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Hardy & Harper, Inc. - 2017-06-05
RECEIVED BY % /A Y (Name) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION HzY TO: City Treasurer FROM: City Clerk DATE: �I� // ,� 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 Approved (,e t .S-/ /7 (Council Approval Date) Agenda Item No. -`/ City Clerk Vault No. (GiaU..Sr SIRE System ID No. C,1211),3 CITY OF HUNTINGTON BEACH v INTERDEPARTMENTAL COMMUNICATION DATE: 3/6/2018 TO: THOSE LISTED HEREON FROM: Joseph Fuentes, Contract Administrator �F SUBJECT: Retention Release Payment - PO #23054 OJ Supplier #19125 Co. #213 Adams Avenue and Atlanta Avenue, Project # CC-1502 Contractor's Name: Hardy & Harper, Inc. - Santa Ana Address: 1312 East Warner Ave City, State and Zip Code: Santa Ana, CA, 92705 Phone Number: (714) 444-1851 City Business License Number: A011016 Notice of Completion (Date by City Clerk): 10/9/2017 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. 's (Z.� (g Date I certify that there are no outstanding invoices on file. Date Travis K. Nopkins, Director of Public Works Joyce Zacks, Deputy 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. 5�3 Ll < ate Estanislau, City Clerk ,�_lLi 4"i%' �� Attachments S�Bf/g 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-4150663 -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: Joseph Fuentes P,O. Box 190 — 2000 Main Street Huntington Beach, CA 92548 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder 11111111111111IIII1IIIIIIIIIIIII11II11lllll 111 Jill I I 1111111NO FEE *$ R 0 0 0 9 6 3 3 6 2 8$ A 2017000438918 3:34 pin 10/16117 7 40S N12 1 0.00 0.00 0,00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to Hardy & Harper, Inc. - Santa Ana , who was the company thereon for doing the following work to -wit: Adams Avenue and Atlanta Avenue, Project # CC•1502 That said work was completed 10/09/2017 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 10109/2017. per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract Fidelity and Deposit Company of Maryland, was surety for the bond given by the said company as required This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. --c- gz=== /d / 3 f-11 L Director of Public WorK or City Engineer Date City of Huntington Beach, California STATE OF CALIFORNIA) County of Orange ) ss: City of Huntington Beach ) I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof, the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. This document is solely the official business of� the City of Huntington Beach, as contemplated 10 — t 3 under Government code section 27383 and Director of Public Works or City Engineer Date should be recorded free of charge. City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) about:blank 10/16/2017 This bond was executed in Bond No. 7653578M two (2) identical counterparts. MAINTENANCE BOND i<NOW ALL PERSONS BY THESE PRESENTS: That Hardy & Harper Inc. (contractor's name) 1312 E. Warner Avenue Santa Ana CA 92705 (contractor's street address, city and state and zip code) as Principal (hereinafter called Contractor), and: Fidelity and Deposit Company of Maryland (surety's name) 777 South Figueroa StreetSuite 3900, Los Angeles, CA 90017 (surety's street address, city and state and zip code) a corporation organized and existing under the laws of the State of with its principal office in the City of Schaumburg. IL as Surety (hereinafter called Surety), are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owner), in the amount of * Dollars ($1.446.663.46 ), 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, *One Million Four Hundred Forty Six Thousand Six Hundred Sixty Three and 46/100 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 June 19, 20L 7, entered into a contract with Owner for the Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlantic Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502, Federal Aid Project STPL-5181(188) in accordance with drawings and specifications prepared by N/A which contract is by reference made a part hereof (hereinafter referred to as the Contract); and 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 October 9 , 2017, 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 Owner's written notice of default, either: (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall save the Owner harmless from any claims, judgments, liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner. t 5-4584/I ] 813 9 1 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 22nd day of February , 20 18 Principal Raised Corporate Seal [MUST BE AFFIXED] Principal Raised Corporate Seal [MUST BE AFFIXED] NOTES: Hardy & Harper Inc. (Contractor Name) By: (Seal) Steve Kirschner Vice President (Title) Fidelity and De osit Company of Maryland (Surety Na e) By: (Seal) Dwight Reilly, Attorney -in -Fact APPROVI�.�.-�AST- R`M,,;� B Michael E. Gates, City Attorney 1. Acknowledgments must be completed and returned 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 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 Oran On February 22. 2018 before me, Tina Pham, Notary Public Date Here Insert Name and Title of the Officer personally appeared Steve Kirschner Name( of Signer( who proved to me on the basis of satisfactory evidence to be the person(K) whose name(8) is/axe subscribed to the within instrument and acknowledged to me that he/state/tivy executed the same in his/lter/their authorized capacity(ies), and that by his/h)er/their signature(g) on the instrument the person(a), or the entity upon behalf of which the person(x) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. TINA PHAM WITNESS my hand and official seal. COMM. #2149384 ;Notary Public California a } V ORANGE COUNTY Signature _,_ My Comm. Expires Apr I , 2020 Si nature 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: Maintenance Bond Document Date: February 22, 2018 Number of Pages: 2 Signer(s) Other Than Named Above: Dwight Reilly Capacity(ies) Claimed by Signer(s) Signer's Name: Steve Kirschner ❑✓ Corporate Officer — Title(s):y (,P Presiriant ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Hardy & Harper, Inc Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: _C�ezu��C>e-� ��-t'��✓_,+5cz,,z::uv�C.r.C;���u�:z�.e;u< �,t;c%,c;z�`c.�e,�r,;-c,.;e� ;z��e%c,�:�<>r_,:�C,ci �;:c,r�z�-,-_< �_c;c;:< 02014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #f5907 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 February 22, 2018 before me, Susan Pugh Notary Public (insert name and title of the officer) personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(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. susAN PUGH COMM. #2105405 Ow Notary Public -California ORANGE COUNTY LL Comm. Expires Apr 29, 2019 Signature (Seal) Susan Pugh 1 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by Michael P. Bond, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Daniel HUCKABAY, Dwight REILLY, Arturo AYALA, Shaunna Rozelle OSTROM and Michael CASTANEDA, all of Orange, California, EACH its true and lawful agents and Attomey-in-Facts, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 28th day of November, A.D. 2017. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Dawn E. Brown Secretary State of Maryland County of Baltimore On this 28th day of November, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Michael P. Bond, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 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 CC-IS02 Contract: Project: Adams Ave Rehab — The undersigned contractor on the above -referenced project ("Project") hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit requirements specified for each particular classification of work, as set forth in the wage -rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this " day of February 20 is at Santa Ana California. Hardy & Harper, Inc. (Contractor Name) APPROVED A''S,,TO FORM By: Michael E. Gates City Attorney 1 CONTRACTOR'S CERTIFICATE E I Steve Kirschner (Naive of'Declarant) 1. Hardy & Harper, Inc. state and certify that: _ is the general contractor to the City of Huntington Beach ("City") on Contract No. cc-1502 (the "Contract") for the construction of the public work of improvement entitled: Adams Ave Rehab (the "Project") 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3. Except for the claims listed below and the disputed claims listed in paragraph five (5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the contractor arising from the performance of the Contract, have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): None 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services, materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write "NONE"). None I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Santa Ana on this 16 day of February 20 18 . (Signalure o ` ant) APPROVED AS TO=FORM . Michael/E. Gates City,Attorney 1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: CC-1502 Project: Adams Ave Rehab 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 26 day of February 20 Is at Santa Ana , California. Hardy & Harper, Inc. (Contractor Name) APPROVED AS�'O FORM Michael E. Gates City Attorney 1 CONSENT OF SURETY TO REDUCTION IN OWNER ❑ OR PARTIAL RELEASE OF RETAINAGE ARCHITECT ❑ Conforms with the American Institute of CONTRACTOR ❑ ❑ Architects, AIA Document G707A SURETY Bond No. 7653578 OTHER ❑ TO OWNER: ARCHITECT'S PROJECT NO: N/A (Name and address) City of Huntington Beach 2000 Main St. CONTRACT FOR: CC No. 1502, Federal Aid Project Huntington Beach, CA 92648 STPL-5181(188), Asphalt PROJECT: CONTRACT DATED: June 19, 2017 (Name and address) Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlantic Avenue Rehabilitation from Beach Boulevard to Newland Street In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above. the (Insert name and address of Surety) Fidelity and Deposit Company of Maryland 777 South Figueroa Street, Suite 3900 Los Angeles, CA 90017 SURETY, on bond of (Insert name and address o% Contractor) Hardy & Harper, Inc. 1312 E. Warner Avenue Santa Ana, CA 92705 CONTRACTOR, hereby approves the reduction in or partial release of retainage to the Contractor as follows: Release of Retention in the amount of $72,333.18 The Surety agrees that such reduction in or partial release of retainage to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of Huntington Beach 2000 Main St. Huntington Beach, CA 92648 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: March 8, 2018 (Insert in writing the month followed by the numeric date and year) Fidelity and Deposit Company of Maryland (Surety) (Signature of authorized representative) Attest: Dwight Reilly, Attorney -in -Fact (Seal): (Printed name and title) S-2133/GEEF 12/00 FRP 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 Oran On March 8, 2018 before me, Melissa Ann Vaccaro, Notary Public (insert name and title of the officer) personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(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. MELISSA ANN VACCARO l Commission # 2068090 WITNESS my hand and official seal. Z Notary Public - California z z; z '" Orange County My Comm. Expires May 12, 2018 Signature���xV"°f���� �=�-�� � (Seal) Melissa Ann Vaccaro Bond No. 7653578 ZURICH AMERICAN INSURAtNCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by Michael P. Bond, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Daniel HUCKABAY, Dwight REILLY, Arturo AYALA, Shaunna Rozelle OSTROM and Michael CASTANEDA, all of Orange, California, EACH its true and lawful agents and Attorney -in -Facts, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 28th day of November, A.D. 2017. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Michael P. Bond Vice President By: Dawn E. Brown Secretary State of Maryland County of Baltimore On this 28th day of November, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Michael P. Bond, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attomevs-in- Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time. CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attomey is still in full force and effect on the date of this certificate: and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 8th day of March , 2018 . 51 ra Eiioy.. Z y a Its I Michael C. Fay, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 www.zurichna.com/en/claims RECEIVED BY: (Name) (Date) TO: FROM: DATE: SUBJECT CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION City Treasurer City Clerk 5L� 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. CJ U oZ MSC No. Other No. g:/forms/bond transmittal to treasurer Approved (- f ,S-/ / 7 (Council Approval Date) Agenda Item No. '7 City Clerk Vault No (aloo. so SIRE System ID No. 30,2 --,) 3 Document-4150663-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: Joseph Fuentes P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder II I II II II I I I II �� I I II I �� NO FEE * S R 0 0 0 9 6 3 3 6 2 8 S 2017000438918 3:34 pm 10116117 7 405 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 THIS SPACE FOR RECORDER'S USE ONLY NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to Hardy & Harper, Inc. - Santa Ana , who was the company thereon for doing the following work to -wit: Adams Avenue and Atlanta Avenue, Project # CC•1502 That said work was completed 10/09/2017 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 10/09/2017, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract Fidelity and Deposit Company of Maryland, was surety for the bond given by the said company as required This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. ---c- /d -13111 C Director of Public WorK or City Engineer Date City of Huntington Beach, California STATE OF CALIFORNIA) County of Orange ) ss: City of Huntington Beach ) I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof; the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. This document is solely the official business of the City of Huntington Beach, as contemplated j0 —1 3 l under Govemment code section 27383 and Director of Public Works or City Engineer Date should be recorded free of charge. City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) about:blank 10/16/2017 4+� i x.�i i. i•, ., y ._�?' +lei. 15, is.. ,.,F�. :i�� ".�. �s. � .'t t � ��kc �' � ':�.'... .. _� ' t' I, RECEIVED CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Narhe)l after signing/dating (Date) ' TO: FROM: DATE: SUBJECT: CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION City Treasurer `City Clerk 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. It MSC No. Other No. g:/forms/bond transmittal to treasurer (Company Name) Approved �,A—/ / (Cou'ncil Approval Date) Agenda Item No. City Clerk Vault No.7�a SIRE System ID No.�c FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND HARDY & HARPER, INC. FOR THE ADAMS AVENUE REHABILITATION AND ATLANTA AVENUE REHABILITATION PROJECTS CC-1502 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 HARDY & HARPER, 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 the Adams Avenue Rehabilitation and Atlanta Avenue Rehabilitation Projects 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, 16-5093/Hardy & Harper CC-1502 - 04/2016 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 teens, 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 16-5093/Hardy & Harper CC-1502 - 04/2016 2 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 23 CFR § 635.410 (attached as Exhibit "C"); 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 16-5093/Hardy & Harper CC-1502 - 04/2016 3 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 One Million "Three, Hundred Eighty -Eight Thousand Dollars ($1,388,000.00), 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 sixty-five (65) consecutive working days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other 16-5093/Hardy & Harper CC4502 - 04/2016 4 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 5 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance 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 16-5093/Hardy & Harper CC-1502 - 04/2016 6 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 Seven Hundred Dollars ($700.00) 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 16-5093/Hardy & Harper CC-1502 - 04/2016 7 CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the . findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR. be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. 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. 16-5093/Hardy & Harper CC-] 502 - 04/2016 8 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 9 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 his or her 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 CITY may promptly investigate the conditions. E. If the CONTRACTOR disputes the DPW's written response on the Demand, or the CITY fails to respond within the time prescribed, the CONTRACTOR may so notify the City Engineer, in writing, either within fifteen (15) days of receipt of the City Engineer'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. 16-5093/Hardy & Harper CC-1502 - 04/2016 10 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 16-5093/Hardy & Harper CC-1502 - 04/2016 11 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 brir,.g 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 12 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAI.VER 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 16-5093/Hardy & Harper CC-1502 - 04/2016 13 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 14 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 prod ucts/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 pennitted. 16-5093/Hardy & Harper CC-1502 - 04/2016 15 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: 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 16 22. 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. 23. 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 16-5093/Hardy & Harper CC-1502 - 04/2016 17 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 pennitted 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. 24. 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. 25. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 26. 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 16-5093/Hardy & Harper CC-1502 - 04/2016 18 Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 27. 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 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 16-5093/Hardy & Harper CC-1502 - 04/2016 19 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 27(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) To buy only steel and iron manufactured in the United States pursuant to Section 635.410 of Title 23 of the Code of Federal Regulations, which is attached at Exhibit "C." (2) To incorporate Section 27(C) of this Agreement into each subcontract and further require each subcontractor to incorporate Section 27(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 affirinative 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 27(D) of this Agreement into each subcontract and further require each subcontractor to incorporate Section 27(C) into any lower tier subcontract or purchase order. 16-5093/Hardy & Harper CC-1502 - 04/2016 20 28. . IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 306 of the Clean Air Act and section 508 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. 29. 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 21 30. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default by CONTRACTOR, CITY may elect not to terminate this Agreement; in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR. If it is subsequently determined by a court of competent jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 31 and any damages shall be assessed as set forth in Section 31. 31. 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, 16-5093/Hardy & Harper CC-1502 - 04/2016 22 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. 32. 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. 33. 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. 34. 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. 35. 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 16-5093/Hardy & Harper CC-] 502 - 04/2016 23 expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 36. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section I hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: City of Huntington Beach ATTN: Jot Fuentes, Public Works 2000 Main Street Huntington Beach, CA 92648 37. SECTION HEADINGS TO CONTRACTOR: Hardy & Harper, Inc. ATTN: Steve Kirschner 1312 East Warner Ave. Santa Ana, CA 92705 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. 16-5093/Hardy & Harper CC-1502 - 04/2016 24 38. 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. 39. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 40. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. 41. 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 16-5093/Hardy & Harper CC-] 502 - 04/2016 25 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. 42. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 43. 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. 44. 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. 16-5093/Hardy & Harper CC-]502 - 04/2016 26 45. 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. 46. 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 terns 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. 47. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. 16-5093/Hardy & Harper CC-] 502 - 04/2016 27 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on �LC-�t�L� 0-5'201.7. CONTRACTOR By: _�g Steve Kirschner print name _ ITS: (circle one) Chairman/Presiden ice President CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California A, a A 7L I Ai 04 ayor C>gty_ Clerk � �11-4�-,�;� AND INITIATED AND APPROVED: By. Kristen,Paulino " print name Director of Public Works ITS: (circle one _ ecreta Chief Financial Officer/Asst. Secretary - Treasurer REVIEW APPROVED: ity anager 16-5093/Hardy & Harper CC-] 502 - 04/2016 28 EXHIBIT A (Contractor's Proposal) 16-5 09 3 /federal ly-funded-constructi on -contract. doc/rev. 2#2016 SECTION C PROPOSAL for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or Jump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY -ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern overextended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount Of] 0%of Amount which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond forjL% ", as the case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda here, if any: C-2 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) PROJECT BASE BID: Basis of Award ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ......................................... C-2.2 to C-2.8 ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ........................................ C-2.9 TO C2.14 1. ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET r' �u . $ C��v BID IN FIGURES 2. ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS I AND 2) $ 3V 1 000 BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.2 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract :. - Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $ 00v $ l7�000 2 - - TRAFFIC CONTROL PLAN 1 LS $ �OD $ 1 oav 3 FURNISH PROJECT TRAFFIC CONTROL 1 LS $ $ '30 0:5;0 4 - FURNISH AND INSTALL SIGNING AND STRIPING 1 LS $ I� 1�•7® $ )f 5 -- PROJECT SPECIFIC SWPPP 1 LS $ I)oO $ 1 ovo REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). ®c)�l (�(� 6 1 (INCLUDES ALL APPURTENANCES,CURB g EA $ $ GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT A 0.17' ASPHALT I ' w �� 7 3 RUBBER HOT MIX (AR M) WET 2,800 TN $ r V ` Iq $ 1 PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. 7 EA $ � $ S I �60 9 5 ADJUST STORM DRAIN MANHOLE TO GRADE. 10 EA $ goo $ 00® REPLACE WATER VALVE BOX Q 10 6 ASSEMBLY AND ADJUST TO 11 EA $ 0 L/ $eco— GRADE PER HB STD PLAN 612. C-2.3 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' (� 11 7 TO ZERO FROM NEW FINISHED 22,400 SF $ $ SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. 12 INTENTIONALLY LEFT BLANK COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.34' �o 13 g 138,000 SF $ $ FROM NEW FINISHED SURFACE PER PLANS 14 INTENTIONALLY LEFT BLANK CONSTRUCT NEW 0.17' B-PG-70- 10-RAP A.C. BASE COURSE �(J (, 15 8 OVER 95% COMPACTED 1,700 TN $ 1U I "I $ SUBGRADE PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. 16 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION PREPARE CORNER �;00 �® 17 g ,AND 3 EA $ $ I RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES SLOT PAVEMENT, AGGREGATE 18 10 900 LF $'s BASE, LOT DRAINS, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD �U! go FROM WALK TO EXISTING 19 11 SLOPE, RELOCATING 13,500 SF $ $ IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.4 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const : Contract Unit Extended No : No. Description (Quantity Unit Price Amount 20 INTENTIONALLY LEFT BLANK REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY/ALLEY APPROACH I j I O� �� I 21 12 ("W" AND TYPE SHOWN ON 690 SF $ " $ ' PLAN) PER STD PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. INCLUDES SLOT I r l`• �� �Z �p/o 3I 22 13 (ITEM 21170 SF r $ $ 1 PAVEMENT, AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB PER HB STD PLAN 201 (CF=8"). (INCLUDES 23 14 SLOT PAVEMENT, AGGREGATE 225 LF BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT LOCAL DEPRESSION PER HB STD PLAN 302. (INCLUDES SLOT ®D� 3 0190 24 15 PAVEMENT, AGGREGATE BASE, 1 EA $_ $ AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC i q 25 16 SIGNALS AND LIGHTING 52 EA $ 1 � $ SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". IN C-2.5 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract - -Unit Extended No. No., Description Quantity Unit Price Amount REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP AND ROOTS TO 24" BELOW TOP ©©® �j 26 17 OF SIDEWALK/GRADE WITHIN 44 EA $ PROPOSEDIMPROVEMENT AREA. PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. 27 INTENTIONALLY LEFT BLANK FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED BY AGENCY. (INCLUDES ALL !.So 31 ,760 28 18 2500 SF $ $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN �'%'Jt '� / /„ �/ t / 7.36 29 19 IDENTIFIED BY CONTRACTOR 90 CY $ $ 1 AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 30 20 EDISON. CONTRACTOR TO 3 EA NOT CONTRACTOR COORDINATE WITH ERICK OEN BID ITEM AT (714) 895-0242. 31 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S-'a, 053, S-054 AND S-055. ,� fl�� � d�� 32 21 1 EA $ $ CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT (714) 593-7645. JADJUST MONITORING WELL Foo 1, 00 33 22 COVER TO GRADE. .2 EA $ $ C-2.6 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER FIB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 11300 34 23 BUSHES OR GROUND COVER 48 EA $ $ AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND PLANT NEW 10' BROWN TRUNK HEIGHT TRACHYCARPUSFORTUNEI PALM TREE PER FIB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF ��� 35 24 EXISTING LANDSCAPING, 6 EA $ $" BUSHES OR GROUND COVER AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). C-2.7 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid 'Const Contract: Unit Extended No. No. Description Quantity Unit Price Amount CONSTRUCT AND / OR REMOVE AND RECONSTRUCT 4" THICK PERVIOUS COLORED STAMPED CONCRETE IN MEDIANS PER 36 25 SPECIFICATIONS AND HB STD 780 SF $ 13 $ 01! PLANS 711. (ITEM INCLUDES REMOVAL OF EXISTING GROUND COVER, AND SLEEVING OF EXISTING IRRIGATION LINES.) FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED I VVV V -3 00V r1 37 - - EQUAL COATING ON THE NEW 3 EA $ $ SJ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ TotalAmount Bid in Words:............ ........... . ... ...... .................... * .. ................................ .. .... ..... .............. .. .. .............. ... .. j .. ..... ...... . ... ...... . . . . . ...... . ... ..... ..... ..... ....... .... ..... ....... ... * .............. ... ** ...... ..... .... . . ............. I k; �'/s:;//7d WOIJV� - I/O CepfS C-2.8 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.9 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit _ Extended No. No. '' Description Quantity - Unit Price Amount 1 LS 1 1 00 0 )11000 1 -- MOBILIZATION $ 1 $ 2 TRAFFIC CONTROL PLAN 1 LS $ 1,0oo $ 11000 - - 3 FURNISH PROJECT TRAFFIC 1 LS $ ®off% $ CONTROL 4 FURNISH AND INSTALL SIGNING 1 LS $ � 710 ' 7� $ ` ` ( /� / AND STRIPING PROJECT SPECIFIC SWPPP 1 LS P Wo 5 - - $ $ REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). ALL �'(��� / r �l �� ) 6 1 (INCLUDES 3 EA $ $ APPURTENANCES,CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCTAO.17' ASPHALT 7 3 RUBBER HOT MIX (A HM) WET 2,600 TN $ PROCESS OVERLAY. $ 4 ADJUST SEWER MANHOLE TO 12 EA $O� — $ tC/ 00 GRADE. 9 5 ADJUST STORM DRAIN EA Koo $$ 0c) MANHOLE TO GRADE.2 REPLACE WATER VALVE BOX �oV 10 6 ASSEMBLY AND ADJUST TO 23 EA $ $ () 700- GRADE PER HB STD PLAN 612. C-2. 10 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 36,400 SF $ e-J—) $11 SURFACE PRIOR TO 0.1T ARHM OVERLAY PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 12 8 FROM NEW FINISHED SURFACE 13,700 SF $ a� $ PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.34' 3 0 1 13 9 49,900 SF $ $ FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. ® 14 10 PAVEMENT TO A DEPTH OF 0.67' 7,300 SF $ $ FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17'AND 0.50' B-PG-70-10-RAP A.C. BASE 15 9 & 10 COURSE OVER 95% 1,000 TN $ COMPACTED SUBGRADE PRIOR TO 0.17' ARHM OVERLAY. RAISE SURVEY WELL MONUMENT TO GRADE AND 16 11 PREPARE CORNER RECORD 1 EA $� $ (PRE- AND/OR POST - CONSTRUCTION). SET SURVEY MONUMENTATION AND PREPARE CORNER ��� 17 12 4 EA $ $ % RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 13 SLOT PAVEMENT, AGGREGATE 405 LF $ $ BASE, LOT DRAIN, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2. 11 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount' REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING jo 19 14 SLOPE, RELOCATING 3,400 SF $ IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) SAWCUT AND REMOVE EXISTING SIDEWALK AT EXISTING AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 3. (ITEM 3,000 20 15 INCLUDES REMOVAL OF 3 EA $ $ SIDEWALK, 6 LF OF NEW SIDEWALK, NON -CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR AGENCY APPROVED EQUAL AND MULCH.) REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY ("W" AND TYPE iI i.1 1 I 21 16 SHOWN ON PLAN) PER STD 750 SF $ PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. INCLUDES SLOT i I 011-74 22 17 (ITEM 1,740 SF $ $ PAVEMENT, AGGREGATE BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 23 INTENTIONALLY LEFT BLANK 24 INTENTIONALLY LEFT BLANK )® C-2. 12 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const > Contract Unit Extended No. No.;:. Description Quantity_ Unit Price Amount INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 18 SIGNALS AND LIGHTING 22 EA $ $ SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 26 19 AND ROOTS TO 24" BELOW TOP 4 EA � �� $ kX2��� $ / OF SIDEWALK / GRADE WITHIN PROPOSEDIMPROVEMENT AREA. FURNISH AND INSTALL BRIDGE DECK MEMBRANE OVER ENTIRE BRIDGE DECK SURFACE 3c) ovo 27 20 51000 SF $ V� $ (INCLUDES ALL ASSOCIATED WORK PER PLANS AND SPECIFICATIONS). FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED BY AGENCY. (INCLUDES ALL �,O 3 28 21 2,500 SF $_ $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 77, 7 29 22 IDENTIFIED BY CONTRACTOR 90 CY $ $ s AND VERIFIED BY AGENCY. 30 INTENTIONALLY LEFT BLANK ADJUST VERIZON VAULT/MANHOLE TO GRADE BY NOT A CONTRACTOR 31 23 VERIZON. CONTRACTOR TO 4 EA BID ITEM COORDINATE WITH RAY ROUNDTREE AT (714) 375-6760. J C-2. 13 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid : Const Contract Unit ::. Extended No. No.. Description Quantity Unit Price Amount ADJUST OCSD SEWER MANHOLE TO GRADE, PER 32 24 OCSD STD. PLANS S-053, S-054 & 2 EA $ ,, �``�1 �/V $ S-055. CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT 714-593-7645. 33 INTENTIONALLY LEFT BLANK FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, UrJ(�j / 34 25 BUSHES OR GROUND COVER 1 EA $ $ AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). 35 INTENTIONALLY LEFT BLANK 36 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED] �" 37 - - EQUAL COATING ON THE NEW 6 EA $ I ` $ / CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ 3 ()o � Total Amount Bid in Words:' �v`��l�/ ��1� "'` % S'x C-2. 14 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 PWC J Dollar %', of Items) Sub'e mractor License Registration # Amount Contract Number fn SV {' ivy fi �(U aYA IY)qr' M _7100 3 av Kti ftk I I Ave U ys(3 C-16 JC0000100 151 ot1 1 By submission 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 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 8th at Santa Ana CA Date City State Steve Kirschner being first duly sworn, deposes and says that he or she is Vice President of Hardy & Harper, Inc the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived. or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Steve Kirschner (Hardy & Harper, Inc) Name of Bidder Signature of Bidder ice President 1312 P. Warner Ave., Santa Ana, CA 92705 Address of Bidder 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 Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, Project CC No. 1502, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: Hardy & Harper, Inc Contractor By Steve Kirschner - Vice 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 W No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 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: 5/8/17 Hardy & Harper, Inc Contractor XWA By Steve Kirschner - Vice President Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Hardy & Harper, Inc Bidder Name 1312 East Warner Ave. Business Address Santa Ana California 92705 City, State Zip ( 714 ) 444-1851 Telephone Number 215952; A, C-8, C12 State Contractor's License No. and Class 3/13/63 Original Date Issued 12/31/17 Expiration Date The work site was inspected by Corey Kirschner of our office on May 8th , 2017 . The following are persons, firms, and corporations having a principal interest in this proposal: Fred T. Maas, Jr - President, Treasurer Sly Steve Kirschner - Vice President - Dan T. Maas - CEO Kristen S. Paulino - Sec The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Hardy & Harper, Inc Company Name Signature of Bidder Steve Kirschner - Vice President Printed or Typed Signature Subscribed and sworn to before me this day of , 201_ NOTARY PUBLIC NOTARY SEAL C-8 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 ❑ 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 Ora F77TINA PHAM COMM. #2149384Notary Public -California N ORANGE COUNTY y Comm. Expires Apr 17, 2020 K Seal Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this ._ 8__ day of May 20 17 _, by Date Month Year (and (2) Name of Signer( proved to me on the basis of satisfactory evidence to be the person( who appeared before me. Signature 1—'JAA Y Sign Lure 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: Bidder's Information Number of Pages: I___ Signer(s) Other Than Named Above: Document Date: May 8, 2017 None r;-C ,..,Y.,C:L`c„{`z%C: �; e Cz,,.s 02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910 Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, protect work within public streets, an area containing high ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert."}. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. 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 Simi Valley 2929 Tapo Canyon Road, Simi Valley, CA 93063 Name and Address of Public Agency Name and Telephone No. of Project Manager: $1,213,960.50 Contract Amount Fuad Shamout; 805-583-6788 Street Rehabilitation "Type of Work Provide additional project description to show similar work: Annual Minor Street Rehabilitation 2. City of Walnut; 21201 La Puente Rd., Walnut, CA 91789 Name and Address of Public Agency Name and Telephone No. of Project Manager: Natalie Avila; 909-594-9702 11/15 _ Date Completed $1,077,000.00 Resurfacing Project 11/15 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Area 1 & 2 Street Resurfacing Proiect 3 • Citv of Palm Desert; 73-510 Fred Waring Drive., Palm Desert, CA 92260 Name and Address of Public Agency Name and Telephone No. of Project Manager: Bo Chen; 310-370-5099 $639,204.74 Street Rehabilitation 2/16 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Portola Ave STP Rehabilitation Project C-9 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. Mike Amundson Name of proposed Project Manager Telephone No. of proposed Project Manager: 714-444-1851 Schleisman Rd Overlay $333,333.00 Road Overlay work 8/15 Project Name & Contract Amount Type of Work Date Completed Minor Street Maintenace Phase I $1,543,000.00 Street Maintenance 4/14 Project Name & Contract Amount Type of Work Date Completed Phase 3 Street Rehabilitation $1,075,484.00 Street Rehabilitation 6/14 Project Name & Contract Amount Type of Work Date Completed 2. Dennis Bevle Name of proposed Superintendent Telephone No. of proposed Superintendent: Street Improvement & Main Street Bridge Rehab $1,188,570.00 Street Improvement 1/15 Project Name & Contract Amount Type of Work Date Completed Foothill Blvd Pavement Rehabilitation $1,076,200.00 Pavement Rehabilitation 11/1.5 Project Name & Contract Amount Type of Work Date Completed Street Resurfacing Project $1,187,987.00 Resurfacing Project 12/14 Project Name & Contract Amount Type of Work Date Completed C-1.0 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/Publ icWorks/SB854FactSheet_6.30.14.pdf DIR's Contractor Registration Link — Cal (844) 522-6734 littps://efiling.dir.ca.gov/PWCR/ActionServIet?action=displayPWCRegistrationFonn DIR's Contractor Registration searchable database: https://efiIiiig.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 1,725.5. 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: 5/8/17 PWC Registration #: 1000000076 Hardy & Harper, Inc Contractor By Steve Kirschner - Vice President Title C-11 5/9/2017 California Department of Industrial Relations - Contact DIR Public Works : search Public Works Contractor (PVVC) Registration Search This is a listing of current and active IPWC registrations pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720 of the California Labor Core.) Enter at least one search criteria to display active registered public works conaactor(s) matching your selections. Registration Year: Current Fiscal Year: 2016/17 PWC Registration Number: 34567890 Contractor Legal Name: tiardy & Harper, Inc License Number: example: 123456 Licen—kup County: Select County Search Results One registered contractor found. 1 .Details Legal Name Registration County City Registration Expiration Number Date Date View HARDY & HARPER, INC. 1000000076 ORANGE SANTA ANA 06/08/2016 06/30/2017 Export as !:",'d I fli). v2.201 6010 1 V you L3 https://efiling.dir.ca.gov/PWCR/Search.action 1/1 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 1.0% 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. Hardy & Harper, Inc Contact Person: Steve Kirschner Contact Phone: 714-444-1851 Signed: Date: 5/8/17 *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 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to www.calregs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System ;GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Requirements. Retain the original form in vour grant file. GRANTEE NAME: CITY OF HUNTINGTON BEACH GRANT NUMBER: TRP7-16-0001 2000 Main Street, Huntington Beach, CA 92648 PRIMARY CONTACT NAME: JAMES WAGNER PE, SENIOR CIVIL ENGR, PUBLIC WORKS DEPT. CONTRACTOR NAME: Hardy & Harper, Inc AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Steve Kirschner - Vice President MAILING ADDRESS: 1312 E. Warner Ave., Santa Ana, CA 92705 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of'Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, 1 declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I have disclosed all such occurrences in an attached signed statement that explains the , facts and circumstances of the listed events. Signature Date 5/8/17 C-1 3 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq.- or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or (j) The person or entity has violated an Order issued in accordance with section 183ft or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remcdiate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) "The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc proposed subcontractor MA-,n ff1'-1 hereby certifies that he has X has not _, participated in a previous contract or subcontract subject to the equal o ortunity 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 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc proposed subcontractor hereby certifies that he has X has not —, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 1 1 1 14, 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 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid EQUAI, EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder ('Hardy & Harper, Inc , proposed subcontractor �iM� sto r-, p E I C t L , 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, 1 1 1 14, oi- 1 1246, 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 (111 CFR 60-1.7(b) ( I)), 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 Cl'R 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO- I ) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual EQUAL. EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc Exhibit 12-11 Sample Bid proposed subcontractor SC)6ffV —So rye , 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, 1 1 1 14, 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 (I I 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 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid EQUAL EMPLOYMENT OPPORTUNTI'Y CERTIFICATION The bidder Hardy & Harper, Inc proposed subcontractor Q I C- `tom Se-1(y)Z,-Q- , 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, 1 1 1 14, 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 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc , proposed subcontractor hereby certifies that he has X , has not , participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 1 1 114, 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) ( I ) 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 October 2016 C-15 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 If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-16 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-17 October 2016 Local Assistance Procedures Manual Exhibit 12-H Noneollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of DEPARTMENT OF PUBLIC WORKS. Sample Bid In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above 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-18 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 debannent 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-19 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 Forn-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-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ®a. contract ® a. bid/offer/application ® a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter_ f. loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: El Prime Subawardee Tier if known NONE Congressional District, if known 6. Federal Department/Agency: N/A 8. Federal Action Number, if known: N/A 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) NONE Congressional District, if known 7. Federal Program Name/Description: N/A CFDA Number, if applicable 9. Award Amount, if known: N/A b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) N/A (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S NONE actual ❑ planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in -kind; specify: nature e deferred value F 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 l l: Hardy & Harper, Inc has not paid any funds in regards to this project. (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ❑ No }� t6. 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: Steve Kirschner 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: Vice President 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.: 714-444-1851 Date: 5/8/17 Federal Use On Authorized for Local Reproduction Standard Forni - LLL Page 12 of 22 C-21 October 2016 a r 00 N Li uu N 0 0 c c vi 0 0 c c> 0 0 c c > 0 0 c c> 0 0 c c> O O c c> 0 0 0 0 0 0 0 0 10 0 0 0_ 1 0_ 0 Q O o E E E E I E E E E E E E E '� E E E E E E .-i Ln i/} O Ln E .� Ln iv iv O Ln E i O L!1 .-I Ln iv iv .� L!1 O iv iv Ln .� iv L!1 O Ln i/} O L!1 c-I L!1 i/} i/} m v v {/} {/} {/} v v t/} 11 �. {/} v v I.l {/} v v {/} Ll v {/} {/} I.l v �. {/} v v LL 3 v v v v 0 v v 0 v v 0 v v 0 v v 0 v to v to v to v to v c ❑ El El i ❑❑❑❑ ¢ ❑ ❑❑ ¢ ❑❑❑ ¢ ❑❑❑ ¢ ❑❑ ¢ GJ u E a g m I'il. LU z m o > L � � o E E U 7 R z 41 7 z 0� N c o c GJ oc u v � J Q 6 Ln Y E c au �I v — c u O u y a m u m O OE Q Ln 0 .Q v 0 66 E GJ a� J m GJ m r Z O O U �p O J � O N N 41 41 41 N � f0 �0 l0 l0 l0 �0 Ln E Z V Z V Z u Z u Z u Z u N V _ ¥ ƒ 0 )/{ \.. f � ( © co _ 0 \\/ E \ - 0 C k § / E . + a . . 0 § . o g e z ±\) nz;--E \\2 / ca §\ Co j E §� . f � 2 { \ \ 12 C U) CL CL /U) { _a z \� / ± � / 0 \\{ \ z \. \ \ § z A U Local Assistance Procedures Manual Exhibit 17-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors INSTRUCTIONS — FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. S. Contractor/Consultant - Enter the contractor/consultant's fine name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied - .Enter description of work, services; or materials provided. Indicate all work to be perfonned by DBEs including work performed by the prime contractor/consultant'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. 10. Company Name and Business Address - Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE. The Non -DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment - Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 1 S. Original DBE Commitment Amount - Enter the "Total Claimed DBE Participation Dollars" from Exhibits 15-G or 10-02 for the contract. 16. Total - Enter the sum of the "Contract Payments" Non -DBE and DBE columns. 17. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 19. Phone - Enter the area code and telephone number of the person signing the form. 20. Date - Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature - A Local Agency Representative must sign their name to certify that the contracting records and on -site performance of the DBE(s) has been monitored. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 23. Phone - Enter the area code and telephone number of the person signing the form. 24. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 C-31 July 23, 2015 5/9/2017 California Department of Industrial Relations - Contact DIR Fll �Mi !:jlI1+74rjka3 f 1 w lv' 4 ioa l:t public Works , Pull,,.. WJ ris Can' ru t�r,PWr) Ra.gis",ratiJr. Search Public Vlorks ContrcdCtor (PWC:) Re?gist—" i :ion Search This is a listing of current and active PWC registrations pursuant to Division 2, Part 7, Chapter! (commencing with section 1720 of the California Labar Code.) Enter at least one search criteria to display active registered pubFc works contractors) matching your selections. Registration Year: Current Fiscal Year: 2016/17 PWC Registration Number: , example: ,121341567890. Contractor Legal Name: V&E . License Number: example_.123456 Contractor License' okup County: Select County Search Results One registered contractor found. 1 Details Legal Name Registration County -City Registration Expiration Number Date Date View V&E TREE SERVICE, INC 1000001936. ORANGEORANGE 05/1.7/2016 06/30/2017 Lxport as: .._l l P01 v2.20160101 https:Hefii I i ng.di r.ca.gov/PW C R/Search.action 1 /1 5/9/2017 California Department of Industrial Relations - Contact DIR �i (1C Ji�G.t.CtJfrll�! Alai '_ .,. halt t y Self App! er 'ip Soar#�, Public Works , Public Works(PWC) Regis0-atiur: Starch Public Works Contruetor (PWC) Registration S,I Larch This is a listing of current and active PWC reg,strations pursuant to Division 2, Part 7, Chapter 1 (cornmencing with section 1720 of the California Labor Code.) Enter at least one search criteria to display active registered public works conlractor(s) matching your selections. Registration Year: Current Fiscal Year: 2016/17 PWC Registration Number: example: 123456789,0 Contractor Legal Name: EBS Utilities Adjusting, Inc License Number: example:_ 123456 .., C-tractor I_icenr! ! —,up County: Select County .o�C Search Results One registered contractor found. 1 Details Legal Name View . EBS UTILITIES ADJUSTING, INC https:Hefii I i ng.di r.ca.gov/PW C R/Search.action 1 /1 5/9/2017 California Department of Industrial Relations - Contact DIR it '-�j i'j Public Works ' Public Work,; Cont rac"or Rgpstrat�on Sccvch PUblic Works Contraor_(PWC" Registral.'Jon Searo-, This is a listing ofcurrent and active PWC registrations pursuant to Division 2, Part 7, Chapter 1 (commencing with section 1720 of the California Labor Code.) Enter at least one search criteria to display active registered public works con Ira ctor(s) matching your selections. Registration Year: Current Fiscal Year: 2016/17 v ----- ----- PWC Registration Number: example: 1234567890 Contractor Legal Name: CaseLand License Number: �:,example: 123456 -ict, -inse Conti , or Lico 1-00['Up County: Select County -------------- Search Results One registered contractor found. I Details Legal Name Registration County City Number View CASE LAND SURVEYING, INC. 1000001533 ORANGE ORANGE Registration Expiration Date Date 06/21/2016 06/30/2017 Export as, L 1 *' v2.201 6011 C 1 https://efiling.dir.ca.gov/PWCR/Search.action 1/1 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31 ° (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This its to acknowledge receipt and review of Addendum Nu e, date above Compahy Name By to rSGhnet - dlC� H B119-Dbte _ rresldt All bidders must acknowledge and include the receipt of this Addendum with.y9ur bid.proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thru 0-9 (9 Sheets) Add new pages "APPENDIX 0 PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX 0 PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix O to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This is to acknowledge receipt and review of Addendum Num o, dated ve Inc _ ompany Name y s-�(� �1rsC�tner -VtC,� Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: The City of Huntington Beach 2. Contract DBE Goal: 6% 3. Project Description: Pavement Resurfacing and/or Rehabilitation Projects 4. Project Location: Adams Ave. /Beach BI. to Newland St. and Atlanta Ave. / Beach BI. to Newland St. 5. Bidder's Name: Hardy & Harper, Inc 6. Prime Certified DBE: ❑ 7. Bid Amount: -+ (r 38?Jr 00 O 8. Total Dollar Amount for ALL Subcontractors: V,84- , 4-i2.00 9. Total Number of ALL Subcontractors: 10. Bid Item 11. Description of Work, Service, or Materials 12. DBE Certification 13. DBE Contact Information 14. DBE Dollar Number Supplied Number (Must be certified on the date bids are opened) Amount fit A -T liuc�ing, Hauling �utGhClsPi 3r 2-- LMC-T(Qng0tt i 2=-51 flVA1D►1 mot• cjRrl) 10-3B2 jg2rgOD.c)o ftTRiB 2 of OIL (K7rT(aO) JM(VPq vateyr g2509 Local Agency certifies that all DBE certifications are valid and informs 15. TOTAL CLAIMED DBE PARTICIPATION qZ qW .O 6 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 "Subconi or List" mitted with your bid. Written confirmation of ea is d DBE i equired..01 5/9/17 1 . Preparer's Signature 17. Date Steve Kirschner 714-444-1851 18. Preparer's Name Vice President 20. Preparer's Title 19. Phone 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 July 23, 2015 C-23 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. STPL-5181(188) Bid Opening Date 5/9/17 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 6 % 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 followin- items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement Focus Journal 5/5/17 Trade Journal 5/5/17 Twitter 5/5/17 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 Please see accompany DBE goodfaith documents C-24 Page 15-1 OB 12-04 June 29, 2012 Exhibit 15-H DBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items N Of (Y/N) Contract Please see accompany DBE goodfaith documents 100% of Subcontractor's quote 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: Traffic Loops Crackfilling; 946 S. Emerald St., Anaheim, CA 92804 714-520-4026 (Price too high) Treesinith; 1551 N. Miller St., Anaheim, CA 92806 (714) 996-6037 ( Price too high) Names, addresses and phone numbers of firms selected for the work above: Smithsons Electric; 1938 E. Katella Ave., Orange, CA 92867 (714) 997-9556 V & E Tree; PO Box 3280, Orange, CA 92865 (714) 997-0903 E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or inforirnation related to the plans, specifications and requirements for the work which was provided to DBEs: Please see accompany DBE goodfaith documents Page 15-2 June 29, 2012 C-25 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: Please see accommanv DBE aoodfaith documents 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 Please see accompany DBE aoodfaith documents H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): Please see accompany DBE goodfaith documents NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. "PLEASE NOTE: HARDY & HARPER, INC IS SIGNATORY TO THE OPERATOR CEMENT MASON, CONTRACTOR LABORER UNION AND DOES ALL THEIR HIRING THROUGH THESE UNIONS. Page 15-3 OB 12-04 C-26 June 29, 2012 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 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. hnclude 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). 1.6. 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. C-27 Page 2 of 2 July 23, 2015 I cc N Q W y OC C C 0 010 C O C O C C C 0 C 0 > C C C C 0 0 > C C 0__ C 0 C 0 > 10 C C 0 C 0 C 0 > 10 C C 0 C O C O > o I E E E E E ci L!1 O ci Ln ci ti r O ci Ln ci L ci L!1 O L!1 ci ci L ti � N O ci Ln ci L ti i O ci Ln ci L ti i v O ci Ln ci L � V V v V lv V L V V lv V V v LL V V lv lv V V LL V V [/T V tv V LL V V VT V lv V LL V V VT V lV V LL 4- 3 O O a ❑ o a ❑ ® ❑ m a ❑ ❑❑ a mllimilrilm allilillorilahillilid m m f6 t/ CE C @ C Z O i+ o o ° Z U Z Z 1-il-E I g— M U N U O O c �.c E m m m m m m m F- n E U U m C N m Y N U p E ri� Eo H H H H H H H m a U 4 � O O c O o CD O U O C CD c � u CM L U � W .2 (\ m p •�"- E � ao Z Z Z Z Z Z o Z M O � U cTi--- c Q a mD a2 U a N U f6 4- U O C6 >; o Q1 a (n N rn N C m O Q > 2 U O O M U to m m O- 2 m C m CL T U o > a) M O U -_ o Za N le > > Q Ta c CO il Y U W N C N m m O m X �o 0) s cp LLI Z U a L a E.N a O m m CO a {n m f� C co c) >, O2 E m O N U U N O Z W 0 M � U c- N m O CL LO N j a d U N N W a O) N 00 O c` N o {n _� - p 00 m tD X n J F- 0) F- .W N m t r- (D J N NO O m a Q� �O n > o n inU Y) w 00 N UU a _jrn cnrn U) N — — - — a� LL 'O N o N L o U •� — O O N c Y d m 7 m N E E d m C ) m m C o m > E o mr N m J — O T U c N L) C ` m a) Q c c>i Cep U in C ) LO _ U U p 0 0- U� �:3Lr5 co O O w E W O O N N a ern m � w O o O 0 O- 0 O 0 00 O o � CV 0 U 0] U O a0 N O � O (� � O O ('(� N E Z N � CO M CO M N Cp � � � O � N O E m c c a� 3 Y t- O LO 3 E Cp 6 - E o c V c a V ° O V 2 N c ♦- - - U -� W a w K F- m O O ° O o s z m c Q 0 w o I- o N w N � J U � d 0 3 o E cu m U O C Z N Z ) 5 O v '0 K c -0 m U a) o Z o W N 3 c O N w oo m c U E.n Q w� w 0 3 ~ o N Q L_ (� F- o, U 1= Y L a LLl O N 3 o U U > w a) U) ^ 0 O N N N m W C m � _m Z � V1 cO `ma a a m We c O 42 a � N � O � O U m 'c LU Lo E C Q n £: U J w O a o O Z O U > co O m o u'i m 3 c O C N I From: Tina Pham Bcc: "DarrellCbAShoonaLandscaQe.carr,"; Lb5Aaz ll rtsalasinc.com'; "ruel.delcastillo-d�coastur "inf(aldavidstreeservice.com"; "dfmcampos(a)aol com"; " rstuglobalroadsealing_com'; "ahernandez(d)herconcomgany.com"; "accounting(wkatolandscaoin_g:com'; "scyjunior,1d)ao1com"; "ktetreault(&saddlebacksuiveys.com'; "info(alsocaltreecare.com'; "Christopher Stjamesc)aol.com"; "dawn astatewidestripes.com"; "brenda(d;supersealan i�stripe.c2pL; °trafficloopl @sbcglobal.net°; "i ramirezn treesm ith. n et" Subject: City of Huntington Beach Date: Monday, May 08, 2017 4:13:33 PM Attachments: ADDENDUM 2-NEW APPENDIX 0-Bridge Membrane Soc.odf CC-1502ADDENDUM 1ReplacementPagesA-2E-6E-31.12_df First Half CIVILSPEC CC1502.pdf Good Afternoon, This is a follow up for the advertisement that was sent to you via email/fax for the City of I-luntington Beach —Adam Ave & Atlanta Ave Rehabilitation. If interested please provide a quote by 5/9/17 C� 2:00 PM. Specs and plans are attached to this ernail for your reference. 1-hank you, 7,w',1 Pk2 v1 t Hardy and Harper, Inc. 1312 East Warner Avenue Santa Ana, CA 92705 Direct: (714) 352-7026 Office: (714) 444-1851 Fax: (714) 444-2850 Hardy a*L& Harper LS, o� p-rcv_c(� s wSvY of Rwavvdaw Orp- .a Co -re, http://orpliancareinitiative corn 5/10/2017 Ad Proofs I Adam Ave - Atlanta Ave FOCUS JOURNAL AD The advertisement below was published in the DBE GoodFaith Minority, Women, Small, & Disabled Veteran Business Focus Journal at www.dbegoodfaith.com on 05/05/2017 02:29 PM. The ad ran from the publication date until the bid date listed on the notice. R�ar�dl, & Harper, ,o,: HardyHarper,& Inc. is seeking qualified DBE Outreaoch rdinator .................._.. - _.............. Corey Kirschner Co t c't 1312 E. Warner Ave. Santa Ana, CA 92705 Tel: (714) 444-1851 ext. Fax: (714) 444-2801 Email: cKirschner@hardyandharper.com Adam Ave - Atlanta Ave STPL-5181(188) City of Huntington Beach Huntington Beach, Orange County, CA 1i:.tJu` 05/09/2017 at 2:00 Project D e We are seeking quotes for: Striping, Trucking, Manhole, Survey, Detector Loops, Tree Removal, Landscape, Irrigation. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. https://www.dbegoodfaith.com/submit_order/docs/ad_proofs.php?docs_adid=38437 1/3 5/10/2017 Ad Proofs I Adam Ave - Atlanta Ave TRADE JOURNAL AD The advertisement below was published in the DBE GoodFaith's Minority, Women, Small, & Disabled Veteran Business Trade Journal, Outreach Impact, at www.trade.dbegoodfaith.com on 05/05/2017 02:29 PM. The ad ran from the publication date until the bid date listed on the notice. �a�rdy H a rp. e,, n' ,. Hardy & Harper, Inc. is seeking qualified DBE Corey Kirschner Adam Ave - Atlanta Ave Contact 1312 E. Warner Ave. STPL-5181(188) Santa Ana, CA 92705 Tel: (714) 444-1851 ext. Fax: (714) 444-2801 Email: cKirschner@hardyandharper.com City of Huntington Beach Project Location Huntington Beach, Orange County, CA F5,f d P) �' 14, (-., '-1 1 -- ........ .. 05/09/2017 at 2:00 Proi;'e(1 We are seeking quotes for: Striping, Trucking, Manhole, Survey, Detector Loops, Tree Removal, Landscape, Irrigation. We are an equal opportunity employer. The plans and specs are available for your review at our office or we can fax you the proposal schedule. Bonds will not be required from qualified subcontractors. TWITTER POST The Twitter post below was published at www.twitter.com/dbegoodfaith on 05/05/2017 02:29 PM. DTDBE GoodFaith Inc. Hardy & Harper, Inc. is seeking DBE s in Huntington Beach dbegoodfaith.com/good-faith-ad.