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HomeMy WebLinkAboutJRH Construction Company, Inc. - 2016-12-19RECEIVED BY: l- (Name) r- (Date) TO: FROM: DATE: SUBJECT City Treasurer CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION City Clerk i Bond Acceptance I have received the bonds for (Company Name) i CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. � Other No. g1forms/bond transmittal to treasurer Approved Agenda Item No. City Clerk Vault No SIRE System ID No (Council Approval Date) iCUL.C� y DATE: TO: CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION 4/9/2018 THOSE LISTED HEREON FROM: Jim Escutia, PW Contract Administrator SUBJECT: Retention Release Payment - PO #22679 OP Supplier #109924 Co. #100 Police Department Securtity Lobby & Limited ADA Improvements, Project # MSC 510 and 515 Contractor's Name: JRH Construction Address: 17795 Sky Park Circle City, State and Zip Code: Irvine, CA 92614 Phone Number: (714) 247-1510 City Business License Number: A298190 Notice of Completion (Date by City Clerk): 10/18/2017 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. -'7111611 batet Travis K. Hop I certify that there are no outstanding invoices on file. h_/11I10 ( �, ct m Date Joyce Director of Public Works , 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. 41-/ 1 - + e Date Robin Estanislau, City Clerk Attachments 1. Notice of Completion 2. Maintenance Bond 3. Certificate of Compliance with Prevailing Wage Laws 4. Contractor's Certificate 5. Certificate of Compliance with Title VI I of the Civil Rights Act and Equal Employment Opportunity Act of 1972 6. Consent for Release letter from the Surety Company 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 14-13 -19 Bond Acceptance I have received the bonds for C(� (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. CC No. MSC No. 5 C 0 S L S Other No. g:/forms/bond transmittal to treasurer 14 I OZ2 L.� Approved 12,11 q I ICY (Council Approval Date) Agenda Item No. ': City Clerk Vault No. lU 0 (� • �V SIRE System ID No. OX b Document-41675 83-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: Jim Escutia P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder 11 i 1 IIIII III�I 11111 111�1 11111111111111II fll 1 I1i NO FEE *$ R 0 0 0 9 6 4 0 1 5 9 $ * 2017000443259 3:46 pm 10/18/17 90 405 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 JRH Construction, who was the company thereon for doing the following work to -wit: Police Department Securtity Lobby & Limped ADA Improvements, Project # MSC 510 and 515 That said work was completed 10/17/2017 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 10/17t2017, per City Council Resolution No. 2003-70 adopted October 6, 2003, That upon said contract Suretec Insurance Company, was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. C Director of Public rks 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 1� d ADC the City of Huntington Beach, as contemplated o under Government code section 27383 and 'Director of Public Wo s or City Engineer Date should be recorded free of char e. City of Huntington Beach, California THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING iNFORMATION (Additional recording fee applies) about:blank 10/18/2017 EXECUTED IN TWO COUNTERPARTS MAINTENANCE BOND KNOW -ALL PERSONS BYTHESC PRESENTS: That JRH Construction Company, Inc 17795 Sky Pair.. Suite J Irvine Cf (contractor's street as Prindipal (hereinafterzalled Cordractor),.end: SureTec Insurance Company 31�31 Camino Del Rio N.. Suite 1450. (surety's street adds (contractor's name) id state.and Ap cos suret.s name) � 92108 Ate and zip cddti) Bond #4410286 Premium: Included In Performance Bond .a corporation organized and ousting underihe laws of the State of Texas with it§ principal bffi'ce in the City of San Diego, California as Surety (hereinafter called surety), am holdfrrmly-bound unto CITY OF HUNTINGTON BEACH as Obligee (hereinafter called Owne . in -the amount of ** Dollars ($ 727,833,70 ), equivalent to -the entire contract amount'including'all orders, 'for -the • Payment. whereof Contractor and Suro(y bind Ihems>=lees, their hefts, executors, odministrators, sumessors, and assigns, jointly and severally famlyby.ihese ppresents, **Seven Hundred Twenty Seven Thousand Eight Hundred Thirty-three and 70/10) WHEREAS, Suretyts a duly admftfad surety Insurer under the laws of the State oi.Callfamia; and Surety.is.ced filled and listed in -the U.S. Department of the Treasury ClrWlarSM, and:-able•to provldQproaf of bohding limitatlon shown in said clrcular•Is sufficient to provide bonds In'the emount.retiOred by said Vontract; and Suretrhas providdd Mandal strength ratings from reputWe Companies, such as •from &M. Vest, Moody'a, Standard . Poor`s, to vaUdate dmt'Surety has posidva ratings of being secure or stable; and Surety is regltteired and listed wlth'the•Caftrnla •Department of Insurance; and Cort-actor has by written agreement. dated December 19 2016, entered into -a contract -with thwnerforthe Police nenartment Securitv Lobby & Limited DA improvements MSC 510 & MSC 515 _ -in accordance with drawings and .speo(flcations prepared by which .contract -is by -reference made a part hereof (hereinafter -referred to as the Contrar4l and The -Contract provides that the principal will guarantee, for a pedgd of.one year, lhe-wor'k performed as W of the Contract from and against alldefects to materials and workmanship: and The Contras{ also provides thdt the Contractor shalf secure ContmctWs obligations during the one-year period with -a bond executad bya:surety duly admitted In the state:of Callforrila; and The Contract has been completed, and the,Owner Contractor and Surety agree that•the commencement Ante. for ItNs Guarantee and Bond shall:be October 18 ,ap17. -NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shalt, for •a period of one yearfrom and aflerfhe date of:completion•and acceptance of the Contract by Owner, repair and/or replace any and all defects -arising in the Work, whether resenting front defective materials or dafective work=nshlp, then this obligation shall be mull and.vold; otherwise ft•will,remain in full force -and effect. The Surety hereby•weives notice of any alteratlon-or extensfon oftime made by the Owner. Whenever Contraotor-shall be, and dedared by Owner to be in default under tha Contract, the Surety shall, within thirty (30) ,days following Owners written notice of default, either. (a) remedy the default, or (b) shall promptly complete the Contract in accordance with Its--terms-and conditions. Surety+ Shall -Gave. the Owner barmtess from.any ttaims, judamanta,•liens or losses ahsirig from the Surety's faliure to either remedy the default or to eamplete' the Contract In accordance With its terns and condlHans In a timely manner. 154584A181.39 Menever the Principal shall be, •and•dedared bythe Owner to be In default under She Contract, which •shall include Ithout limitation, -any breach or default of the 'Contract,•then, eifter-written notice from the Owner to the- Surely, as ravlded for.below, the Surety shall.alther (a) -remedy the default or breach by the Principal; or shall promptly and ithfully take chorge'of the Work and complete the Work In accordancevAlKthe requirements of -the Contract with a ontractor oiherthan the Principal, at Its own expense, and raake•available as.work progresses sufficient'funds to pay a cost of compfellon.iess the unpaid balance of the Contract IndWding other costs and damages for which the rely rnay:be llableberaunder, provided, however, that the procedure•bywhich the Surety undertakes to dledharge obligations under this Bond shall be sub[ent to the advance written. -approval of•the' Owner. fliiti ttiitly (9d) days otter'Surety's receipt of a written notice from Owner of the failure of perforrhance of the orrtred by the Prtneipal, :ii'shaA be the ditty of the Surety to give to the Owner a notice, In wr9ting, of the SurelyQ faction to (a) remedy the default(s).or the Rrin6 al prornptly,.ar (b) arrange for performance of the Contract promptly y a oonitaolor athsr thart'tlde PtSrtclpal, time b04ng of essence to this Bond. In said •Notice of Election, tt� Surety hall state :the data of camrnencement of ifs MM or remedy of the'Prindpal's default(t) or Its performance of the :ontraci. The Surety's obligations for cure or rarrredy, Ind4de bUt are not.pm(ted to: torrr'etion of detective work 4utd ornpletton of the C:7ntra>rt, addlflonal legal, design professional and delay costa adsfng :from Suretya actions or divre tb act . and iiquldata'd damages (or if -no Gquldatad damages are apeeffied in 1ha Contract, actual damages aused by delayed performance or non-performance by.ft Prindpdo. The Surety shall give prompt when notice to is Owner upon completion of the cure arremady'of-the'Prfnclpal's defawlt(s) of its performance of the .Contract. the Surety does issue -its Notice of Section and does not pr'bceed to cure .or -remedy the Principals. default(s) of its Ntrrnarrca of the Work'vvtbmfn thlrty-(30) days o ter receipt of a•written notice from Owner, Surety shag -be -deemed be.in ijafault on the s bond, and the O ner ahsll•be entitled to -enforce any remedy-avallable to'Owner_ r rlght rfaetion sfia'il aoorzte on Us bond to or for the use of.arry person or corporation other•than the owner named .neln or the successors of.Owner. and sealed this 28th day of March zA 18 ,ncipradf Raised Corporate Seri [A USTSEAFFMED) Poncipal Raised Corporate'Seal 11$T Eta: AFFIXED) Nq-rES; i. Acknowiadgmants must be Completed -and returned as peltt of tiro bond, 2' Raised CoMorate Seals arp rnandatory, 3, Plorsse e99ctl Power of Anomay. I5458a/ UDS (rdie) SureTec Insurance Company ty 'lame) By, (Sash Charles L e, ttorney- n-Face APPROVED Asi WF -9O1RM:,,. -, i11chael E. Ga es, City Attorney -• ` ._ r 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 3-28-18 Date before me, Lexie Sherwood personally appeared Charles L. Flake LEXIE SHERWOOD COMM. # 2203287 3 0 NOTARY PUBLIC • CALIFORNIA n M ORANGE COUNTY t Comm. Exp. JULY 27, 2021 , Notary Public, Insert Name of Notary exactly as it appears on the official seal Name 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 _ Place Notary Seal Above Signature of Of6tary Public; Lexie bherwood 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: MAINTENANCE BOND Document Date: 10-18-17 Signers) Other Than Named Above: N/A Capacity(ies) Claimed by Signer(s) Signer's Name: CHARLES L. FLAKE ❑ Individual ❑ Corporate Officer—Title(s):_ ❑ Partner ❑ Limited ❑ General ® Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: SURETEC INSURANCE COMPANY 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 LEVHTED 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, Heather Willis 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 Ten Million and 00/100 Dollars ($10,000,000.00) 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 ath day of August , A.D. 2017 . 1-14, URA1-0 SUA RETEC Z7k77 NY . \�aS ••.......... F� Lull. X q g= By: John Knox ., resi nt State of Texas ss: Ms4 , County of Harris •••••-• On this 8th day of August , A.D. 2017 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. XENIA CHAVEZ IS Notary Public, State of Texas Comm. Expires 09-10-2020 Notary ID 129117659 X ra 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 28TH day of 2018 , A.D. V 11Y1Z � 7 - M. Br nt Bely,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. State of California County of Orange ACKNOWLEDGMENT } } ss } 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. On _-� • c1 a • i S , before me, Michelle D. Baldwin a Notary Public, personally appeared John R. Hundley Jr who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal Z / & /Z, /'ZZ- za::� MICHELIE D. BALDWIN COMM,# 2201211 rrnn Sign ure of Notary Public (SEAL) € NOTARY PUBLIC-CALIFORNIA V1 oRANOE COUNTY 4tnou+V MY CON'. EXP. JULY 12, 2021 A Certification. -of Compliance with Prevailing Wage Laws To:: City of Huntington Beach Department&Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re:. Certification of Compliance with Prevailing Wage Laws Contract: MCS 510 MSC 515 Project: Police Department Security Lobby & Limited ADA Improvements 2000 Main Street Huntington Beach, CA 92648 The undersigned contractor on the above -referenced project ("Project") hereby certifies that -all laborers,: mechanics; .apprentices,. trainees,,watchmeri: and guards employed by him or by any subcontractor performing work: under the, contract for the :Project .have been -pai.d pursuant: to'the minimum wage and bona -fide fringe:benefit requirements specified for.each.particular classification of work, as set forth inahe 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 lsth :day of October 2017 a� Irvine 77 _ , California. John F ' hael E. Gates City Attomey 1 -CONTRACTOR'S CERTIFICATE 1, John R. Hundley, Jr. ,state and certify that: (Name of Declarant) 1. JRH Construction Company, Inc. is the: general contractor to the City of Huntington Beach.(".City"): on Contract No. MCS 51 O MSC 515 (the "Contract") for the construction of the public work of improvement entitled: Police Department Security Lobby and Limited ADA Improvements :(the, "Proiect")._ 2. AlI 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 thet disputed: claims. listed in paragraph:five (5), all persons supplying labor, services; materials and equipment to the:Project, including:91 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 liavebeen :executed by all persons who performed work on orsupplied labor, services..; materials, and/or equipment for:use atthe.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-peturyunder the laws of the State. of California that the foregoing is true and correct. Executed at Irvine on this 18th day oaf October 2� 17 APPROVED AS Michael,,E. Gates City,.Attorney 1 of Declarant) Jbhn,,Rt. Hundley, Jr. Certification of Compliance with Title. VII ofthe Civil Rights Act. and Equal. Employment Opportunity Act of 1972 To City of Huntington. Beach Department.of.Public Works 2000 Main Street/P.O. Sox 190 Huntington Beach; .CA. 92648 Re;: Certification of Compliance with Title VII ofthe-Civil. Rights Act and Equal Employment Opportunity Act of 1972. Contract: MCS 510 MSC 515 Project: Police Department Security Lobby and Limited ADA Improvements 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 .1.972 :and .Executive Order :l 1246, and.has not discriminated against any employee.or.applieant.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). 1 declare .under penalty ofperjury under the laws of the State of California that the foregoing is true and correct:. Executed this . latn day of .I EXECUTED IN TWO COUNTERPARTS CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ Bond# 4410286 CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER ❑ AIA DOCUMENT G707 PROJECT: Police Department Security Lobby & Limited ADA Improvements MSC 510 & MSC (name, address) 515 - City of Huntington Beach, CA TO (Owner) City of Huntington Beach Attn: Jim Escutia 2000 Main Street Huntington Beach, CA 92648 ARCHITECT'S PROJECT NO: CONTRACT FOR: Construction CONTRACT DATE: December 19, 2016 Final Contract Amt.: $727,833.70 LINTRACTOR: JRH Construction Company, Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety as it appears in the bond). SureTec Insurance Company 3131 Camino Del Rio N., #1450, San Diego, CA 92108 SURETY COMPANY, on bond Of (here insert name and address of Contractor) JRH Construction Company, Inc. 1779.5 Sky Park Circle, Ste. J, Irvine, CA 92614 CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company Of any Of Its Obligations t0 (here insert name and address of Owner) City of Huntington Beach 2000 Main Street, Huntington Beach, CA 92648 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, SureTec Insurance Company the Surety Company has hereunto set its hand this 3rd Attest: (Seal): day Of April SureTec Insurance Company Surety o111 any Signature ,of Authorized Representative , OWNERS, 20 18 Charles L. Flake / Attorney -In -Fact Title NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION AIA® ONE PAGE 01970 THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVE., NW, WASHINGTON, D.C. 20006 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 Oran On 4-03-18 Date before me, Lexie Sherwood personally appeared Charles L. Flake LEXIE SHERWOOD COMM. # 2203287 3 z-. NOTARY PUBLIC 0CALIFORNIA 0 ,r ORANGE COUNTY Comm. Exp. JULY 27, 2021 , Notary Public, Insert Name of Notary exactly as it appears on the official seal Name(s who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. / Signature Z06,� � / _` Place Notary Seal Above Signature of Nota Public exie /herwood 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 LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Charles L. Flake, David L. Culbertson, Spencer Flake, Heather Willis 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 Ten Million and 00/100 Dollars ($10,000,000.00) 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 9/10/2020 _ 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 Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20`" 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 8th day of August , A.D. 2017 . 609,11"a SURETEC T!2E ANY .....N O 9 sg_ By. w W y John Knox ., resi nt f State of Texas ss: cr.�4� '1 �, �g County of Harris ......•.. On this 8th day of August , A.D. 2017 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. .�``J,jfkvP0'o, XENIA CHAVEZ ,i1 `�L� Notary Public, State of Texas A9+: Comm. Expires 09-10-2020 '�.;;0F'�•` X is avez Notary Public ,,,,,�� Notary ID 129117659 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 da of PR 018 A.D. tSeeta B nt Be y, Assistant 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. Document-41675 83 -Page-1 Page 1 of 1 PLEASE COMPLETE THIS INFORMATION RECORDING REQUESTED BY: WHEN RECORDED MAIL TO: CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attm Jim Escutia P.O. Box 190 — 2000 Main Street Huntington Beach, CA 92648 TITLE Recorded in Official Records, Orange County Hugh Nguyen, Clerk -Recorder NO FEE *$ R 0 0 0 9 6 4 0 1 5 9$ 2017000443259 3:46 pm 10/18/17 90 405 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 JRH Construction, who was the company thereon for doing the following work to -wit: Police Department Securtity Lobby & Limited ADA Improvements, Project # MSC 510 and 515 That said work was completed 10/17/2017 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 10/17/2017, per City Council Resolution No. 2003-70 adopted October 6, 2003. That upon said contract Suretec Insurance Company, was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. Director of Public 42&s 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 d the City of Huntington Beach, as contemplated under Government code section 27383 and `4irector of Public Wo s 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/ 18/2017 RECEIVED BY: ( > rl (Name) (Date) CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office after signing/dating CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Clerk DATE: 1 M — �/ SUBJECT: Bond Acceptance I have received the bonds 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 i A -a C -i'i",)4 e L-0 rn (Company Name) Approved (Council Approval Date) Agenda Item No. City Clerk Vault No. (/fit. �)j SIRE System ID No. "A1�Q ` l In CDBG FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND J RH G01-/S'T2uc -r10^1 40A11914A✓Y, IAt e FOR D _ 44Z7_M eA rr LO t3 l3 Y S EGv Q � T 4f L IktCT— �}DA 1MPkpV6/b 6A,,TS MsC S/U ^`V0 /45GSlS 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 J P-14 Go.-1S"f2.uc-rio-d comPANy "CITY," and v , a T , hereinafter referred to as "CONTRACTOR." -,-'oRPoP-ATron6 WHEREAS, the Federal Department of Housing and Urban Development is providing partial funding for this Contract to CITY through a Community Development Block Grant; WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, SF:16-5215/142605.doe/rev. 12/2016 1 including, but not limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and 'include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public SF:16-5215/142605.doe/rev. 12/2016 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. All bid documents, including the Notice Inviting Bids, the Special Instructions to Bidders, CONTRACTOR's proposal, (attached as Exhibit "A"), "Form HUD-4010," the Federal Labor Standards Provision of the United States (attached as Exhibit "B"), and "Standard Federal Equal Employment Opportunity Construction Contract Specifications," as established by Federal Executive Order 11246 (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 SF:16-5215/142605.doc/rev. 12/2016 3 (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed . /^ S►X Nv-0 SI trKo vc T+0VSA0J0 St k S /YTY^S E✓Ea/ Dollars ($ ), as set forth in the Contract Documents, to be paid as provided in this 6(oli 667. &o 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 U)CAKl*/ (A within y� (/n.5 ) consecutive p,Y s from the day the Notice to Proceed is issued by DPW, 6.4jE 14wl)90 F1 ✓F 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 SF:16-5215/142605.doc/rev. 12/2016 4 the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope 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. SF:16-5215/142605.doc/rev. 12/2016 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: 1. A bond in the amount of one hundred percent (100%) of the Agreement price to guarantee CONTRACTOR's faithful performance of the work; and 2. A bond 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 SF:16-5215/142605.doe/rev. 12/2016 6 in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is nat in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of Dollars ($5�0 )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 SF:16-5215/142605.doc/rev. 12/2016 7 to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. 