provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name ERIK JOHANSSON ELLEN BELL JENNIFER ANAYA FRAN LEFLER MELISSA LOPEZ Address ALL OF TUSTIN, CALIFORNIA Limit of Power ALL $100,000,000.00 This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 25TH day of JANUARY 1 2017 Attest GREAT AMERICAN INSURANCE COMPANY msaq � I Assistant Secretary Div siona[ Senior vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C. KITCHIN (877-377-2405) On this 25TH day of JANUARY 2017 , before me personally appeared DAVID C. KITCHIN, to me known, being duly sworn, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts ofsuretyship, or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature ofsuch officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this J U L 2 7 2017 day of �e Assistant Secretary S1029AF (06/15) EXHIBIT B (Required Contract Provision For All Federal Aid Construction Contracts FHWA 1273) 30 SFF:17-5732/158097/CalTrans-Federal Contract 6/17 EXHIBIT B Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS I. General II, Nondiscrimination III. Nonsegregated Facilities IV. Davis -Bacon and Related Act Provisions V. Contract Work Hours and Safety Standards Act Provisions VI. Subletting or Assigning the Contract VII. Safety: Accident Prevention Vlll. False Statements Concerning Highway Projects IX Implementation of Clean Air Act and Federal Water Pollution Control Act X. Compliance with Govemmentwide Suspension and Debarment Requirements XI. Certification Regarding Use of Contract Funds for Lobbying ATTACHMENTS A. Employment and Materials Preference for Appalachian Development Highway System or Appalachian Local Access Road Contracts (included in Appalachian contracts only) L GENERAL 1. Form FHWA-1273 must be physically incorporated in each construction contract funded under Title 23 (excluding emergency contracts solely intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require its inclusion in all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services). The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Form FHWA-1273 must be included in all Federal -aid design-huild contracts, in all subcontracts and in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services). The design -builder shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Contracting agencies may reference Form FHWA-1273 in bid proposal or request for proposal documents, however, the Form FHWA-1273 must be physically incorporated (not referenced) in all contracts, subcontracts and lower -Fier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 2. Subject to the applicability criteria noted in the following sections, these contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractors immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and FHWA. 4. Selection of Labor. During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal -aid highway unless it is labor performed by convicts who are on parole, supervised release, or probation. The term Federal -aid highway does not include roadways functionally classified as local roads or rural minor collectors. II. NONDISCRIMINATION FHWA-1273 — Revised May 1, 2012 The provisions of this section related to 23 CFR Part 230 are applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The provisions of 23 CFR Part 230 are not applicable to material supply, engineering, or architectural service contracts. In addition, the contractor and all subcontractors must comply with the following policies: Executive Order 11246, 41 CFR 60, 29 CFR 1625- 1627, Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), Title Vl of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The contractor and all subcontractors must comply with: the requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3. Note: The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60, and 29 CFR 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), and Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The following provision is adopted from 23 CFR 230, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements_ 1. Equal Employment Opportunity: Equal employment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, ru les, regulations (28 CFR 35, 29 CFR 1630, 29 CFR 1625-1627, 41 CFR 60 and 49 CFR 27) and orders of the Secretary of Labor as modified by the provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract The provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract In the execution of this contract, the contractor agrees to comply with the following minimum specific requirement activities of EEO: a. The contractor will work with the contracting agency and the Federal Government to ensure that it has made every good faith effort to provide equal opportunity with respect to all of Its terms and conditions of employment and in their review of activities under the contract. b. The contractor will accept as its operating policy the following statement: "It is the policy of this Company to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age or disability. Such action shall include: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre -apprenticeship, and/or on- the-job training." 2. EEO Officer: The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so Page 10 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action, or who are substantially involved in such action, will be made fully cognizant of, and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and its implementation will be reviewed and explained. The meetings will be conducted by the EEO Officer. b. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer, covering all major aspects of the contractors EEO obligations within thirty days following their reporting for duty with the contractor, c. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractors procedures for locating and hiring minorities and women. d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees. e. The contractors EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of meetings, employee handbooks, or other appropriate means. 4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees the notation: "An Equal Opportunity Employer." All such advertisements will be placed in publications having a large circulation among minorities and women in the area from which the project work force would normally be derived_ a_ The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minorities and women. To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority and women applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, the contractor is expected to observe the provisions of that agreement to the extent that the system meets the contractors compliance with EEO contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions. c. The contractor will encourage its present employees to refer minorities and women as applicants for employment. Information and procedures with regard to referring such applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall betaken without regard to race, color, religion, sex, national origin, age or disability. The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to insure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. Exhibit 12-G Required Federal -Aid Contract Language b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage practices. c. The contractor will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is found, the contractor will promptly take corrective action. If the review indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly investigate all complaints of alleged discrimination made to the contractor in connection with its obligations under this contract, will attempt to resolve such complaints, and will take appropriate corrective action within a reasonable time. if the investigation indicates that the discrimination may affect persons other than the complainant, such corrective action shall include such other persons. Upon completion of each investigation, the contractor will inform every complainant of all of their avenues of appeal. 6. Training and Promotion: a. The contractor will assist in locating, qualifying, and increasing the skills of minorities and women who are applicants for employment or current employees. Such efforts should be aimed at developing full journey level status employees in the type of trade or job classification involved. b. Consistent with the contractors work force requirements and as permissible under Federal and State regulations, the contractor shall make full use of training programs, i.e., apprenticeship, and on- the-job training programs for the geographical area of contract performance. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. The contracting agency may reserve training positions for persons who receive welfare assistance in accordance with 23 U.S.C. 140(a). c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of employees who are minorities and women and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for minorities and women. Actions by the contractor, either directly or through a contractors association acting as agent, will include the procedures set forth below: a. The contractor will use good faith efforts to develop, in cooperation with the unions, joint training programs aimed toward qualifying more minorities and women for membership in the unions and increasing the skills of minorities and women so that they may qualify for higher paying employment. b. The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. c. The contractor is to obtain information as to the referral practices and policies of the labor union except that to the extent such information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the contractor, the contractor shall so certify to the contracting agency Page 11 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual and shall set forth what efforts have been made to obtain such information. d. In the event the union is unable to provide the contractor with a reasonable flow of referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability, making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to provide sufficient referrals (even though it is obligated to provide exclusive referrals under the terms of a collective bargaining agreement) does not relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from meeting the obligations pursuant to Executive Order 11246, as amended, and these special provisions, such contractor shall immediately notify the contracting agency. 8. Reasonable Accommodation for Applicants f Employees with Disabilities: The contractor must be familiar with the requirements for and comply with the Americans with Disabilities Act and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. 9. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract. a. The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract. b. The contractor will use good faith efforts to ensure subcontractor compliance with their EEO obligations. 10. Assurance Required by 49 CFR 26.13(b): a. The requirements of 49 CFR Part 26 and the State DOT's U.S DOT -approved DBE program are incorporated by reference. b. The contractor or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT -assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy as the contracting agency deems appropriate. 11. Records and Reports: The contractor shall keep such records as necessary to document compliance with the EEO requirements. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work and shall be available at reasonable times and places for inspection by authorized representatives of the contracting agency and the FHWA. a. The records kept by the contractor shall document the following: (1) The number and work hours of minority and non -minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment opportunities for minorities and women; and Exhibit 12-G Required Federal -Aid Contract Language (3) The progress and efforts being made in locating, hiring, training, qualifying, and upgrading minorities and women; b. The contractors and subcontractors will submit an annual report to the contracting agency each July for the duration of the project, indicating the number of minority, women, and non -minority group employees currently engaged in each work classification required by the contract work. This information is to be reported on Form FHWA-1391. The staffing data should represent the project work force on board in all or any part of the last payroll period preceding the end of July. If on-the-job training is being required by special provision, the contractor will be required to collect and report training data. The employment data should reflect the work force on board during all or any part of the last payroll period preceding the end of July. Ill. NONSEGREGATED FACILITIES This provision is applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The contractor must ensure that facilities provided for employees are provided in such a manner that segregation on the basis of race, color, religion, sex, or national origin cannot result. The contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's obligation extends further to ensure that its employees are not assigned to perform their services at any location, under the contractor's control, where the facilities are segregated. The term "facilities" includes waiting rooms, work areas, restaurants and other eating areas, time clocks, restrooms, washrooms, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees. The contractor shall provide separate or single -user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. IV. DAVIS-BACON AND RELATED ACT PROVISIONS This section is applicable to all Federal -aid construction projects exceeding $2,000 and to all related subcontracts and lower -tier subcontracts (regardless of subcontract size). The requirements apply to all projects located within the right-of-way of a roadway that is functionally classified as Federal -aid highway. This excludes roadways functionally classified as local roads or rural minor collectors, which are exempt. Contracting agencies may elect to apply these requirements to other projects. The following provisions are from the U.S. Department of Labor regulations in 29 CFR 5.5 "Contract provisions and related matters" with minor revisions to conform to the FHWA-1273 format and FHWA program requirements. 1. Minimum wages a. All laborers and mechanics employed or working upon the site of the work, will be paid unconditionally and not less often than once a week, and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR part 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics. Page 12 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph t,d. of this section; also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, That the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under paragraph 1.b. of this section) and the Davis -Bacon poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. b. (1) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (i) The work to be performed by the classification requested is not performed by a classification in the wage determination; and (ii) The classification is utilized in the area by the construction industry; and (iii) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained in the wage determination. (2) If the contractor and the laborers and mechanics to be employed In the classification (if known), or their representatives, and the contracting officer agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate), a report of the action taken shall be sent by the contracting officer to the Administrator of the Wage and Hour Division, Employment Standards Administration, U.S. Department of Labor, Washington, DC 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary. (3) In the event the contractor, the laborers or mechanics to be employed in the classification or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits, where appropriate), the contracting officer shall refer the questions, including the views of all interested parties and the recommendation of the contracting officer, to the Wage and Hour Administrator for determination. The Wage and Hour Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30- day period that additional time is necessary. Exhibit 12-G Required Federal -Aid Contract Language (4) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs 1.b.(2) or 1.b.(3) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. c. Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. d. If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. 2_ Withholding The contracting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor under this contract, or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to Davis - Bacon prevailing wage requirements, which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the contracting agency may, after written notice to the contractor, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds until such violations have ceased. 3. Payrolls and basic records a. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1 xiv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. Page 13 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual b. (1) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the contracting agency. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee ( e.g. , the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available for this purpose from the Wage and Hour Division Web site at httpJlwww.dol.gov/esa/whdiforms/wh347instr.htm or its successor site. The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker, and shall provide them upon request to the contracting agency for transmission to the State DOT, the FHWA or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements. It is not a violation of this section for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records, without weekly submission to the contracting agency.. (2) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (i) That the payroll for the payroll period contains the information required to be provided under §5.5 (a)(3#) of Regulations, 29 CFR part 5, the appropriate information is being maintained under §5.5 (a)(3Mi) of Regulations, 29 CFR part 5, and that such information is correct and complete; (ii) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations, 29 CFR part 3; (iii) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (3) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 3.b.(2) of this section. (4) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. c. The contractor or subcontractor shall make the records required under paragraph 3.a. of this section available for inspection, copying, or transcription by authorized representatives of the contracting agency, the State DOT, the FHWA, or the Department of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submit the required records or to make them available, the FHWA may, after written notice to the contractor, the Exhibit 12-G Required Federal -Aid Contract Language contracting agency or the State DOT, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds, Furthermore, failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. 4. Apprentices and trainees a. Apprentices (programs of the USDOL). Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Employment and Training Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program, who is not individually registered in the program, but who has been certified by the Office of Apprenticeship Training, Employer and Labor Services or a State Apprenticeship Agency (where appropriate) to be eligible for probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program. Any worker listed on a payroll at an apprentice wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed. In addition, any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. Where a contractor is performing construction on a project in a locality other than that in which its program is registered, the ratios and wage rates (expressed in percentages of the journeyman's hourly rate) specified in the contractor's or subcontractor's registered program shall be observed. Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program. If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification. if the Administrator determines that a different practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. b_ Trainees (programs of the USDOL). Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in Page 14 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual a program which has received prior approval, evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration, The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration. Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program. If the trainee program does not mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the croresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually perforrmed. In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed. In the event the Employment and Training Administration withdraws approval of a training program, the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. c. Equal employment opportunity. The utilization of apprentices, trainees and journeymen under this part shall be in conformity with the equal employment opportunity requirements of Executive Order 11246, as amended, and 29 CFR part 30, d. Apprentices and Trainees (programs of the U.S. DOT). Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal -aid highway construction programs are not subject to the requirements of paragraph 4 of this Section IV. The straight time hourly wage rates for apprentices and trainees under such programs will be established by the particular programs. The ratio of apprentices and trainees to journeymen shall not be greater than permitted by the terms of the particular program. 5. Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. 6, Subcontracts. The contractor or subcontractor shall insert Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. 7. Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 maybe grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12, Exhibit 12-G Required Federal -Aid Contract Language 8. Compliance with Davis -Bacon and Related Act requirements. All rulings and interpretations of the Davis -Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein incorporated by reference in this contract. 9. Disputes concerning labor standards. Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR parts 5, 6, and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contracting agency, the U.S. Department of Labor, or the employees or their representatives. 10. Certification of eligibility_ a. By entering into this contract, the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). b. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1). c. The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S,C. 1001. V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The following clauses apply to any Federal -aid construction contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be inserted in addition to the clauses required by 29 CFR 5.5(a) or 29 CFR 4.6. As used in this paragraph, the terms laborers and mechanics include watchmen and guards. 1.Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. 2. Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (1.) of this section, the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph (1.) of this section, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1.) of this section. Page 15 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual 3. Withholding for unpaid wages and liquidated damages. The FHWA or the contacting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (2.) of this section. 4. Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (1.) through (4,) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1.) through (4.) of this section. VI. SUBLETTING OR ASSIGNING THE CONTRACT This provision is applicable to all Federal -aid construction contracts on the National Highway System. 1. The contractor shall perform with its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere in the contract) of the total original contract price, excluding any specialty items designated by the contracting agency_ Specialty items may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractor`s own organization (23 CFR 635.116). a. The term "perform work with its own organization" refers to workers employed or leased by the prime contractor, and equipment owned or rented by the prime contractor, with or without operators. Such term does not include employees or equipment of a subcontractor or lower tier subcontractor, agents of the prime contractor, or any other assignees. The term may include payments for the costs of hiring leased employees from an employee leasing firm meeting all relevant Federal and State regulatory requirements. Leased employees may only be included in this term if the prime contractor meets all of the following conditions: (1) the prime contractor maintains control over the supervision of the day-to-day activities of the leased employees; (2) the prime contractor remains responsible for the quality of the work of the leased employees; (3) the prime contractor retains all power to accept or exclude individual employees from work on the project; and (4) the prime contractor remains ultimately responsible for the payment of predetermined minimum wages, the submission of payrolls, statements of compliance and all other Federal regulatory requirements. b. "Specialty items" shall be construed to be limited to work that requires highly specialized knowledge, abilities, or equipment not ordinarily available in the type of contracting organizations qualified and expected to bid or propose on the contract as a whole and In general are to be limited to minor components of the overall contract 2. The contract amount upon which the requirements set forth in paragraph (1) of Section VI is computed includes the cost of material and manufactured products which are to be purchased or produced by the contractor under the contract provisions. Exhibit 12-G Required Federal -Aid Contract Language 3. The contractor shall furnish (a) a competent superintendent or supervisor who is employed by the firm, has full authority to direct performance of the work in accordance with the contract requirements, and is in charge of all construction operations (regardless of who performs the work) and (b) such other of its own organizational resources (supervision, management, and engineering services) as the contracting officer determines is necessary to assure the performance of the contract 4. No portion of the contract shall be sublet, assigned or otherwise disposed of except with the written consent of the contracting officer, or authorized representative, and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the contract Written consent will be given only after the contracting agency has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. 5. The 30% self -performance requirement of paragraph (1) is not applicable to design -build contracts; however, contracting agencies may establish their own self -performance requirements. VIE. SAFETY: ACCIDENT PREVENTION This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract 2. It is a condition of this contract, and shall be made a condition of each subcontract, which the contractor enters into pursuant to this contract, that the contractor and any subcontractor shall not permit any employee, in performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety, as determined under construction safety and health standards (29 CFR 1926) promulgated by the Secretary of Labor, in accordance with Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 3704). 3. Pursuant to 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Secretary under Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C.3704). Vill. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers, contractors, suppliers, and workers on Federal -aid highway projects, it is essential that all persons concerned with the project perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or misrepresentation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these Page lb of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual and similar acts, Form FHWA-1022 shall be posted on each Federal -aid highway project (23 CFR 635) in one or more places where it is readily available to all persons concerned with the project 18 U.S.C. 1020 reads as follows: "Whoever, being an officer, agent, or employee of the United States, or of any State or Territory, or whoever, whether a person, association, firm, or corporation, knowingly makes any false statement, false representation, or false report as to the character, quality, quantity, or cost of the material used or to be used, or the quantity or quality of the work performed or to be performed, or the cost thereof in connection with the submission of plans, maps, specifications, contracts, or costs of construction on any highway or related project submitted for approval to the Secretary of Transportation; or Whoever knowingly makes any false statement, false representation, false report or false claim with respect to the character, quality, quantity, or cost of any work performed or to be performed, or materials furnished or to be furnished, in connection with the construction of any highway or related project approved by the Secretary of Transportation; or Whoever knowingly makes any false statement or false representation as to material fact in any statement, certificate, or report submitted pursuant to provisions of the Federal -aid Roads Act approved July 1, 1916, (39 StaL 355), as amended and supplemented; Shall be fined under this tide or imprisoned not more than 5 years or both." IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. By submission of this bid/proposal or the execution of this contract, or subcontract, as appropriate, the bidder, proposer, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows: 1. That any person who is or will be utilized in the performance of this contract is not prohibited from receiving an award due to a violation of Section 508 of the Clean Water Act or Section 306 of the Clean Air Act. 2. That the contractor agrees to include or cause to be included the requirements of paragraph (1) of this Section X in every subcontract, and further agrees to take such action as the contracting agency may direct as a means of enforcing such requirements. X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal -aid construction contracts, design -build contracts, subcontracts, lower -tier subcontracts, purchase orders, lease agreements, consultant contracts or any other covered transaction requiring FHWA approval or that is estimated to cost $25,000 or more — as defined in 2 CFR Parts 180 and 1200. 1. Instructions for Certification — First Tier Participants: a. By signing and submitting this proposal, the prospective first tier participant is providing the certification set out below. Exhibit 12-G Required Federal -Aid Contract Language b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective first tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction. If it is later determined that the prospective participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the contracting agency may terminate this transaction for cause of default. d. The prospective first tier participant shall provide immediate written notice to the contracting agency to whom this proposal is submitted if any time the prospective first tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. e. The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," "principal,' and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). f. The prospective first tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. g. The prospective first tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions," provided by the department or contracting agency, entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. h. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (bttps://www.epls.gov/), which is compiled by the General Services Administration, i. Nothing contained in the foregoing shall be construed to require the establishment of a system of records in order to render in good Page 17 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual faith the certification required by this clause. The knowledge and information of the prospective participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. j. Except for transactions authorized under paragraph (f) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 2. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — First Tier Participants: a. The prospective first tier participant certifies to the best of its knowledge and belief, that it and its principals: (1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency; (2) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and (4) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. b. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Participants: (Applicable to all subcontracts, purchase orders and other tower tier transactions requiring prior FHWA approval or estimated to cost $25,000 or more - 2 CFR Parts 180 and 1200) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d. The terms "covered transaction," 'debarred," "suspended," "ineligible," "participant," "person," "principal," and "voluntarily Exhibit 12-G Required Federal -Aid Contract Language excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Excluslon-Lower Tier Covered Transaction,' without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (httys:/hvww,epls.gov/), which is compiled by the General Services Administration. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph a of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Lower Tier Participants: 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency. Page 18 of 24 July 2016 EXHIBIT B Local Assistance Procedure Manual 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING This provision is applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 (49 CFR 20). 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying,' in accordance with its instructions. 2. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 3_ The prospective participant also agrees by submitting its bid or proposal that the participant shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such recipients shall certify and disclose accordingly. Exhibit 12-G Required Federal -Aid Contract Language Page 19 of 24 July 2016 RFADCON-n1 BANDRAKOWICZ -- T ,4coR�" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/18/2017 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 have ADDITIONAL INSURED provisions or 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 The Wooditch Company Insurance Services, Inc. 1 Park Plaza, Suite 400 Irvine, CA 92614 (CONTACT NAME: PHNE ! (A/C No, Ext): (949) 553-9800 (A/c, No):(949) 553-0670 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Executive Risk Indemnity_, Inc. 35181 INSURED INSURER B:Federal Insurance Company 20281 INSURERC: Beador Construction Company, Inc. INSURER D 26320 Lester Circle Corona, CA 92883 INSURER E INSURER F : COVERAGES CERTIFICATE NLJMRER- REVISION NUMRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR L J TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF M D POLICY EXP M/ D LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X 54303366 01/15/2017 01/15/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea ON 100,000 $ tI_� MED EXP Anyone person)_ PERSONAL & AOV INJURY 5,000 $ $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PGEN'L AGGREGATE LIMIT APPLIES PER POLICY JECT LOC OTHER PRODUCTS - COMP/OP AGG $ 2,000,000 EBL IS 1,000,000 B AUTOMOBILE 1J_XOWNED LIABILITY ANY AUTO SCHEDULED AUTOS ONLY F AUTOS 54303365 01/15/2017 01/15/2018 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY(Perperson $ BODILY INJURY (Per accident) $ XHIRED NONpWNED AUTOS ONLY X l AUTOS ONLY (EerOacutlent)AMAGE $ $ UMBRELLAA LIAB I OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS -MADE AGGREGATE _ l $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PRO PRIE R/PER/EXECUTIVE ❑ OFFICER/MEMBEBER EXCLUDED? (Mandatory in NH) N / A X 54303367 01/15/2017 01/15/2018 TH- X (_STATUTE_( OR I E L. EACH ACCIDENT 1,000,000 $ E L. DISEASE - EA EMPLOYEE( $ 1,000,000 If yes, descnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Brookhurst Bridge BPMP, Project #CC 1449, Bridge Preventive Maintenance Project. glaip/wcwv City of Huntington Beach, its officers, elected or appointed officials, employees, agents, and volunteers are include0A?)041Jt' as re General Liability per attached endorsement. This insurance shall apply as Primary and Non -Contributory per attached endorsement. Waiver of Subrogation for Workers' Compensation: See Attached Endorsement. _ By: HAEL E. GATES CITY ATTORNEY F HUNTINGTON BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Huntington Beach THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y 9 ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main Street P.O. Box 190 Huntington Beach, CA 92648 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: BEADCON-01 BANDRAKOWICZ 1 ACORO' LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Beador Construction Company, Inc. 26320 Lester Circle Corona, CA 92883 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 r_1•nuuner_1■ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Cancellation: *Except 10 Days Notice of Cancellation for Non -Payment of Premium. *Should this policy be cancelled before the expiration date, The Wooditch Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement.* ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 54303366 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations City of Huntington Beach, its officers, elected or RE: Magnolia Bridge BPMP; Project# CC 1448 appointed officials, employees, agents and Brookhurst Bridge BPMP; Project # CC 1449 volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: 54303366 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization s : Location And Description Of Completed Operations City of Huntington Beach, its officers, elected or RE: Magnolia Bridge BPMP; Project # CC 1448 appointed officials, employees, agents and Brookhurst Bridge BPMP; Project # CC 1449 volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: 54303366 COMMERCIAL GENERAL LIABILITY 10-02-2461 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE FOR SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Additional Insured: Where required by written contract SCHEDULE Location Of Covered Operations: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: (1) The Additional Insured is a named insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. 10-02-2461 (Ed. 7-15) Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule where required by written contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/1S/2017 Insured Beador Construction Company, Inc. Insurance Company Federal Insurance Co. WC 00 03 13 (Ed. 4-84) © 1983 National Council on Compensation Insurance. Policy No. 54303367 Countersigned by Endorsement No. N/A Premium RECEIVED BY: (Name) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating (Date) �q CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: )6)m117 SUBJECT: Bond Acceptance I have received the bonds for JZ---2�v%`L, I CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. (Company Name) K,� /f 0-7ZO .3 d 4 AFW043 Approved (Council Approval Date) CC NO. MSC No. Agenda Item No. City Clerk Vault No. Other No. SIRE System ID No. g:/forms/bond transmittal to treasurer Executed in duplicate originals Bond No. CA1844013 Premium: Included in Performance Bond PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS City of Huntington Beach (hereafter referred to as "City") has awarded to 8eador Construction Com an , Inc. 26320 Lester Circle, Corona, (hereinafter referred to as "Principal', a contract Contract's for the work described as follows: Brookhurst Bridge BPMP Project #CC 1449 (Project Title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to furnish a bond to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law, by a duly admitted surety insurer under the laws of the State of California (hereinafter referred to as "Surety"); and Surety is certified and listed in the U.S_ Department of the Treasury Circular 570, and has provided proof of sufficient bonding limitation, as shown in said circular to provide bonds in the amount required by said Contract; and Surety has provided financial strength ratings from reputable oompanles, such as from A.M. Best, Moody's or Standard & Poor's, to validate that Surety has positive ratings of being secure or stable; and Surety is registered and listed with the California Department of Insurance, NOW THEREFORE, we, the undersigned Principal, and (name and address of Surety) as Surety, are held and firmly bound unto City and County of Orange in the penal sum of Eight Hundred Sixty Six Thousand Three Hundred and 001100ths dollars is 866,300.00 ), this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code ("Claimants") for all labor, materials or services used or reasonably required for use In performance of the work described in the Contract, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond. Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. Page t of 2 154964/127542 PAYMENT BOND 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, extension of time, alteration, addition, or modification to the terms of the Contract, the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such parry's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: October 11, 2017 ATTEST (Corporate Seal) Beador_Conit)uction Company, Inc. I ncipal Name) By: Name - Title:. Q'0ej,at^-� ATTEST Great American Insurance Company (Corporate Seal) (Surety Name) By:. Name: Eriklohansson (Signature of Attorney -in -Fact for Surety) (Attach At,omay-in-Fact Certificate) ( j 714-505-7011 (Area Code & Telephone Number for Surety) APPROVED AS TO FORM: By , i'rw. .-MChael E. Gates, City Attorney It✓</W Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority or any person signing as attorney -In -fact must be attached. Page 2 of 2 15-4964/127542 PAYMENT BOND CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT f7 .71. F,;7F--. 7. F-,17 7-1f7F7 71 7 -1, F" F State of California LJ U County of Riverside SS. F On October 12, 2017 before me, R. Quezada, Notary Public Date Name and Title of Officer L Personally appeared David A. Beador 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 F' executed the same in his/her/their authorized capacity(ies), and that by his/her/their CI R. QUEZADA signature(s) on the instrument the person(s) . Commission C2100414 E or, the entity upon behalf of which the person(s) Cj < Notary Public - California Z acted, executed the instrument. > Orange County My Comm. Expires Mar 19, 2019 I certify under PENALTY OF PERJURY under the laws the State California that the foregoing of of paragraph is true and correct. WITNESS my hand and official sea], L, Signature of N6tary Public L: Place Notary Seal Above OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document • Description of Attached Document Title or Type of Document: F, Document Date: Number of Pages: Signer(s) Other Than Named Above: r Signer's Name: Signer's Name: Individual —Individual —Corporate Officer Title(s): —Corporate Officer Title(s) —Partner- Limited General Partner- Limited General Attorney -in -Fact Trustee Guardian or Conservator _Other: Signer is Representing: —Attorney-in-Fact —Trustee —Guardian or Conservator Other: Signer is Representing Top of thumb here CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On OCT 1 12017 before me, Date personally appeared E. M. Bell, Notary Public Here Insert Name and Title of the Officer Erik Johansson Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/XX subscribed to the within instrument and acknowledged to me that he/115executed the same in his/Ik p;authorized capacity(ies), and that by his/Y�' r;signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. TO E. M. BELL C\j COMM. # 2151184 NOTARY PUBLIC CALIFORNIA K LOS ANGELES COUNTY o 1 My comm. expires Apr. 29, 2020 It Place Notary Seal Above 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. 7 Signature 9 Signature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 GREAT AMERICAN INSURANCE COMPANY(R) Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than SIX POWER OF ATTORNEY No. 0 15088 KNOW ALL MEN BY THESE PRESENTS: That the GREATAMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attomey-in-fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power ERIK JOHANSSON ELLEN BELL ALL OF ALL JENNIFER ANAYA FRAN LEFLER TUSTIN, $100,000,000.00 MELISSA LOPEZ JAMES W. JOHNSON CALIFORNIA This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 19TH day of SEPTEMBER 2017 Attest GREATAMERICAN INSURANCE COMPANY �asw Assistant Secretary Drvtsional Semor vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C. KITCHIN (877-377-2405) On this 19TH day of SEPTEMBER 2017 , before me personally appeared DAVID C. KITCHIN, to me known, being duly swom, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. stun a WNW MY Oollr kftEoese*18= This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED. That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations to the nature thereof,, to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER, That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretory of the Company maybe affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed tIOCT 1 1 2017 day of Assistant Secretary S1029AF (06/15) Executed in duplicate originals PERFORMANCE BOND Bond No. CA1844013 Premium: $12,163.00 KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS City of Huntington Beach (hereafter referred to as "CiV) has, by written agreement dated Auizust 21.2017 entered into a contract with Beador Construction Company, Inc. (name and address of Contractor) (hereinafter referred to as "Principal')), for performance of the work described as follows'.. Brookhurst Bridge BPMP, Project #CC 1449 (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract', are incorporated herein by this reference made a part hereof as though set forth herein in full; and Said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract, by a duly admitted surety insurer under the laws of the State of California (hereinafter referred to as "Surety'); and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and has provided proof of sufficient bonding limitations as shown in said circular to provide bonds in the amount required by said Contract; and Surety has provided financial strength ratings from reputable companies, such as from A.M. Best, Moody's, or Standard & Poor's, to validate that Surety has positive ratings of being secure or Stable; and Surety is registered and listed with the California Department of Insurance, NOW, THEREFORE, we, the undersigned, as Principal, and Great American Insurance Company (name and address as Surety, are held and firmly bound unto City and the County of Orange in the penal sum of Dollars ($ 866,300.00 ), this amount being not less than one hundred percent of the price set forth in the Contract, in lawful money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the Principal shall promptly, fully and faithfully perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall indemnify and save harmless City and all of City's officers, agents and employees and the County of Orange (hereinafter collectively referred to as "Obligees) from any end 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 15-4964/t27541 Bond No. CA 1844013 to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations, changes, deletions, additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code §§ 2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of Its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. October 11, 2017 VP\G4. Ai7EST (Corporate Seal) Beaddr Construction Company, Inc. F i ;I. (Principal Name) �8 By: Name: ,11 art Title: ?yQ &-X ATTEST Great American Insurance Company (Corporate Seal) (Surety Na By: i Name: Erik Tohansson (Signature of Attorney -in -Fact for Surety) (Attach Attomey-in-Fact Certificate) f 1 714-505-7011 (Area Code & Telephone Number for Surety) APPROVEDAS�TO`FOREvt:, .,. r `Michael E. Gates, City Attorney p- Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of Me authority of any person signing as attorney -in -fact must be attached. PERFORMANCE BOND Page 2 of 2 t5-4584/I17174 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT I, - n, n, 7,, ,—IF-.. ,r-_ r'. -7 F , -i r ;—, r. r n, �i� r n, rl��l �_ r 1, 1 r, r_ F7 ;- 17,j-, - - F7 F7 I I i State of California c F,; County of Riverside SS. r' r On October 12, 2017 before me, R. Quezada, Notary Public _ , Date Name and Title of Officer Personally appeared David A. Beador - F_ Name(s) of Signer(s) - Who proved to me on the basis of F.li satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument L and acknowledged to me that he/she/they executed the same in his/her/their authorized -' 'i °��^'�-• capacity(ies), and that by his/her/their T R. OUEZADA signature(s) on the instrument the person(s) Commission #1 2100414 z California or, the entity upon behalf of which the person(s) _ instrument. Notary Public z acted, executed the ;- Z ` Oran a Count n 1 My Comm. Expires Mar 19, 2019 F> 1 certify under PENALTY OF PERJURY under the Ci laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal, - - r, S,gnatureKof Notary Public _ (-_ Place Notary Seal Above OPTIONAL LJ r_1 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 r' Description of Attached Document Title or Type of Document: r r' Document Date: it Number of Pages: [j Signer(s) Other Than Named Above: r: Li r Signer's Name: _Individual _Corporate Officer Title(s): _ Partner- Limited General —Attorney-in-Fact _Trustee _Guardian or Conservator _Other: ri Signer is Representing: Top of thumb here Signer's Name: _Individual _Corporate Officer Title(s) —Partner--Limited—General _Attorney -in -Fact _Trustee —Guardian or Conservator _Other: Signer is Representin Top of thumb here CALIFORNIA. . •. .GA .Ow .A .VA _Vw .A .A .A .p .A .A .A .A _Vi _il .A .A .A .A . .N .•P .VA .A .A A .A .A .VA .A .A .A .A .A .p..C� .A .0. .A .A .A .A .A .A .V.: A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On OCT 1 1 2017 before me, Date personally appeared E. M. Bell, Notary Public Here Insert Name and Title of the Officer Erik Johansson Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/XX subscribed to the within instrument and acknowledged to me that he/,§bXAbW executed the same in his/ITp;authorized capacity(ies), and that by his/DCO;signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. E. M. BELL m F a� aZ COMM. # 2151184 5_ NOTARY PUBLIC CALIFORNIA a,r LOS ANGELES COUNTY aL� My Comm, expires Apr. 23, ?_G20 it 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. 6� ASignature '�' Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: •b _b .b .b .b .b -b -b _ b .b .0 .b .b _b . , ', .b .b .b .b .b .b •b .b ,b •b .b .b .b _b .b .b .b •b .b .b -b -b b .b .b .b .b •b GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than SIX POWER OF ATTORNEY No. 0 15088 KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof, provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power ERIK JOHANSSON ELLEN BELL ALL OF ALL JENNIFER ANAYA FRAN LEFLER TUSTIN, $100,000,000.00 MELISSA LOPEZ JAMES W. JOHNSON CALIFORNIA This Power of Attorney revokes all previous powers issued on behalf of the attorney(s) -in- fact named above. IN WITNESS WHEREOF the GREATAMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 19TH day of SEPTEMBER 1 2017 Attest GREAT AMERICAN INSURANCE COMPANY X44 may, nsur Assistant Secretary Divisional Senior Vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C. KITCHIN (877-377-2405) On this 19TH day of SEPTEMBER 2017 , before me personally appeared DAVID C. KITCHIN, to me known, being duly sworn, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. &f38fIA. Word N0" P^ 3W of ft Mp Can�lan 6�S 0�1>4�20 This Power ofAttorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorised, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts ofsuretyship, or other written obligations in the nature thereof; to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company maybe affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature ofsuch officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION 1, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this OCT 1 1 2017 day of @ Assistant Secretary S1029AF (06/15) 10/1 &2017 Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent For Service Reference Information NAIL Group List Lines of Business Workers' Compensation Complaint and Request for Action/Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Aetion Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information GREAT AMERICAN INSURANCE COMPANY 3+01 E. FOURTH STREET CINCINNATI, OH 45202-4201 800-545-4269 Old Company Names AMERICAN CONTINENTAL INSURANCE COMPANY MANUFACTURERS & MERCHANTS INDEMNITY CO. SELECTIVE INSURANCE COMPANY Agent For Service Vivian Imperial 818 WEST SEVENTH STREET SUITE 930 LDS ANGELES CA 90017 Reference Information Effective Date 12/06/1976 09/05/1956 06/15/1972 NAIL # : J 16691 California Company ID #: 1301-1 Date Authorized in California: Flo/ 17/1945 License Status: UNLIMITED -NORMAL Company Type: Property & Casualty State of Domicile: OHIO back to top NAIC Group List hnps:f interactive.web.insurance.ca.gov/companyprofile/companyprofile?event=companyProfile&doFunction=getCompanyProfile&eid=3259 1/2 CONTRACTOR'S SWORN STATEMENT AND WAR.'Tt.ANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROW _�c,_c1y_�� ,�,�e.x�.c� Ni, I-, PmEcT: (Contractor Name) (7-0-- G e2iosdp iesl��c;e��e DT (Street Address) (City, State and Zip) TO: CITY OF FBUNTTNGTON BEACH DECLARATION Attar Tod heretp 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 Gty of Huntington Beach ("City") and the above -named Contractor ("Contractor') for the above -described project ("Project`). I declare under penalty of perjury under the laws of the StatSp California that the above statement Is true and correct. Signed on _ �L " i ' (1 2011 at _ (�O 11-CA^,&1 1 C 14 (Date) /1 ( (Cty, Strafe) it Whqq i along ❑eclaration) •� �i r}`uii WARRANTY 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 "'arranties provided by Contractor, Said insurance shall contain Additional Insured Endarsement 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 afarementioned Endorsement eviden(ing condnued coverage which meets the Contact requirements. S)gned on �')( 1 ( ) , 200 at _.. C O"^CA , LA (Date) (City, State) CONTRAC11"M Narne; By Name. - a Title; Pry' 2 1.2 City of Huntington Beach Y Business License `r ` `- • 714 536-5267 FAX 714 536-5934 Lori Ann Farrell Harrison Chief Financial Officer BEADOR CONSTRUCTION COMPANY INC 26320 LESTER CIRCLE CORONA CA 92883 Dear Business Owner: P.O. Box 190 Huntington Beach, CA 92648 Thank you for your payment. Attached is your City of Huntington Beach Business License. Please note that approximately one month prior to the license expiration date, you will be mailed a renewal notice for the coming year. If for any reason your renewal notice does not arrive, you are still responsible to renew and pay your business license amount prior to the expiration date. You will incur penalties if this payment is not received by the expiration date. Please post the business license in public view. If you do not transact business from a fixed location within the city, you must carry this license with you at all times. Your business vehicle should also carry this license, and the license plate number of the vehicle(s), if applicable, should match the one on the business license. Please notify Business License if there are any changes of ownership, address, business name, business vehicle, or type of business conducted. Additionally, please notify the city if you discontinue your business. If your business is operated in a commercial, retail, or industrial location, you will need to contact the Planning and Building Department regarding the requirement for a Certificate of Occupancy. For additional questions or information on this matter call 714-536-5271. The Planning and Building Department is located on the 3rd floor of City Hall. There are many resources available to our licensed business people. We have listed a few that might be of interest and assistance to you. City of Huntington Beach Economic Development Department - 714-536-5582 Huntington Beach Chamber of Commerce - 714-536-8888 Huntington Beach SCORE (Service Corps of Retired Executives) - 714-550-7369 Fictitious Business Name Information - 714-834-2889 State Board of Equalization (seller's permit information) - 949-440-3473 If you have any questions, please call a Business License representative at 714-536-5267. City Of Huntington Beach Business License Business Name / Service Address BEADOR CONSTRUCTION COMPANY INC License Type Contractor Owner / Corporation BEADOR CONSTRUCTION COMPANY INC THIS LICENSE IS ONLY FOR THE BUSINESS AND TYPE SHOWN. IT IS FOR THE PERSON TO WHOM ISSUED AND IS NON -TRANSFERABLE. RENEWAL IS DUE ON OR BEFORE THE EXPIRATION DATE. POST IN PUBLIC VIEW License Number A300565 Effective Date 11/01/2017 Expiration Date 10/31/2018 Amount Paid $190.75 SIC 1522 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk October 19, 2017 David A. Beador Beador Construction, Inc. 26320 Lester Cr. Corona, CA 92883 Re: Brookhurst St Bridge Preventive Maintenance — CC-1449 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, 4�� 4u4J� Robin Estanislau, CIVIC City Clerk RE:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand Dept. ID PW 17-050 Page 1 of 2 Meeting Date: 8/21/2017 *pr-Mc-� 7-0 CITY OF HUNTINGTON BEACH REQUEST FOR. CITY COUNCIL ACTION MEETING DATE: 8/21/2017 SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Award and authorize execution of a construction contract with Beador Construction Company, Inc. in the amount of $866,300.00 for the Brookhurst Street Bridge Preventive Maintenance, CC-1449; and, approve an appropriation of funds to the Bridge Preventive Maintenance Program grant fund account Statement of Issue: On August 1, 2017, bids were opened for the Brookhurst Street Bridge Preventive Maintenance, CC-1449. Staff requests that the City Council award the contract to Beador Construction Company, Inc., the lowest responsive and responsible bidder. Financial Impact: A total of $80,802 is currently available in Gas Tax account 20790010.82800. An additional appropriation of $80,000 from the Gas Tax undesignated fund balance is requested to provide the total grant match of $154,012 and additional salary charges towards the project. Approximately 88% of eligible construction costs will be reimbursed to the City through Bridge Preventive Maintenance Program (BPMP) grant funds, up to a maximum of $1,188,719. An appropriation to the Bridge Preventive Maintenance Program (BPMP) grant account 97085001.82800 is requested. Recommended Action: A) Accept the lowest responsive and responsible bid submitted by Beador Construction Company, Inc., in the amount of $866,300.00; and, B) Appropriate $80,000 from the Gas Tax (207) undesignated fund balance to account 20790010.82800; and, C) Appropriate $1,188,719 in grant funds to BPMP grant account 97085001.82800; and, D) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids, and provide staff with alternative direction. Analysis: The Brookhurst Street Bridge was constructed in 1958. Parts of the bridge have deteriorated due to vehicular traffic and from tidal flux over the past five decades. This bridge preventive maintenance project consists primarily of the removal and replacement of the concrete barriers and Item 11. - 1 HB -132- Dept. ID PW 17-050 Page 2 of 2 Meeting Date: 8/21/2017 chain link railing; removal and patching of unsound concrete at the bridge bents and columns; removal and replacement of AC pavement overlay; and appurtenant work as required. Bids were opened publicly on August 1, 2017. The verified bid amounts are listed below: Bidding Contractor Submitted Bid Verified Bid Beador Construction Company, Inc.