-.. https:/AAtww.dbegoodfaith.com/submit-order/docs/ad_proofs.php?docs-adid=38437 5/10/2017 Ad Proofs I Adam Ave - Atlanta Ave ,III,- �7 1 t,' https://www.dbegoodfaith.com/submit—order/docs/ad_proofs.php?docs adid=38437 3/3 5/10/2017 Sol iciation Log I Adam Ave - Atlanta Ave SOLICITATION LOG This document contains the solictations logs for: Project: Adam Ave - Atlanta Ave Contract/Bid #: STPL-5181(188) Awarding Agency/Owner: City of Huntington Beach Certification # of Firms DBE 25 ..... Total: 25 ASHOONA LANDSCAPE 1248 WEST SIXTH STREET • SANTA ANA, CA, 92703 • Cert: DBE Cert. #42320 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission AXIOM ENGINEERING & SCIENCE CORP 1322 BELL AVE. STE.1 G • TUSTIN, CA, 92780 • Cert: DBE Cert. #33641 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address jphou@axiomes.net Fax Transmission Send Date $Time Delivery Status 2017-05-0514:39:21 PST Delivered Fax Number Send Date & Time Tranmission Status (714) 247-1006 2017-05-05 15:40:35 PST Successful BERT W SALAS, INC. 10769 WOODSIDE AVENUE, SUITE 201 • SANTEE, CA, 92071 • Cert: DBE Cert. #77 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address bsalaz@bertsalasinc.com Send Date &Time Delivery Status 2017-05-05 14:39:21 PST Delivered https://www.dbegoodfaith.com/submit_order/docs/solicitation_Iog.php?docs adid=38437 IR 5/10/2017 Sol iciation Log I Adam Ave - Atlanta Ave Fax Transmission Fax Number Send Date & Ti11 me Tranmission Status (619) 258-3515 2017-05-05 15:40:05 PST Successful BLUE OCEAN CIVIL CONSULTING 201 W. HARVEY AVENUE • SANTA ANA, CA, 92707 • Cert: DBE Cert. #43614 (Women -owned) was identified in the California Unified Certification Program database on 05/05/2017. BUTLER & SON TRUCKING 441 E. MONTWOOD AVE. • LA HABRA, CA, 90631 • Cert: DBE Cert. #15094 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status No Email Address n/a n/a Fax Transmission Fax Number Send Date & Time Tranmission Status (714) 871-1834 2017-05-05 15:41:32 PST Failed CALIFORNIA PROFESSIONAL ENGINEERING INC 929 OTTERBEIN AVENUE, UNIT E • LA PUENTE, CA, 91748 • Cert: DBE Cert. #31277 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. ... Email Transmission Email Address van@cpengineeringinc.com Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number Send Date &' 'Time-, Tranmission Status (626) 810-1322 2017-05-05 15:40:09 PST Successful CALLAND ENGINEERING, INC 576 E. LAMBERT ROAD • BREA, CA, 92821 • Cert: DBE Cert. #40329 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status https://www.dbegoodfaith.com /submit_order/docs/solicitation_log.php?docs_adi d= 38437 2/7 5/10/2017 Soliciation Log I Adam Ave - Atlanta Ave lee@callandeng.com 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number Send Date &Time Tranmission Status (714) 671-1090 2017-05-05 15:41:57 PST Successful COAST SURVEYING, INC 15031 PARKWAY LOOP, SUITE B • TUSTIN, CA, 92780 • Cert: DBE Cert. #2128 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address rueI.deIcastillo@coastsurvey.com Fax Transmission Fax Number (714) 918-6277 DAVID'S TREE SERVICE Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 15:40:19 PST Successful 19051 GOTHARD ST. • HUNTINGTON BEACH, CA, 92648 • Cert: DBE Cert. #42628 (Minority -owned) was identified in the California Unified Certification Program database on 05105/2017. Email Transmission Email Address inf@davidstreeservice.com Fax Transmission Fax Number (714) 842-0135 DM TRUCKING Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 15:40:05 PST Successful 2872 W. KEYS LANE • ANAHEIM, CA, 92804 • Cert: DBE Cert. #41119 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Del11 ivery Status dfmcampos@aol.com 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number Send Date & Time Tranmission Status (714) 821-7860 2017-05-05 15:39:42 PST Successful DREAMBUILDER CONSTRUCTION CORP 1324 E LAWSON LN. • PLACENTIA, CA, 92870 • Cert: DBE Cert. #38712 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017, https://www.dbegoodfaith.com/submit_order/docs/solicitation_log.php?docs_adid=38437 3/7 5/10/2017 Soliciation Log I Adam Ave - Atlanta Ave Email Transmission Email Address Send 11 Date & Time Delivery Status alex.singh@dreambuildercorp.com 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number Send Date & Time Tranmission Status (714) 646-3698 2017-05-05 15:39:54 PST Successful GLOBAL ROAD SEALING, INC 10832 DOROTHY AVE • GARDEN GROVE, CA, 92843 • Cert: DBE Cert. #31176 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address grs@globalroadsealing.com Fax Transmission Fax Number (714) 893-0945 Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 15:40:05 PST Successful HERCON COMPANY, INC. 30211 AVENIDA DE LAS BANDERAS, STE 200 • RANCHO SANTA MARGARI, CA, 92688 • Cert: DBE Cert. #35158 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address ahernandez@herconcompany.com Fax Transmission Fax Number (949) 216-9053 Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 16:46:17 PST Failed JP SEPULVEDA TRUCKING 2781 WEST BRIDGEPORT AVE. • ANAHEIM, CA, 92804 • Cert: DBE Cert. #42166 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address jpsepulveda@sbcglobal.net Fax Transmission Fax Number v ry (714) 229-9684 Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 16:45:03 PST Failed KATO LANDSCAPE INCORPORATED 18182 BUSHARD ST • FOUNTAIN VALLEY, CA, 92708 • Cert: DBE https://www.dbegoodfaith.com/submit_order/docs/solicitation_log.php?docs_adid=38437 4/7 5/10/2017 Soliciation Log I Adam Ave - Atlanta Ave Cert. #35398 (Minority -owned) was identified in the California Unified Certification Program database on 05105/2017. Email Transmission Email Address Send Date & Time Delivery Status accounting@katolandscaping.com 2017-05-0514:39:21 PST Delivered Fax Transmission Fax Number Send Date & Time Tranmission Status (714) 963-6424 2017-05-05 15:39:58 PST Successful KELSURVEYS INC 1740 E GARRY AVENUE STE. 110 • SANTA ANA, CA, 92705 • Cert: DBE Cert. #34096 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status kelvink@kelsurveys.com 2017-05-05 14:39:21 PST Delivered Fax "transmission Fax Number Se11 nd Date & Time Tranmission Status (949) 660-1758 2017-05-05 15:40:24 PST Successful PAYCO SPECIALTIES, INCORPORATED 120 NORTH SECOND AVE. • CHULA VISTA, CA, 91910 • Cert: DBE Cert. #102 (Women -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address rebecca@payco.biz Fax Transmission Fax Number (619) 427-1620 Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 15:40:11 PST Successful S.C. YAMAMOTO, INC. 2031 EMERY AVENUE • LA HABRA, CA, 90631 • Cert: DBE Cert. #39686 (Minority -owned) was identified in the California Unified Certification Program database on 05105/2017. Email Transmission Email Address Send Date & Time Delivery Status scyjunior@aol.com 2017-05-0514:39:21 PST Bounced Fax Transmission Fax Number Send Date & Time Tranmission Status (562) 690-1540 2017-05-05 15:39:45 PST Successful hftps:/Avww.dbegoodfaith.com/submit—order/docs/solicitation log.php?docs adid=38437 5f7 5/10/2017 Soliciation Log I Adam Ave - Atlanta Ave SADDLEBACK SURVEYS, INC. 9 CORPORATE PARK, SUITE 110 • IRVINE, CA, 92606 • Cert: DBE Cert. #38047 (Women -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status ktetreault@saddlebacksurveys.com 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number a Send Date & Time Tranmission Status (949) 215-8631 2017-05-05 15:40:05 PST Successful S® CAL TREE CARE, INC 375 NORTH HALE AVE • ESCONDIDO, CA, 92029 • Cert: DBE Cert. #37070 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status info@socaltreecare.com 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number Send Date & Time 1-11-11 Tranmission Stat11 us (760) 747-6016 2017-05-05 15:45:46 PST Successful ST. JAES TRUCKING '12151 CORVETTE DR. • GARDEN GROVE, CA, 92841 • Cert: DBE Cert. #43803 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status Christopher_StJames@aol.com 2017-05-0514:39:21 PST Delivered Fax Transmission Fax Number Send Date &Time Tranmission Status No Fax Number n/a n/a STATEWIDE STRIPES, INC 7320 MISSION GORGE ROAD • SAN DIEGO, CA, 92120 • Cert: DBE Cert. #32232 (Minority -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address dawn@statewidestripes.com Fax Transmission Fax Number (858) 560-0158 Send Date & Time Delivery Status 2017-05-05 14:39:21 PST Delivered Send Date & Time Tranmission Status 2017-05-05 15:39:52 PST Successful https:/Avww.dbegoodfaith.com/submit order/docs/solicitation_log.php?docs adid=38437 6R 5/10/2017 Sol iciation Log I Adam Ave - Atlanta Ave SUPER SEAL & STRIPE, INC 310 A STREET • FILLMORE, CA, 93015 • Cert: DBE Cert. #2003 (Women -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status brenda@supersealandstripe.com 2017-05-0514:39:21 PST Delivered Fax Transmission Fax Number (805) 524-7428 Send Date & Time Tranmission Status 2017-05-05 15:40:16 PST Successful TRAFFIC LOOPS CRA►CKFILLING, INC 1915 W BALL RD. • ANAHEIM, CA, 92804 • Cert: DBE Cert. #38033 (Women -owned) was identified in the California Unified Certification Program database on 05105/2017. Email Tranwission Email Address Send Date & Time Delivery Status trafficloops@sbcglobal.net 2017-05-0514:39:21 PST Delivered Fax Transmission Fax Number Send Date & Time Tranmission Status (714) 520-4027 2017-05-05 15:40:09 PST Successful TREESMITH ENTERPRISES, INC 1551 N. MILLER ST • ANAHEIM, CA, 92806 • Cert: DBE Cert. #35817 (Women -owned) was identified in the California Unified Certification Program database on 05/05/2017. Email Transmission Email Address Send Date & Time Delivery Status jrarriirez@treesmith.net 2017-05-05 14:39:21 PST Delivered Fax Transmission Fax Number Send Date & Time Tranmission Status (714) 996-6057 2017-05-05 15:40:19 PST Successful https://www.dbegoodfaith.com/submit_order/docs/solicitation_log.php?docs adid=38437 7/7 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid Noncollusion Affidavit (Title 23-United States Code Section 112 and Public Contract Code Section 7106) To the CITY / COUNTY of Huntington Beach/ Orange DEPARTMENT OF PUBLIC WORKS. In 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. Steve Kirschner - Vice President Page 9 of 22 C-18 October 2016 Local Assistance Procedures Manual DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 Exhibit 12-11 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. Steve Kirschner - Vice President Page 10 of 22 C-19 October 2016 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc proposed subcontractor V � U Tttei , 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, 1 1 1 14, 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 (4 I 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 CPR 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) ( I ) 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. Departmenr. Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc Exhibit 12-11 Sample Bid proposed subcontractor Mfoy FaVMC 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, 1 1 1 14, or 11246, and that, where required, lie 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 Fpderal Highway ministration or by the Director, Office of Federal Contract Compliance, U.S. Dep /fLabw- Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc Exhibit 12-11 Sample Bid proposed subcontractor ut(lftl(�� , 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, 1 1 1 14, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director ofthe 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 CPR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form. 100 (EEO-]) 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. Departnlef_ �Aoi. Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-11 Sample Kid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc proposed subcontractor .--E:;1{G 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, 1 1 114, 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 a;id subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exe".npt from the equal opportunity clause are set forth in 41 CPR 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. Departmen;-e 6r. Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc Exhibit 12-11 Sample Bid proposed subcontractor w=nd cu 1� _ 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, 1 11 14, oi- 1 1246, 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 (4 I CFR 60-1.7(b) (I)), 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 A Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-11 Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Hardy & Harper, Inc , proposed subcontractor S , 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, 1 1 114, oi- 1 1246, 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: fhe above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (I)), 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 $16,000 or under are exempt.) Currently, Standard Form 100 (EEO-]) 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 Highwa rninistratio or by the Director, Office of Federal Contract Compliance, U.S. Department ofLab or.*V / _ Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT Exhibit 12-11 Sample Bid 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 1 101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a 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. Bidder are caution that 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 Ll No If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-16 October 2016 Local Assistance Procedures Manual Exhibit 12-11 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-17 October 2016 Bid Bond CONTRACTOR: (Name, legal status and address) Hardy & Harper, Inc. 1312 E. Warner Avenue Santa Ana, CA 92705 OWNER: (Name, legal status and address) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 Bid Bond Number: CSB A-4929 SURETY: (Name, legal status and principal place of business) Fidelity and Deposit Company of Maryland 777 South Figueroa Street, Suite 3900 Los Angeles, CA 90017 This document has important legal consequences. Consultation with An attorney is encouraged with respect its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered Plural where applicable. BOND AMOUNT: Ten Percent (10%) of Amount Bid PROJECT: Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlantic Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502, Federal Aid Project STPL-5181(188) 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 furnished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractors 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 here from and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 5th day of Mav, 2017 0 Zi (Wlitness) HardT& Hamer Inc. (Pr inci al (Seal) (Title) s-e,c, Fidelity and Deposit Company of Ma_yr land J (Surety) (Seal) (Witness) \ (Title) Dwight Reilly, Attorney -in -Fact By arrangement with the American Institute of Architects, the National Association of Surety Bond Producers (NASBP) (www.nasbp.or) makes this form document available to its members, affiliates, and ALL associates in Microsoft Word format for use in the regular course of surety business. NASBP vouches that i the original text of this document conforms exactly to the text in AIA Document A310-2010, Bid Bond. Subsequent modifications may be made to the original text of this document by users, so careful review of its wording and consultation with an attorney are encouraged before its completion, execution or acceptance. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 ��',cr..c�`;�oc�,cK`,c�R.�t,,�,c�^,c•C•`,i�c--M.c�(`,c�i^,t-�^,�F.`.c�.,cK��,c--F>.;c�6-.c-R'�!'c,V^c:f :r�c+,�^> {'UGC;E=Y`S�^�`a-2c.F'".��'r�i��"�,��S1d�.� ���(.�'L�c.'��� Tl:i A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange On May 5 2017 before me, Tina Pham, Notary Public . Date Here Insert Name and Title of the Officer personally appeared Steve Kirschner Namek17 -ir of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(g) whose name(I�) is/axe subscribed to the within instrument and acknowledged to me that he/sKe/tlley executed the same in his/her/their authorized capacity(iG5), and that by his/her/their signature(g) on the instrument the person(x), or the entity upon behalf of which the person(x) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and of' ial seal. ,. • ry TINA PRAM o COMM. #2149384 (p ro ,Notary Public•COlifornla ORANGE COUNTY { Signature My Comm, Expires Apr 17. 2020 SI nature 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: Bid Bond _ Document Date: May 5, 2017 Number of Pages: 1 Signer(s) Other Than Named Above: Dwight Reilly Capacity(ies) Claimed by Signer(s) Signer's Name: Steve Kirschner 1Z Corporate Officer — Title(s): Vice President ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: _Hardy & Harper, Inc Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: �- = — — — = —"— � —'— _ _a._ `_-GQ=G�'_�..`_�_ `�Z= v`��;z"v'''��Z�--E�L�`z.-;z:[;`���zce;� c.�`z�'! _rv�4�e_z>�;• 02014 National Notary Association • www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 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, accura State of California County of Oran or validitv of that document. On 05/05/2017 before me, Susan personally appeared Dwight Reilly , Notary Public 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. SUSAN PUGH COMM. #2105405 �+ N w• ^ Notary Public -California -a }/ ORANGE COUNTY a My Comm. Expires Apr 29, 2019 I certify under PENALTY OF PERJURY under the laws of the state of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature of Notary OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIlVIED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ MEMBER of LLC ® ATTORNEY -IN -FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) DESCRIPTION OF ATTACHED DOCUMENT I: • : • n1lI Title or Type of Document One Number of Pages 05/05/2017 Date of Document Signer(s) other than named above Bond No. CSBA-4929 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Daniel HUCKABAY, Dwight REILLY, Arturo AYALA, Shaunna Rozelle OSTROM and Michael CASTANEDA, all of Orange, California, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 29th day of March, A.D. 2017. ATTEST: Assistant Secretary Joshua Lecker ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND / 'wa OEIpSso/ .•t3 IN • (/ N . k; ? Go�rory 0 EAL AIM O r.n. � ;7?'`-• '' T.`'•.. 7 Vice President Michael Bond State of Maryland County of Baltimore On this 29th day of March, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and JOSHUA LECKER, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA-F 012-0079B R 4 1 t �'6 x fr r k I �F s r 2 A } i , � 1 z _ - i I t � i l � 00 '- N a? O � �. �uo� U o Cl) ®. 3 o a; La0 ANN-C CO C) CDt l0l CD LF �. U O N m EXHIBIT B (Required Contract Provision For All Federal Aid Construction Contracts) 16-5093/federally-funded-construction-contract.doc/rev_ 902016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language EXHIBIT 12-G REQUIRED FEDERAL -AID CONTRACT LANGUAGE (.For Local Assistance Construction Projects) The following language must be incorporated into all Local Assistance Federal -aid construction contracts. The following language, with minor edits, was taken from the Code of Federal Regulations. 1. DISADVANTAGED BUSINESS ENTERPRISES (DBE).........................................................2 A. DBE COMMITMENT SUBMITTAL..................................................................................2 B. GOOD FAITH EFFORTS SUBMITTAL.............................................................................3 C. EXHIBIT 15-G - CONSTRUCTION CONTRACT DBE COMMITMENT...................................4 D. SUBCONTRACTOR AND DISADVANTAGED BUSINESS ENTERPRISE RECORDS.................4 E. PERFORMANCE OF DISADVANTAGED BUSINESS ENTERPRISES.....................................4 2. BID OPENING............................................................................................................5 3. BID RIGGING.............................................................................................................5 4. CONTRACT AWARD...................................................................................................5 5. CONTRACTOR LICENSE............................................................................................5 6. CHANGED CONDITIONS.............................................................................................6 A. DIFFERING SITE CONDITION........................................................................................6 B. SUSPENSIONS OF WORK ORDERED BY THE ENGINEER..................................................6 C. SIGNIFICANT CHANGES IN THE CHARACTER OF WORK................................................6 7. BEGINNING OF WORK, TIME OF COMPLETION AND LIQUIDATED DAMAGES.................7 8. BUY AMERICA..........................................................................................................7 FURNISH STEEL AND IRON MATERIALS TO BE INCORPORATED INTO THE WORK WITH CERTIFICATES OF COMPLIANCE. STEEL AND IRON MATERIALS MUST BE PRODUCED IN THE U.S. EXCEPT ...........................7 9. QUALITY ASSURANCE................................................................................................8 10. PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS................................8 11. FORM FHWA-1273 REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONTRACTS ....... 9 12. FEMALE AND MINORITY GOALS...............................................................................18 13. FEDERAL TRAINEE PROGRAM...................................................................................19 14. TITLE VI ASSURANCE................................................................................................21 15. USE OF UNITED STATES -FLAG VESSELS (CARGO PREFERENCE ACT)...........................22 Page 1 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 1. DISADVANTAGED BUSINESS ENTERPRISES (DBE) Under 49 CFR 26.13(b): The contractor, subrecipient 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 recipient deems appropriate. Take necessary and reasonable steps to ensure that DBEs have opportunity to participate in the contract (49 CFR 26). To ensure equal participation of DBEs provided in 49 CFR 26.5, the Agency shows a goal for DBEs. Make work available to DBEs and select work parts consistent with available DBE subcontractors and suppliers. Meet the DBE goal shown elsewhere in these special provisions or demonstrate that you made adequate good faith efforts to meet this goal. It is your responsibility to verify that the DBE firm is certified as DBE at date of bid opening. For a list of DBEs certified by the California Unified Certification Program, go to: http://www.dot.ca.gov/hq/bep/find certified.htrn. All DBE participation will count toward the California Department of Transportation's federally mandated statewide overall DBE goal. Credit for materials or supplies you purchase from DBEs counts towards the goal in the following manner: • 100 percent counts if the materials or supplies are obtained from a DBE manufacturer. • 60 percent counts if the materials or supplies are obtained from a DBE regular dealer. • Only fees, commissions, and charges for assistance in the procurement and delivery of materials or supplies count if obtained from a DBE that is neither a manufacturer nor regular dealer. 49 CFR 26.55 defines "manufacturer" and "regular dealer." You receive credit towards the goal if you employ a DBE trucking company that performs a commercially useful function as defined in 49 CFR 26.55(d)(1) through (4) and (6). a. DBE Commitment Submittal Submit the Exhibit 15-G Construction Contract DBE Commitment form, included in the Bid book. If the form is not submitted with the bid, remove the form from the Bid book before submitting your bid. If the DBE Commitment form is not submitted with the bid, the apparent low bidder, the 2nd low bidder, and the 3rd low bidder must complete and submit the DBE Commitment form to the Agency. DBE Commitment form must be received by the Agency no later than 4:00 p.m. on the 4th business day after bid opening. Other bidders do not need to submit the DBE Commitment form unless the Agency requests it. If the Agency requests you to submit a DBE Commitment form, submit the completed form within 4 business days of the request. Submit written confirmation from each DBE stating that it is participating in the contract. Include confirmation with the DBE Commitment form. A copy of a DBE's quote will serve as written confirmation that the DBE is participating in the contract. If you do not submit the DBE Commitment form within the specified time, the Agency will find your bid nonresponsive. Page 2 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language b. Good Faith Efforts Submittal If you have not met the DBE goal, complete and submit the DBE Information - Good Faith Efforts, Exhibit 15-H, form with the bid showing that you made adequate good faith efforts to meet the goal. Only good faith efforts directed towards obtaining participation by DBEs will be considered. If good faith efforts documentation is not submitted with the bid, it must be received by the Agency no later than 4:00 p.m. on the 4th business day after bid opening. If your DBE Commitment form shows that you have met the DBE goal or if you are required to submit the DBE Commitment form, you must also submit good faith efforts documentation within the specified time to protect your eligibility for award of the contract in the event the Agency finds that the DBE goal has not been met. Good faith efforts documentation must include the following information and supporting documents, as necessary: l . Items of work you have made available to DBE firms. Identify those items of work you might otherwise perform with your own forces and those items that have been broken down into economically feasible units to facilitate DBE participation. For each item listed, show the dollar value and percentage of the total contract. It is your responsibility to demonstrate that sufficient work to meet the goal was made available to DBE firms. 2. Names of certified DBEs and dates on which they were solicited to bid on the project. Include the items of work offered. Describe the methods used for following up initial solicitations to determine with certainty if the DBEs were interested, and the dates of the follow-up. Attach supporting documents such as copies of letters, memos, facsimiles sent, telephone logs, telephone billing statements, and other evidence of solicitation. You are reminded to solicit certified DBEs through all reasonable and available means and provide sufficient time to allow DBEs to respond. 3. Name of selected firm and its status as a DBE for each item of work made available. Include name, address, and telephone number of each DBE that provided a quote and their price quote. If the firm selected for the item is not a DBE, provide the reasons for the selection. 4. Name and date of each publication in which you requested DBE participation for the project. Attach copies of the published advertisements. 5. Names of agencies and dates on which they were contacted to provide assistance in contacting, recruiting, and using DBE firms. If the agencies were contacted in writing, provide copies of supporting documents. 6. List of efforts made to provide interested DBEs with adequate information about the plans, . specifications, and requirements of the contract to assist them in responding to a solicitation. If you have provided information, identify the name of the DBE assisted, the nature of the information provided, and date of contact. Provide copies of supporting documents, as appropriate. 7. List of efforts made to assist interested DBEs in obtaining bouding, lines of credit, insurance, necessary equipment, supplies, and materials, excluding supplies and equipment that the DBE subcontractor purchases or leases from the prime contractor or its affiliate. If such assistance is provided by you, identify the name of the DBE assisted, nature of the assistance offered, and date assistance was provided. Provide copies of supporting documents, as appropriate. 8. Any additional data to support demonstration of good faith efforts. The Agency may consider DBE commitments of the 2nd and 3rd bidders when determining whether the low bidder made good faith efforts to meet the DBE goal. .Page 3 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language e. Exhibit 1 S--G -Construction Contract DBE Commitment Complete and sign Exhibit 15-G Construction Contract DBE Commitment included in the contract documents regardless of whether DBE participation is reported. Provide written confirmation from each DBE that the DBE is participating in the Contract. A copy of a DBE's quote serves as written confirmation. If a DBE is participating as a joint venture partner, the Agency encourages you to submit a copy of the joint venture agreement.) d Subcontractor and Disadvantaged Business Enterprise Records Use each DBE subcontractor as listed on Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) and Exhibit 15-G Construction Contract DBE Commitment form unless you receive authorization for a substitution. The Agency requests the Contractor to: 1. Notify the Engineer of any changes to its anticipated DBE participation 2. Provide this notification before starting the affected work 3. Maintain records including: • Name and business address of each 1sc-tier subcontractor • Name and business address of each DBE subcontractor, DBE vendor, and DBE trucking company, regardless of tier • Date of payment and total amount paid to each business If you are a DBE contractor, include the date of work performed by your own forces and the corresponding value of the work. Before the 15th of each month, submit a Monthly DBE Trucking Verification form. If a DBE is decertified before completing its work, the DBE must notify you in writing of the decertification date. If a business becomes a certified DBE before completing its work, the business must notify you in writing of the certification date. Submit the notifications. On work completion, complete a Disadvantaged Business Enterprises (DBE) Certification Status Change, Exhibit 17-0, form. Submit the form within 30 days of contract acceptance. Upon work completion, complete Exhibit 17-F Final Report — Utilization of Disadvantaged Business Enterprises (DBE), First -Tier Subcontractors. Submit it within 90 days of contract acceptance. The Agency will withhold $10,000 until the form is submitted. The Agency releases the withhold upon submission of the completed form. e. Performance of Disadvantaged Business Enterprises DBEs must perform work or supply materials as listed in the Exhibit 15-G Construction Contract DBE Commitment form, included in the Bid. Do not terminate or substitute a listed DBE for convenience and perform the work with your own forces or obtain materials from other sources without authorization from the Agency. The Agency authorizes a request to use other forces or sources of materials if it shows any of the following justifications: 1. Listed DBE fails or refuses to execute a written contract based on plans and specifications for the project. 2. You stipulated that a bond is a condition of executing the subcontract and the listed DBE fails to meet your bond requirements. Page 4 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 3. Work requires a contractor's license and listed DBE does not have a valid license under Contractors License Law. 4. Listed DBE fails or refuses to perform the work or furnish the listed materials. 5. Listed DBE's work is unsatisfactory and not in compliance with the contract. 6. Listed DBE is ineligible to work on the project because of suspension or debarment. 7. Listed DBE becomes bankrupt or insolvent. 8. Listed DBE voluntarily withdraws with written noticefrom the Contract 9. Listed DBE is ineligible to receive credit for the type of work required. 10. Listed DBE owner dies or becomes disabled resulting in the inability to perform the work on the Contract. 11. Agency determines other documented good cause. Notify the original DBE of your intent to use other forces or material sources and provide the reasons. Provide the DBE with 5 days to respond to your notice and advise you and the Agency of the reasons why the use of other forces or sources of materials should not occur. Your request to use other forces or material sources must include: 1. One or more of the reasons listed in the preceding paragraph. 2. Notices from you to the DBE regarding the request. 3. Notices from the DBEs to you regarding the request. If a listed DBE is terminated or substituted, you must make good faith efforts to find another DBE to substitute for the original DBE. The substitute DBE must perform at least the same amount of work as the origin a] DBE under the contract to the extent needed to meet the DBE goal. The substitute DBE must be certified as a DBE at the time of request for substitution. Unless the Agency authorizes (1) a request to use other forces or sources of materials or (2) a good faith effort for a substitution of a terminated DBE, the Agency does not pay for work listed on the Exhibit 15-G Construction Contract DBE Connzit7nent form unless it is performed or supplied by the listed DBE or an authorized substitute. 2. BID OPENING The Agency publicly opens and reads bids at the time and place shown on the Notice to Bidders. 3. BID RIGGING The U.S. Department of Transportation (DOT) provides a toll -free hotline to report bid rigging activities. Use the hotline to report bid rigging, bidder collusion, and other fraudulent activities. The hotline number is (800) 424-9071. The service is available 24 hours 7 days a week and is confidential and anonymous.. The hotline is part of the DOT's effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the DOT Inspector General. 4. CONTRACT AWARD If the Agency awards the contract, the award is made to the lowest responsible and responsive bidder. 5. CONTRACTOR LICENSE The Contractor must be properly licensed as a contractor from contract award through Contract acceptance (Public Contract Code § 10164). Page 5 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 6. CHANGED CONDITIONS a. Differing Site Conditions 1. During the progress of the work, if subsurface or latent physical conditions are encountered at the site differing materially from those indicated in the contract or if unknown physical conditions of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent in the work provided for in the contract, are encountered at the site, the party discovering such conditions shall promptly notify the other party in writing of the specific differing conditions before the site is disturbed and before the affected work is performed. 2. Upon written notification, the engineer will investigate the conditions, and if it is determined that the conditions materially differ and cause an increase or decrease in the cost or time required for the performance of any work under the contract, an adjustment, excluding anticipated profits, will be made and the contract modified in writing accordingly. The engineer will notify the contractor of the determination whether or not an adjustment of the contract is warranted. No contract adjustment which results in a benefit to the contractor will be allowed unless the contractor has provided the required written notice. 4. No contract adjustment will be allowed under this clause for any effects caused on unchanged work. (This provision may be omitted by the Local Agency, at their option.) b. Suspensions of Work Ordered by the Engineer 1. If the performance of all or any portion of the work is suspended or delayed by the engineer in writing for an unreasonable period of time (not originally anticipated, customary, or inherent to the construction industry) and the contractor believes that additional compensation and/or contract time is due as a result of such suspension or delay, the contractor shall submit to the engineer in writing a request for adjustment within 7 calendar days of receipt of the notice to resume work. The request shall set forth the reasons and support for such adjustment. 2. Upon receipt, the engineer will evaluate the contractor's request. If the engineer agrees that the cost and/or time required for the performance of the contract has increased as a result of such suspension and the suspension was caused by conditions beyond the control of and not the fault of the contractor, its suppliers, or subcontractors at any approved tier, and not caused by weather, the engineer will make an adjustment (excluding profit) and modify the contract in writing accordingly. The contractor will be notified of the engineer's determination whether or not an adjustment of the contract is warranted. 3. No contract adjustment will be allowed unless the contractor has submitted the request for adjustment within the time prescribed. 4. No contract adjustment will be allowed under this clause to the extent that performance would have been suspended or delayed by any other, cause, or for which an adjustment is provided or excluded under any other term or condition of this contract. c. Significant Changes in the Character of Work The engineer reserves the right to make, in writing, at any time during the work, such changes in quantities and such alterations in the work as are necessary to satisfactorily complete the project. Such changes in quantities and alterations shall not invalidate the contract nor release the surety, and the contractor agrees to perform the work as altered. If the alterations or changes in quantities significantly change the character of the work under the contract, whether such alterations or changes are in themselves significant changes to the character of the work or by affecting other work cause such other work to become significantly different in character, an adjustment, excluding anticipated profit, will be made to the contract. The basis for the adjustment shall be agreed upon prior to the performance of the work. If a basis Page 6 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language cannot be agreed upon, then an adjustment will be made either for or against the contractor in such amount as the engineer may determine to be fair and equitable. 3. If the alterations or changes in quantities do not significantly change the character of the work to be performed under the contract, the altered work will be paid for as provided elsewhere in the contract. 4. The term "significant change" shall be construed to apply only to the following circumstances • When the character of the work as altered differs materially in kind or nature from that involved or included in the original proposed construction; or • When a major item of work, as defined elsewhere in the contract, is increased in excess of 125 percent or decreased below 75 percent of the original contract quantity. Any allowance for an increase in quantity shall apply only to that portion in excess of 125 percent of original contract item quantity, or in case of a decrease below 75 percent, to the actual amount of work performed. 7. BEGINNING OF WORK, TFYIE OF COMPLETION AND LIQUIDATED DAMAGES The Contractor shall begin work within 15 calendar days after the contract has been approved by the attorney appointed and authorized to represent the City/County of This work shall be diligently prosecuted to completion before the expiration of WORKING DAYS beginning on the fifteenth calendar day after approval of the contract. (Insert amount of Liquidated Damages) The Contractor shall pay to the City/County of the sum of $ per day, for each and every calendar day's delay in finishing the work in excess of the number of working days prescribed above, 8. BUY AMERICA Furnish steel and iron materials to be incorporated into the work with certificates of compliance. Steel and iron materials must be produced in the U.S. except: 1. Foreign pig iron and processed, pelletized, and reduced iron ore may be used in the domestic production of the steel and iron materials [60 Fed Reg 15478 (03/24/1995)1; 2. 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 U.S. may be used. Production includes: 1. Processing steel and iron materials, including smelting or other processes that alter the physical form or shape (such as rolling, extruding, machining, bending, grinding, and drilling) or chemical composition; 2. Coating application, including epoxy coating, galvanizing, and painting, that protects or enhances the value of steel and iron materials. Page 7 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 9. QUALITY ASSURANCE The Agency uses a Quality Assurance Program (QAP) to ensure a material is produced to comply with the Contract. You may examine the records and reports of tests the Agency performs if they are available at the job site. Schedule work to allow time for QAP. 10. PROMPT PAYMENT OF FUNDS WITHHELD TO SUBCONTRACTORS (The local agency must include one of the following three provisions to ensure prompt and full payment of any retainage from the prime contractor, or subcontractor, to a subcontractor. Remove or strike out the methods not used.) (EITIJER) No retainage will be withheld by the agency from progress payments due the prime contractor. Retainage by the prime contractor or subcontractors is prohibited and no retainage will be held by the prime contractor from progress due subcontractors. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the California Business and Professions Code. This requirement shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime Contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor or deficient subcontract performance, or noncompliance by a subcontractor. (OR) No retainage will be held by the agency from progress payments due the prime contractor. Any retainage held by the prime contractors or subcontractors from progress payments due subcontractors shall be promptly paid in full to subcontractors within 30 days after the subcontractor's work is satisfactorily completed. Federal law (49CFR26.29) requires that any delay or postponement of payment over the 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime Contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance, or noncompliance by a subcontractor. (OR) The agency shall hold retainage from the prime contractor and shall make prompt and regular incremental acceptances of portions, as determined by the agency, of the contract work, and pay retainage to the prime contractor based on these acceptances. The prime contractor, or subcontractor, shall return all monies withheld in retention from a subcontractor within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49CFR26.29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency's prior written approval. Any violation of this provision shall subject the violating prime contractor or subcontractor to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies otherwise available to the prime contractor or subcontractor in the event of a dispute involving late payment or nonpayment by the prime contractor, deficient subcontract performance, or noncompliance by a subcontractor. Page 8 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 11. FORM FHWA-1273 REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONTRACTS (Excluding ATTACHMENT A - EMPLOYMENT AND MATERIALS PREFERENCE FOR APPALACHIAN DEVELOPMENT HIGHWAY SYSTEM OR APPALACHIAN LOCAL ACCESS ROAD CONTRACTS) [The following 10 pages must be physically inserted into the contract without modification.] Page 9 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS L 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 Viil. False Statements Concerning Highway Projects IX Implementation of Clean Air Act and Federal Water Pollution Control Act X. Compliance with Governmentwide Suspension and Debarment Requirements Xi. Certification Regarding Use of Contract Funds for Lobbying ATTACHMENTS A. Employment and Materials Preference for Appalachian Development Highway System or Appalachian Local Access Road Contracts (included in Appalachian contracts only) I. GENERAL 1. Form FHWA-1273 must be physically incorporated in each construction contract funded under Title 23 (excluding emergency contracts solely intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require its inclusion in all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services). The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shall be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Form FHWA-1273 must be included in all Federal -aid design -build contracts, in all subcontracts and in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services). The design -builder shall be responsible for compliance by arty subcontractor, lower -tier subcontractor or service provider. Contracting agencies may reference Form FHWA-1273 in bid proposal or request for proposal documents, however, the Form FHWA-1273 must be physically incorporated (not referenced) in all contracts, subcontracts and lower -tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 2. Subject to the applicability criteria noted in the following sections, these contract provisions shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract. 3. A breach of any of the stipulations contained in these Required Contract Provisions may be sufficient grounds for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and FHWA. 4. Selection of Labor: During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal -aid highway unless it is labor performed by convicts who are on parole, supervised release, or probation. The term Federal -aid highway does not include roadways functionally classified as local roads or rural minor collectors. It. 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 VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The contractor and all subcontractors must comply with: the requirements of the Equal Opportunity Clause in 41 CFR 60-1.4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 60-4.3. Note: The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60, and 29 CFR 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with Title 23 USC Section 140, the Rehabilitation Act of 1973, as amended (29 USC 794), and Title VI of the Civil Rights Act of 1964, as amended, and related regulations including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The following provision is adopted from 23 CFR 230, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements. 1. Equal Employment Opportunity: Equal employment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 1630, 29 CFR 1625-1627, 41 CFR 60 and 49 CFR 27) and orders of the Secretary of labor as modified by the provisions prescribed herein, and imposed pursuant to 23 U.S.C. 140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract. The provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract. In the execution ofthis 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 Local Assistance Procedure Manual Exhibit 12-G 3. Dissemination of Policy: All members of the contractor's staff who are authorized to hire, supervise, promote, and discharge employees, or who recommend such action, or who are substantially involved in such action, will be made fully cognizant of, and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met, the following actions will be taken as a minimum: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months, at which time the contractor's EEO policy and its implementation will be reviewed and explained. The meetings will be conducted by the EEO Officer. b. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer, covering all major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor. c. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's procedures for locating and hiring minorities and women. d. Notices and posters setting forth the contractor's EEO policy will be placed in areas readily accessible to employees, applicants for employment and potential employees. e. The contractor's EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of meetings, employee handbooks, or other appropriate means. 4. Recruitment: When advertising for employees, the contractor will include in all advertisements for employees the notation: "An Equal Opportunity Employer." All such advertisements will be placed in publications having a large circulation among minorities and women in the area from which the project work force would normally be derived. a. The contractor will, unless precluded by a valid bargaining agreement, conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minorities and women. To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority and women applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrals, the contractor is expected to observe the provisions of that agreement to the extent that the system meets the contractor's compliance with EEO contract provisions. Where implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions. c. The contractor will encourage its present employees to refer minorities and women as applicants for employment. Information and procedures with regard to referring such applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditions, and employee benefits shall be established and administered, and personnel actions of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without regard to race, color, religion, sex, national origin, age or disability. The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to insure that working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. 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 contractor's work force requirements and as permissible under Federal and State regulations, the contractor shall make full use of training programs, i.e., apprenticeship, and on- the-job training programs for the geographical area of contract performance. In the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated in the special provision. The contracting agency may reserve training positions for persons who receive welfare assistance in accordance with 23 U.S.C, 140{a}. c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of employees who are minorities and women and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for minorities and women. Actions by the contractor, either directly or through a contractor's association acting as agent, will include the procedures set forth below: a. The contractor will use good faith efforts to develop, in cooperation with the unions, joint training programs aimed toward qualifying more minorities and women for membership in the unions and increasing the skills of minorities and women so that they may qualify for higher paying employment. b. The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such union will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. c. The contractor is to obtain information as to the referral practices and policies of the labor union except that to the extent such information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the contractor, the contractor shall so certify to the contracting agency Page 11 of 24 July 2016 Local Assistance Procedure Manual Exhibit 12-G and shall set forth what efforts have been made to obtain such information. d. In the event the union is unable to provide the contractor with a reasonable flow of referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability; making full efforts to obtain qualified and/or qualifiable minorities and women. The failure of a union to provide sufficient referrals (even though it is obligated to provide exclusive referrals under the terms of a collective bargaining agreement) does not relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from meeting the obligations pursuant to Executive Order 11246, as amended, and these special provisions, such contractor shall immediately notify the contracting agency. 8. Reasonable Accommodation for Applicants / Employees with Disabilities: The contractor must be familiar with the requirements for and comply with the Americans with Disabilities Act and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. 9. Selection of Subcontractors, Procurement of Materials and Leasing of Equipment: The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract. a. The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract. b. The contractor will use good faith efforts to ensure subcontractor compliance with their EEO obligations_ 10, Assurance Required by 49 CFR 26.13(b): a. The requirements of 49 CFR Part 26 and the State DOT's U.S. DOT -approved DBE program are incorporated by reference. b. The contractor or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT -assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy as the contracting agency deems appropriate. 11. Records and Reports: The contractor shall keep such records as necessary to document compliance with the EEO requirements. Such records shall be retained for a period of three years following the date of the final payment to the contractor for all contract work and shall be available at reasonable times and places for inspection by authorized representatives of the contracting agency and the FHWA. a. The records kept by the contractor shall document the following: (1) The number and work hours of minority and non -minority group members and women employed in each work classification on the project; (2) The progress and efforts being made in cooperation with unions, when applicable, to increase employment opportunities for minorities and women; and 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 Forni FHWA-1391. The staffing data should represent the project work force on board in all or any part of the last payroll period preceding the end of July. If on-the-job training is being required by special provision, the contractor will be required to collect and report training data. The employment data should reflect the work force on board during all or any part of the last payroll period preceding the end of July. III. NONSEGREGATED FACILITIES This provision is applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more. The contractor must ensure that facilities provided for employees are provided in such a manner that segregation on the basis of race, color, religion, sex, or national origin cannot result. The contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's obligation extends further to ensure that its employees are not assigned to perform their services at any location, under the contractor's control, where the facilities are segregated. The term "facilities" includes waiting rooms, work areas, restaurants and other eating areas, time clocks, restrooms, washrooms, locker rooms, and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees. The contractor shall provide separate or single -user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. IV. DAVIS-BACON AND RELATED ACT PROVISIONS This section is applicable to all Federal -aid construction projects exceeding $2,000 and to all related subcontracts and lower -tier subcontracts (regardless of subcontract size). The requirements apply to all projects located within the right-of-way of a roadway that is functionally classified as Federal -aid highway. This excludes roadways functionally classified as local roads or rural minor collectors, which are exempt. Contracting agencies may elect to apply these requirements to other projects. The following provisions are from the U.S. Department of Labor regulations in 29 CFR 5.5 "Contract provisions and related matters" with minor revisions to conform to the FHWA-1273 format and FHWA program requirements - I. 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 Local Assistance Procedure Manual Exhibit 12-G Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions of paragraph 1.d. of this section; also, regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans, funds, or programs which cover the particular weekly period, are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided, That the employer's payroll records accurately set forth the time spent in each classification in which work is performed. The wage determination (including any additional classification and wage rates conformed under paragraph 1.b. of this section) and the Davis -Bacon poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible place where it can be easily seen by the workers. b. (1) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate and fringe benefits therefore only when the following criteria have been met: @ 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. Required Federal -Aid Contract Language (4) The wage rate (including fringe benefits where appropriate) determined pursuant to paragraphs 1.b.(2) or 1.15.(3) of this section, shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. c. Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. d. If the contractor does not make payments to a trustee or other third person, the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found, upon the written request of the contractor, that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program. 2. Withholding The contracting agency shall upon its own action or upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor under this contract, or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to Davis - Bacon prevailing wage requirements, which is held by the same prime contractor, so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics, including apprentices, trainees, and helpers, employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic, including any apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages required by the contract, the contracting agency may, after written notice to the contractor, take such action as may be necessary to cause the suspension of. any further payment, advance, or guarantee of funds until such violations have ceased. 3. Payrolls and basic records a. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work and preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work. Such records shall contain the name, address, and social security number of each such worker, his or her correct classification, hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in section 1(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR 5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in section 1(b)(2)(B) of the Davis -Bacon Act, the contractor shall maintain records which show that the commitment to provide such benefits is enforceable, that the plan or program is financially responsible, and that the plan or program has been communicated in writing to the laborers or mechanics affected, and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs, the registration of the apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs. Page 13 of 24 July 2016 Local Assistance Procedure Manual Exhibit 12-G b. (1) The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to the contracting agency. The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be included on weekly transmittals. Instead the payrolls shall only need to include an individually identifying number for each employee ( e.g. , the last four digits of the employee's social security number). The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available for this purpose from the Wage and Hour Division Web site at http://www.dol.gov/esa/whd/forms/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)(ii) of Regulations, 29 CFR part 5, the appropriate information is being maintained under §5.5 (a)(3)(i) of Regulations, 29 CFR part 5, and that such information is correct and complete; (ii) That each laborer or mechanic (including each helper, apprentice, and trainee) employed on the contract during the payroll period has been paid the full weekly wages earned, without rebate, either directly or indirectly, and that no deductions have been made either directly or indirectly from the full wages earned, other than permissible deductions as set forth in Regulations, 29 CFR part 3; (iii) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed, as specified in the applicable wage determination incorporated into the contract. (3) The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shalt 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 16 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 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 contractors 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 201.6 Local Assistance Procedure Manual Exhibit 12-G 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 frnge benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually perfornied. 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 3C. d. Apprentices and Trainees (programs of the U.S. DOT). Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal -aid highway construction programs are not subject to the requirements of paragraph 4 of this Section IV. The straight time hourly wage rates for apprentices and trainees under such programs will be established by the particular programs_ The ratio of apprentices and trainees to journeymen shall not be greater than permitted by the terms of the particular program. 5. Compliance with Copeland Act requirements. The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract. 6. Subcontracts. The contractor or subcontractor shall insert Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR 5.5. 7. Contract termination: debarment. A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. 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 fine 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 Local Assistance Procedure Manual Exhibit 12-G 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. V1. 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. 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 rontains all pertinent provisions and requirements of the prime contract. 5. The 30%self-performance requirement of paragraph (1) is not applicable to design -build contracts; however, contracting agencies may establish their own self -performance requirements. VII. SAFETY: ACCIDENT PREVENTION This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as it determines, or as the contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. 2. It is a condition of this contract, and shall be made a condition of each subcontract, which the contractor enters into pursuant to this contract, that the contractor and any subcontractor shall not permit any employee, in performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety, as determined under construction safety and health standards (29 CFR 1926) promulgated by the Secretary of Labor, in accordance with Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 3704), 3. Pursuant to 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Secretary under Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C.3704). Vill. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. In order to assure high quality and durable construction in conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers, contractors, suppliers, and workers on Federal -aid highway projects, it is essential that all persons concerned with the project perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or misrepresentation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these Page 16 of 24 July 2016 Local Assistance Procedure Manual Exhibit 12-G 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 Stat. 355), as amended and supplemented; Shall be fined under this title or imprisoned not more than 5 years or both." IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. By submission of this bid/proposal or the execution of this contract, or subcontract, as appropriate, the bidder, proposer, Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows: 1. That any person who is or will be utilized in the performance of this contract is not prohibited from receiving an award due to a violation of Section 508 of the Clean Water Act or Section 306 of the Clean Air Act. 2. That the contractor agrees to include or cause to be included the requirements of paragraph (1) of this Section X in every subcontract, and further agrees to take such action as the contracting agency may direct as a means of enforcing such requirements. X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal -aid construction contracts, design -build contracts, subcontracts, lower -tier subcontracts, purchase orders, lease agreements, consultant contracts or any other covered transaction requiring FHWA approval or that is estimated to cost $25,000 or more — as defined in 2 CFR Parts 18G 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. 