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 SF:16-5215/142605.doc/rev. 12/2016 8 other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DEMANDS FOR ADDITIONAL TIME OR MONEY A. Definitions. (1) "Change Order" means a document signed by 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 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, 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 SF:16-5215/142605.doc/rev. 12/2016 9 (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. 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 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 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 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 CONTRACTOR disputes the DPW's written response on the Demand, or the CITY fails to respond within the time prescribed, 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, SP:16-5215/142605.doc/rev. 12/2016 10 and request an informal conference to meet and confer for settlement of the Demand. Upon CONTRACTOR's request, the DPW ,shall schedule a meet and confer conference within thirty (30) days to seek to resolve. i 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, 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 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 SF:16-5215/142605.dochev. 12/2016 11 the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant. 14. PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof. From each progress estimate, five percent (5%) will be deducted and retained by CITY and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR. When CONTRACTOR has, in the judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as determined from the bid schedule, and if DPW finds that satisfactory progress has been and is being made, CONTRACTOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discretion by DPW, less all previous payments and less all previous retained amounts. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty (30) 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 SF:16-5215/142605.doc/rev. 12/2016 12 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. 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 CONTRACTORS affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION DEFENSE HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected' or appointed officials, employees, agents, and volunteers from and SF:16-5215/142605.doc/rev. 12/2016 13 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 CON'IRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent act or omission of 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. SF:16-5215/142605.doc/rev. 12/2016 14 CONTRACTOR shall filrnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to 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 shalt provide coverage in not less than the following amount: combined single limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as (the "Additionally Insured Parties") as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary and non-contributory with any other valid and collectible insurance or self-insurance available to the Additionally Insured Parties. Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties. All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties. Under no circumstances shall said above -mentioned insurance SF: 16-5215/ 142605.doc/rev. 12/2016 15 contain a self -insured retention without the express written consent of CITY; however, an insurance policy "deductible" of $5,000.00 is permitted. 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: l . 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 SF:16-5215/142605.doc/rev. 12/2016 16 and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 23. CALIFORNIA PREVAILING WAGE LAW AND FEDERAL DAVIS- BACON ACT. 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 6f 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. SF:16-5215/142605.doc/rev. 12/2016 17 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. C. This Agreement also is subject to the Federal Davis -Bacon Act. The, minimum rate of wages for each craft or type of worker needed to execute the PROJECT shall be those as determined by the United States Secretary of Labor. If there is a difference between the minimum wage rates predetermined by the Secretary of Labor and the general prevailing wage rates determined by the Director of the California Department of Industrial Relations for similar classifications of labor, CONTRACTOR and subcontractors shall pay not less than the higher wage rate. 24. CALIFORNIA EIGHT -HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. SF:16-5215/142605.doc/rev. 12/2016 18 B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty-five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is required or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in any one (1) calendar week in violation of California Labor Code Section 1815. 25. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 26. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 27. EQUAL EMPLOYMENT OPPORTUNITY During the performance of this Agreement, CONTRACTOR agrees as follows: A. CONTRACTOR will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. CONTRACTOR will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: 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. CONTRACTOR agrees to post in conspicuous SF:16-5215/142605.doc/rev. 12/2016 19 places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. B. CONTRACTOR will, in all solicitations or advertisements for employees placed by or on behalf of CONTRACTOR, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. C. CONTRACTOR will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with CONTRACTOR's legal duty to furnish information. D. CONTRACTOR will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer, advising the labor union or workers' representative of CONTRACTOR's commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. SF:16-5215/142605.doc/rev. 12/2016 20 E. CONTRACTOR will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the United States Secretary of Labor. A copy of Executive Order 11246, as amended, is attached as Exhibit C. F. CONTRACTOR will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. G. In the event of CONTRACTOR's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or in part and CONTRACTOR may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. H. CONTRACTOR will include the provisions of sub -paragraphs A through G in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each sub -contractor or vendor. CONTRACTOR will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event CONTRACTOR becomes SF:16-5215/142605.doc/rev. 12/2016 21 involved in, or is threatened with, litigation with a sub -contractor or vendor as a result of such direction, CONTRACTOR may request the United States to enter into such litigation to protect the interests of the United States. 28. RECORD RETENTION Financial records, supporting documents, statistical records, and all other CONTRACTOR records pertinent shall be retained for a period of three years from the date of the City filing the Notice of Completion of the PROJECT. The only exceptions are the following: A. If any litigation, claim, or audit is started before the expiration of the 3- year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken. B. When the non -Federal entity is notified in writing by the Federal awarding agency, cognizant agency for audit, oversight agency for audit, cognizant agency for indirect costs, or pass -through entity to extend the retention period. C. Records for real property and equipment acquired with Federal funds must be retained for 3 years after final disposition. - D. When records are transferred to or maintained by the Federal awarding agency or pass -through entity, the 3-year retention requirement is not applicable to the non - Federal entity. E. Records for program income transactions after the period of performance. In some cases recipients must report program income after the period of performance. Where there is such a requirement, the retention period for the records pertaining to the earning of the SF:16-5215/142605.doc/rev. 12/2016 22 program income starts from the end of the non -Federal entity's fiscal year in which the program income is earned. F. Indirect cost rate proposals and cost allocations plans. This paragraph applies to the following types of documents and their supporting records: indirect cost rate computations or proposals, cost allocation plans, and any similar accounting computations of the rate at which a particular group of costs is chargeable (such as computer usage chargeback rates or composite fringe benefit rates). (1) If submitted for negotiation. If the proposal, plan, or other computation is required to be submitted to the Federal government (or to the pass - through entity) to form the basis for negotiation of the rate, then ,the 3-year retention period for its supporting records starts from the date of such submission. (2) If not submitted for negotiation. If the proposal, plan, or other computation is not required to be submitted to the Federal government (or to the pass - through entity) for negotiation purposes, then the 3-year retention period for the proposal, plan, or computation and its supporting records starts from the end of the fiscal year (or other accounting period) covered by the proposal, plan, or other computation. 29. NOTICE OF THIRD -PARTY CLAIM Pursuant to Public Contracts Code Section 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. SF:16-5215/142605.doc/rev. 12/2016 23 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 29 and any damages shall be assessed as set forth in Section 29. 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, CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or SF:16-5215/142605.doc/rev. 12/2016 24 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 SF:16-5215/142605.doc/rev. 12/2016 25 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) br 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:.3 1 M Esc crr/ A 2000 Main Street Huntington Beach, CA 92648 37. SECTION HEADINGS TO CONTRACTOR: J IZ 4 1r-0a1STZUC- 1 (v P J '�i /n/G A-rTA1: J o 14 AJ Z. N v AJD 17795 sky PA►2l< c-rec(-6ISuI-rc -J =RuI"iG/ c,A 9Z, 6 1 V 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. 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 SP:16-5215/142605.do&ev. 12/2016 26 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 parry 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 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 SF:16-5215/142605.doc/rev. 12/2016 27 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 parry 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. 45. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and, right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. SF:16-5215/142605.doc4ev. 12/2016 28 46. 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. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed L a by and through their authorized officers on 20/6 SF:16-5215/142605.doc/rev. 12/2016 29 CONTRACTOR. By: Joh .Hundley, Jr., President print name TTS: (cir e one) Chairman/Pre� Preside AND By: ' ljL,4' n R. Hundley, Sr., Secretary/Treas print name ITS. circle one) Secretary/Chief Officer/Asst. Secretary - Treasurer CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California INITIATED AND ZOVED: Director of Pu c Works tl YZVMWED PPROVED: City Manager APPROVED A.VA FORM: City Attorney SF:16-5215/142605.doc/rev. 12/2016 30 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange } On .1anuar4 R ?n17 before me, Tiffany C Rank.,. Notary Public, Date personally appeared John R. Hundley, Jr., President (here insert name and title of the officer) who proved to me on the basis of satisfactory evidence to be the person() whose name() is/ar-e- subscribed to the within instrument and acknowledged to me that he/sley.executed the same in his/hrrfi'l�authorized capacity(i-es), and that by his/li$r44wir 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. TIFFAN ,� C. KS '� mom•`= Commission No 2062533 <; z '�` '�' NOTARY PUBLIC CALIFORNIA ORANGE COUNTY »»•-»»' My Comm. Expires APRIL 6, 2018 i Signature: (Seal) Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL Number of Pages: 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 Idocument. STATE OF CALIFORNIA COUNTY OF Orange } On _lane A. 20117 before me, Tiffany/ (' Ranks, Notary Public, Date (here insert name and title of the officer) personally appeared _ Inhn R. HundlPy, sr_, SPr­rPtary/TrPasurPr who proved to me on the basis of satisfactory evidence to be the person() whose name(,) is/a-e- subscribed to the within instrument and acknowledged to me that he/:,he/� executed the same in his/ -Mtthmir authorized capacity(iesj; and that by his/krTITMr signatureO 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. Signature: iption of Attached Document Title or Type of Document: Document Date: Other: TIFFANY C. BANKS Commission No.2063533 zo z =w,� NOTARY PUBLIC-CALIFORNIA P ORANGE COUNTY My Comm. Expires APRIL 6, 2018 (Seal) OPTIONAL Number of Pages: "�sl-tro5tilleSe€7rye �O7�)9�_�� 1 Wl�'wCaift>I"I1i`i p�5ttlt LIs CalitmmjMobile NotrryNemork v vN-C MN1n(com EXHIBIT A (Contractor's Proposal) SF: 16-5215/ 142605.doc/rev. 12/2016 31 , L-�)�4 / 6 / 7- A - SECTION C PROPOSAL for the construction of MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS 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 therefore, 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 105 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 re -advertise 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 Bidder's Bond for 10 . 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 O d r' Signature 1 10/24/2016 F, .0. - 2 10/27/2016 3 10/27/2016 J % 4 10 31 2016 PROJEC ID SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per plans and specifications $ yA �a1 2. PD Lobby ADA Construct improvements per Improvements (Separate Funding Source) plans and specifications. Refer to the following plan p U $ (0. sheets for ADA scope of work: Al.0, Al. 1, A2.0, A2.1, A3.1, A4.0, E3.0, E4.0, E5.0 Total Bid Amount in Words: Total Bid Amount $ (p j ) , -� S ," , C_2 The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. l.: New Carpet tile floor to match, per schedule. Refer to sheet A 1. 1. Additive Alternate No. 2: New office ceiling grid and acoustical tile to match adjacent ceiling grid (existing light fixtures to remain). Refer to sheet A2.1. $ � , Lump Sum (use figures only) $ c�Dy vc;!S - (use figures only) Lump Sum Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. C-3 e KNOW ALL MEN BY THESE PRESENTS, that we JRH Construction Company, Inc. as principal, hereinafter called the "Principal," and SVk&EC 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 ($ too ) 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 Police Department Lobby Security and Police Department Limited ADA Renovations Pro ect No. MSC-510 Lobb Securit ; MSC-51 -ADA Re va �ox�s NOW, THEREFORE, if the contract -be timely awarded to the rincipal an� e rincipal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract. shall .furnish evidence of financing in a .manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project; and PROVIDED, FURTHER, unless the bid documents require that bid security remain in effect for a longer period of time, Surety shall have no liability hereon if a contract for the bid amount is not awarded to Principal within 64 days of the date hereof. SIGNED, sealed and dated this 7th day of November 2016 JRH Consructi n Com n Inc. (Principal) BY: BY: sigetec bid bond file.doc Rev 1.1.06 John R/ Hundley, Jr., President Charles L. FXak"e ` , Attorney -in -Fact CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT 11 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that I document. STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me, Tiffany C. Banks Notary Public, Date appeared John R. Hundley. Jr.. President (here insert name and title of the officer) 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. •• ,. ��=-.� TIFFANY C. BANKS Commission " y No. 2063533 0 z a NOTARY PUBLIC -CAI IFOR ORANGE COUNTY NIA -- My C- miExplres APRIL 6, 2018 Signature: (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Other: 2015 Apostille Service_ 707-992-5551 «v%wv Cal ifo nia l2ostille. s California ;Mobile Notary Nemork wwvv,.CAM'NN.ann 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 9 of Orange I Pn 11-07-16 before me, Lexie Sherwood Date Insert Name of Notary exactly as it appears on the official seal personally appeared Charles L. Flake Name(s) of Signer(s) LEXIE SHE RWOO ,D ,D COMM. # 2031782 E NOTARY PUBLIC 0CALIFORNIA G s ` ORANGE COUNTY 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 Place Notary Seal Above Signature of trotaij 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 LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint 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: Five Million and 001100 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 5/18/2017 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 206 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 18th day of May A.D. 2015 �rppnlull�V4lnllpy SURETEC INSURANCE COMPANY o� VFIAtJC waw �s; .......... RUJ i v= John ox Jr. resident State of Texas ss:County ofHarris On this 18th day of May , A.D. 2015 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. C UELYN MALDONADONotary PublicState of Texasomm. Exp. 5/18/2017 Jacq elyn Maldonado, Notary Public My commission expires May 18, 2017 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 7TH ^day of NOVEMBER / 2016 , A.D. . Breift Beaty; Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. 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 Dollar Item(s) State Lie.# Amount % of Name and Address o Subcontractor and Class DM # Contract �GZ• .L/ L N V-ct (-3r 0YS .AE U1\ w_ C 0 �t4Z 0 � �a tW� C��.��L �c E , \'k-c ix'i C, c,'.. l J 75 � fOOc-O 35c S r, 4Cia . Qu�'1tay T M E41 r ,' � ; �Irc���,CL 4c)qz 782 MOO CiL�G�rv�( � `C�cT�LZiI�iUOv- a�. CA, C'2-10 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-4 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 Dollar Item(s) State Lic.# Amount % of Name and Address of Subcontractor DIR # Contract y�and -Class L4 i 0000D ` L 7'4CA V �i c of k �30 �-('513'l 1 4 IC:oc3vo _ "% Rif - 11 Tows (r� - )IC%�I j �qCS• CAA G 4y { Itz;n�>> U-5 5 +_, 10 1tE30q *Innoo - ( o G� S C c. Qc 'C�f C-3� �� i�a y7 105, % 0 ;L�� c �r�< < ce[rl5-')01 j G000 - C i SE lJ, CA 96245 u 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-4 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 Lic.# and Class DIR # Dollar Amount % of Contract T a—r.� �,_� C-" 9 I l 0 �y��4�1p C .5 L �l©oc?oa- ( I El ��� L �ut7o tI A �. 3 k 9 yq 601 � I 000tw - �� �of000. 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-4 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 Lie.# and Class DIR # 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-4 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 Lic.# and Class DIR # 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-4 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 11 s 16 at Irvine , CA Date City State John R. Hundley, Jr. being first duly sworn, deposes and says that he or she is President of JRH Construction Company, Inc the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. JRH Cons,tructi n Company, Inc. Named Bidder ignature/f Bidder 17795,5kv Park Circle/ Suite J. rvij6e, CA 92614 Idvess of Bidder C-5 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 November 8, 2016 before me, Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr.. President (here insert name and title of the officer) 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. TIFFANY C. BANKS Commission No.2063533 z z NOTARY PUBLIC-CALIFORNIA j ORANGE COUNTY ¢ My Comm. Expires APRIL 6, 2018 Signature: (Seal) OPTIONAL (Description of Attached Document Title or Type of Document: ocument Date: Other: Number of Pages: 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 PROJECT NAME, (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: November 8, 2016 C-6 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley. Jr., President (here insert name and title of the officer) 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. F g.ly C. BANKS Commission No.2063533 zo NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY y My Comm. Expires APRIL 6,2018 Signature: (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: 2olS A ostille See i e, 707 `.)