* $866,300.00 $866,300.00 John S. Meek Company, Inc. $894,587.50 $894,587.50 Peterson -Chase General Engineering Construction, Inc. $896,686.00 $896,686.00 United Engineering & Construction, Inc. $962,864.28 $962,864.28 *See Attachment 2 As announced at the public bid opening, Beador Construction Company, Inc. submitted the apparent low bid of $866,300.00. Upon review of the bid package, staff found discrepancies in the bid amount and promptly notified the bidder. On August 7, 2017, Beador Construction Company, Inc. submitted the attached correspondence to explain the discrepancies. Staff found the documentation and references submitted by Beador Construction Company, Inc. to be acceptable. Therefore, staff recommends award of the construction contract to Beador Construction Company, Inc., in the amount of $866,300.00. The total estimated project cost, including the construction contract, contingencies, supplementals, environmental monitoring, and project management is approximately $1,342,000. Public Works Commission Action: The Public Works Commission reviewed and approved CC-1448 on August 19, 2015, with a vote of 7-0-0-0. Environmental Status: A Categorical Exclusion was approved on September 15, 2015, in compliance with NEPA. Mitigated Negative Declaration No. 14-006 was approved on April 15, 2015, in compliance with CEQA. Strategic Plan Goal: Enhance and maintain infrastructure Attachment(s): 1. Location Map 2. Correspondence from Beador Construction Company, Inc. dated August 7, 2017 HB -133- Item 11. - 2 Item 1 I is is�JnH>10MJO w is G�JVHsnB \ < z mQ / Z i O u; � iS V110NO4 w E— Z `d � � Q 1 - U \� o iS ONVNIIN z Q Q o z z o0 v 0A18 HOb3B QP '1 Q21VM '1S 1SbRHH00b8 Li i,_i u_i i, i i,_i i, i w 0 ¢ ¢ ¢ ¢ ¢ ¢ z 1S ObVHSRB z w m¢ ' 1S VnONOVWz . o 1S a 4NVI NM z z aAlB w z g HOV38 w U Q O ¢ ¢ ¢ ¢ ¢ ¢ '(`r o ¢ O -LLI � 12 O��G 1S Q2lVH100 � 0 W �Q� w '1S 1S3M N30 100 F � ¢ �s� vi w w w �' P Q_ Q I - 'Is Sall (13 Q '1S o 3lVO9NIbdS g GpP w Od '1S M z WVHVb0 o Q w sJti� '1S VOIHO YMOG I w Q '1S NIRON09-ld 'NM H00218)1VS U CL U - 3 HB -134- Beador Construction Company, Inc. August 7, 2017 City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 Attn: Jonathan Claudia, PE Senior Civil Engineer RE: Acknowledgement of Addendum 1 and Confirmation of Bid Price Brookhurst Avenue Bridge Preventive Maintenance, C.C. No. 1449 Mr. Claudia: In response to our bid on August lst for the aforementioned project, we hereby provide the fallowing acknowledgement: 1) Addendum 1 Receipt. Sign copy attached. The addendum had no impact on our bid prices and/or casts as we are a union contractor and already utilize the established prevailing wage rates in our bid and estimate thereof 2) Our submitted lump price of $866,300.00 was the correct lump sum and intended bid amount. As I understand, the submitted extended contract item unit pricing did not compile to this amount which was an inadvertent error due to two minor errors. Our spreadsheet was inaccurately tabulated and did not include item 1. Moreover, our bid spreadsheet estimated quantity on item 18, was incorrectly input at 13,874 SF in lieu of the actual estimated quantity of 16,874 SF thus raising the bid total when extended using the correct quantity (add of 3000 SF @ $1.50 per SF) by an additional $4500.00. As such, item 1 should remain $44,000.00, item 18 unit price should remain at $1.50 (extended to $25,311.00) and item 5 should be reduced by adding the inadvertent sums above of $44,000.00 and $4,500.00 bringing it to $109,253.00. We apologize for the confusion. Should you have any further questions, comments or concerns, please feel free to contact me. Sincerely, Beador Constru 0,resident Company, Inc. David A. Beado 26320 Lester Circle Carona, CA 92883 •(951) 674-7352 . (951) 674-7495 Fax a License #720483 H B -135- Item 11. - 4 Local Assistance Procedures Manual Exhibit I5-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: 1 ` 01= t, -4 -' `' 2. Contract DBE Goal: 3. Project Description: 2w iet VVZS.r 4,y_fE.r�i� rr�f ° ii,"+t>�0-a 47+� �t 4. Project Location: P*,i:,1 5. Bidder's Name:�'4tTLzC r % ' a�t�. 6. Prime Certified DBE: ❑ 7. Bid Amount:a 8. Total Dollar Amount for ALL Subcontractors: 1�*Z'DE, &-34-3Z 9. Total Number of ALL Subcontractors: 10. Bid Item 11. Description of Work, Service, or Materials 12. DBE Certification f3. DBE Contact information (Must certified on the daytime bids are opened) 14. DBE Dollar Number Supplied Number Amount t z, t3 V 4,%'6--7 35- /be / ar - >�. u,,.t�"i trr� 1.7-1).44 -Z i big) f� A39dr�= -Z�k i 2.�7 G 61� Z.- e4�t" T-VrL r vc s i7'irt:� r c Mrs G r¢t c g Z 2SU ��JQC.w(rk�c_ r15} 1 E�� rrf S 3S7drZ �UtL iYL.Ar e- MA7.-fry.- A-t(T �erv.�a CA 09 •-S'4-0 'o`ia Local Agency to Complete this Section 21. Local Agency Contract Number: 15, TOTAL CLAIMED DBE PARTICIPATION 22. Federal -Aid Project Number: i D 010 23. Bid Opening Date: IMPORTANT: Identify all DBE firms being claimed for credit. 24. Contract Award Date: regardless of tier. Names of the First Tier DBE Subcontractors and their respective items) of work listed above must be consistent, where a pli l* Win the names and items of the work in the Local Agency certifies that all DBE certifications are valid and information on "Sub c n ra torsubmitted with your bid. Written confirmation of this form is complete and accurate. each ist B is required. 25_ Local Agency Representative's Signature 26. Date 16. reparer'sSii�gnature 17. Date 27, Local Agency Representative's Name 28. Phone 18. Preparer's Name 19. Phone �tE Sr C)F,c r — 29, Local Agency Representative`s Title 20, Preparer's Title DISTRIBUTION: 1. Original -Local Agency 2. Copy - Cattrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result in de -obligation of federal funds on contract. Include additional copy with award package. ADA Notice: For individuals with sensory disabilities, this document is available in altemate formats. For information call (916) 654-6410 or TDD (916) 654- 3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. C-22 Page I of 2 July 23, 2015 a a Item 1 1 . - 5 HB -136- Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT CONTRACTOR SECTION 1. Local Agency - Enter the name of the local or regional agency that is funding the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Location - Enter the project location as it appears on the project advertisement. 4. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). 5. Bidder's Name - Enter the contractor's firm name. 6. Prime Certified DBE - Check box if prime contractor is a certified DBE. 7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor. 8. Total Dollar Amount for ALL Subcontractors —Enter the total dollar amount for all subcontracted contractors. SUM = (DBEs + al I Non -DBEs). Do not include the prime contractor information in this count. 9. Total number of ALI, subcontractors — Enter the total number of all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 10. Bid Item Number - Enter bid item number for work, services, or materials supplied to be provided. 11. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs including work perfonned by the prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 12. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be certified on the date bids are opened. 13. DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted contractors. Also, enter the prime contractor's name and phone number, if the prime is a DBE. 14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 15. Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DBE participation claimed ("Total Claimed DBE Participation Dollars" divided by item "Bid Amount"), If the total % claimed is less than item "Contract DBE Goal," an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM). 16. Preparer's Signature - The person completing the DBE commitment form on behalf of the contractor's firm must sign their name. 17. Date - Enter the date the DBE commitment form is signed by the contractor's preparer. 18. Preparer's Name - Enter the name of the person preparing and signing the contractor's DBE commitment form. 19. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 20. Preparer's Title - Enter the position/title of the person signing the contractor's DBE commitment form. LOCAL AGENCY SECTION 21. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 22. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 23. Bid Opening Date - Enter the date contract bids were opened. 24. Contract Award Date - Enter the date the contract was executed. 25. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Contractor Section of this form is complete and accurate. 26. Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 27. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the contractor's DBE commitment form. 28. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 29. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the contractor's DBE commitment form. Page 2 of 2 C-23 July 23, 2015 HB -1 ; 7- Item 11. - 6 G&F Concrete Cutting, Inc. 13653 Alondra Blvd., Santa Fe Springs, CA 90670 562229.0227 FAX 562.229.0231 7-31-17 State License 590310 UDBE / DBE / MBE / WMBE Certified CUCP, Caltrans, MTA & MWD, DIR#1000001776 Project: Brookhurst St. Bridge Preventive Maintenance. Huntington Beach, CA Beador Construction Attn: Estimating P. 951-674-7352 dabeador@beador.com CONTRACT PROPOSAL Loa oLwork as ftWows: 1) Bid Item 12 Remove unsound concrete 34 CF. Price per CF $320.00 = $10,880.00 2) Bid Item 13 Remove concrete barrier 317 LF. Price per LF $144.32 = 545,749.44 Note: Prices are based on work hours between 6am-5pm, Monday -Friday. Standby out our control will be charged at 5108.00 per hour per person. Contractor to supply falsework to catch any debris from falling into the water. Contractor to supply access to all locations for the removal of the unsound concrete. Included: Two mobilizations included, additional mobilizations will be $864.00 each. Excluded: Layout, SWPPP, retention, license fees, permits/permit fees, cost of bond, engineering, soils test, removal and handling of hazardous or toxic materials, flagging, traffic control, barricades, dust partitions, temporary fencing, removal of shoring or form material; protective covers, demolition utilities, shoring or bracing, locate/cut/cap utilities, excavation, access to work, scaffolding, dowel holes, backfill and compaction, patching or grouting, damage to unknowns in or below slab, wash down, pressure washing, overtime and waiver of subrogation. If accepted, this proposal is to become part of the contract. G&F Concrete Cutting, Inc. Submitted by: Michael Phillips, Estimator 949-887-7428 Accepted by: Authorized Signature Print Name • Quote valid for 90 days from above date. • SBE/DBE/Ny'MBE/,VIBE Certified. Union Signatory • Any additional permits or licenses for individual cities/job sites, additional charges will apply. Waivers of subrogation add 3%. G&F Concrete Cutting, Inc. will not accept any back -charges unless notified within 24 hours of damages occurring and given sufficient time to identify and repair said back -charges. Bid will revert to T&M if no authorized signature is returned before start of job. Page 1 of 1 Item 11. - 7 HB -138- ar ct t u u 27 M GO U wa im G pi 0 ECG U 'CS ac (2) LE HB -139- Item I I. - 8 >8/01/17 01:10PM PDT DRS Rebar Inc —? 9516747495 Pg 2/7 Bid Proposal Form License #981885 CUCP 443947 rL%)BEZSBELM DIR Registration #1000048191 Bid Date: 08/01/2017 Project Name: Brookhurst Street Preventative Maintenance ITEM ITEM CODE DESCRIPTION QTY. UNIT UNIT PRICE APPROX. TOTAL 16 CONCRETE BARRIER 317 LF $32.34 $10,254.48 (TYPE 26 MODIFIED) APPROXIMATE TOTAL: $10,254,48 Special Note Price does not include additional rebar where existing has more than 20% reduction in the cross - sectional diameter. Scooe of Work Exclusions 1. All testing and inspection and/or any related costs thereof other than mill test reports. (Rebar, mechanical coupler, and/or welded hoop test bar samples to be provided F.O.B. trucks jobsite). 2. Supplying, installing, and/or maintaining any form of rebar cap or safety device on installed reinforcing steel or stored reinforcing steel. (Per OSHA Standards). 3. Cost of pour watchman. Item 11. - 9 H Q -140- )8/01/17 01:10PM PDT DRS Rebar Inc -> 9516747495 Pg 3/7 4. All permits (except hauling) and licenses, other than city/county business licenses and State Contractor's License, required for the work. 5. Cutting, burning, cleaning, straightening and/or bending of existing steel, bars protruding from precast structures, and/or improperly placed drill and grout/bond dowels. 6. Drilling, coring, grouting, dry packing and the placing of bars into and/or through drilled holes. 7. Cost of Bonds. 8. Metal tags and/or original mill tags. 9. Any or all reinforcing steel, and/or wire mesh not shown on drawings unless specifically included in Scope of Work. 10. Rebar placing drawings prepared, reviewed, signed, sealed or stamped by a licensed engineer. 11. All welding. 12. Breakout dowels, formsavers, couplers, etc. and/or installation of the same. 13. Prestressing and/or prestressing material. (including but not limited to any additional reinforcing steel required by any prestressing/post tensioning system. 14. Masonry steel, other than deformed rebar. 15. Added reinforcing in precast work for lifting stresses or pick-up devices. 16. Reworking of any reinforcing steel and/or cables extending from precast piles. 17. Protection of exposed steel for future construction. 18. Installation of steel pile anchor dowels. 19. Rigging and/or setting of prefabricated approach slab mats. 20. Field bending of rebar for contractor's convenience other than by additive quote. 21. The cost of reworking, rehabilitating and/or replacing reinforcing steel damaged or lost as a result of flood conditions. If storm damage should occur, responsibility for steel stored in locations designated by Contractor, shall be for Contractor's account. 22. Traffic control (lane closures, barricades, flagmen, signs, lights, etc.). 23, Any reinforcing referred to as "Spec, Steel", "Allowance", and/or "As directed by Engineer" other than by additive quote. Accessories, wire mesh and/or mechanical couplers will not be included in this type of additive quote. 24. Drilling, coring, and or any excavation involved in the permanent and or temporary placement of Cast -In -Drilled -Hole Rebar cages. 25. The rigging, "setting", supporting, and or bracing of Cast -In -Drilled -Hole Rebar cages. (Cages to be tied and stock -piled) 26. Coating of exposed existing rebar with Epoxy Coating. HB -141- Item 11. - 10 )8/01/17 01:1OPM PDT DRS Rebar Inc —> 9516747495 Pg 4/7 General Conditions 1. The Contractor shall furnish design information and construction schedules in sufficient time to allow for preparation and approval of submittals (if required). 2. Contractor's acceptance of all the terms and conditions of this Bid/Offer shall be conclusively evidenced by Contractor listing, permitting/directing performance, or signing and returning this offer. 3. Subcontractor may begin performance of work, pending receipt of an executed final agreement. However, should a final mutually acceptable agreement not be forthcoming or should the term and conditions of Subcontractor's offer be altered or modified, Subcontractor reserves the right to immediately stop performance and Contractor agrees to indemnify Subcontractor for all costs and loss of profit. 4. The Contractor shall furnish, without charge, suitable equipment fully operated for hoisting/lowering rebar and accessories, including unloading trucks, staging of rebar and accessories to points of installation, setting of columns, wall cages and/or any other pre -tied assemblies and including any power placing of individual bars that Subcontractor may require. S. The Contractor is to provide Subcontractor with a minimum of 2 Hours of actual hook time. (Hook time is the amount of time that the hoisting hook is actively supporting any reinforcing steel) (These hours are for Subcontractor use only and do not include hoisting/lowering of materials for any F.O.B. jobsite material and/or unloading, stockpiling and setting of tied and stockpiled cages or mats, all of which must be rigged, unloaded and hoisted by others. 6. All layout lines, grades, and templates, racks and or/bracing shall be provided by Contractor without charge. 7. Full access to all working areas for material, equipment, and manpower. 8. Level space for delivery, assembly and storage of steel, accessible to tractor -semi -trailer deliveries and adjacent to jobsite location where steel is to be and/or hoisted/lowered. 9. Adequate lighting and ventilation as required. Ventilation shall be defined as air that is breathable and free of contaminates produced by contractor and/or other trades. (i.e. sandblasting in close proximity to Subcontractor's "working area", dust being produced by heavy machinery, etc.) 10. The contractor shall provide level space for delivery, assembly and storage of steel, accessible to tractor -semi -trailer deliveries adjacent to jobsite location where steel is to be used and/or hoisted/lowered. 11. No retention shall be withheld on F.O.B. if approved by owner. 12. No back charges or claims of the Contractor for services provided shall be valid except by an agreement in writing. 13. Field labor is to be performed during Subcontractor's regular working hours, eight hours per day, Monday — Friday with the exclusion of Union Holidays (Holidays observed by the Item 11. - 11 HB -142- )8/01/17 01:1OPM PDT DRS Rebar Inc —> 9516747495 Pg 5/7 Ironworkers' Union). All other labor shall be charged accordingly, (Overtime, weekend, or Holiday rates). Night work is excluded except by additive quote, 14. Subcontractor shall not be required to continue performance if, after Contractor has received payment for the properly performed work of Subcontractor, timely payments are not made to Subcontractor. 15. Cost of Subcontractor show -up and/or stand-by time, scheduled by the Contractor, when work is not ready shall be for Contractor's account. A sufficient amount of work area must be ready and available for at least eight (8) hours of work per man scheduled that day. 16. All sums not paid when due shall bear an interest rate of 2% per month or the maximum legal rate permitted by law, whichever is greater, and all costs of collection, including attorney fees, shall be paid by Contractor as prescribed by Section 7108.5 of the California Business and Professions Code, 17. No provision of this Subcontract shall serve to void Subcontractor's entitlement to payment for properly performed contract/extra work or suitably stored materials, or to void Subcontractor's right to file a lien, stop notice, and/or claim on its behalf. 18. If Subcontractor is required by the Contractor to perform change order/extra work, said extra work must be authorized in writing by Contractor's Field Management personnel having apparent authority to authorize such extra work or an officer of the Contractor. Such written/executed directives from the Contractor shall constitute acceptance of financial responsibility by Contractor and a billable event upon completion of the work. 19. Subcontractor warrants the merchantability of its work for a period of one (1) year from substantial completion of such work, and excludes any other warranties, express or implied, including any warranties of fitness for a particular purpose. Subcontractor's warranty does not extend to any work that has been misused, abused, modified, improperly or insufficiently maintained; to defects caused by normal wear under normal usage; or to any materials supplied but not manufactured by Subcontractor. Contractor's sole and exclusive remedy in case of nonconforming work is replacement or repair of such work. 20, Contractor shall provide Subcontractor with copies of all contract documents applicable to Subcontractor's performance, duties, or obligations at its Headquarters Office. 21. Subcontractor shall be provided a mutually approved construction schedule providing a reasonable time in which to make delivery of submittals, materials and/or labor so as to commence and complete the performance of the Subcontract. 22. Subcontractor shall not be responsible for delays, accelerations, or defaults where occasioned by any cause beyond its control: delays caused by Owner, General Contractor, Architect and/or Engineers. 23. Subcontractor shall be entitled to equitable adjustment in the Subcontract amount for additional costs due to unanticipated project delays or accelerations caused by the Contractor H B -143- Item 1.1. - 12 )8/01/17 01:10PM PDT DRS Rebar Inc -> 9516747495 Pg 8/7 or others under the direct control of Contractor, and whose acts is not Subcontractor's responsibility. 24. The Contractor shall make no demand for liquidated damages for delays in excess of the amount specified in the Contract Documents and no liquidated damages may be assessed against Subcontractor for more than the amount paid by the Contractor for unexcused delays to the extent actually caused by the Subcontractor. 25. In the event of any offer under a cost reduction incentive provision of the General Contract and/or change order negotiations, Contractor shall protect Subcontractor's interest and shall keep Subcontractor fully apprised of all other offers, which may affect Subcontractor's job in progress. Contractor shall offer the Subcontractor the right to participate fully in all negotiations relevant to Subcontractor's work. 26. Splices in reinforcing bars and/or construction joint dowels for Contractor's convenience shall be for Contractor's account, Bar splices required due to low overhead, power lines and/or deficiencies in hoisting equipment unless specifically shown on contract drawings at that particular location shall also be for Contractor's account. 27. Subcontractor shall not be liable for repair of any damage caused by others outside the control of subcontractor. Approval for pouring or embedment in concrete shall terminate Subcontractor's responsibility for that portion of the work, 28. Subcontractor shall not be responsible for any information furnished by others, including but not limited to structural design or details, placing plans, bar lists, or bending details. 29. Contractor shall furnish, without charge, templates/starter walls constructed with sufficient accuracy to support vertical reinforcing steel within placing tolerances specified by owner. Templates/Starter walls shall not be double formed before reinforcing steel is installed unless prior approval has been granted by Subcontractor, 30. Contractor shall furnish adequate parking for all Subcontractor employees at no cost to Subcontractor within three (3) standard blocks of the jobsite. If Contractor does not provide this parking, Contractor will pay extra to Subcontractor for all parking related costs, including cost of vehicle parking, cost of shuttle service, and travel time costs while Subcontractor employees are in transit unless specifically included in the Scope of Work/Price or by additive quote. 31. Contractor will provide at all times ongoing full access to all areas of the project for at least one Subcontractor Foreman's truck to provide supplies and accessories as needed for the project. 32. Contractor shall furnish approved work drawings of the temporary support system for columns, wall cages, and/or any assemblies regardless of height, which the bid documents, may require. Contractor shall furnish and maintain adequate bracing, rigging, cables and guys, set all "deadmen" required to guy vertical reinforcing, and comply with the temporary system design. (Rigging includes but is not limited to: chokers, shackles, spreader bars, etc.) Item 11. - 13 xB -144- ?8/01/17 01:10PM PDT DRS Rebar Inc -> 9516747495 Pg 7/7 33. Contractor shall furnish proper layout lines for all concrete elements such as footings, slabs, walls, columns, openings, depressions, etc. Subcontractor will layout its own reinforcing steel from the contractor provided lines. 34. Ramps adequate to allow semi -tractor -trailer deliveries of reinforcing steel to point of final placement shall be furnished by Contractor for all work below grade and shall be maintained in place until all work below grade is complete. If above ramps are not provided, all cost for equivalent service shall be for Contractors account. 35. Contractor shall furnish, at no cost to Subcontractor, hoisting/lowering of employees and materials to points of installation, whenever required. 36. Contractor shall furnish adequate working heavy duty CAL/OSHA scaffolding/platforms as required from which placing of reinforcing steel can be safely performed. 37, DRS Rebar Inc is a Rebar Subcontractor and above quote with this Proposal shall include Placement and furnishing of Reinforcing Steel only for the bid items listed. Certain exclusions may exist as stated in "Scope of Work Exclusions", "General Conditions", or by "Special notes" sections of this Proposal. 