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 terns "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 (bgps:/Av)y;v.epIs.eov7, 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. Local Assistance Procedure Manual Exhibit 12-G 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 lower tier transactions requiring prior FHWA approval or estimated to cost $25,000 or more - 2 CFR Parts 180 and 1200) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d- The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," "principal," and "voluntarily 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 Participanf' refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers). e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (ii"s://www.cols.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 c 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 Local Assistance Procedure Manual Exhibit 12-G Required Federal -Aid Contract Language 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING This provision is applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 (49 CFR 20) 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Deport Lobbying," in accordance with its instructions. 2. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 3. The prospective participant also agrees by submitting its bid or proposal that the participant shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such recipients shall certify and disclose accordingly. Page 19 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 12. FEMALE AND MINORITY GOALS To comply with Section II, "Nondiscrimination," of "Required Contract Provisions Federal -Aid Construction Contracts," the following are for female and minority utilization goals for Federal -aid construction contracts and subcontracts that exceed $10,000: The nationwide goal for female utilization is 6.9 percent. The goals for minority utilization [45 Fed Reg 65984 (10/3/1980)] are as follows: MINORITY UTILIZATION GOALS Economic Area Goal (Percent) _ Redding CA: 174 Non-SMSA (Standard Metropolitan Statistical Area) Counties: 6.8 CA Lassen; CA Modoc; CA Plumas; CA Shasta; CA Siskiyou; CA Tehama Eureka, CA 175 Non-SMSA Counties: 6.6 CA Del Norte; CA Humboldt; CA Trinity San Francisco -Oakland -San Jose, CA: SMSA Counties: 7120 Salinas -Seaside -Monterey, CA 28.9 CA Monterey 7360 San Francisco -Oakland 25.6 CA Alameda; CA Contra Costa; CA Marin; CA San Francisco; CA San Mateo 7400 San Jose, CA 176 CA Santa Clara, CA 19.6 7485 Santa Cruz, CA CA Santa Cruz 14.9 7500 Santa Rosa CA Sonoma 9.1 8720 Vallejo -Fairfield -Napa, CA CA Napa; CA Solano 17.1 Non-SMSA Counties: CA Lake; CA Mendocino; CA San Benito 23.2 _ Sacramento, CA: SMSA Counties: 6920 Sacramento, CA 16.1 177 CA Placer; CA Sacramento; CA Yolo Non-SMSA Counties 14.3 CA Butte; CA Colusa; CA El Dorado; CA Glenn; CA Nevada; CA Sierra; CA Sutter; CA Yuba Stockton -Modesto, CA: SMSA Counties: 5170 Modesto, CA 12.3 178 CA Stanislaus 8120 Stockton, CA 24.3 CA San Joaquin Non-SMSA Counties 19.8 CA Alpine; CA Amador; CA Calaveras; CA Mariposa; CA Merced; CA Tuolumne Page 20 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 179 Fresno -Bakersfield, CA SMSA Counties: 0680 Bakersfield, CA CA Kern 2840 Fresno, CA CA Fresno Non-SMSA Counties: CA Kings; CA Madera; CA Tulare 19.1 26.1 23.6 Los Angeles, CA: SMSA Counties: 0360 Anaheim -Santa Ana -Garden Grove, CA 11.9 CA Orange 4480 Los Angeles -Long Beach, CA 28.3 CA Los Angeles 6000 Oxnard -Simi Valley -Ventura, CA 21.5 180 CA Ventura 6780 Riverside -San Bernardino -Ontario, CA 19.0 CA Riverside; CA San Bernardino 7480 Santa Barbara -Santa Maria -Lompoc, CA 19.7 CA Santa Barbara Non-SMSA Counties 24.6 CA In o; CA Mono; CA San Luis Obispo San Diego, CA: SMSA Counties 7320 San Diego, CA 16.9 181 CA San Diego Non-SMSA Counties 18.2 CA briperial For the last full week July during which work is performed under the contract, you and each non material - supplier subcontractor with a subcontract of $10,000 or more must complete For n FHWA PR-1391 (Appendix C to 23 CFR 230). Submit the forms by August 15. 13. FEDERAL TRAINEE PROGRAM For the Federal training program, the number of trainees or apprentices is This section applies if a number of trainees or apprentices is specified in the special provisions. As part of your equal opportunity affirmative action program, provide on-the-job training to develop full journeymen in the types of trades or job classifications involved. You have primary responsibility for meeting this training requirement. If you subcontract a contract part, determine how many trainees or apprentices are to be trained by the subcontractor. Include these training requirements in your subcontract. Where feasible, 25 percent of apprentices or trainees in each occupation must be in their 1st year of apprenticeship or training. Distribute the number of apprentices or trainees among the work classifications on the basis of your needs and the availability of journeymen in the various classifications within a reasonable recruitment area. Before starting work, submit to the City/County of Page 21 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language 1. Number of apprentices or trainees to be trained for each classification 2. Training program to be used 3. Training starting date for each classification Obtain the City/County's of approval for this submitted information before you start work. The City/County of credits you for each apprentice or trainee you employ on the work who is currently enrolled or becomes enrolled in an approved program. The primary objective of this section is to train and upgrade minorities and women toward journeymen status. Make every effort to enroll minority and women apprentices or trainees, such as conducting systematic and direct recruitment through public and private sources likely to yield minority and women apprentices or trainees, to the extent they are available within a reasonable recruitment area. Show that you have made the efforts. In making these efforts, do not discriminate against any applicant for training. Do not employ as an apprentice or trainee an employee: 1. In any classification in which the employee has successfully completed a training course leading to journeyman status or in which the employee has been employed as a journeyman 2. Who is not registered in a program approved by the US Department of Labor, Bureau of Apprenticeship and Training Ask the employee if the employee has successfully completed a training course leading to j ourneyman status or has been employed as a journeyman. Your records must show the employee's answers to the questions. In your training program, establish the minimum length and training type for each classification. The City/County of _ and FHWA approves a program if one of the following is met: 1. It is calculated to: ■ Meet the your equal employment opportunity responsibilities ■ Qualify the average apprentice or trainee for journeyman status in the classification involved by the end of the training period 2. It is registered with the U.S. Department of Labor, Bureau of Apprenticeship and Training, and it is administered in a way consistent with the equal employment responsibilities of Federal -aid highway construction contracts Obtain the State's approval for your training program before you start work involving the classification covered by the program. Provide training in the construction crafts, not in clerk -typist or secretarial -type positions. Training is allowed in lower level management positions such as office engineers, estimators, and timekeepers if the training is oriented toward construction applications. Training is allowed in the laborer classification if significant and meaningful training is provided and approved by the division office. Off -site training is allowed if the training is an integral part of an approved training program and does not make up a significant part of the overall training. The City/County of reimburses you 80 cents per hour of training given an employee on this contract under an approved training program: 1. For on -site training 2. For off -site training if the apprentice or trainee is currently employed on a Federal -aid project and you do at least one of the following: ■ Contribute to the cost of the training ■ Provide the instruction to the apprentice or trainee ■ Pay the apprentice's or trainee's wages during the off -site training period 3. If you comply this section. Page 22 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language . Each apprentice or trainee must: 1. Begin training on the project as soon as feasible after the start of work involving the apprentice'-. or trainee's skill 2. Remain on the project as long as training opportunities exist in the apprentice's or trainee's work classification or until the apprentice or trainee has completed the training program Furnish the apprentice or trainee: Copy of the program you will comply with in providing the training Certification showing the type and length of training satisfactorily completed 14. TITLE VI ASSURANCES During the performance of this Agreement, the contractor, for itself, its assignees and successors in interest (hereinafter collectively referred to as CONTRACTOR) agrees as follows: (1) Compliance with Regulations: CONTRACTOR shall comply with the regulations relative to nondiscrimination in federally assisted programs of the Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be amended from time to time, (hereinafter referred to as the REGULATIONS), which are herein incorporated by reference and made a part of this agreement. (2) Nondiscrimination: CONTRACTOR, with regard to the work performed by it during the AGREEMENT, shall not discriminate on the grounds of race, color, sex, national origin, religion, age, or disability in the selection and retention of sub -applicants, including procurements of materials and leases of equipment. CONTRACTOR shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the agreement covers a program set forth in Appendix B of the Regulations. (3) Solicitations for Sub -agreements, Including Procurements of Materials and Equipment: In all solicitations either by competitive bidding or negotiation made by CONTRACTOR for work to be performed under a Sub -agreement, including procurements of materials or leases of equipment, each potential sub -applicant or supplier shall be notified by CONTRACTOR of the CONTRACTOR'S obligations under this Agreement and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin. (4) Information and Resorts: CONTRACTOR shall provide all information and reports required by the Regulations, or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be detennined by the California Department of Transportation or FHWA to be pertinent to ascertain compliance with such Regulations or directives. Where any information required of CONTRACTOR is in the exclusive possession of another who fails or refuses to furnish this information, CONTRACTOR shall so certify to the California Department of Transportation or the FHWA as appropriate, and shall set forth what efforts CONTRACTOR has made to obtain the information. (5) Sanctions for Noncompliance: In the event of CONTRACTOR's noncompliance with the nondiscrimination provisions of this agreement, the California Department of Transportation shall impose such agreement sanctions as it or the F14WA may determine to be appropriate, including, but not limited to: (a) withholding of payments to CONTRACTOR under the Agreement within a reasonable period of time, not to exceed 90 days; and/or (b) cancellation, termination or suspension of the Agreement, in whole or in part. (6) Incorporation of Provisions: CONTRACTOR shall include the provisions of paragraphs (1) through (6) in every sub -agreement, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. Page 23 of 24 July 2016 Local Assistance Procedures Manual Exhibit 12-G Required Federal -Aid Contract Language CONTRACTOR shall take such action with respect to any sub -agreement or procurement as the California Department of Tra isportation or FHWA may direct as a means of enforcing such provisions including sanctions for noncompliance, provided, however, that, in the event CONTRACTOR becomes involved in, or is threatened with, litigation with a sub -applicant or supplier as a result of such direction, CONTRACTOR may request the California Department of Transportation enter into such litigation to protect the interests of the State, and, in addition, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. 15. USE OF UNITED STATES -FLAG VESSELS The CONTRACTOR agrees - To utilize privately owned United States -flag commercial vessels to ship at least 50 percent of the gross tonnage (computed separately for dry bulk carries, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or commodities pursuant to this contract, to the extent such vessels are available at fair and reasonable rates for United States -flag commercial vessels. To Furnish within 20 days following the date of loading for shipments originating within the United State 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 (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. To insert the substance of the provisions of this clause in all subcontracts issued pursuant to this contract. MAINTAIN RECORDS AND SUBMIT REPORTS DOCUMENTING YOUR PERFORMANCE UNDER THIS SECTION Page 24 of 24 July 2016 EXHIBIT C (Buy America) 16-5 093lfederally-funded-construction-contract. doclrev. 94l2016 EXHIBIT C Code of Federal Regulations Title 23 - Highways Volume: 1 Date: 2001-04-01 Original Date: 2001-04-01 Title: Section 633.102 - Applicability. Context: Title 23 - Highways. CHAPTER I - FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION. SUBCHAPTER F - TRANSPORTATION INFRASTRUCTURE MANAGEMENT. PART 633 -REQUIRED CONTRACT PROVISIONS. Subpart A - Federal -Aid Construction Contracts (Other Than Appalachian Contracts). § 633.102 Applicability. (a) The required contract provisions and the required proposal notices apply to all Federal -aid construction contracts other than Appalachian construction contracts. (b) Form FHWA-1273, 'Required Contract Provisions, Federal -aid Construction Contracts," contains required contract provisions and required proposal notices that are required by regulations promulgated by the FHWA or other Federal agencies. The required contract provisions of Form FHWA-1273 shall be physically incorporated in each Federal -aid highway construction contract other than Appalachian construction contracts (see § 633.104 for availability of form). (c) For contracts authorized under certification acceptance procedures, an alternate format for inclusion of required contract provisions may be used pursuant to 23 CFR part W. (d) The required contract provisions contained in Form FHWA-1273 shall apply to all work performed on the contract by the contractor's own organization and to all work performed on the contract by piecework, station work, or by subcontract. (e) The contractor shall insert in each subcontract, except as excluded by law or regulation, the required contract provisions contained in Form FHWA-1273 and further require their inclusion in any lower tier subcontract that may in turn be made. The required contract provisions of Form FHWA-1273 shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the requirements contained in the provisions of Form FHWA-1273. (f) The State highway agency (SHA) shall include the notices concerning certification of nonsegregated facilities and implementation of the Clean Air Act and Federal Water Pollution Control Act, pursuant to 40 CFR part 15, in all bidding proposals for Federal -aid highway construction projects. As the notices are reproduced in Form FHWA-1273, the SHA may include Form FHWA- 1273 in its entirety to meet this requirement. A " Q® `v(f'R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/15/2017 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 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 endorsements . PRODUCER Wood Gutmann & Bogart 15901 Red Hill Ave., Suite 100 Lic #0679263 CONTACT NAME: Katie Frye P"oNE 714-824-8344 FAx E-MAIL . kfrye@wgbib.com INSURERS AFFORDING COVERAGE NAIC # Tustin CA 92780 INSURER A:EVANSTON INS CO 35378 INSURED HARDY-1 INSURER B :Zurich American Insurance Co. 16535 INSURER C: First Mercury Insurance Co 10657 Hardy & Harper, Inc. INSURERD:Great American Insurance Co. 16691 Maas Equipment, LLC 1312 E. Warner Ave. Santa Ana CA 92705 INSURER E: INSURER F : rnvcoer_ce f%C0TiCIf%ATt= ullRnracra• 2145479295 RPVIRIAN NIIMRFR- ------------------ ------ ----------- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCEADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY WACGL000006023002 12/31/2016 12/31/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGE TO TED PREMISES Ea occurrence) $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY [X]PE0 LOC $ OTHER: B AUTOMOBILE LIABILITY BAP373645411 10/1/2016 10/1/2017 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ D UMBRELLA LIAR X OCCUR TUE406784501 12/31/2016 12/31/2017 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 EXCESS LIAR CLAIMS -MADE DED I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE WC373645312 10/1/2016 10/1/2017 X I PER OTH- ST ATUTE ER _ E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I L A Pollution Liability 15CPLOWE00089 7/1/2015 7/1/2017 $2,000,000 agg $1,000,000 occ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ENDORSEMENTS ATTACHED ONLY APPLY AS REQUIRED BY WRITTEN CONTRACT SUBJECT T E TERMS AND CONDITIONS OF THE POLICY. APPROVED RE: Adams Avenue Rehabilitation and Atlanta Avenue Rehabilitation Projects - CC1502 B ADDITIONAL INSURED: MICHAEL E. GATES See Attached... CITY ATTORNEY OF HUNTINGTON BEACH City of Huntington Beach 2000 Main Street Huntington Beach CA 92648 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. @ 1988*014 ACORD ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD All rights reserved. AGENCY CUSTOMER ID: HARDY-1 _ LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Wood Gutmann & Bogart NAMED INSURED Hardy & Harper, Inc. Maas Equipment, LLC 1312 E. Warner Ave. Santa Ana CA 92705 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: AnnITIONA1 RFMARI(C THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers GENERAL LIABILITY: Additional insured applies per attached endorsements CG 20 33 04 13 and CG 20 37 04 13. Primary and Non Contributory wording applies per attached endorsement FMIC-GL-1002 (10/2015). Waiver of Subrogation applies per attached endorsement CG 24 04 05 09. AUTOMOBILE LIABILITY: Additional insured applies per attached endorsement CA 20 48 1013 and U-CA-424-FCW (04-14). Primary wording applies per the attached CA 01 43 10 13. Waiver of Subrogation applies per attached endorsement CA04441013. WORKERS COMPENSATION: Waiver of Subrogation applies per attached endorsement WC 04 03 06 04-84. ACORD 101 (2008/01) U 2=5 AGUKU GUKt'UKA I IUN. An rlgnis reserves. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BAP 3736454-12 COMMERCIAL AUTO CA 20 01 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR -ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Insurance Company: AMERICAN ZURICH INSURANCE COMPANY Policy Number: BAP 3 7 3 6 4 5 4 -12 Effective Date: 10 - 0 1 - 2 016 Expiration Date: 10 - 01- 2 017 Named insured: HARDY & HARPER, INC. Address: 1312 E WARNER AVE SANTA ANA CA 92705- Additional Insured (Lessor): ALL LESSORS Address: 1312 E WARNER AVE SANTA ANA, CA USA 92705 Designation Or Description BLANKET ANY LEASED VEHICLE WITH LEASE GREATER Of "Leased Autos': THAN 6 MONTHS CA 20 01 1013 C Insurance Services Office, Inc., 2011 Page 1 of 2 Coverages Limit Of insurance Covered Autos Liability $ 1 0 0 0 0 0 0 Each "Accident" Actual Cash Value Or Cost Of repair Whichever Is Less, Minus Comprehensive SEE ENDT Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus Collision SEE ENDT Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus Specified Causes Of Loss Deductible For Each Covered "Leased Auto" Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Coverage 1. Any "leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow. 2 For a "leased auto" designated or described in the Schedule, the Who is An Insured provision under Covered Autos Liability Coverage is changed to include as an "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: a. You; b. Any of your "employees' or agents; or c. Any person, except the lessor or any .,employee' or agent of the lessor, operating a "leased auto" with the permission of any of the above. 3. The coverages provided under this endorsement apply to any "leased auto" described in the Schedule until the expiration date shown in the Schedule, or when the lessor or his or her agent takes possession of the "leased auto", whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a "leased auto". 2 The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor, we will obtain his or her rights against any other party. C. Cancellation 1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition. 2 If you cancel the policy, we will mail notice to the lessor. 3. Cancellation ends this agreement. D. The lessor is not liable for payment of your premiums. E. Additional Definition As used in this endorsement: "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. Page 2 of 2 0 Insurance Services Office, Inc., 2011 CA 20 01 1013 POLICY NUMBER: BAP 3736454-12 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organ¢ation(s): ALL CALIFORNIA OPERATIONS will The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the `loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: PAP 3736454-12 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WHICH IS REQUIRED TO BE NAMED AS A RESULT OF A WRITTEN CONTRACT WITH YOU AND WHICH WE HAVE ON FILE VIA CERTIFICATE OF INSURANCE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 C Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY #WACGL0000060230012 COMMERCIAL GENERAL LIABILITY EFFECTIVE: 12/31/16 - 12/31/17 CG 20 33 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL_ GENERAL. LIABILITY COVERAGE PART A. Section It -- Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contractor agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law: and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. S. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to. 1. "Bodily injury", „property damage„ or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, reaps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the dams against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury" involved the rendering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 0413 Q Insurance Services Office, Ina, 2012 Page 1 of 2 2. "Bodily injury" or "property damage" occurring after: a. 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 b. 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 C. With respect to the insurance afforded to these additional insureds, the fo€lowing is added to Section III-- Urrilts Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the appiicable limits of Insurance shown in the Declarations; whichever is less. This endorsement shag not increase the applicable limits of Insurance shown in the Declarations. CG 20 33 0413 0 Insurance Services Office, Inc.; 2012 Page 2 of 2 POLICY NUMBER: WACGL04000602300 2 COMMERCIAL GENERAL LIABILITY EFFECTIVE: 12/31/16 to 12/31/17 CG 20 37 0413 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As required by written contract signed by both parties prior to Coverage under this endorsement applies to all commercial the loss. and residential construction, excluding any construction operations, work or activities performed on any condominiums (as defined by controlling applicable statute), "tract homes" or "townhouse projects". "Tract homes" means _10_ or more single-family dwellings constructed by a developer consecutively or concurrently on a single or subdivided parcel or tract of land utilizing common or similar design elements, floorplans or blueprints. "Townhouse projects" means mulfi-unit housing consisting of homes in a row of the same or similar design with common walls or with very narrow spacing between adjacent sidewalls. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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 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 2. 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. CG 20 37 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition 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 an additional insured 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 prior to the injury or damage that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. However, the insurance provided under this endorsement will not apply beyond the extent required by such contract or agreement. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. This endorsement forms a part of the Policy to which attached, effective on the inception date of the Policy unless otherwise stated herein. (The following information is required only when this endorsement is issued subsequent to preparation of the Policy.) Endorsement effective Policy No. Endorsement No. Named Insured Countersigned by F M I C -G L-1002 (10/2 015 ) POLICY NUMBER: WA-CGL-0000060230-02 COMMERCIAL GENERAL LIABILITY CG24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: A person or organization you have agreed in a written contract to waive any Right of Recovery against provided the Written Contract is executed prior to the Injury or Damage. Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 EI r'gIIC,y w. VVl.3/30-i031 1 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHTTO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation pre- mium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL CALIFORNIA OPERATIONS WC 252 (4-84) WC 04 03 06 (Ed. 4-84) Page 1 of 1 RECEIVED BY: (Name) (Date) • TO: FROM: DATE: SUBJECT: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION City Treasurer City Clerk Bond Acceptance I have received the bonds for CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. Other No. g:/forms/bond transmittal to treasurer (Company Name) ;76 S3-5- 7-6f/ Approved Agenda Item No. City Clerk Vault No. SIRE System ID No Ste/ (CoLfncil Approval ate) THE FINAL PREMIUM IS PREDICATED ON THE This bond was executed in FINAL CONTRACT PRICE two (2) identical counterparts. [Jwilatl! 1 a 1 ■ 1 KNOW ALL PERSONS BY THESE PRESENTS: Bond No, 7653578 Premium: See Performance Bond WHEREAS, City of Huntington Beach (hereafter referred to as "City'') has. awarded to Hardy, Harper Inc 1312 E. Warner Avenue Santa Ana CA 92705 (name and address of Contractor) (hereinafter referred to as "Principal"), a contract ("Contract") for the work described as follows: Adams Avenue Rehabilitation and Atlanta Avenue Rehabilitation Projects CC-1502 (Project Titled WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to furnish a bond to secure the :payment of clainis of laborers, mechanics, materialn-ien, 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 companies, such as from AA1. 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 Fidelitv and Deposit Companv of Marvland 777 South Fiqueroa Street Suite 3900 Los Angeles CA 90017 (name and address of Surety) as Surety, are held and firmly:bound unto City in the penal sum of One Million Three Hundred Eighty Eiqht Thousand and 001100 dollars (89 388,000.00 4, 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 GBLtGATION 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 wont 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 employeesof 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 earned 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.. PAYME N1 BOND Pa,e E of 1 -455 14/1 t 735T V 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 vw&k 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 terrns of the Contract, the. contract documents or the work thereunder' Surety also waives the provisions of CCalifornia Civil Code §§ 2848 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 party's proper legal name and that the individuals signing this instrument have been duiy 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 June 15, 2017 ATTEST Hardy & Harper, Inc. (Corporate Seal) (P�t ci #slam By: Narne:Steve Kirschner Title: vice President ATTEST Fidelity and Deposit Company of Maryland (Corporate Seal) jSurety Name) By: Name_ Dwight Reilly (Signature of Attorney -in -Fact for Surety) (Attach Attorney -gin -Fact Certificate) 2t 13)270-0600 (Area Code & Telephone Number for Surety; APPROVED AS By:. E., Gates, -City Attorney f-1, !Vote: This bond trust be executed in duplicate and dated, afi signaturals must be notarized, and evidence of Lhe authoft of arty person signing at adtomey-in-fact must be attached. Page 2 of 2 I SA5 S4tt.1735 3 PAYMENT BOND CALIFORNIA•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 June 15. 2017 before me, Vanesss Garcia, Notary Public Date Here Insert Name and Title of the Officer personally appeared Steve Kirschner Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(x) whose name(o is/axe subscribed to the within instrument and acknowledged to me that he/sKe/thsey executed the same in his/hoer/their authorized capacity(i(G), and that by his/h)er/their signature( on the instrument the person(a), or the entity upon behalf of which the person(x) acted, executed the instrument. [@7N,11t"ary VANESSA GARCIA COMM. #2151902 n Public -California N IrORANGE COUNTY amm. Expires May 3, 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 \/ 1 6? lv�c� 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: Payment Bond Document Date: June 15, 2017 Number of Pages: 1 Signer(s) Other Than Named Above: Dwight Reilly Capacity(ies) Claimed by Signer(s) Signer's Name: Steve Kirschner EZ Corporate Officer — Title(s): Vice Pres'd,=nt ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Hardy & Harper, Inc Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator F-1 Other: Signer Is Representing: -ei 'y � •ti6'a' •y<'m G'd -ar -y 'r 'e� •cam -ai •d -ai -✓4'e/gy "d "yy "c+ "� -ci •e.4'ar ••� "e' 'r •d •m •d -•, 'er •d -ems •er •e• "✓ 'y -e, •e• •d "y "e'• " 02014 National Notary Association - www.Nationa[Notary.org - 1-800-US NOTARY (1-800-876-6827) 'Item #5907 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 June 15, 2017 before me, Susan Pugh, Notary Public (insert name and title of the officer) personally appeared - Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(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. 's``"`r`": SUSAN PUGHCOMM.#2105405 -ir Notary Public -California ORANGE COUNTY U. h1y Comm. Expires Apr 29, 2019 Signature (Seal) ^� Susan Pugh 1 Bond No. 7653578 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Daniel HUCKABAY, Dwight REILLY, Arturo AYALA, Shaunna Rozelle OSTROM and Michael CASTANEDA, all of Orange, California, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 29th day of March, A.D. 2017. ATTEST: B Assistant Secretary Joshua Lecker ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Np� agly�� ^Q DE�psJ` � Eli SEAL o: gGa � o Vice President Michael Bond State of Maryland County of Baltimore On this 29th day of March, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and JOSHUA LECKER, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. + +,1111111 fI r ix riY. ? •ii i Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA-F 012-0079B 6/19/2017 Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC 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 Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information FIDELITY AND DEPOSIT COMPANY OF MARYLAND 1299 ZURICH WAY SCHAUMBURG, IL 60196 800-382-2150 Old Company Names Agent For Service KARISSA LOWRY 2710 GATEWAY OAKS DRIVE SUITE 15ON SACRAMENTO CA 95833 Reference Information Effective Date NAIC #: 39306 California Company ID #: 2479-4 Date Authorized in California: 01/01/1982 License Status: UNLIMITED -NORMAL Company Type: Property & Casualty State of Domicile: MARYLAND back to top NAIC Group List NAIC Group #: 0212 ZURICH INS GRP Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AIRCRAFT AUTOMOBILE BOILER AND MACHINERY BURGLARY CREDIT FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY https://i nteractive.web.i nsurance.ca.gov/com panyprofile/com panyprofi le?event=com panyProfii le&doF uncti on=getCom panyProfii I e&ei d=6217 1/2 6/19/2017 Surety Bonds - Certified Companies Executive Risk Indemnity Inc. (NAIC #35181) BUSINESS ADDRESS: 15 Mountain View Road , Warren , NJ 07059. PHONE: (908) 903-2000. UNDERWRITING LIMITATION b/: $126,714,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MP, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Delaware. Explorer Insurance Company (NAIC #40029) BUSINESS ADDRESS: P.O. BOX 85563, SAN DIEGO, CA 92186 - 5563, PHONE: (858) 350-2400 x-2550. UNDERWRITING LIMITATION b/: $10,147,000. SURETY LICENSES c,f/: AZ, CA, CO, CT, HI, ID, IL, IN, IA, MD, MA, MI, MS, MT, NJ, NV, NM, OR, PA, TN, TX, UT, VT, VA, WA, WV. INCORPORATED IN: California. T Back To Top Fair American Insurance and Reinsurance Company (NAIC #35157) BUSINESS ADDRESS: One Liberty Plaza, 165 Broadway, New York, NY 10006. PHONE: (212) 365-2200. UNDERWRITING LIMITATION b/: $24,182,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, VI, WA, WV, WI, WY. INCORPORATED IN: New York. Farmers Alliance Mutual Insurance Company (NAIC #19194) BUSINESS ADDRESS: P.O. Box 1401, McPherson, KS 67460. PHONE: (620) 241-2200. UNDERWRITING LIMITATION b/: $16,564,000. SURETY LICENSES c,f/: CO, ID, IA, KS, MN, MO, MT, NE, NM, ND, OK, SD. INCORPORATED IN: Kansas. Farmington Casualty Company (NAIC #41483) BUSINESS ADDRESS: ONE TOWER SQUARE, HARTFORD, CT 06183. PHONE: (860) 277-0111. UNDERWRITING LIMITATION b/: $29,133,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Connecticut. Farmland Mutual Insurance Company (NAIC #13838) BUSINESS ADDRESS: ONE WEST NATIONWIDE BLVD., 1-04-701, COLUMBUS, OH 43215 - 2220. PHONE: (515) 508-3300. UNDERWRITING LIMITATION b/: $17,059,000. SURETY LICENSES c,f/: AL, AZ, AR, CA, CO, DE, DC, FL, GA, ID, IL, IN, IA, KS, KY, MD, MI, MN, MS, MO, MT, NE, NV, NC, ND, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WA, WV, WI, WY. INCORPORATED IN: Iowa. FCCI Insurance Company (NAIC #10178) BUSINESS ADDRESS: 6300 University Parkway, Sarasota, FL 34240 - 8424. PHONE: (800) 226-3224. UNDERWRITING LIMITATION b/: $53,562,000. SURETY LICENSES c,f/: AL, AZ, AR, CO, DC, FL, GA, IL, IN, IA, KS, KY, LA, MD, MI, MS, MO, NE, NC, OH, OK, PA, SC, TN, TX, VA. INCORPORATED IN: Florida. Federal Insurance Company (NAIC #20281) BUSINESS ADDRESS: 15 Mountain View Road , Warren , NJ 07059. PHONE: (908) 903-2000. UNDERWRITING LIMITATION b/: $1,186,080,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MP, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, VI, WA, WV, WI, WY. INCORPORATED IN: Indiana. FEDERATED MUTUAL INSURANCE COMPANY (NAIC #13935) BUSINESS ADDRESS: 121 EAST PARK SQUARE, OWATONNA, MN 55060. PHONE: (507) 455-5200, UNDERWRITING LIMITATION b/: $286,243,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, ID, IL. IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Minnesota. Fidelity and Deposit Company of Maryland (NAIC #39306) BUSINESS ADDRESS: 1299 ZURICH WAY, SCHAUMBURG, IL 60196 - 1056. PHONE: (847) 605-6000. UNDERWRITING LIMITATION b/: $14,738,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MP, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, VI, WA, WV, WI, WY. INCORPORATED IN: Maryland. FIDELITY AND GUARANTY INSURANCE COMPANY (NAIC #35386) BUSINESS ADDRESS: One Tower Square, Hartford, CT 06183. PHONE: (860) 277-0111. UNDERWRITING LIMITATION b/: $1,929,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Iowa. Fidelity and Guaranty Insurance Underwriters, Inc. (NAIC #25879) BUSINESS ADDRESS: One Tower Square, Hartford, CT 06183. PHONE: (860) 277-0111. UNDERWRITING LIMITATION b/: $8,620,000. SURETY LICENSES c,f/: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY. INCORPORATED IN: Wisconsin. Financial Casualty & Surety, Inc. (NAIC #35009) BUSINESS ADDRESS: 3131 Eastside, Suite 600, Houston, TX 77098. PHONE: (800) 392-1604. UNDERWRITING LIMITATION b/: $1,506,000. SURETY LICENSES c,f/: AZ, CA, CT, DE, FL, l Translate) hftps://www.fiscal.treasury.gov/fsreports/ref/suretyBnd/c570_a-z.htm 8/23 Rating Search: Search Advanced Search An Print or PDF Fidelity and Deposit Company of Maryland (�) A.M. Best #: 000387 NAIC #: 39306 FEIN #: 133046577 Administrative Office View Additional Address Information 1299 Zurich Way Schaumburg, IL 60196-1056 United States Web: www.zurichna.com Phone: 800-987-3373 Fax:877-962-2567 Assigned to Financial so-iLngmRating insurance companies "BEST 710 that have, in our A+ superior opinion, a superior ability to meet their ongoing insurance obligations. Based on A.M. Best's analysis, 050457 - Zurich Insurance Group Ltd is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Financial Strength Rating View Definition Rating: Affiliation Code: Financial Size Category Outlook: Action: Effective Date: Initial Rating Date: A+ (Superior) g (Group) XV ($2 Billion or greater) Negative Affirmed December 01, 2016 June 30, 1922 Long -Term Issuer Credit Rating View Definition Long -Term: aa- Outlook: Negative Action: Affirmed Effective Date: December 01, 2016 Initial Rating Date: September 14, 2004 u Denotes Under Review Best's Rating Best's Credit Rating Analyst Rating Issued by: A.M. Best Rating Services, Inc. Senior Financial Analyst: Darian Ryan Senior Director: Michael J. Lagomarsino, CFA, FIRM Disclosure Information View A.M. Best's Rating Disclosure Form A.M. Best Affirms Credit Ratings of Zurich 1�_ Insurance Company Limited and Its Main Rated I' Affiliates December 01, 2016 A.M. Best has provided ratings & analysis on this company since 1922. Powered by A.M. Best's Global Insurance Database Page I of 3 THE FINAL PREMIUM IS This bond was executed in PREDICATED ON THE two (2) identical counterparts. FINAL CONTRACT PRICE KNOW ALL PERSONS BY THESE PRESENTS: Bond No.7653578 Premium: $7,160.00 WHEREAS, City of Huntington Beach (hereafter referred toas'City") has, by wCitten agreement stated .20—, entered into a contract with Of (hereinafter referred to as 'Principal'), for performance of the work described as follows: Adams Avenue Rehabilitation and Atlanta Avenue Rehabilitation (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 Linder 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, Nloody'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 as Surety, are held and (name and address of Surety) bound unto City in the penal sum of One Million Three Hundred Dollars 1,388,000.00 }, this amount being .not less than one hundred percent of the price set forth in the Contract, in lawrful 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 tS SUCH THAT if the Principal shall promptly, fully and faithUly perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall indemnify and save harmless City and all of City's officers, agents and employees (hereinafter collectively referred to as ;'Obligees"} fromary and all losses, liability and damages, claims, judgments, stop notices, fees and costs of every description, whether impDsed 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 or 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 Contractor any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety under this Bond. Surety waives notice of any adiustment of contract or contract price, and any other alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, and agrees 15-4594/1 M74 Bond No. 7653578 to automatically adjust the penal. sum of this Band 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 Band shall surrivethe. 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 naive 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 hasor may have by reason of any failure of the Principal to execute or properly execute this bond. gated: June 15, 2017 ATTEST Hardy & Harper, Inc. (Corporate Seal) By: t' €incipalej i. netName, e Title. Vice PrPGi dPxl± ATTEST Fidelity and Deposit Company of Maryland (Corporate Seal). fsurety.Name) By: Natne- Dwight Reilly tSignature of Attorney -in -Fact for Surety) (Attach Attorney -in -Fact Certificate) 2t 1 � 270-0600 (Area Code & Telephone Number for Surety) APPROVED AS TO City Attorney el Note- This Mond must be executed in duplicate and dated, all signatures trust be notarized, and evidence of the authority of arty person signing as adomey-in fact must be at?ached. PERFORMANCE BOND Page 2 of 2 1 ;i84f117174 CALIFORNIA• • • i 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 June 15 2017 before me, Vanessa Garcia Notary Public Date Here insert Name and Title of the Officer personally appeared Steve Kirschner Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(x) whose name(s�) is/acre subscribed to the within instrument and acknowledged to me that he/sKe/tliey executed the same in his/her/their authorized capacity(i(�fi), and that by his/h)Rr/their signature(g) on the instrument the person(sr), or the entity upon behalf of which the person(x) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. @my VANESSA GARCIAyCOMM. #2151902 M Signature Notary Public -California XSignature of Notary Public ORANGE COUNTY Comm. Expires May 3, 2020 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: Performance Bond Document Date: June 15, 2017 Number of Pages: 1 Signer(s) Other Than Named Above: Dwight Reilly Capacity(ies) Claimed by Signer(s) Signer's Name: Steve Kirschner ❑v Corporate Officer — Title(s): virP Praciriant ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Hardy & Harper, Inc Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator I-1 Other: Signer Is Representing: 02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 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 June 15, 2017 before me, Susan Pugh, Notary Public (insert name and title of the officer) personally appeared Dwight Reilly who proved to me on the basis of satisfactory evidence to be the person(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 Susan SUSAN PUG COMM. #2105405 ro Notary Public -Cali fornia ORANGE COUNTY LL My Comm. Expires Apr 29, 2019 (Seal) Bond No. 7653578 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Daniel HUCKABAY, Dwight REILLY, Arturo AYALA, Shaunna Rozelle OSTROM and Michael CASTANEDA, all of Orange, California, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 29th day of March, A.D. 2017. ATTEST: Assistant Secretary Joshua Lecker ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND tH �. 4•• of� —.low ; 6 Vice President Michael Bond State of Maryland County of Baltimore On this 29th day of March, A.D. 2017, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and JOSHUA LECKER, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. Constance A. Dunn, Notary Public My Commission Expires: July 9, 2019 POA-F 012-0079B 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 June 23, 2017 Hardy & Harper, Inc. Attn: Steve Kirschner 1312 East Warner Ave. Santa Ana, CA 92705 Re: Adams Avenue and Atlanta Avenue Rehabilitation Projects — CC-1502 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. erely, 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 PW17-022 Page 1 of 2 Meeting Date: 6/5/2017 Awt9kl&-�� 7 CITY OF HUNTINGTON BEACH REQUEST FOR. CITY COUNCIL ACTION MEETING DATE: 6/5/2017 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: Accept the lowest responsive and responsible bid and authorize execution of a construction contract with Hardy & Harper, Inc. in the amount of $1,388,000.00 for the Adams Avenue Rehabilitation and Atlanta Avenue Rehabilitation Project, CC-1502 Statement of Issue: On May 9, 2017, bids were publicly opened for the Adams Avenue Rehabilitation and Atlanta Avenue Rehabilitation Project. City Council action is requested to award the construction contract to Hardy & Harper, Inc., the lowest responsive and responsible bidder. Financial Impact: Funding in the amount of $1,620,000 is included in the FY 16-17 budget; in the Measure M Business Unit 21390026 ($1,120,000) and in the OCTA Grant Fund, Business Unit 87390009 ($500,000). Recommended Action: A) Accept the lowest responsive and responsible base bid submitted by Hardy & Harper, Inc. in the amount of $1,388,000.00; and, B) 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, or provide staff with alternative action. Analysis: The proposed project will rehabilitate Adams Avenue (Beach Boulevard to Newland Street) & Atlanta Avenue (Beach Blvd. to Newland Street). The segments of Adams Avenue and Atlanta Avenue were last rehabilitated in 1990 and 1984 respectively. Rehabilitation methods include grinding out and replacing failed asphalt concrete as well as standard overlay. Sewer manholes and water meter boxes and valves will be adjusted to grade. Areas of raised or settled curb, gutter, and sidewalk will be replaced as necessary. The project is using a sustainable paving material which utilizes rubberized asphalt concrete (RAC) which contains crumb rubber derived from 100% California waste tire rubber. A two inch layer of RAC uses over 2,000 waste tires per lane mile. The project will divert more than 8,000 waste tires that would otherwise end up in a landfill. Including this project, the use of RAC in the rehabilitation of the City's arterial streets has resulted in the diversion of over 311,000 waste tires. H B _ Item 4. - 1 Dept. ID PW17-022 Page 2 of 2 Meeting Date: 6/5/2017 Bids were publicly opened on May 9, 2017, with the following results: BIDDER'S NAME BID AMOUNT (Amount Read at Bid Opening and Basis of Award) Total Contract Amount Hardy & Harper, Inc. $1,388,000.00 $1,388,000.00 All American Asphalt $1,430,244.00 $1,430,244.00 R.J. Noble Co $1,474,357.00 $1,474,357.00 Excel Paving $1,497,762.00 $1,497,762.00 Griffith Company $1,675,447.50 $1,675,447.50 EBS General Engineering, Inc $1,892,295.00 $1,892,295.00 The engineer's estimate for the project is $1,350,000. Staff recommends awarding a contract to Hardy & Harper, Inc. in the amount of $1,388,000.00. Hardy & Harper, Inc. has provided acceptable street rehabilitation construction in the past year for the Nichols Street Rehabilitation Project from Warner Avenue to Slater Avenue. The total project cost is estimated to be $1,620,000.00, which includes the construction contract, project management, construction contingency, and supplemental items (soils and materials testing, construction support services by outside firms, and additional engineering support). In addition to the grant funding of $500,000 from the OCTA Arterial Pavement Management (APM) program, reimbursement from the Cal Recycle Rubberized Asphalt Concrete (RAC) grant in the amount of $35,000 is anticipated. Public Works Commission Action: The Public Works Commission reviewed and approved CC-1502 on March 16, 2016, with a vote of 6-0-1 (Capps -absent). Environmental Status: The project is categorically exempt pursuant to Class 1, section 15031 c of the California Environmental Quality Act. Strategic Plan Goal: Enhance and maintain infrastructure Attachment(s): 1. Project Location Map Item 4. - 2 HB -34- s9� P�G�O � ~ V)0 BOLSA AVE O U V) NTS = Mc FADDEN AVE. U w z v~i Q J EDING R � AVE. z p < Z V) o 05 a AVE. m m o Of w V)\\Coo c� Ja WAR ER V) a Z AVE. cl w 0 0 w SLATER J o0 = AVE. C4O 0 0 TALBERT AVE. 3�, ELLIS AVE. % PROJECT LOCATION (DADAMS AVE. ( BEACH TO NEWLAND ) N O2 ATLANTA AVE. ( BEACH TO NEWLAND ) LEGEND ARTERIAL REHABILITATION LOCATIONS GARFIELD � AVE. 2 Q o V) V) 0 Of YORKTOWN g AVE. ?� UTIC w ADA S Z AVE. q c INDIANAPOLIS o AVE. ATLANTA AVE. _ o o m m Of HAMILTON AVE. m OCEAN BANNING 2 ARTERIAL REHABILITATION, CC-1502 PROJECT LOCATION MAP CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS HB ->>-- REV 02/11 /16 . Item 4. CITY OF HUNTINGTON BEACH PROJECT NAME: Adams Avenue and Atlanta Avenue CC#: CC-1502 BID OPENING DATE: 5/9/2017 TIME & LOCATION: 2:00 PM City Council Chambers ENGINEER'S ESTIMATE: $1,350,000.00 BIDS SUBMITTED (AS READ AT OPENING) PTS 07282015 Version 15 CC1502 C'C� - isa� � 1 ,-^ S �� s 47Ziq,.}7Pr Esparza, Patty From: David Ward [dward@ocregister.com] Sent: Friday, April 07, 2017 9:05 AM To: Esparza, Patty Cc: Wagner, James Subject: Re: Legal ad for the FIB Wave - CC-1502 Good morning Patty. Your notice is all set and ready to go. Have a great weekend! Ad410931032 Run Date 4/13 & 4/20 & 4/27 Cost $945.00 PROOF NOTICE INVITING SEALED BIDS for the construction of ADAMS AVENUE REHABILITATION FROM BEACH LEVARD AND TON EWLAND STREET" ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID P ROJ ECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUN- TI NGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2.00 PM on May 9 2017. Bids will be public, IV opened in the Council Chambers unless otherwise posted. Copies ai the Plans Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street Huntington Beach CA 926-8, upon payment of a $21-00 nonrefundable fee if pickW up, or Payment of a $41.00 nonrefundable fee If sent by UPS ground delivery (bidder shall pay additional costs for special delivery), Plans, Specifications, and contract documents can be down Ioa ded tt ree on AG E N CY vt ebsite. httr•;#.vvi.huntincrtonbeachco,aav:'aovernment,department!Publlc_ work This isa Davis -Bacon prolectand the Federal Regulationswill 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, 2X0 ,Main Street, Hun- tington Beach, CA 926, 8. The AGENCY will deduct 5% retention from all prog9ress payments. The Contractor may substitute an escrow holdersurety 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 }w[II 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, dolor, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared an the approved Pro- posal forms in conformance with the Instructronsto Bidders as deter- mined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGEN- CY for an amount no less than 1€ %of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor*s License ssthe The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All ex- tension of unit prices will be subject to *,verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. ProleetDescriptlon: The protect consists of the following street segments (1) Adams Avenue from beach Blvd. to Newland Street, and (2) Atlanta Avenue from Beach Blvd. to Neviland. The proposed improvements includes grinding the existing pavement; removing failed roadway sections and replacing with new base course asphalt concrete (AC)and new finish course rubberized asphalt concrete (RAC); removinginstalling concrete curb and gutter; cross gutters, sidewalk and access romps; adjusting manholes and monitoring well covers, adjusting survey monuments; replacing and adjusting water vcal.%- assemblies to grade; removing trees that have uplifted side- walks and installing new trees; and installing traffic loops and striping, The contract shall allow the Contractor 6b working days to complete the contract. Atlanta Avenue construction shall commence after substantial corn- pletion (as determined by AGENCY) of Adams Avenue project. Both shall be construciedwithin the allowable total working days. The Project Disadvantage Business Enterprises (DBE) goal is 6.0% The AGENCY reserves the right to reject any or al 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. 2016.58. Attest: 1%1 Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH Published: Huntington Beach Wave April 13, 20, 27, 2017 10931032 '4," CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT 2000 Main Street P.O Box 1 90 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: April 6, 2017 Project/C.C. No.: CC No. 1502 Regarding: ADAMS AVENUE AND ATLANTA AVENUE REHABILITATION ® 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: Item # I Copies I Pages I Descr)ption 1 1 2 Notice Inviting Sealed Bids for CC No. 1502 ADAMS AVENUE AND ATLANTA AVENUE REHABILITATION These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your action ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For reviewicomment ❑ Other: Remarks: Per Resolution 2016-58 (adopted on 916116), the City Council authorized the advertisement of the above fisted arterial rehabilitation project. Please find the attached Notice Inviting Sealed Bids for advertisement on 04113117, 04/20117, and 04127117, The bid opening is scheduled for 05/09/17 at 2:00 PM in the City Council Chambers, If you have any questions regarding the enclosed attachment, feel free to contact me at 'wa ner s rfcit -hb.or or (714) 536-5467. cc: file - James Wagner, PE, Senior ]vil Engineer GAConstruction Contracts (CCs)\CC1502 Arterial Rehab -Adams Ave -Atlanta Ave \ENGINEERING\NISB, eBidboard & BID RESULTS\N1SB CC-1502 TRANSMITAL TO CLERK.docx NOTICE INVITING SEALED BIDS for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 PM on May 9, 2017. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $21.00 nonrefundable fee if picked up, or payment of a $41.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). Plans, Specifications, and contract documents can be downloaded free on AGENCY website. http://www.huntinZonbeachca.gov/govemment/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. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY, The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A one week prior to the federal -aid contract award by City Council. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern, Project Description: The project consists of the following street segments (1) Adams Avenue from beach Blvd. to Newland Street; and (2) Atlanta Avenue from Beach Blvd. to Newland. The proposed improvements includes grinding the existing pavement; removing failed roadway sections and replacing with new base course asphalt concrete (AC) and new finish course rubberized asphalt concrete (RAC); removing/installing concrete curb and gutter; cross gutters, sidewalk and access ramps; adjusting manholes and monitoring well covers, adjusting survey monuments; replacing and adjusting water valve assemblies to grade; removing trees that have uplifted sidewalks and installing new trees; and installing traffic loops and striping. The contract shall allow the Contractor 65 working days to complete the contract. Atlanta Avenue construction shall commence after substantial completion (as determined by AGENCY) of Adams Avenue project, Both shall be constructed within the allowable total working days. The Project Disadvantage Business Enterprises (DBE) goal is 6.0% 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 y-z-7-17 NOTICE INVITING SEALED BIDS for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 PM on May 9, 2017. Bids will be publicly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $21.00 nonrefundable fee if picked up, or payment of a $41.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). Plans, Specifications, and contract documents can be downloaded free on AGENCY website. http://www.huntingtonbeachca.gov/govemment/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. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A one week prior to the federal -aid contract award by City Council. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: The project consists of the following street segments (1) Adams Avenue from beach Blvd. to Newland Street; and (2) Atlanta Avenue from Beach Blvd. to Newland. The proposed improvements includes grinding the existing pavement; removing failed roadway sections and replacing with new base course asphalt concrete (AC) and new finish course rubberized asphalt concrete (RAC); removing/installing concrete curb and gutter; cross gutters, sidewalk and access ramps; adjusting manholes and monitoring well covers, adjusting survey monuments; replacing and adjusting water valve assemblies to grade; removing trees that have uplifted sidewalks and installing new trees; and installing traffic loops and striping. The contract shall allow the Contractor 65 working days to complete the contract. Atlanta Avenue construction shall commence after substantial completion (as determined by AGENCY) of Adams Avenue project. Both shall be constructed within the allowable total working days. The Project Disadvantage Business Enterprises (DBE) goal is 6.0% 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 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This is to acknowledge receipt and review of Addendum Number One, dated above. Company Name Date By All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. Addendum 1, CC-1502 No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A one week prior to the federal -aid contract award by City Council. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: The project consists of the following street segments (1) Adams Avenue from beach Blvd. to Newland Street; and (2) Atlanta Avenue from Beach Blvd. to Newland. The proposed improvements includes grinding the existing pavement; removing failed roadway sections and replacing with new base course asphalt concrete (AC) and new finish course rubberized asphalt concrete (RAC); removing/installing concrete curb and gutter; cross gutters, sidewalk and access ramps; adjusting manholes and monitoring well covers, adjusting survey monuments; replacing and adjusting water valve assemblies to grade; removing trees that have uplifted sidewalks and installing new trees; and installing traffic loops and striping. The contract shall allow the Contractor 65 working days to complete the contract. Atlanta Avenue construction shall commence after substantial completion (as determined by AGENCY) of Adams Avenue project. Both shall be constructed within the allowable total working days. I'he Project Disadvantage Business Enterprises (DBE) goal is 6.0% 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. This project has a Requirement for the FIRST INVOICE to be processed b�l date certain Therefore. the following schedule shall be adhered to by the .AGENCY and the CONTRACI-OR: FIRM DATE ACTION REQUIRED On June 5. 2017 The AGENCY shall a�Nard contract to CONTRACTOR selected. On or Before June I5, 2017 The CONTRACTOR shall attend the Pre -Construction ivleetin.o. On or Before July 10, 2017 The AGENCY shall issue the Notice to Proceed to CONTRACTOR. On or Before Juiy 14, 2017 The CONTRACTOR shall submit I `t Invoice 1`or Project to AGENCY. 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 Addendum], CC-1502, Replacement Pages A-2, E-6 & E-31 Addendum 1, CC-1502 2-10 AUTHORITY OF BOARD AND THE ENGINEER. [Add the following]. The Contractor shall give at least 24 hours advance notice when he or his subcontractor will start or resume the work. The above notice is to be given during working hours, exclusive of Saturday, Sunday or AGENCY holidays for the purpose of permitting the Engineer to make necessary assignments of his representatives. 2-11 INSPECTION. [Replace the second sentence with the following.] The Contractor shall notify the Engineer 48 hours before inspection is required. If the Contractor elects to work under this contract more than 8 hrs./day or more than 40 hrs./week, Saturday, Sunday, or AGENCY holidays, the Contractor shall arrange with the Engineer for the required inspection service and pay Special Inspection Fees which will be charged at the following rates: 4 hrs. or less/day - 5484.00 4 hrs. to 8 hrs./day - $968.00 Holidays 4 hrs. or less/day - S 584.00 4 hrs. to 8 hrs./day - $1,213.00 When Special Inspection is required, the Contractor shall notify the AGENCY and pay inspection fees 24 hours in advance. If the Contractor is directed by the AGENCY to work tinder this contract more than 8 hrs./day or more than 40 hrs./week, the Special Inspection fee requirements will be waived. E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31 Addendum 1, CC-1502 Cracks '/4 inch and greater shall be cleaned for the entire crack depth using sandblasting, brushing, and air blowing techniques as required to provide a crack free from all debris, dust, loose material and moisture. Gouging or plowing may be required to remove incompressible debris in the crack. The cleaned crack shall be filled with granulated tire rubber, plasticizer and filler, as manufactured by Crafco as Polyflex Type 3, or approved equal. All crack filler material shall be in conformance with the following specifications: ASTM D6690 (formerly ASTM D1190), AASHTO M324 Type I (formerly AASHTO M173) for "Joint and Crack Sealant, Hot -applied, for Concrete and Asphalt Pavements," and Federal Specification SS-S-164. All holes shall be cleaned of loose materials and filled with Type IIl-C3 PG 64-10 asphalt surface course and compacted to a smooth even surface with the adjacent existing pavement. 302-5.10.1 Crack Sealing Payment. [Add the following subsection 302-5.10.1:]. Payment for Crack Sealing shall be included in the bid price for other items of work unless there is the contract unit bid price for crack sealing which shall include full compensation for application of sealant and no additional compensation will be allowed therefor. 302 9 ASPHAL C RIL BBER HOT MIX (ARUIN1) 302-9.10 Nlaterial Transfer Device (Shuttle Buggy). I/Vld the iollowin-J. 302-9.10.1 General [Add the !61101 v tgl. Ill onler to reduce asphalt consolidation vdiich, once laid. is difficult to repair Icavim, rock packets and a N%eakcned roadwa-, pavement section. The Shuttle Buggy shall be u,�cd f6r the placement of AIII Ill. The material tran>fer device speed shall be adiusted to the speed of'the paver to maint yin a continuous, nonstop paving operation. 302-9.10.2 ai'laterials and Ecluipinent. (Acid the firllowin- the Shuttle liuggyshall have it minimum sur- capaciv, of 15 ton,. shall be self propelled and capable of moving independent ofthe paver. and small be equipped vaith the followiulx: (a) Front -Dump Hopper and Conveyor. 