()')-�55i ti�Avw.Cali forniaA oStIlle.LIS C<aliti)mia ?e obilc' N'otw Network urvbv.0 MNN.com DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ® No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-7 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: November 08, 2016 JRH Construction company, Inc. y Title C-8 Handley, Jr., President 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 STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me, Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr.. President (here insert name and title of the officer) 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. .. .TIFFANY C. BANKS Commission No. 2063533 10 Z `� NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY f; My Comm. Expires APRIL 6, 2018 Signature: (Seal) Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL Number of Pages: 3 11 i Anosull Service. ?t)7 yg -�Sti1 S l4bG Calrlc�[nta. ostille tics Cafi €3nu� i Mobile Not€tr�v �N two k tv�vtivC`AMNN c �m BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: JRH Construction Company, Inc. Bidder Name 17795 Sky Park Circle, Suite J. Business Address Irvine, CA 92614 City, State Zip (714 ) 247-1510 Telephone Number 784858, A & B State Contractor's License No. and Class 09/21/2000 Original Date Issued 09/30/2018 Expiration Date The work site was inspected byscott Veatch of our office on October 18 2016 The following are persons, firms, and corporations having a principal interest in this proposal: John R. Hundley, Jr. President John R. Hundley, Sr. Secretary/Treasurer The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the cont act for the proposed work and improvements in accordance with the plans and specificationset forth. / Name S' ature of dder ohn R. HVfidley, Jr. =this ped Signature Subscribed and sworn 8 day of November , 2016 NOTARY PUBLIC —Please see attached notary acknowledgement C-9 NOTARY SEAL CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley. Jr.. President (here insert name and title of the officer) 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. ...-.--•.�••---••--°•••-•'- •A.N€�S TIFFP,:�4Y C. BA�! r— Commission No.2063533 zo c� :4 ~ NOTARY PUBLIC-CALIFORNIA Z �' ORANGE COUNTY ��g2m,. J� •--•y Comm. Expires APRIL 6, 2018 Signature: �� (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. List below the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: L Portola Springs ES, 12100 Portola Springs, Irvine, CA 92618 Name and Address of Public Agency Bruce Monroe, 949-936-5000 Name and Telephone No. of Project Manager $1,387,222.70 New School 02/2016 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: New School classroom buildings and playground equipment installation 2. HBHS Baseball Field, 1905 Main St. Huntington Beach, CA Name and Address of Public Agency Lori Hammell, (714) 903-7000 ext. 4350 Name and Telephone No. of Project Manager $1,191,767.86 Modernization Contract Amount Type of Work Provide additional project description to show similar work: Modernization of Baseball Field, Dug out, and bleachers. 02/2016 Date Completed 3. So. E1 Monte H.S. Snack Bar, 1001 Durfee Ave, South E1 Monte, CA 91733 Name and Address of Public Agency Chris Knowland, Inspector, 626-786-4331 Name and Telephone No. of Project Manager $3,072,196.00 New Building 06/2016 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Built snack bar facility included, HVAC, Plumbing, and electrical. C-10 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 John R. Hundley, Jr. Name of proposed Project Manager Telephone No. of proposed Project Manager: 7 14 - 2 4 7 -1 s 10 HBHS Baseball Field Modernization 2/2016 Project Name & Contract Amount Type of Work Date Completed Portola Springs ES New School 02/2016 Project Name & Contract Amount Type of Work Date Completed So E1 Monte Snack Bar New Building 06/2016 Project Name & Contract Amount Type of Work Date Completed 2. Chris Ivany Name of proposed Superintendent Telephone No. of proposed Superintendent: 7 14 - 3 3 s- 7 1 a 6 Heroes Hall Renovations Modernization 11/2016 Project Name & Contract Amount Type of Work Date Completed So E1 Monte Snack Bar New Buidling 06/2016 Project Name & Contract Amount Type of Work Date Completed HBHS Baseball Field Modernization 02/2016 Project Name & Contract Amount Type of Work Date Completed Gil CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771. ] (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 ] 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. ] 4.pdf DIR's Contractor Registration Link — Call (844) 522-6734 https:HefiIing.dir.ca.gov/PWCR/ActionServIet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database: https:Hefiling.dir.ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771. ] (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, or no later than contract award date. Date: Novmber 8, 2016 DIR #: 1000003263 C-12 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 November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr.. President (here insert name and title of the officer) 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: (Seal) Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL .....�T,r F,r.'.4Y. C.pBANKS Commission No.2063533 NOTARY PUBLIC-CALIFORNIA n z ORANGE COUNTY MY Comm. Expires APRIL 6, 2018 Number of Pages: 2U15Arlosti)leiy%ywCali 16mi` Dostille tis Cali t6mia Mobile Notaiv Nemork y"vyvCAMNNcom 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): n' 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: JRH Construction Company, Inc. Contact Person: John R. H dley, Jr sident Contact Phone: 714-247- 510 Signed: l Date: Nove er 8 , 2016 *Note: The above c ification is required by the Department of Housing and Urban Development (24 CFR 135 and Subti e 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). C-13 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Ora On November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr.. President (here insert name and title of the officer) 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. ................................... TIFFANY C. BANKS Commission No.2063533 Z4r__4u- NOTARY PUBLIC-CALIFORNIA c? ORANGE COUNTY My Comm. Expires APRIL 6, 2018 Signature: (seal) Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL Number of Pages: 2015Apo:Lille,Sereic ?07992j551 tGWN'CalIforniaAmstillelIS Calif6rniu11obileNotaryNi1vvork yvw"vCAMNNcony EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.321, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. MSC-510 and MSC-515 Bid Opening Date November s, 2016 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 W/M/S/DVBE Contract & Construction News 10/11/2016 & 10/14/2016 Thomas Bid Register 10/11/2016 & 10/14/2016 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 Solicitation and Dates N/A C-15 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. Bidder Normally Items of Work Performs Item Breakdown Amount Percent of (Y or N) of Items M Contract N/A 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: N/A Names, addresses and phone numbers of firms selected for the work above: N/A 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: N/A C-16 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: N/A 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 Greensheet Advertisment 10/11/2016 & 10/14/2016 0 H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): N/A NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code_ Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and State_ (4) Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION, SIGN HERE: (1) Name underlich business is conducted JRH Construction Company, Inc. (2) (Signature) ohn R.fkundley, Jr., Pres`"ident Impress Corporate Seal here (3) Incorporated under the laws of the State of California (4) Place of Business 17795 sky Park Circle, suite J. (Street and Number) City and State Irvine, CA (5) Zip Code 92614 (6) E-Mail bidding@j ncconst . com Telephone No. 714-247-1510 NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley. Jr.. President (here insert name and title of the officer) 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. - o� , TIFFANY C. BANKS a;- Commission No.2063533 z. Z `w � NOTARY PUBLIC-CALIFORNIA 2 �` o ORANGE COUNTY My Comm. Expires APRIL 6, 2018 Signature: (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: 2M5AnostilleSeivicc.07y92-55ti1\v\y,yy.Call Io AMNNcom List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: John R. Hundley, Jr., President John R. Hundley, Sr., Secretary/Treasurer Scott Veatch, Vice President C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: JRH Construction Company, Inc -LOCATION: 17795 sky Park circle, suite J S,,-. (-n a -) r 7 a PROJECT DESCRIPTION: Huntington Beach Police Department Renovation TOTAL CONTRACT AMOUNT: U 51 J 5 3 , $ r BIDDATE: 11/8/2016 BIDDER'S NAME: JRH Construction Company, In CONTRACT DBE GOAL: 0 CONTRACT ITEM OF WORK AND DESCRIPTION DBECERTNO. NAME OF EACH DBE DOLLAR AMOUNT ITEM NO. OR SERVICES TO BE AND EXPIRATION (Must be certified on the date bids DBE SUBCONTRACTED OR MATERIALS DATE are opened - include DBE address TO BE PROVIDED (or contracted ifthe and phone number) bidder is a DBE) General Contract 1785168, 7/31/201E JRH Construction Company, t�JJ 17795 Sky Park Circle, Ste. J Irvine CA 92614 714-247-1510 For Local Agency to Complete: Local Agency Contract Number: Total Claimed DBE Participation $ '° 5 3, Federal -aid Project Number: Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Nrl ignature f Bidder 11/8/ 016 7 14 - 47-1510 Date (Ar Code) Tel. No. Print Name Signature Date Jo R. Hundley, Jr. , President P son to Contact (Please Type or Print) Local Agency Representative (Area Code) Telephone Number: Local Agency Bidder DBE Commitment (Construction Contracts) (P.ev 6/26/09) C-21 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 November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr.. President (here insert name and title of the officer) 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. ,M.......... =rrA'. TIFFANY C.g =,,w•_ p ' Commission No.2063533 z Z p NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY " y Comm. Expires APRIL 6, 2018 Signature: (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: %U15 ttsti!Ie S ,rti ee, ?17 'trF-;Stil bil��Lt-.C,aliforni�iA OSttllt.tis Cal€li-raia M bile Notar✓ Netvoak yyw�y,CAMNN.com PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 F.XHIRIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder JRH Construction Company, Inc. [proposed subcontractor JRH Construction Company, Inc. J hereby certifies that he/she/it 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/she/it 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. (eeoc.gov/employers/eeolsurvey/index.cfm) 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 cov ` ing the delinq nt period or such other period specified by the Federal Highwaydministrati or by the Direct r, Office of Federal Contract Compliance, U.S. Department of Labor. E , Signature: / Date: 11/8%2016 Print Name: 11 JohV R. Hundley, Jr. Title: President C-23 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 November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr., President (here insert name and title of the officer) 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. TIFFANY C. BANKS W mo Commission No.2063533 z z `� i' NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY MY Comm. Expires APRIL 6, 2018 Signature: (Seal) ff OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: 2�i15 A osnlle Sere ice. 70 992-55: 1 w%vv, Cali t6i-nl'ostilte,LIS Caihii)rni r MkA)ile Notmv Nemork sv�,,'w.CAMNN.corn F,XHIRIT F, NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE DEPT TENANT IMPROVEMENTS) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the . contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder,has also signed this Noncollusion Affidavit. Bidders ar cautioned at m criminal Jr Signature: Date: 11/ /2016 Print Nam • Jo R. Hundley, Title: President se (certification may subject the Bidder to C-24 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me , Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr., President (here insert name and title of the officer) 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. - »»»»»-........... °T TIFFANY C. BAN S . o Commission No.2G63533 z Z� NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY »�-•.»».�.MY Comm. Expires APRIL 6, 2018 i Signature: /` (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: 2l)1 j �1 x�:>Cilie cr��ce_ it)7 9 -ti5 1 v t%%bt C lltf_t�rntF1A Otittll Is yv�,vtiN,.CA1v NN.com EXHIBIT F 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 with Bidder 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 him/her 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. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above rtification.is-partthe Proposal. Signing this Proposal on the signature portion the of shalJ41-so constitu e signature of this Certification. Signature: l Date: 11/8/2016 Print Name: Jo n R. Hundley, Jr. Title: President C-25 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange } On November 8, 2016 before me, Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley, Jr.. President (here insert name and title of the officer) 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. L Signature: (Seal) Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL T. J Ti IFFA,' C.TAW�S t o' 0 Commission No.2063533 z Z ?; �' NOTARY PUBLIC-CALIFORNIAORANGE COUNTY »-•-•-....»�. My Comm. Expires A� $. Number of Pages: EXHIBIT G 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 an,. that all such subrecipients shall certify and disclose accordindv. / I Signature: ",,l l i Date: 11/t/2016 Print Name: John R. Hundle , Jr. Title: President C-26 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 November 8, 2016 before me , Tiffany C. Banks Notary Public, Date (here insert name and title of the officer) personally appeared John R. Hundley, Jr.. President 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. F TIFFANY C. BANKS mo Commission No.2063533 z� NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY Mom. Expires APRIL 6, 2018 r' Signature: (Seal) Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL Number of Pages: 2 i l ? Apostille Sen ice '707 �492- 5i i tiyw,, ' Call fbi nia Apostille tiIS C tl iCorn;u Motile Notary Nemork ;vw'�y CAN,1NN com EXHIBIT H DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract ❑ a. bid/offer/application ❑ a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e.loan guarantee year quarter_ f. loan insurance date of last report_ 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier ifknown Congressional District, ifknown 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, ifknown 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) $ Actual 1:1planned 12. Form of Payment (check all that apply): Ba. cash - b. in -kind; specify: nature value 13. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes11 No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title: person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than Telephone No.: Date: $100,000 for each such failure. Federal Use Only: Standard Form LLL Rev. 09-12-97 Authorized for Local Reproduction Standard Form - LLL C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H 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 C-28 different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11) Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13) Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 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. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 RXHIRIT I FEDERAL LOBBYING RESTRICTIONS Section 1352, Title 31, United States Code prohibits Federal funds from being expended by the recipient or any lower tier subrecipient of a Federal -aid contract to pay for any person for influencing or attempting to influence a Federal agency or Congress in connection with the awarding of any Federal -aid contract, the making of any Federal grant or loan, or the entering into of any cooperative agreement. If any funds other than Federal funds have been paid for the same purposes in connection with this Federal -aid contract, the recipient shall submit an executed certification and, if required, submit a completed disclosure form as part of the bid documents. A certification for Federal -aid contracts regarding payment of funds to lobby Congress or a Federal agency is included in the Proposal. Standard Form - LLL, "Disclosure of Lobbying Activities," with instructions for completion of the Standard Form is also included in the Proposal. Signing the Proposal shall constitute signature of the Certification. The above referenced certification and disclosure of lobbying activities shall be included in each subcontract and any lower -tier contracts exceeding $100,000. All disclosure forms, but not certifications, shall be forwarded from tier to tier until received by the Engineer. The Contractor, subcontractors and any lower -tier contractors shall file a disclosure form at the end of each calendar quarter in which there occurs any event that requires disclosure or that materially affects the accuracy of the information contained in any disclosure form previously filed by the Contractor, subcontractors and any lower -tier contractors. An event that materially affects the accuracy of the information reported includes: 1) A cumulative increase if $25,000 or more in the amount paid or expected to be paid for influencing or attempting to influence a covered Federal action; or 2) A change in the person(s) or individual(s) influencing or attempting to influence a covered Federal action; or 3) A change in the officer(s), employees(s), or Member(s) contacted to influence or attempt to influence a covered Federal Action. 20 SF:16-5215/142584 L City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Nurr JRH Construction Company, Inc. Company Name November 8, 2016 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. dent 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 November 8, 2016 before me, Tiffany C. Banks Notary Public, Date personally appeared John R. Hundley. Jr.. President (here insert name and title of the officer) 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. .»»».».».....»».......................�.,,, a F,. TIFFANY C. BANKS . m Commission No.2063533 NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY y My Comm. Expires APRIL 6, 2018 ...... -. Signature: (Seal) OPTIONAL tion of Attached Document Title or Type of Document: Date: Other: Number of Pages: City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3, 2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, JRH Construction Company, Inc. Company Name November 8, 2016 Date Dated October 27, 2016. //0 John R. Hun ley, r., President All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA COUNTY OF Orange I On November 8, 2016 before me, Public, Date personally appeared John R. Hundley, Jr.. President C. Banks (here insert name and title of the officer) otary 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. '"'"""'"'""»'������» � ile FANY C. BANKS f'ro Commission No.2063533 NOTARY PUBLIC-CALIFORNIA ORANGE COUNTY My Comm. Expires APRIL 6, 2018 Signature: Description of Attached Document Title or Type of Document: Document Date: Other: Seal) — � A�,iNAL Number of Pages: ? d 5 Anostiiie Service. 707 992�' 55I C ahfcorniaADOstille LIS www C'AMNNV com City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUs(a)republicservices.com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact — Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell: 714-328-8341 Lauren. kandel(cD-redhawkus.com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated MCE controls Model # HMC-1000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor: ThyssenKrupp contact — Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Daniel.VanMil(a)-thyssenkrupp.com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppelevator.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2"d floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2.0. 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached): 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Nur JRH Construction Company, Inc. Company Name November 8, 2016 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. sident 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 November 8, 2016 before me , Public, Date Tiffanv C. Banks personally appeared John R. Hundley. Jr.. President (here insert name and title of the officer) otary 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 C. pB MKS o TIFFA� n No 2063533 `• :.'<. Commiss,o CpUFURNiA fr Ilk . NoTAR RA Ge COUNTY C X ires Al �y Comm. —!P: ».'....