12SS Kelley Ave Corona, CA 92882 Ruben Sandoval: Owner/President Phone: 951-415-2458 Email: rsandoval2740 ahoo.com HB -145- Item 11. - 14 Jul 31 1707:19a Full Traffic Maintenance 951 5209980 p.2 FULL TRAFFIC � 'ITENANCE, INC. State License 1*780910 (A-C31) - DBE/MBE/SB — DM #1000005561 L-mail: TRAFFIC CONTROL, SUB -CONTRACTOR QUOTATION Attn: Estimator Project: Brookhurst Street Bridge Preventative Maintenance Date: July 31 , 2017 City of Hunting Beach, CA Prices are good from711/17-6130118 Item Description Amount Option 1 One lane, one direction, two -man crew one mile only $ 1590.35 Option 3 Any add' 1 closures (i.e. Flip flops, opposite direction) w/ same crew $ 795.17 Option 4 For each additional lane add $ 122.93 Option 5 For each additional mile add $ 122.93 O tio�__ �3n_.ranp,c�p�r�vullaneclosure 1-3 ramps add $ 122•`�� �..----�"�" O tian 9 City street lane closureldetour "� .__ ' � $ 1590.35 � Z.Di�iS Option 1 O Ramp closure, 1- 4 ramps $ 1590.35 ,� Option 1 7 Shoulder closures $ 1590,35 Option V Attenuator truck w/driver 8-hour shir"�, Plus $.65 a mile $ 1202.84 Option 1(a) Two -man crew flagging for 8-hour shift 1540.35 � 5 t .3� 2,�(HS = 9 ,") C) We need one hour set up time and one hour pick up time. Please provide 10 working ys' notice eforc job begins. This is a basic traffic control quote. No construction area signs were quoted for this project. If this project requires portable transverse rumble strips. please contact our office for quote. Rates listed above are the standard rates and does not include any rumble strips. Additional provisions: A. Shift prices are for eight (8) hours. Overtime will be billed at $116.81 per person -hour. B. Muitiply rates by 1.5 for Saturdays and 2 for Sundays and Holidays and after 12 hours of work will be billed at $155,73, C. F.T.M. is signatory with the Laborers union and certified with the State. Travel time and per diem are not included in price; charges wi11 apply for all Travel Time (TT) occurring before or after the 8-hour shift. D. Payment is due within thirty days from invoice date 1.5% Monthly Finance Charge after 30 days. E. No retention for traffic control. F. If required additional equipment (i.e. Changeable Message Sign, Attenuator Truck) to be provided by F,T.M. for an additional charge. G. Prime Contractor is responsible to obtain all permits required from Cities involved. H. Prime Contractor is responsible to coordinate and pay for Highway patrol unit. I Additional 3 '/ percent increases added every year on Jung: 30"This proposal will become part of any contract. J. If Special wording insurance is needed the amount to be paid by Contractor along with Waivers of Subrogation Insurance the % of payroll will be charged to contractor. If notary services are required, Prime Contractor is responsible for those charges. K. If equipment is rented for set up only, contractor is responsible for closure and equipment until FTM picks it up. L. No work will be performed until this proposal is signed and iaxedlmailed to our Corona office. If you need a bid for the signs please fax plans to 951-520-9980. Thank you for the opportunity, Sammy Salgado Signature of Acceptance Full Traffic Maintenance, Inc. 217 Lewis Court, Corona, CA 92882 Office: (951) 520-9990 Title Fax: (951)520-9990 Date Item 11. - 15 KB -146- Jul 31 17 07:19a Full Trafiic Maintenance 951 5209980 p.3 FULLTRAFFIC MAINTANENCE INC, DBE CERTIFIED 217 Lewis Court, Corona CA 92882 Phone (951)520-9990 Fax (951)520-9980 FU? LTRAFFICPSl3CGLOBAL.NET DBE Certified # 35742 To: Estimator Date: July 31, 2017 `Light Tower Rental $85.00 per day - $255.00 per week - $765.00 per month *Solar Arrow Board Rental $30.00 per day - $130.00 per week - $400.00 per month *Changeable Message Sign Rental $85.00 per day - $340.00 per week - $915.00 per month *Impact Attenuator Vehicle Rental $265.00 per day - $1040.00 per week - $2890.00 per month {mileage fee of $.50 per mile — portal to portal) *Traffic Truck Vehicle Rental $265.00 per day - $1040.00 per week - $2890.00 per month (mileage fee of $.50 per mile — portal to portal) * All equipment rentals are subject to a delivery and pick up charge * All rentals and material are subject to availability * See second sheet for price on sages items Submitted by: Sammy Salgado Date: Company: Accepted by: 1-13 -147- Item 11. - 16 Jul 31 17 07:19a Full Traffic Maintenance 951 5209980 pA 217 Lewis Court Corona, CA 92882 Office: 951.5 20,9990 Fax: 951.520,99809 CRASH BARRELS CHANNELIZERS BUTYL PADS (8X8) REFLECTIVE ROLL UP SIGNS REFLECTIVE LEFT PATCH STAY & BRACKET SPRING STAND TYPE I BARRICADE TYPE 11 BARRICADE TYPE III BARRICADE W/FEET ANSI CLASS 11 VEST ANSI CLASS III VEST ANSI REFLECTIVE MESH PANTS ANSI REFLECTIVE WATER PROOF PANTS ANSI CLASS II PARKA 28" 10LB 6/4 CONE (FREEWAY) 28" 7LB 6/4 CONE DELINEATOR W/12LB BASE CUSTOM ALUMIUM SIGNS # 200, 4D0, 700, 14CO & 2100 36" 48"X48" 48" Website: www.ftminc.net Email: fulltroffic@sbcglobaLnet $ 195.00 ea. $ 16.10 ea. $ 2.10 ea. $ 95.30 ea. $ 18.50 ea. $ 27.30 ea. $ 117.30 ea. $ 23.95 ea. $ 25.50 ea. $ 86.90 ea. $ 12.50 ea. (add $3.00 for each X after 2XL) $ 16.35 ea. (add $3.00 for each X after 2XL) $ 16.00 ea. (add $3.00 for each X after 2XL) $ 19-50 ea. (add $3.00 for each X after 2XL) $ 38.25 ea. (add $3.00 for each X after 2XL) $ 16.10 ea. $ 13.90 ea. $ 16.15 ea, CALL FOR QUOTE *ALL EQUIPMENT RENTALS AND MATERIAL ARE SUBJECT TO AVAILABILITY*ALL PRIICING IS SUBJECT TO CHANGE Item 11. - 17 HB -148- Q o w. .Q X C K C C 4 P cd a V l.i V �51, H B _ 1.49_ Item 11. - 18 9'd 0866 OZ9 l96 aoueuajuieVq oipjjjln_� eb6.LUL l Jul31 1707:19a 54na16 Full Trafilc Maintenance Unified Certification Program 951 5209980 p,6 Back To Query Forn, Search Returned 1 Records Query Criteria Firm ID: 35742 Licenses; A General Engineering Contractor Firm Type: DBE Firm ID Firm/DBA Name Address Linei Address LIne2 City State Zip Codei Zip Code2 Mailing Address Une1 Mailing Address Line2 Mailing City Mailing State Mailing Zip Code Mailing Zip Code2 Certification Type Entail Contact Name Area Code Phone Number Alt Area Code Alt Phone Number Fax Area Code Fax Phone Number Agency Name Counties Districts DBE NAICS ACDBE NAICS Work Codes Licenses Trucks Gender Ethnicity Firm Type h4:/ www.dotca.govtjc:g% erySubrnitrio 35742 FULL TRAFFIC IUTAINTENANCE, INC. 217 LEWIS COURT CORONA CA 92882 DBE sarnmysalgado@sbcgloba I_net SAMUEL J. SALGADO (951 ) 520-9990 ( 951 } 520-8980 CITY OF LOS ANGELES 19; 30; 33; 36: 37: 07: 08: 11: 12: 561990; Wed May 04 14:06:59 PDT 2016 C0612 SAFETY SUPPLIER; C0800 Traffic S VL,)o. Marking and Traffic Control Materials Supplier, C1200 CONSTRUCTION AREA SIGNS; C120t TRAFFIC CONTROL SYSTEM; C5601 SIGN STRUCTURE; C5620 ROADSIDE SIGN; C8605 MESSAGE SIGNS, LIGHTING & SIGN ILLUrAINA7iON: A General Engineering Contractor, C31 Construction Zone Traffic Control Contractor, C61 Limited Speciaky Ccnlractor, D:2 Sign Installation; M HISPANIC DBE Back To�}C uery Forul 1/1 Item 11. - 19 H B -150- Full Traffic Maintenance, Inc. 217 Lewis Court QUOTE Corona, Ca. 92882 SHEET 951-520-9990 951-520-9980 fax BEADOR CONSTRUCTION BROOKHURST BRIDGE --- SLED TL-2 ABSORB 350 TL-2 $6,125.00 each $6,192.00 each ..- ...... -- Plus tax 1%& f0) Z , vv rc 29= 12, 364.too . '3503 , —7.6 �b �3 3�3.71a 4 E — Kim HB -l5l- Item 11. - 20 01/17/200B 00:42 8059290501 PAGE 01/01 LA IMA 914DIR 1000005131,D: 08/01/2017 Project. Brookhurst Street Bridge Preventive Maintenance CC-1449 Huntington Beach, California 110 5. Mary Ave Ste. 92 #103 Nipomo, CA, 93444 Phone:805-748-8576 Fax; 8OS-929-OS01 E-Mail; vb@lafirmainc,com We are pleased to provide you with a bid for the items listed below based on plans and specifications and (0) addendum Description Unit Prepare Storm Water Pollution Prevention LS Plan Quantity Unit Price Total 1x $2,250.00=$2,250.00 Exclusions and qualifications. 1, Special testing and permits not in contract. 2. Price includes (1) electronic copy and (5) printed copies. 3, BMP materials and supplies not in contract. 4. Final Hard Copes delivered when we receive final payment, 5. Price Good For 90 Days Only. 6. Annual Report ($1000) and NOT ($600) not in the contract. THA Y4U F R YOUR TIME AND CONSIDERATION, VICENTE BRAVO, Item 11. - 21 HB -152- CITY OF HUNTINGTON BEACH BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE C.C. No. 1449 BID OPENING DATE: August 1, 2017 TIME: 2:00 P.M. ENGINEER'S ESTIMATE: $945,000 BIDS SUBMITTED (AS READ AT OPENING) BIDDER'S NAME APPARENT RANK APPARENT BID AMOUNT ACL Construction, Inc. All American Asphalt Beador Construction Company, Inc .166 300 John S Meek Co 7-� Peterson -Chase General Engineering Construction Powell Constructors Inc. i RSB Group Truesdell Corporation of California United Engineering &Construction Inc. r - i Bid Results CC-1449 _• a JACta > tL p Z cc N C�- l�lU�j d:do� 13738 N4iJNilNt1N 34 A 113 NUT) A 113 00 .z Wd i — 9nv ttol 03AI 03 Q�n 0 c/L SECTION A NOTICE INVITING SEALED BIDS for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 in the CITY OF HUNTINGTON BEACH 711Y %/7 71,A_ h� 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 August 1, 2017. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents shall be available after July 10, 2017 from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $20.00 nonrefundable fee if picked up, or payment of a $40.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). The AGENCY does not charge a fee for Plans, Specifications, and contract documents downloaded from: http://www.huntingtonbeachca.gov/government/departments/public works/Bids/ 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 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code, Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. A-1 No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. All extensions of unit prices will be subject to verification by the AGENCY. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 total 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 award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: This bridge preventive maintenance project consists primarily of the removal and replacement of the concrete barriers and chain link railing; removal and patching of unsound concrete at the bridge bents and columns; removal and replacement of AC pavement overlay; and appurtenant work as required. • The contract allows the Contractor 130 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $945,000. • The Project Disadvantage Business Enterprises (DBE) goal is 16%. • For the Federal Trainee Program, the number of trainees required is 1 (see Appendix I). 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 6th day of September 2016, by Resolution No. 2016-58. Attest: /s/ Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH A-2 FOB CITY OF HUNTINGTON BEACH 2000 Main Street P.O. Box 190 Huntington Beach, CA 92648 LETTER OF TRANSMITTAL Attention: Robin Estanislau To: City Clerk's Office 2000 Main Street Huntington Beach, CA 92648 Fax (714) 374-1573 Date: June 30, 2017 Project/C.C. No.: C.C, Nos. 1448 & 1449 Regard i ng: MagnolialBrookhurst Bridge Preventive Maint. ® We are sending you: ❑ By Mail ❑ By Fax Mail (Number of pages including this sheet:) ❑ We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other: Notice inviting Sealed Bids Item # Copies Pages I Description 1 1 2 Notice inviting Sealed Bids for Magnolia Bridge Preventive Maintenance, CC-1448 (Word. doc) 2 1 2 Notice Inviting Seated Bids for Magnolia Bridge Preventive Maintenance, CC-1448 ( di) 3 1 2 Notice Inviting Sealed Bids for Brookhurst Bridge Preventive Maintenance, CC-1449 (Word. doc 4 1 2 1 Notice Inviting Seated Bids for Brookhurst Bridge Preventive Maintenance, CC-1449 (, do 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: Please find attached the Notice inviting Seated Bids for advertisement in the OC Register on 7/11117, 7/18117 and 7125/17. The public bid opening is scheduled for 2:00 P.M. on 8/01117. Please contact me at 374-5380 with any questions you may have regarding this, By: Jonathan Claudio, Senior Civil Engineer c: file GACONSIRUCTION CONTRAM (CCS)\CC1356 WARNER BRIDGE REi1ABILrrATION PROGRAM\!\ENG.INLTMNG\ADVTJMSEMENT\MAGNOLIA CC-1448 AND BROORHURST CC-1.449\N1SB TRANSM=AL TO CLERK CC-1448 & CC-1449 NOTICE INV ITING SEALED BIDS for the construction of BROOKHURST STREETBRIDGE PREVENTIVE MAINTENANCE (O V E R TALBE RT CHANNEL.) FEDE RAL AID PROJECT BPMPL-5181 (172) C.C. No. 1AW in the CITY 0 F 14 UNT I N GTON BEACH 'UBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUN- FINGTON BEACH, as AGENCY. invites sealed bids for the ab".,ve tated proiect and will receive such bids in the office of the City :lerk, Second Floor, 2000 Whin Street, Huntington Beach California 2644 up to the hour of 2:00 P_M.on August 1, 2M7. Bids will be rublicly opened inthe Council Chambers unless otherwise posted. :opies of the Plans, S Ncificat ions, and coniract documents shall be iva i I a ble after J u Iy 10, 2017 from the Off ice of the Director of P u bl is Vorks. 2000 !Rain Street, Huntington Beach, CA 9264S, upon payment rf a kh0.00 nonrefundable fee if nicked up. or pa;iment c f a QL00 ionrefundable fee if sent by UPS ground del ivery (bidder shall past additional costs for specialdelivery). The AGENCYcbxs not charge i fee for Plans, Specifications; and contract documents downloadea rom : -his is a Davis -Bacon proiect andthe Federal Peaulations will been- orced. Any contract entered into pursuant tothis noticewiII incor - ate the provisions of the Federal Labor Standards which are on file it the office of the Director of Public Works, 2000 vain Street, Hun- ington Beach, CA 92648, "he AGENCY will deduct 5% retention from all progress payments. he Coniractor may substituieanescrow holder surety of equal value o the retention in accordance wiih the provisions of the Public Con - ract Code, Section 10263. The Contractor shall be beneficial mvnerof he s u rety a nd s ha I I rece ive a ny i me rest t he reon. "he AGENCY herebt affirmatively ensures that minority business ,nterprises will be afforded full opportunity to submit bids in re- ponse to this notice and will not be discriminated against on the ba- is of race. color. national origin, ancestry,sex;. or religion in any o nsideration leading iothew aard of contraci. do bid shall be considered unless it is pre rared on the approved Pro- .osal forms in conformance with the Instructions to Bidders as deter- nined by the AGENCY. All extensions of unit prices will be subject o verification bry the AGENCY. In the case ofdiscrepanciesin the imounts bid, unit prices, shall govern over extended amounts, and cords shall govern overfigures. "he bid mull beaccompcsnied by certified check, cashierschecIor Bidder`s bond made payable to the AGENCY for an amount no less han 10% of the total arrmunt bid. The successful bidder shall be li- ensed in accordance with provisions of the Business and Professions :ode and shall possess a State Contractors License Class A at the ime of the award. The successful Contractor and his subcontractors vill be required to possess business licenses From the AGENCY. 'reject Description • This bridge preventive rriai ntenance project onsrsts primarily of the removal and replacement of the concrete carriers andchain Iinkrailing;: removaland patching of un5oundcon- rete at the bridge bents and columns • removal ana replacement of -.0 pavement overlay; and appurtenant workas required. • The coniract allows the Contractor 19 working days to complete the contract. • The engineers esti maie. of probable construction cost for the work inc l uded in the basis of a -ma rd is W415�OOO. The Proiect Disadvantage Business Enterprises (DBE) goal is 16%9 • For the Federal Trainee Program, the number of trainees required isI (see Appendix1). The AGENCY reserves the right to reiect any or all bids, to waive = ony irregularity and to take all bids under advisement for a max, - mum period of 60 days: -,By ORD ER of the CITY COUNCIL of the CITY OF HUNTIN GTON BEACH, CALIFORNIA, the 6th day of September2IN4 by Resolu- -1 ion No.2M 6-56. 4tte st.. /s` Robi n E sta n i s la u 1 CITY CLERK OF THE CITYOF HUNTI NGTON BEACH iPiihlkh. Clrnnaa r uanty Raaistar .1 ulv 11.1A. 7:5.9017 P-90A9 ing7tQdi7 On Wed, Jul 5, 2017 at 12:18 PM, Esparza, Patty <PEsparza@surfci -hb.org> wrote: Hello again Sandra: Attached are two additional legal ads that need to be published in the OC Register on the following three dates: July 11, 2017, July 18, 2017 and July 25, 2017. Please confirm when possible, thanks. Patty Esparza, CMC Assistant City Clerk City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 (714) 536-5260 Sandra Campos Orange County Register 2190 Towne Centre Place Anaheim, CA 92806 Main Line: 714-796-2209 Direct Line: 714-796-6748 Email: scamyos6'ZscnE.com * PLEASE NOTE NEW EMAIL ADDRESS AFFIDAVIT OF PUBLICATION STATE OF CALIFORNIA, ) ) ss. County of Orange ) I am a citizen of the United States and a resident of the County aforesaid; I am over the age of eighteen years, and not a party to or interested in the above entitled matter. I am the principal clerk of The Orange County Register, a newspaper of general circulation, published in the city of Santa Ana, County of Orange, and which news- paper has been adjudged to be a newspaper of general circulation by the Superior Court of the County of Orange, State of California, under the date of November 19, 1905, Case No. A-21046, that the notice, of which the annexed is a true printed copy, has been published in each regular and entire issue of said newspaper and not in any supplement thereof on the following dates, to wit: July 11, 18, 25, 2017 "I certify (or declare) under the penalty of perjury under the laws of the State of California that the foregoing is true and correct": Executed at Santa Ana, Orange County, California, on Date: July 25, 2017 The Orange County Register 625 N. Grand Ave. Santa Ana, CA 92701 (714) 796-2209 PROOF OF PUBLICATION SECTION A NOTICE INVITING SEALED BIDS for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUN- TINGTON 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 August 1, 2017. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents shall be available after July 10, 2017 from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $20.00 nonrefundable fee if picked up, or payment of a $40.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). The AGENCY does not charge a fee for Plans, Specifications, and contract documents downloaded from: http([www.huniingtonbeachca.gov/ggovernme_- wportments(public_ works/Bids/ This is a Davis -Bacon project and the Federal Regulations will be en- forced. Any contract entered into pursuant to this notice will incorpo- rate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works, 2000 Main Street, Hun- tington Beach, CA 92648. The AGENCY will deduct 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Con- tract Code, Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in re- sponse to this notice and will not be discriminated against on the ba- sis 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 Pro- posal forms in conformance with the Instructions to Bidders as deter- mined by the AGENCY. All extensions of unit prices will be subject to verification by the AGENCY. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. The bid must be accompanied by a certified check, cashier'scheck, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the total amount bid. The successful bidder shall be li- censed 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 award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: This bridge preventive maintenance project consists primarily of the removal and replacement of the concrete barriers and chain link railing; removal and patching of unsound con- crete at the bridge bents and columns; removal and replacement of AC pavement overlay; and appurtenant work as required. • The contract allows the Contractor 130 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $945,000. • The Project Disadvantage Business Enterprises (DBE) goal is 16%. • For the Federal Trainee Program, the number of trainees required is 1 (see Appendix 1). The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maxi- mum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 6th day of September 2016, by Resolu- tion No. 2016.5E . Attest: /s✓ Robin Estanislau Publish: Orange County Register July 11,18, 25, 2017 R-208910976940 UNSUCCESSFUL BIDS CC-1449 Brookhurst Street Bridge Preventive Maintenance City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk October 23, 2017 John S. Meek Company, Inc. 14732 So. Maple Avenue:. Gardena, CA 90248 RE: Brookhurst Street Bridge Preventive Maintenance — CC-1449 Enclosed please find your original bid bond for CC-1449. Sincerely, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand KNOW ALL MEN BY THESE PRESENTS, that we John S. Meek Company, Inc. as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 1330 Post Oak Boulevard ste 1100, Houston, TX 77056, as surety, hereinafter called the "Surety," are held and firmly bound unto City of San Clemente as obligee, hereinafter called the Obligee, in the sum of Ten Percent of the Amount Bid ($10% of Amt Bid) 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 Brookhurst Street Bridge Preventive Maintenance (Over Talbert Channel), Federal Aid Proiect BPMPL-5181 (172) - C.C. No. 1449. NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 60 days of the date hereof. SIGNED, sealed and dated this 27th day of July, 2017. Joh (Pri BY: TIT SureTec Insurance Company BY: Erik Johansson, Attorney -in -Fact Bid Bond Form Rev 1.1.06 CALIFORNIA-. •. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Orange ) On JUL Z 7 2017 before me, Date personally appeared E. M. Bell, Notary Public Here Insert Name and Title of the Officer Erik Johansson Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/NK subscribed to the within instrument and acknowledged to me that he/executed the same in his/lk$authorized capacity(ies), and that by his/signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. ------------ E. M. BELL o COMM. # 2151184 g ' NOTARY PUBLIC CALIFORNIA ' LOS ANGELES COUNTY My comin. expires Apr. 29, 2020 It Place Notary Seal Above 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 ot,�"�� Signature of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 SECTION C PROPOSAL for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guarantee 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 completed to the satisfaction of the AGENCY. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the contract, the undersigned agrees that in the event of the BIDDER's default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find bid bond in the amount of $ 10% of bid amount which said amount is not less than 10% of the Total Amount Bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be). Any standard Surety Bid Bond form is acceptable. BIDDER shall sianifv receipt of all Addenda here, if any: Addenda No. Date Received ` , j Bidder- nature 1 1 July 24, 2017 C-2 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item Contract Unit Extended No. Quantity Unit Description Price Amount 1 LS Mobilization Iasi SlKs 10&19QS 1 $ $ 1 LS Prepare Storm Water Pollution Prevention Plan 2 $ 1;633"00 $ 103'00 1 LS Water Pollution Control 3 $ R7, 706L' $ -A7,70a 00 3 EA Emergency Evacuation 4 $ 1 000`v0 $ 6i000'00 1 LS Traffic Control 5 cc $ 1 ; �o� 06 $ lqq,500' 27,030 SF Saw Cut, Grind and Remove AC Pavement 6 $ 1 S $ 63 TN Asphalt Tack Coat and AC Leveling Course Pavement 7 $ , 00 $ 340 TN ARHM Finish Course Pavement $ �a $ 6766p 8 C-z.1 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 240 LF Install 4' High Environmental Protection Fence nstall Striping and Pavement Markings 135,0001 SF (Slurry ove ncrete $ q /tW""' .0,36 p-)'j160ull L) S719- (z 12 $ `1 S+tJO $ l q 0 317 LF Remove Concrete Barrier 13 $ $ 317 LF Remove Chain Link Railing G u 14 $ a " $ 1 15 1 ent Concrete (Patch) Concrete Barrier (Type 26 Modified) $ 'Iqb6 701()0 C-2.2 PROJECT BID SCHEDULE BROOKHLIRST ST. BRIDGE PREVENTIVE MAINTENANCE. C.C. No. 1449 Item Contract Unit Extended No. Quantity Unit Description Price Amount 317 LF Wildlife Protection Railing CAO 3� 17 $ MI N& 16,874 SF Seal Concrete Bridge Deck 5. "" 18 $ $ 65 LF Chain Link Fence 19 $ (Yfl $ i2 a iss Total Amount Bid in Figures: $ $gu 8'7 Total Amount Bid in Words. Ci5j,+ k�tj-;jiN-r4 ��wz -rlwus .................................... ................ ..............................._..........................................................................� . (/4- E1k Stven Ouilar a C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the Bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Nam. e and Address of State Class. DIR Dollar % of Item(s) Subcontractor License:. Number Amount Contract ..Number:. . tj,$,U Sc t} K Ana, 5 �;, �lc'iK G11 %pC(� 1 5 �rrl Cube S 1�G75 $ joc�oi� g s3 ra$, y� �E-- --gym --- C,r5' CA 5y[7e"6- Po "'neAi hefkl� 1 76 36) 6 cV,\ 1006C %Y76 C 10 (Y res-'). L(V C3� KCAL_ W,(�Proo+, by `3�057 , s�,os�� G3a 13 Sc�-)•-� �"e S r,'ny 5, �� cap l 100000 C60 5 p c�nfan J CA i6 (K Fv u- i00000 �1) LI'm = Sw� V4cl{4, C k -i 3 By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of Los Angeles I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 07/31 /2017, at — Gardena CA Date City State John S. Meek , being first duly sworn, deposes and says that he or she is President of John.. S Meek Comfy Inc the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the Bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham: bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the Bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. John S. Meek Company, Inc. Name of Bidder Ll Signature of Bidder 14732 So. Maple Avenue, Gardena CA 90248 Address of Bidder Subscribed and sworn to before me this day of , 201 NOTARY PUBLIC NOTARY SEAL C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL •. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Los Angeles ) On July 31, 2017 before me, Anna Lisa Paila, Notary Public Date Here Insert Name and Title of the Officer personally appeared John S. Meek Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(&) whose name(s) is/art subscribed to the within instrument and acknowledged to me that he/si@/Uwy executed the same in his/hadawr authorized capacity(iea), and that by his/laer/tom signature(s) on the instrument the person(s), or the entity upon behalf of which the person(&) acted, executed the instrument. ANNA LISA PAILA + Notary Public - California i :-® Los Angeles County Z Commission # 2149290 j M Comm. Wires Ma 14, 2020 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 Sign ure of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator n Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02015 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449, (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 promises and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: July 31, 2017 John S. Meek Company, Inc. President Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes R No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a Public Works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: July 31, 2017 John S. Meek Company, Inc. C'.nntrnctor President Title C-7 BIDDER'S INFORMATION Bidder certifies that the following information is true and correct: John S. Meek Company Inc. Bidder Name 14732 So. Maple Avenue Business Address Gardena CA 90248 City, State Zip ( 310 ) 830-6323 Telephone Number 709151 A, B, HAZ State Contractor's License No. and Class July 5, 1995 Original Date Issued July 31, 2019 Expiration Date The work site was inspected by Ken Allred of our office on Itj 95 , 2017 . The following are persons, firms, and corporations having a principal interest in this proposal: John S. Meek John S. Meek Company, Inc. C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. John S. Meek Company, Inc. Compa Name j Sign toe Bidder John S. Meek Printed or Typed Signature Subscribed and sworn to before me this __._ day of , 201_ A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of _ County of On Month, Day, and Year personally appeared before me, Insert Name and Title of Notary 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. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles ) On July 31, 2017 before me, Anna Lisa Paila, Notary Public Date Here Insert Name and Title of the Officer personally appeared John S. Meek Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(a) whose name(s) is/arm subscribed to the within instrument and acknowledged to me that he/gift-" executed the same in hisMeWtheit' authorized capacity(isa), and that by his/laer/theif signature(&) on the instrument the person(&), or the entity upon behalf of which the person(&) acted, executed the instrument. ANNA LISA PAILA Notary Public - California i , d Los Angeles County z a Commission # 2149290 r Mg Comm. Ez ires M&Z 14, 2020 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 (::j ignature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator F 1 Other: Signer Is Representing: 02015 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1 -800-876-682 7) Item #5907 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The Bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the Bidder has performed similar work within the past five years: 1. C� ��;.('��n�� OQ,f.-�k; ).)VO Vu60'A, Ad,1,CAyl3ss- Name and Address of Public Agency 2. Name and Phone # of Agency's Project Manager: J �,lMeS Ton ; (� 61 1 L04 (a AAA 96 �e WA'bj by� � (fir UAA [VkS11 �/10 (I 193T 5-io G Project Name Contract Amount Date Completed led description of Bidder's scope of work to demonstrate similar work experience: +eiu� W A'�NA fir,,-fP t__(-nAflpl, deWv1JR6 1, 6ofyaly- 1AW k- 4) (I k NIA N, , W CA , P"Vk�d 5'tr' �Oi K9 - big, CA 1 &3 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Joy V C) 4 U - ` •5) - 21 11 Project Name Contract Amount Date Detailed description of Bidder's scope of work to demonstrate similar work experience: Re�urr i-wo , �r; ► ��� ��A ��4��c .C�n�rol � dc�l%i'��� (<���c,fe 3. L©un &- L AA le f ;ems Name and Address of Public Agency V90 Name and Phone # of Agency's Project Manager: Po�- �= S�iJ�jev3►tr/ ��6-�%Sg-3�SS Project N Detailed descriptior,*f of Bidder's scope of work to demonstrate similar work experience: &3qC t^c1� I dt, c� hr �Cc c Cm� f_� 4e,,,,), ") , (c%r1C/c�C W-Vf t , A,`Ie-5 . Sffcef- fib Wrl5 5f1/12,211 . C-10 BIDDER'S CRITICAL STAFF The Bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the Bidder at the time the referenced projects were completed. 1. Kn WceA Name of proposed Construction Project Manager OJ Phone # of proposed Construction Project Manager: Project Name & Contract Amount Type of Work Date Completed ,! Project Name & Contract Amount Type of Work &k"f Project N e & Contract Amount Type of Work L� w- 5 Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: 310136 -0d 3 S N1 ( Date Completed 1611 S Date Completed Lo)Hmvon br,licUldwos h6foj�- &'�' 11-/ c [I b Project Name & Contract Am unt Type of Work Date Completed Q 9l613 Project Nam & Contract Amount Type of Work Date Completed Tdwd 5frg( tg1 it-l%k 4� 73J' "qo �ekwglkter', ct Name & Contract Amount Type of Work 1 31 l� Date Comple- C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The Bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: John S. Meek Company Inc. Contact Person: Contact Phone: Signed: Date: John S. Meek *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link — Call (844) 522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayP W CRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a) which states: "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. Date: July 31, 2017 DIR #: 1000002928 John S. Meek Company, Inc. Contractor President Title C-13 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder John S. Meek Company Inc. , proposed subcontractor hereby certifies that he has x , has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 6 of 22 C-14 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not x been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes tl No If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-15 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 8 of 22 C-16 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid Noneollusion 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 conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shal I 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 Non -collusion Affidavit is pail of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 9 of 22 C-17 October 2016 Local Assistance Procedures Manual DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 Exhibit 12-H Sample Bid The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 10 of 22 C_1 g October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 11 of 22 C-19 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPL,ETETHIS FORM TO DISCLOSE? LOBBYING AU11VI I ltS I'UKSUAN I IU,51 U.3.u. I»/ 1. Type of Federal Action: 2. Status of Federal Action; 3. Report Type: =a, contract a. bid/offer/application a, initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter_ f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier , if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, it'know'n: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. 10a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (cheek all that apply) 13, Type of Payment (check all that apply) $ ❑ actual 7 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 e deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes 7 No D 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352_ This disclosure of lobbying reliance vas placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure_ Federal Use Signature: Print Name: Title: Telephone No.: Date: Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the form is inadequate, Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered Federal action, 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11, Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box. Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. sF-LLLJnstrm6.ns Rev 06-04-9WENDSFll Page 13 of 22 C-21 October 2016 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 12-B Bidder's List of subcontractor (DBE and Non -DBE) Part I As of March 1, 2015 Contractors (and sub -contractors) wishing to bid on public works contracts shall be registered with the State 'Division of Industrial Relations and certified to bid on Public Works contracts. Please register at: httDs://efiling.dir.ca.gov/PWCR/AcfonServlet?action=displaVPWCRegistrationForm In accordance with Title 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 of the Public Contract Code of the State of California, as amended, the following information is required foreach sub -contractor who will perform work amounting to more than one half of one percent (0.5%) of the Total Base Bid or $10,000 (whirhever is greater1 Photoconv this form for additional firms. Subcontractor Name and Location Line Item & Description Subcontract Amount Percentage of Contractor Bid Item Sub- = License Number contracted DIR Reg Number DBE (Y/N) DSE Cert Number Annual Gross Receipts Name; id i f kV�!ijj4yxI _ +_M <$1 million Lj <$5mill+on City, State:t�iri ftlt CIS <$10 million <$15miIlion Age of Firm:-7) yrs. Na me: tl tvilef P^+ {i A, � P ��[! �r+ + �f / / C� `LV ' r� r j "" C " t ' -770b r G � <Sl miltion <55 million City, State: (t C�Pf�/ jl 06(r0l"I�7� <$10million {S35million Age of Firm: t 7, yrs. _ Name: ftac7T r !' V LchclC f ?� lS + � � j , <$1 million <55 million City, State-Cu I r 1 <$10 million <$15 million Age of Firm: 4(Z yrs. Name: b ��ICFt'�LCti �A ] ��j I + f l9 'J r� p J 7C �-* <$3 million <$5 million <$10 million City, State:"t�1 5�y'y [ ,r /� cA Fe. J rl'A / L I7 (��( 00 I -i 1 6 <$15 million Age of Firm: A yrs. Name: � [ctdr. I pp �'t1t�41 A+t _ f �r'i7i' lzlfl Q� J {j{ 4;. --7 19� 7S$ <$3 million $5 million City, States sI (? a� <$10 million <$15 million Age of Firm: ;k-. yrs. ame.� I[eyrre tf ° 3t �V2 l r ��Q rduv LJ <$I million <$5 million City, State: CA" LUUoo� �v4� <$10 millior, <$15 million l Age of Firm:�c�5 yrs. Distribution 1) Original -Local Agency Flle 2) Copy-DLAE w/ Award Package C-27 Page I of 2 September 2016 I --cal Assis(aiice Prc�c€:dures Manual FxhilTit 12-13 Bidder's List of Sutacontraclors (L)BE and NON. -DBE,) Exhibit. 1.2-11 Bidder's List of subcontractor (I)BE and Non-I)BE) fart 1 As of March l_ 2015 C'ontractory (and suh-coniraciors) wishing, to hid on public works contracts shall he registered with the State Division of Industrial Relations, and cc:rtificci to bid Oil t'ublic Works contracts. Illeaise register, at: lttt s:/ef_iling.dir.ca,,gov/PWCR/ActiortServlet?acting=displayPWCRegistrationForm In accordance ,vith 1 ltle 49, Section 26A 1 ot`the gods; Cif+.deiatl Reuulations, and Section 4104 ofthe Public Ci)iitract (_C)& of the ``state. ofC'alif6rni,a, as amended, Iltc toIlC%wl11C; YnIt3r177atti3lt is rel'ftltrlrfl f{1C L.3ti17 sub -Con tractor wl10 will pCr'tCli'ttl w[7f'k ainciumino to irl(3rC tltiiti one half C}t L1nC j]CrCrltt `li3} caCtite '9 ataI 1.3'ISC 1.3ic1 nr 1{1,til}(1 (whichever is greater). Photocopy this forth for additional firms. Subcontractor Name and Location Namc: ��i.1- ?R C t __. City. State: tine Item $. Description 1 ) 1 t 1tnJ4 FE�G� Suhtontract Amount Percentage of Contractor Bid Item Sub- License Number contracted DIR Reg Number r 72. ` 6-q �G - DBE (Y/N) a ( 14 DRE Cert Number Annual Gross Receipts C (( ��,� _ - c$1 million _❑ ❑ <$5 million - rT _$10 ntaNian <s15 million l Age of Film: 15, YTS - Name: i - _.........___ <$1 million - -- r$5 anillion <$7.0 million _<$15 mullion _. Age of Firrn' — yes. City, State: Name: Cali, State- j _....-_........_..__� <51 million _ a •millia�n _........--...------- ❑--- c$1.0 million ❑ <$15 million Age of Virm: — yrs. — Namv4 ❑ <$1. million <$5 million ❑ <$10 million <515 million City, state,: - Age of Firm: _yr, . --- Name: I. <51 rnillion _. <$5 million -$10 million t$1S million 1 City, state: — Age of Firm: Vrs. -- iVarnr--: ciiy, Stag: --� _._ _ -..... -._... --- __..._--- $] rnil3)an -..❑._—... •Ksj [hill V{➢f1 .__._.. _.. --- [— _-$1ti million l <$15 million Age of Firm: TyrsJ Distribution: 1) Original -Local .Agency He 2) Copy-DLAF wf Award Package Page f of 2 C _77 Septem her 2016 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 1.2-B Bidder's List of subcontractor {DBE and Non -DBE} Part 2 In accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provide a quote or bid but were not selected to participate as a subcontractor on this project. Photocopy this form for additional firms. ❑istribution: 1) Original -Local Agency File 2j. Copy-DLAE w/Award Package C-28 Page 2 of 2 September 2016 I..ocifl Assktance Procedures Ma€,ual Fshihit 12-k Bidder's List o!' Sulwoutractors (iDUL: acid NON- DRk") Exhibit 12-B Bidder's List of subcontractor (DBE and Non -DBE) Part 2 III accordance wit11 I ItIe 49, seGtioll 20 of the Code ot, FedcraI IkegoIations, the BIcfder shall tist all subcontractor ctor who provide a quote or bid but were not select"I to pa€ticipate as a subcontractor on this project. I'hutocopy this farm far additional firms. Subcontractor Name and Location Line Item & Description Subcontract Amount Percentage of Contractor Bid Item Sub- � License Number contracted DIR Reg Number DRE i (Y/N) I ORE Cert Number Annual Grass Receipts Name: _ ._..T I ' '' ] / cz,4 P � 1 L^-' f J. ! �._._.�7P r�1 Q IS1 r7milion _ ss million City, State. ! !� � f C �$li3 milflvn I- ........<5,Is Mill Age of Firm: yr5- ND111t- 1 __ f l i �j /�i � b 1 ',�,715 v t, `� 7 AIsh V �r <$I Million -- ❑ s5 rri,Ilian i - �$1U tn311ion City, State: F rt C _ `� .., j EGG E, {I / <$15 ni lhon - 4e of Firm: yfs t�i€1 {Yt': -..._.._p i 7 Crjl Tnil or1 Ilion ._..._._.. City. State: I ❑ <$_10 nkillinri�.^ ® <515 mill kt]11 Age of Fir€13; _ yf's, Name: 3 I - -�- ❑ <$1 million <SS million _ _._..... <510 million I _.<$15 million (ity, State; Age of Firm, ___ yrs.T- Name: [ <$1 million <S5 million ❑ <$10 rr 0lioi1 a 1` mi9lian C.kty, State: 1 Age Dt Flan: yrS. Name- - ___..._— i I t C$1 million _ ❑ <SS millian City, State: ❑ <$1[, fnd ior, _.,.._. ._..._ <$15 million Age of f irrw- r'' I I)istrihut€on: 1}Original-I.©cal Agency File 2) Copy, DLAE wj Award Package Page 2 of 2 C-Zfi September 2016 local Assistance Procedure-, Manual f.:xl)ibit I?-U Mcitler's list of Subcontractors (LDRU. and NON-llRE) Exbibit 12-B Bidder's List ofsuhcontractor (I)BE and Nara -DBE) Part 2 In accordance will) l itle 49t Section 20 ot'dic Code of federal Rqulatioris,, the Bidder shall list all .,ubconiracior w1lo provide is tluoic or hid but were not selected to pailicipate as to subcontractor on this projet:t. Photocopy this forin for additional firms. Subcontractor Name and Location Naine: Line Item & Description Subcontract Amount percentage of Bid Item Sub- contracted Contractor 7(Y/N) License Number_Number D1R Reg Number DBE Cert Annual GroSS ReCeif7tS <$1 rllrl1loo -_--...._�.._........-._-..Y,i - -_ E55 million C$1Q mlliliori <515 million —_......._._ City, %tat(-.: Age of Firm: _ yrs. Name: ijj <$3. million <$5 million City, state. --- L} <$10 million million Age of Firm: _., yrs. Nawe.. ❑ ._ -------- ':$�f 4lli llYUi1 City, State: _•.w._v" — Q <510 illmllion million Age of Firm: Y yrs ..•__...._.. _ Name: City, State; --- © :$i rrmillion <$5 rnillia)ri _....._.. $]0 million w......,_<$15 million Age of Firm yrs Name.: _.---..._.._._.._. `j ± II i l � ��� million - <$5 million r t _._.-.-----.. $]. t: nlilikx) $J.5 million (Icy, StotP: j'-- ---Age of l'i!ni: _ yr 5, Ndmei l � _ .._..��__� J <$11-nillion _ CS5 million _ � ❑ 510 131rllilzn� million [mt State: -- .�__ i'. � Age of Firm yrs, I)ist.rihtution: 1) Origirlal-Local Agency He 2) Copy•pLAL w/ Award Package Pa-e 2 of 2 t`-28 Septemher 2016 Ucal Assistance Procedures Manual Exhibit 12_B Bidder's List of Subcontractors (DBE and NON-1)RE) Exhibit 12-B Bidder's List of subcontractnt- (DBE and Non -DBE) Part 2 In accordance with Title 49. Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provide a quote or bid but were not selected to pailicipa(e as a subcontractor on this project. Photocopy this form for additional firms. Subcontractor Name and Location Name: City, State: Na me: City,State: Name: City, State: Name: City, State: Name: City, State: Name -- City, State: Line item & Description Subcontract Percentage of Contractor Amount Bid Item Sub- License Number contracted DIR Reg Number Distribution: 1) Original -Local Agency Fife 2) Copy-DLA[ wJ Award Package DBE I DBE Cert (YfN) Number Annual Gross Receipts J <$1 million <$5 million ] <$10 million 1_<$15 million L. Of Firm � _ yrs. j <$I million ] <$5 million ] <$10million ]_ <$15 million Age of Firm: _yrs. <$1 million <$5 million ] <$10 million ] <$15 million Age of Firm: — yr5. ] <$1 million <$5 million ] <w) million <515 million_ Age of Firm: _ yrs. ] 71 million F <$5 million ] <$10 million 15 million Age of - �Firm: ,_,yrs. T <$1 million -� <$5 million <$10 million �c$15 million Age of Firm: _yrs. C-2$ Page 2 of 2 September 2016 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181(172) C.C. No. 1449 July 24, 2017 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Brookhurst Street Bridge Preventive Maintenance, C.C. No. 1449: 1. The Federal Labor Rates contained in Appendix I —Part 2 of the Project Specifications for the Brookhurst Street Bridge Preventive Maintenance, C.C. No. 1449 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 07/14/2017). The attached FEDERAL LABOR RATES (Publication Date 07/14/2017) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 24, 2017. John S. Meek Company, Inc. Company Name July 31, 2017 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. POA#: 510610 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Melissa Lopez, Ellen Bell, Frances Lefler, Erik Johansson, Jennifer C. Anaya, James W. Johnson, Kevin S. Bogart, Scott M. Milne its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for, providing the bond penalty does not exceed Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 12/31/2019 and is made under and.by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20`h of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 25th day of July , A.D. 2017 . SUFANCc� SURETF,C E ANY \a ,........,, X 9 By nJohn Knox resi nt State of Texas ss: 7�`.. 1 `D;% �€ County of Harris .-...... On this 25th day of July A.D. 2017 before me personally 7ame John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above 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. .flyPUXENIA CHAVEZ Notary Public, State of Texas v+� Comm. Expires 09-10-2020 Notary ID 129117659 X to avez, Notary Public y commission expires September 10, 2020 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of .Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this day of A 20 A.D Br nt Be y, Assistant Se etary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. CALIFORNIA•ACKNOWLEDGMENT CIVILCODE§11 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Los Angeles ) On July 31, 2017 before me, Anna Lisa Paila, Notary Public Date Here Insert Name and Title of the Officer personally appeared John S. Meek Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/eta subscribed to the within instrument and acknowledged to me that he/sh@/t*q executed the same in his/4er/t#wir authorized capacity(isg), and that by his/der/tom signature(s) on the instrument the person($), or the entity upon behalf of which the person(&) acted, executed the instrument. ANNA LISA PALA Notary Public California A!E,*d i -® Los Angeles County n Z Commission # 2149290 My Comm. Ex Tres Ma 14, 2020 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 �,411 Sig ature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator n Other - Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator n Other: Signer Is Representing: ©2015 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 JOHN S. "MEEK� . 14732 So. Maple Avenue Gardena, CA 90248 Y ir. ux City of Huntington Beach Lai ' = ci Deliver to the Office of City Clerk r= 2000 Main Street, Second Floor Huntington Beach, CA 92+648 "SEALED BID" for BROOKHURST STREET BRIDGE PREVENTATIVE MAINTENANCE, C.C. No. 1449 In the CITY OF HUNTINGTON BEACH DO NOT OPEN WITH REGULAR MAIL Bid Date: Aucust 1. 2017 at 2:00 mm. City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Robin Estanislau, City Clerk October 23, 2017 Peterson -Chase General Engineering Construction, Inc. 16351 Construction Circle West Irvine, CA 92606 RE: Brookhurst Street Bridge Preventive Maintenance — CC-1449 Enclosed please find your original bid bond for CC-1449. Sincerely, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand PREMIUM: NIL Bond No. 0284226 GWM r1NERICAN INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS, that we, Peterson -Chase General Engineering Construction, Inc. as principal, and the GREAT AMERICAN INSURANCE COMPANY, a corporation existing under the laws of the State of Ohio, having its Administrative Office at 580 Walnut Street, Cincinnati, Ohio 45202, as surety, are held and firmly bound unto, City of Huntington Beach, Department of Public Works as obligee, in the penal sum of Ten Percent of Amount Bid DOLLARS ($ 10 0 ), lawful money of the United States of America, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. SIGNED, sealed, and dated this 24th day of July 20 17 WHEREAS, the said principal is herewith submitting a proposal for Brookhurst St. Bridge Preventive Maintenance No.1449 NOW, THEREFORE, the condition of this obligation is such that, if the said principal shall be awarded the said contract, and shall within sixty ( 60 ) days after receiving notice of such award enter into a contract and give bond for the faithful performance of the contract, then this obligation shall be null and void otherwise the principal and surety will pay unto the obligee the difference in money between the amount of the principal's bid and the amount for which the obligee may legally contract with another party to perform the work, if the latter amount be in excess of the former; but in no Peterson -Chase General event shall the liability hereunder exceed the penal sum hereof. Engineering Construct ion; Inc. / /1 Pnncioal LGIdAT AMERICAN IVURANCE COMPANY By �. 4,pencer F1ake,Atmrnev in Fact CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA County of Orange On 7/24/17 before me, Erin A. Sherwood , Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake �� ERIN A. SHERWOOD a "f:; Z Commission # 2118628 Notary Public -California z ',;a Orange County r My Comm. Expires Jul 6, 2019 Place Notary Seal Above 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. 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 4� Signature Sig 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 the form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s):_ ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Top of thumb here Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s): — ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: SECTION C PROPOSAL for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guarantee 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 fmaI compensation under the contract will be based upon the actual quantities of work completed to the satisfaction of the AGENCY. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the contract, the undersigned agrees that in the event of the BIDDER's default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this oposal f bid, find in the amount of $ 1 O 6 ?__1+ which said amount is not less than 10% of the Total Amount Bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for—% ", as the case may be). Any standard Surety Bid Bond form is acceptable. BIDDER shall signify receipt of all Addenda here, if any: Addenda No. Date Received . " Bid/ er's Si nat r 1 7/24/2017 /n/,% r' C-2 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item Contract Unit Extended' No. Quantity Unit Description Price Amount..' .'. 1 1 LS Mobilization 2 1 1 3 1 re Storm Water 11 LS (Water Pollution Control EA lEmergency Evacuation tion Plan 4 1 $o 00) $15 o0o — 1 LS Traffic Control �g"CKDO �gS,oc* 5 $' $ A 27,030 SF Saw Cut, Grind and Remove AC Pavement 1 7 1 o■ Asphalt Tack Coat and AC Leveling Course Pavement 11".Cos to TN IARHM Finish Course $ �`Io' $ 51, 8Cd- C-2.1 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 item Contract Unit Extended' No. Quantity Unit Description Price Amount 240 LF Install 4' High Environmental Protection Fence 9 $ ►S ' $ 3 too - 1 LS Install Striping and Pavement Markings 10 $ 30ovo-- $ 30 v-0o — 135,000 SF Slurry Seal 1 11 $ 0' $ S(o,7d0- 12 34 CF Remove Unsound Concrete $ 3Zo- $ 10 ft- 13 317 LF Remove Concrete Barrier $ l'a$ ` $ �{ S 14 317 LF Remove Chain Link Railing $ 30` $ SId7- 15 34 CF Portland Cement Concrete (Patch) $ 3 $� 16 317 LF Concrete Barrier (Type 26 Modified) $ (�iS' $22t�3iS C-2.2 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item Contract Unit Extended'' Na. Quantit JUnitDescription Price Amount 317 LF Wildlife Protection Railing 17 $ ►ZS— $39 ZS 16,874 SF Seal Concrete Bridge Deck 18 $ )150 $Z51 SI)— 65 LF Chain Link Fence 19 $ �� $ ve II Total Amount Bid in Fiqures: $ — SSQ(e. f.'(P(n — II Total Amount Bid.in..Words: ............................................................................................. Qwv i E i5 h�- hvrawtdl N (v�— Si ,f- `.iN--,0 v %0-nck !& i X h U r7 �J�( e,; tI V41 t f& x d b Ra v--s C-2.3 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the Bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid . 1Vame and Address of State Clais.: D..IR Dollar % of :: Item(s) Subcontractor License.: Number Amount Contract Number (tr4v Ske,l � V �p 3a s . w, llaw Ac. �,SO t L 1%q 1 S _ z7F R; ak+o CA � 85(ofo a A1 Cnrt1 P_'n C2 ggol Ca%iY1cat'&.Vvj �ti245�-I A'15 U5 ►ulxxw tQ8 N� Uu - S Sur\ V �i lko.'i C 1A Pa"rnenrN' Co"In� Co 11 t o-Lgo Car) Se%41Y- 3 , o3c0oq �' 1oMc938 1 , S40— (,p TV Va , CA 32, R'C. TrwS'-L spe al" &+ A, 3, 2 lb U3$ �N. Svvk 0"(r\ Ave BV7Cyl, 1p=b'$p 2Z,'1� J o , CA C3Z vjcs- r- r\ 1SS33 E- Arrow ��J 1�Aa93 10�oo6�S S1,37o (o lrwir�,(Q, By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds finished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California SS. County of Orange I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 7/31/17 , at Irvine , EA Date City State Dick W. Vog_els , being first duly sworn, deposes and says that he or she is Vice President of Peterson -Chase G.E.C., Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the Bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the Bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Dick W. Vogels Name of Bidder 16351 Construction Circle West, Irvine, CA 92606 Address of Bidder Subscribed and sworn to before me this day of , 201 NOTARY PUBLIC c-a NOTARY SEAL CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 .1�1',See Attached Document (Notary to cross out lines 1-6 below) ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange KALI GOGLANIAN Commission O 2103746 Notary Public - California Oranpe County OMYComm Expires Mar 19, 2019 Subscribed and sworn to (or affirmed) before me on this 31 day of July 20 17 by Date Month Year (1) Dick W. Vogels (and (2) Name(s) of Signer(s) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature — I Signature of -Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages Signer(s) Other Than Named Above: Document Date: C < ©2014 National Notary Association - www.NationaiNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5910 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen.: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449, (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 promises and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public" Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 7/31 /2017 Peterson -Chase General Engineering Construction, Inc. Contractor C-s W. Vogels ice President Title DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes 21 No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a Public Works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Peterson -Chase General Engineering Construction, Inc. Contractor Date: 7/31/2017 C-7 Title BIDDER'S INFORMATION Bidder certifies that the following information is true and correct: Peterson -Chase General Engineering Construction, Inc. Bidder Name 16351 Construction Circle West Business Address Irvine CA 92606 City, State Zip ( 949 ) 252-0441 Telephone Number 615876 - Class A C13 C32 State Contractor's License No. and Class 3/23/1991 Original Date Issued 3/31/2019 Expiration Date The work site was inspected by Dick W. Vogels of our office on July 27 , 2017 The following are persons, firms, and corporations having a principal interest in this proposal: Greg Chase - President Dick W. Vogels - VP/Sec/Treas. C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. _Peterson -Chase General Engineering Construction, Inc. Company Name ipi& W. Vogels Printed or Typed Signature Subscribed and sworn to before me this31 day of July , 2017 . A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On 7/31 /2017 before me, Kali Goglanian, Notary Month, Day, and Year Insert Name and Title of Notary personally appeared Dick W. Vogels 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. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. U1N WITNESS my hand and KAU 60t31AN ConMssion 0 2103746 a Notary Pum • California orange county Comm ros Mar 19 2019 Signature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The Bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the Bidder has performed similar work within the past five years: City of Irvine - One Civic Center Plaza, Irvine, CA 92606 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Davina Buenavista - 949-724-6937 Bridge Maintenance and Repairs 1 19,700.00 6/19/2017 Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: _Concrete bridge deck surface, treat bridge, striping, repair spalled surface area 2. City of Santa Clarita - 23920 Valencia Blvd, Ste 120, Santa Clarita, CA 91355 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Monica Heredia - 661-255-43-32__ FY 12-13 Bridge Maintenance Program Project M0093-A 18 85600 2015 Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: Treat bridge deck, reD it spalling concrete Caltrans - 1120 N Street, Sacramento, CA 95814 Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Purisimo Rosal Clean and Treat Bridge Deck Replace Joint Seals 984,493.90 6/2017 Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: Prepare concrete deck surface structural concrete, joint seal, striping C-10 BIDDER'S CRITICAL STAFF The Bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff) proposed for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the Bidder at the time the referenced projects were completed. Greg Stevens Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: 949-252-0441 Bridge Maintenance and Repairs 119,700.00 Bridge Repair 6/2017 Project Name & Contract Amount Type of Work Date Completed Treat Bridge Decks with Methacrylate and Replace Joint Seals 1,573,586.80 Bridge Treatment 7/2017 Project Name & Contract Amount Type of Work Date Completed Treat Bridge Deck with Methacrylate, and Replace Seals 287,297.85 Bridge Treatment 10/2016 Project Name & Contract Amount Type of Work Date Completed 2. Daniel Hidalgo Name of proposed Construction Superintendent Phone # of proposed Construction Superintendent: 949-252-0441 Bridge Maintenance and Repairs 119,700.00 Bridge Repair 6/2017 Project Name & Contract Amount Type of Work Date Completed Treat Bridge Decks with Methacrylate and Replace Joint Seals 1,573,586.80 Bridge Treatment 7/2017 Project Name & Contract Amount Type of Work Date Completed Treat Bridge Deck with Methacrylate, and Replace Seals 287,297.85 Bridge Treatment 10/201 6i Project Name & Contract Amount Type of Work Date Completed C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The Bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): X 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: Peterson -Chase General Engineering Construction, Inc_ *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link — Call (844) 522-6734 https://efiling.dir.ca.gov/PWCR/ActionServlet?action=displayPW CRegistrationForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCRJSearch.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a) which states: "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. Date: 7/31 /2017 Peterson -Chase General Engineering Construction, Inc. Contractor C-13 By Aick W. Vogels Vice President Title Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Peterson -Chase General Engineering Construction, Inc. , proposed subcontractor hereby certifies that he has X , has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or l I246,.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-I.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 6 of 22 C-14 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes L] No K If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-15 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE 10232 STATEMENT In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 8 of 22 C-I6 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Sid Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Orange DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived; or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 9 of 22 C-17 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 10 of 22 C-1 g October 2016 Local Assistance Procedures Manual . Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) if any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 11 of 22 C-19 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES CUMPL.EI6 IRIS FUKM IV UlSiULUJh. WBBYINU AI I IV t tnN ruttsUAN I IU 11 U.a.t. 1.315e 1. Type of Federal Action. 2. Status of Federal Action: 3. Report Type: �,I contract a. bid/offer/application a. initial cb. 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 repot4 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known Congressional District, if known 6. Federal Department/Agency: 7. Federal Program Name/Description: C Number, if applicable 8. Federal Action Number, if known; 9. Avv Amount, if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including individual, I me, f me MI) address if differen ast n7, e, ING Lkj-"B Y (attach Continuation Sheet(s) if necessary) 11, Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ ❑ actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission 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: (attach Continuation Sheet(s) if necessary) 15. Continuation Shcet(s) attached: Ves ❑ No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure oflobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This infdnnation will be reported to Congress semiannually and will be available for public inspection. Any person who tails to file the required disclosure shall be subject to a civil penalty ol'not less than $10,000 and not more than $100,000 I'or each such failure. Federal Use Signature; Print Name: Telephone No.: Date; W _ Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S,C. section 1352. The filing of a form its 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), H . Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box. Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C.20503. SF-LLL-Instmomns Rm06-O4-90aENDIFU Page 13 of 22 C-21 October 2016 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181(172) C.C. No. 1449 July 24, 2017 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Brookhurst Street Bridge Preventive Maintenance, C.C. No. 1449: 1. The Federal Labor Rates contained in Appendix I —Part 2 of the Project Specifications for the Brookhurst Street Bridge Preventive Maintenance, C.C. No. 1449 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 07/14/2017). The attached FEDERAL LABOR RATES (Publication Date 07/14/2017) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 24, 2017. Peterson -Chase General Engineering Construction, Inc Company Name 31, 2017 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than FIVE No.0 14901 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof, provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power DAVID L. CULBERTSON RICHARD A. COON ALL OF ALL CHARLES L. FLAKE LEXIE SHERWOOD ANAHEIM, $100,000,000.00 SPENCER FLAKE CALIFORNIA This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 8TH day of DECEMBER 1 2015 Attest GREAT AMERICAN INSURANCE COMPANY Assistant Secretary Divi.einnal Senior Vice President STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C. KiTCHw (877-377-2405) On this 8TH day of DECEMBER 2015 , before me personally appeared DAVID C. KITCHIN, to me known, being duly sworn, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. V.: ".6 v. t This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of GreatAmerican Insurance Company by unanimous written consent dated .Tune 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior vice Presidents, Divisional vice Presidents and Divisonal Assistant vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts ofsuretyship, or other written obligations in the nature thereof, to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company maybe affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature ofsuch officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this 24TH day of JULY , 2017 J Assistant Secretary S1029AF (06/15) Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: City of Huntington Beach 2. Contract DBE Goal: _ 1 6 % 3. Project Description: Brookhurst St. Bridge Preventive Maintenance 4. Project Location: Brookhurst St. 5. Bidder's Name: Peterson -Chase G.E.C., Inc. 6. Prime Certified DBE: ❑ 7. Bid Amount: 8. Total Dollar Amount for ALL Subcontractors: 9. Total Number of ALL Subcontractors: 10. Bid Item Number 11. Description of Work. Service, or Materials Supplied 12. DBE Certification Number 13. DBE Contact Information (Must be certified on the date bids are opened) 14. DBE Dollar Amount 5 S� Q va l . -rya i'r✓ 1394u 2oSe ii Fun+-aAa, CA q-V319 at t,a Z'1 b - SS82 Local Agency to Complete this Section 15. TOTAL CLAIMED DBE PARTICIPATION 21. Local Agency Contract Number: 22. Federal -Aid Project Number: I 23, Bid Opening Date: 24. Contract Award Date: IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work Its "d above must be consistent, where applicable with the nam nd items of the work in the Local Agency certifies that all DBE certifications are valid and information on this form is complete and accurate. "Subcontractor Ls ' sub i e your bid. Written confirmation of e DBE re'u' e . 7/31 /17 25. Local Agency Representative's Signature 26. Date 16, Pre arer's Signatu e 17, Date ick W. Vogel 949-252-0441 27. Local Agency Representative's Name 28. Phone . Preparer's Name 19. Phone Vice President 29. Local Agency Representative's Title 20. Preparer's Title DISTRIBUTION: 1. Original — Local Agency 2. Copy — Caitrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result in de -obligation of federal funds on contract. Include additional copy with award package. ADA Notice: For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654- 3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. C-22 Page I of 2 July 23, 2015 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT CONTRACTOR SECTION 1. Local Agency - Enter the name of the local or regional agency that is funding the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Location - Enter the project location as it appears on the project advertisement, 4. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). 5. Bidder's Name - Enter the contractor's firm name. 6. Prime Certified DBE - Check box if prime contractor is a certified DBE. 7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor. 8. Total Dollar Amount for ALL Subcontractors — Enter the total dollar amount for all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 9. Total number of ALL subcontractors — Enter the total number of all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 10. Bid Iten► Number - Enter bid item number for work, services, or materials supplied to be provided. l I. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs including work performed by the prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 12. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be certified on the date bids are opened. 13, DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted contractors. Also, enter the prime contractor's name and phone number, if the prime is a DBE. 14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 15. Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DBE participation claimed ("Total Claimed DBE Participation Dollars" divided by item "Bid Amount"), If the total % claimed is less than item "Contract DBE Goal," an adequately documented Good Faith Effort (GFE) is required (see Exhibit l5-H DBE Information - Good Faith Efforts of the LAPM). 16. Preparer's Signature - The person completing the DBE commitment form on behalf of the contractor's firm must sign their name. 17, Date - Enter the date the DBE commitment form is signed by the contractor's preparer. 18. Preparer's Name - Enter the name of the person preparing and signing the contractor's DBE commitment form. 19. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 20. Preparer's Title - Enter the position/title of the person signing the contractor's DBE commitment form. LOCAL AGENCY SECTION 21, Local Agency Contract Number - Enter the Local Agency contract number or identifier. 22. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 23. Bid Opening Date - Enter the date contract bids were opened, 24. Contract Award Date - Enter the date the contract was executed. 25. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Contractor Section of this form is complete and accurate. 26, Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 27. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the contractor's DBE commitment form. 28. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 29. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the contractor's DBE commitment form. Page 2 of 2 C-23 July 23, 2015 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort EXHIBIT 15-H DBE INFORMATION —GOOD FAITH EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No, BPMPL-5181 (172) Bid Opening Date A/1/2017 The City of Huntington Beach, established a Disadvantaged Business Enterprise (DBE) goal of 16 % for this project, The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g,, a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications ONE Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation NONE Page 15-1 OB 12-04 C-24 June 29, 2012 Exhibit 15-H Local Assistance Procedures Manual DBE Information -Good Faith Effort C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of (Y/N) Contract NONE D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Narnes, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: NONE Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: NONE Page 15-2 June 29, 2012 C-25 013 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases frorn the prime contractor or its affiliate: NONE G. The narnes of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results NONF H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NONE NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY, Page 15-3 OB 12-04 C-26 June 29, 2012 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 12®B Bidder's list of subcontractor (DBE and lion -DBE) Part 1 As of March 1, 2015 Contractors (and sub-contractors)iuishing to bid on public works contracts shall be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at- httos:Ifefiling.dir.ca.govIPWCR/Action5ervlet?action=displayPWCReglstrationForrn in accordance with Title 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 of the Public Contract Code of the State of California, as amended, the following information is required for each sub -contractor who will perform work amounting to more than one half of one percent (0_5'1/6) of the Total Base Sid or $10,000 fwhirhrver is urPatPrl Phatoennv this. form for additional firms. Subcontractor Name and Location Line item & Desviption Subcontract Amount Percentage of Bid Item Sub- contracted Contractor License Number DBE (YEN) DBE Cert Number Annual Gross Receipts FIR Reg Number Name: _-+ %Az OW+ } �f � �`� <$1 million <55 rnidlion <$10 million City. State: n �tnQOW_ I, ) 1 C- million Age of Firm:rm: _yrs. Name: CS �^ �] <$1 million c$S million Gty, State: TU fltGI tD y <$10million cSlSmillion Age of firm: yrs. Na ACOr +'n lg_ ( + C 1 , I tt r �[ "t 1 `144 S � <S1 million LJ <$5 million City, State: L nd SUA VA "r � ! r c510 million C$15 Million Age of Firm: _ yrs. Name: r 4Q�e <$1 million <55 million City�,i4state: IJIf ItiC <$1(l millian Age of Firm: _yrs. Nam _ ��`L ,y 3V❑ 1 r C l a i b y f �J <$1 million <$5 million City, State: /+y V r <$10 million <$15 million Age of 'Firm: _ yrs_ "fa a jr�- t5-k,_ ii Fat0 r jf„ jrJ <$1 million <SS million City, state: - Wf L� f <$10 million <S15 million Age of Firm�,� yrs. Drrstributlon: 1) Griginal•Locai Agency File 2) Copy-DLAE w,f Award Package 'Wage f of 2 C-27 September 2016 Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors {DBE and NON -DBE} Exhibit 12-B Bidder's List of subcontractor {DBE and Non -DBE} Part 2 In accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provide a quote or bid but were not selected to participate as a subcontractor on this project. Photocopy this form for additional firms. Subcontractor Name and Location Line item & Description Subcontract Amount Percentage of Bid Item Sub- contracted Contractor License Number DBE {Y/NJ DBE Cert Number Annual Gross Receipts ❑IR Reg Number Name: j <51 mill ion <$5 million City, State: <$10 million ® <$15 million Age of Finn' _ yrs. Name: <$1 million ❑ <55 million _. . City, State: <$10 million <$15 million Age of Firm:— yrs. Name: <$1 million <$5 million City, State: <$10 million ❑ <$15 million Age of Firm: yrs. Name: .. .. ❑ <$1 million !❑ <$5 rni i+un " City, State: ❑ <$10 million <$15 million w Age of firm: ` yrs- Name: l ❑ <51 million _ ❑ <S5 million city, State ❑ <510 million <$15 million Age of Firm: yrs, Name: t :. U <$1 million ❑ <$5 million City, State: + ❑ <$10 million <$15 million Age of Firm:L _yrs. Distribution: 1� original -Local Agency File 2) Copy-DLAE w/ Award Package C-28 Page 2 of 2 September 2016 PETERSON-CHASE GENERAL. ENGINEERING CONSTRUCTION, INC. 16351 CONSTRUCTION CIRCLE WEST IRVINE, CA 92606 u� co LLJ Ci �- "SEALED BID" For BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE C.C. NO. 1449 IN THE CITY OF HUNTINGTON BEACH - DO NOT OPEN WITH REGULAR MAIL DELIVER TO THE OFFICE OF THE CITY CLERK 2000 MAIN STREET, SECOND FLOOR City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk October 23, 2017 United Engineering & Construction, Inc. 336 N. Central Ave., Suite.,10A Glendale, CA 91203 RE: Brookhurst Street Bridge Preventive Maintenance — CC-1449 Enclosed please find your original bid bond for CC-1449. Sincerely, Robin Estanislau, CIVIC City Clerk RE:ds Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, THAT WE United Engineering & Construction Inc 336 N. Central Ave #10A. Glendale, CA 91203 as Principal, hereinafter called the Principal, and The Gray Insurance Company P.O. Box 6202 Metairie LA 70009-6202 a corporation duly organized under the laws of the State of LA as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach 2000 Main Street, Huntington Beach, CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid Dollars ($ 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Brookhurst Street Bridge Preventive Maintenance 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 materials 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 (witness) day of July 1 2017 United Engineering & Construction Inc (Seal) O (Title) (01S he Gra Insurance Com an(Surety) (Seal) E A L ; Witness) y�•• ,� ,A * attomey4n-Fact Heather Burroughs (Title) AIA DOCUMENT A310 • BID BOND • AIA • FEBRUARY 1970 ED. • THE AMERICAN INSTITUTE OF ARCHITECTS,1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 GAi."RNIIA ALL-Pt1>iiME, ACICliFOWLEDGMEW CML CODE § I189. k no9arp pubko or othar officer, conVIaiaag thls cetficntt verbs only the idontity of the ir► who mgnod ttra dXlj tent to +'u iwh tEiis c tifr fe i� sEfat tetl, and nr9 tie- i L0hi*=, acovtec� or saOdity of that dCtulrt9P41'r -.tate at N4j!j_Cg 2i0_a----------------- County of Durham ,. July 26, 2017 tat fore me,, Jason Lee Sayers Data mere fnwrt Akm and WNW of ft Offi we pwsonaly appeared Heather Burroughs Xanm(s) or.STgna*) who pr6ed to me. cxr the bask iof satisfactory, evidencIe to be U* pemon(s) whoss. name(i) Ware subscribed. to the within .astrument and acknowledgW to ma.that lteAhe/they executed 6--: sarrm .irn Ws/her{their Whorized capscityl" and that by histherikk- r.signatur4j mi tha instrumentihs persoD(s)l or tfid eiitlty uppn behalf of sahicft the persrni(s) acted; efc ctit«d the lristrunlent. f certify under PENALTY OF PERJURY. Luidw the laws of 1he State of Ca9fcsnia that the.foregoingparagrapb i 11c►a and`onrrsate Mi RS WITNESS my hand and cif F •ir al. .C. Signature My24-2020. f it ce. Not" Seat Above Though this section is o0vWrA completing this informaffiin can dater adF`emlbn of ltre d octmient or fr lulent taaltechmenf a this form Ito an yr intanded document. Desoription of Attadhed Dacwnent. Titles or Type of Document' Document Date;: Number tit Paget Sipner(s):Other ban turn-d 3h0m. Capacity(les) Cl airned.by Signen0) gner"s Name: � ,.. Signer's Narne. C1 Corporate, C t( mr — Tit sus)-: ' Corporate O fic — Titlefs):. 0 Partner — 0 Urn ted L3 General El Partner — 1-2 Umited Ci GeneW 0 IndNldua9 G'Altorney in Fact 0 Individual f7j Attonwy to Fact 1-7I Trustee lei GuanAan or.Gonsmalor. F, Trustee' 0 Guardian ar Conseruatbr tether Qihwr Signer IsRspreserit Signer is R e resenting: C014 rational Notary J soc t`on . mvw.Noo" Notsr f:org d y r}tlQ tJ5 tJ0`CA13i° (1 �ti0-6?��I�i t If it ? PLANS SPECIFICATIONS AND CONTRACT DOCUMENTS for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 Prepared Under the Supervision of: ??,OFESSIO, A 0 No. S4676 Expo 9/30/18 1�x k \ uc-�\� OF CAS 7/6/2017 Michael A. Thomas S.E., R.S.E. No. S4676 Approved by: Thomas 'N"erbel, PE, City Engineer, R.C.E. No. 53 Date /J-7 Date li NOTE: If there are any questions relative to this project, please call Jonathan Claudio at. - CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS 2000 MAIN STREET HUNTINGTON BEACH, CALIFORNIA 92648 (714) 536-5431 TABLE OF CONTENTS SECTION A NOTICE INVITING SEALED BIDS..................................................................................... A-1 SECTION B INSTRUCTIONS TO BIDDERS.............................................................................................B-1 1. Proposal Forms.......................................................................................... ....B-1 .............. 2. Proposal Guarantee......................................................................................................B-1 3. Proposal Signature.......................................................................................I...............B-1 4. Delivery of Proposal................................................................... .......................B-2 5. Return of Proposal Guarantees....................................................................................B-2 6. Taxes............................................................................................................................B-2 7. Disqualification of Bidders..........................................................................................B-2 8. Contractor's License Requirement...............................................................................B-2 9. References....................................................................................................................B-2 10. Listing of Subcontractors .......................................... .. ....B-3 ........................................... 11. Discrepancies and Misunderstandings .......................................................................B-3 12. Equivalent Materials..................................................................................................B-3 13. Legal Responsibilities................................................................................................B-3 14. Award of Contract ............. ......................................................................................... B-3 15. Material Guarantee.....................................................................................................B-4 16. Execution of Contract................................................................................................B-4 17. Submission of Bonds and Insurance..........................................................................B-4 18. Addenda ............................................... ...................................................................... B-5 19. Bid Protest..................................................................................................................B-5 20. Questions to the Engineer..........................................................................................B-5 9 SECTION C PROPOSAL........................ ........................................................................................................ C-1 Project Bid Schedule........................................................................................ C-2.1 - C-2.3 List of Subcontractors......................................................................................................C-3 NoncollusionAffidavit....................................................................................................C-4 UtilityAgreement............................................................................................................C-5 Disqualification Questionnaire........................................................................................C-6 Compensation Insurance Certification .................... ......................................................... C-7 Bidder's Information........................................................................................................C-8 Bidder's Project History and Public Agency References...............................................C-10 Bidder's Critical Staff.....................................................................................................C-11 Bidder's Certification.....................................................................................................C-12 California Department of Industrial Relations (DIR) Certificate...................................C-13 Equal Employment Opportunity Certification— ............................................................ C- 14 PublicContract Code.....................................................................................................C-15 Noncollusion Affidavit............................................................................. ................... ..C-17 Debarment and Suspension Certification......................................................................C-18 Nonlobbying Certification ........................... ................................... .............................. C-19 Exhibit 15-G Local Agency Bidder DBE Commitment................................................C-22 Exhibit 15-H DBE Information — Good Faith Effort .....................................................C-24 Exhibit 12-B Bidders List of Subcontractors (DBE and Non-DBE).............................C-27 SECTION D SAMPLECONTRACT............................................................................................................ D-1 SECTION E SPECIAL PROVISIONS........................................................................................... E-1 PART 1 GENERAL PROVISIONS SECTION 1 - TERMS, DEFINITIONS, ABBREVIATIONS, UNITS OF MEASURE, AND SYMBOLS .................................E-2 1-2 TERMS AND DEFINITIONS SECTION 2 - SCOPE AND CONTROL OF THE WORK ................................E-2 2-1 AWARD AND EXECUTION OF THE CONTRACT 2-4 CONTRACT BONDS 2-5 PLANS AND SPECIFICATIONS 2-8 RIGHT-OF-WAY 2-9 SURVEYING 2-10 AUTHORITY OF THE BOARD AND THE ENGINEER 2-11 INSPECTION Iv SECTION 3 - CHANGES IN WORK................................................................E-7 3-3 EXTRA WORK 3-6 CLAIM RESOLUTION SECTION 4 - CONTROL OF MATERIALS ......................................................E-9 4-1 MATERIALS AND WORKMANSHIP SECTION 5 - UTILITIES..................................................................................E-10 5-1 LOCATION 5-2 PROTECTION 5-4 RELOCATION 5-5 DELAYS SECTION 6 - PROSECUTION, PROGRESS AND ACCEPTANCE OF THE WORK .................................... E-11 6-1 CONSTRUCTION SCHEDULE AND COMMENCEMENT OF THE WORK 6-2 PROSECUTION OF THE WORK 6-7 TIME OF COMPLETION 6-9 LIQUIDATED DAMAGES SECTION 7 - RESPONSIBILITIES OF THE CONTRACTOR .......................E-13 7-1 THE CONTRACTOR'S EQUIPMENT AND FACILITIES 7-2 LABOR 7-3 LIABILITY INSURANCE 7-5 PERMITS 7-8 WORK SITE MAINTENANCE 7-9 PROTECTION AND RESTORATION OF EXISTING IMPROVEMENTS 7-10 PUBLIC CONVENIENCE AND SAFETY 7-12 ADVERTISING SECTION 8 - FACILITIES FOR AGENCY PERSONNEL.............................E-26 8-1 GENERAL SECTION 9 - MEASUREMENT AND PAYMENT ........................................ E-26 9-3 PAYMENT v PART 2 CONSTRUCTION MATERIALS SECTION 200 - ROCK MATERIALS..............................................................E-29 200-1 ROCK PRODUCTS 200-2 UNTREATED BASE MATERIALS SECTION 201- CONCRETE, MORTAR AND RELATED MATERIALS .......................................................E-29 201-1 PORTLAND CEMENT CONCRETE 201-2 REINFORCEMENT FOR CONCRETE 201-8 WATERPROOFING DECK SEAL SECTION 203 - BITUMINOUS MATERIALS................................................E-33 203-5 SLURRY SEAL 203-6 ASPHALT CONCRETE 203-11 ASPHALT RUBBER HOT MIX (ARHM) SECTION 206 - MISCELLANEOUS METAL ITEMS ...................................E-38 206-5 METAL RAILINGS SECTION 21.3 - ENGINEERING FABRICS ....................................................E-39 213-2 GEOSYNTHETICS SECTION 214 - TRAFFIC STRIPING, CURB AND PAVEMENT MARKINGS, AND PAVEMENT MARKERS ................................................ E-40 214-1 GENERAL 214-4 PAINT FOR STRIPING AND MARKINGS 214-5 THERMOPLASTIC MATERIAL FOR TRAFFIC STRIPING AND MARKINGS SECTION 215 - TRAFFIC SIGNING .............................. ................................ E-41 PART 3 CONSTRUCTION METHODS SECTION 300 - EARTHWORK.......................................................................E-42 300-1 CLEARING AND GRUBBING 300-2 UNCLASSIFIED EXCAVATION SECTION 302 - ROADWAY SURFACING ....................................................E-47 302-1 COLD MILLING OF EXISTING PAVEMENT 302-4 SLURRY SEAL SURFACING 302-5 ASPHALT CONCRETE PAVEMENT SECTION 303 - CONCRETE AND MASONRY CONSTRUCTION.............E-54 303-1 CONCRETE STRUCTURES 303-9 WATERPROOFING DECK SEAL SECTION 304 - METAL FABRICATION AND CONSTRUCTION.............E-56 304-2 METAL RAILINGS SECTION 307 - STREET LIGHTING AND TRAFFIC SIGNALS .................E-57 SECTION 314- TRAFFIC STRIPING, CURB AND PAVEMENT MARKINGS, AND PAVEMENT MARKERS................................................E-59 314-2 REMOVAL OF TRAFFIC STRIPING AND CURB AND PAVEMENT MARKINGS 314-6 TEMPORARY STRIPING, SIGNING, AND RAISED PAVEMENT MARKINGS vii APPENDICES APPENDIX A DOWNLOAD PUBLIC WORKS STANDARDS, TRUCK ROUTE, TRASH PICK UP SCHEDULE, STREET SWEEPING SCHEDULE, AND TEMPORARY WATER METER APPENDIX B DOWNLOAD ADDITIONAL COPIES OF PROJECT PLANS AND SPECIFICATIONS APPENDIX C DOWNLOAD REGIONAL WATER QUALITY CONTROL BOARD PERMITS APPENDIX D BUSINESS LICENSE REQUIREMENTS APPENDIX E INSURANCE AND INDEMNITY REQUIREMENTS APPENDIX F BOND FORMS APPENDIX G LOCATION MAP APPENDIX H REGULATORY PERMITS AND ENVIRONMENTAL DOCUMENTS APPENDIX I PART I - FEDERAL & STATE REQUIREMENTS FOR FEDERAL - AID CONSTRUCTION PROJECTS PART 2 --- FEDERAL LABOR RATES PART 3 - STATE LABOR RATES APPENDIX J CALTRANS ENCROACHMENT PERMIT APPENDIX K OCFCD ENCROACHMENT PERMIT APPENDIX L STANDARD SPECIAL PROVISIONS FOR TRAFFIC SIGNALS AND LIGHTING SYSTEMS APPENDIX M UNDERGROUND SERVICE ALERT IDENTIFICATION NUMBER APPENDIX N SURVEY MONUMENTATION INFORMATION APPENDIX O STANDARD PLANS APPENDIX P AGENCY EXTRA WORK FORMS viii SECTION A NOTICE INVITING SEALED BIDS for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 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 August 1, 2017. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents shall be available after July 10, 2017 from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $20.00 nonrefundable fee if picked up, or payment of a $40.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). The AGENCY does not charge a fee for Plans, Specifications, and contract documents downloaded from: http://www.hwitinaonbeachca.gov/government/departments/public works/Bids/ 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 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code, Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. A-1 No bid shall be considered unless it is prepared on the approved Proposal forms in conformance , with the Instructions to Bidders as determined by the AGENCY. All extensions of unit prices will be subject to verification by the AGENCY. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. 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 total 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 award. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: This bridge preventive maintenance project consists primarily of the removal and replacement of the concrete barriers and chain link railing; removal and patching of unsound concrete at the bridge bents and columns; removal and replacement of AC pavement overlay; and appurtenant work as required. • The contract allows the Contractor 130 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $945,000. • The Project Disadvantage Business Enterprises (DBE) goal is 16%. • For the Federal Trainee Program, the number of trainees required is 1 (see Appendix I) 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 6th day of September 2016, by Resolution No. 2016-58. Attest: ' /s/ Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH ' I � A-2 I � SECTION B INSTRUCTIONS TO BIDDERS 1. Proposal Forms Bids shall be submitted in writing on the Proposal forms provided by the AGENCY. All information requested therein must be clearly and legibly set forth in the manner and form indicated. The AGENCY may reject any proposal not meeting these requirements. The bid shall be filed with the City Clerk, Second Floor City Hall, 2000 Main Street, Huntington Beach, California, which shall be endorsed with the Project Title and C.C. No. as it appears on the Notice Inviting Sealed Bids. The sealed envelopes will be publicly opened and read at the time and place stated in the Notice Inviting Sealed Bids. Bidders or their authorized agents are invited to be present at the opening. Unauthorized conditions, limitations, or provisions attached to a proposal will render it informal and may cause its rejection. The complete proposal forms shall be without interlineations, alterations, or erasures. Alternative proposals will not be considered unless requested. No oral, telegraphic, or telephonic proposals or modifications will be considered. The proposal may be withdrawn upon request by the bidder without prejudice to himself prior to, but not after the time fixed for opening of bids, provided that the request is in writing, that it has been executed by the bidder or his duly authorized representative, and that it is filed with the AGENCY. All associated work, labor, materials, and bid quantities to construct the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 as depicted on the Plans and/or Specifications shall be included within the Total Amount Bid shown on page C-2.3 of the Project Bid Schedule, and no additional compensation will be allowed therefor. The Total Amount Bid shall be the basis of award as verified by the AGENCY. 2. Proposal Guarantee Proposals must be accompanied by a proposal guarantee consisting of a certified or cashier's check or bid bond payable to the AGENCY in the amount not less than 10% of the total amount named in the proposal. Any proposal not accompanied by such a guarantee will not be ' considered. Said check or bond shall be made payable to the AGENCY, and shall be given as a guarantee that the bidder, if awarded the Work, will enter into a contract within 10 working days after the award and will furnish the necessary bonds as hereinafter provided. In the case of I' refusal or failure to enter into said contract, the check or bond, as the case may be, shall be forfeited to the AGENCY. 3. Proposal Signature If the proposal is made by an individual, it shall be signed and his full name with his address shall be given; if it is made by a firm, it shall be signed with the co -partnership name by a member of the firm who shall sign his own name and the name and address of each member shall be given; and if it is made by a corporation, the name of the corporation shall be signed by its ' duly authorized officer or officers attested by the corporate seal, and the names and titles of all officers of the corporation shall be given. B-1 4. Delivery Of Proposal I Proposals shall be enclosed in a sealed envelope plainly marked on the outside: "SEALED BID" for BROOKfIURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 in the CITY OF HUNTINGTON BEACH - DO NOT OPEN WITH REGULAR MAIL DELIVER TO THE OFFICE OF THE CITY CLERK, 2000 MAIN STREET, SECOND FLOOR Proposals may be mailed or delivered by messenger. However, it is the bidder's responsibility alone to ensure delivery of the proposal to the Office of the City Clerk prior to the bid opening hour stipulated in the Notice Inviting Sealed Bids. Late proposals will not be considered. 5. Return Of Proposal Guarantees The proposal guarantees of the second and third lowest bidders will be held until the awarded bidder has properly executed all contract documents. Within 10 working days after the award of contract, the remaining proposal guarantees accompanying all other proposals will become null and void and returned to the unsuccessful bidders. ' 6. Taxes No mention shall be made in the proposal of Sales Tax, Use Tax or any other tax, as all amounts bid will be deemed and held to include any such taxes which may be applicable. 7. Disqualification Of Bidders In the event that any bidder acting as a prime contractor has an interest in more than one ' proposal, all such proposals will be rejected and the bidder will be disqualified. This restriction does not apply to subcontractors or suppliers who may submit quotations to more than one bidder, and while doing so, may also submit a formal proposal as a prime contractor. 8. Contractor's License Requirement ' This project requires the Contractor to possess a valid State of California contractor's license of the proper classification in accordance with the provisions of Public Contract Code Section 10164. 9. References All reference information called for in the bid proposal must be submitted with the bid proposal. ' Failure to submit reference information demonstrating the bidder's similar work experience, as determined by the AGENCY, may lead to rejection of such proposal as being non -responsive. B-2 I i I 10. Listing Of Subcontractors Bidders shall list in the bid proposal the name and place of business of each subcontractor who will perform work or labor or render services for the Contractor in an amount in excess of one- half of one percent of the Contractor's total bid or $10,000, whichever is greater. It. Discrepancies And Misunderstandings Bidders must satisfy themselves by personal examination of the work site, Plans, Specifications and other contract documents, and by any other means as they may believe necessary, as to the actual physical conditions, requirements and difficulties under which the work must be performed. No bidder shall at any time after submission of a proposal make any claim or assertion that there was any misunderstanding or lack of information regarding the nature or amount of work necessary for the satisfactory completion of the job. Should a bidder find any errors, omissions, or discrepancies in the Plans, Specifications, or other contract documents or should he be in doubt as to their meaning, he shall notify the AGENCY. Should it be found necessary, a written addendum will be sent to all bidders. Any addenda issued during the bidding period shall form a part of the contract and shall be included with the proposal. 12. Equivalent Materials Requests for the use of equivalents to those specified, must be submitted to the AGENCY 10 working days prior to the need of such materials. Within that time, the AGENCY will issue a written response indicating approval or disapproval of such request. It is the sole responsibility of the successful bidder to prove to the AGENCY that such a material is truly an equivalent. 13. Legal Responsibilities All proposals must be submitted, filed, made and executed in accordance with State and Federal ' laws relating to bids for contracts of this nature whether the same or expressly referred to herein or not. Any bidder submitting a proposal shall by such action thereby agree to each and all of the terms, conditions, provisions and requirements set forth, contemplated and referred to in the Plans, Specifications and other contract documents, and to full compliance therewith. Additionally, any bidder submitting a proposal shall, by such action thereby, agree to pay at least the minimum prevailing per diem wages as provided in Section 1773, et. seq. of the labor code for each craft, classification or type of workman required as set forth by the Director of Industrial Relations of the State of California. 1 14. Award Of Contract ' The award of contract, if made, will be to the lowest responsive and responsible bidder as determined solely by the AGENCY. The AGENCY reserves the right to reject any or all proposals, to waive any irregularity, and to take the bids under advisement for a maximum period of 60 days. In no event will an award be made until all necessary investigations are made to the responsiveness, responsibility, and qualifications of the bidder to whom the award is ' contemplated. B-3 15. Material Guarantee The successful bidder may be required to furnish a written guarantee covering certain items of work for varying periods of time from the date of acceptance of the work by the AGENCY. The work to be guaranteed, the form, and the time limit of the guarantee will be specified in the special provisions and/or other contract documents. Said guarantee shall be signed and delivered to the AGENCY before acceptance of the contract by the AGENCY. Upon completion of the contract as determined by the AGENCY, the amounts of the two contract bonds required in Section 2-4, "CONTRACT BONDS," of the Standard Specifications for Public Works Construction, may be reduced to conform to the total amount of the contract bid prices for the items of work to be guaranteed, and this amount shall continue in full force and effect for the duration of the guarantee period. However, the Payment Bond cannot be reduced until the expiration of 35 days after the date of recordation of the Notice of Completion. 16. Execution Of Contract The successful bidder shall execute a written contract with the AGENCY on the form of agreement provided, and shall secure all insurance and bonds required by the Specifications within 10 working days from the date of the award. Failure to enter into a contract shall be just cause for the annulment of the award and the forfeiture of the proposal guarantee. If the successful bidder fails to execute the contract, the AGENCY may award the contract to the second lowest responsible bidder. If the second lowest responsible bidder fails to execute the contract, the AGENCY may award the contract to the third lowest bidder. On the failure of such second or third lowest responsible bidder to execute the contract, such bidder's guarantees shall be likewise forfeited to the AGENCY. The work may then be re -advertised. 17. Submission of Bonds And Insurance The successful bidder will be required to furnish the necessary bonds and insurance to the AGENCY within 10 working days from the award of contract. See Appendix F for the AGENCY approved Payment Bond and Performance Bond forms. The Contractor may use any standard form for the Bid Bond. The successful bidder shall provide a certificate stating that the bonding company is admitted to do business in the State of California. This certification may be obtained from the Executive Officer and Clerk of the Superior Court at the following address & phone: Orange County Superior Court Probate Court Operations 341 The City Drive P.O. Box 14171 Orange, CA 92613-1571 (714) 935-6061, Contact Linda C. Wallace Prior to the issuance of the Notice to Proceed, the AGENCY must be furnished with a Policy Endorsement, from the successful bidder's insurance company, naming the AGENCY as an additional insured. B-4 li 18. Addenda The effect of all addenda to the contract documents shall be considered in the bid package and ' said addenda shall be made part of the contract documents and shall be returned with the bid package. Failure to submit any such addenda with the bid package may render the bid irregular and may result in its rejection by the AGENCY. 19. Bid Protest � I � I To be considered timely, a bid protest must be filed within the following time limits: (a) Protests based upon alleged defects or improprieties in the bid documents shall be filed prior to the date of bid opening. (b) All other protests must be filed within five calendar days after the protester knew or should have known the basis of the protest, but no later than five calendar days after the date of when the bids were due to the AGENCY. 20. Questions to the Engineer Questions regarding the bid documents (i.e., Plans, Specifications, contract documents, bid forms, etc.) will be received by the Engineer up to five working days prior to the bid opening as specified in SECTION A. Questions asked of the Engineer after this time will not be addressed. 11 B-5 SECTION C PROPOSAL for the construction of BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181 (172) C.C. No. 1449 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the Plans and Specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 130 working days, starting from the date specified in the Notice to Proceed. T BIDDER declares that this proposal is based upon careful examination of the work site, Plans, Specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guarantee 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 completed to the satisfaction of the AGENCY. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 I If awarded the contract, the undersigned agrees that in the event of the BIDDER's default in ' executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY's notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and ' this bid and the acceptance hereof may, at the AGENCY's option, be considered null and void. Accompanying this proposal of bid, find in the amount of $ which said amount is not less than 10% of the Total Amount Bid, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may ' be). Any standard Surety Bid Bond form is acceptable. BIDDER shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature 2q -- 0 15K= C-z City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE (OVER TALBERT CHANNEL) FEDERAL AID PROJECT BPMPL-5181(172) C.C. No. 1449 July 24, 2017 Notice To All Bidders: The following clarifications and/or revisions are hereby made to the Project Plans, Specifications, and Special Provisions for the Brookhurst Street Bridge Preventive Maintenance, C.C. No. 1449: 1. The Federal Labor Rates contained in Appendix I —Part 2 of the Project Specifications for the Brookhurst Street Bridge Preventive Maintenance, C.C. No. 1449 shall be replaced with the attached FEDERAL LABOR RATES (Publication Date 07/14/2017). The attached FEDERAL LABOR RATES (Publication Date 07/14/2017) shall be the Federal labor rates in effect for the above named project. This is to acknowledge receipt and review of Addendum Number One, dated July 24, 2017. V1X lA �rO e ✓1 PAC( Campany Na e 5-1— Zot-7 Date 'f � 16_�' 1'--'A'4 V__ By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jonathan Claudio at (714) 536-5431. PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item No. Contract Quantity Unit Description Unit Price Extended Amount 1 1 LS Mobilization $ 71, 3 ?- '71323 U 2 1 LS Prepare Storm Water Pollution Prevention Plan $ SOC70, o $3000. O n 3 1 LS Water Pollution Control $ $ 4 3 EA Emergency Evacuation $ ('f $ 5 1 LS Traffic Control $ O e7orl m $ 60 - mo 6 27,030 SF Saw Cut, Grind and Remove AC Pavement 3.5� $ P�r605- 7 63 TN Asphalt Tack Coat and AC Leveling Course Pavement n v $ )3� 23o, = $ 340 TN ARHM Finish Course Pavement !X-- C-21 PROJECT BID SCHEDULE BROOKHURST ST. BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 Item No. Contract Quantity Unit Description Unit Price Extended Amount 9 240 LF Install 4' High Environmental Protection Fence $ G', ter $ �lboo, 10 1 LS Install Striping and Pavement Markings $ 30 oon $ 30 000. 11 135,000 SF Slurry Seal $ a j6 $ 9� GOO, co 12 34 CIF Remove Unsound Concrete $ n $ ,2 z lOd • m 13 317 LF Remove Concrete Barrier $ Wo,t9w $%ql7&'0, 14 317 LF Remove Chain Link Railing $ 30- o o $ 15 34 CIF Portland Cement Concrete (Patch) $ 200- C � $ 2-00 , 317 LF Concrete Barrier (Type 26 Modified) C-2.2 PROJECT BID SCHEDULE 8RDDKHUR8T8T.BRIDGE PREVENTIVE MAINTENANCE, C.C.No. 1440 Item Contract Unit Extended No. Quantity Unit Description Price Amount 317 LF Wildlife Protection Railing 16,874 SF Seal Concrete Bridge Deck 65 LF Chain Link Fence ................... ....... i ........ ........... AA1-*1 �W.o 0 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. (�, Bid Name and Address of State Class DIR Dollar % of Item(s) Subcontractor License Number Amount Contract Number .. 4� !7 3 7 •70 �� f 7,.72, l ?l 2.0 �. C J7°k 0101 G5,7 A43 (0000n .1q01Q4, S'.a9/ 4d°I 2 6,9 S Atl ikwLeac..,,- "6.4- 267n�3 I�- two �o t4s3e s. 03/ By submission of this proposal, the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. Tiiat the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. ME C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID State of California ss. County of dos Er\� I declare under penalty of perjury under the laws of the State ofCalifornia that the foregoing is true and correct and that this declaration is executed on.fiteo" /� 1 Date City State i'ew r4being first duly sworn, deposes and says that he or she is Q, esP ')'-,'k-- of tJn�'4e ►����,�(o,,siruj,'.� ztclhe 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. Al- 11;. SSEHIiIAN IS U ry(�.•; y ryCjTl` a'i UELIC a rf-.:..'vRidlii n Gxn pJ�;^.�' 25 2019 Comm Un1� � Qtn",rza � Cons -'ru c,bkr mac, Name of Bidder Signature of hidder Pal JAle, CA GtIZo3 Address of Bidder Subscribed and sworn to before me this h day of i25% , 2011 . 1 NOTARY PUBLIC NOTARYSEAL C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449, (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 iw)ith the operation to be performed and the hazards involved. " The undersigned also promises and agrees that all such work shall be perfonmed 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: v/ l k _o l-i UYI 1-Pd h eery Con _%ty ul ;t# C Contractor By Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes &(N�To 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 questiomnaire. c-6 Fi COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a Public Works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 1/51-Zok "7 Contractor By Title C-7 Insurance Services Global Resources — Client Focused July 26, 2017 United Engineering & Construction Inc 336 N. Central Ave #10A Glendale, CA 91203 Bid Date: August 1, 2017 Owner: City of Huntington Beach Project: Brookhurst Street Bridge Preventive Maintenance Construction Risk Services 4309 Emperor Boulevard, Suite 300 Durham, NC 27703 Phone (919) 281-4500 Fax (888) 746-8761 Toll Free (800) 672-1674 Enclosed please find the above captioned bid bond, executed per your request. The bid bond must be executed by an authorized representative of your company with signature and corporate seal (if applicable). We urge you to check all of the documents enclosed for accuracy, including the Power of Attorney, signatures, dates, amounts, description, and any other attachments required. This will avoid the possibility of having a low bid rejected because of clerical error. Please verify that the bond form attached is the form required by the specifications. Thank you and please call me should you have any questions. Heather Burroughs , Attorney -in -Fact v NOTE: The bid bond authorization is based upon your original estimate. IF THE ACTUAL BID PRICE EXCEEDS THIS ESTIMATE BY 10% OR MORE, PLEASE CONTACT US FOR ADDITIONAL AUTHORITY! Your bid results are very important. Please send this information to our office via email to jsayers@bbandt.com or fax at 888-746-8781 within 24 hours of the bid opening. Contractors Name Contract Price 1. 2. 3. IF YOUR BID IS NOT LISTED ABOVE — WHAT WAS YOUR BID PRICE? COMMENTS: THE GRAY INSURANCE COMPANY THE GRAY CASIJAL'1'Y & SURETY COMPANY GENERAL POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS, THAT The Gray Insurance Company and The Gray Casualty & Surety Company, corporations duly organized and existing under the laws of Louisiana, and having their principal offices in Metairie, Louisiana, do hereby make, constitute, and appoint: Heather Burroughs on behalf of each of the Companies named above its true and lawful Attorney -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its deed, bonds, or other writings obligatory in the nature of a bond, as surety, contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $10,000,000. Surety Bond Number: Bid Bond Principal: United Engineering & Construction Inc Obligee: City of Huntington Beach This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty & Surety Company at meetings duly called and held on the 26'h day of June, 2003. "RESOLVED, that the President, Executive Vice President, any Vice President, or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings, and all contracts of surety, and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney, and to attach the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond, undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF, The Gray Insurance Company and The Gray Casualty & Surety Company have caused their official seals to be hereinto affixed, and these presents to be signed by their authorized officers this 12`h day of September, 2011. By: r ✓� � Attest: y����� ��f/j �P�SY• 8'S�9 Q� SEAL kMichael T. Gray Mark S. Manguno o? SEAL a President, The Gray Insurance Company Secretary, and The Gray Insurance Company, ` "• •* •• ''� Vice President, The Gray Casualty & Surety Company The Gray Casualty & Surety Company State of Louisiana ss: Parish of Jefferson On this 12'h day of September, 2011, before me, a Notary Public, personally appeared Michael T. Gray, President of The Gray Insurance Company and Vice President of The Gray Casualty & Surety Company, and Mark S. Manguno, Secretary of The Gray Insurance Company and The Gray Casualty & Surety Company, personally known to me, being duly sworn, acknowledged that'they signed the above Power of Attorney and affixed the seals of the companies as officers of, and acknowledged said instrument to be the voluntary act and deed, of their companies. S. If Lisa S. Millar, Notary Public, Parish of Orleans State of Louisiana '�9rFOF LOVES`°' My Commission is for Life uuammm�o••••` i, Mark S. Manguno, Secretary of The Gray Insurance Company and The Gray Casualty & Surety Company, do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 26th day of July , 2017 S E A L} a f S E A L Mark S. Manguno, .� •� g Secretary ;yti The Gray Insurance Company r •••.......•• `` The Gray Casualty & Surety Company I ' BIDDER'S INFORMATION Bidder certifies that the following information is true and correct: ' Bidder Name U�j 3K ' Business Address G I1-�Jlnl Imo. C�}- GII 203 City, State Zip (Stk) 6,62--So�� Telephone Number Cf03Z37 lA 13 State Contractor's License No. and Class -1120107 Original Date Issued Zo/ 17 Expiration Date The work site was inspected by of our office on , 117. The following are persons, firms, and corporations having a principal interest in this proposal: e z ' 11 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, ' financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the Plans and Specifications set forth. Company Name Signature Printed or Typed Signature Subscribed and sworn to before me this day of _ , 201 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of %rJ/,%� ) County of Z -,-, On f1l tea/ beforeme, %"��sS�`► ►G1 ri ; /��7��Y /J�ub%/�' M nth, Day, and Year Insert Name and Title of Notary personally appeared C 'qe 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. 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. JILL t��ASSEHiAN COMM # 2109459 (Yj i. NOTAR`! PUBLIC s CALIFORNIA n Si LOS ANGELES COUNTY //✓�! Comm. Exp MAY 25. 2019 ignature of Notary Public (PLACE NOTARY SEAL ABOVE) C-9 BIDDER'S PROJECT HISTORY AND PUBLIC AGENCY REFERENCES The Bidder shall provide information to demonstrate his/her past work experience on projects of similar (or greater) size and scope of the BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449. Bidders may submit additional sheets, using the format shown, to further demonstrate his/her history of similar work experience. Listed below are the names, address and telephone numbers for three public agencies for which the Bidder has performed similar work within the past five years: 1. l o e 2_- Name and Address of Public Agency 2. 3. Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: Name and Address of Public Agency Name and Phone # of Agency's Project Manager: Project Name Contract Amount Date Completed Detailed description of Bidder's scope of work to demonstrate similar work experience: C-10 2 3 IMII ENC;tNE=ErI"c( 6, C:ONSI-1:41-iC: T IOi\I iNE::. SUMMARY OF RELEVANT EXPERIENCE CITY OF LOS ANGELES, DEPARTMENT OF PUBLIC WORKS Attachment A 1.1 Project Name: HTP VDM Pedestrian Bridge Rehabilitation, W.O. SZH11544 (#011) Contact Name: Anita Wu, (310) 648-6243 Purpose of Contract: Remove & restore aluminum cladding panels, blast paint bridge, support structure Total Cost: $638,640 Start Date: January 2010 End Date: January 2011 INSTALL INC. 2.1 Project Name: Contact Name: Purpose of Contract Total Cost: Start Date: End Date: White Wave Foods Sewer Line Upgrade (#002) Kenneth Cronch, (919) 774-0506 Effluent water disposal system $95,400.00 September 2008 October 2008 ENVIRONMENTAL MANAGEMENT CORP. 3.1 Project Name: Contact Name: Purpose of Contract: Total Cost: Start Date: End Date: 3.2 Project Name: Contact Name: Purpose of Contract Total Cost: Start Date: End Date: 3.3 Project Name: Contact Name: Purpose of Contract: Total Cost: Start Date: End Date: Clement Pappas Sewer Line Repair (#004) Randy Jones, (303) 518-5865 Install new 8" sewer line to tie new treatment plant into City Sewer System $243,187.00 January 2009 March 2009 Clement Pappas Mechanical Line Construction Phase 1 (#005) Randy Jones, (303) 518-5865 Effluent water treatment and disposal system for Juice Factory $405,028.00 March 2009 December 2009 Clement Pappas Mechanical Line Construction Phase 2 (#013) Randy Jones, (303) 518-5865 Effluent water treatment and disposal system for Juice Factory $44,653.00 August 2010 December 2010 Aiw i 151 f= #V C'; 1 rJ E I9 I I PSI l_; 'S.' C:C:I_P"S f'r 10ili INC. SUMMARY OF RELEVANT EXPERIENCE CITY OF ALHAMBRA, DEPARTMENT OF PUBLIC WORKS Attachment A 4.1 Project Name: Almansor Park Lower Lake Improvements (#006) Contact Name: Ali Cayir, (714) 883-8677 Purpose of Contract: Restoration of existing lake. Removal of old liner & placement of new along with decorative rock & landscaping Total Cost: $446,602.00 Start Date: April 2009 End Date: October 2009 5. COUNTY OF LOS ANGELES, DEPARTMENT OF PUBLIC WORKS 5.1 Project Name: Warm Springs Tank Install (#007) Contact Name: Louis Nagy (805) 653-7900 Purpose of Contract: Install Water Treatment Plant for potable water Total Cost: $137,018.00 Start Date: October 2009 End Date: December 2009 5.2 Project Name: Warm Springs Treatment Plant (#012) Contact Name: Louis Nagy (805) 653-7900 Total Cost: $37,084.00 Start Date: July 2010 End Date: August 2010 COUNTY OF LOS ANGELES, PUBLIC HEALTH DEPARTMENT 6.1 Project Name: Contact Name: Purpose of Contract Total Cost: Start Date: End Date: 6.2 Project Name: Contact Name: Purpose of Contract: Total Cost: Start Date: End Date: 6.3 Project Name: Contact Name: Purpose of Contract: Total Cost: Start Date: End Date: Acton Rehabilitation Center Phase 1 (#009) Everett Bryson (661) 269-7003 Restoration of existing building at rehab camp $102,000.00 December 2009 February 2010 Acton Rehabilitation Center Phase 2 (#014) Everett Bryson (661) 269-7003 Continuing restoration of existing building at rehab camp $35,045.00 July 2010 August 2010 Acton Rehabilitation Center Phase 3 (#018) Everett Bryson (661) 269-7003 Continuing restoration of existing building at rehab camp $92,306.00 May 2011 September 2011 7 P, t7-FIiIi1iC3 6'. 9CJE: Ii(_),v INC- SUMMARY OF RELEVANT EXPERIENCE DEPARTMENT OF TRANSPORTATION 7.1 Project Name: Contact Name: Purpose of Contract Total Cost: Start Date: End Date: 7.2 Project Name: Contact Name: Purpose of Contract: Total Cost: Start Date: End Date: Attachment A El Centro Sunbeam Rest Areas, 11-261514 (#016) Alan Babicky (858) 688-1526 Effluent water treatment and disposal system for rest area $1,078,316.00 September 2010 September 2011 Emulsion Tank @ Various Locations in San Bernardino County, 08-ON1404 (#027) Efe Adodo / Scott Gueltzow, (951) 830-6695 Demolition, Concrete work, Tank Installation, Piping and Electrical Work $727,451.75 October 2012 May 2013 CITY OF BEVERLY HILLS, DEPARTMENT OF PUBLIC WORKS 8.1 Project Name: Reservoir #4 Rehabilitation (#026) Contact Name: Anne Zaworski , (310) 285-2520 Purpose of Contract: Earthwork, Retrofitting, Piping, Lining, Pump Installation and Electrical works Total Cost: $1,559,054.60 Start Date: July 2012 End Date: June 2013 9. CITY OF HEMET, DEPARTMENT OF PUBLIC WORKS 9.1 Project Name: SCADA System for Wells and Reservoir Tanks (#028) Contact Name: Victor Monz , (951) 765-3847 Purpose of Contract: Instal SCADA System for Wells & Reservoir Tanks Total Cost: $350,804.86 Start Date: March 2013 End Date: November 2013 10. COUNTY OF LOS ANGELES, INTERNAL SERVICES DEPARTMENT 10.1 Project Name: ISD Various Location Repair & Upgrade (#030) Contact Name: Roy Pierce , (323) 26 7-2 30 7 Purpose of Contract: Various repairs Total Cost: $TBD Start Date: January 2015 End Date: December 2015 COUNTY OF LOS ANGELES, INTERNAL SERVICES DEPARTMENT E�N(�ffJPFi-2INt_; tS. SUMMARY OF RELEVANT EXPERIENCE Attachment A 11. Project Name: Water Well No.5 Pumping Facility Project Contact Name: John Griffin, (714) 375-5011 Purpose of Contract: Civil, Mechanical and Electrical work Total Cost: $564,640 Start Date: November 2015 End Date: August 2016 12. Project Name: TUSTIN UNIFIED SCHOOL DISTRICT Beckman High School — Synthetic Multi -Purpose Field Contact Name: Ray Purcell, (858) 228-7912 Purpose of Contract: Civil, Mechanical and Electrical work Total Cost: $461, 780 Start Date: August 2016 End Date: November 2016 13. Project Name: California Transportation Bridge Rail Upgrade and Deck Replacement, Project 12-OH5304 Contact Name: Irvin Nguyen, (949) 279-8590 Purpose of Contract: Bridge Construction Total Cost: $996,292 Start Date: December 2016 End Date: August 2017 14. Project Name: City of Lake Forest Village Pond Park Contact Name: Douglas Erdman, (949) 282-5233 Purpose of Contract: Park Total Cost: $2,103,687 Start Date: April 2017 End Date: February 2018 I BIDDER'S CRITICAL STAFF The Bidder shall provide information to demonstrate that both the Construction Project Manager (office staff) and Construction Superintendent (field staff] proposed for BROOKHURST STREET BRIDGE PREVENTIVE MAINTENANCE, C.C. No. 1449 have had similar work experience on at least 3 different projects within the past five years. The proposed critical staff members need not have been employed by the Bidder at the time the referenced projects were completed. "Yrx 9y � i cP Name of proposed Construction Project Manager Phone # of proposed Construction Project Manager: -j 14 ) 3g Z-- $7 (-4 P \elo . .512.G F� �c R.eSUA?V.Q- Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed z. -C1os� kC) eptp— ' Name of proposed Construction Superintendent � I � I � I � I Phone # of proposed Construction Superintendent: Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work Date Completed Date Completed Date Completed RESUME Lawrence E. Pulice 670 S. Rosalind Dr. Orange, CA 92869 (714)-744-2717 Cell (714) 392-8764 E-Mail Address puliceornage@aol.com SUMMARY: 42 years of experience in estimating and field supervision of heavy road and bridge projects. Extensive experience in earth fill dams, landfills, heavy rail work, structural concrete, underground utilities, tie -back and soil nail shoring, rock excavation and micro piles. Experience working with Caltrans, OCTA, United States Navy, railroads and many other public agencies. Worked on numerous large-scale and challenging projects always keeping safety as a priority while still bringing the jobs in on time and under budget. Employment History: 4-15 to 11-15 Guinn Construction, Bakersfield, Ca Position: Superintendent Guinn is a heavy dirt moving Co, for the commercial and industrial sector. 8-10 to 2-14 USS CAL BUILDERS, STANTON, CA Position: Superintendent Project: Los Angeles County Sanitation District $90 Million Project consist of the construction of 4 miles of rail work for Union Pacific including beam in place, precast concrete wall, underground work, box culverts and bridge construction. OTCA rail grade separator and 400 ft. long bridge $30 Million. City of Anaheim road widening with Cal Trans, type 1 retaining walls $10 Million. 10-07 to 8-10 ERRG TUSTIN, CA Position: Project Superintendent/Construction Manager El Toro Marine Base land fill closures for the United State Navy. Project: Consolidation of existing waste and the placing of 150,000 CY of foundation material and placing of 200,000 CY of clay cap. Also, drainage features. My responsibilities as Construction Manager was to work closely with lead project manager and regional manager overseeing a team of design and construction tasked with conceptual planning, scheduling cost estimating, final work planning. Projects now in the construction stage is Marine Base 29 Palms design build $10 million land fill. Project includes excavation, waterline, sewer and building construction. Other type of work included demolition and soil remediation. 01-05 to 10-07 BRENT ENGINEERING, IRVINE, CA Position: Project Superintendent Project Ortega Hwy. 33 million Project consist of micro pile and rock anchors for shot crete walls, side hill viaduct bridge, retaining walls, rock excavation, storm drain and A/C paving. 01-04 to 01-05 E.B.S., CORONA, CA Position: Public Works Superintendent Duties: Manage projects from pre -construction through the completion. Organization of equipment, labor and materials. The maintaining of all safety procedures and quality control of projects. Type of Projects: Road reconstruction. 08-02 to 01-04 MZT, SANTA ANA, CA Position: Superintendent Type of work: Site preparation for the construction of Prado Dam in Corona. Work included land clearing of 500 acres and building of haul roads. Owner Army Corps of Engineers. Contract $2.75 million. The construction of roads at Fort Lewis, WA. Work included land clearing, earth work, drainage and paving. Contract $1.5 million. 1-5 ramp construction in Mission Viejo, CA. Work included excavation, bridge widening, concrete paving and A/C paving. 09-00 to 08-02 GRIFFITH COMPANY, SANTA FE SPRINGS, CA Position: Project Superintendent Type of work: Reconstruction of Valencia interchange 1-5 and city road work projects. Reconstruction of Pier B's road for Port of Long Beach which included replacement of a water main and new storm drain system. 09-98 to 09-02 BALDI BROTHERS, BEAUMONT, CA Position: Project Superintendent Type of work: Land fill cover for the United States Navy, Port Hueneme, Ca. Project: Placing various types of geotextile materials over the existing dump area. Storm drain work, detention basin, excavation of approximately 250,000 CY of material and the import of approximately 500,000 CY of spec material over the geotextile material. 11-92 to 08-98 INLAND ASPHALT COMPANY, UPLAND, CA Position: Estimator/Project Manager Type of work: School site development from the rough grading through building foundations and road construction from lane widening to total road removal and underground work. 09-90 to 11-92 MITCHELL PACIFIC, PALM SPRINGS, CA Position: Project Superintendent Project: Seismic retro fitting of a 12-story bell tower for the University of Riverside. Work included driving of concrete friction piles for new foundation, doweling to existing concrete columns and pouring a new column to the existing. Also, the bell chamber installed structural steel for diagonal bracing. Contract $3 million. Also, the building of a pump station for Rialto water that included the building of a intake manifold and the 36 inch CIVIL supply pipeline. Contract $1 million. 06-85 to 09-90 VANCE CORP., RIALTO, CA Position: Project Superintendent Type of work: Road, highway and airport fields. Either new or reconstruction which includes major excavation, grading, underground, structural concrete work and paving. Total site development for school reconstruction. Estimator on selected projects and supervised million dollar plus projects. Handled all pre -construction scheduling, planning of labor, material, equipment and costs. Largest project was a site development for a mobile home park for the city of Rialto, CA. Contracts price $10 million. 03-83 to 06-85 C. J. LANGENFELDER, BALTIMORE, MD Project: Superintendent Type of work: Owner of the project is United States Steel Corporation in Waynsburg, PA. The project was building a 3 million CY fill dam, a 35 acre reservoir for the reclamation of acid water from the coal mines. The installation of a $5 million piping system for drainage and water recovery including major structural concrete placement for overflow and intake structures and pipe cradles through the valleys. Contract $25 million. 06-79 to 02-83 ANJO CONSTRUCTION, PITTSBURGH, PA Position: Superintendent Type of work: Reconstruction of a section of Interstate 80 for PennDot. Removal and replacing section of P.C.C. roadway, asphalt paving, bridge repair and drainage work. My duties included the supervision of the various areas of work to be completed and coordinating the necessary labor and equipment needed for the project. 05-77 to 06-79 E.C.I., PITTSBURGH, PA Position: Project Superintendent Type of work: Owner, Kanawh Coal Co., Charlestion, WA. The project was building a earth fill dam. Land clearing of 20 acres, 1.5 million CY, 2000 1f of 24 in. RCP pipe for the decant line and all concrete structures. 06-72 to 04-77 WESTERN PAVING, BELL GARDENS, CA Position: Estimator Type of work: Estimated excavating asphalt paving, concrete work for highway construction, private work for site development for commercial and industrial parks. Supervisor of all projects from bid to conclusion. Project size from $50k to $10 Mil 40 HR Hazmat Refresher 2010 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): 'V/ 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: RCZ4 ra,-� (T14 ) 4o-,f -kC)00 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-12 I' CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771.1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works ' projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refiuidable O registration fee for contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate. DIR FACT SHEET on SB 854 http://www.dir.ca.goN,/DLSE/PublicWorks/SB854FactSheet 6.30.14.pdf I' DIR's Contractor Registration Link — Call (844) 522-6734 https://efiling.dir.ca. gov/PW CR/ActionServlet?action=displayPWCRegistrationForrn DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCR/Search.actioil II am aware and will comply with the provisions of Labor Code Section 1771.1(a) which states: "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, ' subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perfonii public work pursuant to Section 1725.5. It is not a ' violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid. Date: i — 3 ( — 2-017 Contractor U By ID Title C-13 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder (%I�ej G i rue `ors 1 C - 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. Dote: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause aree set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or Linder are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. C-14 Page 6 of 22 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has , has not 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 1 100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PCBLIC 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 thee 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 I] No Z If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-15 October 2016 Local Assistance Procedures Manual PUBLIC CONTRACT CODE 10232 STATEMENT Exhibit 12-H Sample Bid In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two-year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 8 of 22 C-16 October 2016 t Local Assistance Procedures Manual Exhibit 12-H Sample Sid t Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) ' H•J3 To the CITY / COUNTY of (12> /' ti DETARTWENT OF)!UBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder ' declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that ' the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to ' from bidding; bidder has in any manner, directly put in a sham bid, or that anyone shall refrain that the not ' 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 tother 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 tnot, 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, tpartnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. � I � I Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. � I C-17 Page 9 of 22 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 The bidder, under penalty of perjury, certifies that, except as noted below, he/she or any other person associated therewith in the capacity of owner, partner, director, officer, manager: • is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal agency; • has not been suspended, debarred, voluntarily excluded or determined ineligible by any Federal agency within the past 3 years; • does not have a proposed debarment pending; and • has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidder ' responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of acti on. 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. i I' Page 10 of 22 C-1 8 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: {I) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. ' (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions, This certification is a material representation of fact upon which reliance was placed when this transaction was made or ' entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 11 of 22 C-19 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETETHIS FORM TO DISCLOSh LOB BYIN(y AC I IV I I!'J I'UKNUAN I 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: =a. contract F-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 Only: e. loan guarantee year quarter_ f, loan insurance date of last report 4. [Fame and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier if known Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9, Award Amount, if known: b. Individuals Performing Services (including address if different from No. 1 Oa) (Iasi name, first name, MI) (attach Continuation Shect(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S ❑ actual 7 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 e deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: YesEl No 7 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352_ This disclosure of lobbying Signature: reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required Print Name: pursuant to 31 U S C_ 1352, This information will be - reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required Title: _ disclosure shall be. subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure_ Telephone No.: Date: Authorized for Local Reproduction Federal Use Only: Standard Form - LLL Page 12 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of'covered Federal action or a material change to previous filing pursuant to title 31 U.S.C. section I352. 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 al l items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. l . Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence, the outcome of a covered Federal action. 2. Identifv 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 suba«ard 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, sub -rants 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 (11`13) number, grant announcement number, the contract grant. or loan award dumber, 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 aNyard/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box. Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identif}, the Federal offeer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted, 15, Check whether or not a continuation sheets) is attached. 16, The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information, Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget; Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. sr-LLLdnslr=ions Rev. 06-04-90«ENDIF» I � I � I � I � Page 13 of 22 ' C-21 October 2016 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: 3. Project Description: 4. Project Location: 5. Bidder's Name: 8. Total Dollar Amount for ALL Subcontractors: 2. Contract DBE Goal: 6. Prime Certified DBE ❑ 7. Bid Amount: 9. Total Number of ALL Subcontractors: 10. Bid Item Number 11. Description of Work, Service, or Materials Supplied 12. DBE Certification Number 13, DBE Contact information (Must be certified on the date bids are opened) 14. DBE Dollar Amount Local Agency to Complete this Section 21. Local Agency Contract Number: 15. TOTAL CLAIMEC? C?$E PARTICIPATION 22. Federal -Aid Project Number: 23, Bid Opening Date: 24. Contract Award Date: IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier. Names of the First Tier DBE Subcontractors and their respective item(s) of work listed above must be consistent, where applicable with the names and items of the work in the Local Agency certifies that all DBE certifications are valid and information on "Subcontractor List" submitted with your bid. Written confirmation of this form is complete and accurate. each listed DBE is required 25. Local Agency Representative's Signature 26. Date 16. Preparer's Signature 17. Date 27. Local Agency Representative's Name 28. Phone 18, Preparer's Name 19. Phone 29. Local Agency Representative's Title 20. Preparer's Title DISTRIBUTION: 1. Original — Local Agency 2. Copy — Caltrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result in de -obligation of federal funds on contract. Include additional copy with award package. ADA Notice: For individuals with sensory disabilities, this document is available in alternate formats For information call (916) 654-6410 or TDD (916) 654- 3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. Page 1 of 2 C-22 July 23, 2015 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment INSTRUCTIONS — CONSTRUCTION CONTRACT DBE COMMITMENT CONTRACTOR SECTION 1. Local Agency - Enter the name of the local or regional agency that is funding the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Location - Enter the project location as it appears on the project advertisement. 4. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). 5. Bidder's Name - Enter the contractor's firm name. 6. Prime Certified DBE - Check box if prime contractor is a certified DBE. 7. Bid Amount - Enter the total contract bid dollar amount for the prime contractor. 8. Total Dollar Amount for ALL Subcontractors — Enter the total dollar amount for all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 9. Total number of ALL subcontractors -- Enter the total number of all subcontracted contractors. SUM = (DBEs + all Non -DBEs). Do not include the prime contractor information in this count. 10. Bid Item Number - Enter bid item number for work, services, or materials supplied to be provided. 11. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs including work performed by the prime contractor's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 12. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be certified on the date bids are opened. 13, DBE Contact Information - Enter the naive, address, and phone number of all DBE subcontracted contractors. Also, enter the prime contractor's name and phone number, if the prime is a DBE. 14. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime contractor if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 15, Total Claimed DBE Participation - $: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DBE participation claimed ("Total Claimed DBE Participation Dollars" divided by item "Bid Amount"). If the total % claimed is less than item "'Contract DBE Goal," an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM). 16. Preparer's Signature - The person completing the DBE commitment form on behalf of the contractor's firm must sign their name. 17. Date - Enter the date the DBE commitment form is signed by the contractor's preparer. 18. Preparer's Name - Enter the name of the person preparing and signing the contractor's DBE commitment form. 19. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 20. Preparer's Title - Enter the position/title of the person signing the contractor's DBE commitment form. LOCAL AGENCY SECTION 21. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 22. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 23, Bid Opening Date - Enter the date contract bids were opened. 24. Contract Award Date - Enter the date the contract was executed. 25. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Contractor Section of this form is complete and accurate. 26, Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 27. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the contractor's DBE commitment form. 28. Phone - Enter the area code and phone number of the person signing the contractor's DBE commitment form. 29. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the contractor's DBE commitment form. I � I � Page 2 of 2 C-23 July 23, 2015 , Local Assistance Procedures Manual Exhibit 15-H DBE [nformation - Good Faith Effort EXHIBIT I5-H DBE INFORMAT[ON —GOOD FA[TH EFFORTS Federal -aid Project No. DBE INFORMATION - GOOD FAITH EFFORTS Bid Opening Date The established a Disadvantaged Business Enterprise (DBE) 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 DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications u Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation c� t Page 15-1 OB 12-04 C-24 June 29, 2012 I Exhibit 15-H Local Assistance Procedures Manual DBE Information -Good Faith Effort C, The items of work which the bidder made available to DBE firms including, where appropriate, , any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage ' Performs Item Items {$) Of (YIN) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE; Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: Page 15-2 June 29, 2012 C-25 OB 12-04 Local Assistance Procedures Manual Exhibit 1.5-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-3 OB 12-04 C-26 June 29, 2012 M Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 12-B Bidder's List of subcontractor (DBE and Non -DBE) Part 1 As of March 1, 2015 Contractors (and sub -contractors) wishing to bid on public works contracts shall be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at: https://efiling.dir,ca.gov/PWCR/ActionServlet?action=displaVPWCRegistrationForm In accordance with Title 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 of the Public Contract Code of the State of California, as amended, the fnllnwinu information is rernrired for each sub -contractor who will perform work amounting to more than one half of one percent (0.5%) of the Total Base Bid or $10,000 (whichever is greater). Photocopy this form for additional Firms. Subcontractor Name and Location Line Item & Description Subcontract Amount Percentage of Bid Item Sub- contracted Contractor License Number DBE (Y/N) DBE Cert Number Annual Gross Receipts DIR Reg Number Name: <$1 million <$5 million City, State: Li <$10 million <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million ❑ <$5 million City, State: <$10 million <$15 million Age of Firm: _ yrs. Name: <$1 million [] <$5 million City, State: <$10 million ❑ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million ❑ <$5 million City, State: ❑ <$10 million <$15 million Age of Firm: yrs. Name: <$1 million Lj <$S million City, State: <$10 million ❑ <$15 million Age of Firm: , yrs. Name: Lj <$1 million ❑ <$5 million City, State: <$10 million <$15 million Age of Firm: yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package C-27 Page I of 2 September 2016 M Local Assistance Procedures Manual Exhibit 12-B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit I2-B Bidder's List of subcontractor (DBE and Non -DBE) Part 2 1n accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractor who provide a quote or bid but were not selected to participate as a subcontractor on this project. Photocopy this form for additional firms. Subcontractor Name and Line Item & Description Subcontract Percentage of Contractor DBE DBE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number contracted DIR Reg Number Name: ❑ <$1 million <$5 million City, State: <$1D million EJ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million ❑ <$5 million City, State: ❑ <$10 million ❑ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million <$5 million City, State: ❑ <$10 million ❑ <$1S million Age of Firm: , yrs. Name: ❑ <$1 million [] <$5 million City, State: ❑ <$10 million <$15 million Age of Firm: _ yrs. Name: ❑ _<$1 million <$5 million City, State: ❑ <$10 million <$15 million Age of Firm: yrs. Name: ❑ <$1 million <$5 million City, State: r <$10 million <$15 million Age of Firm: _ yrs. Distribution: 1) original -Local Agency File 2) Copy-DLAE w/ Award Package Page 2 of 2 C-28 September 2016 �� pasr�ee ���a 336 N. Central Ave, suite 10A Glendale, Ca 91203 u., x W ac > a ;oz oo,� ... ` 7(a 2;., P 'd po c : Foy B ro o'K�t, �L»^.e��-- a �,'c [�,�r��s o�d�0° , �' 1�✓vl . � C ' �,26�16 RECEIVED B/Y.: J X— L/✓.i%�.f (Name) S (Date) / • CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Cler/k DATE: C!'2 �/ r SUBJECT: Bond Acceptance have received the bonds for / l�°� '-'��i �� 1%C/) �r �..%'r r')7C ,1.41,( ✓�1-� . (Company Name) r .1 CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. A 1 Warranty or Maintenance Bond No. SAA1WL'r✓. 7,- 2- 7 TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other SA,1/ 1,2-0 7 Re: Tract No. Approved 77� (Council Approval Date) �1 CC No. Agenda Item No. /L' MSC No. City Clerk Vault No.� Other No. SIRE System ID No. g:/forms/bond transmittal to treasurer