'file amvepor shall provide a positive retrain( zilong, the sides of the conveyor to prevent niatetial spillage. Shuttle Buggies having paver style hoppers shall have a horizontal bar restraint placed across the foldahle wings which prevents the wings ¢ron7 heing fbIded. (b) Paver Hopper Insert. The paver hopper insert shall have a minimum capacity of I4 tons. (c) Mixer/Agitator lvtcchan sm. This r.-mixin- mechanissri shall consist ofa se-mented. anti- segregation, re -mixing auger or rvw full-length lonnirtdinal paddle mixers designed for the purpose ofre-mixing the ARHM. The longitudinal paddle mixers shall be located in the paver hopper insert, 302-9.10.3 structures. [Add the following. The Shuttle Baggy rna} be allowed to travel over strUCIUres undU t11c following conditions: (a) approval will be giv en be the Engineer. (b) the vehicle shall be emptied of AR1-iM material prior to crossing the suructure and shall travel at crawl speed across the structure. (c) The tires of the vehicle .shall travel opt or ill close proximity and parallel to the beam and%or girder (:ties of the strucure. E-31 Addendum 1, CC- 1502, Replacement Pages A-2, E-6 & E-31 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 Huntington Beach Wave, a newspaper that has been adjudged to be a newspaper of general circulation by the Superior Court of the County of Orange, State of California, on July 1, 1998, Case No. A-185906 in and for the City of Huntington Beach, County of Orange, State of California, 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: April 13, 20, 27, 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 April 27, 2017 Signature Huntington Beach Wave 625 N. Grand Ave. Santa Ana, CA 92701 (714) 796-2209 Proof of Publication NOTICE INVITING SEALED BIDS for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTAAVENUE REHABILITATION „ FROM BEACH BOULEVARD TO NEWLAND STREET, CC N0.1502 " FEDERAL AID PROJECT STPL-5181088) CITY OF HUNTINGTON BEACH j PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF..HUN- TINGTON BEACH, as AGENCY,. invites sealed bids for the above stated proiects and will receive such bids in -the office of the City Clerk, Second Floor, 2000 Main'Street, Huntington Beach, California 192648, up to the hour of 2:00 PM on May 9, 2017. Bids will be public- ly opened in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are lavailable-from the Office of the Director of Public Works,, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a 421.00 nonrefundable fee if picked up, or payment of a $41.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for saecial deliverv). Plans. Specifications, and contract documents This is a Davis -Bacon proiect 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, CA92648.. 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 affirm6tively ensures that minority business 'enterprises will be afforded full opportunityto 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. The bid must be accompanied by a certified (check, cashier's check, or bidder's bond made payable to. the AGEN- CY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business Wand Professions Code and shall possess•q.State Contractor's License City Council. The successful Contractor and his subcontractors wm be required to possess business licenses from the AGENCY. All ex- tension of unit prices will be sublect to verification by the AGENCY. In case of a variation between the unit, price and the extension; the unit price.wiII govern. Proiect Description: The proiect consists of the following' street segments (1) Adams Avenue from beach Blvd. to Newland Street; and (2) Atlanta Avenue from Beach Blvd. to Newland. The proposed improvements includes grinding the existing pavement; removing failed roadway sections and replacing with new base course asphalt concrete '(AC) and' new finish course rubberized asphalt concrete ,(RAC); removing/installing concrete curb and gutter; cross gutters, sidewalk and access ramps; adiusting manholes and monitoring well covers, adiusting survey monuments; replacing and adiusting water valve assemblies to grade; removing trees that have uplifted side- walks and installing new trees; and installing traffic .loops and striping. The contract shall allow the Contractor 65 working days to complete the contract. Atlanta Avenue construction shall commence after substantial com- pletion (as determined by AGENCY) of Adams Avenue proiect. Both shall be constructed within the allowable total working days.i The Proiect Disadvantage Business Enterprises (DBE) goal s 6.0% The AGENCY reserves the right'to reject any or all bids, to waive any'irregularity and to take all bids under advisement fora 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. 2016-58. Attest: /s/ Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON,BEACH Published: Huntington Beach.Wave April 13, 20, 27, 2017, 10931032 AFFIDAVIT OF PUBLICATION Proof of Publication STATE OF CALIFORNIA, ) ) ss. County of Orange ) I am a citizen of the United States and a resident — "NOTICE INVITING`SEALED BIDS of the County aforesaid; I am over the age Of ADAMSAVENUEthe REHABILITATION TO NEWLAND STREET eighteen years, and not a party t0 Or interested inAND FROM BEACH BOULEVARD AVENUE REHABILITATION -4TLANTA FROM BEACH BOULEVA the above entitled matter. I am the principal clerk 15DTO02WLANDSTREET, FEDERALAID PROJECT STPL-5181(188) of the Huntington Beach Wave, a newspaper in the CITY OF HUNTINGTON BEACH'. that has been adjudged to be a newspaper Of PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUN- TdNGTON. BEACH, as AGENCY, invites sealed bids for f the City in uc Clerk Seco dsFloor, 2000rMain receive Hch untington Beach�California PM on May 9, 2017_ Bids will be public- general circulation by the Superior Court Of the 92648, up to the hour of 2:00 Chambers unless otherwise posted. County of Orange, State Of California, On July 1, ly opened in the Council and contract documents are Copies of`the Plans, office of Director-of92, of a $21n.00' f 1998, Case No. A-1 85906 in and for the City Of availableCA uponPpalymentr Hunt ngton.OBeach nonrefundable fee if picked up, or payment of a $41.00 nonrefundable pay additional for if specialbdeli delivery). Plans, Specifications, and Huntington Beach, County of Orange, State Of can be downloaded free on AGENCY website. . government/departmen____ ts/Public- California; that the notice, of which the annexed http://www.huntingtonbeachca.gov wor`s ids ---- proiect and the FederalRegulations;will lie en - incorpo-: is atrue printed CO has been published in each p py, p This is a Davis -Bacon forced. Any contract entered into pursuant to this nonce will the Federal Labor Standards, which are on fi the provisions ofle' 2000 Main Street, Hun-' rate at the office of the Director of Public Works, regular and entire issue of said newspaper and tington Beach, CA 92648. deduct5% retention from all progress payments. not in any supplement thereof on the followingThe The AGENCY will Contractor may substitute an escrow holder surety of equal value to the retention in accordance with The provisions of the Public Con- shall be beneficial owner of dates, to wit: tract -Code; Section 10263. The Contractor the surety and shall receive any interest thereon., April 13, 20, 27, 2017 The -AGENCY- hereby affirmatively ensures that minority, business', enterprises will be-afforded'full opportunity to submit bids in re-, eancestry,n or sis oferace, color,Cnational'lorigin, sex religion ineanY "I certify (or declare) under the penalty of consideration leading to the award of contract. on The approved Pro,' perjury under the laws of the State of California No bid shall be considered:unless it is prepared posal forms in conformance with the Instructions to ;Bidders as deter- . bidders d made to the AGEN that the foregoing is true and Correct"; bonust check eashie 's check or payable CY'for an amount no'less than of the amount bid. The'successful be licensed in accordance with provisions of the Business License Executed at Santa Aria, Orange County, bidder shall and Professions Code and shall possess a State Contractor's Class A one week prior To The federal -aid contract award by Contractor and his subcontractors will California, On CITY Council. The successful be required to possess business licenses from the AGENCY. All ex- -business the of a variation betwll eentihetutnit price and the extension, April 27, 2017 of unit price will govern. ' m beachtBlvd.tto Newland Street; segmentse(1)jAdams Avenuerfr iimprovemtentsa Includes (grinding cthB1 existingepavvement; rhe emoving, base course asphalt failed roadway sections and •rePlacin9 with new finish and 'gutter; crzed ossCgutte s; ibber(RAC)7eremoving/' stalling concrete curt sidewalk and access ramps; adjusting manholes and monitoring well covers, adjusting survey monuments; replacing and adjusting water valve assemblies to grade; removing trees that have uplifted side- installing new trees; and installing traffic loops and Si nature g walks and, -striping. e allow the Contractor 65 working days to complete The contract shall the contract. Atlanta determinedubyjAGENCY) of Adams Avenue pp iect. Both Huntington Beach Wave (as shall be constructed within the allowable total working days. Enterprises (DBE) goai l s 6.0% 625 N. Grand Ave. The Project Disadvantage Business reserves right to reject any or all bids, to waive Santa Ana, CA 92701 The AGENCY ,the any irregularity and to take all bids under advisement fora maxi- (714) 796-2209 mum period of 60 days. , BY ORDER of the CITY COUNCIL of The CITY OF HUNTINGTON September 2016, by Resolu- BEACH, CALIFORNIA, the 6Th day of tion No. 2016-58. Attest:. /s/ Robin Estani'slau CITY CLERK OF THE CITY OF HUNTINGTON BEACH •; Wave April 13, 20, 27, 2017 10931032 .. Published: Huntington Beach City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thru 0-9 (9 Sheets) Add new pages "APPENDIX O PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX O PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix O to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This is to acknowledge receipt and review of Addendum Number Two, dated above. Company Name Date By All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. APPENDIX O BRIDGE DECK MEMBRANE SPECIFICATION APPENDIX 0 PAGE 1 ADDENDUM 2, CC-1502 TENCATE Miraf i� TENCATE GEOSYNTHETICS Americas Mirafi° MTK SONOINE .._-.._........_._.. B9NOING SFAUNe STR£SSBEU£F Mirafi® MTK is a self -adhering waterproofing membrane designed especially for pavement reflective crack control and as a moisture barrier to prevent water permeation or penetration though pavement surfaces and the subsequent damage that moisture causes in the roadway sub -base. TenCate Geosynthetics Americas Laboratories are accredited by a2La (The American Association for Laboratory Accreditation) and Geosynthetic Accreditation Institute — Laboratory Accreditation Program (GAI-LAP). Mechanical Properties' Test Method Unit Minimum Average Roll Value Thickness ASTM D17772 mils mm 65(1.7) Grab Tensile Strength ASTM D4632 Ibs N 160 712 Grab Tensile Elongation ASTM D4632 % 60 Puncture Strength ASTM E154 Ibs N 200 890 Permeance ASTM E96, Method B perms 0.05 (max) Strip Tensile ASTM D882 Ibs/in kN1m 50(1,8) Pliability ASTM D146 '/4" Mandrel 180° -25°F No cracks in fabric or rubberized asphalt Testing performed on composite 21/i' Presser Foot Physical Properties Unit Typical Value Roll Dimensions width in m 12(0.3) 18 0.5 24 0.6) 36 0.9 Roll Dimensions (length) ft (m) 200 (61) 200 (61) 100 (30) 50 (15.2) Roll Per Box each 1 1 1 1 Thickness (ASTM D1777), Puncture Strength (ASTM E154), Permeance (ASTM E96, Method B), Strip Tensile (ASTM D882) and Pliability are not covered by our current A2LA accreditation. Disclaimer: TenCate assumes no liability for the accuracy or completeness of this information or for the ultimate use by the purchaser. TenCate disclaims any and all express, implied, or statutory standards, warranties or guarantees, including without limitation any implied warranty as to merchantability or fitness for a particular purpose or arising from a course of dealing or usage of trade as to any equipment, materials, or information furnished herewith. This document should not be construed as engineering advice. Mirafi® is a registered trademark of Nicolon Corporation. Copyright© 2015 Nicolon Corporation. All Rights Reserved. , TENCATE.. materials that make a difference N"o rn USA 365 South Holland Drive Tel 706 693 2226 Pendergrass, GA 30567 Tel 888 795 0808 FGS000009 ETQ R 15 Fax 706 693 4400 www.tencate.com ia�a sr� GAI-LAP-25-97 ACCtiH6� Eur Testing Lab 1291.01 & 1291.02 APPENDIX O PAGE 2 ADDENDUM 2, CC-1502 E Self -Adhering Waterproofing Membranes Waterproofing, Reflective Crack Control As a pavement ages, imperfections appear, joints become prominent and cracks occur, allowing water to infiltrate into and weaken the'subgrade causing even more damage to the pavement. Asphalt overlays are commonly used over asphalt and concrete surfaces to extend the life of the pavement and reduce the effects of aging, saturated subgrade and fatigue. Eventually, the process will repeat itself, as cracks and joints reflect through the new overlay. MirafP' MTK is a preformed composite membrane designed, specifically to prevent water from permeating into joints and large cracks and to minimize the number and size of reflective cracks. Mirafi" MTK is used to seal concrete and wood bridge decks. MiraV MTK products are comprised of self -adhering rubberized asphalt and durable polypropylene non- woven fabric. A peel -and -stick release paper makes installation fast and simple. ay benefits of " � Appltcatioos • Reduces further structural deterioration • Highway and street surfaces • Easy and cost effective to install • Transverse and longitudinal cracks • Can be installed in a wide range of temperatures • Concrete joints • Reduces traffic disruption • ,Lane -widening joints • Minimizes reflective cracking when bridging • Taxiways and runways transverse and longitudinal cracks • Bridge deck restoration • Minimizes reflective cracking between dissimilar surfaces • Minimizes reflective cracking of concrete joints • Prevents surface moisture intrusion ati1C%fi •Provides stress -relief layer to pavement section • Adheres to concrete, asphalt and woad decks 'r r A,Z, TENCATET11 INSTALLATION TENCATE® MIRAFI MTK WATERPROOFING MEMBRANE INSTALLATION GUIDELEINES FOR JOINTS, CRACKS and BRIDGE DECKS Prepared by: TenCateTm Geosynthetics North America 365 South Holland Drive Pendergrass, GA 30567 Tel. (706) 693 — 2226 Fax (706) 693 — 2044 www.tencate.com January 9, 2014 e TENCATE APPENDIX PAGE ADDENDUM 2, CC- 1502 Miraf i` TENCATE,, INSTALLATION SECTION 1- INSTALLATION GUIDELINES FOR PAVEMENT CRACKS AND REPAIRS MATERIAL DESCRIPTION TenCate® MTK is a unique, very cost effective waterproofing and stress relief membrane comprised of self -adhering rubberized asphalt and durable polypropylene non -woven paving fabric. A release paper, which is removed prior to placement, covers the self-adhesive mastic and provides for easy installation. The material is a minimum 65 mil in thickness. TenCate® MTK prevents surface moisture intrusion and delays reflective cracking. The material is roll packaged in boxes with the following dimensions: • 12" x 200' • 18" x 200' • 24" x 100' • 36" x 50' 12" and 24" will cover 200 square feet, 18" will cover 300 square feet and 36" will cover 150 square feet of surface. Applications • Longitudinal and transverse joints • Alligator cracks (fatigue cracks) • Bridge and Parking Deck Waterproofing Equipment No unique or special equipment is required for installing TenCate® MTK. Utility knives work well in cutting the membrane and release sheet. Surface Preparation Existing pavement surface must be cleaned of all loose dirt and debris and be dry. Cracks wider than 3/8-inch should be filled with suitable crack filler. Severally spalled or other distressed areas must be repaired according with accepted paving practices. Portland cement concrete pavement slabs should be stable. Excessively subsided joints or faulted joints should be repaired by applying a thin hot mix leveling course. If a leveling course is used, crack sealing is not necessary. Note: Commercial crack filler expands under the heat of an overlay and therefore the crack should be filled level or just below the existing pavement surface. Primer Surface shall be primed as follows. Primer must be used on all concrete and milled surfaces. On old asphalt surfaces (not milled), primer is not needed if temperatures are 70°F and rising. On new asphalt surfaces, primer is not needed unless temperatures are too cool to obtain a good bond between membrane and pavement. This can occur with surface temperatures between 400 and 50°F. The liquid adhesive shall be placed on the surface, at a minimum rate of 400 square TENCATE APPENDIX 0 PAGE 5 ADDENDUM 2, CC-1502 Miraf i �) 4%5, TENCATE," INSTALLATION feet per gallon (250 square feet per gallon on milled surfaces). The primer must be completely dry prior to application of the membrane. Any suitable priming material composed of refined asphalt and rapid drying solvent may be used. It is recommended that POLYGUARD 650 RC LIQUID ADHESIVE or equal be used (which has been tested for compatibility with TenCate® MTK); meeting ASTM D41, which is a solvent based liquid adhesive. Primer may be applied using brushes, rollers or by spraying at the prescribed rate of application. Never apply primer to wet or frozen surfaces. Areas primed and not covered with membrane within 24 hours should be re -primed. Smoothness and porosity of existing asphalt and or concrete surface may affect coverage rate. Do not apply liquid adhesive at heavier rates than recommended. Excessive material build-up will delay drying and membrane application Temperature: The surface temperature should be 45' F and above when installing TenCate® MTK. Storage temperature should not exceed 125 F. Slope Considerations: Asphalt pavements are more prone to shoving and shearing on steep grades especially in areas of stopping or sharp turning. TenCate® MTK can be installed on grades with slopes up to 10% on normal pavement conditions. If there are concerns of existing pavement surface, overlay thickness, asphalt mix traffic volumes or construction procedures please contact TenCate® Geosynthetics Americas or your local distributor. Installation Center the roll over the joint or crack to be treated with the release paper attached. Allow for a material overrun of 2 to 3 inches beyond each end of the crack to ensure a waterproof seal. Cut the membrane with utility knife. Install the TenCate® MTK by removing release paper. In the case of Portland cement concrete, transverse joint strips shall be applied before longitudinal joint strips to minimize the chance of the membrane peeling. On longitudinal joints allow 2 to 3 inches overlap in the direction of traffic. Material should be laid smooth and adhere well to the existing pavement by rolling the membrane with a pickup truck or pneumatic roller. A stiff broom can also be used to aid adhesion. Trafficking Limited traffic will not damage TenCate® MTK membrane and can be opened to construction traffic. However if local conditions require that traffic should be permitted and in the judgment of the engineer that safety is not issue, the pavement with the membrane can be opened to traffic. Signs should warn motorists that the driving surface might be slippery when wet and speeds reduced accordingly. In all cases where the membrane will be exposed to vehicular traffic, primer shall be used to ensure adhesion to the underlying pavement surface. Application of Overlay Tack coat: A standard prepaving tack coat is applied over the TenCate® MTK and the remaining portion of the surface before placing the hot mix asphalt layer. Overlay Thickness: A minimum compacted thickness of 1-1/2 inches is recommended. Repair of localized distressed Areas TENCATE APPENDIX 0 PAGE 6 ADDENDUM 2, CC-1502 Milf i� t TENCATEm INSTALLATION TenCate® MTK can be used as a preventive maintenance tool on locally distressed pavement areas such as alligator -cracked areas and patched potholes in parking lots, streets, highways, and on any other paved area. Preparation: Pavement surface to be treated should be clean and dry. Localized areas of base failure and alligator cracking may in some cases require base repairs and a leveling course prior to installation. This is an engineering or "best -practice" judgment. Potholes should be repaired using procedures recommended by Asphalt Institute. A leveling course may also be required where grooves in a milled pavement have rough vertical surfaces; however TenCate® MTK can be installed over a finished milled surface. TenCate® MTK Placement: Position the roll, with release paper attached over the distressed area. Allow at least 4 to 6 inches additional material for overlapping sound pavement adjoining the patch. Unroll membrane by removing the release paper. Allow 2 to 3 inches overlap if adjacent panels are required to cover the distressed area. Roll the membrane to ensure adhesion to the existing surface. Note: For cold weather patching, the surface area to be patched may be heated with a torch to assist with adhesion. The mastic side of the TenCate® MTK may be lightly warmed also. Paving Operations Place a standard paving tack coat over the membrane and pavement. The use of a cutback is not recommended. The use of vibratory rollers is not recommended over the areas where the membrane has been installed. This is generally resolved by slowing the roller to reduce the shear forces and using a static roller on the secondary passes. It may be appropriate to wait for the hot mix to cool at the lower levels of acceptable compaction temperatures. Storage and Handling It is recommended that the product be stored in a cool, dry place away from direct sunlight. Storing membrane in the sun on a hot day may make the membrane sticky and hard to work with. On cooler days, exposure to sunlight will assist in softening the material to assist in installation. Long-term storage should be indoors at temperatures < 125' F. SECTION 2- ADDITIONAL INSTALLATION INSTRUCTIONS FOR BRIDGE I PARKING DECKS INSTALLATION PRIMING: • When substrate is ready, apply Polyguard (or equal) 650 RC Liquid Adhesive at a rate of 400 square feet per gallon (250 square feet on milled surfaces). • Never apply 650 RC Liquid Adhesive to wet or frozen surfaces. • Allow primer to dry TENCATE APPENDIX 0 PAGE 7 ADDENDUM 2, CC-1502 Miraf i` %A, TENCATE„ INSTALLATION • Prime only the area which can be covered with membrane in the same working day. Areas primed and not covered with membrane within 24 hours should be re -primed. Smoothness and porosity of the concrete will affect coverage rate. • Do not apply liquid adhesive at heavier rates than recommended. Excessive material build-up will delay drying and membrane application. MTK MEMBRANE INSTALLATION - HORIZONTAL SURFACES: • At curbs, posts or projections, apply a double layer of MTK membrane going out at least 6 inches onto the horizontal, and 2" up the vertical face. Roll membrane firmly into the vertical/horizontal interface to eliminate any air pockets. • MTK membrane should be applied to the primed surface starting at the low point and working to the high point using a shingling technique. • Side laps should be a minimum of 3 inches and end laps a minimum of 6 inches. • The entire membrane should be firmly rolled with a rubber tired asphalt roller or hand roller. This will insure excellent adhesion and minimize air pockets between the substrate and membrane. • At posts or projections, apply either a double layer of MTK membrane going out at least 6 inches in all directions. • At drains, apply a double layer of MTK membrane. • Inadequately lapped seams and damaged areas should be patched with small sections of MTK membrane. The patch area should extend at least 6 inches beyond the defect. • All wrinkles should be slit and overlapped, and repaired as above. • All inside and outside corners shall be treated with 12 inch strips. The membrane should be placed over the corner treatment. It is recommended that inside corners have a minimum 3/ inch fillet of LM 95 Liquid Membrane or latex modified cement mortar. • Double ply all non -working joints or cracks over 3/16" width with a 6" to 12" piece of MTK membrane. 650 Mastic should be applied to all edges, overlapping seams, and end terminations. The recommended application rates for 650 Mastic is either: 0 100 linear feet of a 1" wide bead per gallon, if using material from 5 gallon pails o Or o at the rate of 65 linear feet per 30 ounce tube, when applying a'/z" wide bead • 650 Mastic should then be worked into the seam with a trowel to insure proper sealing. • A tack coat of asphalt or asphalt emulsion is applied prior to the bituminous overlay. • It is recommended that the bituminous overlay be not less than 1.5" in thickness after compaction. • The use of vibratory rollers over MTK membrane is not recommended. Note: Polvauard 650 Mastic DESCRIPTION: POLYGUARD 650 MASTIC is an asphalt /rubber based mastic which provides excellent adhesion to the MTK membrane, structural concrete, masonry, and wood surfaces. 650 MASTIC (or equal) is recommended to protect the termination edges, overlaps, patches and any additional detailing areas. On vertical applications, 650 MASTIC must be applied on both the bottom and top terminations of the MTK material TECHNICAL DATA: PHYSICAL PROPERTIES TYPICAL RESULTS TENCATE APPENDIX 0 PAGE 8 ADDENDUM 2, CC-1502 Miraf i �%5, NCATE,, INSTALLATION Color Black Specific Gravity 1.12 Flash Point (PM Closed Cup) 105EF (41 EC) APPLICATION: POLYGUARD 650 MASTIC is supplied either in a 5 gallon pail or in a 30 oz. caulking tube. If some material is applied with a caulking gun the bead must be struck with a trowel to insure the 650 MASTIC is worked into the termination edges. If the material is supplied in a pail, it may be applied with either a trowel or by hand using rubber gloves as precautions. When applied as a temporary cut-off, trowel the 650 MASTIC over the membrane in a very thin layer, and allow to cure a minimum of 12 hours before placement of additional MTK membrane. On the bottom edge of any vertical application, 650 MASTIC must be applied liberally to these areas. 650 MASTIC should also be applied around any protrusions, drains, or any areas requiring patching, or specific detailing. Disclaimer: TenCate assumes no liability for the accuracy or completeness of this information or for the ultimate use by the purchaser. TenCate disclaims any and all express, implied, or statutory standards, warranties or guarantees, including without limitation any implied warranty as to merchantability or fitness for a particular purpose or arising from a course of dealing or usage of trade as to any equipment, materials, or information furnished herewith. This document should not be construed as engineering advice. Mirafi is a registered trademark of Nicolon Corporation. Copyright© 2013 Nicolon Corporation. All Rights Reserved. TENCATE Miraf i`� APPENDIX 0 PAGE 9 ADDENDUM 2, CC-1502 UNSUCCESSFUL BIDS CC-1502 Adams Ave. and Atlanta Ave. Rehabilitation VA/,-//7�2. y CITY OF HUNTINGTON BEACH PROJECT NAME: Adams Avenue and Atlanta Avenue CC#: CC-1502 BID OPENING DATE: 5/9/2017 TIME & LOCATION: Z00 PM City Council Chambers ENGINEER'S ESTIMATE: $1,350,000.00 BIDS SUBMITTED (AS READ AT OPENING) BIDDER'S NAME FINAL APPARENT BID RANK AMOUNT All American Asphalt -Coronas7✓1r, California Professional Engineering, Inc. - La Puente EBS General Engineering, Inc - Corona Excel Paving - Long Beach ` .✓ y¢? �• �' Griffith Company - Santa Fe Springs 7S yy� S Hardy & Harper, Inc. - Santa Ana Y� s.� R.J. Noble Co - Orange + ,y ✓7 y Sequel Contractors, Inc. - Santa Fe Springs Sully -Miller Contracting Company - Brea Vido Samarzich, Inc. - Alta Loma PTS 07282015 Version 15—CC 1502 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 July 21, 2017 All American Asphalt P. O. Box 2229 Corona, CA 92878 RE: Adams Ave. & Atlanta Ave. Rehabilitation — CC-1502 Enclosed please find your original bid bond for CC-1502. Sincerely, Robin Estanislau, CMC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand "SEALED BID" FOR CC-1502 - ADAMS AVENUE - ATLANTA AVENUE FEDERAL # STPL-5181(188) DO NOT OPEN WITH REGULAR MAIL �'�fi� : DELIVER TO THE OFFICE OF THE CITY CLERK 2000 MAIN STREET SECOND FLOOR .. 't` n.. ly ALL AMERICAN AS11FlAI.T RETURN REQUESTED City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thru 0-9 (9 Sheets) Add new pages "APPENDIX 0 PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX 0 PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix 0 to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This is to acknowledge receipt and review of Addendum Number Two, dated above. All American Asphalt Company Name By Mark Luer, President May 3rd, 2017 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This is to acknowledge receipt and review of Addendum Number One, dated above. All American Asphalt Company Name By Edward J. Carlson, Vice President May 2nj 2017 Date All bidders must acknowledge and include the receipt of this Addendum with your bid Proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. SECTION C PROPOSAL for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-t 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 Bid Bond in the amount of 10% which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond 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 &gnature 1 May 1st, 2017,,,�' 1 Edward J. arlson, Vice President z /A -�) 7 - C-2 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) PROJECT BASE BID: Basis of Award ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ......................................... C-2.2 to C-2.8 ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ........................................ C-2.9 TO C2.14 1. ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET SIq .157lQ.00 BID IN FIGURES 2. ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $ , 0� s BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-a.a ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const, Contract" Unite Extend ed' iVo No, , Descri tion Quantity Unit Amount 1 - - MOBILIZATION i LS 2 i6 OD 2 - - TRAFFIC CONTROL PLAN 1 LS $1 Da �)bo— $ 10,30D 3 - FURNISH CONTROL PROJECT TRAFFIC 1 LS $ y 5 A600 — 4 - FURNISH AND INSTALL SIGNING 1 LS $ lot060 — $ q 000 — AND STRIPING 5 -- PROJECT SPECIFIC SWPPP 1 LS $ Z4.500— $��,p0 �- REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL APPURTENANCES,CURB 9 EA $ 3 _hCO — $ 31 9�b6 -- GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT A 0.17' ASPHALT 7 3 RUBBER HOT MIX (ARHM) WET 2,800 TN $ COO — PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. 7 EA $ 20 • — $ 5. D D __ 9 5 ADJUST STORM DRAIN MANHOLE TO GRADE. 10 EA $ 1 ZO - -- $ 7, 00 — REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 11 EA $ GRADE PER HB STD PLAN 612. C-2.3 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract UnR ;- Extended No No ,Descri"tion . tQuantity Unit Price;. Amounts,,; COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 22,400 SF $ 0 $ck 2— SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. 12 INTENTIONALLY LEFT BLANK COLD MILL EXISTING A.C. 13 8 PAVEMENT TO A DEPTH OF 0.34' 138,000 SF $ Q • Z 4 $ 5g q FROM NEW FINISHED SURFACE PER PLANS 14 INTENTIONALLY LEFT BLANK CONSTRUCT NEW 0.17' B-PG-70- 10-RAP A.C. BASE COURSE 15 8 OVER 95% COMPACTED 1,700 TN $ V `--- $ 10S SUBGRADE PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. 16 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 17 9 AND PREPARE CORNER RECORD (PRE- AND/OR POST - 3 EA $ cd 214 $ CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 10 SLOT PAVEMENT, AGGREGATE 900 LF $ • -- $ 13-s 00 — BASE, LOT DRAINS, AND ALL •&�3 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD 19 11 FROM WALK TO EXISTING SLOPE, RELOCATING 13,500 SF $_ AID $ cm 0100 — IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.4 ADAMS (BEACH - NEWLAND) PRn-lFr_T Rin Cr61Fnm F Bid Canst ContFact Unite E)dended r No No'. Descri' tion. Quantity Unit Price`': Amount . 20 INTENTIONALLY LEFT BLANK REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY/ALLEY APPROACH 21 12 ("W" AND TYPE SHOWN ON 690 SF $ 3 • --- $ qd — PLAN) PER STD PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 13 (ITEM INCLUDES SLOT PAVEMENT, AGGREGATE BASE 2,170 SF $ 2 0 • $ 3 .4 0 0 — - AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN ]PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB PER HB STD PLAN 201 (CF=8"). (INCLUDES 23 14 SLOT PAVEMENT, AGGREGATE 225 LF $ 5 3 • ` $1� 2 S �-- BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT LOCAL DEPRESSION PER HB STD PLAN 302. (INCLUDES SLOT 24 15 PAVEMENT, AGGREGATE BASE, 1 EA $ OO —~ $ 5 AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 16 SIGNALS AND LIGHTING SYSTEMS, 2005 EDITION. SPLICE 52 EA $2�— LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". C-2.5 ADAMS (BEACH - NEWLAND) PRnJECT R1n Sr_Wl:nlu F Bid Const Contract ! Unit < Extended No Deseri' tion , �4uantity,> Unit Price a Amount' REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP AND ROOTS TO 24" BELOW TOP 26 17 OF SIDEWALK/GRADE WITHIN PROPOSEDIMPROVEMENT 44 EA $ 1 , $ Q �� — AREA, PULLOUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. 27 INTENTIONALLY LEFT BLANK FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 18 BY AGENCY. (INCLUDES ALL 2500 SF $-- ITEMS NECESSARY TO ) -- COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 29 19 IDENTIFIED BY CONTRACTOR 90 Cy $ (9 9 • $Aj ( 0 AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 30 20 EDISON. CONTRACTOR TO 3 EA NOT A CONTRACTOR COORDINATE WITH ERICK OEN BID ITEM AT (714) 895-0242. 31 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 32 21 053, S-054 AND S-055. 1 EA $ I ZO O CONTRACTOR TO COORDINATE ---r i- WITH MIKE BOLSTER AT (714) 593-7645. 33 22 ADJUST MONITORING WELL 2 EA $ cJ $30 COVER TO GRADE. C-2.6 ADAMS (BEACH - NEWLAND) PR0JFCT RM SC14Fr1111 F Bid ,' Const m Contract Unit Extended NoNo' pescrl motion Givantity_ Uri# Price ` Amount" FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716,718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 34 23 BUSHES OR GROUND COVER 48 EA $ ZOOAND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND PLANT NEW 10' BROWN TRUNK HEIGHT RACHYCARPUSFORTUNEI PALM TREE PER HB STD. PLANS 714, 715.716, 718&719AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF 35 24 EXISTING LANDSCAPING, 6 EA $ a 6 $ 1 1 q 00 BUSHES OR GROUND COVER AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). C-z.7 ADAMS (BEACH - NEWLAND) PRn_IFrT Pin cruanm F Bid Cons "Contract Unit Extended ` ' ,.,Descri flon . Quantity Unit -`Amount: ., CONSTRUCT AND / OR REMOVE AND RECONSTRUCT 4" THICK PERVIOUS COLORED STAMPED CONCRETE IN MEDIANS PER 36 25 SPECIFICATIONS AND HB STD PLANS 711. (ITEM INCLUDES 780 SF $ $ `- --- REMOVAL OF EXISTING GROUND COVER, AND SLEEVING OF EXISTING IRRIGATION LINES.) FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 - - EQUAL COATING ON THE NEW 3 EA $_ (Q 4 `— $� Z 1 CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Ftal Amount Bid in Figures: $ �`'� �J 2- 00 Total Amount Bid in Words: ihN Eve wm -t ou SA 0 b v tv It 0a:b -v o c-_W1 H skx z. Ml_'A 4 eg-o CE N-r S C-z.s SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.9 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE "Bid , Const P s Contracll �, Unit'. F�ctended No. No bescri lion a ':.,, , Quantity Unit price,, Amount,`r`r 1 - - MOBILIZATION 1 1 LS $ Z _ 5 U O -- $ Z `' 2 - - TRAFFIC CONTROL PLAN 1 LS $ jj' OO `-- $--1 C) j._. 1 S -- FURNISH PROJECT TRAFFIC 1 LS $ $ 3(Q ZUO " CONTROL 4 - - FURNISH AND INSTALL SIGNING AND STRIPING 1 LS 0 $-� 't D ®v _ 5 -- PROJECT SPECIFIC SWPPP 1 LS $2.0— $ Z . (p 00 REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL APPURTENANCES,CURB 3 EA $DO — $ l O D '— GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) ASPHALT 7 lCONSTRUCTA0.17' 3 RUBBER HOT MIX (ARHM) WET 2,600 TN $ S• $ A 6151WO — PROCESS OVERLAY. r 8 4 JADJUST SEWER MANHOLE TO 12 EA $ Z0 • '-- $ `� WO — GRADE. 9 5 ADJUST STORM DRAIN MANHOLE TO GRADE. 2 EA $ -� Z _ $ t _ -- REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 23 EA $ GRADE PER HB STD PLAN 612. C-2. to ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Canst Contract Unit Extended , No 1Ja Descri tion ,. _"Quantity Unit ,, Price Amount_,". COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 36,400 SF $ QSURFACE PRIOR PRIOR TO 0,17' ARHM T OVERLAY PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 12 8 FROM NEW FINISHED SURFACE 13,700 SF PRIOR TO 0.17' ARHM OVERLAY, PER PLANS, COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.34' FROM NEW FINISHED SURFACE 49,900 SF —r— PER PLANS. COLD MILL EXISTING A.C. 14 10 PAVEMENT TO A DEPTH OF 0.67' FROM NEW FINISHED SURFACE 7,300 SF $_____ • �� $ PER PLANS. PLANS. CONSTRUCT NEW 0.1r AND 0.50' B-PG-70-10-RAP A.C. BASE 15 9 & 10 COURSE OVER 95% 1,000 TN $ �� • _ $ Q� �— COMPACTED SUBGRADE PRIOR TO 0.17' ARHM OVERLAY. RAISE SURVEY WELL MONUMENT TO GRADE AND 16 11 PREPARE CORNER RECORD 1 EA $_7A • — $ �ZO _ �-- (PRE- AND/OR POST - CONSTRUCTION). SET SURVEY MONUMENTATION 17 12 AND PREPARE CORNER 4 EA $ DO �-- $ S. — �CO) RECORD (PRE- AND/OR POST- —�y�---- —I — ------ CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8'). (INCLUDES 18 13 SLOT PAVEMENT, AGGREGATE 405 LF $ $ BASE, LOT DRAIN, AND ALL — T ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2. 11 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULF Bid Gonst Unit`=."Extended No No x Descri tion,Quanhty Unit Pricer ;Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING 19 14 SLOPE, RELOCATING 3,400 SF $ . - $ 2 �o `- IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) SAWCUT AND REMOVE EXISTING SIDEWALK AT EXISTING AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 3. (ITEM 20 15 INCLUDES REMOVAL OF 3 EA $ (a . - $ ICI 5 • -- SIDEWALK, 6 LF OF NEW SIDEWALK, NON -CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR AGENCY APPROVED EQUAL AND MULCH.) REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY ("W" AND TYPE 21 16 SHOWN ON PLAN) PER STD 750 SF $ `— $ PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 17 (ITEM INCLUDES SLOT 1,740 SF $ Z S 3(¢,, PAVEMENT, AGGREGATE BASE, -� AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 23 INTENTIONALLY LEFT BLANK 24 INTENTIONALLY LEFT BLANK C-2. 12 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid ` Const °" „� f ontract ; Unit hE- ended No ' _No Descri' tian .: .Quantity =Unit PrIce „ ,Amount INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 18 SIGNALS AND LIGHTING 22 EA $ Z l i� • -- $_ 2.0 —' SYSTEMS, 2005 EDITION. SPLICE �� LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "ID". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 26 19 AND ROOTS TO 24" BELOW TOP OF SIDEWALK I GRADE WITHIN--- 4 EA �- PROPOSEDIMPROVEMENT AREA. FURNISH AND INSTALL BRIDGE DECK MEMBRANE OVER ENTIRE 27 20 BRIDGE DECK SURFACE (INCLUDES ALL ASSOCIATED 5 000 SIF $ $ %o 0 �-- (� 3� -T WORK PER PLANS AND SPECIFICATIONS). FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 21 BY AGENCY. (INCLUDES ALL 2,500 SF $ $00 -- ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 29 22 IDENTIFIED BY CONTRACTOR 90 CY $ (k o1 • — $ (Q , 'Z l Ci — AND VERIFIED BY AGENCY. �- 30 INTENTIONALLY LEFT BLANK ADJUST VERIZON VAULTIMANHOLE TO GRADE BY NOT A CONTRACTOR 31 23 VERIZON. CONTRACTOR TO 4 EA COORDINATE WITH RAY gip ITEM ROUNDTREE AT (714) 375-6760. C-2. 13 ATLANTA (BEACH-NEWLAND) PDn_ICrT RIn Crucnl It C Const "' Contract s Unit, fi Extended llo No .Descri tion Quantity Unit Pr1ce,`Amount. ADJUST OCSD SEWER MANHOLE TO GRADE, PER 32 24 OCSD STD. PLANS S-053, S-054 & 2 EA $�7, 00 - $ Z. goo S-055. CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT 714-593-7645. 33 INTENTIONALLY LEFT BLANK FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 34 25 BUSHES OR GROUND COVER 1 EA $ ZZ OO $AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). 35 INTENTIONALLY LEFT BLANK 36 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 -- EQUAL COATING ON THE NEW 6 EA $ CONCRETE INSIDE OF AGENCY SEWERMANHOLEMANHOLE RING. Total Amount Bid in Figures: $ rJ I �' g . D 0 Total Amount Bid in Words: '51u Ii��Dn�,D 1 '(mil 5 VAN NuWA(�� EIl,��1E�N b�l.l.WQ-S ZEf�D CANTS C-2. 14 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 PWC Dollar % of Items) Subcontractor License Registration # Amount Contract Number tt-c`ntrtR c�IPR: ,CA � 31 I o000o I �l �Ce �3 t2-- Z . �i l C-32 W0ATh5 1- 3 S A NxOr) EN G i M eraz N 317�I 1ooa0o3g2, #5)&z5•- C) 3 9 It�lltlNt;-toN P�X1�,CiR RDPmS -3 3y 5 kW-ro L_AND5CA0-r JCL 3�t FDUNIRIN"JA 1,Gi 01P122 c-2q (vaxx c� 13�s .�'�. p�DMr�S lkl'I w D S L) P-\J ,pr(Le�1tQ,17 ���►11 1000�1�33 �sj�,ov— 0.3��. C3V-1w19 6, C'Pt RdHrnS 25 Svh lit t SarJ C[ PA C. ft�t_�2b o�r�v�,�cA By submission of this proposal, the Bidder certifies: I. 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 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 I! Zji7 , at Corona , Date City State Edward J. Carlson , being first duly sworn, deposes and says that he or she is Vice President of All American Asphalt 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. All American Asphalt Name of Bidder Signature of Bid erEdward J. Carlson, Vice President 400 East Sixth Street, Corona, CA 92879 Address of Bidder C4 CALIFORNIA JURAT GOV CODE § 8202 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 Riverside B. ROYSTER Commission # 2083832 Z �1 Notary Public California Z Riverside County Z D My Comm. Expires Oct 26, 2018 Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 2nd day of May 2017, Date Month By (1) Edward J. Carlson Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) (,) (2) (and Name of Signer Proved'"to me on the basis of satisfactory evidence tfie the person who appeared before me.) Signature Signature ofNotary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document Noncollusion Affidavit Document Date: 5-2-17 Number of Pages: 1 Signer(s) Other Than Named Above: None Top of thumb here 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 Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, Project CC No. 1502, (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 itrstruction, is familiar with the operation to be performed and the hazards involved " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: May 2017 C-5 All American Asphalt Contractor By Edward J. 6arlson Title Vice President 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? 17 Yes dNo 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: May 2 Ej 2017 C-7 All American Asphalt Contractor BY Edward J. Ca son Vice President Title t. r "WINIM BIDDER certifies that the following information is true and correct: All American Asphalt Bidder Name 400 East Sixth Street Business Address Corona, CA 92879 City, State Zip ( 951 ) 736-7600 Telephone Number 267073 Class A, C-12 State Contractor's License No. and Class 01/19/71 Original Date Issued 1 /31 /2018 Expiration Date The work site was inspected by Jim McGee of our office on May 2, ,4 12017. The following are persons, firms, and corporations having a principal interest in this proposal: Mark Luer, President 400 East Sixth Street Edward J. Carlson, Vice President Corona, CA 92879 Michael Farkas, Secretary Ph: (951) 736-7600 Fax: (951) 736-7646 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. All American Asphalt Company Name . .// Signature of Bidder Edward J. Carlson, Vice President Printed or Typed Signature Subscribed and sworn to before me this _ fLay of _� , 201 _Z . NOTARY PUBLIC C-8 NOTARY SEAL CALIFORNIA JURAT GOV CODE § 8202 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 Riverside 8. ROYSTER Commission # 2083832 Z . `� Notary Public - California z Riverside County n My Comm. Expires Oct 26, 2018 Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 2nd day of May 12017 Date Month By (1) Edward J. Carlson Name of Signer Proved to me on the basis of satisfactory evidence be the person who appeared before me (.) (,) (and (2) of Signer Prove Ad me on the basis of satisfactory evidence be the person who appeared before me.) Signature Signature of WOary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document Title or Type of Document Bidder's Information Document Date: 5-2-17 Number of Pages: 1 Signer(s) Other Than Named Above: None Top of thumb here Top of thumb here Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing high ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert."}. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. 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. City of Riverside 3900 Main Street, Riverside CA 92501 Name and Address of Public Agency Name and Telephone No. of Project Manager: Steve Howard, (951) 826-5708 $3,400,725.00 Preservation and Maintenance 06/2016 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. City of Rancho Santa Margarita 2212 El Paseo Rancho Santa Margarita, CA 92688 Name and Address of Public Agency Name and Telephone No. of Project Manager: Man Maximous, (949) 839-7044 $245,190.00 Residential Overlay 09/2016 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3. City of Victorville 14343 Civic Drive Victorville, CA 92392 Name and Address of Public Agency Name and Telephone No. of Project Manager: Bruce Miller, (760) 269-0045 $2,611,215.00 Road Reconstruction 07/2016 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-9 1 Fi. ht `d- Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. Jim McGee Name of proposed Project Manager Telephone No. of proposed Project Manager: (951) 736-7600 2012/2013 Street Resurfacing $2,970,000.00 05/2014 Project Name & Contract Amount Type of Work Date Completed 2012/2013 Pavement Rehabilitation $970,000.00 12/2013 Project Name & Contract Amount Type of Work Date Completed Bristol Street Rehabilitation $6,951,475.00 12/2014 Project Name & Contract Amount Type of Work Date Completed 2, Rick Selph Name of proposed Superintendent Telephone No. of proposed Superintendent: (951) 736-7600 Route 74 Contract No. 12-OL6404 $1,124,057 05/2013 Project Name & Contract Amount Type of Work Date Completed 2011/12 Overlay & Slurry Seal Program $5,995,000.00 05/2013 Project Name & Contract Amount Type of Work Date Completed Pavement Management Improvements 05/2013 Project Name & Contract Amount Type of Work Date Completed C-10 w y. 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/PWCRJActionServiet?action—displayPWCRegistrationForm DIR's Contractor Registration searchable database: https:/,Iefiling,dir.ca.gov/PWCR/Searc h. 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. All American Asphalt Contractor 14f/�� By Edward J. Carlson Title Date: May, &1 2017 PWC Registration #: 1000001051 C-tt Vice President BIDDER"S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN I992, SECTION 3 TITLE 24, Code of Federal Regulations, Part I35* 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 I35 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10010 of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: All American Asphalt Contact Person: Mark Luer, President Contact Phone: (951) 736-7600 Signed: Mark Lue%re�,d.�nt_,,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 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to www,ca(recs.corn If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System (GMS). For f u-ther instruction about logging into GMS and uploading this form, reference the Procedures and Requii,etrtents. Retain the original form in Your grant file. GRANTEE NAME: CITY OF HUNTINGTON BEACH GRANT NUMBER: TRP7-16-0001 1 g 2000 Main Street, Huntington Beach, CA 92648 t l PRIMARY CONTACT NAME: JAMES WAGNER PE, SENIOR CIVIL ENGR, PUBLIC WORKS DEPT. CONTRACTOR NAME: All American Asphalt AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Edward J. Carlson MAILING ADDRESS: 400 East Sixth Street, Corona, CA 92879 i As tire arithorized representative of tihe above identified contractor, 1 declare ander penalty of perjury under the laws of the State of California that within the preceding three (3) years, ?raise of the events listed in Section 17050 of Title 14, California Code of Regulations, Nairtral Resources, Division 7, has occurred with respect to the above identified i contractor. Alternatively, as the authorized representative of the above identified contractor, 1 declare raider penalty of perjory raider I the laws of the State of California that within the preceding three (3) years, if a?ry of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, l have disclosed all such ocerurences in an attached signed statement that explains the facts and circumstances of the listed events. SFgtrature�- date Ma �J 2017 Edward J. Carlson Vice President C-13 1 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycie) RELIABLE CONTRACTOR DECLARATION CalRecyele 168 (Revised 7113) Title 14 CCR, Division 7, Chapter I Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycie agreement, grantee or borrower is unreliable and should be placed on the CalRccycle Unreliable Contractor, Subcontractor. Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054. and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycie due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRccycle loan, as evidenced by written notice from CalRccycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycie, or (c) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecyele contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRccycle contract, any subcontract for a CalRecyele agreement, grant, or loan, resulting in termination of the CalRecycie contract, subcontract, grant or loan by the CalRecyele or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycie contract, subcontract, grant or loan; or (i) .The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or 0) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRccycle to remediatc, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) The person or entily owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20010 or more of the entity, if that other entity: 1. is on the Unreliable List; or, 1 Owned 20% or more of an entity on the Unreliable List at the lime of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Sid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder All American Asphalt proposed subcontractor hereby certifies that he has -V, has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has 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 contractor 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 October 2016 C-15 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 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.L 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 ofthe 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 Ll No If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-16 October 2016 Local Assistance Procedures Manual Exhibit 12-I1 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-17 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 7t06) To the CITY / COUNTY of Riverside 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-18 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. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. C-l9 Page 10 of 22 October 2016 Local Assistance Procedures Manual NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS Exhibit 12-H Sample Bid The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 11 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLd TE THIS FORM TO DISCLOSE; LOBBYING, ACTIVITIES POR5UANT TO 31 U.&C, 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid Poficriapplication Q a. initial b. grant b. initial award b, material chatygc c, cooperative agrLement c, post -award d. loan For Material Range Only: c. loan guarantee year_ quarter— f loan insurance date of7ast report q. Name and Address of Reporting Entity .5. If Reporting Entity in No/dis Subawardee, Enter Name and Address of Prime: Prime FISubawardee Tier--, if known Congressional District, if known G. 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 i 7. Federal " Program NameMescription: r t,. MA Number, if applicable 9. A-,v'ard Amount, if known: b. Individuals Performing Services (including address if different from No. IOa) (last name, first name, MI) (attach Continuation Sheets) if necessary) it. Amount of Payment (check all thal-upply) 13. Type of Payment (check all that apply) S actual a planned a, retainer i` b. one-time fee 12, For of Payment (check all,that apply): c. commission a. cash ! d contingent fee b. in -kind; specify: nature c deferred r' value f other, specify 14. Brief Description of Ser ices Performed or to be performed and Dates) of Service, including afficer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation She:t(s) if necessary) 15. Conlinuati` on Shect(s) attached: ties No i 16_ Information mquesiLd through this form is authorized by Title 31 U.§C. Section 1352. This disclosure of lobbying Signature: reliance wa`s placed by the tier above when his transaction was made`orentered into. This disclosure is required print Name: Edward J. Carlson pursuant to 31 U.S.C. 1352. This information will be mporeYl to Congress semiannually and will be available for e VicPresident public inspection. Any person who fails to file the required Title:— a ,, resit disclosum shall be subject to a civil penalty of not less than $10,000 and not more than S 100,000 for each such failum. Telephone No.: (951) 736-7600 Date: IUse 0 Authorize! for Local Reproduction Standard Form - LLL Page 12 of 22 C-21 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 ofa 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 ofa 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 repotting 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 subawardec 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" them 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). IL 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 employce(s) contacted or the officer(s) employee(s) or Members) of Congress that were contacted. 15. Check whether or not a continuation shect(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 ALhstmak,. x, 06.04_%.ENUF„ Page 13 of 22 C-22 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 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 following information is required 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 $10,000 (whichever is greater). Photocopy this form for additional firms. Subcontractor Name and Location Line Item & Description Subcontract Amount Percentage of Bid Item Sub- contracted Contractor License Number DBE (Y/N) DBE Cert Number Annual Gross Receipts DIR Reg Number Name: S�tJfQtJ ENb1 1 Pb)(►3� yY1S PtiLflirrTlR 3� 51(QZS -- 0. 39 X.3 (�� <$l million <$5 million City, State: �-kQ V 610V) v_-;�PrceJCA oowo 3`12 <$10 million <$15 million Age of Firm: 2d yrs. Name: F��� ��N DSG'i PC— �DR�V1`J 3�} -35 TV} t} �j�-{ (9$)3 }5 t,� Q ` 0 �b(s 1 ZZ Y 3 1�M <$1 million <$5 million City, State: 10V01►g VO vri \i� �14 I OX00004(Q <$10 million <$15 million Age of Firm: 3b yrs. Name: Svn\YH50V� E�Tict C 111 LA S Z S I41 LIRN-TA � 25 5 «d ' 1 ' % (9I � � <$1 million ® <$5 million City, State: y oa- t oGf-1 Llf� <$10 million [WWI UIO ❑ <$15 million Age of Firm: Myrs. Name: GASrcLIPIYJ� �j1JRVrc�i((VZD ��iiY�S�F` n (N-�� ej�OO 1 I O 3$•�, L�j'111 N ❑ <$1 million ® <$5 million City, State: 16000Q 15 33 <$10 million <$15 million Age of Firm: 21-0 yrs. Name: -50ftwo4 PRv�rn pt (LWcV�Tfi I uC �1 Z _ Z, . 5 'l. t f Jy <$1 million <$5 million City, State: CM V4? __65) CA <$10 million (Ococo(� �/_ lX <$15 million Age of Firm: yrs. Name: _ <$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-28 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 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: c �t �� sP ca�fl4ru`� Allv�wts f fLAO-Tip k*" ADO � N I n IlQ 0 <$1 million LJ <$5 million City, State: vf ��� GI� =00() 3O(Q ® <$10 million ❑ <$15 million Age of Firm: Zd yrs. Name: ❑ <$1 million ❑ <$5 million City, State: EJ <$10 million ❑ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million El <$5 million City, State: El <$10 million ❑ <$15 million Age of Firm: _ yrs. Name: ❑ <$1 million ❑ <$5 million City, State: ❑ <$10 million El <$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. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/Award Package Page 2 of 2 C-29 September 2016 Local Assistance Procedures Manual Exhibit 17-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) 0 and First -Tier Subcontractors INSTRUCTIONS — FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. 5. Contractor/Consultant - Enter the contractor/consultant's firm name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant'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. 10. Company Name and Business Address - Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE. The Non -DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment - Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount - Enter the "Total Claimed DBE Participation Dollars" from Exhibits 15-G or 10-02 for the contract. 16. Total - Enter the sum of the "Contract Payments" Non -DBE and DBE columns. 17. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 19. Phone - Enter the area code and telephone number of the person signing the form. 20. Date - Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature - A Local Agency Representative must sign their name to certify that the contracting records and on -site performance of the DBE(s) has been monitored. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 23. Phone - Enter the area code and telephone number of the person signing the form. 24. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 C-31 July 23, 2015 a �- Local Assistance Procedures Manual Exhibit 15-C Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: The City of Huntington Beach 2. Contract DBE Goal: 6% 3. Project Description: Pavement Resurfacing and/or Rehabilitation Projects 4, Project Location Adams Ave. /Beach B1. to Newland St. and Atlanta Ave. / Beach BI. to Newland St. ^ ,t 5. Bidder's Name All American Asphalt 6 Prime Certified DBE: ❑ 7. Bid Amount. 1 4- c�' 2�1-� 8 Total Dollar Amount for ALL Subcontractors: 13 ( s 9 r`�i Z. 9. Total Number of ALL Subcontractors I �:7 10: Bid Item 11. Description of Work. Service, or Materials Supplied 12. DBE Certification DBE Contact Information 14. DBE Dollar Dollar Number Number (Must be certified on the date bids are opened) Amount erns i4� 35 1 r� P�a..n4l� AA 35318 191U BoshlPlrd r•_ V. (OS)3'75 Al kniA _1,, 1 ��f1 (`114) 163-4fnlri 34 re-e- 1 r n t Su ( Ali, of I 0,4147 "54v's.IAYL�cZ 1`10 I E BC l-L-O ) CA . It �3L- 722_—Q `32 SU8 Local Agency to Com lets this Section' $ Oil! IS 21. Local Agency Contract Number. CC-1502 22. Federal -Aid Project Number. STPL-5181(188) 15. TOTAL CLAIMED DBE PARTICIPATIONr] ) "7 % 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 items) of work listed above must be consistent, Local Agency certifies that all DBE certifications are valid and information on where applicable with the names and items of the work in the "Subcontractor List" submitted with your bid. Written confirmation of this form is complete and accurate. each listed DBE regwre May&{ 17 26. Local Agency Representative's Signature 26. Date 16. Prdparees Signature i 17. Date Edward J. Carlson (951) 736-7600 27. Local Agency Representative's Name 28. Phone 18. Preparees Name 19. Phone Vice President 29. Local Agency Representative's Title 20. Preparees 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 disabdities, this document is avaC,able in alternate formats. For information tail (916) 654-6410 or TOO (916) 654- 3880 Cr write Records and Forms Management, 1120 N Streel, MS-89, Saltramento. CA 95814. Page 1 of 2 July 23, 2015 C-23 r"e. r ,72-- 7 2- 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. STPL-5181(188) Bid Opening Date May 9th, 2017 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 6 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders sliall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement www.classafiedads.com 4/20/17 www.claforniabids.com 4/20/17 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 MSL Electric 4/20/17 BC Traffic Specialist 4/20/17 ABC Resources 4/20/17 CAT Tracking 4/20/17 California Professional En ineerin High Light Electric 4/20/17 4/2 /Q 17 Caseland Surveyin�c and Mapping 4/20/17 C-24 Page 15-1 OB 12-0� June 29, 2012 Exhibit 15-11 DBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (YEN) Contract art -0 34,E 6 8 �3-75 4.8 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: KAT6 (—AN D SC —A pC 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: Made Plans and Specs available in our office free of charge Page 15-2 -- June 29, 2012 C-25 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining; necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): Name of Agency/Organization Method/Date of Contact Results www.clasifiedads.com Ad/ 4/20/17 www calif�rniahids cnm Ad! 4/20/17 H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): 'SEE ATTACHED" NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-3 OB 12-04 C-26 June 29, 2012 A!R4 a A;7rNe,14L�N - ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 MSL Electric Co. 4938 East La Palma Avenue Anaheim, CA 92807 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. Box 2229, CORONA. CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DIR #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 9t" 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator '101/2017 FedEx Ship Manager - Print Your Label(s) C N C r D o �T. 4 00 (D a) O V N 4 w .il © r11'I x = -1 m—o O p z o cc� ono _ n —'S —'S o Z CD C/7 C/7 o D CK) r r o om mmm o � mo mnmc� OZ �m{z �q "-) Dn �� => b - _ D m m c� U)U) �_ _ C) nz w 91 o n� m � m m m o o = O7 (7D P DC7= O Z .1,C . �. O m9 �o Zr D mw 0 0 5a6�2s,•Foca53� :1 After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. painted original label for stripp.ng, Using a photocopy of this label for shipping purposes is fraudulent and could result in i rges. along with the cancellat on of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,mis delivery, or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees. costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. !ttps://wwvv.fedex.com/shipping/shipAction.handle?method=doContinue 1/ ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 BC Traffic Specialist 638 West Southern Avenue Orange, CA 92865 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. Box 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 D I R #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 9th 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator !'.)112017 FedEx Ship Manager - Print Your Label(s) C N M W 00 O 2 m z C m z c m �46.J21CFIX-53c l 0 CO 0 -n 0 m 0 D After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. zoADmA or ors r �Z Vim- Z yC� cnc��o rn Cn ti = D cm WCnn W� mD rn w V W m 0 0 m C-)D Cn Cn rn m�D m A c_oo Zr D mm0 m V O r, e printed original label for shipp.rg. Using a photocopy of this label for shipping purposes is fraudulent and coald result in i:a,rg,a, alo ,g with the :ancellatior, of your FedEx aceount number. Use of Ihiis system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not he responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless YOU declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees. costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. h! I ps 7/ww,,�,. fedex.com /shipping/shi pActi on.handl e?method= doC onti nue ALL AMERICAN ASP HALT AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 ABC Resources 1527 West State Street Ontario, CA 91762 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. BOX 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DI #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 9th 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator _1/2.1/201 i FedEx Ship Manager - Print Your Label(s) O z D o V 00 cQ O 0 0 00 V N Z --� < A F' n O rn O� z� Fm Qw D J171117021401w e y �Q6J4C;FD6,5,CI 0 D CO 0 iD m 70 0 m After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. CO ADZQ Z o oF:rT1A AA M1>-Q OZZ U)M{Z cnD -aM�o m, Z U)- =D D C cncn MD rn� w W 0 re printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudu ent and could result in Ailing c.a, ges, along with the cancellation of your Fed Ex account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. nttps://wwvi_fedex.com/shipping/shi pAction.handle?method=doContinue �a All qN�L ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 CAT Tracking 2950 Rubidoux Blvd. Riverside, CA 92509 ATTN: Estimating ALL AM E RI CAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. BOX 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DIR #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91" 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 1i21/2017 Fed Ex Ship Manager - Print Your Label(s) 0 z D z. •- o;r x 4 00 QD M O O N O 00 w rn J171117021401uv z o o co z_ o �Dzo Corr-� �o;0 mDrG� o fD D OZ Z cW M-< o m cZ �D ���o o --I DD �nnz v C7 n� = A IT!� � rmD w N ti cn o r o T(D cv o 546.121CFD6)53C: i After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. he printed original label foi sh f)p.rig. Using a photocopy of this label for shipping purposes is haudulent and could result in €ges, along vpith the cancellat:_on of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current Fed Ex Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non- delivery, misdelivery, or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current Fed Ex Service Guide apply. Your right to recover from Fed Ex for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorneys fees, costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FeclEx Service Guide. https://www if ctex.com/shipping/shipAction.handle?method=doContinue 1/ 1 ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 California Professional Engineering 929 Otterbein Avenue, Unite E La Puente, CA 91761 ATTN-. Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. BOX 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE 0267073 A,C12 D I R #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91h 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator ,1/21/2017 FedEx Ship Manager - Print Your Label(s) 0 0 0 C cQ X 00 4 00 cfl cr cQ cQ 4 iN N) N) .A m U) O ;0 0 C M Z G) 2 191 'zo <, o s� oD0 o C- o C �m Z m n D cn 4 �00 cn N cn 0 m X CO im z G m Cn M M C CO 0 Z n -i 0 n z D v 0 m Cn O Z D it M Z 0 Z M m Z G7 After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. z 0 worm �70 foTIF�G7 0Z NM-z Np �-M(70 Ap Zp� M- SA A m2A j� W 0 W (7A(n N m0O Z m0p 0 m... m � SON Z r A mWM 0 =�r? ""IV he ,Printed original label for shipping. Using a photocopy of this label for stripping purposes is fraudulent and could result in �;ihon, aiges, along with the ancelialor of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees. costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. �1I1ps//www.fedex.com/shipping/shipAction.handle7method=doContinue '.,?I ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 High Light Electric 6942 Ed Perkic Street, Suite A Riverside, CA 92504 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. Box 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DI #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91h 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator I/21/201 i FedEx Ship Manager - Print Your Label(s) 0 z D o 4 V 00 cfl cs� cfl cfl w 0 00 0" 00 0 it W U) m z m m I; O N Z tr After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place Irihel in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. -2 m— )m-z �Moo =znn �-0 M_ � D W 0 l F prinled original label fof shy} ; ng_ Using a photocopy of this label for shipping purposes > f r uduleni and could result in iling t; r�,l s, along ;ill the „ancOaton uf your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not he. responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non- delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorneys fees, costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. hops://w.v.�.fedex.com/shipping/shipAction.handle?method=doContinue 1/ 1 ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 Caseland Surveying and Mapping 614 North Eckhoff Street Orange, CA 92868 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. BOX 2229. CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A.C12 DIP #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 9th 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator /21/201 i FedEx Ship Manager - Print Your Label(s) M 0 Z N D 0 w CD c� D a) Z m 0 0 n T 546J2P=FI7653C1 -i 0 After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. Z 0 00FPD,:2 momnr0 n M � Z n -<_ Mn nnz U)m =n n C:- U)U) M_ mn m 0 0 0 �.L")AV ho printed original label for shlph„ ng. Using a photocopy of this label for shipping purposes :s fraudulent and could result in a r �i ar g s, along with the cancc;llr�l on of ��our FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be. responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attornev's fees. costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedE,_ Service Guide. i;.:ps://v,,ww.fedex.com/shipping/shi pAction.handle?method=doContinue 1 /1 1 ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 Bali Construction 9852 Joe Vargas Way South El Monte, CA 91733 ATTN.- Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. BOX 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DIR #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91" 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator ,I /21 /2017 FedEx Ship Manager - Print Your Label(s) z. rnL J171117021401uv r,o ZO r. 0 0 0 00 � W D MO pp mph Z ���-2 m,znz O O (nm SD D m IT!c- Mn: D —i ;7 � rn m CO Tn z o D D co -< W w 746J�7GFD�1�h:C1 After printing this label: 1 . Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. ! 4e pi in red original label for sl,'o ;ng_ Using a photocopy of this label for shipping purposes is fraudulent and could result in Annwith the cater chat 'r, f ; cur. FedEx account nur nber. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attornr;y's fees. costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authnrized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. i)ttps:!/w�vrv.fedex.com/shipping/shipAction.handle?method=doContinue 1/1 Ire 1 ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 LNA Concrete Structures 15455 Tern Street Chino Hills, CA 91709 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. Box 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE 4267073 A,C12 DIR #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91" 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator ':)1120 1 FedEx Ship Manager - Print Your Label(s) o �T. 4 v 00 ILO cry CQ 00 w w cn can cn m M Z m m 546J21CFD6iS a,- l O After printing this label- 1 . Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. Place lahel in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. CO AAT.O ZO oFma TO rn> j 5 OZ UA)m-<Z U)p ��7n0 To �Z>Z- U)N =A A CW U)U) C/)— mp J W O e ,Minted original label for shipr r,q_ Us e g a photocopy of this Zabel for shipping purposes is fraudulent and co Id result in cras along With the cancellatlor of your FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery, or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attornev's fees, costs, and other forms of damage whether direct, incidental,consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precioLis metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current Fe.dEx Service Guide. l,rt JR.,haw�\n,.ferlex.com/shipping/shipAction.handle?method=doContinue 1 ALL AMERICAN ,ASPHALT - AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 Treesmith Enterprises 1551 North Miller Street Anaheim, CA 92595 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. Box 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A.C12 DIP, #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91h 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator !';_112017 FedEx Ship Manager - Print Your Label(s) C N o �T. 4 ,00 W to CO 00 0 Cr) (J N O Z N .A D j C> w C> D Cn Cn 22 it r m X Cn 0 IT! IT! IT! IT! Cn Cn 2 2 IT! IT! zz IT! IT! Cn Cn IT! IT! Cn Cn '46J2 _FDt : ca After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. oan�o 'm n)>cmiz �mc>— �n =z'Dn U)U)n �-o M_ my ,� I W 4' 0 0 'Ihe printed original Zabel at shipp-ng. Using a photocopy of this label for shipping purposes is fraudrd-"n' and could result in . rg ;s. along k-vitl: the cant l ation of your FedEx account number. Use of this systern constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, Unless :fou declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. U ps:/lvdv,::,,,.:.fedex.conllshi i � Aping/shipAction.handle.?method=doContinue 1%�rxA! X14 0 ,OL ALL AMERICAN ASPHALT AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 Austin Enterprise 13421 Snow Road Bakersfield, CA 93314 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 P.O. Box 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DIR #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Project STPL-5181(188)." This project bids May 91h 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (951) 736-7600. Sincerely, Kelley Cima Project Administrator 1F,2 1/20'1 FedEx Ship Manager -Print Your Label(s) n D c cfl 0 W Z W =M- 191 -{ (D After printing this label: 1. Use the 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. CO AD T.O ZO o��A r OO Z cnm-Z D m rl EZDZ (n� SD D C - CnCn C/)� mq w 0 0 !�e primed original lahol for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in �<< along with the cancellation of yOUr FedEx account number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non-delivery,misdelivery,or misinformation, mlr,ss you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees: costs, and other forms of damage whether direct, incidental,cons equentia1, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FEr1F_x Service Guide. nitps://w,A.;w.fedex.com/shipping/shipAction.handle?method=doContinue 1/11 1 NL ALL AMERICAN -ASPHALT- AN EQUAL OPPORTUNITY EMPLOYER April 20, 2017 Maneri Traffic Control 47423 Rainbow Canyon Road Temecula, CA 92S92 ATTN: Estimating ALL AMERICAN ASPHALT ALL AMERICAN AGGREGATES T 951-736-7600 F 951-739-4671 RO. Box 2229, CORONA, CA 92878-2229 CONTRACTORS LICENSE #267073 A,C12 DIR #1000001051 We will be bidding on a project in the City of Huntington Beach called "Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1S02 Federal Aid Project STPL-S181(188)." This project bids May 9th 2017. We are requesting bids from DBE Businesses for the following items of work: Striping & Markings & Removals Survey Tree Removals and/or Root Pruning & Root Ball Storm Drain Improvements Stamped Concrete Irrigation Hookup Stamped Concrete We have Plans and Specifications for review in our office. If you have any questions please contact Jim McGee at (9S1) 736-7600. Sincerely, Kelley Cima Project Administrator 1/2 1/201 FedEx Ship Manager - Print Your Label(s) o� o # V V 00 00 C)'1 00 4 00 Z7 Z n � O N D — o O CCU ZO AAT0 P,2 M m0 Oz >KM2 o D D �p Wm-- o(M'� m m i> C TTN11 �v /73 ;0 � M,m 2A p rD U� -_ illA 0 D O T T cGi, T T_ N 0 0 0 y ci ci o tv Z O O o <ZZ O —1 —1 ;0 W C�A(n � O-1 �:�EO z m�� m A m,.. �o Z�A MOD w m 0 After printing this label: 1. Use aloe 'Print' button on this page to print your label to your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned. rintrd c,tigna1 label fcr shi_�K r1g, Using a shotocot�; of this label fo; shipping purposes s *'audu!r. amd co ld result in along vvith the : anc, >(iat:on )f ycur edEX. t ccount number. Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay, non- delivery, misdelivery,or misinformation, _finless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current FedEx Service Guide apply. Your right to recover from FedEx for any loss, including intrinsic value of the package, loss of sales, income interest, profit, attorney's fees.. costs, and other forms of damage whether direct, incidental, consequential, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current F(-,dE?: Service Guide. h!t)s://www.;edex.com/shippinglshipAction.handle?method=doContinue 1/1 4/21/2017 Seeking DBE Subs!! - Classified Ad & 6� M M- M y 4 I Hello, Kim Bird not you? Your stuff Heln Post an ad (free) Leo out Search for — SEARCH CommunityAnnouncements Search for... Community: Announcements • All Categories • Jobs • Vehicles • Items for Sale • Pets • Real Estate • For Rent • Services • Personals • Community • All CominwI4 • Announcements • Cam • Churches • Free Stuff • Garage Sales • General Entertainment • Items Wanted • Lost & Found • Musicians & Bands • Volunteers • Zip or city • Riverside - San Bernardino • More locations --► Your ad has been posted. Post another ad Edit this ad Hel1page Your stuff Share your ad for more visibility! Huntington Beach, CA in Huntington; SEARCH Beach, CA Seeking DBE Subs!! hftps://www.classifiedads.com/announcements/3553pknOhfw3 1/4 4/21/2017 Share & Like Seeking DBE Subs!! - Classified Ad Share this Created: April 21, 2017 Expires: October 21, 2017 Viewed: 0 times Avoid scams 17 ot1 0 Ad #262933748 Signs of fraud: wire transfer, money orders, cashier checks, shipping, escrow, "transaction protection", "guarantee". Be safe by dealing locally. Read more Overview Respond to this Ad Ad number:#262933748 Contact:Kim Bird Phone:951-736-7600 City:Corona Zip:92879 Posted in: Orange County Announcements Description Respond to this Ad From Certified DBE Subcontractors and Suppliers for the Following Project: City of Huntington Beach Report this ad Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard To Newland Street, CC No. 1502 Federal Aid Project STPL-5181 (188) Bid Date: May 9th, 2017 @ 2PM Quotes are requested for (but not limited to) the following services & Suppliers: Striping and Markings Tree Removals and/or Root Pruning & Root Ball Traffic Detector Loops Survey https://www.classifiedads.com/announcements/3553pknOhfw3 2/4 4/21/2017 Traffic Control Devices and/or plans Seeking DBE Subs!! -Classified Ad Irrigation Hookup Stamped Concrete ALL AMERICAN ASPHALT (Equal Opportunity Employer) P.O. BOX 2229 Corona, CA 92878-2229 (951)736-7600 Fax; (951) 736-7646 Information and/or assistance regarding or obtaining plans and Specifications are available upon request Respond to this Ad Your name Your email Message F.S_e_nd_16essage Type of problem: 0 Harassment �U Spam `-) Scam or fraud Wrong category Violation of terms Other (please comment) Your email (optional) publicworks@allamericanasphalt.com -' I would like a response URL (optional) https://www.classifiedads.com/announcements/3553pknOhfw3 3/4 4/21/2017 Comment (optional) Seeking DBE Subs!! - Classified Ad p� :a Sending... Sending... Ads retawd to announcements 40% Off Announcements View our Stunning 2017 Collection. Get Free Shipping- on orders $49+ www.Shutterfly.com 50% Off Graduation Invitations - Free Shipping. Ends Soon. 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All rights reserved. https://www.classifiedads.com/announcements/3553pknOhfw3 4/4 All American Asphalt Sub -contracting & Vendor Opportunities Phone (951) 736-7600 Public Works Fax (951) 736-7646 Project: Adams Ave And Atlanta Owner: City of Huntington Beach Estimator: JIM MCGEE Bid Date & Time: 05/09/17 @2PM (Bid should be fax'd to the above number at least 1 hr prior to Bid Time) Subcontracting Opportunities in the following areas ; Underground Miscellaneous Water Improvements Landscaping & Irrigation- Street Trees Sewer Improvements Fencing and/or Railing GUARD RAIL Storm Drain Improvements Mass Grading / Earthwork Underground Linings and/or Coatings Pulverizing and/or Cement Treat, Lime Treat Adjust Utilities to Grade / Install Monuments Crack Filling / Joint Sealing Cast -In -Place Structures & V-Ditches Heater Re -Mix and/or Cold Recycling Electrical Tree Removals and/or Root Pruning & Root Ball Traffic Detector Loops Irrigation Hookup 1 Traffic Signal Improvements Street and/or Parking Lot Lighting Engineering/Testing Dry Utilities Testing and/or Inspection Relocate Pull Boxes Survey Concrete Traffic Control Devices and/or Plans Masonry Wall (Grouted River Rock) Specialty Wall Finishes Stamped Concrete Striping & Markings & Removals Specialty Concrete / Monument Wall Monument Signs Steel Placement Slurry Seal Grinding / Grooving Painting and/or Finishes ROCK COBBLE BLANKET Chip Seal CMB All American Asphalt is an Equal Opportunity Employer and encourages the participation of Certified DBE/MBE/WBE/DVBE Subcontractors and/or Vendors. Subcontractors may be required to submit Payment & Performance Bond equal to 100 % of their bid at a maximum additional cost of 1 1 /2 % of total bid amount. Subcontractor will be required to fully execute All American Asphalt standard subcontract. PLANS & SPECS ARE AVAILABLE FOR REVIEW AT THE OFFICE OF ALL AMERICAN ASPHALT AT 400 E. SIXTH ST., CORONA, CA. 92879 TELE: 951-736-7600 NAPC North America Procurement Council Menu Register for Free Logout Click HERE to download your free copy of our neW Magazine TRILLIONS Users who violate the Terms of Usage of this site may have their IP blocked temporarily or permanently and may face legal prosecution. Read More.. Seeking DBE Subcontractors and Suppliers Edit Description : From Certified DBE Subcontractors and Suppliers for the Following Project: City of Huntington Beach Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard To Newland Street, CC No. 1502 Federal Aid Project STPL-5181 (188) Bid Date: May 9th, 2017 @ 2PM Quotes are requested for (but not limited to) the following services & Suppliers: Striping and Markings Tree Removals and/or Root Pruning & Root Ball Traffic Detector Loops Survey Traffic Control Devices and/or plans Irrigation Hookup Stamped Concrete ALL AMERICAN ASPHALT (Equal Opportunity Employer) P.O. Box 2229 Corona, CA 92878-2229 (951)736-7600 Fax; (951) 736-7646 Information and/or assistance regarding or obtaining plans and Specifications are available upon request Category : MBE/DBE/WBE/VBE/LBE Expiration :05/09/2017 date Publisher Information Name : Jim McGee Location: California TEL : 951-736-7600 Email :jmcgee@allamericanasphalt.com Posted:04/21 /2017 09:35 am Last updated:04/21 /2017 09:35 am Bid On Construction Get Unlimited Contractor Leads. Bid 1000's of Projects Nationwide. Go to bidclerk.com Post an Ad My Ads Search Ads 11, 1 s t e -n T?o Y o tj c u rn e y Ads by Category Cars & Trucks Const. Equip. Const. Materials Employment MBE/DBE/WBE/VBE/LBE Misc. 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Box 1227. Baltimore. MD 21203-1227 BID BOND KNOW ALL MEN BY THESE PRESENTS: That we, ALL AMERICAN ASPHALT BOND NO.085 97 423 , as Principal, (hereinafter called the "Principal"), and FIDELITY AND DEPOSIT COMPANY OF MARYLAND P.O. Box 1227, Baltimore, Maryland 21203, a corporation duly organized under the laws of the State of Maryland, as Surety, (hereinafter called the "Surety"), are held and firmly bound unto City of Huntington Beach as Obligee, (hereinafter called the "Obligee"), in the sum of TEN PERCENT OF THE TOTAL BID PRICE IN -------- Dollars ($ 10% OF TOTAL BID PRICE ),for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 Federal Aid Proiect STPL-51810 Bid Date: May 9, 2017 NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or contract documents with good and sufficient surety for the faithful performance of such contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter into such contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another parry 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 20th day of April A D 2017 ALL AMERICAN ASPHALT (SEAL) �1 Prin ipal Witness Title t.rt cc Cf-e-� Ac n (- FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety By o r 1+ PQK; � _ (SEAL) Rebecca Haas -Bates 4ttnrnev-in-Fact Printed in cooperation with the American Institute of Architects (AIA) by Fidelity and Deposit Company of Maryland. Fidel iry and Deposit Company of Maryland vouches that the language in the document conforms exactly to the language used in AIA Document A-310, February 1970 Edition. BID7000077..0701 f CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT 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 validitv of that document. State of California County of Riverside On May 2, 2017 before me, B. Royster, Notary Public Date Here Insert name and Title of the Officer personally appeared Edward J. Carlson and Michael Farkas 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 8. ROYSTER and acknowledged to me that he/&he/they executed the same in Commission # 2083832 z #is/f /their authorized capacity(ies), and that by #isther/their a -.: Notary Public - California z signature(s) natures on the instrument the erson s or the entity upon behalf z: a 9 () P (), Y P z Riverside County of which the person(s) acted, executed the instrument. My Comm. Expires Oct 26, 2018 I certify under PENALTY OF PERJURY under the laws of the State of California that the forgoing paragraph is true and correct. WITNESS my,., nd an fficial seal. Signature Place Notary Seal Above SignatUre of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to person relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document Bid Bond — City of Huntington Beach Document Date: April 20, 2017 Number of Pages: 3 Signer(s) Other Than Named Above: Rebecca Haas -Bates, Attorney -in -Fact Capacity(ies) Claimed by Signer(s) Signer's Name: Edward J. Carlson Signer's Name: Michael Farkas ❑ Individual ❑ Individual X Corporate Officer — Title(s): Vice President X Corporate Officer — Title(s): Secretary ❑ Partner ❑ ❑ Limited ❑ General HTTIH ❑ Partner ❑ ❑ Limited ❑ General ❑ Attorney in Fact ❑ Attorney in Fact OF SIGNER ❑ Trustee Top of thumb here ❑ Trustee Top of thumb here ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: CALIFORNIA• •. CIVIL , at�Cc�Lc�C.at.a .a .a .atrSiC_at.a .�.� . C a..w .w w w• a .a .w _aC!aa!�•.w .. .a .w .w . .aC.aC-C�Ya 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 Califomia } County of Orange j On 04/20/2017 Date before me, A. MacFarlane, Notary Public personally appeared Rebecca Haas -Bates Here Insert Name and Title of the Officer NameKof Signer* who proved to me on the basis of satisfactory evidence to be the persons} whose name(bj. is/are subscribed to the within instrument and acknowledged to me that He/she/they executed the same in hislher/theii' authorized capacity, and that by hi-r.4her/iha& signatureZ'S}.on the instrument the person(,, or the entity upon behalf of which the personis}. acted, executed the instrument. A. MACFARLANE NotaryPublic- California Z z Orange County n Commission # 2188592 My Comm. Expires Mar 27, 2021 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 4 � 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: Bid Bond Document Date: 04/20/2017 Number of Pages: One 1 Signer(s) Other Than Named Above: All American Asphalt Capacity(ies) Claimed by Signer(s) Signer's Name: Rebecca Haas -Bates ❑ Corporate Officer — Title(s): • Partner — ❑ Limited ❑ General ❑ Individual QAttorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Fidelity and Deposit Company ol'Maryland Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General Ll Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: �,c':✓ e c.-✓.'rim, -ri �r 'e/�b 'aic'✓c"!c'.vti �'=�� �' dc�:�.�� �✓ ✓. g � �. 'ei '„4'.v .v 'ei4 y 'ri -ei 'e�4'✓ c• ✓cry •rii• EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attomeys-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attomey-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: 'That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the loth day of May, 1990. RESOLVED: 'That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WIJEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 2WIday of Y l 201% . 44 eggs, Michael Bond, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED INFORMATION TO: Zurich American Insurance Co. Attn: Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 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 July 21, 2017 EBS General Engineering, Inc. 1320 E. Sixth St., Stet. 100 Corona, CA 92879 RE: Adams Ave. & Atlanta Ave. Rehabilitation — CC-1502 Enclosed please find your original bid bond for CC-1502. Sincerely, Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand 40 o� d) a _O N C%j CO U CF) fa . Q a) cV �a � U o O "�. • O)C) • �CO a) CO c y N y.., .-. O . O a) uj �,U0 C M r CUOc42 SECTION C PROPOSAL for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find bid bond in the amount of 10% bid amountwhich said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond 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 X X Bidder's Signature 1 5/1 2 5/3 C-2 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) PROJECT BASE BID: Basis of Award ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ......................................... C-2.2 to C-2.8 ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ........................................ C-2.9 TO C2.14 1. ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET BID IN FIGURES 2. ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.2 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 -- MOBILIZATION 1 LS $1000O ' $ U y—,)' 2 - - TRAFFIC CONTROL PLAN 1 LS $--�_ $ s 3 FURNISH PROJECT TRAFFIC 1 LS $ t/-Y l $ 5, ot% r CONTROL 4 FURNISH AND INSTALL SIGNING 1 LS $ AND STRIPING 5 - - PROJECT SPECIFIC SWPPP 1 LS $ coo $ lxz REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. 6 1 (CASE SHOWN ON PLAN). (INCLUDES ALL g EA $ l ,, ll $V S�� APPURTENANCES, CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,800 TN $ PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 7 EA $ GRADE. 9 5 ADJUST STORM DRAIN 10 EA $ 20D $ 0C O — MANHOLE TO GRADE. 10 6 REPLACE WATER VALVE BOX ASSEMBLY AND ADJUST TO 11 EA _ $ �SU'- $ 050 — GRADE PER HB STD PLAN 612. C-2.3 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 22,400 SF $ x $ boo SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. 12 INTENTIONALLY LEFT BLANK COLD MILL EXISTING A.C. 13 8 PAVEMENT TO A DEPTH OF 0.34' 138,000 SF "w $ 11�� $ FROM NEW FINISHED SURFACE PER PLANS 14 INTENTIONALLY LEFT BLANK CONSTRUCT NEW 0.17' B-PG-70- SE .� 15 8 OVER 95% COMPACTED 1,700 TN $ $�o SUBGRADE PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. 16 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION AND PREPARE CORNER DUb J 17 g RECORD (PRE- AND/OR POST - 3 EA $ $ CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=B"). (INCLUDES SLOT PAVEMENT, AGGREGATE �j �- �'✓ 500 18 10 900 LF $ $� BASE, LOT DRAINS, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING % C/ 19 11 SLOPE, RELOCATING 13,500 SF $�� $ C IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.4 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 20 INTENTIONALLY LEFT BLANK REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL 21 12 DRIVEWAY/ALLEY APPROACH ("W" AND TYPE SHOWN ON 690 SF $ $ r PLAN) PER STD PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 13 (ITEM INCLUDES SLOT 2,170 SF $ ' $� PAVEMENT, AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN P LACE. ) REMOVE AND RECONSTRUCT MEDIAN CURB PER HB STD PLAN 201 (CF=8"). (INCLUDES ee11 Q _-- I 23 14 SLOT PAVEMENT, AGGREGATE 225 LF $ $ li�%CO BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT LOCAL DEPRESSION PER HB 24 15 STD PLAN 302. (INCLUDES SLOT PAVEMENT, AGGREGATE BASE, 1 EA i ��� $ $ v f AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC SIGNALS AND LIGHTING 52 EA $ --$ — 25 16 SYSTEMS, 2005 EDITION. SPLICE - LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". C-2.5 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid . Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP AND ROOTS TO 24" BELOW TOP 26 17 OF SIDEWALK/GRADE WITHIN 44 EA $ $ PROPOSED IMPROVEMENT AREA. PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. 27 INTENTIONALLY LEFT BLANK FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 18 BY AGENCY. (INCLUDES ALL 2500 SF $ r-- $ 1S00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 29 19 IDENTIFIED BY CONTRACTOR 90 CY $ $ / zl,��_' / AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 30 20 EDISON. CONTRACTOR TO 3 EA NOT A CONTRACTOR COORDINATE WITH ERICK OEN BID ITEM AT (714) 895-0242. 31 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 32 21 053, S-054 AND S-055. 1 EA $ iw $ I v CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT (714) 593-7645. 33 22 ADJUST MONITORING WELL 2 EA $ �� $ l�V COVER TO GRADE. C-2.6 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No.. No. Description Quantity Unit Price Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, \\ "d� 34 23 BUSHES OR GROUND COVER 48 EA $ t $ v AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND PLANT NEW 10' BROWN TRUNK HEIGHT TRACHYCARPUS FORTUNEI PALM TREE PER HB STD. PLANS 714,715,716,718&719AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, Sao 35 24 BUSHES OR GROUND COVER 6 EA $ $ AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). C-2.7 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount CONSTRUCT AND / OR REMOVE AND RECONSTRUCT 4" THICK PERVIOUS COLORED STAMPED 36 25 CONCRETE IN MEDIANS PER SPECIFICATIONS AND HB STD 780 SF $ $ PLANS 711. (ITEM INCLUDES REMOVAL OF EXISTING GROUND COVER, AND SLEEVING OF EXISTING IRRIGATION LINES.) FURNISH AND INSTALL ZEBRON, 37 - - SANCON OR CITY APPROVED EQUAL COATING ON THE NEW 3 EA $ $ O ' CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ �7 , 0 / Total Amount Bid in Words: ......:�1��...�.....�i...-... ................ ..........► T� ffi C-2.8 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.9 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount 1 - - MOBILIZATION 1 LS $ ^ '� $ 5 t"pU 2 - - TRAFFIC CONTROL PLAN 1 LS is ODU ' s 3,ub � 3 - FURNISH PROJECT TRAFFIC 1 LS $ $�,�� ' CONTROL �T 4 FURNISH AND INSTALL SIGNING AND STRIPING 1 LS $ U (ice f $� 5 - - PROJECT SPECIFIC SWPPP 1 LS $3ccai "` $�� REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL 3 EA ✓ $ $ ' i APPURTENANCES,CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,600 TN $ U $� PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 12 EA $ �U r $� GRADE. 9 5 ADJUST STORM DRAIN 2 EA $ / D V $ MANHOLE TO GRADE. REPLACE WATER VALVE BOX 6s o — o 10 6 ASSEMBLY AND ADJUST TO 23 EA $ $ GRADE PER HB STD PLAN 612. C-2. 10 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' �� °-- co 11 7 TO ZERO FROM NEW FINISHED 36,400 SF $ $ SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' _ LI D 12 8 FROM NEW FINISHED SURFACE 13,700 SF $�_ $ PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.34' 49,900 SF C $ i SS J $ 7�s FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 14 10 PAVEMENT TO A DEPTH OF 0.67' 7,300 SF 99 $ v o $ jo� FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW OATAND 0.50' B-PG-70-10-RAP A.C. BASE a q ,- Yo 15 9 & 10 COURSE OVER 95% 1,000 TN $ D $ li COMPACTED SUBGRADE PRIOR TOO. 17' ARHM OVERLAY. RAISE SURVEY WELL 16 11 MONUMENT TO GRADE AND PREPARE CORNER RECORD 1 EA $ �, Sob f $ 5Do (PRE- AND/OR POST - CONSTRUCTION). SET SURVEY MONUMENTATION AND PREPARE CORNER 0 ,-- s 17 12 4 EA $ $ RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 13 SLOT PAVEMENT, AGGREGATE 405 LF $ $ -V ,- BASE, LOT DRAIN, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2. 11 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING 19 14 SLOPE, RELOCATING 3,400 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) SAWCUT AND REMOVE EXISTING SIDEWALK AT EXISTING AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 3. (ITEM INCLUDES REMOVAL OF 3 EA $ 0D $ 20 15 SIDEWALK, 6 LF OF NEW SIDEWALK, NON -CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR AGENCY APPROVED EQUAL AND MULCH.) REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL 21 16 DRIVEWAY ("W" AND TYPE SHOWN ON PLAN) PER STD 750 SF $ f $ (� PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 17 (ITEM INCLUDES SLOT 1,740 SF CC $ J $ 00 �- 22 PAVEMENT, AGGREGATE BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 23 INTENTIONALLY LEFT BLANK 24 INTENTIONALLY LEFT BLANK C-2. 12 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 18 SIGNALS AND LIGHTING 22 EA $ 2 $ d f SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 26 19 AND ROOTS TO 24" BELOW TOP 4 EA $ �� $ OF SIDEWALK / GRADE WITHIN PROPOSEDIMPROVEMENT AREA. FURNISH AND INSTALL BRIDGE DECK MEMBRANE OVER ENTIRE BRIDGE DECK SURFACE 5,000 SF $ ']�- $ / ✓� cto� 27 20 (INCLUDES ALL ASSOCIATED WORK PER PLANS AND SPECIFICATIONS). FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 21 BY AGENCY. (INCLUDES ALL 2,500 SF $ ✓ $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN < 29 22 IDENTIFIED BY CONTRACTOR 90 CY $ AND VERIFIED BY AGENCY. 30 INTENTIONALLY LEFT BLANK ADJUST VERIZON VAULT/MANHOLE TO GRADE BY NOT A CONTRACTOR 31 23 VERIZON. CONTRACTOR TO 4 EA BID ITEM COORDINATE WITH RAY ROUNDTREE AT (714) 375-6760. C-2. 13 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. Description Quantity Unit Price Amount ADJUST OCSD SEWER 32 24 MANHOLE TO GRADE, PER OCSD STD. PLANS S-053, S-054 & 2 EA $ v f $ S-055. CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT 714-593-7645. 33 INTENTIONALLY LEFT BLANK FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF 34 25 EXISTING LANDSCAPING, BUSHES OR GROUND COVER 1 EA '` ^ $�� $� AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). 35 INTENTIONALLY LEFT BLANK 36 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 - - EQUAL COATING ON THE NEW 6 EA $�I J $��� CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. �� S Total Amount Bid in Figures: $ "7qo) Total Amount Bid in Words: S j ti e V rjI-S J C-2. 14 U 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 $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Item(s) Name and Address of Subcontractor State License Number Class DIR PWC Registration # Dollar Amount % of Contract 3`1 �(ee- N ►m l (V 51' - �� rye ��• q - t6 �O �c�ca�ui`63`6 'BOG (. 5,C'Ma- P0000j7$y — C\'P, CC). lo00 a0 ai, �L CGA— ,J'm4-(� � Inc, -J, 99 po (MI'S� J 0 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 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 5/8/17 , at Corona , __CA Date City State Joseph A. Nand , being first duly sworn, deposes and says that he or she is President of EBS General Engineering, Inc. the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. EBS General Engineering, Inc. Name of Boidder Si�y-natA of Bidder Sixth St., Ste 100 Corona CA 92879 ss of Bidder C-4 California All -Purpose Acknowledgement State of California ) County of Orange On -' ''Iq beforeme, William E. Ellis, Jr. a Notary Public Personally Joseph A. Nanci WILLIAM E. ELLIS JR. Commission # 2127998 =� s" Notary Public - California z Z ,� Z ' Orange County v My Comm. Expires Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: who proved to me on the basis of satisfactory evidence to be the person) whose namets)js/are subscribed to the within instrument and acknowledged to me that he/ shsAh" executed the same in hisfimrftheir- authorized capacityOos,), and that by hisAwiftheiF signatureN on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. c , Notary Public Signature Document Date: Number of Pages: Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited 0 General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited C -General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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 Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, Project CC No. 1502, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 5/8/ 17 C-5 EBS General Engineering, Inc. 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 IgNo 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: 518117 C-7 EBS General Engineering, Inc. President Title BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: EBS General Engineering, Inc. Bidder Name 1320E Sixth St Ste 100 Business Address Corona CA 92879 City, State Zip ( 951 ) 279-6869 Telephone Number 720016 A State Contractor's License No. and Class 3/31/96 Original Date Issued 3/31/18 Expiration Date The work site was inspected by Joseph A. Nanci of our office on 5/ 1 , 2011. The following are persons, firms, and corporations having a principal interest in this proposal: Joseph A. Nanci, President 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. EBSkeneral Engineering, Inc. ame Signatur of Bidder Josep A. Nanci Printed or Typed Signature Subscribed and sworn to before me this _ day of , 201_ NOTARY PUBLIC C-8 NOTARY SEAL California All -Purpose Acknowledgement State of California } County of Orange On !s-I •kI beforeme, William E. Ellis, Jr Personally appeared_ Joseph A. Nanci ~� WILLIAM E. ELLIS JR. Commission # 2127998 Q -a Notary Public - California z z! ounty Orange Cr My Comm. Expires Oct 23, 2019 Notary Public Seal Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: a Notary Public who proved to me on the basis of satisfactory evidence to be the personN) whose name.Xis/ate subscribed to the within instrument and acknowledged to me that he/ shMhey executed the same in hisfhcrftkeir authorized capacity0eQ, and that by his/ftmftheir signature on the instrument the personK or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Notary Public Signature umber of Pages: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited C7 General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ACTION AND RESOLUTION BY THE BOARD OF DIRECTOR OF EBS GENERAL, ENGrN'EERrNG, TNIC A CALIFORNIA CORPORATION All of the Board of Directors of EBS General:Engineering, Inc., desiring to insure that all the proper and authorized individuals, who have corporate authority to bind the, said corporation to any and contracts executed by such authorized individuals, have been approved by the board of directors of EBS General Engineering, held a meeting on January 3, 2010. The Board-, following a review of the foregoing matter, and upon motion made and seconded, the Board of Directors hereby determines and votes unanimously as follows: BE IT THEREFORE RESOLVED that Joseph Nanci is hereby designated,authorized and empowered, to be duly authorized with all the attendant powers and authorizations related thereto, to bind, obligate and commit EBS General Engineering, Inc. to any and all contracts executed by and between EBS General Engineering, Inc, and any other Contracting party, There being no further or pending business, before the Board, the meeting was adjourned. Date: January 3, 2010 5 Josepl- , anci, Soie Director ATTESTATION 1, being the Secretary of the above referenced corporation, do hereby certify that the above resolution is the resolution of the corporation. Dated: Jose71anci, Secretary 10 Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing high ground water and pipeline construction in hi,2h ground water regions with trench depths of 8-feet to the invert."}. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 1. See attached reference list Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-9 3 YEAR REFERENCES - PUBLIC WORKS ct Name 12015 Citywide Curb, Gutter, Sidewalk, Driveway Repairs Project Address Owner Various Locations City of Riverside Principal Contact Phone Secondary Project Contact Danny Cwiak, Construction Project Manager (951) 377-5514 Steve Howard Price of Contract Type of Work Dates $407,628 Curb + Gutter, Ramps 11/2014 to 2/2015 2. Project Sewer Replacement Project Project Address Owner Various Locations City of Fullerton Contact Phone Eric Villagracia, Public Works Dept. (714) 738-6853 Price of Contract Type of Work Dates $998,151.00 Sewer, Curb + Gutter 1/2012 to 2/2013 3. Project Sewer Manhole Surface Repair PH II Project Address Owner Fairview and Newport, City of Costa Mesa Costa Mesa Sanitary District Contact Phone Robin Hamers, District Engineer (949) 548-1192 Price of Contract Type of Work Dates $47,420.00 Manhole Repairs 1/2016 4. Project Annual Concrete Repair FY 2014-15 Project Address Owner Various Locations City of Rancho Santa Margarita Contact Phone E. Maximous, Public Works Director (949) 635-1805 Price of Contract Type of Work Dates $53,550.00 Sidewalk 4/2015 to 5/2015 3 YEAR REFERENCES — PUBLIC WORKS ct 1 Avenue Widening Project Address Owner Grand Ave. from First St. to Fourth St. City of Santa Ana Contact Phone Tyrone Chesanek, Principal Civil Engineer (714) 647-5074 Price of Contract Type of Work Dates $172,000.00 Curb + Gutter, Bus Pad 11/2014 to 9/2015 6. Project Concrete Street Rehabilitation, FY 2015-16 Protect Address Owner Various Locations City of Orange Contact Phone Matthew Lorenzen, Project Manager (714) 744-5566 Price of Controct Type of Work Dates $574,850 Minor Concrete, Street Improvements 7/16 to 10/16 7. Project Name Improvements of Livingston Drive Project Address Owner Livingston Dr. between Termino Ave. & 2"d St. City of Long Beach Contact Phone: Danny Besabella (562) 577-6192 Price of Contract Type of Work Dates $1,254,000.00 Street Improvement 8/2012 to 2/2013 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. Willie Ellis Name of proposed Project Manager Telephone No. of proposed Project Manager: 714-448-1136 See attached reference list 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 2• Carlos Rodrieuez Name of proposed Superintendent Telephone No. of proposed Superintendent: 951-256-6235 See attached reference list Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work C-10 Date Completed Date Completed 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/PublieWorks/SB854FactSheet_6.30.14.pdf DIR's Contractor Registration Link — Call (844) 522-6734 https://efiling.dir.ca.gov/P W CR/ActionServlet?action=displayP W CRegistrationForm DIR's Contractor Registration searchable database: https://efil ing.dir.ca.gov/PW CR/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: 5/8/ 17 PWC Registration #: 1000005295 C-11 Title 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: EBS General Engineering, Inc. Contact Person: Joseph A. Nand Contact Phone: 9 1-279-6869 Signed: All Date: /8/17 *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 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to sttivw.calregs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System (GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Reauirements. Retain the original form in your Grant file. GRANTEE NAME: CITY OF HUNTINGTON BEACH GRANT NUMBER: TRP7-16-0001 2000 Main Street, Huntington Beach, CA 92648 j PRIMARY CONTACT NAME: JAMES WAGNER PE, SENIOR CIVIL ENGR, PUBLIC WORKS DEPT. CONTRACTOR NAME: EBS General Engineering, Inc. AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Joseph A. Nanci ....... _.........._....__... MAILING ADDRESS: 1320 E. Sixth St., Ste 100 Corona CA 92879 As the authorized representative of the above identified contractor, 1 declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, I declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I hay disclosed all such occurrences in an attached signed statement that explains the , facts . and circumstances of #te listed events. 5/8/17 Signature Date C-13 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a fording that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting: or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (1) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor: or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or (j) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration: or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site, or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List, (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder EBS General Engineering, Inc. , proposed subcontractor hereby certifies that he has X has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of $10,000 or under are exempt.) Currently, Standard Form 100 (EEO-1) is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b) (1) prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director, Office of Federal Contract Compliance, U.S. Department of Labor. Page 6 of 22 October 2016 C-15 Local Assistance Procedures Manual Exhibit 12-H Sample Bid PUBLIC CONTRACT CODE PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376. Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not X been convicted within the preceding three years of any offenses referred to in that section; including any charge of fraud, bribery, collusion, conspiracy. or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of. any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer. director.. responsible managing officer. or responsible managing employee thereof. as referred to in Section 10285.1. Note: The bidder must place a checkmark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder. or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes[—] No If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-16 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-17 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 Huntington Beach DEPARTMENT OF PUBLIC WORKS. In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true, and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above 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-18 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. N/A Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. 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-19 October 2016 Local Assistance Procedures Manual NONLOBBYING CERTIFICATION FOR FEDERAL -AID CONTRACTS Exhibit 12-H Sample Bid The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief. that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency. a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL. "Disclosure of Lobbying Activities." in conformance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Page 11 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLE'I'E'I'HIS FOKM'I'O DISCLOSE LOHHYINIi AUI IVI I IES YUKJUAN I Iv l u.au. Ise_ 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: �a. contract EK] a. bid/offer/application F T] a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan e. loan guarantee f. loan insurance 4. Name and Address of Reporting Entity Prime Subawardee EBS General Engineering, Inc, Tier if known 1320 E. Sixth St., Ste 100 Corona CA 92879 Congressional District, if known 6. Federal Department/Agency: State of CA - DOT 8. Federal Action Number, if known: STPL-5181(188) 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) N/A For Material Change Only: year quarter_ date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: Adams Ave Rehab & Atlanta Ave Rehab CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) N/A (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) $ 0 actual ❑ planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): c. commission N/A 8 a. cash N/A 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 It: N/A (attach Continuation Sheet(s) if ne 15. Continuation Sheet(s) attached: Yes El No ❑� 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Signature: Print Name: Title: P Telephone No.: 951-279-6869 Date: 5/8/17 Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C-21 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-LLL-Insimciions Rev.OG-(W-IU((ENDIF)) Page 13 of 22 C-22 October 2016 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: The City of Huntington Beach 2. Contract DBE Goal: 6% 3. Project Description: k�- yyv kVe- Y\ "vr1 d N)� A J A JF 4. Project Location: Adams Ave. /Beach BI. to Newland St. and Atlanta Ave. / Beach BI. to Newland /St. 5. Bidder's Name: TN(N Cnr Y1a iw, �Oq 1'�1%f,T�`hq_>C. 6. Prime Certified DBE: ❑ / 7. Bid Amount: F2�A 25 8. Total Dollar Amount for ALL Subcontractors: 9. Total Number of ALL Subcontractors 10. Bid Item 11. Description of Work, Service, or Materials Supplied 12. DBE Certification 13. DBE Contact Information (Must be certified on the date bids are opened) 14. DBE Dollar Number Number Amount Trucking 2037 Ray's Trucking 86) c � IV, /, 7 U -vim.. w k 7 _ ;�5 L-00D-� �03 3 i9 o 21. Local Agency Contract Number: CC-1502 22. Federal -Aid Project Number: STPL-5181(188) 23. Bid Opening Date: 24. Contract Award Date: Local Agency certifies that all DBE certifications are valid and information on this form is complete and accurate. 25. Local Agency Representative's Signature 26. Date 27. Local Agency Representative's Name 29. Local Agency Representative's Title 28. Phone 15. TOTAL CLAIMED DBE PARTICIPATION 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 "Subcont ctor List" submitted with your bid. Written confirmation of each lisft DBE,is require 5/8/17 16' Pr pWr's Signature 17. Date Jos ph A. Nanci 951-279-6869 18. reparer's Name 19. Phone President 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 l of 2 July 23, 2015 C-23 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort EXHIBIT 15-H DBE INFORMATION —GOOD FAITH EFFORTS Federal -aid Project No. DBE INFORMATION - GOOD FAITH EFFORTS STPL-5181(188) Bid Opening Date 5/9/17 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 6 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation Hardy Landscape 5/5/17 See list of frequently used vendors 5/5/17 C-24 Page 15-1 OB 12-04 June 29, 2012 Exhibit 15-H DBE Information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (Y/N) Contract Traffic Control, Utilities Yes Construction Materials, Survey, SWPPP No Striping, Loops, Tree Remocal, Landscape No 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: Covered in EBS RFQ (attached) Page 15-2 June 29, 2012 C-25 OB 12-04 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: Cnye'red in FRS` RF((attarhed) 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): fax reports email print-(n tg NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-3 OB 12-04 C-26 June 29, 2012 i gmral engirteenng,1 c. EBS GENERAL ENGINEERING, Inc. An Equal Opportunity Employer, is requesting quotations from all qualified DBE,MBE,WBE sub -contractors and material suppliers for the following project: Adams Ave Rehab and Atlanta Ave Rehab; CC No. 1502 City/Location: Huntington Beach County: Orange Bid Date: Tuesday, March 9`h @ 2 pm We are requesting bids for the following trades and/or supplies: Traffic Control, Construction Materials: PCC, Asphalt, Crushed Misc. Base, Survey, SWPPP, Sign & Stripe, Pavement Marking, Cold Mill, Detector Loops, Tree Removal, Landscape, Utilities Bid documents can be viewed at or obtained from: Email for plans + specs: bids @ebsgeneral.c-on or visit our Dropbox: httus:''wvew.dro box.corrilsi-i/zv3l�izx,hexlal y iSZAADgIbY'r'K8nVrBSriN JN sVa?dl=0 ❑ Will Bid ❑ Will Not Bid ❑ HUD Section 3 ❑ MBE/WBE ❑ DBE ❑ SBE ❑ Other Certification (please specify): EBS General Engineering, Inc. is an Equal Opportunity Employer. We encourage and actively solicit proposals from DBE subcontractors and suppliers on all our projects. All qualified DBE subcontractors must be registered and certified by the California Department of Transportation. All subcontractors must possess a current contractor's license, insurance, and worker's compensation coverage meeting EBS requirements. All subcontractors will be required to sign the EBS Master Subcontractor Agreement. Performance and payment bonds up to 100% may be required for the full amount of the subcontract price. Prior to the bid, you can contact our office if you require assistance in bonding, lines of credit, insurance, obtaining necessary equipment, supplies, materials or services etc., which may be required by the Owner. EBS is signatory to Operating Engineers, Construction Laborers, and Cement Masons unions. Cristina Whitcher T- Uor '�rn�,r. r m-afar From: Cristina Whitcher Sent: Friday, May 05, 2017 1:15 PM To: Rene Ocampo Subject: RFP: 5/9 Huntington Beach Adams & Atlanta Good afternoon, EBS is requesting subcontractor quotes for 'Traffic Control' on the following upcoming bid: Adams Ave Rehab and Atlanta Ave Rehab City of Huntington Beach Bid Date: 5/9/17 @ 2 pm Please use the following link to plans and specs: https://www.dropbox.com/sh/zv3hzxhexlalyh5/AADgIbYrk8nVrB8hNppJN sVa?dl=0 Thank you, Cristina Whitcher gewral ea it rin, inc. Cristina Whitcher From: Cristina Whitcher Sent: Thursday, May 04, 2017 4:35 PM To: 'Ranjith Dassanayake' Subject: RFP: 5/9 Huntington Beach Adams & Atlanta Good afternoon, EBS is requesting subcontractor quotes for 'Landscape' on the following upcoming bid: Adams Ave Rehab and Atlanta Ave Rehab City of Huntington Beach Bid Date: 5/9/17 @ 2 pm Please use the following link to plans and specs: https://www.dropbox.com/sh/zv3hzxhexlalyh5/AADgIbYrk8nVrB8hNppJN sVa?dl=0 Thank you, Cristina Whitcher genera[ e4neenn, inc. 1320 E. Sixth Street, Ste 100 Corona CA 92879 — Ph: (951) 279-6869 Category Misc. Suppliers Landscape Tree + Shrub Survey Top Soil Company Name Harrington Ind. Plastics HD Supply Midori Landscape Quality Growers BrightView Marina Park West Pierre Landscape Sierra Landscape Diversified Landscape V+E Tree Treesmith So Cal Tree Care, Inc. David's Tree Service Case Land On -Point Landmark Surveying Solutions Precision Engineering Surveyors CL Surveying and Mapping Viramonte EBS Frequently Used Vendors/ Suppliers/ Subcontractors Phone # Fax # DBE/WBE/MBE 951-784-0256 No 714-689-8100 No 714-751-8792 No 951-371-7193 No 714-546-7975 No 714-704-0407 No 949-546-8363 No 626-587-2121 No 951-245-1686 N(ry . IA-5 M Yes 714-997-0903 No / 714-996-6037 714-996-60 "ano J 760-747-6225 760-747-60 57y w5/5 714-842-6345 714-381-4622 )Dacy 714-628-9848 714-628-8905 909-792-2221 909-784-1836 909-863-9044 909-863-9433 909-862-6326 909-862-6328 909-484-4200 909-484-4229 909-597-7232 Grind Pavement Recycle 951-682-1091 Lindy's Cold Planing 562-697-2286 562-697-2039 No #39880 E#C8765 d / #38284 lo No No -#40089 WBE fj Materials Triumph Geo-Synthetics Ayus & Co Logans Marketing Western Materials Construction Signs + BC Traffic Chrisp Full Traffic Maint Hi -Way Saftey Pavement Recycle Traffic Control Engineers Traffic Solutions A Cone Zone E-Nor Traffic Control Flash Traffic Inc Tack - Coat Ramsey Oil Western Oil Metal Grate + Frame Alhambra Foundry Brooks Products South Bay Curb-O-Let Sweeper Stripe/ Markings 909-573-8801 323-474-4040 619-233-3766 805-409-4230 714-974-1190 909-746-0356 951-520-9990 909-591-1781 951-682-1091 714-447-6077 866-537-1260 951-734-9535 310-513-6209 661-262-6003 951-736-7628 805-647-0693 626-289-4294 909-947-7470 619-956-2780 562-867-4587 Coffelt 714-992-4121 DSS Sweeping and Water Truck Rental 760-200-7244 Chrisp 909-746-0356 Superior Pavement Markings 714-995-9100 Cat Tracking 951-682-1494 714-237-1549 323-474-4040 619-233-3768 951-520-9980 951-734-2887 310-513-6299 661-262-6099 #9076 J #42425 MBE #4595 MBE No No - #35742 MBE No No No No #36878 WBE #37118 MBE #39950 WBE J No No No No No No - #39807 WBE `',5 �".I No No 951-682-1491 - #2005127974 WBE Hygiene Andy Gump 661-251-7721 No Diamond Environmental 888-744-7191 No Electrical Misc Crack Seal Traffic Loops Crackfilling California Professional Eng. Servitek Los Angeles Signal Construction 1&R Concrete Products Global Road Sealing, Inc. Rubberized Crack Filler Sealant Sewer Covarrubias Bros Construction Consultant/ Storm Water Services Chaudhary & Associates Appian UDBE SWPPP Fence Pipe ACE Fence Company Defence Company Gwinco 714-520-4026 714-520-4027 626-810-1338 626-810-1322 626-227-1650 626-478-1300 909-599-2201 909-599-2722 951-943-5855 951-940-9207 714-893-0845 714-893-0945 714-680-3573 951-600-1751 951-600-4975 707-255-2729 707-255-5021 510-854-9402 510-222-0972 626-333-0727 626-333-7843 626-338-2288 626-470-9723 909-930-1693 909-944-9908 #38033 `/ #31277 #38446 / #4838 / - #7807 - #031176 No -#784171 038134 #34153 #43263 b.esj BROADCAST REPORT TIME 05/05/2017 11:55 NAME EBSGENENG FAX 9512799112 TEL 9512799112 SER.# BROEBJ807087 PAGE(S) 01 DATE TIME FAX NO./NAME DURATION PAGE(S) RESULT COMMENT 05/05 11:29 2451847 25 01 05/05 11:30 17149966057 26 01 05/05 11:31 17607476016 22 01 ECM 05/05 11:33 17143814622 00 00 SY 05/05 11:33 19098639433 25 01 05/05 11:34 19098626328 25 01 05/05 11:35 19094844229 26 01 ECM 05/05 11:36 15626972039 15 01 ECM 05/05 11:37 17142371549 16 01 ECM 05/05 11:38 13234744040 00 00 SY 05/05 11:39 16192333768 15 01 ECM 05/05 11:40 5209980 22 01 ECM 05/05 11:40 7342887 24 01 05/05 11:42 13105136299 0 00 BUSY 05/05 11:44 17145204027 20 01 ECM 05/05 11:45 16268101322 19 01 ECM 05/05 11:46 16264781300 23 01 ECM 05/05 11:47 19095992722 24 01 05/05 11:47 17072555021 19 01 ECM 05/05 11:49 15102220972 00 00 BUSY 05/05 11:54 16612626099 25 01 w BUSY: BUSY/NO RESPONSE NG : POOR LINE CONDITION CV : COVERPAGE 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 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-27 July 23, 2015 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 I, 2015 Contractors (and scab -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: littRs;llefiling,dir.ca.govIPWCR/ActionServiet?action=di5playPWCReg istrationForm In accordance with Title 49, Section 26.11 of the Code of federal Regulations, and Section 4104 of the Public Contract Code orthc 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%) of the Total Base Bid or $ 10,000 whichever is rcater). 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 e: �J Uo(}, !L �v r r <$1 million <$5 million City, state: L e$IO million c$15 million Aga of firm: YrS. [ G /4—' LJ c$1 million <$5 million ity, State: v t c$t[] million c$]5 million Agee of firm: yrs. Name s , r' t rr J l CIAf t . ! ` { <$1 million r$s million City, State: j<$10 1CWUjj7 million <$1Q mi1119r1 Age of Firm: yrs_ Name: a T <$1 million c$5 million City, State: 10 million c$15 million Age of Firm. R yrs. Name: a=: <$I million C$S million City, State: e$10 million c$15 million Age of Firm:yrs. Name: 3�v. r$1 million <$5 million City, State: E$10 million Lj ¢$15 million Age of Firm: rs. Distribution. 1) Original -Local Agency File 2) Copy-❑LAE wJ Award Package +t�,2$ 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 1n accordance with Title 49, Section 26 of the Code of Federal Regulations, �e 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 DIR Reg Number contracted Na <$1 million City, State, <W million <$15 million E.�0L�U f firm°—yrs. Name: a. e Age of ❑ <$i million <$5 million t' t <$10 million City,State: <$15 million Age of Firm: yrs. <$1 million Name: <$5 million r :Ll ' s City, State: <$10 million ❑ <$15 million K, Age of Firm: yrs. <fiEl <$1 million Name: _ <$5 million City, State: El <$10 million <$15 million . _ Age of Firm: _ yrs. <$1 million Name: <$5 million City, State: ❑ <$10 million Li <$15 million Age of Firm: rs, ~ <$1 million Name: Y z" LJ <$5 million City, State: <S10 million <$15 million r xL" . Age of Firm: yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE wt Award package Page 2 of 2 C-29 September 2016 Local Assistance Procedures Manual Exhibit 17-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors ExuiBIT 17-F FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number 2. Federal -Aid Project Number 3. Local Agency 4. Contract Completion (Date 5. Contra ctor/Consullant 6- Business Address 7. Final Contract Amount 8. Contract Item Number 9. Description of Work, Service, or Materials Supplied 10. Company Name and Business Address 11. DBE Certification Number 12. Contract Payments 13. Date Work Completed 14. Date of Final Payment Non -DBE DBE 15. ORIGINAL DBE COMMITMENT AMOUNT $ 16. TOTAL List all first -tier sulcontractorslsubconsultants and DBEs regardless of tier whether or not the firms were originally fisted for goal credit- If actual DBE utilization (or item of work) was different than that approved at the time of -. ditional n.e i :N aM„d .,,,.,,Im ...ilif., —1h oniif. If nn c.ihrontrartnr Jsuhconsultants were used on the contract. indicate on the form. I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT 17. Contractor/Consultant Representative's Signature 16. Contractor/Consultant Representative's Name 19. Phone 1951-279-6869 26. Date I CERTIFY THAT THE CONTRACTING RECORDS AND ON -SITE PERFORMANCE OF THE DBEtsj HAS BEEN MONITORED 21. Local Agency Representative's Signature 22. Local Agency Representative's Name 23. Phone 24. Dake DISTRIBUTION: Original - Local Agency, Copy -- Caltrans District Local Assistance Engineer. Include with Final Report of Expenditures ADA NOTICE: For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233, Local Assistance Procedures Manual TTY 711, or write to Records and Forms Management. 