« Signature: (seal) OPTIONAL iption of Attached Document Title or Type of Document: Number of Pages: Document Date: Other: 2015 AposLillc Seat zr �U7 �} -,5yCal t'IbrniaApost�ilie, LIS Clifi)r;�€j Mobile Notaryhetwork v�CAMNN cone City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FOUR For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31, 2016 Notice to All Bidders: Plaase note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Nur JRH Construction Company, Inc. Company Name November 8, 2016 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. sident 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 November 8, 2016 before me, Tiffany C. Banks Notary Public, Date (here insert name and title of the officer) personally appeared John R. Hundley, Jr.. President 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. TIFFANY C. BANKS o _ Commission No.2063533 z L) =' i' NOTARY PUBLIC-CALIFORNIA z� ORANGE COUNTY My Comm. Expires APRIL 6,2018 . i Signature: i (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FIVE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations November 2, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide %" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide'/4" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in.. 5) Where applicable, locksets will be Corbin Russwin. Keyway is 59C1— 6 PIN-10. This is to acknowledge receipt and review of Addendum Nur JRH Construction Company, Inc. Company Name November 8, 2016 Date All bidders must acknowledge the receipt of this Addendum Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. :BID DUE: November 8, 2016 PROJECT NAME: Police Dept. Improvements Bic! #MSC-510 & MSC-515 TIME: 2PM SUBMIT BID To: City of Huntingtom Beach - City Clerk 2000 Main Street, Second Floor — -- Huntington Beach, CA 92648 BIDDER/CONTRACTOR: JRH CONSTRUCTION COMPANY, INC. _ CONTRACTOR ADDRESS: 17795 Skypark Circle, Suite J, Irvine, CA 92614 CONTRACTOR PHONE: 714/247-1510 fax: 714/247-1516 CONTRACTOR CONTACT: John R. Hundley, Jr., President LICENSE NUMBER: 784858 DIR NUMBER: 1000003263 Class: A & B j. - �Ps:l:ti L n ri i iJ Ci ijvlu EXHIBIT B DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. MSC-510 and MSC-515 Bid Opening Date November 8, 2016 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 W/M/S/DVBE Contract & Construction News 10/11/2016 & 10/14/2016 Thomas Bid Register 10/11/2016 & 10/14/2016 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 Solicitation and Dates N/A C-15 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. Bidder Normally Items of Work Performs Item Breakdown Amount Percent of ($) Contract (Y or N) of Items N/A 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: N/A Names, addresses and phone numbers of firms selected for the work above: N/A 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: N/A C-16 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: N/A 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 Greensheet Advertisment 10/11/2016 & 10/14/2016 0 H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): N/A - NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 List below names of president, vice president, secretary and assistant secretary, if corporation; if a partnership, list names of all general partners and managing partners: John R. Hundley, Jr., President John R. Hundley, Sr., Secretary/Treasurer Scott Veatch, Vice President C-20 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code_ Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business City and State_ (4) Zip Code (5) E-Mail (Street and Number) Telephone No. C-18 IF A CORPORATION, SIGN HERE: (1) Name under (2) (Signature) business is conducted JRH Construction Company, Inc. R./Hundlev, Jr., President Impress Corporate Seal here (3) Incorporated under the laws of the State of California (4) Place of Business 17795 sky Park Circle, suite J. (Street and Number) City and State Irvine, CA (5) Zip Code 92614 (6) E-Mail bidding@jrhconst.com Telephone No. 714-247-1510 NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: John R. Hundley, Jr., President John R. Hundley, Sr., Secretary/Treasurer Scott Veatch, Vice President C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM sky Park Circle, suite J JRH Construction Company, Inc -LOCATION: LOCALAGENCY: p y� LOCATION: =ruin., CA 92614 PROJECT DESCRIPTION: Huntington Beach Police Department Renovation TOTAL CONTRACT AMOUNT: � w 5 { 1 � � 3 . $ _ BIDDATE: 11 / 8 / 2 016 BIDDER'S NAME: JRH Construction Company, In CONTRACT DBE GOAL: 0 CONTRACT ITEM NO. ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a DBE) DBECERTNO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT DBE General Contract 1785168, 7/31/201f JRH Construction Company, J l t L 2 e 17795 Sky Park Circle, Ste. J Irvine CA 92614 714-247-1510 For Local Agency to Complete: Local Agency Contract Number: Total Claimed DBE Participation $ `� Federal -aid Project Number: y Federal Share: Contract Award Date: Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Nrl dder 714- 47-1510 F:DZate (Ar Code) Tel. No. Print Name Signature Date Local Agency Representative undley, /Jr. , President `, -"on to Contact (Please Type or Print) (Area Code) Telephone Number: Local Agency Bidder DBE Commitment (Construction Contracts) (Rev 6/26/09) C-21 CERTIFICATE OF LIABILITY INSURANCE ATE M/DDIYYYY) DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Garrett/Mosier/Griffith/Sistrunk Risk Management & Insurance Services 12 Truman Irvine, CA 92620 CONTACT NAME: P"c"N Est): 949 559-6700 FAX No): 949 559-6703 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Scottsdale Insurance Company www.gmgs.com OB84519 INSURED JRH Construction Company, Inc. 17795 Sky Park Circle, Unit J INSURER B : American Fire and Casualty Company INsuRERc: Travelers Property Casualty Co. of America INSURERD: Everest National Insurance Company Irvine CA 92614 INSURER E: Westchester Surplus Lines Ins. Company INSURER F : COVERAGES CERTIFICATE NUMBER: 33687228 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD//YYYY POLICY EXP MM IDD//YYYY LIMITS A V COMMERCIAL GENERAL LIABILITY BCS0035660 10/1/2016 10/1/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE a OCCUR $2,500 Deductible DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 V MED EXP (Any one person) $ Excluded Contractual Liability PERSONAL& ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY PRO- JECT 7 LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY 13AA1756725177 10/1/2016 10/1/2017 o accidentSINGLE LIMIT $(Ea 1,000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOSDamage HIRED NON -OWNED ✓ AUTOS ONLY AUTOS ONLY Ph Physical yPerOPERT Collision Ded: $500 BODILY INJURY (Per accident) $ DAMAGE n $ $✓ $ Com rehensive Ded: 500 1 C �/ UMBRELLALIAB OCCUR ZUP71M4122916NF 10/1/2016 10/1/2017 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB H CLAIMS -MADE Underlying Policies: GL, Auto, EL AGGREGATE $ 5,000,000 DED I ✓ I RETENTION $10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y❑ OFFICER/MEMBEREXCLUDED? NIA 7600003520161 10/1/2016 10/1/2017 SPER TATUTE EORH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Contractors' Pollution Liability G2816775001 10/1/2016 10/1/2017 $1,000,000 Each Pollution Condition $2,000,000 General Aggregate Mold & Non Owned Disposal Site $5,000 Ded. Each Pollution Condition Deductible: $10 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Police Dept. Lobby Security and ADA APPROVE This certificate may be relied upon only if the certificate addendum referred to herein is attached hereto. MICHAEL E. GATES CITY ATTORNEY CITY OF HUNTINGTON BEACH CERTIFICATE HOLDER CANCELLAtION City Of Huntin ton Beach 20y0 Main Street Huntington Beach CA 92648 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES THE EXPIRATION DATE THEREOF, NOTICE ACCORDANCE WITH THE POLICY PROVISIONS. BE CANCELLED BEFORE WILL BE DELIVERED IN AUTHORIZED REPRESENTATIVE Calvin Sistrunk ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 33687226 116/17 A/G/U/W/Poll (Intl Cut -Through) I Blanca Roque 1 1/9/2017 2:21:47 PM (PDT) I Page 1 of 8 AGENCY CUSTOMER ID: LOC #: ACOREP ADDITIONAL REMARKS SCHEDULE Page of AGENCY Garrett/Mosier/Griffith/Sistrunk NAMED INSURED JRH Construction Company Inc. 17795 Sky Park Circle, Unit J Irvine CA 92614 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Huntington Beach ADDRESS: 2000 Main Street Huntington Beach CA 92648 RE: Police Dept. Lobby Security and ADA As respects General Liability coverage, the City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers are added as Additional Insured, per CG20370413 & CG20100413 attached and this insurance is primary/ noncontributory per CG20010413 attached. As respects Automobile Liability coverage, the City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers are added as Additional Insured, per CA20480299 attached and this insurance is primary per policy form CA00010306. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 33687228 1 16/17 A/G/U/W/Poll (Intl Cut -Through) I Blanca Roque 1 1/9/2017 2:21:47 PM (PDT) I Page 2 of 8 BCS0035660 JRH Construction Company, Inc. COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 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 your policy provided that.- (1) The additional insured is a Named In- sured under such other insurance; and CG 20 01 04 13 (2) You have agreed in writing in a contract or agreement that this insur- ance would be primary and would not seek contribution from any other insur- ance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 33667226 1 16/17 A/G/U/W/Poll (Incl Cut -Through) I Blanca Roque 1 1/9/2017 2:21:47 PM (PDT) I Page 3 of 8 BAA1756725177 JRH Construction Company, Inc. 5. Other Insurance a. For any covered "auto" you own, this Cov- erage Form provides primary insurance. For any covered "auto" you don't own, the in- surance provided by this Coverage Form is excess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is connected to another vehicle, the Liability Coverage this Coverage Form pro- vides for the "trailer" is: (1) Excess while it is connected to a motor vehicle you do not own. (2) Primary while it is connected to a cov- ered "auto" you own. b. For Hired Auto Physical Damage Coverage, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or . borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is primary for any liability as- sumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the lim- its of all the Coverage Forms and policies covering on the same basis. 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the bal- ance, if any. The due date for the final pre- mium or retrospective premium is the date shown as the due date on the bill. If the es- timated total premium exceeds the final premium due, the first Named Insured will get a refund. 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "acci- dents" and "losses" occurring: a. During the policy period shown in the Dec- larations; and b. Within the coverage territory. The coverage territory is: a. The United States of America; b. The territories and possessions of the United States of America; c. Puerto Rico; d. Canada; and e. Anywhere in the world if: (1) A covered "auto" of the private passen- ger type is leased, hired, rented or bor- rowed without a driver for a period of 30 days or less; and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. We also cover "loss" to, or "accidents" involv- ing, a covered "auto" while being transported between any of these places. 8. Two Or More Coverage Forms Or Policies Issued By Us If this Coverage Form and any other Coverage Form or policy issued to you by us or any company affiliated with us apply to the same "accident", the aggregate maximum Limit of In- surance under all the Coverage Forms or poli- cies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy. This condition does not apply to any Coverage Form or policy issued by us or an affiliated company specifically to apply as excess insurance over this Coverage Form. SECTION V —DEFINITIONS A b. If this policy is issued for more than one B. year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy. "Accident" includes continuous or repeated expo- sure to the same conditions resulting in "bodily in- jury" or "property damage". "Auto" means: 1. A land motor vehicle, "trailer" or semitrailer de- signed for travel on public roads; or CA 00 0103 06 © ISO Properties, Inc., 2005 Page 9 of 12 ❑ 33687228 1 16/17 A/G/U/W/Poll (Intl Cut -Through) I Blanca Roque 1 1/9/2017 2:21:47 PM (PDT) I Page 4 of 8 POLICYNUMBER: BCS0035660 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations THE CITY OF HUNTINGTON BEACH, POLICE DEPT. LOBBY SECURITY ITS OFFICERS, ELECTED OR AND ADA IMPROVEMENT'S APPOINTED OFFICIALS, 2000 MAIN STREET EMPLOYEES, AGENTS AND HUNTINGTON BEACH, CA 92648 VOLUNTEERS, 2000 MAIN STREET, HUNTINGTON BEACH CA 92648 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured principal as a part of the same project. 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. CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 33667226 116/17 A/G/U/W/Poll (Incl Cut -Through) I BIanca Roque 11/9/2017 20SWet BMpVPDT) I Page 5 of 8 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 2. Available under the applicable Limits Insurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. © Insurance Services Office, Inc., 2012 of the the CG 20 10 0413 33687228 116/17 A/G/U/W/Poll (Intl Cut -Through) I Blanca Roque 11/9/2017 21r2"ell (DtlpYPCT) I Page 6 of 8 POLICY NUMBER: BCS0035660 COMMERCIAL GENERAL LIABILITY 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 THE CITY OF HUNTINGTON BEACH, POLICE DEPT. LOBBY SECURITY ITS OFFICERS, ELECTED OR AND ADA IMPROVEMENTS APPOINTED OFFICIALS, EMPLOYEES 2000 MAIN STREET AGENTS AND VOLUNTEERS HUNTINGTON BEACH CA 92648 2000 MAIN STREET HUNTINGTON BEACH, CA 92648 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". H owever: 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. CG 20 37 0413 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 33687228 116/17 A/G/U/W/Poll (Incl Cut -Through) I Blanca Roque 11/9/2017 2JUSUr 'l (Dt3py PDT) I Page 7 of 8 POLICY NUMBER: BAA1756725177 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS 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" under the Who Is An Insured Provi- sion 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 indi- cated below. Endorsement Effective: 1 /6/2017 Countersigned By: Authorized Representative) Named Insured: JRH Construction Company, Inc. SCHEDULE Name of Person(s) or Organization(s): The City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers; 2000 Main Street, Huntington Beach, CA 92648 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ❑ 33687228 1 16/17 A/G/U/W/Poll (Incl Cut -Through) I Blanca Roque 1 1/9/2017 2:21:47 PM (PDT) I Page 8 of 8 CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROM: JRH Construction Company, Inc. PROJECT: Police Department Security Lobby & (Contractor Name) Limited ADA Improvements MCS 510 & MSC 515 Project 17795 Sky Park Circle, Suite J (Street Address) Irvine, CA 92614 (City, State and Zip) TO: CITY OF HUNTINGTON BEACH DECLARATION Attached hereto is a true and correct copy of the current.Certificate of Insurance and Additional Insured Endorsement CG - c 1185, which Certificate complies with the insurance requirements of the Contract by and between the City of Huntington Beach ("City) and the above -named Contractor ("Contractor) for the above -described project ("Project'). I declare under penalty of perjury under the laws of the State of Cali mia that the above statement is true and correct. Signedon_January 6 .2016 Irvine, A (Date). (City, State)( of Individual Who is Contractor hereby warrants and agrees i" a iin Products and Completed Operations Insurance in compliance with the insurance requirements of the Contract for the Project. Said Insurance shall be maintained through and until the expiration of all Warranties provided by Contractor. Said insurance shall contain Additional Insured Endorsement CG 2010 1185, naming City as an additional Insured. Contractor shall supply to City, on at least an annual basis, a Certificate of Insurance and the aforementioned Endorsement evidencing continued coverage which meets the Contract requirements. Signed on January 6 .2016at Irvine, CA (Date) (City, ate) -- CONTRACTOR: Name.,/JRH Con truction Comp ny, nc. 1`2 l / "' 2776212 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 / -1/6 -- A /2 Bond Acceptance I have received the bonds for\,—Z� ��L�1�7C C/ l�J�'1 P,4,yL/ 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) Approved Agenda Item No. City Clerk Vault No. SIRE System ID No r (Council Approval Date) EXECUTED IN TWO COUNTERPARTS BOND #4410286 PREMIUM: INCLUDED IN PERFORMANCE BOND PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach (hereafter referred to as "City") has awarded to JRH CONSTRUCTION COMPANY INC (name and address of Contractor) (hereinafter referred to as 'Principal"), a contract (*Contract") for the work described as follows: POLICE DEPARTMENT SECURITY LOBBY & LIMITED ADA IMPROVEMENTS MSC 510 & MSC 515 (Project Title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to furnish a bond to secure the payment of claims of laborers, mechanics, malerialmen, and other persons as provided by law, by a duly admitted surety insurer under the laws of the State of Cafifornia (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 A.M. Best, Moody's or Standard & Poor's, to validate that Surety has positive ratings of being secure or stable; and Surety is registered and listed with the California Department of Insurance. NOW THEREFORE, we, the undersigned Principal, and SURETEC INSURANCE COMPANY 3033 5TH AVENUE SUITE 300. SAN DIEGO CA 92103 (name and address of Surety) as Surety, are held and firmly bound unto City in the penal sum of SIX HUNDRED SIXTY ONE THOUSAND SIX HUNDRED SIXTY—SEVEN AND N01100 dollars ($ , ), this amount being not less than one hundred percent (100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code ("Claimants') for all labor, materials or services used or reasonably required for use in performance of the work described in the Contract, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. PAYMENT BOND Page i of 2 15.4584/117357 Surety stipulates and agrees, for value received, that no change, extension of time, alteration, addition or modification to the terms of the Contract, or any contract document or any work to be performed thereunder, whether made after notice or not, shall in any way affect, impair or release the obligations of Surety under this bond. Surety hereby waives notice of any such change, extension of time, alteration, addition, or modification to the terms of the,Contract, the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849. 114 WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety, by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond_ Dated: JANUARY 3, 2017 ATTEST JRH ONSTRUC 0 -COMPANY INC. (Corporate Seal) (Pri ci al t�{a e B y: me: JO R. Hund e Jr Title_ Pr i dent ATTEST SURET C INSURANCE COMPANY (Corporate. Seal) (Surety Name) e Na ; SP E mENC R F AKE - (Signature of Attorney -in -Fact for Surety) (Attach Attorney -in -Fact Certificate) L_j (619) 400-4100 (Area Code 8 Telephone Number for Surety) APPROVED AS TO -FORM'. By: Mi hae� I E. Gates,-Uty Attorney L Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attomey-in-fact must be attached. PAYMENT BOND Page 2 of2 t5-4564d117357 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT notary public or other officer completing this certificate verifies only the identity of the individual who signed e document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that STATE OF CALIFOW TIA COUNTY OF Orange } On .lani iaW F, ?Q17 before me, Tiffany (' Rankc Notary Public, Date personally appeared John R. Hundley, Jr., President (here insert name and title of the officer) who proved to me on the basis of satisfactory evidence to be the personN whose namee is/ar— subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his ei authorized capacitybi—_ . and that by his er eir 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. Signature: / (Seal) l ' Description of Attached Document Title or Type of Document: Document Date: Other: OPTIONAL Number of Pages: 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 1-3-17 before me, Lexie Sherwood Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Spencer Flake Name(s) of Signer(s) LEXIE SHERWOOD COMM. # 2031782 9 C9 ' Wit..