1120 N Street, MS-89, Sacramento, CA 95814. Page I of 2 C-30 July 23, 2015 V Local Assistance Procedures Manual Exhibit 17-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors INSTRUCTIONS — FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. 5. Contractor/Consultant - Enter the contractor/consultant's firm name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant'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. 10. Company Name and Business Address - Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE. The Non -DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment - Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount - Enter the "Total Claimed DBE Participation Dollars" from Exhibits 15-G or 10-02 for the contract. 16. Total - Enter the sum of the "Contract Payments" Non -DBE and DBE columns. 17. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 19. Phone - Enter the area code and telephone number of the person signing the form. 20. Date - Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature - A Local Agency Representative must sign their name to certify that the contracting records and on -site performance of the DBE(s) has been monitored. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 23. Phone - Enter the area code and telephone number of the person signing the form. 24. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 C-31 July 23, 2015 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This is to acknowledge receipt and review of Addendum 1\ EBS General Engineering, Inc. Company Name 5/8/ 17 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thru 0-9 (9 Sheets) Add new pages "APPENDIX O PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX O PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix O to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This is to acknowledge receipt and review of Addendum Number TYq, dated above. EBS General Engineering, Inc. Company Name By 5fR/17 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. 1-.114:191'Ll 7 KNOW ALL MEN BY THESE PRESENTS, that we EBS General Engineering, Inc. as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 9737 Great Hills Trail, Suite 320, Austin, Tx 78759, as surety, hereinafter called the "Surety," are held and firmly bound unto city of Huntington Beach as obligee, hereinafter called the Obligee, in the sum of ten percent of amount bid in. ) 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 Adams Ave Rehabilitation and Atlanta Ave Rehabilitation Project No.: CC1502; Federal Aid Project No. STPL-5181(188) 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 contractshall 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 3rd day of May .2017 EBS General (Principal) BY: ineering, Inc. TITLE: IJoseph A. Nanci, President u reT BY: S encer Flake Attorney -in -Fast suretec bid bond file.doc Rev 1.1.06 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 5-03-17 before me, Lexie Sherwood Date Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake Name(s) of Signer(s) -; LEXIE SHERWOOD C9 2F COMM. # 2031782 9 NOTARY PUBLIC a CALIFORNIA 'n ORANGE COUNTY =r Comm. Exp. JULY 27, 2017 , Notary Public, 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 4�yu�_ Za_tt.-twv Place Notary Seal Above Signature orNotaVy Public exie Sherwood OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s):_ ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s): — ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: POA#: 510123 SureTec Insurance Company LLVHTED 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 Charles L. Flake, David L. Culbertson, Spencer Flake 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 12/3112019 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 12th day of April A.D. 2017 . SVRAN"cF SURETEC T!2E ANY 1�-0 By: U W 5 z John Knox resi nt State of Texas ss: s`�� 1 ; x County of Harris -• ' On this 12th day of April A.D. 2017 before me personally came John Knox Jr., to me known, who, being by me. duly swom, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the ..Board ofDirectors.of said Company; and that he signed his name thereto by like order. XENIA CHAVEZ _Notary Public, State of Texas +` Comm. Expires 09-10-2020 „1111%%WNotary 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 3RD day of M4,y 2017 , A.D. V/Z//Z7_ Br nt Be , 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 All -Purpose Acknowledgement State of California } County of Orange On beforeme, William E. Ellis, Jr. Personally appeared Joseph A. Nanci WILLIAM E. ELLIS JR. Commission # 2127998 a : _1b Notary Public California D My CowvP a Notary Public who proved to me on the basis of satisfactory evidence to be the persons) whose nameXis/aff subscribed to the within instrument and acknowledged to me that he/ -ske/thgy executed the same in hisfhcrftfteir- authorized capacity(ie�Q, and that by hishruTftheir signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. I ,u Notary Public Seal Notary Public Signature Description of Attached Document Title or Type of Document: Docfiment Date: Number of Pages:. Signer(s) Other than Named Above: Capacity(ies) Claimed by Signer(s) ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited Q General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: OPTIONAL ❑ Individual ❑ Corporate Officer: ❑ Partner - ❑ Limited 0 General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 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 July 21, 2017 Excel Paving Company 2230 Lemon Ave. Long Beach, CA 90805 RE: Adams Ave. & Atlanta Ave. Rehabilitation — CC-1502 Enclosed please find your original bid bond for CC-1502. Sincerely, to I UFI M� Z 1 = 1 �= Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand pALP, INC. ODA EXC R PAVWJ CO~ 27200 LEkiffim, kMWE LUNU 6E" UA 90M - :f Cku- iL, A,,) � , 4p, F;b+tk c-IX a WMALIKIAJ City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This is to acknowledge receipt and review of Addendum Number O dated above. ML� MUM Company Name EKGEL PAVIING COMPANYBy Curtis P. Brown III President MAY .q 7017 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thru 0-9 (9 Sheets) Add new pages "APPENDIX 0 PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX 0 PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix 0 to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This ' e receipt and review of Addendum Number Two ated above. EXCEL PAVING COMPANY Company Name Curtis P. Brown III MAY _ c M17 President Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. SECTION C • PROPOSAL for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. • C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. *TgNFINCEMIT OF AWUNT W Accompanying this proposal of bid, find in the amount wrgA Ier"% said amount is not less than 10% of the aggregate of the total bid price, as required byte o ice 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. a3 Bidder shall signify receipt of all Addenda here, if any: . Addenda No. Date Received Bidder's Signature U rtis P. t3rown III P�'�CJI)�NT 2 0 0 C-2 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) PROJECT BASE BID: Basis of Award ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ......................................... C-2.2 to C-2.8 ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ........................................ C-2.9 TO C2.14 1. ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET BID IN FIGURES 2. ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $\ BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO.1502 FEDERAL AID PROJECT STPL-5181(188) ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.2 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE 1 - - MOBILIZATION 1 LS $0�yuy� 2 - - TRAFFIC CONTROL PLAN 1 LS $ Z�oO, � $ 1, oo 3 1 LS $ $ _ _ FURNISH PROJECT TRAFFIC `� CONTROL �UuuT 4 1 LS $ _ _ FURNISH AND INSTALL SIGNING r $ l q= AND STRIPING � 5 - - PROJECT SPECIFIC SWPPP 1 LS $ ''1"3UU REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL 9 EA $ wU $ -jn e00 APPURTENANCES,CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,800 TN $ $ 7,1003G- PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 7 EA $ �� $ 35-00� GRADE. 9 5 ADJUST STORM DRAIN 10 EA $. $_ MANHOLE TO GRADE. REPLACE WATER VALVE BOX h 000. 10 6 ASSEMBLY AND ADJUST TO 11 EA $ $ GRADE PER HB STD PLAN 612. C-2.3 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Corst Contract 3 Unit Extended Description; " ,. ,!, , . Quantity Unit Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 22,400 SF SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. 12 INTENTIONALLY LEFT BLANK COLD MILL EXISTING A.C. 13 8 PAVEMENT TO A DEPTH OF 0.34' 138,000 SF y� $ 0 •90 $ �pq FROM NEW FINISHED SURFACE PER PLANS 14 INTENTIONALLY LEFT BLANK CONSTRUCT NEW 0.17' B-PG-70- 10-RAP A.C. BASE COURSE 15 8 OVER 95% COMPACTED 1,700 TN $ ��.� $ SUBGRADE PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. 16 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 17 9 AND PREPARE CORNER 3 EA $ �, $ 2A1 RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=B"). (INCLUDES 18 10 SLOT PAVEMENT, AGGREGATE 900 LF $ BASE, LOT DRAINS, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD 19 11 FROM WALK TO EXISTING SLOPE, RELOCATING 13,500 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.4 rglc No' 20 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE INTENTIONALLY LEFT BLANK REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY/ALLEY APPROACH 21 12 ("W" AND TYPE SHOWN ON 690 SF $ $ t(! PLAN) PER STD PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 13 (ITEM INCLUDES SLOT 2,170 SF $ PAVEMENT, AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB PER HB STD PLAN 201 (CF=B"). (INCLUDES 23 14 SLOT PAVEMENT, AGGREGATE 225 LF $ BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT LOCAL DEPRESSION PER HB STD PLAN 302. (INCLUDES SLOT 24 15 PAVEMENT, AGGREGATE BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 1 EA .I$ Mo. --- W INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 16 SIGNALS AND LIGHTING 52 EA $ SYSTEMS, 2005 EDITION. SPLICE — LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". C-2.5 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract b Unit Ektoide',517777- No. No Descr�ption`y ,_ ; t, ,_. Quantity Unit Price Amount REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP AND ROOTS TO 24" BELOW TOP 26 17 OF SIDEWALK/GRADE WITHIN 44 EA ''�� $ k b00 $ 000 PROPOSEDIMPROVEMENT AREA. PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. 27 INTENTIONALLY LEFT BLANK FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 18 BY AGENCY. (INCLUDES ALL 2500 SF $ $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) 29 19 OVER EXCAVATION WHEN IDENTIFIED BY CONTRACTOR 90 CY $ �5� $ AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 30 20 EDISON. CONTRACTOR TO 3 EA NOT A CONTRACTOR COORDINATE WITH ERICK OEN BID ITEM AT (714) 895-0242. 31 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 32 21 053, S-054 AND S-055. 1 EA $ $ CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT (714) 593-7645. 33 22 ADJUST MONITORING WELL 2 EA $ COVER TO GRADE. C-2.6 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Unit IFURNISH tY uanta Umount AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OFEXISTING LANDSCAPING, 34 23 BUSHES OR GROUND COVER 48 EA AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND PLANT NEW 10' BROWN TRUNK HEIGHT TRACHYCARPUS FORTUNEI PALM TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF 35 24 EXISTING LANDSCAPING, 6 EA $ WVO.! $ •� I BUSHES OR GROUND COVER AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). C-2.7 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE CONSTRUCT AND / OR REMOVE AND RECONSTRUCT 4" THICK PERVIOUS COLORED STAMPED CONCRETE IN MEDIANS PER 36 25 SPECIFICATIONS AND HB STD 780 SF $ PLANS 711. (ITEM INCLUDES REMOVAL OF EXISTING GROUND COVER, AND SLEEVING OF EXISTING IRRIGATION LINES.) FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 - - EQUAL COATING ON THE NEW 3 EA $ $ q .� V CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Fiqures: $ C1 � OkA. --"' Total Amount Bid in Words: C-2.8 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO.1502 FEDERAL AID PROJECT STPL-5181(188) ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.9 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE 1 1 - - IMOBILIZATION 2 1 - - ITRAFFIC CONTROL PLAN 3 - - FURNISH PROJECT TRAFFIC CONTROL 4 - - FURNISH AND INSTALL SIGNING AND STRIPING 1 I LS I$ 0 M, - I$ �l Qi)j% I 1 I LS I$ 'iSDD'' I$ 2S� 1 I LS I$ `& ate — I$ ( l a6 _ I 5 - - PROJECT SPECIFIC SWPPP 1 LS $ `-tS�O •� $ Ll REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL 3 EA — $ SOfl. $ 3� APPURTENANCES, CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,600 TN $ �I�p. i $ , K) PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 12 EA $ QUO! $ GRADE. 9 5 ADJUST STORM DRAIN 2 EA $ �� $ j MANHOLE TO GRADE. 10 6 REPLACE WATER VALVE BOX ASSEMBLY AND ADJUST TO 23 EA n $ Sol-- $ GRADE PER HB STD PLAN 612. C-2. 10 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const a Contract ;' Unit Extended. ; - No y No Description Quantity Unit ;_ Price Amount COLD MILL EXISTING A.C. 11 7 PAVEMENT TO A DEPTH OF 0.17' TO ZERO FROM NEW FINISHED 36,400 SF 1 $ $ I Hit - SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. COLD MILL EXISTING A.C. 12 8 PAVEMENT TO A DEPTH OF 0.17' FROM NEW FINISHED SURFACE 13,700 SF $ $ PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.34' 49,900 SF $ $ FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 14 10 PAVEMENT TO A DEPTH OF 0.67' 7,300 SF $ $ 0 1_ — FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17' AND 0.50' 15 9 & 10 B-PG-70-10-RAP A.C. BASE COURSE OVER 95% 1,000 TN $ 10.E $ —1 o0co-_ COMPACTED SUBGRADE PRIOR TO 0.17' ARHM OVERLAY. RAISE SURVEY WELL 16 11 MONUMENT TO GRADE AND PREPARE CORNER RECORD 1 EA $600- $ boo (PRE- AND/OR POST - CONSTRUCTION). SET SURVEY MONUMENTATION 17 12 AND PREPARE CORNER 4 EA $ iom $ 2 - RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 13 SLOT PAVEMENT, AGGREGATE 405 LF $ O $ 3 BASE, LOT DRAIN, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2. 11 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended,;.. No No j,j Description Quantity Unit Price Amount . REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD 19 14 FROM WALK TO EXISTING SLOPE, RELOCATING 3,400 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) SAWCUT AND REMOVE EXISTING SIDEWALK AT EXISTING AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 3. (ITEM 20 15 INCLUDES REMOVAL OF 3 EA SIDEWALK, 6 LF OF NEW SIDEWALK, NON -CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR AGENCY APPROVED EQUAL AND MULCH.) REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY ("W" AND TYPE 21 16 SHOWN ON PLAN) PER STD 750 SF $ 3. $ q 1 sy PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 17 (ITEM INCLUDES SLOT 1,740 SF $ 12, $ PAVEMENT, AGGREGATE BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 23 INTENTIONALLY LEFT BLANK 24 INTENTIONALLY LEFT BLANK C-2. 12 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const , , Contract Unit Extentletl No No Description. , `; Quantity Unit Price Amount: INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 18 SIGNALS AND LIGHTING 22 EA $ ?i)Vl, $ 1 , SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 26 19 AND ROOTS TO 24" BELOW TOP 4 EA $ $ Id40 . OF SIDEWALK / GRADE WITHIN PROPOSEDIMPROVEMENT AREA. FURNISH AND INSTALL BRIDGE DECK MEMBRANE OVER ENTIRE SD 27 20 BRIDGE DECK SURFACE 5,000 SF $ $ (l m — (INCLUDES ALL ASSOCIATED WORK PER PLANS AND SPECIFICATIONS). FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 21 BY AGENCY. (INCLUDES ALL 2,500 SF $ $ ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) 29 22 OVER EXCAVATION WHEN IDENTIFIED BY CONTRACTOR 90 CY $ �� $ AND VERIFIED BY AGENCY. 30 INTENTIONALLY LEFT BLANK ADJUST VERIZON VAULT/MANHOLE TO GRADE BY NOT A CONTRACTOR 31 23 VERIZON. CONTRACTOR TO 4 EA BID ITEM COORDINATE WITH RAY ROUNDTREE AT (714) 375-6760. C-2. 13 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const _ Contract Unit - Extentled No f No I „Description,.tr, , 11".:Quantity Unit Price Amount ADJUST OCSD SEWER MANHOLE TO GRADE, PER 32 24 OCSD STD. PLANS S-053, S-054 & 2 EA $ $ S-055. CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT 714-593-7645. 33 INTENTIONALLY LEFT BLANK FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716,718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 34 25 BUSHES OR GROUND COVER 1 EA $ $ 1 3 D0,- AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). 35 INTENTIONALLY LEFT BLANK 36 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, 37 - - SANCON OR CITY APPROVED EQUAL COATING ON THE NEW 6 EA /I __ $ l0 $ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ CA\ Total Amount Words:.._._..........t !``� i'` 7( ....B.!d....in _......._................._.. ..__........... _____......_ - _._....._._ ._.............. ,.�._ _.._..._ C-2. 14 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 Item(s) Name and Address of Subcontractor State License Class DIR PWC Registration # Dollar Amount % of Contract Number M . 3Ic sc � k V 44,W t cc-� 16 its Q'u �. O(o titi Cti1 o0o�o�8t, �I1�00. �'� w u wr `'► 6(D '� U A 35gb't ti t 0000 i t g L e. M of r\ A SDI% i✓v► q1,j o tkvtun Avc. - (* SW'('VW bPftc-s c1- A s, Ck c;z 100 M01 1(- 3�oa�o Z 3 LM VV l C-Ijo"' 1\novdV-3Xs NIA-S 'WINM a�lgs-3 loo&Z7oll TDO .3 C'? 6 4 ��' Wr 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 • 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 , at MAY 0 9 2n17 , Date City State .,.,urus t=1 1i3ro n III President , being and says that he et -skis T of CAM"M 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. • e WCNA SCR PAVING C Name of Bidder Signature of Bidder Curtis P. Brown III President 2230 LF-MON AVENUE LG 3EACH, CA S k^ E^` Address of Bidder C-4 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. State of California County of Los Angeles On MAY - 9 7017 before me, C. Phillips, Notary Public Notary Public, (Here insert name and title of the officer) personally appeared Curtis- P. Brown III 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. (�h& Signature of Notary Public C. PHILLIPS t COMM. #2170177 m �r � Notary Public -California { - LOS ANGELES COUNTY LL My Comm. Expires Oct 29, 2020IS (Notary Seal) - ��aa ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form if required. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/*ey;- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk. e• Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. S Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). ;;^,surely atL:ch this document to the signed document C 2004-2015 ProLink Signing Service, Inc. - All Rights Reserved www.TheProLinkcom - Nationwide Notary Service 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 Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, Project CC No. 1502, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding • upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: • MAY 0 9 70117 i F,� . EXCEL PAVING COMPW ! Contractor Y Curtis P. Brown III President Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes � No If the answer is yes, explain the circumstances in the space provided. • Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. 0 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. 0 Date: MAY 0 9 2017 • PALP IBC, EXCR PAIWaNG CCA, .A,�Y Contractor Y Title Curtis P. Brown III President C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name 271.0 LRrill AVENUE LUNG CEA CHO CA Business Address City, (562)599-5841 Telephone Numbero7A I E UC, 6MV. .At State Contractor's License No. and Class Original Date Issued bpi't'l AG G Expiration Date State Zip The work site was inspected by of our office on , 201'� The following are persons, firms, and corporations having a principal interest in this proposal: Curtis P. Brown III President and Chief Executive Officer Bruce E. Flatt Vice President and Chief Financial Officer Michele E. Orakulich Assistant Secretary 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. P °_G. EXCEL PANG A�jy Coma a e Signature of Bidder Curtis P. Brown III President Printed or Typed Signature Subscribed and sworn to before me this day of MAY - 9 2Q17 , 201 ' C, PHIL6IPS COMM, #2170177 }" Notary Public -California re LL NOTARY PUBLIC� kA . ' LOS ANGELES COUNTY s o20 C. Phillips, iV ry Public C-s • Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing high ground water and pipeline construction in high ground water regions with trench depths of 8-feet to the invert."I. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. 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. W�N" kh111D Name and Address of Public Agency 0 2. is Name and Telephone No. of Project Manager: Contract Amount Type of Work ,. ST, i. FA Provide additional project description to show similar work: L Name and Address of Public Agency Date*Completed Name and Telephone No. of Project Manager:68�, g\\ Hot.— umr s-f k( Contract Amount Type of Work Date Completed Provide additional project description4o show similar work: 3. C 1b �00A Name and Address of Public Agency Name and Telephone No. of Project Manager: 11L- n✓ l ci#)t W n Contract Amount wt e of Work Provide additional project description to show similar work: Date Completed C-9 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1. Name of proposed Project 1Vlzanager Telephone No. of proposed Project Manager: (562) 599-5941 Project Name & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed Project Name &I ,Contract Amount Type of Work Date Completed Name of proposed Superintendent Telephone No. of proposed Superintendent: (.5421599-5641 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-10 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=displayPWCRegistrationForm 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: APR 2 6 2017 PWC Registration #: 1(� �j� 1 • Contractor Y Title Curtis P. Brown III President C-11 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED 1N 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. INUBA Contractor: Contact Person: Contact Phone: Signed: Date: MAY 0-9 ZU11 Curtis P. Brown III President *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. • • U C-12 • • STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to www.calreQs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System (GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE INFORMATIONS GRANTEE NAME: CITY OF HUNTINGTON BEACH GRANT NUMBER: TRP7-16-0001 2000 Main Street, Huntington Beach, CA 92648 PRIMARY CONTACT NAME: JAMES WAGNER PE, SENIOR CIVIL ENGR, PUBLIC WORKS DEPT. CONTRACTOR INFORMATION?' R :.: CONTRACTOR NAME: 4xC PAIP, NG AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: C,P, BROWN .r MAILING ADDRESS: m9 I_l:Moca AVENUE CA Sv1r05 As the authorized representative of the above identified contractor, 1 declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, 1 declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, 1 have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature --- Date MAY 0 9 iV i` (Curtis P. Brown III President C-13 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency;or (j) The person or entity has violated an Order issued in accordance with section 18304; or, • (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee; or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION WR a WEL The bidder PAInNG CMMW ,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. • C-15 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 here y declares under penalty of perjury under the laws of the State of California that the bidder has _ , has not !been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1. Note: The bidder must place a 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 other -.:vise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation? Yes F-1 No If the answer is yes, explain the circumstances in the following space. NN • Page 7 of 22 C-16 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid 11 • 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. C-17 Page 8 of 22 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) LOS ANGELES To the CITY / COUNTY of 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-18 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. • aW • 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-19 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. 0 �J Page 11 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: ® a. bid/offer/application b. initial award c. post -award 4. Name and Address of Reporting Entity Prime ❑ Subawardee Tier if known WC. D A F: ! pAV#M CaMpoy LEA, Ci�� AVEE.,Yuk ongressional District, if known LMG i6EA 6.v""ruueral Department/Agency: • C7 8. Federal Action Number, if known: FEO, 9"073914 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 2230 LEMON AVENUE LC" BEACH, CA S•OEC6 3. Report Type: ® a. initial b. material change For Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) S actual ❑ planned a. retainer b. one-time fee 12. For of Payment (check all that apply): c. commission Ha. 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 nec sary) 15. Continuation Sheet(s) attached: Yes ❑ No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than S 10,000 and not more than S 100,000 for each such failure. Federal Use On ze Signature: Print Name Name: Curtis P. Brown III Preside :., . PRESIDENT Telephone No.: (562) 599-5641 Date -MAY 0 9 Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C-21 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 (1FB) 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 naives of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box. Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials.-- Identify the Federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev.06-04-90,<ENDIF» C-22 Page 13 of 22 October 2016 Local Assistance Procedures Manual ' Exhilait ° -B Bidder's List of Subcontractors (DBE and NON -DBE) Exhibit 12-B Bidder's List of subcontractor (DBE and Nan -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.//Qfiling.dir.ca.gov/PWCR/ActionServlet?action=displayPWCRe,gistrationForm In accordance with Title 49, Section 26.1.1 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%) of the Total Base Bid or $10,000 whichever is greater). Photocopy Subcontractor Name and Location Name this form for additional Line Item & Description firms, Subcontract Amount Percentage of Bid Item Sub- contracted - Contractor License Number DBE (Y/N) ;' 3?f �' A". DBE Cert Number . Annual Gross Receipts <$1 million DIR Reg Number 5 million City, State: f►Jr l_ / 14JtTil�p F�,Y �� <$10 million <$15 million Age of Firm: rs. Name. <$1 million < 55 City, Sta e: 100 00 1 j �V 10 m9illinn <$15 million Age of Firm yrs. Name Cl 1 tit " , jj, l<I r:JW � LIV ! -j i� x r * { �. ,fi � FAge <$1 million --`<$5 million City, state: LA-AO_4L� Name <$10 million �Qbrgl]� <$15 million Age of Firm: JL yrs. <$1 million <$5 million City, State; I Jj— CA Naner71 1'7 4 CID <$10 million <$15 mili3 n Age of Firm: 5 yrs. million <$5 million City, State: Name: <$10 million <$15 mi lion Age of Firm: 1i yrs. <$1 million <$5 million City, state:` <$10 million <$15 million of Firm: _ yrs. rRr, "a -Coca Agency He 2) Copy-DLAE w/ Award Package '-28 r - 1 of 2 Septe r 2016 Local tance Procedures Manual b, ',A 12_B Bidder's List of Subcontractors (DBE and NUN -DBE) Exhibit 12-B Bidder's List of subcontractor (DBE and Non -DBE) Fart 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/N) DBE Cert Number Annual Gross Receipts DIR Reg Number Name: wm� s$5 million ¢$5 million City, State: .� } ` r4 {j C J� 0 00 <$10 million <$15 million Age of i ir�m: yrs. Name: (/�iP UU'� 'l" r L ' <$1 mil ion <$5 million ity, State: 00 om l0 <$10 millions <$15 millions Age of Firm: 1JQyrs. Name: a ..., <$1 rnillian <$5 million City, State: <$10 million <$15 million Age of Firm: _ yrs. Name: - <$3 million <$5 million City, State: <$10 million <$15 million Age of Firm: yrs. Name: r ,. <$1 million <$5 million City, State: <$10 million LJ <$15 million e of Firm: _ yrs. Name: N, I z } #LJ X <$l rrsiliiars <$5 millionCity, State: <$10 million <$15 million r - ... , , e of Firm:_ yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package Page 2 of 2 C-29 September 2016 Local Assistance Procedures Manual Ex4ibit 1.7--F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors EXMBIT 17-F FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS . 1. Local Agency Contract Number 2. Federal -Aid Project Number 3. Lecal Agency 4. Contract Completion Date 5. Contractor/Consultant 6. Business Address 7, Final Contract Amount 8. Contract Item Number g. Description of Work, Service, or Materials 8uppiied 10. Company Name and Business Address 11. DBE Certification Number 12. Contract Payments 13. Date Worts Completed 14. Date of Final payment Non -DBE DBE 15. ORIGINAL DBE COMMITMENT AMOUNT $ Pavement Rr 16. TOTAL List all first -tier subcontraotor3lsubconsultants and DBEs regardless of tier whether or not the firms were originally listed for goal credit. If actual DBE utilization (or item of work) was differerd than that approved at the time of awardProvide comments on an additional page. List actual amount paid to each entik If no subcontractorslsubconsultants were used on the contract, indicate on the form. I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT 17, Contractor/Consultant Representative's Signature 1S. Contractor/Consultant Representative's Name 1 % Phone I 2n f]atft I CERTIFY THAT THE CONTRACTING RECORDS AND ON -SITE PERFORMANCE OF THE DBE(S) HAS BEEN MONITORED 21. Locai Agency Representative's Signature 1 22. Local Agency Representative's Name DISTRIBUTION: Original — Local Agency, Copy — Caltrans District Local Assistance Engineer. Include with Final Report of Expenditures 23. Phone 24. Date ADA NOTICE: For individuals with sensory disabilities, this document Is available in alternate formats. For information, call (916) 445-1233. Local Assistance Procedures Manual TTY 711, or write to Records and Formes Management, 1124 N Street, MS-89, Sacramento. CA 95514. LJ 'age I of 2 ,y 23, 2015 Local Assistance Procedures Manual Exhibit 17-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors INSTRUCTIONS — FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS 0 ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. 5. Contractor/Consultant - Enter the contractor/consultant's firm name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant'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. 10. Company Name and Business Address - Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. •Include the prime contractor/consultant if the prime is a DBE. The Non -DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment - Enter the date when the prime contractor/consultant made the final payment to the subcontractor/sub consultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount - Enter the "Total Claimed DBE Participation Dollars" from Exhibits 15-G or 10-02 for the contract. 16. Total - Enter the sum of the "Contract Payments" Non -DBE and DBE columns. 17. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 19. Phone - Enter the area code and telephone number of the person signing the form. 20. Date - Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature - A Local Agency Representative must sign their name to certify that the contracting records and on -site performance of the DBE(s) has been monitored. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 23. Phone - Enter the area code and telephone number of the person signing the form. 24. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 C-31 July 23, 2015 Bond No. Bid Bond BID BOND The American Institute of Architects, AIA Document No. A310 (February, 1970 Edition) KNOW ALL MEN BY THESE PRESENTS, that we PALP Inc. dba Excel Paving Compan as Principal hereinafter called the Principal, and Federal Insurance Compan a corporation duly organized under the laws ofthe state of Indiana as Surety, hereinafter called the Surety, are held and fimily bound unto City of Huntington Beach as Obligee, hereinafter called the Obligee, in the sum of Ten percent of the total amount of the bid Dollars (S 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Adams Avenue & Atlanta Avenue Rehabilitation (CC-1502) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material famished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contrail 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 contrail with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 1 sth day of April , 2017 PALP Inc. dba Excel Paving Company Witness Principal (Seal) QAIII� 7 Curtis P. Brown III Preside Tide 9�A C/k Witness tali L OMKYU(;H, ASST. SECRETARY ORSC 21328 (5/97) Federal Insurance Company 3�'4 0 Suzety (Seal) By; Douglas app Attomey-in-Fad 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 April 18, 2017 before me, Debra Swanson, Notary Public (insert name and title of the officer) personally appeared Douglas A. Rapp , who proved to me on the basis of satisfactory evidence to be the person($) whose name($) is4Fe. subscribed to the within instrument and acknowledged to me that he/ehe4lvey executed the same in hisl*&M Leif authorized capacity(*&& , and that by his*@F49ir signature(jr) on the instrument the person(8); or the entity upon behalf of which the person(o) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. «,�°FrNF DEBRAMANSON N COMM. # 2170759 ;0 o NOTARY PUBLIC-CAUFORNIA X ' ORANGE COUNTY MY COMM, EXP. NOV 10.2020 Signature(Seal) Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY pacific Indemnity Company Warren, NJ 07059 cNuse Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Douglas A. Rapp and Timothy D. Rapp of Aliso Viejo, California ---------------- each as their true and lawful Attorney- in- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 16th day of December, 2011. Kenneth C. Wendel, Assistant Secretary T Norris, Jr., Vice President STATE OF NEW JERSEY County of Somerset ss. On this 16th day Of December, 2011 before me, a Notary Public of New Jersey, personally came Kenneth C. Wendel, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Kenneth C. Wendel, being by me duly sworn, did depose and say that he is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By- Laws of said Companies: and that he signed said Power of Attomey as Assistant Secretary of said Companies by like authority; and that he is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the signature of David B. Norris, Jr., subscribed to said Power of Attorney is in the genuine handwriting of David B. Norris, Jr., and was thereto subscribed by authority of said By- laws and in deponent's presence. Notarial Seal KATHERINE J. ADELAAR tAR�`4ys► NOTARY PUBLIC OF NEW JFkSFI �j Ne, 2316685 G�' `- v 6�Comr *WOn Expires July 14, 2014 PV G4, Notary Public �'EIAI JE4� CERTIFICATION Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: "All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the President or a Vice President or an Assistant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The signature of such officers may be engraved, printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys- in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." I, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies') do hereby certify that (i) the foregoing extract of the By- Laws of the Companies is true and correct, (ii) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands, and Federal is licensed in American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and (iii) the foregoing Power of Attorney is true, correct and in full force and effect Given under my hand and seals cf said Companies at Warren, NJ this 'i8th day of April, 2017 d t �oWOO' Af MS�d ~FW Kenneth C. We el, Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903- 3656 e-mail: surety@chubb.com Form 15-10- 022513- U (Ed. 5- 03) CONSENT 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. State of California County of Los Angeles On MAY - 9 2017 before me, C. Phillips, Notary Public (Here insert name and title of the personally appeared Curtis. P. Brown III and Michele E. Drakulich Notary Public, 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 Notary Public a..� C. PHILLIPS o COMM. #21.70177 M Notary Public -California It }'> LOS ANGELES COUNTY LL (Notary Seal) My Comm. Expires Oct 29, 2020I� ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT (Title or description of attached document) (Title or description of attached document continued) Number of Pages Document Date (Additional information) CAPACITY. CLAMED BY THE SIGNER ❑ Individual (s) ❑ Corporate Officer (Title) ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is to be recorded outside of California. In such instances, any alternative acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e..certiifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form if required • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/dw)-,- is /are ) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with the office of the county clerk Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely a±`ach this document to the signed document C 2004-2015 ProLiak Signing Service, roc. - All Rights Reserved wwwTheProLinkcoot - Nationwide Notary Service 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 July 21, 2017 Griffith Company 12200 Bloomfield Ave. Santa Fe Springs, CA 90670 RE: Adams Ave. & Atlanta Ave. Rehabilitation — CC-1502 Enclosed please find your original bid bond for CC-1502. Sincerely, Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities. Anjo, Japan ♦ Waitakere, New Zealand Grittith Company 12200 Bloomfield Ave. Santa Fe Springs, CA. 90670 j City of Huntington Beach The Office of the City Clerk 2000 Main Street, Second Floor Huntington Beach, California, 92648 SEALED BID City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thrul 0-9 (9 Sheets) Add new pages "APPENDIX O PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX O PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix O to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This is to acknowledge receipt and review of Addendum Number Griffith Company/, Company Name By cas alker, Vice President / Regional Manager 05/03/2017 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This is to acknowledge receipt and review of Addendum Number Griffith Company Y /,/ Company Name B cas J. alker, Vice President/ Regional Manager 05/03/2017 Date All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. SECTION C PROPOSAL for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C49J If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find Bidder's Bond in the amount Of 10% which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for ° ') as he case may be) Any standard Surety Bid Bond form is acceptable. Bidder shall signify receipt of all Addenda her , if a . .— Signature C_2 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) PROJECT BASE BID: Basis of Award ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ......................................... C-2.2 to C-2.8 ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ........................................ C-2.9 TO C2.14 1. ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $ d .. gl i L { , l_ l "1 BID IN FIGURES 2. ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: ,(TOTAL FOR ITEMS I AND 2) $ It u-7(;-, L4 L41- S0 BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.2 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid , Gonsf Contract - Unit Extended No. -Noy N: p �; Descri tion� .�Quantity� Unit Price •��� Amount .. 1 - - MOBILIZATION 1 LS $ (� S, 060 ; $ 05OX •__� 2 - - TRAFFIC CONTROL PLAN 1 LS $ �S �O'- $ 600 3 FURNISH PROJECT TRAFFIC 1 LS $a 14600 . — $ 00. CONTROL 4 - FURNISH AND INSTALL SIGNING 1 LS $ $ 060 AND STRIPING 5 - - PROJECT SPECIFIC SWPPP 1 LS $ d $4,006, REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL g EA $ $,�, —� APPURTENANCES,CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) CONSTRUCT A 0.17' ASPHALT 7 3 RUBBER HOT MIX (ARHM) WET 2,800 TN $ �] — $C 1046w PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 7 EA $ $ q , GRADE. 9 5 ADJUST STORM DRAIN 10 EA — $ $ MANHOLE TO GRADE. 10 6 REPLACE WATER VALVE BOX ASSEMBLY AND ADJUST TO 11 EA $ CQ'lS. $S. GRADE PER HB STD PLAN 612. C-2.3 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid. Co* Contract . f Unit - Extended No Noy: I ;.� Description r Quantity Unit Price Amo'u`nt _ �= „ COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' �l " c) 11 7 TO ZERO FROM NEW FINISHED 22,400 SF $ $ SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. 12 INTENTIONALLY LEFT BLANK COLD MILL EXISTING A.C. 13 8 PAVEMENT TO A DEPTH OF 0.34' 138,000 SF 11 $ o L4 3 , l $ S Lqo FROM NEW FINISHED SURFACE PER PLANS 14 INTENTIONALLY LEFT BLANK CONSTRUCT NEW 0.17' B-PG-70- 15 8 10-RAP A.C. BASE COURSE OVER 95% COMPACTED 1,700 TN �- $ $ SUBGRADE PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. 16 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 17 9 AND PREPARE CORNER 3 EA $ loo • n $ (�/ �O RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 10 SLOT PAVEMENT, AGGREGATE 900 LF $ $ ��/ u oQ BASE, LOT DRAINS, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING 19 11 SLOPE, RELOCATING 13,500 SF IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.4 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid .Const Contract Unit Extended No No - Description �� rQuantty ,Unit Price =Amou'nt 20 INTENTIONALLY LEFT BLANK REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL 21 12 DRIVEWAY/ALLEY APPROACH ("W" AND TYPE SHOWN ON 690 SF $ 12 • $ 2 - PLAN) PER STD PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 13 (ITEM INCLUDES SLOT 2,170 SF $ $ PAVEMENT, AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB PER HB STD PLAN 201 (CF=8"). (INCLUDES S 23 14 SLOT PAVEMENT, AGGREGATE 225 LF $ $ BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT LOCAL DEPRESSION PER HB 24 15 STD PLAN 302. (INCLUDES SLOT PAVEMENT, AGGREGATE BASE, 1 EA $ _ $ AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 16 SIGNALS AND LIGHTING 52 EA $ $ SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". C-2.5 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid, Const Contract Unit Extended . No: = NoF. ;; Description _w Quantity_ Unit Price =_Amount, ,' REMOVE EXISTING TREE AND ROOTS, GRIND TREE STUMP AND ROOTS TO 24" BELOW TOP 26 17 OF SIDEWALK/GRADE WITHIN 44 EA $ co, $ —)ol 1466.PROPOSEDIMPROVEMENT AREA. PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. 27 INTENTIONALLY LEFT BLANK FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 18 BY AGENCY. (INCLUDES ALL 2500 SF �j. $ I - - l D $ o �W ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN "b 2' 2eo 29 19 IDENTIFIED BY CONTRACTOR 90 Cy $ $ AND VERIFIED BY AGENCY. ADJUST EDISON VAULT/MANHOLE TO GRADE BY 30 20 EDISON. CONTRACTOR TO 3 EA NOT A CONTRACTOR COORDINATE WITH ERICK OEN BID ITEM AT (714) 895-0242. 31 INTENTIONALLY LEFT BLANK ADJUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 053, S-054 AND S-055. (� ' 32 21 CONTRACTOR TO COORDINATE 1 EA $ '� $ WITH MIKE BOLSTER AT (714) 593-7645. 33 22 JADJUST MONITORING WELL 2 EA $ — $ COVER TO GRADE. C-2.6 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No „ ;,'No, - Description :: , Quantity,,, Unit Price Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, �� 0''\\�� )66 ' 34 23 BUSHES OR GROUND COVER 48 EA $ 1 $ / AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND PLANT NEW 10' BROWN TRUNK HEIGHT TRACHYCARPUSFORTUNEI PALM TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, EA I1 6r/ ux.— 35 24 BUSHES OR GROUND COVER 6 $ lJ�w. $ AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). C-2.7 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE ,Bid:. C6nst C-ontrkt -Lurflf� ictende'd E' Np�-, -.vscnpt`-- 'Description D Quaritity- n# Pride, AMpunt--, CONSTRUCT AND / OR REMOVE AND RECONSTRUCT 4" THICK PERVIOUS COLORED STAMPED CONCRETE IN MEDIANS PER 36 25 SPECIFICATIONS AND HB STD 780 SF $ (9, S-- $ 1 q! S-0 PLANS 711. (ITEM INCLUDES REMOVAL OF EXISTING GROUND COVER, AND SLEEVING OF EXISTING IRRIGATION LINES.) FURNISH AND INSTALL ZEBRON, 37 SANCON OR CITY APPROVED EQUAL COATING ON THE NEW ICONCRETE 3 EA $ 3"S $ INSIDE OF AGENCY I SEWER MANHOLE RING. Total Amount Bid in Figures: $ 1 1 0 g I � � q0 - a!M�.......... .............................................................................*............... .................."""*.............0...............*...... ....... ....... ..........f..M .....,.0 ..... ...... Total Amount Bid in Words: 0 hi ... 231VJ4 A A Ina 4 4gA i oe I V1 I wi v v v � U k`-- % V LYU L I I--- ' M, C-2.8 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.9 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid - Const ; + - Contact = Unit- . = - Extended - No ,; '!No Description Quantity Unit ..; Price ., Amount 1 - - MOBILIZATION 1 LS $ $ 0c& • 2 - - TRAFFIC CONTROL PLAN 1 LS $ jb03 • — $ , OOC) • — 3 FURNISH PROJECT TRAFFIC 1 LS $ $ OOO CONTROL 4 FURNISH AND INSTALL SIGNING 1 LS $ $ AND STRIPING 5 - - PROJECT SPECIFIC SWPPP 1 LS $ 0 o $ e0esco, REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL 3 EA $ APPURTENANCES,CURB GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,600 TN _ $ 1-] $Zi PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO 12 EA $ 1 jQ00.— $ GRADE. 9 5 ADJUST STORM DRAIN 2 EA $ , $ MANHOLE TO GRADE. 10 6 REPLACE WATER VALVE BOX ASSEMBLY AND ADJUST TO 23 EA $ 40 $�s(�'� GRADE PER HB STD PLAN 612. C-2. 10 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Co ritract' uh it, Ektdhdq':,: d CNOst t qpanti�y Unit ',,nce,, Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0. 17' 11 7 TO ZERO FROM NEW FINISHED 36,400 SF $ SURFACE PRIOR TO 0.17'ARHM OVERLAY PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0. 17' 12 8 FROM NEW FINISHED SURFACE 13,700 SF PRIOR TO 0.17'ARHM OVERLAY, PER PLANS COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.34' 49,900 SF FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 14 10 PAVEMENT TO A DEPTH OF 0.67' 7,300 SF FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17'AND 0.50' 15 9 & 10 B-PG-70-1 O-RAP A.C. BASE COURSE OVER 95% 1,000 TN $ -7 COMPACTED SUBGRADE PRIOR TOO. 17' ARHM OVERLAY. RAISE SURVEY WELL MONUMENT TO GRADE AND 16 11 PREPARE CORNER RECORD 1 EA $ $ (PRE- AND/OR POST - CONSTRUCTION). SET SURVEY MONUMENTATION 17 12 AND PREPARE CORNER 4 EA $ RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 13 SLOT PAVEMENT, AGGREGATE 405 LF $ BASE, LOT DRAIN, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) Q C-2. 11 �TU��T�/����A-��8|��Fl\ '`.^~`...'`�~^~`......^-,.^~`..~/ quantit REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN SAWCUT AND REMOVE EXISTING SIDEWALK AT EXISTING AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 3. (ITEM 20 15 INCLUDES REMOVAL OF 3 EA SIDEWALK, 6 LF OF NEW SIDEWALK, NON -CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR AGENCY APPROVED EQUAL AND MULCH-) REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL 21 16 DRIVEWAY ("W" AND TYPE SHOWN ON PLAN) PER STD 750 SF $ PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. PAVEMENT, AGGREGATE BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN 23 INTENTIONALLY LEFT BLANK 24 INTENTIONALLY LEFT BLANK ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE r_Bid_ Const .. , �, ; � �Contract� ,-� ;Unit.;.. Ectended. _ o No _ ;' Description Quantity 'Unit - P.,rice F : r Amount INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 18 SIGNALS AND LIGHTING 22 EA $ SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 26 19 AND ROOTS TO 24" BELOW TOP 4 EA $ $ OF SIDEWALK / GRADE WITHIN PROPOSEDIMPROVEMENT AREA. FURNISH AND INSTALL BRIDGE DECK MEMBRANE OVER ENTIRE 27 20 BRIDGE DECK SURFACE 5,000 SF $ $ 2 (INCLUDES ALL ASSOCIATED WORK PER PLANS AND SPECIFICATIONS). FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 21 BY AGENCY. (INCLUDES ALL 2,500 SF t� $ �� $ J r co' ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN _ 29 22 IDENTIFIED BY CONTRACTOR 90 CY r AND VERIFIED BY AGENCY. 30 INTENTIONALLY LEFT BLANK ADJUST VERIZON VAULT/MANHOLE TO GRADE BY NOT A CONTRACTOR 31 23 VERIZON. CONTRACTOR TO 4 EA BID ITEM COORDINATE WITH RAY ROUNDTREE AT (714) 375-6760. C-2. 13 4T|4�T4/��4�A-���/|4�Fl\ '`.^~...'`�~^~`......^-..^~..~/ ConsI ADJUST OCSD SEWER MANHOLE TO GRADE, PER S-055. CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT 714-593-7645. 33 INTENTIONALLY LEFT BLANK FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). 35 INTENTIONALLY LEFT BLANK 36 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 EQUAL COATING ON THE NEW 6 EA $ $ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ 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 PWC Dollar % of Item(s) Subcontractor License Registration # Amount Contract Number oe UA, 0 Cat, GOY1 GV % 1°a s w 9 �� vy � I o0o�a�� 11 CA a ?.b iK V , IE� -TW 4fti&0 Pa �� �o ' Sip. o mffU c4 1ZV, �, CST �Gl(.I�i i� lV�(, 2asn RV Ili d I �W011Iso • 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 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 Item(s) Name and Address of Subcontractor State License Number Class DIR PWC Registration # Dollar Amount % of Contract � �rn�o� tn i 1l &WUAA A co I oo000I D �. i�•W Ai V&AAAC 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 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 Item(s) Name and Address of _ Subcontractor State License Number Class DIR PWC Registration # Dollar Amount % of Contract 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 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. Biel Items) Name andAddress of Subcontractor State License Number Class DIR PWC Registration # Dollar Amount % of Contract 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 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 Item(s) Name andAddress of Subcontractor State License Number Class DIR PWC Registration # Dollar Amount % of Contract I 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 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 05/02/17, at Santa Fe Springs—, -CA Date City State Lucas J. Walker , being first duly sworn, deposes and says that he or she is Vice President / Regional Manager of Griffith Company . the party malting 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 of 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 W4--� Griffi C N of Bidder Lucas J. Walker, Vice President / Regional Manager loomfield Ave.. Santa Fe SDrinas. Ca. 90670 of Bidder C-4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT 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 May 5, 2017 before me, Tracey A. Novak, Notary Public Date Here Insert Name and Title of the Officer personally appeared Lucas J Walker 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 TRACEY A, NOVAK Notary Public - California Z Los Angeles County > z Commission # 218�27. My Comm. Expires Mar itiiiiliiii� 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 , ig ature of Notary Public OPTIONAL Though the 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: Noncollusion Affidavit .......... City of Huntington Beach bid document Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Lucas J Walker Signer's Name: RIcorporate Officer -- Title(s): vice President/Regional Manager nCorporate Officer -- Title(s): ❑ Individual ❑ Partner --- ❑ Limited Q General ❑ Attorney in Fact Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Griffith Company RIGHT THUMBPRINT OF SIGNER Top of thumb here Individual Partner --- ❑ Limited ❑ General Attorney in Fact Trustee Guardian or Conservator Other: Signer is Representing: Top of thumb here © 2014 National Notary Association • www.NationalNotary.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 Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, Project CC No. 1502, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 05/02/2017 C-5 Griffith By / 117 Lucas J. Walker Title ent / Regional Manaqer 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 SdNo 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: 05/02/2017 G7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Griffith Company Bidder Name 12200 Bloomfield Ave. Business Address Santa Fe Springs CA 90670 City, State Zip ( 562 ) 929-1128 Telephone Number 88, Class: A B C-8 C12 C27 HAZ State Contractor's License No. and Class 09/24/1929 Original Date Issued 09/30/2018 Expiration Date The work site was inspected by MW °YLU of our office on - a , 201]-1 The following are persons, firms, and corporations having a principal interest in this proposal: Griffith Company - a Corporation Ryan J. Aukerman - Executive Vice President Thomas L. Foss - COB I CEO Jaimie R. Anqus - President The undersigned is prepared to financially or otherwise, to pc accordance with the plans an( ! Griffith( C Subscribed and sworn NOTARY PUBLIC Gordon M. Csutak - VP / CFO / Secretary / Treasurer &cil of the City of Huntington Beach of its ability, rtract for the proposed work and improvements in set forth. Si atu offl3Ydder _L cas J. Walker Vice President I Regional Manager 1 -int 9 o}/`typed Signature me this day of C-S NOTARYSEAL CALIFORNIA JURAT WITH AFFIANT STATEMENT XQSee Attached Document (Notary to cross out lines 1-6 below) nSee Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) t signature or uocument signer NO. i signature or uocumenr oigner No. z pr 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 Los Angeles TRACEY A. NOVAK Notary Public - California z Los Angeles County D Commission # 2185107 My Comm. Expires Mar 27.2021 Seal Place Notary Seal Above Subscribed and sworn to (or affirmed) before me on this 5th day of May 2017 , by Date Month Year (1) Lucas J Walker, VP/Regional Manager ( and (2) Name(s) of Signer(s) proved to me on the basis of satisfactory evidence to be the person who appeared before me.) Signature c/'l'd LAel� Sig atu of Notary Public Tracey A. Novak, otary Public OPTIONAL Though this section is optional, completing this information can deter RIGHT THUMBPRINT OF alteration of the document or fraudulent reattachment of this form to SIGNER 41 an unintended document. Top of thumb here Description of Attached Document Title or Type of Document: Bidders Information Document Date: Number of Pages # Signer(s) Other Than Named Above: Top of thumb here 2014 National Notary Association • www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item#5910 Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of {Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, -project work. _within public streets, an area containing high 14round water and pipeline construction in high �rround water rerrions with trench depths of 8-feet to the invert."}, Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. 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: 2. "Please See Attached List Name and Address of Public Agency Name and "Telephone No, of'Project Manager: Contract Amount Type of Work Date Completed. Provide additional project description to show similar work: Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-9 GRIFFITH COMPANY COMPLETED PROJECTS 5 YEARS PROJECT AGENCY CONTRACT AMOUNT Vermont Avenue Median Improvement City of Los Angeles $ 441,624.00 C-127311 200 N Spring Street RM 355 Start Date: October 2016 Los Angeles, CA 90012 Completion Date: Dec. 2016 Griffith Company Project # 10608 Attn: Carlos Rios carlos.rios cr.lacity.org Phone 213-972-4963 Existing Qantas Hanger Demolition Los Angeles World Airports $ 19,351,737.50 Contract # DA-5040 1 World Way Start Date: January 2016 Los Angeles, CA 90009-2219 Completion Date: December 2016 Griffith Company Project # 10600. Attn: Mark Viceljia Phone: 424-646-5871 Qantas LAX Engineering Hanger Bascon, Inc $ 3,838,660.00 607-500 Redna Terrace Start Date: Sept. 2015 Cincinnati, OH 45215 Completion Date: August 2016 Griffith Company Project # 11632 Attn: Kim Smith Phone: 513-515-6266 E Street Corridor COR 225 Omnitrans $ 1,761,442.00 Hospitality Lane CO 1700 West 5th Street Start Date: Sept. 2015 San Bernardino, CA 92411 Completion Date: December 2015 Griffith Company Project # 10589 Attn: Andres Ramirez, PM Andres. Ramirez(a�omnitrans.org Phone: 909-379-7288 Spectrum Center Dr. Offsite Improvements Hathaway-Dinwiddie $ 1,323,362.00 805 A Irvine Center Drive Start Date: Sept. 2015 Irvine, CA 92618 Completion Date: March 2016 Griffith Company Project # 10586 Attn: Dhaval Panchal PanchaldCcDhdcco.com Phone: 949-954-1071 FedEx LAXR GSE Staging Pavement Federal Express Corp. $ 1,411,413.00 Replacement 3680 Hacks Cross Road, Start Date: August 2015 Building H, 3rd Floor Completion Date: Oct 2016 Memphis, TN 38128 darren.greenburg(a)fedex.com Griffith Company Project # 10583 Attn: Darren Greenburg Phone: 901-434-8753 FED EX Taxilane Ramp Gates FED EX Corp $ 2,842,639.97 Project #8641929, C/F #22883 2601 Main St., 11th Floor Start Date: Sept. 2014 Irvine, CA 92614 Completion Date: April 2016 Griffith Company Project # 20004 Attn: Jon Malan, Sr. Project Mgr. Phone: 949-399-4486 Ramona Express Way Widening Phase II City of San Jacinto $ 4,050,032.97 Cont No. 166 E. Main St., Suite 2 Start Date: August 2014 San Jacinto, CA 92583 Completion Date: Feb. 2015 Griffith Company Project # 20003 Attn: Habib Motlagh, City Engineer Phone: 951-654-3592 Broadway Improvements City of Carson $ 1,289,930.19 701 E Carson Street Start Date: Jan. 2015 Carson, CA 90749 Completion Date: March 2015 Griffith Company Project # 10541. Attn: Rick Boutros Phone: 310-835-5749 updated: 4/6/2017 Page 1 Pacific City Retail C.W. Driver $ 4,498,571.00 Project # 130027 15615 Alton Parkway, Suite 150 Start Date: December 2014 21022 Pacific Coast Hwy. Huntington Beach Irvine, CA 92618 Completion Date: January 2016 Griffith Company Project # 11607 Attn: David Edwards Phone 949-261-5100 Westfield Offsite Improvements @ Westfield, LLC $ 5,228,897.60 Village at Topanga 2049 Century Park East, 41st Floor Start Date: Sept. 2014 Contract # CON_0025 Century City, CA 90067 Completion Date: Dec. 2015 Griffith Company Project # 10540. Attn: Corey Carr Phone: 818-313-2205 Moorpark Street Widening City of Los Angeles $ 1,393,330.25 Woodman Ave to Murrietta 200 N Spring Street RM 355 Start Date: Jan. 2015 WE# E1906435 Los Angeles, CA 90012 Completion Date: Oct. 2016 Griffith Company Project # 10538. Attn: Peter Blikian Peter.blikian@lacity.org Phone 213-485-4671 Irvine Center Drive Rehabilitation City of Irvine $ 1,182,092.50 Culver to Harvard 1 Civic Center Plaza Start Date: June 2014 CIP No.311414 & 351401 Bid No. 14-1001 Irvine, CA 92606 Completion Date: August 2014 Griffith Company Project # 10537. Attn: Uyenl Bui Phone 949-724-6000 Collett Avenue Extention County of Riverside $ 2,316,323.26 Buchanan Street to Pierce Street 3900 Main Street Start Date: April 2014 Bid No. 7190 Riverside, CA 92522 Completion Date: Oct. 2014 Griffith Company Project # 20001. Attn: Steve Howard Phone 951-712-3904 South Milliken Avenue Grade Separation City of Ontario $ 45,396,631.00 303 East B Street Start Date: March 2014 Ontario, CA 91764 Completion Date: April 2017 Griffith Company Project # 10532.10 Attn: Jay Bautista Phone 909-395-2120 Universal City Pedestrian Bridge Los Angeles County, MTA $ 21,425,000.00 Contract # C1043 One Gateway Plaza Start Date: June 2014 Los Angeles, CA 90012-2952 Completion Date: April 2016 Griffith Company Project # 70061. Attn: Brad Owen bowen metro.net Phone: 213-922-7158 Berths 142-143 Port of Los Angeles $ 105,675,310.00 Spec # 2756 425 S. Palos Verdes Street Start Date: March 2014 San Pedro, CA 90733 Completion Date: Feb. 2017 Griffith Company Project # 10526.10 Attn: Mark Rose Phone 310-732-3919 San Jose Ave. Widening @ Charlie Road City of Industry -c/o CNC Engineering $ 463,300.24 Project No 418 255 N Hacienda Blvd., Suite 222 Start Date: February 2014 Contract No. City-1418 City of Industry, CA 91744 Completion Date: June 2014 Griffith Company Project # 10525.10 Attn: Gerardo Perez Phone 626-333-0336 8L-26R Runway Safety Area Project Los Angeles World Airports $ 2,821,245.51 Ontario International Airport 7301 World Way West, 8th Floor Start Date: April 2014 File # DA-4872 Los Angeles, CA 90045 Completion Date: Sept. 2014 Griffith Company Project # 10524.10 Attn: Mark Vicelja mvicelma@lawa.org Phone: 424-646-5871 updated: 4/6/2017 Page 2 -110/C Street Interchange Port of Los Angeles $ 21,748,950.00 SPEC # 2735 425 S. Palos Verdes Street Start Date: January 2014 San Pedro, CA 90733 Completion Date: Feb 2017 Griffith Company Project # 10523.10 Attn: Mark Rose mrose .pola.org Phone 310-732-3919 Slover Avenue Phase 1 County Of San Bernardino $ 1,939,752.04 WO# HB0020 825 E Third Street Room 147 Start Date: January 2014 San Bernardino, CA 92415-0835 Completion Date: May 2014 Griffith Company Project # 10522.10 Attn: Nidham AlRayes, PE Phone: 909-387-1831 Sweetzer Avenue Street Widening City of West Hollywood $ 394,495.61 Project # CIP 1401 8300 Santa Monica Boulevard Start Date: Nov. 2013 West Hollywood, CA 90069-6216 Completion Date: Oct. 2014 Griffith Company Project # 10519.10 Attn: Garrett Salma Phone 213-364-1069 Alumium Property -Container Facility BNSF $ 2,001,931.57 Cont. # BF10004993 3770 East 26th Street, 1st Floor Start Date: Dec. 2013 Vernon, CA 90058 Completion Date: May 2014 Griffith Company Project # 10518.10 Attn: David Miller Phone 909-386-4058 Silver Fire, Route 243 Postmile 18.0/28.3 Caltrans $ 730,212.61 Caltrans No. 08-1 E540 1727 30th Street Start Date: August 2013 Sacramento, CA 95816 Completion Date: November 2013 Griffith Company Project # 10515.10 Attn: Michael Chen, RE Phone 951-830-6017 Panda Liberty Project Gemma Power Systems $ 4,268,282.00 Contract # 1301253-0009-3419 2461 Main Street Start Date: Sept. 2013 Glastonbury, CT 06033 Completion Date: May 2014 Griffith Company Project # 70059.70 Attn: Trish Kohler Phone 860-659-0509 Coastal Dunes Project Los Angeles World Airports $ 1,089,958.74 Contract No. DA-4836 7301 World Way West, 8th Floor Start Date: Nov. 2014 Los Angeles, CA 90045 Completion Date: May 2014 Griffith Company Project # 10512.10 Attn: Mark Vicelja MVicelia(a)lawa.org Phone 424-646-5871 Gilman Springs Road Improvements County of Riverside $ 4,900,878.00 Project No. C2-0140 & CO-0531 4080 Lemon Street Start Date: Sept. 2013 Fed. Aid No. HSIPL-5956(204) Riverside, CA 92501 Completion Date: December 2013 Griffith Company Project # 10510.10 Attn: Gabriel Munoz gmunoz rctlma.org Phone 951-955-6885 Newport Road Widening City of Menifee $ 3,722,832.00 Project No. CIP #01-13 29714 Haun Road Ave. Start Date: August 2013 Menifee, CA. 92586 Completion Date: March 2015 Griffith Company Project # 10507.10 Attn: Bill Gallegos waallegos(a)dudek.com Phone: 909-376-5601 Auto Center Drive - Grade Separation City of Corona $ 21,886,246.79 Project # 04-0106 400 S Vicentia Avenue #210 Start Date: July 2013 Federal Project No. PNRSL-5104(033) Corona, CA 92882 Completion Date: Nov 2015 Griffith Company Project # 10499. Attn: Faisal Zahlout, P.E. fzahlout syrusaengineering.com Phone 562-665-8143 updated: 4/6/2017 Page 3 Wilshire Bus Rapid Transit City of Los Angeles WO# El907532 & El907525 200 N Spring Street RM 355 Contract No. C-122686 Los Angeles, CA 90012 Griffith Company Project # 10497.10 Attn: Vahik Vartanians Phone: 213-485-4652 Pier G- Berths G230-G236 Port of Long Beach Contract # HD-S2243 925 Harbor Plaza Long Beach, CA 90802 Griffith Company Project # 10496.10 Attn: Darrin Lambrigger Phone: 562-283-7200 Silver Lake Reservoir Complex Storage Webcor, Obayashi, Lyles, a JV Replacement Project # 31140.00 6001 W Forest Lawn Los Angeles, CA 90068 Griffith Company Project # 11495.11 Attn: Steve McFadden Phone: 213-239-6460 Metro Foothill Extension Phase 2A Foothill Transit Constructors Contract No. 1135 10704 Shoemaker Avenue Santa Fe Springs, CA 90670 Griffith Company Project # 11489.11 Attn: Steve McFadden Phone: 562-946-1816 Nogales Grade Separation ACE Construction Authority ACE Contract # 12-05 4900 Rivergrade Road, Suite A120 Irwindale, CA 91706 Griffith Company Project # 10486.10 Attn: Charles Tsang Phone 626-962-9292 Moulton Parkway Widening Orange County, DPW W.O. ER09004 1152 East Fruit Street Santa Ana, CA 92701 Griffith Company Project # 10484.10 Attn: George Zaun Phone 714-245-4508 Streeter Avenue Underpass @ City of Riverside Union Pacific Railroad 3900 Main Street Bid No. 7094 Riverside, CA 92522 Griffith Company Project # 10482.10 Attn: Mike Wolf Phone 951-826-5341 Pier G- Berths G23-G236 Terminal Site Devel. Port of Long Beach Contract # HD-S2230 925 Harbor Plaza Long Beach, CA 90802 Griffith Company Project # 10481.10 Attn: Darrin Lambrigger Phone 562-283-7200 BNSF LA Triple Track, BNSF Railway Company Rosemead to La Mirada 720 South B Street Contract # BF10003009 Stockton, CA 95206 Griffith Company Project # 10469.10 Attn: John Fleming Phone Gateway and Streetscapes City of Beverly Hills Wilshire Blvd. to Whittier Drive 345 Foothill Road Griffith Company Project # 10468.10 Beverly Hills, CA 90210 Attn: Tristan D Malabanan, P.E. Phone 310-285-2512 $ 11, 858,160.00 Start Date: Oct. 2013 Completion Date: Jan. 2015 Peter. bilkian(c)lacity.org $ 11,666,176.09 Start Date: May 2013 Completion Date: June 2014 darrin.lam brigger(aD_polb.com $ 1,096,172.93 Start Date: April 2015 Completion Date: Nov. 2015 $ 2,940,537.41 Start Date: Feb 2013 Completion Date: July 2015 $ 47, 365, 888.00 Start Date: May 2013 Completion Date: Nov. 2016 ctsang(c_)theaceproject.org $ 9, 489, 706.65 Start Date: Feb 2012 Completion Date: June 2014 george.zau n (o)ocpw. ocgov. com $ 16,485,716.00 Start Date: November 2012 Completion Date: March 2015 $ 13,037,793.86 Start Date: October 2012 Completion Date: April 2014 darrin.lambrigger(c-)polb.com $ 2,363,344.37 Start Date: June 2012 Completion Date: June 2013 john.fleming@BNSF.com $ 645, 808.81 Start Date: Aug. 2012 Completion Date: Feb 2013 updated: 4/6/2017 Page 4 Exposition Corridor Light Rail Exposition Metro Line CA $ 552,020.00 Phase 1 Street Improvements 707 Wilshire Blvd. 34th Floor Start Date: June 2012 Contract # XP8901-848 Los Angeles, CA 90017 Completion Date: Jan. 2013 Griffith Company Project # 10463.10 Attn: Dave Walker' Dwalker(a)exporail.net Phone Valley View Ave. Grade Separation City of Santa Fe Springs $ 27,539,272.20 Contract # 75AO229 11710 Telegraph Rd. Start Date: Aug. 2012 Griffith Company Project # 70054.70 Santa Fe Springs, CA 90670 Completion Date: Oct 2015 Attn: Noe Negrete, P.E. noenegrete@santafesprings.org 562-868-0511 Route 110 Joint Assemblies Truesdell Corporation $ 194,583.00 Caltrans Project # 07-260504 1310 W. 23rd Street Start Date: Oct 2012 Griffith Company Project # 70053.70 Tempe, AZ 83282-1837 Completion Date: Jan 2013 Contact: Dan Keller, PM icastillo(a truesdellcorp.com Phone: 602-319-5898 1-15-from 7th to Sierra Caltrans $ 77,335,000.00 Caltrans Project # 08-472224 4295 E Jurupa Street Start Date: April 2012 Griffith Company Project # 10462.10 Ontario, CA 91761 Completion Date: July 2013 Attn: Fereydoon Alipanah Phone 909-289-2020 Pepper Avenue Extension City of Rialto $ 8,003,739.82 Contract # 000893-00 150 S Palm Avenue Start Date: July 2012 Griffith Company Project # 10457.10 Rialto, CA 92376 Completion Date: December 2014 Attn: John Wheatly Phone: 909-421-4999 Hamner Avenue Widening Project City of Norco $ 6,230,549.59 2870 Clark Avenue Start Date: June 2012 Griffith Company Project # 10456.10 Norco, CA Completion Date: June 2013 Attn: Lori Askew laskewa-)ci.norco.ca.us Phone: 951-270-5678 $ 4,133,320.00 Mount Lee Washout Emergency Repair City of Los Angeles $ 493,533.02 Contract # C-114793 200 N. Spring St. Start Date: March 2012 Griffith Company Project # 70052.70 Los Angeles, CA 90012 Completion Date: April 2012 Contact: Gene Edwards, PM gene. edwards(a)lacity.org Phone: 213-847-0463 Route 5 - 13 miles north of Castaic Caltrans $ 86,592,381.00 Caltrans Project # 07-252804 1727 30th Street Start Date: March 2012 Griffith Company Project # 10452.10 Sacramento, CA 95816 Completion Date: Nov 2014 Attn: Mustafa Hussain, P.E. mustafa hussain(a)dot.ca.gov Phone 661-257-0273 Interstate 15 @ Clinton Keith Road County of Riverside $ 14,046,174.61 Porject # A2-0264 4080 Lemon Street Start Date: April 2012 Griffith Company Project # 10451.10 Riverside, CA 92501 Completion Date: Aug 2013 Attn: Sean Ronhani $ 13,518,810.00 Phone: 951-955-6800 Sean Rouhani(a�Hill Intl.com San Bernardino 10 Rancho Cucamonga Caltrans-District 8 $ 270,272.00 Contract # OR9304 464 W. 4th Street, Start Date: February 2012 Griffith Company Project # 70051.70 San Bernardino, CA 92401. Completion Date: April 2012 Contact: Chee Ong chee ong()dot.ca.gov (909) 383-6417 (Office) updated: 4/6/2017 Page 5 Boulder Avenue Bridge Improvements City of Highland $ 8,523,448.62 Contract # BRG-04004 27215 Baseline Start Date: Feb. 20, 2012 Griffith Company Project # 70050.70 Highland, CA 92346 Completion Date: May 2014 Contact: Jim Hannigan, PE Jhannigan(o)harris-assoc.com PROJECT SUSPENDED Phone: 760-220-4805 cell $ 8,185,929.14 Vincent Thomas Bridge Emergency Caltrans $ 10,218,235.61 Repair Project 1727 30th Street Start Date: January 2012 Contract # 3X6704 Sacramento, CA 95816 Completion Date: May 2013 Griffith Company Project # 70049.70 Contact:Joan Crews Joan crews(@dot.ca.gov Phone: 213-620-4852 $ 10, 750, 000.00 CPV Sentinel Energy Project Gemma Power Systems Ca., Inc. $ 9,852,933.39 Contract # 1101253-0017-3419 2461 Main Street Start Date: October 2011 Griffith Company Project # 70048.70 Glastonbury, CT 06033 Completion Date: Dec 2012 Contact: Trish Kohler trishkohlera(�gemmapower.com Phone: 860-659-0509 Access Bridge Over Brown's Gulch at LACDPW $ 2,099,930.51 San Gabriel Dam 900 S. Fremont Ave. Start Date: May 2012 Project ID# FCC0001086 Alhambra, CA 91803 Completion Date: April 2013 Griffith Company Project # 70047.70 Contact: Tim Bazinet, PM TBAZINET(a)-dpw.lacounty.gov Phone: 626-458-2185 Magnolia Boulevard City of Los Angeles $ 2,209,371.42 WO# El906349 1149 S Broadway, Suite 810 Start Date: January 2013 Griffith Company Project # 10445.10 Los Angeles, CA 90015 Completion Date: Dec. 2013 Attn: Peter Bilkian, SEA peter.bilkianilacity.org Phone: 213-485-4503 Rancho Santiago Community College Dynalectric Transportation $ 496,073.82 Rancho Santiago CCD Humanities Building 4462 Corporate Center Dr. Start Date: Oct 2011 SCC Signalization Project # 311008 Los Alamitos, CA. 90720 Completion Date: July 2012 Griffith Company Project # 10444.11 Attn: Richard Shackleton Original Contract amount Phone: 714-236-2280 $ 300,237.50 SBX E Street Construction Project Omnitrans $ 79,600,694.53 Cont. # IPM011-5 1700 West Fifith Street Start Date: Nov. 2011 Griffith Company Project # 10443.10 San Bernardino, CA 92411 Completion Date: March 2014 Attn: Andres Ramirez Andres. Ram irez(a)omnitrans.org Phone 909-963-5235 Artesia Downtown Revitalization City of Artesia $ 766,451.16 Cont # PC 2010-1253 18474 Clarkdale Avenue Start Date: April 2012 Griffith Company Project # 10442.10 Artesia, CA 90701 Completion Date: August 2012 Completed early due to Loss of Funding Attn: Carlos A Alba, PE, PLS Phone: 949-766-2686 Taxilane A@ Rehabilitation Phase II Los Angeles World Airports $ 2,059,694.70 @ Van Nuys Airport 7301 World Way West, 3rd Floor Start Date: Nov. 2011 Griffith Company Project # 10436.10 Los Angeles, CA 90045 Completion Date: July 2012 Attn: Eduardo Porto eporto()lawa.org Phone 424-646-5866 Jurupa Avenue Extension City of Riverside $ 4,973,400.02 Bid No. 6946 3900 Main Street Start Date: July 2011 Griffith Company Project #10422.10 Riverside, CA 92522 Completion Date: June 2012 Attn: Danny Cwiak, PE Phone 951-538-3037 updated:4/6/2017 Page 6 Newport Beach Civic Center & Park C.W. Driver $ 2,514,241.00 Project # 10012 15615 Alton Parkway, Suite 150 Start Date: Sept 2011 WO# 10012-SUB-02525S Irvine, CA 92618 Completion Date: May 2013 Griffith Company Project # 11419.11 Attn: David Edwards Completed contract amount: Phone 949-261-5100 $ 3,071,822.00 1-405 Sepulveda Pass Widening Project Kiewit Infrastructure West Co. $ 2,356,524.85 LACMTA Project # C0882 6060 Center Drive, Suite 200 Start Date: April 2011 Griffith Company Project .# 70041.70 Los Angeles, CA 90045 Completion Date: Jan. 2014 Contact: Eric Guttau eric.guttau(a)kiewit.com Phone: 310-846-2400 Metro Subway Station : Los Angeles County, MTA $ 5,383,718.56 Entrance Canopy Proj. No. C0972 One Gateway Plaza Start Date: August 2012 Griffith Company Project #10406.10 Los Angeles, CA 90012-2952 Completion Date: Feb 2013 Attn: Brad Owen bowen(a�metro.net Phone 213-922-7158 Morris Dam 1/0 Rehabilitation Project LACDPW $ 9,426,478.66 Project ID # FCC0000496 900 S. Fremont Ave. Start Date:Jan 2011 Griffith Company Project # 70038.70 Alhambra, CA 91803 Completion Date: Sept. 2013 Contact: Don Lewis TBAZINET(a)dpw.lacounty.gov Phone: 562-299-4613 2010/ 2012 Site Improvements Port of Los Angeles $ 15,336,934.87 Spec 2705 425 S. Palos Verdes Street Start Date: Nov. 2010 Griffith Company Project # 10396.10 San Pedro, CA 90733 Completion Date: Nov 2013 Attn: Mark Rose mrose(a)portla.org Phone 310-732-3919 $ 15,000,000.00 Bradley West Core Walsh Austin JV $ 13,211,183.29 #209133 929 W. Adams Street Start Date: Aug. 2010 Contract DA 4382 Chicago, IL 60607 Completion Date: Dec. 2013 Griffith Company Project # 10390.10 Attn: Bernie Reico breico walshgroup.com Phone 619-778-4960 Bradley W. Concourse Walsh Austin JV $ 44,091,374.17 Project # 209050 929 W. Adams Street Start Date: May 2010 Contract # DA 4337A Chicago, IL 60607 Completion Date: Dec 2013 Griffith Job No. 10387.10 Attn: Bernie Reico $ 28,361,006.00 Phone 619-778-4960 breico(c-)walshgroup.com updated: 4/6/2017 Page 7 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the Iast five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. Darrell Waterman Name of proposed Project Manager . 'telephone No. of proposed Project Manager: 909-204-1283 Streeter Ave. Underpass $16 485 716.00 - Grade Separation March 2015 Project Name & Contract Amount Type of Work Date Completed Metro Entrance Canopy Project $5 383 718.00 - Street Work & Canopy Protect Feb. 2013 Project Name & Contract Amount Type of Work Date Completed Citrus Heights Drive $5 739 653.00 - Street Rehab Project Feb. 2017 Project Name & Contract Amount Type of Work Date Completed 2, Joe Tuttle Name of proposed Superintendent Telephone No, of proposed Superintendent: 562-519-2424 Wilshire Bus Rapid Transit Project $11,858 160 00 - Street Work Project Jan. 2015 Project Name & Contract Amount Type of Work Date Completed _Bradley West Gates Concourse, $44,091,374.00 - Mass Grading/Paving Dec. 2013 Project Name & Contract Amount Type of Work Date Completed Offsite Improvements @ Village r7a Topanga,_$5 223 891 00 - R&R Paving Dec 2015 Project Name & Contract Amount 'Type of Work Date Completed C-1.o 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 .tune 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/PublicWorlcs/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link— Call (844) 522-6734 https://efiling.dir,ca, gov/PW CR/ActionServlet?action--disptayPW CRegistrationForm DIR's Contractor Registration searchable database: bttps://efiIing.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." 1 furthermore will comply by providing proof of registration with DIR �ahe primary contractor, as well as for ALL subcontractors at the time of submitting thebid. Date: 05/02/2017 PWC Registration 4: 1000005611 C-11 Griffith/Com for resident / Regional Man Walker 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: Griffit Com Contact Person: Luc s J. aticer Xice Presid Contact Phone: 56 -9 Signed: Date: *Note: The 44 certification is required by the Department of Housing and Urban Development (24 C 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 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to www.calregs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form, Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System (GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Reauirements. Retain the original form in your grant file. GRANTEE NAME: CITY OF HUNTINGTON BEACH GRANT NUMBER: TRP7-16-0001 2000 Main Street, Huntington Beach, CA 92648 PRIMARY CONTACT NAME: JAMES WAGNER PE, SENIOR CIVIL ENGR, PUBLIC WORKS DEPT. CONTRACTOR NAME: Griffith Company AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: Lucas J. Walker, Vice President / Regional MAILING ADDRESS: 12200 Bloomfield Ave.,Santa Fe Sprinqs CA 90670 As the authorized representative of the above identified contractor, I declare under penalty of perjury under the Ims's of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, I declare under- penalty ofpetjtrly under the laws of the Slate o C ' ornia that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, Californi o of egulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I h e is los d all such occurrences in an attached signed statement that explains the facts and. circumstances q th lis ed,Ivents. I Signature V 111711 I Date 05/02/2017 1 C-13 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7113) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be fled in accordance with section 17055 ct seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal properly loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or (j) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste fire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: I. Was a Principal Manager in an entity on the Unreliable List at the tune of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person wbo owns 20% or more of the entity, if that person: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: 1. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Griffith Company , proposed subcontractor hereby certifies that he has X , has not participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-I.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 October 2016 C-15 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 fi•aud, 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 1n 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 If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-16 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 inunediately 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-17 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 Santa Fe Springs, Los Angeles County 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 fi•om 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-18 October 2016 Vocal 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 C49 October 2016 Local Assistance Procedures Manual Exhibit 12-11 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 1.1 of 22 C-20 October 2016 Local Assistance Procedures Manual Exhibit 12-I3 Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LUBBY1NUAC HVIIthNruxNUArvr rU.sr U.0.v..r��� 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. a. contract [—a a. bid/offer/application Fa-� a. initial b, grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e. loan guarantee year quarter_ f. loan insurance date of last report 4. Name and Address of Reporting Entity S. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: ❑X Prime Subawardee Griffith Company Tier if known 12200 Bloomfield Ave. Santa Fe Springs, Ca. 90670 Congressional District, if known 6. Federal Department/Agency: S. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) 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 (check all that apply) 13. 'Type of Payment (check all that apply) $ 0 actual planned a. retainer b. one-time fee 12. Form of Payment (check all that apply): C. commission a. cash d, contingent fee b. in -kind; specify: nature e deferred value f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including offrcer(s), employee(s), or member(s) contacted, for Payment Indicated in Ite 1: No Lobbying Activities (attach Continuation Sheet(s) if neces y) 15. Continuation Sheet(s) attached: Yes No ❑X !G. 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 din L C - J. Walker pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for Title: V'ce esldent /Regional Manager 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. Telep e o.: 562-929-1128 Date: I Federal Use Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C-21 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 amaterial 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 r•epo:ting entity that designates if it is or expects to be a prune or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item I (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13. Check the appropriate box. Check all boxes that apply. If other, specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s) or employee(s) contacted or the officer(s) employees) or Member(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-r"st",dio Rev. 06-04-90.ENDID) Page 13 of 22 C-22 October 2016 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: The City of Huntington Beach 2. Contract DBE Goal: 6% s Proient Description: Pavement Resurfacing and/or Rehabilitation Projects a PrniPc-t I nnntion. Adams Ave. /Beach BI. to Newland St. and Atlanta Ave. / Beach BI. to Newland St. 5. Bidder's Name: Griffith Company 6. Prime Certified DBE: LI 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 LocaliAgency Eo CompIota this Section 15. TOTAL CLAIMED DBE PARTICIPATION $ 21. Local Agency Contract.Number: CC-1502 22. Federal -Aid Project Number: STPL-5181(188) 23. Bid Opening Date: 24. Contract Award Date: IMPORTANT: I ntify BE fi s being claimed for credit, regardless offer. N es of t First Tier DBE Subcontractors and their respe ",a i ) of w listed above must be consistent, Local Agency certifies that all DBE cerfifications are valid and information on where ap is h the ames and items of the work in the "Subco a t" su itted with your bid. Written confirmation of this form is complete and accurate. each li i fired. 05/02/2017 25. Local Agency Representative's Signature 26. Date 1 . P re r I gnature 17. Date Lu as J/Walker 562-929-1128 27. Local Agency Representative's Name 28, Phone 18 repparer's Name 19. Phone 4esident ice / Regional Manager 29. Local Agency Representative's Title ftPreparer's Title DISTRIBUTION: 1. Original -- Local Agency V 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 July 23, 2015 C-23 Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort EXHIBIT 15-H DBE INFORMATION —GOOD FAITH EFFORTS Federal -aid Project No. DBE INFORMATION - GOOD FAITH EFFORTS STPL-5181(188) Bid Opening Date May 09, 2017 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 6 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial hollow Up Methods and Dates Solicitation C-24 Page 15-1 OB 12-04 June 29, 2012 Exhibit 15-H DRT, information -Good Faith Effort Local Assistance Procedures Manual C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items M Of (V/N) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: Page 1S-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 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 .rune 29, 2012 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). S. 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. S. Total Dollar Amount for ALL Subcontractors — Enter the total dollar amount for all subcontracted contractors. SUM = (DBEs + alI 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 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 nurnber 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. LocaI 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-27 July 23, 2015 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/ActionServiet?action=displaVPWCRegistration Form 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%) 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 NamCA,�20 VI 'C 2 (� 140Lj �ZZ <$1 million <$5million City, State:W . Gii- ?(�2 1 <$10 million <$15 million Age of Firm: yrs. Na e::t -(,I' t �y�)/pA �`� lr1WU��UGK� 1 c.U. ;CtA- P4 K71 r►� /�, �j " � q ( / n l7%,.�,uso- ( In �t '+CS'T��f� <$1million <$5 million City, State: o Rey oy e CA 149fw0 is <$10 million <$15 million Age of Firm: yrs. Name: CAT T14A � p/ �a 112;7_1 V�,� El <$1 million <$5 million City, State: pZACj() VZUblClO@L V Lj <$10 million �D000(F�li--,� ❑ <$15 million Age of Firm: yrs. Name:• _ �' �� ❑ <$1 million ❑ <$5 million City, State: ❑ <$10 million <$15 million Age of Firm: _ yrs. Nam : c d i &, ut)-o4ff1i%r� i3 W6 , �� �a� <$1 million <$5 million City, State: C v t Ll <$10 million ( 000 i 0"1 1 � � i i !�` <$15 million lion Age of Firm: _yrs. !!��j Wl�e, V I �yy/,, /7 ���(/1 1 �u�(( {'� r G, /!A ` / ✓ `�� t I p /e c � �� Mo-1 ` �,� yam'' ` �y ✓ <$1 million ❑ <$5 million City, State: 'nu,er L r (•� L IoOo0oiggb 6 jJ <$10 million <$15 million Age of Firm: yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package C-28 Page 1 of 2 mber 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 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 following information is required 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 LJ <$5 million City, State: <$10 million <$15 million Age of Firm: `yrs. Name: FS ED<$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 <$5 million City, State: <$10 million <$15 million Age of Firm: _yrs. Name: <$1 million ❑ <$5 million City, State: Lj <$10 million _j <$15 million Age of Firm: _ yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package Page 1 of 2 C^28 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 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. 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 following information is required 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 (whirhPvnr k vrPater)- Phntnr•nnv this farm 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 DIR Reg Number contracted Name:�ti <$1 million �r <$5 million City,Stater" <$10 million Bull <$15 million ;'`:, AgeofFirm: _yrs. Name: ,•�� <$1 million <$5 million City, State: <$10 million <$15 million + u . Age of Firm _yrs. Name: � ' <$1 million Y r« a w ❑ <$5 million City, State: <$10 million ❑ <$15 million �- Age of Firm: yrs. Name:� ❑ <$lmillion <$5 ❑ million ❑�<$10 million i { , r "{ �Y City State: ze`" c$15million s Age of Firm: _yrs. "4 Name: <$1 million <$5 million �Mi% 1 fi4� City, State: — <$10 million h r. <$15 million y Age of Firm: _yrs. Name: 3 S 4 <$1 million ❑ <$5 million n Ogg is k i k3 <$10 million City, State: Fant'4' ��� <$15 million l{ Age of Firm: _yrs. Distribution: 1) Originai-Local Agency File 2) Copy-Dl.AE w/ Avrard Package C-28 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 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:/iefiIing.dir.ca.gov/PWCR/ActionServlet?action=disp[aVPWCRegistrationForm 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 (0.501a) of the Total Base Bid or $10,000 (wh;rhever is oreaterl_ Phnfnennv 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 DIR Reg Number contracted Name: <$1 million r <$5 million City, State: < 10 million $ ofF <$15 million Age of Firm: _ yrs. Name: wY�r hl Ej <$1 million <$5 million <$10million City, State: �� � . <$15 million Age of Firm: _ yrs. �k n Name: <$1 million ❑ <$5 million million City, State:<$10 :'�:a�` ❑ <$15 million x Age of Firm: __,_yrs. Name: ( ❑ <$1 million El <$5 million j � �t�� r��; City, State: — ❑ 1$1D million <$15 million tea, t Age oGU f Firm: ^yrs. Name:ANN. R . <$1 million E �' Li <$5 million City, State: —<<1,� <$10 million A.. �s <$15 million M. Age of Firm: _ yrs. Name: «'� " da:uC�ir <$1 million ❑ <$5 million $ 10 million City, State: <$15 million FS,i ajlnr i Age of Firm:_ yrs. Distribution: 1) Original -Local Agency File 2) Copy-aL AE w/ Avrard Package C-28 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 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 rn�e �01 YOU. p2'` C v ` � > � �t ; y4 > °# r 9 ❑ <$1 million <$5 million City, State: (/�Y �� <$10 million ❑ <$15 million Age of Firm:,M yrs. Na I� , /V I1 ' ) ` 1' �t. ❑ <$1 million <$5 million City, State: �(X���� <$10 million ❑ <$15 million Age of Firm• _yrs. Name: "' °w ❑ <$1 million <$5 million ❑ <$10 million <$15 million City, State:" Age of Firm: _yrs. Name: .; �,_- . � ❑ <$1 million ❑ <$5 million City, State: <$10 million <$15 million Age of Firm: _ yrs. Name: "`" f= ❑ <$1 million ❑ <$5 million City, State: ❑ <$10 million <$15 million Age of Firm: _yrs. Name: x r <$1 million ❑ <$5 million <$10 million City, State: ❑ <$15 million Age of Firm: _yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ Award Package Page 2 of 2 C-29 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/N) DBE Cert Number Annual Gross Receipts DIR Reg Number Name: ❑ <$1 million I <$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 <$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. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/Award Package Page 2 of 2 C-29 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 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 DBEE Cert Annual Gross Receipts Location Amount Bid Item Sub- License Number (Y/N) Number DIR Reg Number contracted Name: �,! ❑ <$1 million <$5 million ' ra City, State: ❑ <$10 million za 41NM❑ <$15 million Age of Firm: yrs. Name: �* �g� . ❑ <$1 million _ ❑ <$5 million � i City, State: ❑ <million ❑ <$$1a 1S million t+ !r i Age of Firm: _ yrs. Name: f,a N j " , fs ❑ <$1 million a �Jk 'r ❑ <$10 million City, State: .:..::.:;.4 ❑ <$15 million aox Age of Firm: _ yrs. Name: M >`; �� ❑ <$1 million ❑ <$5 million City, Y <$10 million <$15 million „�Itn 4 kLJ Age of Firm: _yrs. Name: ❑ <$1 million I �. t ❑ <$5 million ! ;� �� -'` t �t ❑ <$10 million City, State: <$15 million Age of Firm: `yrs. Name: <.,. '��� �-x ❑ <$1 million i n >4 n ❑ <$5 million City, State: ❑ <$10 million <$15 million i rk 'rc ti: Age of Firm:_yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/ANvard Package Page 2 of 2 C-29 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 pre vide 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 DIR Reg Number contracted Name: sH§r . 1 million <$5 million r { h +' City, State:, ❑ <$10million ma LR �zti ❑ <$15 million Age of Firm: _yrs. Name: �.. ❑ <$1 million xay E l,tS,�t ❑ 1$5 million < 10 million ❑ $ City, State: <$15 !on Tl �i„F"n'[+{" a:�e:a rwoz. Age of Firm:_ yrs. Name: itt� I'M c faN�4 <_ [] $1 million �iiiaa> <$mllllOn IIli ❑ <$10 million <$15 City, State:T million Age of Firm. yrs. Name: °} �a} ilrip�k7 lt' ' d y�#��r �, ,w�a� " jLJ ❑ <$1 million ❑ <$5 million � 10 million City, State: h3�-'µjj �v l <$15 million ! Age of Firm: _ yrs. Name: �` ' A4x uR ❑ <$1 million _❑ <$5 million ❑ <$10 million ,%; y3 City, State: <$15 million ESL<�Y Age of Firm: ^yrs. Name: �1 C'N✓S)'s hlY �j}rE El million El<$5 million ❑ <$10 million City, State: r HH*�k I x k �.� � ❑ <$15 million Y f °tr Age of Firm: _yrs. Distribution: 1) Original -Local Agency File 2) Copy-DLAE w/A%vard Package Page 2 of 2 C-29 September 2016 Local Assistance Procedures Manual Exhibit I7-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors EXHIBIT 1 7_F FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number 2. Federal -Aid Project Number 3, Local Agency 4. Contract Completion Date 5. Contractor/Consultant 6. Business Address 7. 'Final Contract Amount 8. Contract Item Number 9. Description of Work, Service, or Materials Supplied 10. Company Name and Business Address 11, DBE Certification dumber 12. Contract Payments 13, Date Work Completed 14, Date of Final Payment Non -DBE DBE 15. ORIGINAL DBE COMMITMFNT AMOUNT $ Pavement R, 16. TOTAL List all first -tier suboontractorslsubconsultants and DBEs regardless of tier whether or not the firms were originally listed for goal credit. If actual DBE utilization (or item of work) was different than that approved at the time of award, provide oomments on an additional pace. List actual amount paid to each entity. If no subcontractorslsubconsultants were used on the contract, indicate on the form. I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT 17. Contractor/Consultant Representative's Signature 18. ContractorlConsultant Representative's Name 19. Phone 20, Date I CERTIFY THAT THE CONTRACTING RECORDS AND ON -SITE PERFORMANCE OF THE DBE(S) HAS BEEN MONITORED 21. Local Agency Representative's Signature 22, Local Agency Representative's Name 23. Phone 24, Date DISTRIBUTION: Original — Local Agency, Copy — Caltrans District Local Assistance Engineer, include with Final Report of Expenditures ADA NOTICE: For individuals with sensory disabrlities, this document is available in alternate formats. For information, call (916) 445-1233, Local Assistance Procedures Manual TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814, C-30 Page I of 2 July 23, 2015 Local Assistance Procedures Manual Exhibit 17-F Final Report -Utilization of Disadvantaged Business Enterprises (DBE) and First -Tier Subcontractors INSTRUCTIONS — FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST -TIER SUBCONTRACTORS 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. 5. Contractor/Consultant - Enter the contractor/consultant's firm name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant'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. 10. Company Name and Business Address - Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. It. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE. The Non -DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment - Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount - Enter the "Total Claimed DBE Participation Dollars" from Exhibits 15-G or 10-02 for the contract. 16. Total - Enter the sum of the "Contract Payments" Non -DBE and DBE columns. 17. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 19. Phone - Enter the area code and telephone number of the person signing the form. 20. Date - Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature - A Local Agency Representative must sign their name to certify that the contracting records and on -site performance of the DBE(s) has been monitored. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 23. Phone - Enter the area code and telephone number of the person signing the form. 24. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 C-31 July 23, 2015 CORPORATE OFFICE 3050 E. Birch Street Brea, CA 92821 [7141984-5500 Fax V14] 854-9754 CENTRAL REGION 1128 Currier Parkway Ave. Bakersfield. CA 93308 [B61]392-6640 Fax 16811393-9525 SOuRIERN REGION 12200 Bloomfield Ave. Santa Fe Springs, CA 90670 [5621929-1128 Fax[582] 86441970 smlxcTVP.5 DAv!EION 3050 E. Birch Street Brea, CA 92821 [7141984-000 Fax 17141854-0227 UNDERGROUND DIVISION 3050 E. Birch Street Brea, CA 92821 [7141984-5500 Fax[714]854-0226 LANDSCAPE DIVISION 3050 E. Birch Street Brea, CA 92621 [71419845500 Fax V141854-7843 CONCRETE DIVISION 12200 Bloomfield Ave. Some Fe Springs, CA 90670 [5621929-1128 Fax [562] B64.8970 MATERIALS DIVISION 3050 E Birch Street Brea, CA 92821 [7141984-5500 Fax [7141854-0229 w gri8thcomoefiVnet CAContractors License #88 NV Contractors License #78889 AZ Contractors License #292209 A u�ifr� GRI FF I T H CCeMPANY ]LICENSE CERTIFICATE T E I certify under penalty of perjury uVcoec State of California that the following is tru 88 State Contractor's License No. J Walker, Vice President / Regional Manager CONTRACTORS CICc� STATE LICENSE BOARD -•^^ �� ACTIVE LICENSE 40, 88 CORP :W GRIFFITH COMPANY ..,'A B C-8 C12 C27 HAZ r 1 e*,,.,o.0913012018 www.cslb,ca.gov Griffith Company Is an equal opportunity employer and an employee -owned company" &Im. l vpp Pum Wgoi)a Public Wor#v Contractor (PWQ Registration Search This is a gstft of cunent aril active PWrc ragwratlorm pursuant to Dlvbion 2, Part 7, Chapter 1 (commencing with section 172D of Ve California Labor CoW.) Eater at least one search criteria to dlrptay activa registered public werks eontraclor(e) msfcbing youreelecirorrrt. Registration Year. Currwd F)acat Year.22tt6/17 v PWC Registration Number. :1234567890 Contractor Legal Name: Company Contractor License Lookup License Number. County: 8elaetCataay v Search Results one regMered contactorftald. 1 Deh is i Legal NOW Export as: :M Excel I f,� PDF �DAA I T-Maw nab 100DOMsl ORANGE BprA 0"1/2016:06%w%n17 Yl2i SMD1 PROPOSED RESOLUTION AUTHORIZED SIGNERS OF THE CORPORATION BE IT RESOLVED, that any one, or more of the Officers of this Corporation are hereby authorized to execute and deliver in the name of this corporation any and all bids, authorizations, contracts, notes, deeds, bonds, stoc1cs, declarations, releases and agreements of any nature or sort whatevet. FURTHER RESOLVED, that any one or more of the following are appointed as authorized signers and hereby authorized to execute and deliver in the name of and behalf of this Corporation any and all bids, authorizations, contracts, certifications, declarations and releases, including: bid bonds, labor arld material bonds, performance bonds and stop wtice.bondis. Regional Manager, Division Manager, Assistant Division Manager District Manager, Chief Estimator, General Counsel FURTHER RESOLVED, that any and all persons, fitms, corporations, and other entities shall be entitled to rely on the authority of any one or more of the officers or authorized signers named to bind this Corporation by the execution and delivery of any of the documents or papers set forth heminabove. FURTHER RESOLVED, that the authority granted herebyshall not be modified or revoked except by a resolution to that effect passed by the Board of Directors of this Corporation. FURTHER RESOLVED, that any and all authorization heretofore granted by this Corporation to any officers or authorized signers other than those named, to perform acts in the name of and on behalf of this Corporation similar to the acts authorized above, be and they are here.by.revoked, rescinded and annulled. IN WITNESS WHEREOF, the undersigned has hereunto set his hand and affixed the seal of GRIFFITH COMPANY this 15111 day of March'2016. �• -, 4"�'4 Gordon M. Csutak Vice President/Secretary/CFO Attest: Thomas L. Foss, Chairman of the Board CORMMIEDFFlC£ 3050 E. Birch Street Brea, CA 92821 1714] 984-5500 Fax [7141 B549754 Cel11141. Recalls 1126 Carrier Parkway Ave. Bakersfield, CA 93308 (6611 392-6640 Fax (661] 393-9525 souraeelsReaalls 12200 Bloomfield Ave. Santa Fe Springs, CA 90670 [562] 929-1 b28 Fax 15621 864-8970 SHUerpa£Dm51ols 305U E. Birch Street Brea, CA 92821 [7141 984-5500 Fax [714] 854-0227 UmEaolroUlsODMSIols 3050 E. Birch Street Brea, CA 92821 [7141 984-5500 Fax [7141 85"M6 LA MPEDlvleroa 3050 E. Birch Street Brea, CA 92821 17141 9845500 Fax [714j 854-7843 Colsca£reDrvarols 12200 Bloomfield Ave. Santa Fe Springs, CA 90670 [562] 929-1128 Fax [5621 864-8970 it47m"Lit awls 3050 E. Birch Street Brea, CA 92621 [7141 984-5500 Fax [714] 854-0229 , crlffithcomaanv.net CA Contractors License 988 NV Contractors License #78889 AZ Contractors License #292209 GRIFFITH COMPANY TO: All Griffith Company Employees FROM: Griffith Company Board of Directors Gordon M. Csutak, Secretary DATE: May 13, 2016 SUBJECT: Election of Company Officers Griffith Company Board of Directors is pleased to announce election of the following officers for the ensuing year: Thomas L. Foss: Chairman and Chief Executive Officer Jaimie R. Angus: President Ryan J. Aukerman: Executive Vice President Gordon M. Csutak: Vice President Treasurer and Chief Financial Officer Secretary David A. Diaz: Vice President Field Operations Manager r Daniel A. McGrew: Vice -President, Business Development Lucas J. Walker: Vice President Regional Manager Gary A. Hyles: Assistant Secretary Starr N. Stallings Assistant Secretary Griffith Companyls an equal opportunity employer end an employee -owned company. SINCE 1902 GRIFFITH COAPORAW 0r t 'COMPANY 305C E. Birch Street Brea, CA 92821 [7141984-5500 Fax (7141854-9754 MEMORANDUM CeBma. Retinas, 1128 Carrier Parkway Ave. Bakersfield, CA 93308 TO: All Griffith Company Employees 16611 392-6640 Fax [661] 393-9525 . FROM: Griffith Company Board of Directors so RNRMVN 12200 Bloomfield Ave. Gordon M. Csutak, Secretary , Sans Fe Springs, CA 90670 - (962] 929-1128 Fax 15621864-8970 DATE: May 13, 2016 S111wCtee2 DA1alON 3080 E. Birch Street SUBJECT: Authorized Signers Brea, CA 92921 864-864- GriffithCompany Board of Directors is leased to announce that an one or P y P y Fax [7141 8540227 Fax [ more of the following positions are appointed as authorized signers and hereby authorized to execute and deliver in the name of and behalf of this Corporation 3050 E.aomvoDtreet 3050 E. Birch Street Brea, CA 92821 any and all bids, authorizations, contracts, certifications, declarations and releases including: bid bonds labor and material bonds performance bonds 1 g• f f Fax[7141984-5500 4- Fax [714] 854-0226 and stop notice bonds. LANo#cAoeDmsrox 3050 E. Birch Street Brea, CA 92521 [141 984-651 0 - Bradley E. Austin Chief Estimator Fax [7141854-7843 COAM ereD1119roN Richard S. Carlson Division Manager _ 12200 Bloomfield Ave. Santa Fe Springs, CA 90670 [562] 929-112B Miguel Fenley Division Manager Fax [562] 864-8970 ax7aarasDry cw Tehseen Khan Assistant Division Manager 3050 E. Birch Street Brea, CA 92821 Ronald B. Pierce General Counsel [7141984-5500 Fax [714] 8540229 , Jason C. Spear Chief Estimator w srifffhcomoenv net CA Contractors Mac A. Tarrosa Division Manager License #88 NV Contractors Stephen Timm - Assistant Division Manager License #78889 AZ Contractors Walter E. Weishaar Regional Manager , License #292209 Griffith Company is an equal opportunity employer and an employee -owned company. 51N CE 1'702� I CORPOR476 0Bt`?W G R I F F I T H 3050 E. Birch Street COMPANY Brea, CA 92821 [7141984.550D Fax V141054-9754 CEWMIL REolou 1128 Carder ParkweyAve. Bakersfield, CA9330B EQUAL EMPLOYMENT OPPORTUNITY [6611392-6640 AND A D Fax[6611393-9525 AFFHWATIVE ACTION Sour/law REGM UNDER EXECUTIVE ORDER 11246 12200 Bloomfield Ave. Santa Fe Springs, CA 90370 , [5621928-1128 Fax 15623864-0970 Effective January 10,1964, Griffith Company developed an affirmative action plan for 54s7EANRaWW equal employment opportunity. 4758 Mission Blvd. - Montclair, CA 91762 19091 Ra5040 On April 11, 1978, this plan was revised and amplified. Fax 1909] 270-5042 In January, 1985, this plan was updated to meet the additional requirement of the sn"InterBDmSm 3050 E. Birch Street Century Freeway (1-105). Brea, CA 92821 (7141984-5500 Fax [7141854-0227 In March, 1987, this plan was revised and amplified. (17pC{GROUN" mawN The February 7, 1992 revision was a restatement of said program, including additional 3050 E. Bitch Street Brea, CA 92821 requirements of the Century Freeway. ]7141984-550D Fax[714] 854.0226 In January, 2005, this pion was updated with the current EEO Officer information. T� Lvics iae,/VWOH 3050 E. Birch Street In January 2008, this plan was updated with the current President information. Brea, CA 92821 V141984-550D Fax 1714)854-7843 In February 2016, this plan was updated. Cbrmakrs'D1v✓slou 12200 BloomBeldAve. Statement ofpolicv In order to provide equal employment opportunities to all qualified Santa Fe Spring., CA 90670 persons without regard to race, color, religion, sex, national origin, disability, sexual 15621929-1128 orientation, gender identity, protected veteran status, or any other protected class status Fax [5621864-8970 this company agrees to do the following: (1) recruit, hire, train, and promote persons 0 in all job titles, without regard to race, color, religion, sex, national origin, disability, Ems. Bh h Stare= 305� 92821 sexual orientation, gender identity, protected veteran status, or any other protected class Brea, CA n141984-5500 status (2) base decisions on employment so as to further the principle of equal Fax[714]854-0229 employment opportunity, (3) ensure that promotion decisions are in accord with www,gri#Ithcc[ncanV t principles of equal employment. opportunity by imposing only valid requirements for promotional opportunities, (4) ensure that all personnel actions, including but not CAContractors License#88 limited to compensation, benefits, transfers, lay-offs, return fiom layoffs, company sponsored training, education, tuition assistance, social and recreational programs, will NV contractors License #78889 be administered without regard to race, color, religion, sex, national origin,. disability, Az Contractors sexual orientation, gender identity, protected veteran status, or any other protected class License#292209 status. Griffith Company is an equal opportunity employer find an employee -owned company. Responsibility for the Program Thomas L. Foss, CEO/Chairman of the Board will personally oversee the program and will appoint Gordon M, Csutak as the Equal Employment Opportunity Officer (hereinafter referred to as the EEO Officer) to carry out the program. The EEO Officer is hereby given full authority to carry out the program and is given the responsibility and authority to perform in-depth analyses of the company's total employment process to determine whether and where impediments to equal employment opportunities exist, including but not limited to the following: Develop policy statements and internal and external communication procedures. 2. Assist line management in collecting and analyzing employment data, identifying problem areas, setting goals and timetables and developing programs to achieve goals. 'Such programs shall include specific remedies to eliminate any discriminatory practices discovered in the employment system. 3. Design, implement and monitor internal audit and reporting systems to measure program effectiveness and to determine where progress has been made and where further action is needed and, if necessary, to assure that such action is taken. 4. Report, at least quarterly, to Thomas L. Foss on the progress of each unit in relation to company goals. 5. Serve as liaison between the company, government regulatory agencies, minority and female's organizations and other community groups. 6. Assure that current legal information affecting affirmative action is disseminated to responsible officials. Dissemination of policy 1. Internal Dissemination of Policy. In order to disseminate the EEO Policy to all members of the company staff who are authorized to hire, supervise, promote and discharge employees, or who recommend such action, the company will take the following steps: (a) Include the policy in the company's policy manual; (b) Publicize the policy in company newspapers, magazines, annual reports, and other available media devices; (c) Conduct special meetings with executive, management, and supervisory personnel to explain the intent of the policy and individual responsibility for effective implementation, making clear the chief executive officer's attitude with respect to affirmative action obligations; (d) Schedule special meetings with all other employees to discuss policy and explain individual employee responsibilities; (e) Discuss the policy thoroughly in both employee orientation and management training programs; 2 (f) Meet.with union officials as appropriate to inform them of the policy, and to request their cooperation; (g) Include non-discrimination clauses in any union agreements, and review all contractual provisions to ensure they are non-discriminatory; (h) Publish articles in company publications covering EEO programs, progress reports, promotions, etc., for minority and female employees; (i) Post policy on the company bulletin boards; 0) Ensure that employees featured in product or consumer advertising, employee handbooks or similar publications include both minority and non -minority males and females; (k) Inform employees of the existence of the company's affirmative action policy and enable employees to avail themselves of its benefits; (1) Maintain a working environment free of harassment, intimidation, and coercion at all sites and in all facilities at which Griffith Company employees are assigned to work. Griffith Company shall specifically ensure that all foremen, superintendents, and other onsite supervisory personnel are aware of and carry out the Griffith Company's obligation to maintain such a working environment, with specific attention to minorities or females working at such sites or in such facilities. 2. External Dissemination of Policy. In order to make the company's Equal Employment Opportunity Policy known to all employees, prospective employees, and potential sources of employees, such as schools, employment agencies, labor unions, and college placement offices, the company will take the following action; (a) Inform all recruitment sources verbally and in writing of the company policy, stipulating that these sources actively recruit and refer minorities and females for all positions listed; (b) Incorporate the equal opportunity clause in all purchase orders, leases, and contracts covered by Executive Order 11246, as amended, and its implementing regulations; (c) Notify minority and female organizations, community agencies, community leaders, secondary schools, and colleges of the company policy, preferably' in writing; (d) Inform prospective employees of the existence of the company's affirmative action policy and enable such prospective employees to avail themselves of its benefits; (e) Ensure that employees pictured in consumer or help wanted advertising include both minority and non -minority males and females; (D Send written notification of the company policies to all subcontractors, vendors, and suppliers with requests for appropriate action on their part. Sexual Harassment - Definition and Policy It is the policy of Griffith Company to maintain a work place fi•ee of sexual harassment, intimidation and coercion. All allegations of sexual harassment will be fully reviewed. Disciplinary action will be taken against any employee found to have sexually harassed another employee. Sexual harassment is defined as, but not limited to: Any repeated or unwarranted verbal, visual or physical sexual action, sexually explicit derogatory statement or remark of a sexual nature made by someone in the work place which can be reasonably determined by the recipient and the person(s) reviewing the complaint to be offensive or objectionable or which may cause the recipient or anyone in the immediate area discomfort or humiliation. The company will investigate all complaints of alleged sexual harassment in connection with its obligations under its contracts, will attempt to resolve such complaints, and will take appropriate corrective action. if the investigation indicates that the sexual harassment may affect persons other than the complainant, such corrective action shall include such other persons. Upon completion of each investigation, the company will inform the complainant of its finding and of all avenues of appeal within thirty (30) days of receiving the complaint, To minimize the occurrence of sexual harassment in the work place, and to ensure that all employees understand that such actions will not be tolerated, managers and supervisors shall distribute the policy to every employee and periodically reinforce the importance of compliance. Utilization of Minorities and Females The company will make a good faith effort to meet the designated goals set for the by the Office of Federal Contract Compliance Programs for utilizing minorities and females in the various crafts on all construction jobs during the time this contractor has a federally -assisted, or direct federal construction contract. Recruitment I . When advertising for employees, the company will include in all advertisements for employees the notation: "An Equal Opportunity Employer". The company will insert advertisements in newspapers or other publications having a large circulation among minority and female groups in the area from which the company's workforce would normally be derived. 2. The company will conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minority group applicants, including, but not limitedto, state employment agencies, schools, colleges and minority group organizations. To meet these -requirements, the company will, through the EEO Officer, identify sources of potential minority and female group employees and establish procedures whereby applicants may be referred to the company for employment consideration. 3. The company will encourage its present employees to refer minority and female group applicants for employment by posting appropriate notices or bulletins in areas accessible to all such employees. 10 Personnel Actions Wages, working conditions, and employee benefits shall be established and administered, and personnel action of every type, including hiring, upgrading, promotion, transfer, demotion, layoff, leave of absence, and termination, will be taken without regard to race, color, religion, sex, national origin or disability. The following procedures will be followed: 1. Periodic inspections of project sites will be conducted -to ensure that working conditions and employee facilities do not allow discriminatory treatment of project site personnel. 2. The spread of wages paid within each classification will be periodically evaluated to determine any evidence of discriminatory wage practices. 3. - The company will periodically review selected personnel actions in depth to determine whether there is evidence of discrimination. Where evidence is round, the company 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. 4. The company will investigate all complaints of alleged discrimination in connection with its obligations under its contracts, will attempt to resolve such complaints, and will take appropriate corrective action. 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 company will inform the complainant of its finding and of all avenues of appeal within thirty (30) days of receiving the complaint. Training and Promotion 1. The company will assist in locating, qualifying and increasing the shills of minority and female employees and applicants for employment. 2. Consistent with its requirements and as permissible under Federal and State regulations, the company will make full use of training programs, such as pre - apprenticeship, apprenticeship, or on-the-job training programs, for the geographical area of contract performance. 3. To the extent possible, the company will advise employees and applicants for employment of available training programs and entrance requirements for such programs. 4. The company will periodically review the training and promoting potential of minority and female employees and will encourage eligible employees to apply for such training and promotion. Unions. The company will use its best efforts to obtain the cooperation of any unions with which it has collective bargaining relationships to increase minority and female opportunities within the unions, and to effect referrals of minority and female employees by such unions. 1.1 The company will cooperate with unions, as appropriate, to develop joint training programs aimed at qualifying more minority and female employees for membership in the unions and increasing the skills of minority and female employees so that they may have the 5 opportunity to qualify for higher paying employment. 2. The company will encourage the incorporation of an equal employment opportunity clause into any union agreements stating that such unions will be bound contractually to refer applicants without regard to race, color, religion, sex, national origin, or disability. ' 3. In the event a union is unable to refer minority and female applicants as requested by the company within the time limit set forth in a union agreement, the company will, through its own recruitment procedures, fill the employment vacancies without regard to race, color, religion, sex, national origin, or disability, snaking every effort to obtain qualified female employees, 4. The company will provide immediate written notification to the Director when a union with which it has a collective bargaining agreement fails to refer a minority or female, or when the company has other irilorrnaftion that the urdo l re10'rral process is nnipeding its of or is to meet its obligations. Subcontracting 1. When required by federal contract the company will use its best effort to utilize minority group subcontractors, suppliers and vendors. The company, however, reserves the right to determine if the firm is a bona fide Minority Business Enterprise, 2. The company will use its best effort to assure subcontractor compliance with equal employment opportunity obligations through monitoring and enforcement of "Section 21 - Recourse by Contractor" and "Section 22 - Indemnity Clause for Equal Employment Opportunity Violations" contained in Griffith Company's construction subcontract. Records and Reports 1. The company will keep such records as are necessary to determine compliance with its equal employment opportunity obligations. The records kept by the company will be designed to indicate: (a) The number of minority, non -minority and female group member employees in each work classification. (b) The progress and efforts being made (in cooperation with unions, if appropriate) to increase protected group employment opportunities. (c) The progress and efforts being made in locating, hiring, training, qualifying and upgrading protected group employees. (d) The progress and efforts being made in securing the services of minority group subcontractors. 2 2. All such records will be retained for a period of three years following completion of the contract work and shall be available at reasonable times and places for inspection by authorized representatives of the State and Federal governments. The company reserves the right to require these representatives to show proper credentials. 3. The company will submit all reports required by Executive Order 11246 and appropriate state and federal agencies, and will permit access to its books, records, and accounts by the appropriate governmental agencies and the Secretary of Labor for purposes of investigation to ascertain compliance with the rules, regulations and orders of the Secretary of Labor promulgated pursuant to Executive Order 11246. Other Work. The company agrees that it will be bound by the Equal Opportunity Clause required by Executive Order 11246 with respect to its own employment practices when it participates in nonfederal construction work during which time it also has a federally -assisted or direct federal contract. Assistance in Compliance. The company agrees it will assist and cooperate actively with the appropriate governmental agencies and _ the, Secretary of Labor in obtaining the compliance of contractors and subcontractors with the Equal Opportunity Clause and the rules, regulations, and relevant orders of the Secretary of Labor. The company will furnish such information as may be required for the supervision of such compliance. Non -Segregated Facilities. All employee facilities provided by the company shall be non -segregated. These include, but are not limited to, rest areas, parking lots, drinking fountains, and all other such common facilities. Toilets and necessary changing facilities will offer privacy to both males and females. Post -Award Compliance. It is understood that the OFCCP may review the company's employment practices as well as those of any subcontractors the company has employed during the performance of a federally -assisted or direct federal contract. If the goals for the employment of minorities and females set by the OFCCP are not being met, the company shall still be given an opportunity to demonstrate that it has made every good faith effort to meet its commitment. For the purpose of this policy statement, the term "minority" meads Black, Hispanic, Asian and Pacific Islander, American Indian and Alaskan Native. For the purpose of this policy statement, a bona fide Minority Business Enterprise is a business, firm, or corporation which is at least fifty one percent (51%) owned and operated by a minority person or persons. The purpose of the company's commitment to specific goals for the utilization of minority and/or female employees is to meet the affirmative action obligations under the Equal Opportunity Clause of a federal or federally -assisted contract. This commitment is not intended. and shall not be used to discriminate against any qualified applicant or employee. Refusal to Deal with Debarred or Ineligible Contractors or Subcontractors. The company agrees that it will refrain from entering into any contract or contract modifications subject to Executive Order 11246 with a contractor or subcontractor debarred form or who has not demonstrated eligibility for direct federal or federally -assisted construction contracts pursuant to Executive Order 11246. 7 Griffith Company will use its best effort to meet the goals set forth in the contract specifications. Complaints of non-compliance and grievances are to be directed to the attention of the company's designated Equal Gpp.oitunity Officer: Gordon M. Csutak Griffith Company 3050 E. Birch St. Brea., CA 92821 (714) 984-5500 CEO. and r14alir, . AI+t>a B d 'TL J �.�'. „tn A•. l liliGj L. GJJ, LiLV G111U VIIG{Ill llGlll !lALll�. � Val" Griffith Company Company Name February 1201 b Date 9 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment EXHlBrr 15-G CoNsmumoN CoNTItACT DBE COMMITMENT 1. Local Agency: The City of Huntington Beach 2. Contract DBE Goal: 6% 3: Project Description: Pavement Resurfacing and/or Rehabilitation Projects 4, Project Location: Adams Ave. /Beach BI. to Newland St. and Atlanta Ave. / Beach BI. to Newland St. 5. Bidder's Name: Griffith Company 6. Prime Certified DBE: ❑ 7. Bid Amount: �' 1f 6Sr �t4fi. 50 8. Total Dollar Amount for ALL Subcontractors::73 9. Total Number of ALL, Subcontractors: 10. Bid Item 11. Description of Work, Service, or Materials 12' DBE Certification 13. DBE Contact Information 14, DBE Dollar Number Supplied Number (Must be certified on the date bids are opened) Amount C,ALAV-004411k 'Pf10p6SS1WJA•L N6ettJE8P�INCT ib 2S (W5-TALL-t•R•AVptr— G16tNhl- L00'PS 311:?:?- WZYoTrG, 4►N�AVea uNT � �lC"sgO.eo btfe- Bic - \•33s 6 ►$ tt3 Iw, J,% 42 tS p.��� �C20 \C�M6NT f�TcN1-/tiL W� O PBPAn R•?• LA LcN De 250a N. Pa.M DPwfr Surf aw ZY ENWtv66R-S �$8'l. S�r�ruA� H►4L , G.A 't"SS %2- Sa5-6655 8� 222. 13 IA tc3,,�62•Z 21. Local Agency Contrail Plumber: CC-1502 15. TOTAL CLAIMED DBE PARTICIPATION 22. Federal -Aid Project Number. STPL-5181(188) M a7o 23. Bid Opening Date: 24. Contract Award Date: IMPORTANT: identify,all D firms being claimed for credit, regardless of tier 'Na f First Tier DBE Subcontractors and their respectiv item f wo listed above must be consistent, where appii a the mes and items of the work In the Local Agency certifies that all DBE certifications are valid and Information on "Subco it' or sub ed with our bid. Written confirmation of this form Is complete and accurate. each [is d s 05/02/2017 25. Local Agency Representative's Signature 26. Date 16. Prro is gnature 17. Date �Ltfc alker 562-929-1128 27. Local Agency Representative's Name 28. Phone /I8. a er's Name 19. Phone V• resident / Regional Mana er 29. Local Agency Representative's Titie reparer'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 disabftities, this document is available In alternate formats. For information call (916) 854-6410 or TDD (916) 654- 3880 or write Records and Forts Management, 1120 N Street, MS-89, Sacramento, CA 95814. Page 1 of 2 July 23, 2015 C-23 From: 05/09/2017 12:18 #639 P.001/001 F,AX ED caniornia essional Engineering, Incl Estimate Number Project Name: AdamsAve-AtianticAve Project #: Agency: HUNTINGTON BEACH Bid Due Date: 51912017 929 Otterbein Avenue Unit E La Puente, CA 91748 License # 793907 Exp: 04/30/2017 Classifications: A C-10 C-20; 8A Certified LSBE Certified LA County #54567 Exp: 10/31/2016 SBE Certified DGS #54567 Exp: 10/31/2016 SMBE/DBE/UDBE Certified Caltrans #31277. Exp: - DIR #1000001980 Exp.06/30/2017 Union Signatory *Certifications subject to verification by quote recipient. Bid Due Time: 2;OOpm Conditions Set Forth: 1. Estimate Based On One (1) Mobilization Only Unless Otherwise Noted. Additional Mobilizations at $3,500.00/ea. 2. If Loop Work Quoted: Loop Stub -Out Must Be Existing & Marked If Not Called Out To Replace Per Plans; Cat -Tracking Must be Approved Prior. 