= NOTARY PUBLIC • CALIFORNIA n ORANGE COUNTY COMM Exp. JULY 27, 2017 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 fficial seal. Signature Place Notary Seal Above Signature o of ry 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: Top of thumb here Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s): — ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: POA#: 510123 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint 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: 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 5/18/2017 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 Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 206 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 18th day of May A.D. 2015 '00 `Ra Nc 4% SURETEC INSURANCE COMPANY �s.............cc,.w 0111 B i� ! X q y w w D= John ox Jr.,�lAresident i : 12 Zs State of Texas ss: 7s'•., ,t Y County of Harris '•••••-•••'' ,,rs On this 18th day of May A.D. 2015 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above 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 B oard of Directors of said Company; and that he signed his name thereto by like order. W JACQUELYN MALDONADONotary PublicState of Texas My Comm. Exp. 5/18/2017 Jacq elyn Maldonado, Notary Public My commission expires May 18, 2017 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 3RD day of JANAURY 2017 , A.D. Bre t Beaty, QAA-ssistautretary 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. EXECUTED IN TWO COUNTERPARTS BOND #4410286 PREMIUM $10,117 PERFORMANCE BOND KNOW ALL PERS014S BY THESE PRESENTS: WHEREAS. City of Huntington Beach (hereafter referred to as 'City") has, by written agreement dated DECEMBER 1�2016 entered into a contract with JRH CONSTRUCTION COMPANY, INC. 17795 SKY PARK CIRCLE :SUITE J, IRVINE CA 92614 (name and address of Contractor) ereinafter referred to as "Principal"), for perormance of the work described as follows: OLICE DEPARTMENT SECURTTY T,ORRY F, T.TMTTRTI ATIA TM-PAnc (Project Title) WHEREAS, said contract, and all documents referenced therein (hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full; and Said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract, by a duly admitted surety insurer under the laws of the State of Califomia (hereinafter referred to as 'Surety"): and Surety is certified and listed in the U.S. Department of the Treasury Circular 570, and has provided proof of sufficient bonding limitations as shown in said circular to provide bonds in the amount required by said Contract; and Surety has provided financial strength ratings from reputable companies, such as from A.M. Best, Moody's, or Standard & Poor's, to validate that Surety has positive ratings of being secure or Stable; and Surety is registered and listed with the California Department of Insurance, NOW, THEREFORE, we, the undersigned, as Principal, and SURETEC INSURANCE COMPANY (name and address of Surety) as Surety, are held and firmly bound unto City in the penal sum of _SiX HUNDRED SiXTY ONE THOUSAND SIX HUNDRED SIXTY—SEVEN AND NO/100 Dollars ($661, 667.00 ), this amount being not less than one hundred percent of the price set forth in the Contract, in lawful money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT if the Principal shall promptly, fully and faithfully perform each and all of the covenants, obligations and things to be done and performed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time; and if the Principal shall indemnify and save harmless City and all of City's officers, agents and employees (hereinafter collectively referred to as "Obligees') fromany and all losses, liability and damages, claims, judgments, stop notices, fees and costs of every description, whether imposed by law or in equity, which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract, including all alterations, amendments and modifications thereto, and any warranties or guarantees required thereunder, then this obligation shall be void; otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees, for value received, that no adjustment of the time or price in the Contract or any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract 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 15-4534/1 t 7174 Bond No. 4410286 to automatically adjust the penal sum of this Bond to reflect such adjustments, alterations, changes, deletions, additions or other modifications. Surety agrees to provide written confirmation of such adjustments in the penal sum 10 City on not less than a quarterly basis. Surety also waives the provisions of Civil Code §§ 2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below, that the name of each corporate party being affixed hereto is such party's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its goveming 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:_ JA'TUARy 8, 2017 ATTEST (Corporate Seal) ATTEST (Corporate Seal) (Attach Attorney -in -Fact Certificate) JRH.CONSTRUCXIOhr COMPANY, INC. By: Title: Pregi dent SURET,8C INSURANCV COMPANY / (Surety Name By: _ Name: PENCER FLAKE (Signature of Attorney -in -Fact for Surety) U (619) 400-4100 (Area Code & Telephone Number for Surety) APPROVED AS TO F_ORFfl: By: `-y /'Michael E. Gates, City Attorney /I r��5 Note: This bond must be executed in duplicate and dated, all signatures must be notarized, and evidence of the authority of any person signing as attomey-in-fact must be attached. PERFORMANCE BOND Page 2 of2 154584/117174 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 .lane aN F. 9Q17 before me, Tiffany r Ranko Notary Public, Date (here insert name and title of the officer) onally appeared John R. Hundley, Jr., President who proved to me on the basis of satisfactory evidence to be the person( whose name(s�is/±r-e— subscribed to the within instrument and acknowledged to me that he/sh,-,� executed the same in his/1. r/+� authorized capacity(i s , and that by his/her signature(,Q 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. A Signature: (Seal) OPTIONAL Description of Attached Document Title or Type of Document: Document Date: Other: Number of Pages: 2015 Apostille Service. 707-992-5551 �i'\�yy C'alifomiaApostille.tis California Nlobile Notary Nemork ww�Y CAMNN corn 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 Oran( On 1-3-17 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 COMM. # 2031782 !.,aa: NOTARY PUBLIC •CALIFORNIA n ' f ORANGE COUNTY -' 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 se I. Signature Place Notary Seal Above Signature of Notary Public exie herw00 OPT►ONAL. 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 LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint 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: 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 5/18/2017 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 Attorneys) -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 Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 206 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 1 ath day of May , A.D. 2015 ,N,p11011101�4pi/I(,� SURETEC INSURANCE COMPANY �OSVFANCF�w�4 ................ o By: w w a= John ox Jr: resident D L J Zc State of Texas ss: (. d County of Harris " a/ On this 18th day of May A.D. 2015 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. ff JACOUELYNMALDONADO\ J I I (r Notary Public n\f State of TexasMy Comm. Exp. 5/18/2017 Jacquelyn Maldonado, Notary Public My commission expires May 18, 2017 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the B oard 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 JANAURY / 2017 A.D. . Brent Beaty, Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk January 12, 2017 JRH Construction Company, Inc. ATTN: John R. Hundley, Jr. 17795 Sky Park Circle, Suite J Irvine, CA 92614 Re: Police Dept. Lobby Security & Limited ADA Improvements — MSC-510 and MSC 515 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. Shouldyou.have. any questio:ns.or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. , - - Sincerely, Robin stanislau, CIVIC City Clerk RE: pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand Dept. ID PW 16-069 Page 1 of 2 Meeting Date: 12/19/2016 MEETING DATE: 12/19/2016 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 JRH Construction Company, Inc. in the amount of $661,667 for Police Department Lobby Security and Limited ADA Improvements, MSC-510 and MSC-515 Statement of Issue: A public bid opening was held on November 8, 2016, for the Police Department Lobby Security, MSC-510, and Limited ADA Improvements, MSC-515. City Council action is requested to award a construction contract to JRH Construction Company, Inc., the lowest responsive and responsible bidder. Financial Impact: For MSC-510, funds in the amount of $544,350 are available in the Capital Improvement Project fund, account number 10040314.82200. For MSC-515, Community Development Block Grant funds in the amount of $139,720 are available in the following accounts: 120881501.82200 ($49,720), 85982003.82200 ($58,841), and 81582003.82200 ($31,159). An additional $83,000 is available in Un-Programmed Community Development Block Grant funds, account number 86382003.82000. Recommended Action: A) Accept the lowest responsive and responsible bid submitted by JRH Construction Company, Inc. in the amount of $661,667; and, B) Authorize the Mayor and City Clerk to execute a contract in a form approved by the City Attorney. Alternative Action(s): Reject all bids and provide staff with alternative direction. Analysis: The City's Police Department was constructed in the early 1970's. The lobby business counter is outdated and security enhancements are necessary for the protection of Police personnel and sensitive information. The design and construction of lobby security improvements was approved and funded through the Public Works Capital Improvements Program. The scope of work for MSC 510, the Police Department Lobby Security project, consists primarily of tenant improvements to the existing lobby, demolition and abatement of asbestos materials, constructing a secure counter area with bullet resistant counter and glass, and reconfiguration of offices adjacent to the lobby area. The improvements will also require the upgrade and replacement of lighting, walls, electrical, fire systems, security cameras and data cabling. Additional bid pricing for new carpet tile (Additive Item 7. - 1 H - ?- Dept. ID PW 16-069 Page 2 of 2 Meeting Date: 12/19/2016 Alternate No. 1) and for new ceiling grid (Additive Alternate No. 2) in specified areas was requested in anticipation of including one or both in the award if sufficient project funding is available. The project includes remodeling the restrooms on the first and second floors and upgrades for the elevators that do not meet current standards for accessibility for individuals with disabilities. In FY 14/15, the Public Works Department was awarded Community Development Block Grant funding to design and construct limited ADA improvements to the lobby. The scope of work for MSC 515, the Police Department Limited ADA Improvements project, consists primarily of improvements to the existing public restrooms and elevators in the lobby area to provide accessibility to individuals with disabilities. In order to achieve economy of scale and more efficient project management, plans and specifications for both projects were combined and bid together. A total of seven bids were received and publicly opened on November 8, 2016, with the following result: BIDDING CONTRACTOR BASE BID ADDITIVE ALTERNATE NO. 1 TOTAL JRH Construction Company, Inc. $651,353 $10,314 $661,667 JR Universal Construction, Inc. $695,384 $23,000 $718,384 Kazoni Inc. dba Kazoni Construction $773,376 $12,358 $785,734 Archico Design -Build $777,000 $15,000 $792,000 New Dynasty Construction Co. $792,544 $15,367 $810,911 Mar ani Builders, Inc. $825,000 $10,000 $835,000 Fasone Construction, Inc. $1,023,555 $9,880 $1,033,435 The lowest responsive and responsible bidder, favorable references for similar projects. Staff is Construction Company, Inc. The available funding Alternate No. 1 for new carpet tile in specified areas. includes the Base Bid plus Additive Alternate No. 1. Public Works Commission Action: Not applicable JRH Construction Company, Inc., received recommending award of the contract to JRH for MSC 510 is sufficient to include Additive The recommended award amount of $661,667 Environmental Status: Categorically exempt pursuant to CEQA Article 19, Section 15301(a) Strategic Plan Goal: Enhance and maintain infrastructure Attachment(s): None HB -53- Item 7. - 2 Z-i "Z-6 L-�--ter � �es-�- 4-)) Engineer's Estimate: $ �- 7-5; ooy BID LIST BIDDER'S NAW -RA g - TOTAL BID "- O ev y 3. 1z t S $ ©o 5. $ o0 �c ti -SQ�E$ 9. $ 10. $ 11. $ 12. $ 13. $ 14. $ 0 Lai cif L-f �C-YW Li 00 :Z HJ 8- AON 910? G A 13 3, p Co SECTION A NOTICE INVITING SEALED BIDS for the construction of MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS 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 P.M. on November 3, 2016. Bids will be publicly opened in the City Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $45.00 nonrefundable fee if picked up, or payment of a $75.00 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/government/departments/public works/Bids/ Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code. Pursuant to the provisions of the Labor Code of the State of California, the minimum prevailing rate of per diem wages for each craft, classification or type of workman needed to execute the contract shall be those determined by the Director of Industrial Relations of the State of California, which are on file at the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct 5% retention from all progress payments. The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code, Section 10263. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. A-1 No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. 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 B at the time of the bid opening. 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 primarily of: 1. Tenant improvements to existing Police Department Lobby to include security lobby counter and office reconfiguration. 2. ADA improvements to existing Police Department lobby and public restrooms. A Mandatory Pre -Bid Walk Through is scheduled for Tuesday, October 18, 2016 at 10:00 A.M. The intent is to allow for a walk through of the site only. City staff will not answer any questions during the job walk. All questions should be formally submitted by email to ithompsonAsurfcity-hb.org by 10:00 A.M., Monday, October 24, 2016. • The contract shall allow the Contractor 105 working days to complete the contract. • The architect's estimate of probable construction cost for the work included in the basis of award is: ■ Police Department Lobby Security Improvements — estimate $435,000 ■ Police Department Lobby ADA Improvements — estimate $140,000 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: Robin Estanislau CITY CLERK OF THE CITY OF HUNTINGTON BEACH A-2 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: September 29, October 6, 13, 2016 "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 October 13, 2016 Signature Huntington Beach Wave 625 N. Grand Ave. Santa Ana, CA 92701 (714) 796-2209 Proof of Publication SECTION A NOTICE INVITING SEALED BIDS for the construction of MSC-510 POLICE.DEPT. LOBBY SECURITY and MSO.515 POLICE DEPT. LIMITED ADA RENOVATIONS . ' 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 P.M. on November 3, 2016. Bids will be publicly opened in the City 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 pa ment of a $45.00 nonrefundable fee it picked up, or payment of a $75.00 nonrefundable fee if. sent by -UPS ground delivery (bidder shall pay additional costs for special delivery): Plans, Specifications, and contract documents can a downloaded free on AGENCY web - site. `http://www. huntingtonbeachc.a.gov/government/departments/pu blic_works/Bids/ Any contract entered into pursuant to this notice will incorporate the previsions of the State Labor Code. Pursuant to the provisions of the Labor Code of the State of California, the minimum prevailing rate of per diem wages for each craft, classification or type of workman needed to execute the contract shall be those determined'by the Director.of`Industrial Re-' lations:of the State of California, 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 afford- ed 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 consid- eration leading to the award of contract: No bid shall - be considered unless it is prepared on the approved Proposal forms in con-, formance 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 [Tsppossess a State Contractor's License Class B at the time of the bid opening. The success - Contractor and his subcontractors will be requiredto 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 primarily oh' . 1. Tenant improvements to existing Police Department Lobby to include security lob- by counter and office reconfiguration. 2. ADA improvements to existing Police Department lobby and public restrooms. Mandatory 2 Pre•Bld Walk Through is scheduled for Tuesday, October 18, 2016 at 10:00 A.M. The intent is to allow for a walk through of the site only. City staff will iot answer any questions during the Job walk. All questions should be formally submitted 2yOe6 ail to jthompson@surfclty-hb.org by 10:00 A.M., Monday, October 24,1 *The contract shall allow the Contractor 105 working days to complete the contract. *The *architect's estimateof probable construction cost for the work included in the be- sis of award is: • Police Department Lobby Security Improvements - estimate $435*000 ' Police Department Lobby ADA Improvements - estimate $140,006 fhe AGENCY reserves the right to reject any or all bids, to waive any irregularity and to ake all bids under advisement for a maximum period of,60 days.- 3Y ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 3th day of September 2016, by Resolution No. 2016.58. fittest: . Robin Estanislau CITY. CLERK OF THE CITY OF HUNTINGTON BEACH ?ublished: The.Huntinaton,Beach Wave September 29, October 6, 13, 2016 .. 10201072 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: September 29, October 6, 13, 2016 "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 October 13 2016 Signature Huntington Beach Wave 625 N. Grand Ave. Santa Ana, CA 92701 (714) 796-2209 Proof of Publication — " SECTION A ,NOTICE INVITING SEALED BIDS for the construction of MSC•510 POLICE DEPT. LOBBY, SECURITY and . MSC•515 POLICE DEPT: LIMITED,ADA RENOVATIONS irnhe 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 P.M. on November 3, 2016: Bids will be publicly opened in the City Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from theOffice. of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon pay-' ment of a $45.00 nonrefundable fee if picked up, or payment of a $75.00 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 web - site. http://www. huntingtonbeachca.gov/governmenUdepartments/public_works/Bids/ Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code. Pursuant to the provisions of the Labor Code of the State of California, the., minimum prevailing rate of per diem wages for each craft, classification or type of workman, needed to execute the contract shall be those determined by the Director of Industrial Re-` lations of the State of. California, .which are on file at -the Office of the Director of Public Works, 2000 Main Street; .Huntington Beach, CA. 92648. The AGENCY will deducts% retention from all: progress, paymants. 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 affirmative)y ensures that minority business enterprises will be afford- ed full opportunity to submit bids in.response to this notice and wilf,not,be discriminated against on the basis of race; &"oloe, national origin,.ancestry, sex, or religion in any consid-; oration leading to the award otcon6act'. . . No bid shall, be consider;d unless it is prepared'on the approved•Proposal forms in con- formance 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 B at the time of the bid opening. The success- ful 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 projectbonsists primarily ofe 1. Tenant improvements to existing Police Department Lobby to include security lob- by counter and office reconfiguration. . 2. ADA improvements I, existing Police Department lobby and public restrooms. A Mandatory Pre•Bid Walk Through is scheduled for Tuesday, October 18, 2016 at 10:00 A.M. The intent is to allow fora walk through of the site only. City staff will not answer any questions during the job walk. All questions should be formally submitted' by email to jthompson@surfelty-fib.org by 10:00`A.M., Monday, October 24, 2016. • The contract shall allow the Contractor 105 working days to complete the contract. • The architect's estimate of probable construction cost for the work includedin the be- sis of award is: • Police Department'Lobby Security -improvements -estimate $435,000 • Police Department LobbyADA Improvements - estimate $140,000 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 Gth,day of September2016, by -Resolution No: 2016•S8. Attest: Robin Estanislau CITY CLERK OF THE CITY OF•HUNTINGTON BEACH Published;_ The Huntington Beach Wave.September29, October 6, 13,'2016 ' 10201072 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3, 2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. Company Name Date z All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. UNSUCCESSFUL BIDS MSC-510 & 515 Police Department Lobby Security Engineer's Estimate: $ BID LIST BIDDER'S-NAAM PANK -. TOTAL BID "6UNT 4. J tJ NS7 1 $ �'" s� 3 S 3, G G s. k.A2aiii cc, 1 $7 73 3 7(' • cry g. $ 10. $ 12. $ 13. $ 14. $ 1 S 1 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk January 23, 2017 Archico Design Build 6433 Olea Ln. #201 Carlsbad, CA 92821 RE: Police Department Lobby Security — MSC-510 & 515 Enclosed please find your original bid bond for MSC-510 & 515. Sincerely, At i 4 , Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of MSC-510 POLICE INEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LEMITED ADA RENOVATIONS in the CITE' OF HUNTI GTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTE'' GTON 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 therefore, 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 105 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 re -advertise 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 a�/ and void. Accompanying this proposal of bid, find afc/ 30 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: � PROJECT BID SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per Soo plans and specifications $ 'O®t) 2. PD Lobby ADA Construct improvements per Improvements (Separate Funding Source) plans and specifications. Refer to the following plan y y O� $ 2 ( � �- sheets for ADA scope of work: A1.0, A1.1, A2.0, A2.1, A3.1, A4.0, E3.0, E4.0, E5.0 Total Bid Amount in Words: Total Bid Amount C-2 6 S Oro The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. 1: New Carpet tile floor to match, per schedule. Refer to sheet Al.1. Additive Alternate No. 2: New office ceiling grid and acoustical tile to match adjacent ceiling grid (existing light fixtures to remain). Refer to sheet A2.1. Lump Sum (use figures only) %!P $ 2-yi000 Lump Sum (use figures only) Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. C-3 0 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid or $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Dollar Item(s) State Lic.9 Amount % ©,f Name cased Address of Subcontractor and Class DIR # Contract loo d15q boo . 