3. At Least 2-Weeks Notification Required For Any Loop Work. i-Work Day Based on Eight (8) Consecutive Work Hours per Day. 4, If You Are The Lowest Bidder & Listed CPE, Please Inform Us Within 48 Hours. Electrical Material May Also Contain Long -Lead Items. S. Quote Valid For: 30 Days; California Professional Engineering, Inc. reserves the right to revise quotation as necessary, 6"PE urt -dzd "C 4 t4o 64 rn a- to 04ad &9M a-d/'n chatariae #bred aeeMda.ce tCe g444 a4d a¢ aaBG e"" �411�i f FplescjnpUt392°. 16 1 INSTALL NEW DETECTOR JLOOPS. SPLICE LOOPS TO DLC IN PULLBOX. 18 INSTALL NEW DETECTOR LOOPS. SPLICE LOOPS TO DLC IN PULLBOX EA i 52 210.00 10,920.00 EA 22 210.00 4,620.00 i _..... Exclusions: Bond &Bond Premium; All Permits; All Training Requirements; Sig nag e; Lane Closure Request, Traffic Control, and Traffic Con.trtrI o.I.._ PI - an; Water; Sidewalk Concrete; Regulatory Signs; Stake and/or Survey; Pedestrian Barricade; Hauling Dirt, Debris, & Concrete Foundation Away; All Concrete Work; Handicap Ramps; Repaving Street; Repaving Potholes; USA Marking Removals; Irrigation Work, Striping; Cold Mix; Any Inspection Fees; Detector Cards; DLC's; Temporary Loops; Temporary Signal; And/Or High Voltage Line Conflicts, Unless Otherwise Noted Above. Certificates of Insurance will be provided upon award of subcontract - any change in company standard verbiage may or may not be available depending on our current carrier. Terms: Unless other arrangements are made, payment is due & payable withinin 30 days upon completion; 1.5% monthly interest will apply thereafter. Sid based on entire bill of material and services and is inseparable unless written authorization is provided by CPE. Acceptance _...._....__-- TOTAL: $15,540.00 P17 (626) 810-1338 Fx: (626) 810-1322 Email.• van@cpengineeringinc. com 1-MALONOR EQUI PENTAL T-' LALONDE EOUIPI,,�Elv, 7P,,,,,4.,%,D EXCAVATORS NOUN,uv CAT 303 / JD350 MINI EX CAT 308 / JD85 MINI EX CAT 314 / JD 135 CAT 320 CA T321 /KOM 228 / DOOSAN 235 -.ZERO TAIL SWING CAT335 ICAT 3281 VOLVO 305 IKOM PC308 - ZERO TAIL SWING CAT 3361CAT ;aft 1HIT 350 CAT 349 / CAT 3451HIT 4701HIT450 IKOM PC490 HIT 67011-IIT650 HIT 850 170 185 205 225 230 240 250 260 325 360 EXCAVATORS LONG REACH, RUBBER TIRE HOURLY CAT M322D / DOOSAN 210 / VOL VO 210 RUBBER TIRE CAT 32613241320 LONG REACH 235 240 ,elCAVATOP ATTACHMENTS HOURLY HYD THUMB I GRAPPLE COMPACTION WHEEL (320) COMPACTION WHEEL (330) COMPACTION WHEEL (345) MINI -EX BREAKER 4,500LB. / 5,500LB BREAKER 6,5001_B, / 7,500LB. BREAKER 10,OOOLB. BREAKER 13,OOOLB. BREAKER HYD. PULVERIZER (320) HYD. PULVERIZER (330) HYD, PULVERIZER (345) 40 60 70 80 50 110 140 170 185 135 140 ISO HOURLY DEERE 410 / CA T 430 / CASE 590 DEERE 710 / CA T 450 175 190 BACKHOE A TTACHMENTS HOURLY COMPACTION WHEEL SWIVEL VIBE PLATE BREAKER 55 35 70 80 BLADES HOURLY CAT 140MIDEERE 672E 190 DOZERS HOURLY DEERE 450J /DUAL SLOPEBOARD S, DEERE 850K i SL OPEBOAPD CAT D-6TISLOPEBOARD 185 210 215 SKIP LOADERS HOURLY JOHN DEERE 210 SKIP LASER RECIEVER 170 20 HOURLY CAT2269 BREAKER ISWEEPER 155 50 '!V� i'-L L04DERS' HOURLY CAT938 CAT 950 CAT966 CA T 980 SKELETON Bi(T I FORKS 4 IN I BUCKET/SIDE DUMP 185 195 210 220 20 25 A c K-L'O A D Q 'S HOURLY CAT 963C 230 POL -EPS HOURLY CAT CS54 / VOLVO SO? 158 84"SMOOTH CAT CP56 / VOLVO SD1 158 84 PADDED 185 190 -OPERA'OrORTIPVIE:: ,>,,F- ""OPERATOP OVEE1=1`1114F RATE:550'HR- a LJ1Qr Bare Operated Weight Day Week Month Rentals Cat 3031 JD 351)ofis;>t 7.500 5300 S1,200 S3,600 5160 Breaker 25f 1.000 3,000 40 Cat 308 / JD 85 18,000 5400 51,600 54,800 5175 Breaker 30Of 1,200 3.C,00 ..0 Compaction ivh` 4 125 .500 1.50i1 40 Cat 314 / JD 135 30.000 S475 51.900 55,700 5195 Breaker 325 1.300 3.900 70 Compaction wheel 125 500 1.500 .5 Thumb bucket Ir0 600 1.800 25 Cat 320 45,000 S600 52.400 $7,200 5215 Breaker 17� 1.90u 5.70Q 100 Compaction wheel 150 600 1,800 50 Thumb bucket 195 780 2.340 30 Cat 3201324 Long Reach 45.000 5750 $3,000 59,000 5220 Cat 321 / Kom 228 zero tart sv.;nq 50,000 S650 52.600 57,800 5220 Breaker 475 1,900 5,7(10 100 Compaction •.-!heel 150 600 1.800 50 Thumb bucket 195 780 2.340 30 Hyd. pulverizer 500 2.000 6.000 125 Cat M322 Wheel Exc 45.000 $725 52.900 58,700 S225 Breaker »75 1.900 5.700 100 Compaction wheel 150 600 1.800 50 Thumb bucket 195 780 2.340 30 Hyd. pulverizer 500 2,000 6.000 125 m 308 pro tar avan:.l 70,000 S725 52.900 S8,700 S225 Breaker A75 1.900 5.700 100 Compaction wheel 150 600 1,800 50 Thumb bucket 195 780 2,340 30 Hyd. pulverizer 500 2.000 6.000 125 Cat 328 zero tali swing 75,000 S800 $3,200 S9,600 5230 Breaker 750 3.000 9.000 130 Compaction wheel 175 700 2.100 60 Thumb bucket 195 700 2.340 30 Hyd. pulverizer 700 2.800 8.400 130 Cat 336 / Hit 350 80,000 S850 53,400 510.200 S240 Breaker 750 3.000 9,000 130 Compaction wheel 175 700 ', too 60 Thumb bucket 195 780 2,illo 30 Hyd. pulveraaer 700 2,800 13,10E 130 Cat 349 / Hit 470 100.000 $1.050 S4,200 512.600 5260 Breaker 950 3.€100 ll.100 160 Compaction wheel 200 800 2,400 70 Hyd. pulverizer 850 3.400 10,200 140 Skelton bucket 150 600 1.800 20 Cat 365 / Hit 650 150.000 S1,550 56,200 518,600 5315 JD 800 / Hit 850 175.000 57,500 522.500 5350 Bare Day Week Month Additional buckets/V / skeleton S50 5200 S600 -ippershank 150 600 1,800 ripple 175 700 2.100 Shear.Vib Hammer,Vib Plate Price on request Operator time $105 Overtime rate $50 Revision Date July 2014 :H111] I Ist:-NO46 1ILq&mAWVe4 EQUIPMENT REMTAL (562) 595-6655 fax (562) 595-8833 A I Bare Operated Day Week Month Rentals Case 590 4X4 4101 S300 S1,200 S3,600 S165 Breaker 250 1.000 3.000 50 Compaction wheel 125 500 1.500 40 Cat 450 / JD710 4.4 4ml S450 S1,800 $5,400 SIN Breaker 325 1,300 3.900 70 Compaction wheel 125 5D0 1.500 45 Swivel 95 380 1.140 25 Vib Platc 300 1.200 3.600 60 Bare Operated Day Week Month Rentals Skidsteer S250 S1,000 S3,000 S145 Breaker 225 900 2.700 -10 Sklploader4.44inl S275 S1,100 S3.300 S160 Laser receiver 100 -100 1,200 10 Cat938 S500 S2-0013 ss-nnn 5175 Cat950 S600 S2,400 S7,200 S185 41n I Bucket 1010 .100 1.200 15 Forks 7w 300 900 10 Side Oump 1100 400 1,200 15 Cat966 S775 S3,100 S9,300 S200 Forks -15 300 900 10 Cat 980 S1,050 S4.200 S12,600 S210 Cat 939Track 4,.IqW, S500 S2.000 S6,000 S175 Cat 963 Track 4.n 1 14*,,, S900 S3,600 S10,800 S220 Bare Operated Day Week Month Rentals JD 450mm niopor np1mv S500 S2,000 S6,000 S175 Laser receiver 100 400 1.200 1 C JD 850 f, a,, 5bpeboam rqw., S725 S2,900 S8.700 S200 Cat "T :. ffj nffxsr S800 $3,200 $9,600 S205 Cat 140 Made S650 S2,600 S7,800 S180 Laser 250 1.000 3.000 30 Tracer 75 300 900 10 Cat CS 54 w. Cat CP 56 e... parlfjv! DBEMBE/SBE Bare Operated Day Week Month Rentals S450 S1,800 $5,400 S175 S475 S1,900 S5,700 S180 :,oin us on Bid Bond CONTRACTOR: (Name, legal sialus and address) Griffith Company 12200 Bloomfield Avenue Santa Fe Springs, CA 90670 OWNER: (Nance, legal status and address) City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 BOND AMOUNT: 10% Document A310 TM - 2010 Conforms with The American Institute of Architects AIA Document 310 SURETY: (Name, legal sialus and principal place of husinexx) Liberty Mutual Insurance Company 790 The City Drive South, Suite 200 Orange, CA 92868 Mailing Address for Notices Same as Above Ten Percent of Amount Bid This document has important legal eonsequences. Consultation with an attorney is eneouraged with respect to its eompletion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be eonsidered plural where applicable. PROJECT: (,Vane, location or address and Project number. ifant) Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, CC No. 1502 The Contractor and Surety arc bound to the Owner in the amount set forth above, for Ilia 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 arc suet that if the Owner accepts the bid of the Contraetor within the time specified in the bid doeunlcnts, 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 aecordance kith the terms of such bid, and gives such bond or bonds as may be speeited 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 perforrnanee ofsuch Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exeeed ilia amount of this Bond, between the amount specified in said bid and such larger amount for whieli the Owner may in good faith eontract with another party to perliorni the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full Ibrce and ellect. The Surety hereby waives any notice ol'an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surely shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time liar acceptance ol'bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent lbr an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the temi Contractor in this Bond shall be deemed to be Subcontractor and ilia term Owner shall be dccmcd to be Contractor. When this Bond has been liimished to comply with a statutory or other legal requirement in the location oflhe Pn)jecL any provision in this Bond conllicting with said slalulory or legal requirement shall be deemed deleted hereliT'an revisions cunliirniittg to such statutory or other legal requirement shall be deemed incorporated herein. When so famished, the t le t is that this Bond shall be conslnted US a statutory bond and not us a common la%v bond. Signed and scaled this 2nd day of May, 2017. H— Griffith Cc (Principal) ri,;t„ass) Sta-rr N. Stallings - Asst. Secretary ry By. (fiile) k/ (Seal) I Walker, W/Reglonal Mqr LibertN Wu4 Insurance C (Seal) llPrtnesay Kim Luu By. �.1',U , (Title) Heather Saltarelli , Attorney -in -Fa S-0054tAS 8t10 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT 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 May 5, 2017 before me, Tracey A. Novak, Notary Public Date Here Insert Name and Title of the Officer personally appeared Lucas J Walker 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 TRACEY A. NOVAK Notary Public -California Z Los Angeles County D Commission # 2185107 My Comm. Expires Mar 27, 2021 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. /l C�d'I.UV Signature Signs re of NgAry Public OPTIONAL Though the 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: Bid Bond.......... City of Huntington Beach bid document Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Lucas J Walker Signer's Name: XQCorporate Officer -- Title(s): Vice President/Regional Manager nCorporate Officer -- Title(s): Individual Partner --- Limited 0 General Attorney in Fact ❑ Trustee ❑ Guardian or Conservator Other: Signer is Representing: Griffith Company RIGHT THUMBPRINT OF SIGNERTop of thumb here, " Individual Partner --- ❑ Limited ❑ General Attorney in Fact Trustee Guardian or Conservator Other: Signer is Representing: © 2014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) - Item #5907 CALIFORNIA• •, c,t!rrn�'..i. s,a,��t.1:<+.t.sa�r s.t.+. .v,c: r:.r<c we.wr .. sue.✓.rNs,t!�r. :ass, .. t.:: :�NrN::rtnc�a• :a�^c �t� �r!s, w.•:.,r•ar!c:e -n ot. �t!ar�� A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of Orange ) On MAY Q 92017 before me, Jeri Apodaca, Notary Public Date Here Insert Name and Title of the Officer personally appeared Heather Saltarelli Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(* whose name(} is/ew subscribed to the within instrument and acknowledged to me that Wshe/tom executed the same in his/her/tbek authorized capacity(im), and that by I)pdher/daeir signature( on the instrument the person($), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Califomia that the foregoing paragraph is true and correct. t, . ~ A�JERI APODACA WITNESS my hand and official seal. 'Commission # 20E1689 z Notary Public - Californla z z Orange County r Signature 6' My Comm Expires Oct 12, 2018 . Sign of Not ry 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: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer — Title(s): Partner — C Limited ' �t General Individual Lx Attorney in Fact Trustee C! 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: ©2014 National Notary Association • www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 7680751 m C +� cc -a co d = L cn v d) *_ O O cc d ++ cc d � C N t9 O do ++ 0 C cc L d) r CD in cc L O ,S E O cc 'p A = v cc C > am .a.a L O :3 Z U Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Heather Saltarelli; James A. Schaller; Jeri Apodaca; Kim Luu; Maria Guise; Michael D. Parizino; Rachelle Rheault; Rhonda C. Abel all of the city of NewportBeach , state of CA each Individually if there be more than one named its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as. its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the. president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney, has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 21 st day of March 2017 s} The Ohio Casualty Insurance Company Liberty Mutual Insurance Company 1912 ° 1991 WestAmerican Insurance Company STATE OF PENNSYLVANIA ss COUNTY OF MONTGOMERY David M. Carey, Assistant Secretary On this 21st day of March , 2017 , before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. St, PAS, COMMONWEALTH OF PENNSYLVANIA�G/��, i4oN.vg4l<< Notarial Saul h o 2 Teresa Pasteila. Notary Public By: --_— oF Upper MarionTwp., Montgomery County Teresa Pastella, Notary Public My Commission Expires March 28, 2021 ++i vNSYL`1P� fir Mernbcr, Pennsylvanialassociation cf Nolarics This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV— OFFICERS — Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts — SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the, president and attested by,the secretary. Certificate of Designation — The President. of the Company, acting pursuant to the Bylaws:of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any: and all undertakings; bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of anypower of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and ;West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full {rue and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. M A/iV O q IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day of I 4 2��� 20 (ji,!r y \S up 1991 Renee C. Llewe ssistant Secretary LMS_12873_022017 46 of 500 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 July 21, 2017 R. J. Noble 15505 E. Lincoln Ave. Orange, CA 92856 RE: Adams Ave. & Atlanta Ave. Rehabilitation — CC-1502 Enclosed please find your original bid bond for CC-1502. Sincerely, M!F'1 Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan o Waitakere, New Zealand CITY OF 14UNTINGTON BEACH CITY CLERK 2NDFLOOR 2000 MAIN STREET 14UNTINGTON BEACH/ CA 92648 ADAMS AVE REHAB & ATLANTA AVE REHAB CC NO. 1502 STPL 5181(188) HUNTINGTON BEACH 81 D DATE MAY 09, 2017 TIME. 2:00 PM City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 1, 2017 Notice To All Bidders: Please note the following clarification to the Specifications: 1) Specification Book Replacement Pages A-2, E-6 & E-31 (3 Sheets) Replace page "A-2" with new page "A-2 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Added paragraph explaining that CONTRACTOR shall submit first invoice three working days after the Notice to Proceed. Replace page "E-6" with new page "E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: Revised Section 2-11 Inspection with new labor rates for Special Inspection Fees. Replace page "E-31" with new page "E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31" (1 sheet). Reason: New Section 302-9 regarding the placement of ARHM with a Shuttle Buggy, a material transfer device. This is to acknowledge receipt and review of Addendum Number One, dated above. R.J. NOBLE COMPANY Company Name 05/01/2017 Date X By STEVE ME ZA, S ETARY All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. Addendum 1, CC-1502 No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A one week urior to the federal -aid contract award by City Council. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. All extension of unit prices will be subject to verification by the AGENCY. In case of a variation between the unit price and the extension, the unit price will govern. Project Description: The project consists of the following street segments (1) Adams Avenue from beach Blvd. to Newland Street; and (2) Atlanta Avenue from Beach Blvd. to Newland. The proposed improvements includes grinding the existing pavement; removing failed roadway sections and replacing with new base course asphalt concrete (AC) and new finish course rubberized asphalt concrete (RAC); removing/installing concrete curb and gutter; cross gutters, sidewalk and access ramps; adjusting manholes and monitoring well covers, adjusting survey monuments; replacing and adjusting water valve assemblies to grade; removing trees that have uplifted sidewalks and installing new trees; and installing traffic loops and striping. The contract shall allow the Contractor 65 working days to complete the contract. Atlanta Avenue construction shall commence after substantial completion (as determined by AGENCY) of Adams Avenue project. Both shall be constructed within the allowable total working days. The Project Disadvantage Business Enterprises (DBE) goal is 6.0% 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. This project has a Requirement for the FIRST INVOICE to be processed by date certain. Therefore, the following schedule shall be adhered to by the AGENCY and the CONTRACTOR: FIRM DATE ACTION REQUIRED On June 5, 2017 The AGENCY shall award contract to CONTRACTOR selected. On or Before June 15, 2017 The CONTRACTOR shall attend the Pre -Construction Meeting. On or Before July 10, 2017 The AGENCY shall issue the Notice to Proceed to CONTRACTOR. On or Before July 14, 2017 The CONTRACTOR shall submit 1" Invoice for Project to AGENCY. 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 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31 Addendum 1, CC-1502 2-10 AUTHORITY OF BOARD AND THE ENGINEER [Add the following]. The Contractor shall give at least 24 hours advance notice when he or his subcontractor will start or resume the work. The above notice is to be given during working hours, exclusive of Saturday, Sunday or AGENCY holidays for the purpose of permitting the Engineer to make necessary assignments of his representatives. 2-11 INSPECTION. [Replace the second sentence with the following.] The Contractor shall notify the Engineer 48 hours before inspection is required. If the Contractor elects to work under this contract more than 8 hrs./day or more than 40 hrs./week, Saturday, Sunday, or AGENCY holidays, the Contractor shall arrange with the Engineer for the required inspection service and pay Special Inspection Fees which will be charged at the following rates: 4 hrs. or less/day - $484.00 4 hrs. to 8 hrs./day - $968.00 Holidays 4 hrs. or less/day - $ 584.00 4 hrs. to 8 hrs./day - $1,213.00 When Special Inspection is required, the Contractor shall notify the AGENCY and pay inspection fees 24 hours in advance. If the Contractor is directed by the AGENCY to work under this contract more than 8 hrs./day or more than 40 hrs./week, the Special Inspection fee requirements will be waived. E-6 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31 Addendum 1, CC-1502 Cracks %4 inch and greater shall be cleaned for the entire crack depth using sandblasting, brushing, and air blowing techniques as required to provide a crack free from all debris, dust, loose material and moisture. Gouging or plowing may be required to remove incompressible debris in the crack. The cleaned crack shall be filled with granulated tire rubber, plasticizer and filler, as manufactured by Crafco as Polytlex Type 3, or approved equal. All crack filler material shall be in conformance with the following specifications: ASTM D6690 (formerly ASTM DI 190), AASHTO M324 Type I (formerly AASHTO M 173) for "Joint and Crack Sealant, Hot -applied, for Concrete and Asphalt Pavements," and Federal Specification SS-S-164. All holes shall be cleaned of loose materials and filled with Type III-C3 PG 64-10 asphalt surface course and compacted to a smooth even surface with the adjacent existing pavement. 302-5.10.1 Crack Sealing Payment. [Add the following subsection 302-5.10.1:]. Payment for Crack Sealing shall be included in the bid price for other items of work unless there is the contract unit bid price for crack sealing which shall include full compensation for application of sealant and no additional compensation will be allowed therefor. 302-9 ASPHALT RUBBER HOT MIX (ARHM) 302-9.10 Material Transfer Device (Shuttle Buggy). [Add the following]. 302-9.10.1 General [Add the following]. In order to reduce asphalt consolidation which, once laid is difficult to repair leaving rock pockets and a weakened roadway pavement section. The Shuttle Buggy shall be used for the placement of ARHM. The material transfer device speed shall be adjusted to the speed of the paver to maintain a continuous, nonstop paving operation. 302-9.10.2 Materials and Equipment. [Add the following]. The Shuttle Buggy shall have a minimum surge capacity of 15 tons, shall be self propelled and capable of moving independent Of the paver, and shall be equipped with the following: (a) Front -Dump Hopper and Conveyor. The conveyor shall provide a positive restraint along the sides of the conveyor to prevelr material spillage. Shuttle Buggies having paver style hoppers shall have a horizontal bar restraint placed across the fifl& d. wings which prevents the wings from being folded. (b) Paver Hopper Insert. The paver hopper insert shall have a minimum capacity of 14 tons. (c) Mixer/Agitator Mechanism. This re -mixing mechanism shall consist of a segmented, anti- segregation, re -mixing mtger ur M full-length longitudinal paddle mixers designed for the purpose of re -mixing the ARHM. The longitudinal paddle mixers shal I be located in the paver hopper insert. 302-9.10.3 Structures. [Add the following]. fhe Shuttle Buggy may be allowed to travel over structures under the following conditions: (a) Approval will be given by the Engineer. (b) The vehicle shall be emptied of ARHM material prior to crossing the structure and shall travel at crawl speed across the structure. (c) The tires of the vehicle shall travel on or in close proximity and parallel to the beam and/or girder lines of the structure. E-31 Addendum 1, CC-1502, Replacement Pages A-2, E-6 & E-31 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO For ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) in the CITY OF HUNTINGTON BEACH May 3, 2017 Notice To All Bidders: Please note the following Clarification to the Specifications: 1) Specification Book —ADD APPENDIX O- Bridge Deck Membrane Specification Pages 0-1 thru 0-9 (9 Sheets) Add new pages "APPENDIX O PAGE 1 ADDENDUM 2, CC-1502" through "APPENDIX O PAGE 9 ADDENDUM 2, CC-1502" TO SPECIFICATIONS (9 sheets). Reason: Add New Appendix O to clarify the type of Bridge Deck Membrane Material for Atlanta Avenue bid item #27 and for Atlanta Avenue Construction Note 20. This is to acknowledge receipt and review of Addendum Number Two, dated above. R.J. NOBLE COMPANY Company Name 05/03/2017 Date X X)�dvr�'11 By STEVE MT DOZ ECRETARY All bidders must acknowledge and include the receipt of this Addendum with your bid proposal. For Addendum questions, please call James Wagner at (714) 536-5467 within 24 hours of posting. SECTION C PROPOSAL for the construction of ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO. 1502 FEDERAL AID PROJECT STPL-5181(188) 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 65 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find 10% BIDDER'S BOND in the amount of ---------------------------which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond 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 NO. I MAY 01, 2017 X NO. 2 MAY 03, 2017 STEVE ME ZA, CRETARY X STEVE VEND07SEC TARY G2 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO.1502 FEDERAL AID PROJECT STPL-5181(188) PROJECT BASE BID• Basis of Award ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ......................................... C-2.2 to C-2.8 ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET ........................................ C-2.9 TO C2.14 1. ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET BID IN FIGURES 2. ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET $ 7�i y 8�, 0-0 BID IN FIGURES BASE BID TOTAL AMOUNT LUMP SUM BID IN FIGURES: (TOTAL FOR ITEMS 1 AND 2) $ I,g-74-,5577,0-o BASIS OF AWARD C-2.1 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO.1502 FEDERAL AID PROJECT STPL-5181(188) ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO. 1502 C-2.2 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. DescriptionQuantity UnR Price Amount 1 -- MOBILIZATION 1 LS $ 3 Z,000 , o o $ 3 z, o 0o, do 2 - - TRAFFIC CONTROL PLAN 1 LS $ 500.00 $ 500.00 3 __ FURNISH PROJECT TRAFFIC CONTROL 1 LS $ 24,o o o ov $ Z4; oao. oa 4 - - FURNISH AND INSTALL SIGNING AND STRIPING 1 LS $ Z.lt? 000 o a $ z-o, 000. 0 0 5 - - PROJECT SPECIFIC SWPPP 1 LS $ 17,000.00 $ 17,000.00 REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN A88A FROM BCR TO ECR. (CASE SHOWN ON PLAN). 6 1 (INCLUDES ALL APPURTENANCES,CURB 9 EA $ 3,700.00 $ 33,300.00 GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,800 TN $ 7 1 ' 0 o 1, 2v0 ay PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. 7 EA $ 850.00 $ 5,950.00 8 5 ADJUST STORM DRAIN MANHOLE TO GRADE. 10 EA $ 850.00 8,500.00 REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 11 EA $ 850.00 $ 9,350.00 GRADE PER HB STD PLAN 612. C-23 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Contract Unit Extended No.. lCost Description Quantity Unit Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 22,400 SF $ O •3 4- $ -7, 6 1 t . o o SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. 12 INTENTIONALLY LEFT BLANK COLD MILL EXISTING AC. 13 8 PAVEMENT TO A DEPTH OF 0.34' FROM NEW FINISHED SURFACE 138,000 SF $ 01 - 3 4 1,4 ao . o o PER PLANS 14 INTENTIONALLY LEFT BLANK CONSTRUCT NEW 0.17' B-PG-70- 10-RAP A.C. BASE COURSE 15 8 OVER 95% COMPACTED 1,700 TN $( 7 0 0 $ i k 3 CA0 o• °- SUBGRADE PRIOR TO 0.17' HM OVERLAY, PER PLANS. 16 INTENTIONALLY LEFT BLANK SET SURVEY MONUMENTATION 17 9 ND PREPARE CORNER RECORD (PRE- AND/OR POST - 3 EA 350.00 5 1,050.00 CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=8"). (INCLUDES 18 10 SLOT PAVEMENT, AGGREGATE BASE, LOT DRAINS, AND ALL 900 LF $ 65.00 $ 58,500.00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING 19 11 SLOPE, RELOCATING 13,500 SF $ 6.00 $ 81,000.00 IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE. C-2.4 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. 1 DAM Quantity Unit prim Amount 20 INTENTIONALLY LEFT BLANK REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL l(W' DRIVEWAY/ALLEY APPROACH 21 12 AND TYPE SHOWN ON 690 SF $ 12.50 $ 8.625.00 PLAN) PER STD PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 13 (ITEM INCLUDES SLOT 2,170 SF $ 18.00 39,060.00 PAVEMENT, AGGREGATE BASE AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT MEDIAN CURB PER HB STD PLAN 2D7 (CF=8"). (INCLUDES 23 14 SLOT PAVEMENT, AGGREGATE 225 LF $ 45.00 10,125.00 BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) REMOVE AND RECONSTRUCT LOCAL DEPRESSION PER HB STD PLAN 302. (INCLUDES SLOT 24 15 PAVEMENT, AGGREGATE BASE, 1 $ 1,600.00 $ 1,600.00 AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 16 SIGNALS AND LIGHTING 52 EA $ 210.00 $ 10,920.00 SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE I'D" C-2.5 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bid Const contract unit Extended No. No.FANDROOTS Description Quantity Unit Price Amount E EXISTING TREE AND GRIND TREE STUMP TO 240 BELOW TOP Z6 17 OF SIDEWALKIGRADE WITHIN 44 EA 4. oo . o o $ $ 61,600.00 PROPOSEDIMPROVEMENT AREA PULL OUT ALL ROOTS WITHIN PROPOSED IMPROVEMENTS. 27 INTENTIONALLY LEFT BLANK FURNISH LABOR, EQUIPMENT, D GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 18 BY AGENCY. (INCLUDES ALL 2600 SF $ 0.85 $ 2,125.00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 29 19 IDENTIFIED BY CONTRACTOR 90 Cy $ 100.00 $ �,000.00 D VERIFIED BY AGENCY. JUST EDISON VAULT/MANHOLE TO GRADE BY 30 20 EDISON. CONTRACTOR TO 3 EA NOT A CONTRACTOR COORDINATE WITH ERICK OEN BID ITEM AT (714) 895-0242. 31 INTENTIONALLY LEFT BLANK JUST OCSD MANHOLE TO GRADE PER OCSD STD. PLAN S- 32 21 053, S-054 AND S-055. 1 EA $ 850.00 $ 850.00 CONTRACTOR TO COORDINATE WITH MIKE BOLSTER AT (714) 593-7645. 33 22 JUST MONITORING WELL 2 EA 850.00 $ 1,700.00 $ COVER TO GRADE. C-2.6 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Old Corot Contract Unit Extended No. No. DescriptionQuantity Unit Prig Amount FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716,718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 57,600.00 34 23 BUSHES OR GROUND COVER 48 EA $ 1,200.00 $ AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). FURNISH AND PLANT NEW VY BROWN TRUNK HEIGHT TRACHYCARPUS FORTUNEI PALM TREE PER HB STD. PLANS 714, 715, 716, 718&719AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF 35 24 EXISTING LANDSCAPING, 6 EA $ 1,200.00 $ 7,200.00 BUSHES OR GROUND COVER D IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). C-L7 ADAMS (BEACH - NEWLAND) PROJECT BID SCHEDULE Bld Const Contmd Unit Extended No. No. Dwalption Quantity Unit Fri" Amount CONSTRUCT AND / OR REMOVE AND RECONSTRUCT 4" THICK PERVIOUS COLORED STAMPED CONCRETE IN MEDIANS PER 36 25 SPECIFICATIONS AND HB STD 780 SF 12.50 $ $ 9,750.00 PLANS 711. (ITEM INCLUDES REMOVAL OF EXISTING GROUND COVER, AND SLEEVING OF EXISTING IRRIGATION LINES.) FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 - - EQUAL COATING ON THE NEW 3 EA 650.00 $ 1,950.00 $ CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ °t -7 , 3-7 1. a o I Total Amount Bid in Words: 'E,54 L,�,.� N; �¢, �e ,�,, �►� r 1 T Seve"-j o� D. C-2.8 SECTION C PROJECT BID SCHEDULE ADAMS AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET AND ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET, CC NO.1502 FEDERAL AID PROJECT STPL-5191(lU) ATLANTA AVENUE REHABILITATION FROM BEACH BOULEVARD TO NEWLAND STREET CC NO.1502 C-2.9 ATLANTA (BEACH-NEWLAND) PROJECT WD SCHEDULE Bid Const Contrail Unk Extended No. No. DowA Quantky Unit Prim Amount 1 -- MOBILIZATION 1 LS $ `52/0 6 0 .0 0$ 3 z, 0 0 0 .0 0 2 - - TRAFFIC CONTROL PLAN 1 LS $ 500.00 $ 500.00 3 -- FURNISH PROJECT TRAFFIC CONTROL 1 LS $ t S, o o o- o o $ t. s, o o a. o o 4 -- FURNISH AND INSTALL SIGNING AND STRIPING 1 LS $ t g, o o o• 0 6 $ t g, o o c- o o S - - PROJECT SPECIFIC SWPPP 1 LS $ 17,000.00 $ 17,000.00 REMOVE AND RECONSTRUCT CURB ACCESS RAMP, DEPRESSED CURB, AND GUTTER PER CALTRANS STD PLAN ASSA FROM SCR TO ECR. (CASE SHOWN ON PLAN). S 1 (INCLUDES ALL APPURTENANCES,CURB 3 EA $ 5,200.00 $ 15,600.00 GUTTER, DEPRESSED CURB, SIDEWALK, DOMES, RETAINING CURB, SLOT PAVEMENT, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) 7 3 CONSTRUCT A 0.17' ASPHALT RUBBER HOT MIX (ARHM) WET 2,6W TN $ 7 9 - o $ Z 0 5,4 oo. oo PROCESS OVERLAY. 8 4 ADJUST SEWER MANHOLE TO GRADE. 12 EA $ 850.00 $ 10,200.00 9 5 ADJUST STORM DRAIN MANHOLE TO GRADE. 2 EA $ 850.00 $ 1,700.00 REPLACE WATER VALVE BOX 10 6 ASSEMBLY AND ADJUST TO 23 EA $ 850.00 $ 19,550.00 GRADE PER HS STD PLAN 612. C-2. 10 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit Extended No. No. DowAption Quantity Unk Price Amount COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 11 7 TO ZERO FROM NEW FINISHED 36,400 SF $ 0 • 4- $ 3 '7 6.0 0 SURFACE PRIOR TO 0.17' ARHM OVERLAY PER PLANS. COLD MILL EXISTING A.C. PAVEMENT TO A DEPTH OF 0.17' 12 8 FROM NEW FINISHED SURFACE 13,700 SF $ - 2 $ 3i 736 • o 0 PRIOR TO 0.17' ARHM OVERLAY, PER PLANS. COLD MILL EXISTING A.C. 13 9 PAVEMENT TO A DEPTH OF 0.34' 49,900 SF $ 0- Z $ to/ Ci 7g - ° O FROM NEW FINISHED SURFACE PER PLANS. COLD MILL EXISTING A.C. 14 10 PAVEMENT TO A DEPTH OF 0.67' 7,300 SF $ (9 ` -2 Z $ 1, 6 0 G . 0 0 FROM NEW FINISHED SURFACE PER PLANS. CONSTRUCT NEW 0.17' AND 0.50' B-PG-70-10-RAP A.C. BASE 611000.00 15 9 & 10 COURSE OVER 95% 1,000 TN $ COMPACTED SUBGRADE PRIOR TO 0.17' ARHM OVERLAY. RAISE SURVEY WELL MONUMENT TO GRADE AND 16 11 PREPARE CORNER RECORD 1 EA 1,200.00 $ 1,200.00 $ (PRE- AND/OR POST - CONSTRUCTION). SET SURVEY MONUMENTATION 17 12 AND PREPARE CORNER 4 EA $ 350.00 $ 1,400.00 RECORD (PRE- AND/OR POST - CONSTRUCTION). REMOVE AND RECONSTRUCT CURB AND GUTTER PER HB STD PLAN 202 (CF=B"). (INCLUDES 18 13 SLOT PAVEMENT, AGGREGATE 405 LF $ 72.00 $ 29,160.00 BASE, LOT DRAIN, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) C-2. 11 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Conbact Unit. 00mcled No. No. D"cdpdon Ouandly tint Price Mwunt REMOVE AND RECONSTRUCT SIDEWALK PER HB STD. PLAN 207 AND AS MODIFIED ON PLANS. (INCLUDES OVER EXCAVATION OR FILL FOR CHANGES IN GRADE, RE -GRAD FROM WALK TO EXISTING 19 14 SLOPE, RELOCATING 3,400 SF $ 7.80 $ 26,520.00 IRRIGATION TO BACK OF NEW WALK, RETURNING LANDSCAPING TO PRE - CONSTRUCTION CONDITION AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE.) SAWCUT AND REMOVE EXISTING SIDEWALK AT EXISTING AND CONSTRUCT TREE WELL WITH SIDEWALK PER DETAIL ON SHEET 3. (ITEM 20 15 INCLUDES REMOVAL OF 3 EA $ 550.00 $ 1,650.00 SIDEWALK, 6 LF OF NEW SIDEWALK, NON -CHEMICAL WEED CONTROL BARRIER TO BE DUPONT LANDSCAPE MAX OR AGENCY APPROVED EQUAL D MULCH.) REMOVE AND RECONSTRUCT COMMERCIAL /RESIDENTIAL DRIVEWAY (-W" AND TYPE 21 16 SHOWN ON PLAN) PER STD 750 SF $ 11.50 $ 8,625.00 PLAN 209 OR 211. MATCH EXISTING IMPROVEMENTS TO GRADE. REMOVE AND RECONSTRUCT CONCRETE CURB AND CROSS GUTTER PER HB STD. PLAN 205. 22 17 (ITEM INCLUDES SLOT 1,740 SF $ 21.00 $ 36,540.00 PAVEMENT, AGGREGATE BASE, AND ALL ITEMS NECESSARY TO COMPLETE THE WORK IN -PLACE.) 23 INTENTIONALLY LEFT BLANK 24 INTENTIONALLY LEFT BLANK C-2. l2 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract Unit ,Extended No. No. DescAption Quantity. Unit Prim Amount INSTALL NEW DETECTOR LOOPS PER CITY STANDARD SPECIAL PROVISIONS FOR THE CONSTRUCTION OF TRAFFIC 25 18 SIGNALS AND LIGHTING 22 EA $ 210.00 $ 4,620.00 SYSTEMS, 2005 EDITION. SPLICE LOOPS TO DLC IN PULLBOX. BIKE LANE LOOPS AND ALL LOOPS AT LIMIT LINE SHALL BE TYPE "D". REMOVE EXISTING TREE AND ROOTS; GRIND TREE STUMP 26 19 AND ROOTS TO 24" BELOW TOP 4 EA $ 11¢ o b . ob 5, G o e • o O $ OF SIDEWALK / GRADE WITHIN PROPOSEDIMPROVEMENT AREA. FURNISH AND INSTALL BRIDGE DECK MEMBRANE OVER ENTIRE 27 20 BRIDGE DECK SURFACE 5.000 SF $ Z a 6 $ f 3j e00.4o (INCLUDES ALL ASSOCIATED WORK PER PLANS AND SPECIFICATIONS). FURNISH LABOR, EQUIPMENT, AND GEOGRID FOR SOFT SOIL EXCAVATION WHEN IDENTIFIED BY CONTRACTOR AND VERIFIED 28 21 BY AGENCY. (INCLUDES ALL 2,500 SF $ 0.11 $ 2,12s.00 ITEMS NECESSARY TO COMPLETE THE WORK IN PLACE, EXCEPT BASE COURSE A.C. AND OVER EXCAVATION BID PAY ITEMS.) OVER EXCAVATION WHEN 29 22 IDENTIFIED BY CONTRACTOR 90 CY $ 100.00 $ 9,000.00 AND VERIFIED BY AGENCY. 30 INTENTIONALLY LEFT BLANK ADJUST VERIZON rAULT/MANHOLE TO GRADE BY NOT A CONTRACTOR M 23 VERIZON. CONTRACTOR TO 4 EA COORDINATE WITH RAY BID ITEM ROUNDTREE AT (714) 375-6760. C-2. 13 ATLANTA (BEACH-NEWLAND) PROJECT BID SCHEDULE Bid Const Contract `Unit Extended No. No. Description Quantity Unit Prim Amount ADJUST OCSD SEWER MANHOLE TO GRADE, PER 32 24 OCSD STD. PLANS S-053, S-054 & S-055. CONTRACTOR TO 2 EA $ 850.00 $ 1,700.00 COORDINATE WITH MIKE BOLSTER AT 714-593-7645. 33 INTENTIONALLY LEFT BLANK FURNISH AND PLANT NEW 24" BOX EASTERN REDBUD TREE PER HB STD. PLANS 714, 715, 716, 718 & 719 AS SHOWN ON PLANS. CITY STREET TREE SUPERVISOR OR THE AGENCY'S REPRESENTATIVE SHALL DETERMINE TREE LOCATION. (ITEM INCLUDES REMOVAL OF EXISTING LANDSCAPING, 34 25 BUSHES OR GROUND COVER 1 EA $ 1,200.00 $ 1,200.00 AND IRRIGATION TO A DEPTH OF 24" BELOW TOP OF GRADE TO ACCOMMODATE NEW TREE; REPLACING DAMAGED OR REMOVED IRRIGATION IN KIND; BACKFILLING WITH CLASS A TOP SOIL AND INSTALLATION OF ARBOR-GARD OR AGENCY APPROVED EQUAL AT BASE OF NEW TREE). 35 INTENTIONALLY LEFT BLANK 36 INTENTIONALLY LEFT BLANK FURNISH AND INSTALL ZEBRON, SANCON OR CITY APPROVED 37 - - EQUAL COATING ON THE NEW 6 EA $ 650.00 $ 3,900.00 CONCRETE INSIDE OF AGENCY SEWER MANHOLE RING. Total Amount Bid in Figures: $ LS 7 6. o v Total Amount Bid in Words: 4 l s �„r C"� az.14 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 PWC Dollar % of Item(s) Subcontractor License Registration # Amount Contract Number 1-ZL V4" E 1 fee Set'v�ce. � �a � C979 2-Z6 Po (301, 32$0 651IS0 1000001g36 , 0 'C Ve Co. C120LS 7' 4000 l AJ06e. ��a�►sib �T�nc Po o 3 � 2 3 t� z 11- I0000115u� ��aJ 3, 2 l -6,Ig 27, i� �-e< Z� N I -Zs- 5r)1'+kSo+\ 0e'c+r C_ ►q3,6 E. t/G,-Fel(m wove _� o l00000lGID 15, 00D 0,'%n e q fq � C4Se' lmmd 5J<ve O tt t� L 4 b,l�l Iv. IOcoOo iS33 S,s'0 0 • 774rly `C36Ju00 2 WX (.men, K_ LA,,)s Cce r L CA 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 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 Iten(s) Namelanld Addrm of Svbcon&actor State License Namber am DIR PWt tioo # Dollar . Anio_Wd % of Condwct 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 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 05/09/17 , at ORANGE CA Date City State STEVE MENDOZA , being first duly sworn, deposes and says that he or she is SECRETARY of R.J. NOBLE COMPANY the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. R.J. NOBLE COMPANY Name of Bidder Signature Bidder STEVE MENDOZA, SECRETARY 15505 E. LINCOLN AVENUE, ORANGE, CA 92865 Address of Bidder C-4 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 Califomia County of ORANGE On Os/09/v Date before me, J. DE IONGH, NOTARY PUBLIC personally appeared STEVE MENDOZA Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose names} is/ar$- subscribed to the within instrument and acknowledged to me that he/she/they- executed the same in hisAw/their authorized capacity(ie*,, and that by his/her/their signature(*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 Califomia that the foregoing paragraph is true and correct. .w. J. DE IONGH WITNESS my hand and cia se . 5 Commission # 2128504 Lj ny Notary Public - California D ?a.w Orange County Signature 1; My Comm. Expires Oct 28, 2019 Sig otary Public J. DE IONGH 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) Document Date: 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 ❑ Attomey in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: _ - - ..�s�c.�-.cam^-z:�rsc:�•s���e�c.�:�c:cz.._ _ � - _ _ - - - - _ �c>`rz�c:c:cec.'�.'u.Y_=c:�c:� 02014 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 Adams Avenue Rehabilitation from Beach Boulevard to Newland Street and Atlanta Avenue Rehabilitation from Beach Boulevard to Newland Street, Project CC No. 1502, (I)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved. " The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal -OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: 05/09/2017 R.J. NOBLE COMPANY Contractor x By STEVE MENDOZA, SECRETARY Title C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? 0 Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date; 05/09n7 R.J. NOBLE COMPANY Contractor X By STEVE MENDOZA, SECRETARY Title C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: R.J. NOBLE. COMPANY Bidder Name 15505 E. LINCOLN AVENUE Business Address ORANGE CA 92865 City, State Zip 714 637-1550 Telephone Number 782908 CLASS A & C-12 State Contractor's License No. and Class AUGUST 1999 Original Date Issued AUGUST 31, 2018 Expiration Date The work site was inspected by BRADEN PORTER of our office on MAY 5 , 2017 The following are persons, firms, and corporations having a principal interest in this proposal: R.J. NOBLE COMPANY A CALIFORNIA CORPORATION The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. R.J. NOBLE COMPANY Company x ; Signature of Bidder STEVE MENDOZA, SECRETARY Printed or Typed Signature Subscribed and sworn to before me this 9TH day of NOTARY PUBLIC X J. DE J. DE IONGH Commission # 2128504 MAY , 2017 Z -c>; Notary Public -California z Orange County D My Comm. Expires Oct 28, 2019 R NOTARY SEAL C-8 Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work, specifically referencing the construction of (Describe specific work and experience necessary for project. For example, "Sanitary sewer line installation of at least of 1,000 of 8-inch and greater in public right-of-way. Sanitary sewer lift stations of similar size, project work within public streets, an area containing high ground water and pipeline construction in huh ground water regions with trench depths of 8-feet to the invert."'). Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. 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 CITY OF TUSTIN, 300 CENTENNIAL WAY, TUSTIN, CA 92780 Name and Address of Public Agency Name and Telephone No. of Project Manager: BENNY TENKEAN 714-573-3161 $22.6 MILLION ROAD RECONSTRUCTION WITH STORM DRAIN IMPTS APRIL 2014 Contract Amount Type of Work Provide additional project description to show similar work: TUSTIN RANCH ROAD RECONSTRUCTION WITH STORM DRAIN IMPROVEMENTS Z CITY OF TUSTIN, 300 CEN"IENNIAL WAY, TUSTIN, CA Name and Address of Public Agency Name and Telephone No. of Project Manager: BENNY TENKEAN 714-573-3161 Date Completed $15.1 MILLION ROAD RECONSTRUCTION WITH STORM DRAIN IMPTS APRIL 2014 Contract Amount Type of Work Provide additional project description to show similar work: BARRANCA ROAD RECONSTRUCTION WITH STORM DRAIN IMPTS 3 CITY OF TUSTIN, 300 CENTENNIAL WAY, TUSTIN, CA 92780 Name and Address of Public Agency Name and Telephone No. of Project Manager: BENNY TENKEAN 714-573-3161 Date Completed $10,552,962.00 ROAD RECONSTRUCTION WITH STORM DRAIN IMPTS AUGUST 20I5 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: ARMSTRONG AVE & WARNER AVE EXTENSION PHASE 2, PREP & GRADE, UNDERGROUND PIPE WORK C-9 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1 , KORI PORTER, PROJECT MANAGER Name of proposed Project Manager Telephone No. of proposed Project Manager: 714-637-1550 EXT 359 CITY OF ORANGE ANNUAL PAVEMENT MAINTENANCE $2.8 MILLION CLASS A 02/2014 Project Name & Contract Amount Type of Work Date Completed CITY OF COSTA MESA 2012-2013 STREET REHAB CITY PROJ 13-01 $3.6 MILLION CLASS A 09/2015 Project Name & Contract Amount Type of Work Date Completed CITY OF IRVINE JAMBOREE ROAD PAVEMENT REFIABILITATION $ 1.1 MILLION CLASS A 02/2014 Project Name & Contract Amount Type of Work Date Completed 2 CHUCK SPIERS, GENERAL SUPERINTENDENT Name of proposed Superintendent Telephone No. of proposed Superintendent: 714-743-1383 CITY OF RIVERSIDE MINOR STREET MAINTENANCE PHASE 1 $2.6 MILLION CLASS A Project Name & Contract Amount Type of Work OCTOBER2015 Date Completed COUNTY OF ORANGE AC OVERLAY RESURFACING $5 MILLION CLASS A MARCH 2O14 Project Name & Contract Amount Type of Work Date Completed CITY OF TUSTIN ARMSTRONG AVE & WAGNER AVE $10 MILLION CLASS A Project Name & Contract Amount Type of Work SEPT 2015 Date Completed C-10 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/P WCR/ActionServlet?action--di splayPW 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: 05/090-017 PWC Registration #: 1000004235 R.J. NOBLE COMPANY Contractor By / STEVE MENDOZA, SECRETARY Title 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): XXXX Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: R.J. NOBLE COMPANY Contact Person: STEVE MENDOZA, SECRETARY Contact Phone: 714-637-1550 Signed: X cy� Date: 05/09/2017 *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 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) This form must be completed and submitted to the Department of Resources Recycling and Recovery (CalRecycle) prior to authorizing a contractor(s) to commence work. Failure to provide this documentation in a timely manner may result in nonpayment of funds to the contractor(s). This form is intended to help the CalRecycle's Grantees comply with the Unreliable List requirement of their Terms and Conditions. The Unreliable List provision requires the following: Prior to authorizing a contractor(s) to commence work under the Grant, the Grantee shall submit to CalRecycle a declaration signed under penalty of perjury by the contractor(s) stating that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the contractor(s). Please see the reverse of this page, or refer to www.calregs.com If any of the events listed in Section 17050 have occurred, disclosure is required but will not necessarily result in CalRecycle refusing to approve the contractor. A signed statement explaining the facts and circumstances of the events must be attached to and submitted with this form. Contractor: Complete the form and send original to the Grantee. Grantee: Scan the form and upload it to the grant in CalRecycle's Grant Management System (GMS). For further instruction about logging into GMS and uploading this form, reference the Procedures and Requirements. Retain the original form in your grant file. GRANTEE WFORMi►TION ",' " g GRANTEE NAME: CITY OF HUNTINGTON BEACH GRANT NUMBER: TRP7-16-0001 2000 Main Street, Huntington Beach, CA 92648 PRIMARY CONTACT NAME: JAMES WAGNER PE, SENIOR CIVIL ENGR, PUBLIC WORKS DEPT. CONTRACTOR NAME: R.J. NOBLE COMPANY AUTHORIZED CONTRACTOR REPRESENTATIVE NAME: STEVE MENDOZA, SECRETARY MAILING ADDRESS: P.O. BOX 620, ORANGE, CA 92856 As the authorized representative of the above identified contractor, 1 declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, none of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor. Alternatively, as the authorized representative of the above identified contractor, 1 declare under penalty of perjury under the laws of the State of California that within the preceding three (3) years, if any of the events listed in Section 17050 of Title 14, California Code of Regulations, Natural Resources, Division 7, has occurred with respect to the above identified contractor, I have disclosed all such occurrences in an attached signed statement that explains the facts and circumstances of the listed events. Signature X Date 05/09/2017 STEVE MEN'bOZVECRETARY C-13 STATE OF CALIFORNIA DEPARTMENT OF RESOURCES RECYCLING AND RECOVERY (CalRecycle) RELIABLE CONTRACTOR DECLARATION CalRecycle 168 (Revised 7/13) Title 14 CCR, Division 7, Chapter 1 Article 5. Unreliable Contractors, Subcontractors, Borrowers and Grantees Section 17050. Grounds for Placement on Unreliable List The following are grounds for a finding that a contractor, any subcontractor that provides services for a CalRecycle agreement, grantee or borrower is unreliable and should be placed on the CalRecycle Unreliable Contractor, Subcontractor, Grantee or Borrower List ("Unreliable List"). The presence of one of these grounds shall not automatically result in placement on the Unreliable List. A finding must be made by the Executive Director in accordance with section 17054, and there must be a final decision on any appeal that may be filed in accordance with section 17055 et seq. (a) Disallowance of any and/or all claim(s) to CalRecycle due to fraudulent claims or reporting; or (b) The filing of a civil action by the Attorney General for a violation of the False Claims Act, Government Code section 12650 et. seq; or (c) Default on a CalRecycle loan, as evidenced by written notice from CalRecycle staff provided to the borrower of the default; or (d) Foreclosure upon real property loan collateral or repossession of personal property loan collateral by CalRecycle; or (e) Filing voluntary or involuntary bankruptcy, where there is a finding based on substantial evidence, that the bankruptcy interfered with the CalRecycle contract, subcontract, grant or loan; or (f) Breach of the terms and conditions of a previous CalRecycle contract, any subcontract for a CalRecycle agreement, grant, or loan, resulting in termination of the CalRecycle contract, subcontract, grant or loan by the CalRecycle or prime contractor; or (g) Placement on the CalRecycle's chronic violator inventory established pursuant to Public Resources Code section 44104 for any owner or operator of a solid waste facility; or (h) The person, or any partner, member, officer, director, responsible managing officer, or responsible managing employee of an entity has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy, or any act in violation of any state or federal antitrust law in connection with the bidding upon, award of, or performance under any CalRecycle contract, subcontract, grant or loan; or (i) The person or entity is on the list of unreliable persons or entities, or similar list, of any other federal or California state agency; or Q) The person or entity has violated an Order issued in accordance with section 18304; or, (k) The person or entity has directed or transported to, has or accepted waste tires at, a site where the operator is required to have but does not have a waste tire facility permit; or, (1) The person or entity has transported waste tires without a waste tire hauler registration; or, (m) The person or entity has had a solid waste facility or waste tire permit or a waste tire hauler registration denied, suspended or revoked; or, (n) The person or entity has abandoned a site or taken a similar action which resulted in corrective action or the expenditure of funds by CalRecycle to remediate, clean, or abate a nuisance at the site; or (o) The following are additional grounds for a finding that, a person or entity described below should be placed on the Unreliable List: (1) The person or entity owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (2) The person held the position of officer director, manager, partner, trustee, or any other management position with significant control (Principal Manager) in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (3) The entity includes a Principal Manager who: 1. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; (4) The entity has a person who owns 20% or more of the entity, if that person: I. Was a Principal Manager in an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (5) The entity has another entity which owns 20% or more of the entity, if that other entity: I. Is on the Unreliable List; or, 2. Owned 20% or more of an entity on the Unreliable List at the time of the activity that resulted in its placement on the Unreliable List. (6) Subsection (o) is not intended to apply to a person or entity that purchases or otherwise obtains an entity on the Unreliable List subsequent to its placement on the Unreliable List. C-14 Local Assistance Procedures Manual Exhibit 12-H Sample Bid EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder I . NOBLE COMPANY proposed subcontractor hereby certifies that he has"' has not _, participated in a previous contract or subcontract subject to the equal opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administering agency, or the former President's Committee on Equal Employment Opportunity, all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b) (1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of S 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 October 2016 C-15 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 10295.1 (Chapter 376, Stats. 1995), the bidder hereby declares under penalty of perjury under the laws of the State of Califomia that the bidder has _ , has not xxbeen 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 10295.1. 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? xxxx Yes � No If the answer is yes, explain the circumstances in the following space. Page 7 of 22 C-16 October 2016 Local Assistance Procedures Manual Exhibit 12-H PUBLIC CONTRACT CODE 10232 STATEMENT 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-17 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 HUNTINGTON BEACH/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-18 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. NONE Exceptions will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 10 of 22 C-19 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-20 October 2016 f Local Assistance Procedures Manual Exhibit 12-H Sample Bid DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: Ra. contract �a. bid/offer/application a. initial b. grant b. initial award b. /bawardee, e c. cooperative agreement c. post -award d. loan For MOnly: e. loan guarantee yarter f, loan insurance drt _4. Name and Address of Reporting Entity 5. If Reporting Entityin Nardee,Enter Name and Addres 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 Di rict, if known 7. Federal Progr Name/Description: CFDA N filber, if applicable 9. Award/Amount, if known: b. /Individuals Performing Services (including address if different from No. I Oa) (last name, first name, MI) /aa h Contin tion Sheet(s) if necessary) 11. Amount of Payment (cheapply) 13. Type of Payment (check all that apply) $ actpl ed a. retainer b. one-time fee 12. Form of Payment (checky): c. commission 8 a. cash d. contingent fee b. in -kind; specifa deferred f. other, specify 14. Brief Description of Servmed or to be performed and Date(s) of Service, including officer(s), employee(s), or) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. /U.S.C. nuation S et(s) attached: Yes No 16. Inion reque ed through this form is authorized by Ti.S.C, ction 1352. This disclosure of lobbying Signature: X reas p ced by the tier above when his transactionwe or ntered into. This disclosure is required Print Name:STEVE�tENDOZA put 1 U.S.C. 1352. This information will be reCongress semiannually and will be available for SECRETARY puspection. Any person who fails to file the required Title: die shall be subject to a civil penalty of not less than$1and not more than $100,000 for each such failure. Telephone No.: 714-637-i sso Date: s/9/i� Federal Use Authorized for Local Reproduction Standard Form - LLL Page 12 of 22 C-21 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 fil ing 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-LLL4nstmc1ions Rev.oa-o4.MaENDIFU Page 13 of 22 C-22 October 2016 Local Assistance Procedures Manual Exhibit 15-G Construction Contract DBE Commitment I EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT 1. Local Agency: The City Of Huntington Beach 2. Contract DBE Goal: 6% 3. Project Description: Pavement Resurfacing and/or Rehabilitation Projects 4. Project Location: Adams Ave. /Beach BI. to Newland St. and Atlanta Ave. / Beach BI. to Newland St. 5. Bidder's Name: P.J. NOBLE COMPANY 6. Prime Certified DBE: ❑ 7. Bid Amount: $1,474,357.00 8. Total Dollar Amount for ALL Subcontractors: $93,895.00 9. Total Number of ALL Subcontractors: I 10. Bid Item Number 11. 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 J8327 LMS TRANSPORT, 2751 AVALON ST. 378 TONS various supply portion of liquid asphalt oil JURUPA VALLEY, CA 92509 X $414,00 = $156,492.00 X 60% = $93,895.00 Local Agency to Complete Ville Section 21. Local Agency Contract Number: CC-1502 15. TOTAL CLAIMED DBE PARTICIPATION 93,895.00 6.4 % 22. Federal -Aid Project Number. STPL-5181(188) 23. Bid Opening Date: 24. ContractAward 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. TY 17 25. Local Agency Representative's Signature 26. Date 16. Preparer's Signature 17. Date STE VE MENDOZA 714-637-1550 27. Local Agency Representative's Name 28. Phone 18. Preparer's Name 19. Phone SECRETARY 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 July 23, 2015 C-23 f`. LMS TRANSPORT CA # 434396 0 800-698-6BB6 OFFICE: 951-616-3828 FAX: 951-685-1862 Email: orders@Ims-transport.com or orders@lmncoldmilling.com 2751 Avalon St, Jurupa Valley, Ca 92509 UDBE # 38327 1 SBE# 1770011 UDBE # 405611 SBE# 1795213 COMPANY: RJ Noble ATTN: Estimating BID DATE: 5-9-17 PROJECT NAME: Adams Ave — Huntington Beach Below is LMS Transport's & LMN Incorporated's quote for the above referenced project. If this quote is accepted please send a signed copy to orders@Ims-transport.com or fax to 951-685-1862 • Item #: Oil Supply Only (per ton): 378 of PG64-16 & 99 of PG70-10 @ $368 thru 6/30/17 or $393 thru 10/31/17, • Item # Freight Only (per ton): $21 LTR to Corona and $21 to Orange. • Item Numbers: See rental rates below for cold milling, dump trucks, equipment moves, & flatbeds. INCLUSIONS (PERTAINING TO OIL SUPPLYING/TRUCKING/COLD MILLING): 1. TERMS ARE NET 7 (no sales taxes or environmental fees included). 2. A flat $12 Oil Spill Assessment Fee will be added to each load of oil. 3. LMS TRANSPORT MUST BE NOTIFIED WITHIN 30 DAYS OF BID DATE OR QUOTE WILL BE NULL & VOID. ADDITIONALLY, THIS QUOTE MUST BE SIGNED AND RETUREND TO LMS WITHIN 30 DAYS. 4. EACH ADDITIONAL MOVE/MOBILIZATION IS BASED ON LMN STANDARD RATES (SEE PAGE 2). 5. ADDITIONAL SHIFTS TO BE CHARGED AT LMN STANDARD RATES (SEE PAGE 2). 6. BACK CHARGES NOT PERMITTED FOR TRUCKING OR MILLING WITHOUT SAME DAY APPROVAL. 7. ALL WORK TO BE PERFOMED UNDER THE CUSTOMERS SUPERVISION. EXCLUSIONS (PERTAINING TO OIL SUPPLYING/TRUCKING/COLD MILLING): 1. QCQA, ARHM, TESTING, ENGINEERING, PERMITS, BONDS, FEES, INSPECTION FEES, SWPPP, LAYOUT, SURVEY. 2. SKIP WORK, SWEEPING, DETAIL, MINI GRINDER UNLESS NOTATED UNDER INCLUSIONS. 3. HANDWORK/DETAIL WORK UNLESS NOTATED UNDER INCLUSIONS. 4. TRAFFIC CONTROL LABOR, TRAFFIC CONTROL PLANS, SIGNS & CMS BOARD UNLESS NOTATED UNDER INCLUSIONS. 5. IMPORT & EXPORT, SUBGRADE REMOVAL & COMPACTION, SUBGRADE PREP, GRADING, FINE GRADING, DEWATERING, PETRO-MAT, CLAY, MACADAM, AND ANY UNFORSEEN CIRCUMSTANES OR CONDITIONS. UNLESS NOTATED UNDER INCLUSIONS. 6. PROTECTION OF EXST. UTILITIES, UTILITY ADJUSTMENTS UNLESS NOTATED UNDER INCLUSIONS. 7. STRIPING AND SIGNAGE, SEAL COAT, SLURRY, PRIME COAT, WEEDKILL. UNLESS NOTATED UNDER INCLUSIONS. Customer Name I Signature I Date: LMS & LMN Name I Signature I Date: LMS Transport - CA # 434396 1 LMN Incorporated "A Cold Milling Co." - CSLB # 987495 Western Surety Company BID BOND (Percentage) Bond Number: N/A KNOW ALL PERSONS BY THESE PRESENTS, That we R. J_Noble Com —-------- — — -- _ of Orange, California referred to as the Principal, and Western Surety Com as Surety, are held and firmly bound unto City of Huntington Beach_ , hereinafter hereinafter referred to as the Obligee, in the sum of `?t!'l�j' L '__ ( _ 10 __%) percent of the greatest amount bid, for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Principal has submitted or is about to submit a proposal to Obligee on a contract for CC-1502_ Adams Avenue - Atlanta Avenue Rehabilitiation Federal # STPL - 5181(188) NOW, THEREFORE, if the said contract be awarded to Principal and Principal shall, within such time as may be specified, enter into the contract in writing and give such bond or bonds as may be specified in the bidding or contract documents with surety acceptable to Obligee; or if Principal shall fail to do so, pay to Obligee the damages which Obligee may suffer by reason of such failure not exceeding the penalty of this bond, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED, SEALED AND DATED this 1 _ day of May _ 2017 R. J. Noble Company _ (Principal) By __ (Seal) do a Steve en, S tary Western Surety _Compan ry__ (Surety) 7 By — c �_ -- (Seal) vid Ja( son Attorney -in -Fact Form F5876 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 05/03/17 Date before me, J. DE IONGH, NOTARY PUBLIC personally appeared STEVE MENDOZA Here Insert Name and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the persons} whose names} is/ar� subscribed to the within instrument and acknowledged to me that he/she/they- executed the same in his/her/their authorized capacity(ie*,, and that by his/her/their signature(*on the instrument the person(s); or the entity upon behalf of which the person(s) acted, executed the instrument. J. DE IONGH Commission # 2128504 Z -ad Notary Public California n z ' Orange County My Comm. Expires Oct 28, 2019 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 officj4seal. Signature J. DE IONGH 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: 02014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907 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 May 1, 2017 before me, Lauren Emily Bierman, A Notary Public (insert name and title of the officer) personally appeared David Jacobson, Attorney -in -Fact who proved to me on the basis of satisfactory evidence to be the person(s) whose name(A) is/aFa subscribed to the within instrument and acknowledged to me that he/%ae" executed the same in his/herAhek authorized capacity(ie*, and that by his/kerAhek signature(%) 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°F*�F,r IAUREN EMILY BIERMAN N Q COMM. # 2097240 1; W • r NOTARY PUBLIC-CALIFORNIA X ORANGE COUNTY N MY COMM. EXRJAN 15, 2019 Signature's �.f,1 1 :�1�',_;i�' . ! (Seal) Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint James Scott Salandi, Leonard Ziminsky, David Jacobson, Individually of Irvine, CA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 20th day of April, 2017. �r5uaer"y�,� WESTERN SURETY COMPANY .............` A*P y �sf Ay'P ww�,MTk DA� aul T. Brnflat, Vice President State of South Dakota 1 )T ss County of Minnehaha On this 20th day of April, 2017, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires J. MOHR Noruvuauc June 23, 2021 s ry SOU7} DAKOTA s I. our, Notary Public CERTIFICATE I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporatim, printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this _ — day of .. ...FTrCw' WESTERN SURETY COMPANY 0/r aa`"ar,0 3 �WPi�Q,7 +\`TfA�,.f�e �m .... °w ...... �DPV�� �wnnum�w� L. Nelson, Assistant Secretary Forth F4280-7-2012