5 0 0 2 JN7 -r Ie- Co. Tnc. a713 (emu Tc/ �q513Q 10000061 30,000 3.57. c. Td Nq "00 2 5 5er kry Cl�evca fa/ &v y p 114' looAGo21oti 26WO � /e P o 13ok a 3 3vo q, A Pc.,t la GA 6 51371 air U I L� —Te cd1 Cyr oft r�'oA P y � 3c) Lc, Crvz r�,r,.,r- 758YLIq /o o v o03V 5TOW (.5/ e� eecLACA 25qo I �vscT���P� q z 5�z l00002©1 �v 5�1, o�v ' 6 / Ci4 a 2,no 1 214 9 75 Wc, S'Cr n OL4 �l 100000 I21 q 30,,V0 Z cA , q2 P-7 L12q $;er�k Et � gq�JZ�I 2N WO 2 ; I Sn L' , q- q0 214.5 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-4 J FAM VE jIff 1LffST 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 $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Dollar Item(s) .State Lie.# Amount % of Name and Address of Subcontractor and Class DIR # Contract t Pour Glass � ko6 N 144 Vjwn,-�+ 1 Z3 2�12 3 If�0000ZoZ L1�0� CA a� 3 Ze4 13 �rH'►e_ rre- %Jytr tevA'c'f-0 2 fi ll�,, 3 �f6Z IDb OD3fJ'I 31 5caa 14 5l G dc (e 614 q iZc l Z 163q At,r �/ �(� `j14736 I b0000q� lqi®� G1� I c9v� Zh , /�( ow-e 11911, 4 / p 1[i / n , CA 1710 p Z l4 VS _� co, l ltc- P o 8oV 36 /lI � �1� TOO �6 !o %I (�f%� /00000 117, o00 -5/, Oar - oe"V C O' speul'S P-D ;3 71/9$ 6—&-ir4, C/9 ate' R3 dgg� I o 000ZI& 35600 y Z v-,•r ups I ��• 3 653 / OQ Z l 0,� � ` o >►� - ai I z, of A Co �62,10 l000dnq g0000 /D% By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-4/ 2 ME 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. Name andAddress of Subcontractor State Lic.4 c nd Class �� # Dollar Amount 00 of Coaatrcact Biel Item(s) 19 01 C�� QZ33z �38`787 100000100 rz c0c� 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-4 NONCOLLUMON 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 Z✓yr'✓r ate City State 1aVj*nkJd being first dulx sworn, deposes and says that he or she is of rr1 �'co Deftl &:V 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�kr'o Name of Bidder Signature of idder 50`1 Address of Bidder C-s UTILITY AGREEMENT HONORABLE E MAYOR AND CITY COUNCIL CITY OF HUNTI NGTON ]BLEACH, CALIFORNIA NIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the PROJECT NAME, (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: " Qualifled Person: d 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 tmdersigned further promises and agrees that the provisions herein shall be and are binding upon any subcontractor or subcontractors that may be retained or employed by the undersigned, and that the undersigned shall take steps as are necessary to assure compliance by any said subcontractor or subcontractors with the requirements contained herein. Date: // 7 / 4 j 1, C 0 Contractor By Title C-6 dw,17 e,- DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ® Yes *No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-7 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following, certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: //7 ! U & � (0 14 , 8 Contractor By Title C-8 Awn e.✓ BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: / A��- CQ Bidder Name Z3L2- �&6 � - 30 t Business Address �� �, YI� � �� City, State Zip (qqq ) 272 - gg2G Telephone Number �a / Z- z State Contractor's License No. and Class Original Date Issued ql k /2r Y Expiration Date The work site was inspected byA' 41&vLz1Aaf our office on dCkytf 201jZ. The following are persons, firms, and corporations having a principal interest in this proposal: The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name SiDan re of i der l Printed oil Typed Signature Subscribed and sworn to before me this? day of ��Vy b` ; 20A. (✓Jl'7 7 NOTARY PUBLIC NOTARY SEAL AIR n California Jurat Certificate 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 S.S. County of Subscribed and sworn to (eF BffiffnQd1-before me on this �_ day of �JQvel-v1 kc= r , 20 -L(- , by z c� proved to me on the basis of and satisfactory evidence to be the person(s) who appeared before me. 1� 4""� ' JAIAAE BONIM-Californla ANOS Alotary Pub S€tn t.:r c' i ci==; Pi:rEr Orange (county ? Commission 0 2156733 LOW Comm. Expires Jun 16, 2020 { Ui GO3(;; fp`;G,74:i It'fbl':?':RTE£t,7 ri\Ti r.ry t'afiY7lC, is?, �I: fUSc=vp "rO, C:G i . OPTIONAL INFORMATION %jE+)i33,iryi"+ ti1C tt;fUl"ii)i:i7oF; lii ,i=;> `Bi;7-Ut< fJ' NO i::s I.V'oo by ti Vr it ("okfi <""oru1�E;7t frau 1i w-d r'3i)70v' l ao( IcaiF CimIl? ni Ci 1.%"t :S rtli"gi 10 it-, iti?c l{i 70 r7_ ft' �OCir`t tic uir 7 f17: ' ti,c)L`„' its %lli tO)?F7:. 14_ t lyr oo Cn `e aiiacheis Description of Attached Document The certificate is attached to a document titledtfor the purpose of W�ckdcn-'s tt Method of Affiant Identification Proved to me on the basis of satisfactory evidence: O form(s) of identification O credible vAtness(es) Notarial event is detailed in notary journal on: Page# Entry# Notary contact: containing a , pages, and dated 0 ) ` 7,0 ` Other ❑ Affiant(s) Thumbprint(s) ❑ Describe: l:'Fe ....,i - ..r, t`':�iii_S ; 2v..oE :;C _ _, ,.. .<C :..,-, :;';Y:;:c: ci _ �:c 7C:�'� ttGS*: f�;�„ �-r ejt.� e : e .. 4%\r0ti..{ B�, der's Project H- Stoa•y For the purposes of this project. the bidder shall provide project history of similar work. Bidders are encouraged to submit supplemental relevant project history in addition to the proiects listed herein. List below the names, address and telephone nurnbers for three public agencies for which the bidder has performed similar Mork- within the past five years: 1. Name and Address of Public Agency Naive and Telephone No. of Project Nianager �- -� Contract Amount Type of Work Date Completed Provide additional project description to shove similar work: �, W-- �-✓4 N nottie4l Name andlI ddress of Public Agency 02- -e� Pa (a e- (-� -- Names and Telephone No. of .Project vlanager 1_ � q j 120 Contract Amount Type of Work Date Comp el ted Provide additional project description to shove similar work: 3. Name and' Address of Public Agency 6 ,r \i �d Tele hone No of Project Nian �Y-c..ry lyyC/' tJ rGc� ILa-n /� I ✓A���rns. z5z47g5q i aine al p _ Contract Amount Type of Work Date Completed Aperrintinn fc) CIinw ,Iinilar work: � 3 1,t 'I Hvt-6 a; ARCHICO Design --Build Archic® Design Build References L1c.44: 937122B DIR.': i 000000856 1. Project Name: Euclid & Sunkist Branch Library Renovation Euclid Branch Address: 1340 Euclid St, Anaheim, CA 92802 Sunkist Branch Address: 901 S. Sunkist St, Anaheim, CA 92806 Owner: City of Anaheim Project Number: 15460-01 Contact Person: Robert Palaeologus Phone Number: (562)879-3602 Contract Amount: $ 999,999.00 Contract Date: 1/19/16 Completed Amount: $1,099,433.81 Completed Date: 8/16/2016 Type/Scope of Work: Tenant Improvement (Remodeling Two Branch Library) 2. Project Name: Crew Quarters Rehabilitation for Public Work Operations Project Address: 400 E. Vermont Ave, Anaheim, CA 92804 Owner: City of Anaheim Project Number: 590-412-3131-9605 Contact Person: Tim Flint Phone Number: (949)254-7954 Contract Amount: $283,570.00 Contract Date: 08/31/2015 Completed Amount: $310,156.90 Completed Date: 12/11/2015 Type/Scope of Work: Tenant Improvement (Remodeling Lockers & Bathrooms) 3. Project Name: Material Canopy at Garden Grove Municipal service center Project Address: 13802 New hope St, Garden Grove, CA 92843 Owner: City of Garden Grove Project Number: 5-1124-A Contact Person: Les Ruitenschild Phone Number: (714)741-5348 Contract Amount: $294,600.00 Contract Date: 05/12/2015 Completed Amount: $313,260.00 Completed Date: 1/26/2016 Type/Scope of Work: Building a new canopy over the existing material storage for the city operation yard. 4. Project Name: Fire Station #1 Training Tower Retrofit Project Address: SSS N. Berry Street, Brea, CA 92821 Owner: City of Brea Project Number: 7877 Contact Person: Raul Lising Phone Number: (714)671-4450 Contract Amount: $184,025.00 Contract Date: 04/15/2014 Completed Amount: $206,756.00 Completed Date: 09/17/2014 Type/Scope of Work: Retrofit The training tower 3rd floor slab and replacing stainless steel stair way. v,�,n�w.arcfiico�b.corn � i;�fo�c;;archi<:odb.coi� 2372 Morse Ave. Suite 307 1 Irvine, LA 92614 1 16. 949. 302. 0321 1 Fax 949. 259. 2509 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project. Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein. 1. A/I. h 14 vi'�-� Name of proposed Project Manager Telephone No. of proposed gProject Manager:gVGIi (J Q IL31/ G� �/ byra (ggq) 302- -0,52— l Project Name & Contract Amount Type f Work w6Kle- 8u)16 Project Name G Tee► � LM ��.�,,,� -.� ontract Amount ype of Work Cic-r� S Project 6AAAA Name & Contract Amount Type of Work r) 16-k 6 S i-a V Name of proposed Superintendent � In Date Completed 419,600 ems. Date Completed 570 cl� Ri111215 Date Completed Telephone No. of proposed Superintendent: ` `, 3 10 ecl��ic� Su�k,s�' `i�fc�ry Q�U,at'nn _ it °l a t, ••� i Project Name & Contract Amount Type of Work Date Completed ck4 Mtel�J ro-Ma 4iwran'o�N, 1 158,330., %� �,, nrdr �t _ I`� — 3 0 — 0 Project Name & Contract Amount Type of Work Date Completed Cre,� �� r3 �<JPL��/'+qA -�c PLkbh& k O�eQ_$Zg3> 5--�o.00 je.���'��►�,� fi 1� iI— ���5 Project Name & Contract Amount Type of Work Date Completed Bidder's Critical St2ff 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. Name of proposed Project Manager Telephone No. of proposed Project Manager: Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work Date Completed Date Completed Project Name & Contract Amount Type of Work Date Completed drank Name of proposed Superintendent Telephone No. of proposed Superintendent: l`l y� 0 C� rcw�q F r�s'� �"S kJJe n remodG( - 12a 000 Project Name & Contract Amount Type of Work Date Completed 6 seog`ae' Ceole, Pf),4 Q� Amprv,4,al � ao oav— 0015 Project Name & Contract Amount Type of Work I Date Completed Vdv-ba- U4 c4" Project Name & Contract, ( h ct it ren v vat (,, -h 1 unt Type of Work C-11/2., ON) v 20 Date Completed CONTRACTOR REGISTRATION 1TllRATIION 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.c,ov/PWCR/ActionServlet?action=displayPWCRec,istrationForm 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, or no later than contract award date. cQ Contractor By Date: 1//7/ &16 Title DIR 4: /w000 C-12 L/�Cdn lo✓ 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. 40.9 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: l ✓� , — ` 0 t I v Ca 1 �i Contact Person: Contact Phone: Signed: Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). C-l3 EXHIBIT A DISADVANTAGED BUSINESS ENTER11PI3ISE (DBEI This Project is subject to Part 200.321, 'Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.321, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION — GOOD FAITH EFFORTS FederaIl-anid Project No. q'1-4 Bid Opening Date / V The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 Solicitation and Dates C-15 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. Bidder Normally Amount Percent of Items of Work Performs Item Breakdown Y or N ($) Contract ( ) of Items 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: C-16 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. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: ll (1) Name under which business is conducted— D+� - �Ci1 f� (2) Signature (given and surname) of proprietor ,Ale 611 (3) Place of Business 23%2 #D/Se- jYvi% C4 q&14 (Street and Number) City and State _� ✓f� �r1 �ii-t (4) Zip Code%, 6/14 Telephone No. 2 Z77- — yyZ6 (5) E-Mail /h `�—O CNlii��C� rn w! IF A PARTNERSHIP. SIGN HERE: (1) Name under which business is conducted A / (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business City and State (4) Zip Code (5) E-Mail (Street and Number) Telephone No. C-18 IF A CORPORATION. SIGN HERE: (1) Name under which business is conducted /Aj / /-J- (2) (Signature) (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of (4) Place of Business (Street and Number) City and State (5) Zip Code Telephone No. (6) E-Mail NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS TE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY LOCATION. DESCRIPTION. — PROJECT TOTAL CONTRACT AMOUNT: $ — BID DATE BIDDER'S NAME CONTRACT DBE GOAL: CONTRACT ITEM NO ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS TO BE PROVIDED (or contracted if the bidder is a DBE) DBE CERT NO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT DBE For Local Agency to Complete: Local Agency Contract Number Federal -aid Project Number Federal Share. Contract Award Date. Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Print Name Sigrature Date Local Agency Representative (Area Code) Telephone Number- Total Claimed DBE Participation % Signature of Bidder Date (Area Code) Tel. No, Person to Contact (Please Type or Print) Local Asencv Bidder DBE Commitment (Construction Contracts) (Rev 6/26/09) C-21 PLEASE NOTE: This information may be submitted with your ibid. If it is not, and you are the apparent low ]bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE cornrnnitmeant will be ;rounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description. Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or fiirmshed by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts). to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D (EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Ae cka-) �, 8Vr I d I [proposed subcontractor J hereby certifies that he/she/it has , has not, participated in a previous contract or subcontract subject to the Equal Opportunity clause , s required by Executive Orders 10925, 11114, or 11246, and that, where required, he/she/it 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. (eeoc.gov/employers/eeo I survey/index.efm) 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 Lgboy., Signature: Date: 716 Print Name: Title: dw A tw C-23 EXHIBIT E NONC®IL,IL1(JSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) 11 SC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE IDIEPT TENANT IMPROVEMENTS) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person. partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding: that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosec ion. Signature: Date: 7i Ard itCe D� r� Qu�'61 Print Name: l7 �' rl �ldl�� - V Title: j!�Wnejf C-2 # EXHIBIT F 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 with Bidder in the capacity of owner, partner, director, officer, manager: o 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 him/her 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. Note: 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. Signature: Date: ` avlal Print Name: Title: 4&ngi C-25 EXHIBIT G NONLOB1BYING C1ERTI FII CATRON FOR FEDERAL -AID C©NTRACT� 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 malting 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. Signature: T Date: Z l� Print Name: V Title: 4wn-�� C-26 EXHIBIT H DI-SCLOSURE OF ]LOBBYING ACTIVITIES MX/FPI FTF THIS, FOR ivi TO DISCLOSE LOBBYNG ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: a contract b arant c cooperative agreement d loan y 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 Congressional District, if known 6. Federal Department/Agency: S. Federal Action Number, if kno,,vm: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI 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, iflmown 7. Federal Program Fame/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) S ,S. Z UW ® Actual planned 12. Form of Payment (check all that apply): ®a. cash b in -kind, specify: nature value 13. Type of Payment (check all that apply) a retainer b. one-time fee c commission d contingent fee e deferred f. other, specify ! ✓% 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ® No rl 16. Information requested through this form is authorized by Title 31 U.S C. Section 1352. This disclosure of lobbying reliance Signature was placed by the tier above when his transaction was made or 14 Ientered into "This disclosure is required pursuant to 31 U S C Print Name: iU % ^� O- '4�t8,4, 1, �bI i 1352 'This information will be reported to Congress �� semiannually and will be available for public inspection Any Title person who fails to file the required disclosure shall be subject /��/ to a civil penalty of not less than $10,000 and not more than Telephone No.: K144� 3e,2 0-324 Date: $100,000 for each such failure Federal Use Only: Standard Form LLL Rev. 09-12-97 Authorized for Local Reproduction Standard Form - LLL C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, 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 frill 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 C-28 different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 11) Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13) Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 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. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders. - Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, October 24, 2016. r�, co De-SIV1 Company Name By 1,o 12,4 ////e) Date All bidders must acknowledge'the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3, 2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. /. -Aa- &Okco n - /3 Company Name By to IZI N Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUs(a-)republicservices.com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact— Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell: 714-328-8341 Lauren.kandel(D.redhawkus.com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated MCE controls Model # HMC-1000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor: ThyssenKrupp contact— Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Dan iel.VanMil(cD-thyssenkrupp. com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppelevator.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2"d floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2.0. 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached): 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Number Three, October 27, 2016. Company Name By Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FOUR For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Four, O to , r 31, 2016. Deejcih 8udd Company Name By Date — 10/3 1 l Zp / 6 � All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations November 2, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide 3/" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide 3/" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in. 5) Where applicable, locksets will be Corbin Russwin. Keyway is 59C1— 6 PIN-10. This is to acknowledge receipt and review of Addendum Number FiveZNoveber 2,201 Company Name U By P& &/ Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. THE AMERICAN INSTITUTE OF ARCHITECTS A/A Document A310 Bid Bond BOND # N/A KNOW ALL MEN BY THESE PRESENTS, that we Archico Design Build 6433 Olea Lane, Apt. 201, Carlsbad, CA 92011 (Here insert full name ,and address or legal title of Contractor) as Principal, hereinafter called the Principal, and Developers Surety and Indemnity Company 500 S. Kraemer Blvd., Ste. 300, Brea, CA 92821 (Here insert full name ,and address or legal title of Surety) a corporation duly organized under the laws of the State of Iowa as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach 2000 Main St., Huntington Beach, CA 92648 (Here insert full name ,and address or legal title of Owner) as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Total Bid Amount 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 MSC-510 Police Dept. Lobby Security and MSC-515 Police Dept. Limited ADA Renovations Tenant improvements to the existing Police Department Lobby to include security lobby counter and office reconfiguration. ADA improvements to existing Police Department lobby and public restrooms. (Here insert full name, address and description of project) NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 1st day of November 2016 (Witness) (Witness) Archico Design Build (Principal) (Seal) Developers Sur et mnity Company —1>1116 y) (Seal) e) Yung T. M4 ick , Attorney -In -Fact INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W. WASHINGTON, D.C. 20006 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 November 1, 2016 before me, Kathryn Lopez Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Yung T. Mullick orT� KATHRYN LOPEZ N J r<r COMM. # 2158796 W o NOTARY PUBUC.CAUfORNIA ORANGE COUNTY N �MY COMM. EXP. JULY 1, 2020 Place Notary Seal Above of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PEN the State of Califon and correct. Witness my 4naf Signature Si OPTIONAL IF PERJURY under the laws of thefgregoing paragraph is true ryn Lopez 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: Bid Bond Document Date: November 1, 2016 Number of Pages Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Yung T. Mullick ❑ Individual ❑ Corporate Officer —Title(s): ❑ Partner ❑ Limited ❑ General [� Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: Developers Surety and Indemnity Company Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s): _ ❑ Partner ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Bak 1, 972 _-, I R11,NE, C -. 282 (94� ; 2 e _'- 3WO T xe- ANY "o eech S, _E3E F�'HENTSvna'exrnt aS exz lnsy liml:en, DE'.,ELOPE�RS SURE i'AND INCEM141TY =FANY3-11 NDE%ft 0FrALlF",RNzA, d a - ant, a PP'0:n-': "'Y;jr,g T INIullick. James VV, Modanen, Christine T. 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Ex Tres Oct 13, 2018 P t, Not , Set Abne And I= as Man hmsdof%i wM pan w w a Mc- bns to be me pas",) Whose navy) Arnie sdiscrsc� to "ne ins-nument ono '_' me t,"iainv,tney exe-cute, the sare i-- 1A 5,;Irrtrvir au"n.c.cz"J, Cspanqmj ao yN q Noerov s1modQ on Me asurnet Q pesock" or .he nQ an' be"4 C' Wh A we prsmw anted, ew"Ic me WNTa!, I ce-14y ur.-JW PE;'++`.LTY 0,"7 'ERXRY 051 Re HAF Of be S%A Of C95MA % te VqMg MM9010'"s Erin am c=." dlip CERTIFICATE T,-,�_ '0MR,1VJ`T C7 ,;�_ nf'_EVEL.C��7:1�'S ANG N2LMNA" CCMRAV 0'N"DVAN:T CALFCRI41A, coe5l�,Q 70 codus a yKAH a Me v PQ. chboa M, 1st cia,ycf November; 2016 'q, C, �11 APIR4 koy, OCT, z 01,T to Ic 1967 1"6 N° 6895 STATE OF CAIMRMA. DEPARTMENT OF INSURANCE tM FRANCISCO Certificate of Authority Ttm Is To CzRwy, That, pursuant to the Insurance Code of the State of California, Developers Surety and Indemnity Company Of West Des Moines, Iowa ,organized under the laths of Iowa , subject to its Articles of Incorporation or other fundamental organizational documents, is hereby authorized to transact within this State, subject to all provisions of this CertifxWe, the following classes of insurance: Surety as such classes are now or may hereafter be defined in the insurance .Laws of the State of California. Tiers Cxant cm is expressly conditioned upon the holder hereof now and hereafter being in full compliance with all, and not in violation of any, of the applicable laws and lawful requirements made under authority of the laws of the State of California as long as such laws or requirements are in effect and applicable, and as such laws and requirem,'ents now are, or may hereafter be changed or amended. Ix Wrnw, ss Wmmog, effective as of the. _ 3 o th --day Of August , 19 99 , 1 have hereunto set my hand and caused my official seal to be affixed this. 30tb day pf August ,19 99 Qu By /ryy x J1 if State must be accomplished as rlq! hernia Co ons e promptly after issuance of this Certificate of Authority. Failure to do so will be a violation of Ins. Code OI and will be grounds for revoking this Certificate of Authority pursuant to the oove=ts made in the application therefor and the conditiom contained herein. 92 w— /Dell C" City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk January 23, 2017 Fasone Construction, Inc. 2194 Norwalk Blvd. Santa Fe Springs, CA 90670 RE: Police Department Lobby Security— MSC-510 & 515 Enclosed please find your original bid bond for MSC-510 & 515. Sincerely, Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand 1r- SECTION C PROPOSAL for the construction of MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS 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 therefore, 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 105 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 re -advertise 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 : c v S U r 1C)r, /0 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 Si natur o ..Z Z l -Z" is -z S - Z- t PROJECT BID SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per plans and specifications $ e i cl , 467S 2. PD Lobby ADA Construct improvements per Improvements (Separate Funding Source) plans and specifications. Refer to the following plan $ Zo 7 sheets for ADA scope of work: Al.0, Al. 1, A2.0, A2.1, A3.1, A4.0, E3.0, E4.0, E5.0 Total Bid Amount $ l; 0L3, S 3 Total Bid Amount in Words: 0,1e_ ' I/i v -1 : j- e,� (Y ._h-CC, f,h ; . j � ,d, C-2 The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. 1: New Carpet tile floor to match, per schedule. Refer to sheet A 1.1. Additive Alternate No. 2: New office ceiling grid and acoustical tile to match adjacent ceiling grid (existing light fixtures to remain). Refer to sheet A2.1 $ q go Lump Sum (use figures only) $ �L`- I r '7- Lump Sum (use figures only) Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. C-3 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, October 24, 2016. I'ci s�7rtu vnST L)c�o�� C i . Company Name // - 7 -f Cv Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3, 2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. Ea,�Cix::S. : r Company Name u-7 D9te All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUs(a-)republicservices.com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact — Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell: 714-328-8341 Lauren. kandel(aD-redhawkus.com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated MCE controls Model # HMC-1000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor: ThyssenKrupp contact — Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Daniel.VanMil(cbthvssenkrupp.com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppelevator.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2"d floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2.0. 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached): 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Number Three, October 27, 2016. h/ C,/uAY i)J1S//yC"l�o,� L1 C Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER F_ For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Four, October 31, 2016. r .J/ c 9 Company Name L -' -/C4 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FIVE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations November 2, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide %" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide %" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in. 5) Where applicable, locksets will be Corbin Russwin. Keyway is 59C1— 6 PIN-10. This is to acknowledge receipt and review of Addendum Number Five, November 2, 2016. Company Name // - 7 -/ Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. 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 Dollar Item(s) State Lic.# Amount.. % of Name and Address of Subcontractor and Class DIR # Contract C U I A. t - c 8, o cpJoc�4 v �7sa `17�ci Alc' l'ct/� %inet ��t t C %S.4 .30c TJiY-5sen4rUpp pp Ave, l Esc C_ 2- i vevvo io C is 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-4 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 Dollar Item(s) State Lic.# Amount % of Name and Address of Subcontractor and Class DIR # Contract At'r pl-efr'x '2 1CI Evcx,�t nc. Iur_cac�cz3� /0 TV S'qc>q;���� c �a � n/�rt, ; •r� ;t�3 t � 3 ; 4>�� :3� 1 t s t� R2 vte-rs►de, r-A ASV O'Connor Pl)""�qb"�A 004" nq ZC `43 i Zn iu Roo (,; n� -i 4 131 � ct l� &1 0 C-}�- t-uct 1 jVe C_tS ICE a)US131 // C -A 9 a S C-�y G St't / d;'�c:''t � enoV �C ?'_ r ,.fit-�. L'x,`•�d e� tceck���=sKs' `l 116 w o W 2 III (1'l S C" I Q-1 t?orC)ok'r 33 �crt't4-a � �j�r i ter: 5 C � rltJiv }cam ell t"r ,i " , CU1 i� i�cx trt F-�c Avg G -;L I /C 22 i�oiYio3�.� �-- 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-4 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID 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 (a , at !A) r-ft'-et— Date City State I I eav% %aS0A-P being first dul _ sworn, deposes and says that he or she is PEeS;SPA: - of �s0;..e onsf�� `o;� rhC 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 mernber or agent thereof to effectuate a collusive or sham bid. Fla �OtI � CGil,sliC�d i� � c Name of Bidder l Si ature of Bidder Address of Bidder C-5 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 v �f- HILDA RUIZ y�1� t; Commission # 2041530 Notary Public - California D Los Angeles County My Comm. Expires Sep 16, 2017 Subscribed and sworn to (or affirmed) before me on this day of X1.rilt, VYA P/ .20 9fia , by Date Month Year (1) J "-IAAt \ 4a41°_ -�� ,�,r n (and (2)� ), Name(s) of Signer(s) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signat:re7Lz,�A----/ Signature of Notary Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document j I Title or Type of Document:r l y CO/I U.0 i h h i t r7 aO Document Date: « �� Number of Pages: Signer(s) Other Than Named Above: 02014 National Notary Association • www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the PROJECT NAME, (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: �1 —/Co Contractor (re P Title C-6 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 ',�N0 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-7 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: J I- 7 - I (41' raS01114; Contractor By Title C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name nn l_//24 A,-)tcc'k tll�:� Business Address bb City, U State Zip Telephone Number State Contractor's License No. and Class /q l S Original Date Issued .:S--3i-iR Expiration Date The work site was inspected bykV011 T Sv n .z of our office on , 201_. The following are persons, firms, and corporations having a principal interest in this proposal: 1/0:1 Jn i SC-) .-L 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 fort sac�c�n<' -rr idV\ IchC Compf ny Name Sig tpre of Bidder, e,4i,, -° Soil Printed or Typed Signature mm� Subscribed and sworn to before me this % day of 4, i /p-r"6 201 /,p. NOTARY PUBLIC NOTARY SEAL C-9 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) i ,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 alb r �' C� j- HILDA RUIZ Commission # 2041530 z Notary Public - California z z ' Los Angeles County D My Comm. Ex ires Sep 16, 2017 - Subscribed and sworn to (or affirmed) before me i on this day of Ae�, 20 by Date Month Year (1) ( r-01 !(� _� ✓7 ��� . (and (2) ), Name(g) of Signer(g) proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Signature z��.zl ? Signature of Notary Pc Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document _ Title or Type of Document: `�. "1 0, 0 ✓ �-� ��� rwn �a� rr� Document Date: Number of Pages: Signer(s) Other Than Named Above: ©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. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. List below the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: La.G � e/eJ LDS An p/es Name and Address of Public Agency J Name and Telephone No. of Project Manager 3, � Z-U . Z3 c) 'e na n- f /)f' -," P)VX Pit f U _.I S -A, Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 2(? A-4,c ke(D V � C:S [-nJ r3fd Floor- 2. Lrea ereLf' _ S e/krc,e C 3oo /( /-z,s Name and Address of Public Agency Name and Telephone No. of Project Manager Contract Amount Type of Work Provide additional project description to show similar work: 4�� 3. Name and Address of Public Agency Name and Telephone No. of Project Manager Contract Amount Type of Work Provide additional project description to show similar work: C-10 Date Completed Date Completed Project Description: USCIS 2ND & 3RD FLOOR RENOVATION General Services Administration This project was primarily: Renovation 6: Provide a detailed description of the project and its relevancy to the intended work for this solicitation: Project consisted of the renovation of 30,000 sq ft on 2 floors. One floor was a previous cafeteria which required plumbing to be capped off and removed through several floors which required substantial investigation to not disrupt an occupied and functioning building. This was accomplished without incident. Scope included demolition of walls, steel stud framing to deck above, drywall, T-bar, electrical including new panels and LED lighting to work with a new Building Management Controls System, new conduit for data and security equipment involving the path of travel through multiple floors above which required scanning of concrete floors prior to coring. Other scope included installation of new security doors, paint, vct and carpet. There was also substantial abatement over several occupied spaces and very congested spaces. The HVAC system was a substantial re -work due to previous tenant improvements within the space. All work performed while building was occupied. Fasone Construction successfully mitigated construction challenges and worked closely with project architect, electrical and HVAC engineers and end user Agency. All subcontractors have been long term team members of Fasone Construction with excellent working relationships which ensured successful timely completion. 7. Percentage of work firm self performed: 40% Provide a detailed description of the relevant work your firm self performed on this project: Fasone Construction self -performed, all demo, framing, drywall, electrical, and project management. Exhibit "B" Project Experience — Offeror, Page 2 of 2 Project Description: USAO 4"' FL RENOVATION DESIGN BUILD This project was primarily: Renovation 6: Provide a detailed description of the project and its relevancy to the intended work for this solicitation: This project was a design -build of 19,000 sq ft secured space for United States Attorney's Office, trial preparation. Client provided minimal design intent drawings. Fasone Construction provided a complete set of working construction drawings to conform to USAO specifications including the redesign of HVAC, fire sprinklers and fire alarm systems. Approval of drawings involved review by USAO Security Specialist and other USAO personnel in Washington D.0 together with GSA and local USAO personnel. The design of the fire sprinkler system was complicated and required a coordinated effort with the Fire Sprinkler subcontractor, fire protection engineer, GSA peer review Engineer and client. The challenge was to balance the cost of the sprinkler upgrade while creating a design that meets NFPA 13 requirements as applied to a space where a portion of the use would be designated as Ordinary Hazard Group II while other area use would be Light Hazard Occupancy. Issue resolved to clients satisfaction. Scope included demolition of walls, steel stud framing to deck above, drywall, T-bar, electrical, new conduit for data and security equipment involving the path of travel through multiple floors above which required scanning of concrete floors prior to coring. Other scope included installation of new security doors, paint, vct and carpet. USAO specifications also required installation of man bars in HVAC ductwork and Thermafiber Acoustic Ceiling System for sound retention. All work performed while building was occupied. Fasone Construction successfully mitigated construction challenges and worked closely with project multiple agency parties. All subcontractors have been long term team members of Fasone Construction with excellent working relationships. Project is relevant as the customer was GSA, Project was Design Build, building is an occupied and functioning multi story federal building, involved modifications to architectural components including ceilings, walls, floors, and wall coverings; modification to HVAC systems controls, fire protection sprinkler systems. 7. Percentage of work firm self performed: 40% Provide a detailed description of the relevant work your firm self performed on this project: Fasone Construction self performed Design drawings by in house Architects, all demo, framing, drywall, conduit only for data, electrical, and project management. Exhibit "B" Project Experience — Offeror, Page 2 of 2 Project Description: USCOA FIRST FLOOR REALIGNMENT This project was primarily: Renovation 6: Provide a detailed description of the project and its relevancy to the intended work for this solicitation: Project involved 3 phases of construction at the Richard H. Chambers United States Court of Appeals in Pasadena. Phase I (Approx 831 sf) — Reconfigure space in basement to accommodate two new offices for USMS and GSA and added IT storage room. Work required reconfiguration of HVAC duct work with challenges due to ceiling height. Abatement of plaster was performed by Castlerock• Environmental, a long term subcontractor to Fasone Construction. Scope included steel stud framing, drywall, T-bar, electrical, data conduit and cabling, paint, carpet, new doors and hardware. Phase II (Approx 5,977 sf) — Reconfigure first floor south — consolidated office for IT staff and added a new IT training room. Built four new private offices for staff attorneys. Reorganized library stacks and built new deputy librarians office. Enlarged Judges lounge and enclosed new librarians office. Work required reconfiguration of HVAC duct work, new duct work again with challenges to height elevations. Project also involved building shut downs for fire sprinkler modifications and fire alarm work. This was coordinated with building maintenance staff. Coring of multiple floors to accommodate piping was coordinated and performed with floor scanning prior to work. Abatement of floor mastic was also performed by Castlerock Environmental. Other challenges included differences in floor elevations where walls were demolished. Fasone successfully designed a ramp entrance to space to mitigate challenge. Scope included demolition, steel stud framing to deck above at approx 21ft, drywall, T-bar, electrical, data conduit, cabling and new IT equipment installation, paint, carpet, new doors and security hardware with electrified strikes. Also included new cabinets, counter tops and custom architectural millwork to match existing in Library. Phase III — First Floor North (Approx 3,000 sf) - Created enclosed office space for new copy/fax/file room with new storefront to match existing at Clerks Offices. Painted entire space including removal of all furniture in offices and work stations and installed new carpet in entire space. All work performed while building was occupied. Fasone Construction successfully mitigated construction challenges and worked closely with project Architect to resolve issues. All subcontractors have been long term team members of Fasone Construction with excellent working relationships. Project is relevant as the customer was GSA, building is an occupied and functioning courthouse, involved modifications to architectural components including ceilings, walls, floors, millwork and wall coverings, modification to HVAC systems controls, fire protection sprinkler systems. 7. Percentage of work firm self performed: 60% - Provide a detailed description of the relevant work your firm self performed on this project: Fasone Construction self performed all demo, framing, drywall, electrical, millwork and project management. Exhibit "B" Project Experience — Offeror, Page 2 of 2 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. CFO Ck Name ; proposed Project Manager Telephone No. of proposed Project Manager:.�7� Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work // 2. k%�I/, r. Ci Sn i l (d — Nalne of proposed Superintendent Telephone No. of proposed Superintendent: Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work C-11 Date Completed Date Completed Date Completed Date Completed 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/Public Works/SB854FactSheet_6.30. I 4.pdf DIR's Contractor Registration Link — Call (844) 522-6734 https://efiIing.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 177 L I (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, or no later than contract award date. Date: DIR #: 166nUJ 70so sot, �_ l s �:� c !►^�c; I �dn . tic Contractor By Ps, A v n I Title C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: C717_— `14k— Signed:+,, Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub -contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). C-13 DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.321, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 EXHIBIT B DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 & ),-) lUC 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 Solicitation and Dates A-1 610L: C-15 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. Bidder Normally Items of Work Performs Item Breakdown Amount Percent of (Y or N) of Items ($) 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: IUv�� C-16 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. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: jEn (1) Name under which business is conducted /\) I V- (2) Signature (given and surname) of proprietor (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business (Street and Number) City and S (4) Zip Code Telephone No. (5) E-Mail C-18 IF A CORPORATION, SIGN HERE: [ / (]) Name under which business is conducted r uS�r� 2 �d nS It �c`Cdya n (2) v-t� (Sign ture) (Title) hnpr„ss Corporate Seal here (3) Incorporated under the laws of the State of Cc, 11 (4) Place of Business / Z-4 A o roja(L Z Aid (Street and Number) City and State (5) Zip Code 16 L,, '70 v Telephone No. S-L,7— 719 —3-3 (6) E-Mail 0A__e64hC.. ( o NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 .a�_aC_aC.a 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 (�P) ` ' �� e On yi 1'7�� - �l(, before me, Idit Date _ Here Insert -Name and Title of the Officer personally appeared I ell) Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person() whose name(s) Ware 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. HILDA RUIZ Commission # 2041530 f� Notary Public -California D Si natu�s Los Angeles County g — Signature f Nota Public My Comm. Expires o Sep 16, 2017 g ry 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 � ,S GA®� ���% � ' Title or Type of Document: � %�7�CM, 69� Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) -- Signer's Name: _---_§igner's Name: ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General''' ❑ Partner — ❑ Limited ❑ General y� ❑ Individual ❑ Attorney -in Fact ❑ Individual ❑ Attorney inFEact`� ❑ Trustee ❑ Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer Is Representing: Signer Is Repr�ntirig: 02014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 List below names of president, vice president, secretary and assistant secretary, if a corporation; if a partnership, list names of all general partners and managing partners: coo u i A 0 ' OC .l7L % ct C-20 FXHIRIT n EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder F c�>n �'�1S I/ �'t 1 J �'r1 , /1 C- [proposed subcontractor ,] hereby certifies that he/she/ has_ , has not , participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 1 11 14, or It 246, and that, where required, he/she/it 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. (eeoc.gov/employers/eeolsurvey/index.cfm) 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. Signature: �r Date: Print Name: Ueunll �' f uSvi1-4-2- Title: I)"� S eX-e vi-r C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE DEPT TENANT IMPROVEMENTS) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California 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. Signa Date: Print Title: Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. C-24 EXHIBIT F 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 with Bidder 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 him/her 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. Note: 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. Signature: Date: P Print Name: rcu:c)'t _ Title: Pr.e5 " AJ?f-'+_ C-25 EXHIBIT G 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 fai lure. 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. Signature: Q, Date: 1 'Sf -J Print Name: J-eayu-4 7 i*CucdA ..p Title: P(--e SI cV 1?nJ-- C-26 RYUIRIT " 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, MPnme ❑ Subawardee Enter Name and Address of Prime: Tier ifknown Congressional District, ifknown 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, ifknown 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: b. Individuals Performing Services (including address ifdifferent from No IOa) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. $ () Actual planned 12 Form of Payment (check all that apply): Ba. cash b. in -kind, specify: nature value Type of Payment (check all that apply) a retainer b. one-time fee C. commission d. contingent fee e deferred 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 1 I: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ❑ 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: Jtantlard Perm LLL Kev. U9-12-9 / No A Signature: k Print Name: !? L'c'2 k r 1 Title: Telephone No &7 7, 5*-J.S4- Date: # — 2 - iv Authorized for Local Reproduction Standard Form - LLL C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H. 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 C-28 different from 10 (a). Enter Last Name, First Name and Middle Initial (M1). 1 1) Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13) Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 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. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 THE AMERICAN INSTITUTE OF ARCHITECTS A IA Document A3 10 KNOW ALL MEN BY TI-fESE PRESENTS, that Nve as Principal, hereinafter called the Principal, and Fasone Construction, Inc. 2194 Norwalk Blvd. Santa Fe Springs, CA 90670 ( Here insert full name and address or legal title of Contracted) American Contractors Indemnity Company 601 S. Figueroa Street, 16th Floor, Los Angeles, CA 90017 (Here insert lisp Hanle and addrei> or legal title of Surel} ) a corporation duly organized under the laws of the State of California as Surety, hereinafter called the Surety, are held and firmly bound unto City of Huntington Beach _ 2000 Main Street, Huntington Beach, CA 92648 (Here insert full name and addrt ,s or legal title of Owner) as Obligee, hereinafter called the Obligee, in the SLIM of Ten Percent of Amount Bid Dollars (S 10% of Bid ), For the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executor, administrators, successors and assign, jointly and severally, firmly by'these presents. WHEREAS, the Principal has submitted a bid for MSC-510 Police Dept. Lobby Security and MSC-515 Police Dept. Limited ADA Renovations (Here insert full name and description of project) -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 payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this (Witness) See Attached Acknowledgment (Witness) 1 st day of November Fasone Construction, Inc. (Principal) 2016, ( Seal) (Titl 1 Amer' an Contr to Indemnity Company (Su (Seal) Kevin P. Reed, Attorney -in -Fact (Title) AIA DOCUMENT A310 BID BOND AIA FEBRUARY 1970 ED THE AMERICAN' INSTITUTE OF ARCHITECTS, 17,35 N Y. AVE., U.w, WASHINGYON, D.C. =0006 THIS FORM MUST BE StiBMITTED WITH THE SEALED BID 12 — __ — u IIIIII ihlll!I .� III �: — fill I —POWER OF AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, United States Sur€ty=�ompa a Maryland core I rationI,U11 IIh pecialty Insurance C m��o�=a texas corporation = �o11edtively=fhe IIImlll�lll (IIIIIIII tl IIIIII IIII d,lllll III _ C�nniei these presents) in ,conlstttute oint: d 1, l ll. — — ''IIIIIII',IIIIIIIII�I I II� �II I I'Illllilllll.�lllllllllllf l �lil'I�I!II III�� 'Kevin Paul Reed of Santa Ana alfornia its true and lawful Attorney(s)- i n- fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to executacknowledge and deliver any and all bonds, recognizances, undertaldngs ==or--oth ustruments or contracts_oL=s t TnX&Mlude riders, amen to ts,llalnli I'col'llilllls�llllllnts of surety, pr4l�dil_tlr Gad penaldoes not_exceed _ — one Million***,I!IL 9!i1 Il Ii r!�dVll6111111111111111, Dollars —__ IMPosve�-v��lttarney shall exp�c f—IM urtlrc _ tiorr on DecemberlllQ;8111f1 m�hsl�l ll hi°SII.!IP'lo"Iw'e' orlllllr _ Attorney is grae�uneri _ authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions_ _ _ Ila�r., Lilli!pllllull!Ifl �., �Q'l!19GI4!: — _ — -_ , i n ct og given full power and'autNO'❑ty for and in the:iname of and on behalf_a mpaW to�acec�ieyacknowledge and delt_geT?^ d ho s, II1tlIIPll�glllllll.,d Il. lllou. j Mlu I'I il'n AP 11 i.IWfll!lill, — _ _- - ec€ eni ances aWL agreements or indemn� land)) o!therllllcondnt�onal or obligatory u rC AW in udi" MR1 all consents forftlib ase of�etauied= INoitllllll' . I!Itllllilli� IVI. ! olli 110 lu:. d .Ilus� !uunP Yolluu!�, — - -- er enta �7a_r ina stimates on engilneelnng,Illandilelonsiiuctton hcontracts, and any and aT oMes �_ do"� tE ancelrng or terminatingtha,� Y'rlr thereunder, and any such instruments so executedllby any such Attomey-in-Fact shall be binding -upon dFCompany as if signed by the President A�sealMnd 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 attomey 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--_undertaog to which it is attached. -= — 'IIII iIIIIIIIIIIIII�III'll !'ll IIIIII IIII I,III�I!iI!' Il:IIIIII. M3 1WI`1" EIS FMEOF The CO a ne�ia�. cansOt instrument tol �I �'6 Ine and t e o rate seals to bye o- fffxed s _ p- dgl YII III"Vlu!!IIIICII!IIIIIiIIu'�'df'll!Illp''�191II, — - -__- YDthdayoDecember, 2012. AMERICAN CONTRACTORS INDEMNITY COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY _ CQgoratrSea15:,:I e.,��. DanIP A uilar, Vice President — State of California t, County of Los Angeles SS: _ —_ 'III I I , IIIIIlIl,11 IIIIII' = __ - �_ =- — � _ —�IIIulapi'� II Ilgl !IPIib IIIII VII�, __- Wn�--OtM— a�offlffimmber, 2012, bLfor-_ — riess � a notary pub ic; pe�$ all y, a ar dlli amel P. Aguila _ --__ — -- — IIIIII li i,I tlu�ll "p h,him i'�I:!I IIII �t�----(FIrlE r Arwaiaffh refractors Indemnity � Jrrrted s zrety Compan ,,a U.�S Spec �t�% tnsi{%ance Compan who p�v _ on the basis of satisfactory evidence to be tFie person whose name is subscribe eIlldll to lthe within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. II !I Iluulllllliluolllluull 'ILIIi!illll'I, — - _— ce i irzd r ALTY OF PERJ Ib IIYI'llunderl the la s f the State of Gal rn a tutT f_-gAing paragraph is=�e=___and-correct. =— —_- WhiiI Q'l Iqy --- == —_ MW'FSS—iar�nd official sell. I °j IIRIII IIII III VJI _ _ — y watctlT COnx+daaron 19931 Signature �_� � (Seal) s Notary Angeles •Cn Las npalaa County my Comm. Emms Dac 8, 2016 I, J_eannie--L€e Assistant Secretary of_AmericatLGontra-ors Indemnity Company (Unit d,ll ,ate urety Company and U-S. S�� — m!,Ih!'lll: (,IIIIII :u'' VIhI, IIhIIII — — nsuram C-our a & do hereby certtfaimho�b— j�foregoing is a o eFt to Power of AttomM-%emcee-ems — — — �I' IIII III h fI' II I1t IIlcll lq' !tl' _ - sa Cornpames which is still in iLfQ€e and eTf irtl errrtore, the res' IIY� � I Fis Directors, sell ut�t me-M € IIIII 1 -Attorney are mull force and effect. — — In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this day of �(d IiYI Gir —=— j IIIIII III I;I ICI — — _ _ � = I I' ' !11III'IIII ;;tl,llil ' Illn, —_ — �c rye l� :II,II II ' II Illi ll Bond No. 1`� % 'Q` x =o' �' p `o`_ _�` � \4 ;` Jeannie Lee, Qssistant Secretary Agency No. 7745 _ :NCOP.PO-EU ,�*�„ ; , IIIIII I I IIIIIIIIII191I I I Illlljlll II IIIIII ,III � ! I I ' I 'I' Ill '� IIIII I II, I I� I IIIII. dl 91,uI1.I I, I 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 November 1, 2016 before me, Brandon K. Grindel, Notary (insert name and title of the officer) personally appeared Kevin P. Reed, Attorney -in -Fact 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. ---- :I — 6i NDON K. GPM cEa WITNESS my hand and official seal. !: . r Yl� �+yxx�2G6soGi tL> _`-j' Signature (Seal) 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 January 23, 2017 JR Universal Construction, Inc. 1045 N. Hudson Ave. Los Angeles, CA 90038 RE: Police Department Lobby Security— MSC-510 & 515 Enclosed please find your original bid bond for MSC-510 & 515. Sincerely, Robin Estanislau, CMC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ® Waitakere, New Zealand 7L fD CP o o c)L SECTION C PROPOSAL for the construction of MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS 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 therefore, 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 105 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 re -advertise 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. j Accompanying this proposal of bid, find -F► A owl G1 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, 'y S' nature 1 10 a io 6-k-7 aCI e 3 to W PROJECT BID SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per plans and specifications S'Z/ $ J "( 2. PD Lobby ADA Construct improvements per Improvements (Separate Funding Source) plans and specifications. Refer to the following plan $ / sheets for ADA scope of work: A 1.0, A 1.1, A2.0, A2.1, A3.1, A4.0, E3.0, E4.0, E5.0 Total Bid Amount $ 757 Total Bid Amount in Words•, ,� 4—C-A.&n-:/'2e �sA-,,� �i� �.�� �; �, 'i.•e. ! -✓ n • ® `�� C-2 The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. 1: New Carpet tile floor to match, per schedule. Refer to sheet A]. 1. Additive Alternate No. 2: New office ceiling grid and acoustical tile to match adjacent ceiling grid (existing light fixtures to remain). Refer to sheet A2.1 $ Z_ ?'/ ©6 (T Lump Sum —(use' figures only) $ CZ-/ bd 10 Lump Sum (use figures only) Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. 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 Dollar Items) State Lih# Amount % of Name and Address o Subcontractor and Class DIR # Contract �l-U En-�er � 1.701 AY gri tie 4200 BSSV41 IOW007 AS, 3Ss 7. S Irvine cA clu en-e L. haS tVLLr4 iaz N. (vta un sF. 811 b8 z 100001$66R 0' 35-3 Or-ah -e CA 92 8bS' C53 , Pinner Pkr+l-fimS 35a1 �_ ��- Palma Az- 92a 22-3 l00000goq - iM,380 ArA-V-eCr" CA aZ906 cal �f,e 2td HawktrC `� Szcvri I•y S+- 71301q �'ra-}CCITa t&`io N- P,,0-.{0m" G110, CID l000vog1gl 2,S'� ` O range CA 928 6 7 l^S+lt rock Envi ron men-t-.Q, Sly tooyo Pa i_r-Fer lie 776(OS 10000'p346215, b3s J l • �,L a F� Springs , CA 40G70 21,ezz, CI 2 .4 , t3 F3vif2�- KTM Enfcrpriscs lr\e. c(,q &Poo S. ,Je4'c.rson ,Ste 8. WOOD& 53,775' ip m V- PMf e.SG i 6ro•-1 t ri c r� C1LC (�i ' I'7 q2,; Sky Pe,,V k- C i r. ste C qS1b b $ l0000 ogs-12 ( r v s' n 2 CA-q2..14 -1IV $ev�chr►-irk {�r'ofSt.�c-`ors (o%2- Iv►bsf�y 401 �ti�sy� �OOOU23ba� ✓� ®BO ✓- Mis nihMe( CA- -i21,83 C (a 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-4 FAA 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 $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Dollar Item(s) State Lic.# Amount % of Name and Address of Subcontractor and Class DM # Contract 0-61 i New Air Inc yZG Sier►-� 5+- 47 cl°I52o 1 10=19(o3 P3,700 t1 5,r5vrc1c> , CA g0214S_ czc� RD M Tile �e C a 3 "70 „fit �1e ocecrnside CA,g2-oqq ThySs-e-n krupp f--1cve . tz) - Cvrp. tPS 137 evohr I(001 s. si(s-F Sf. She E. -12`301C woo t'v Q3�8$ro 1000ooZ162 Ccrooq , GA 'M877 c21 .AI VS � 'Pox 11 ll lot $b`f (� P-o. 3e1 t ( 10000 3(01ZL 07, 07.9- $ Los A� eAes ° c4 13o03(o C3� � C. V 17 3 z9 LS Tiff r By submission of this proposal, the Wildle��/rcertifies: 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-4 L 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 andAddrecs of Subcontractor State Lic.# and Class DIR # Dollar Amount % of Contract Wr 004604os2� ��� �� y•� �/�/ J f -i /� Co . �'�- � !3� 66 s/39 1O0000613asod ?'�Z 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-4 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 11 S Ito, at Lvs -rnfi(es' G4- ate City State ✓ Lo being first duly sworn, deposes and says that he or she is i C 1'.2 S i ctev):t ofy (antyeySkl Cdr&V+dn, I0C. 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. Jp- domse'l coy' fi' VA OA , Name of Bidder ►gnature of Bidder N Ave . � os Avg e(eT, eA �l003� Address of Bidder C-5 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 PROJECT NAME, (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: J R On l verses( nC . Contractor � 1 C�E I C-r- S i Jt_= h - - Title C-6 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes >(No If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-7 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: A / g /2016 j1pn + v2,Lo�r� I roc-` . Contractor � I'C---, {���s�deh7�- Title C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: -j R U in i v-e—a6d (6) S tyvch -6n v) o� Bidder Name i� � 1» ► xtSo0 Business ,address . e. C ity, (323> 7 22� � Telephone Number State Contractor's License No. and Class C)9 Original Date Issued Expiration Date State Zip The work site was inspected by ' CAY- LOYA 1YV of our office on /G> / - , 2016. The following are persons, firms, and corporations having a principal interest in this proposal: Esc AV le-( PeA-mo5- 1 d �+ s�r5f-a Ck,--VeZ C . a. O. E�.A,� o-t Lo b ot- a Me < < d,--- za-r-YA d 5 `/+ce 1'1eS1 ' r\1 5-ec-re.� The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name, Notary Public . California Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. List below the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: Ci V C-XC Civic cen4--r Dr-. T a wxc- A Name and Address of Public Agency 17i ,-n e Meer d i ckk c h ("3(0) 7B l --7151 Name and Telephone No. of Project Manager tSC&q 0S3a= P, -6-n g/z3/ ;;)-oi3 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: R:cnova---hz C)'F 1lle 7�1c7 1 % Ce- Deep0,-r+r1 1-e) \4 of HiSSion Vi ee�p Name and Address of Public Agency eh Fri eS (9L4G) 75`33- 081 1 Name and Telephone No. of Project Manager +�7f q , UL4 �a os /Z8/ZoiS- Contract Amount Type of Work Date Completed Provide additional project description to show similar work: LO c, kwcr {—oo rn re- hoye- h -6-n 'PG S a d e+'1A C ,m y'l va i 4-�/ Co I I ie- jc l5-IO C i, [or �t a ��� PGtS a dPvl a �I I b Name and Address of Public Agency a c k ►-n c,-() LGz/,=> ) 'S� g S - 7L4 4�7-6 Name and Telephone No. of Project Manager 4631, q I a Pe- -ham 07 / ;z-o ( b Contract Amount Type of Work Date Completed Provide additional project description to show similar work: }�'1a�In J- jri rl cam►-�o� Y2S0VY-Cc CeXl+er fel�0V6-- h�S C-10 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. I . �Fd ell 0-4- �Obo- h C, Name o proposed Project Manager Telephone No. of proposed Project Manager: C% ( 4) - `�40o dr i c ct �ti c f�viuN L� br•. vi al D0,36I j2�►-x�uG--�1 O{o 1201 to Project Name & Contract Amount Type of Work Date Completed T(5►r-c r e P D 1 j:iT er"5 i c �ewraalo�l Project Name & Contract Amount Type of Work Date Completed Ui'ssiD Viej> LOc,ker 9-oom $ 71'1 l7� ��v�-ham os/28�2o�S' Project Name & Contract Amount Type of Work Date Completed 2. tJ A I ca, rCLz Name of proposed Superintendent Telephone No. of proposed Superintendent: ms-1) -a2A — 3locS Sccrc�a� WC)n I C ti 4900,361 - �.r�dva-i1 �'1 a 40 / 2 0 1 (n Project Name & Contract Amount Type of Work Date Completed Torre,-r,ct- Lc,LrwI-w-ry 4S�-% 23 /2013 Project Name & Contract Amount Type of Work Date Completed Lorur, Qoolm I. � � 4nova+on ©s128 Z2-©1 S Project Name & Contract Amount Type of Work Date Completed C-11 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 l 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/Public Works/SB854FactShect_6.3 0. l 4.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 l 771. l(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, or no later than `contract award date. 1�� Y'is1 ;�(✓l� ��2���r Contractor y ur c� �r PS i clan f Date: �J 20 Title DIR #: 1 �\�� � 0 DO 519 C-12 BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations, Part 135* Economic Opportunities for Low and Very Low -Income Persons The bidder, under penalty of perjury, certifies that except as noted below, any person associated therewith in the capacity of owner, partner, director, officer, or manager (initial the applicable selections): Will ensure that 10% of all new hires as a result of this project shall meet all requirements of Section 3 of CFR Part 135 of the HUD Act of 1968; or Will hire no new employees in conjunction with this project. Will award 10% of its sub -contracts to Section 3 businesses. This certification shall apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person Contact Phone: Signed: Date: J, UniverW Corn- uc*oy1 , I (10. E J *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). C-13 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.321, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. G14 EXHIBIT B DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date 11 fog / ZO 1 b The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 Solicitation and Dates C-15 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. Bidder Normally Items of Work Performs Item Amount Percent of Breakdown ($) Contract (Y or N) of Items 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: C-16 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. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted 0 / A (2) Signature (given and surname) of proprietor (3) Place of Bu (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTNERSHIP, SIGN HERE: (1) Name under which business is LA (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business City and (4) Zip Code (5) E-Mail (Street and Number) Telephone No. C-1 8 IF A CORPORATION, SIGN HERE: (]) Name under which business is conducted (Title) impress Corporate Seal here (3) Incorporated under the laws of the State of C6, � i- uvh101 (4) Place of Business 10 t N - C ly c,Say\ A-V (Street and Number) City and State LDS ��� ��eS p�� i �Y h I G1 (5) Zip Code "t d Telephone No. (6) E-Mail Qclear (� )runsCO - Corn NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 ACKNOWLEDGMENT State of California County of Los -e } ss. On t4o4e n6r Q tLVtu before me. largaS Notary Public, personally appeared dna_ hu�re� who proved to me on the basis of satisfactory evidence to be the person( whose name(ej is -ere subscribed to the within instrument and acknowledged to me that he.�.�H�t�a executed the same in his=her=t�i�e+r authorized capacity. and that by his=', �signatures(,c4 on the instrument the person4,,s4. or the entity upon behalf of which the person(*4 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 cor �YOR~GE ANTO-rw� SOUEI VARGAS WITNESS m, nd nd off I seal. Commission#2086939 J < Notary Public - California z z Los Angeles County My Comm. Expires Oct 20, 2018 Sign it j' OPTIONAL INFORMATION Date of DoCument Type or Title of Doctime,nt Number of Pages in DOCI-Iment Document in a Foreign Langtiage Type of Satisfactory Evidence Personally Known �-vith Paper Identification Paper Identification Credible Witness(es) Capacity of Signer: Trustee Povlei of Attoi ney CE0/CF0.,`C00 President , Vice -President / Secretary/ Tieasurer Other: Other Information: 7 Thumbprint of Signer Check here :f no thumbprint of fnr,, erpnnt is available List below names of president, vice president, secretary and assistant secretary, if a corporation; if partnership, list names of all general partners and managing partners: )Ost A r I e1 ROM0s — Preys aent Se m i o Clwnve z— C. 0.0- LOW VA(A —Vice ?Y6 Al Vxt C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY: LOCATION: PROJECT DESCRIPTION TOTAL CONTRACT AMOUNT: $ BID DATE: BIDDER'S NAME: CONTRACT DBE GOAL: CONTRACT ITEM NO ITEM OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS O BE PROVIDED (or contracted if the bidder is a DBE) DBECERTNO. AND EXPIRATION DATE NAME OF EACH DBE (Must be certified on the date bids are opened - include DBE address and phone number) DOLLAR AMOUNT DBE For Local Agency to Complete: Local Agency Contract Number Total Claimed DBEParticipation Federal -aid Project Number: % Federal Share: Contract Award Date Local Agency certifies that all DBE certifications have been verified and information is complete and accurate. Signature of Bidder Date (Area Code) Tel. No. Print Name Signature Date Local Agency Representative Person to Contact (Please Type or Print) (Area Code) Telephone Number Local Agency Bidder DBE Commitment (Construction Contracts) (Rev 6/26/09) C-21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder RyY) (VerS, C p n-.'ty ✓ C+ ova , I r' C . [proposed subcontractor J hereby certifies that he/she/it has , has not, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, H ] 14, or 11246, and that, where required, he/she/it 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. (eeoc.gov/employers/eeolsurvey/index.cfm) 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. Signature: �--� t- Date:/� Print Name: el�4",�r_��� Title: IlGe X ens',, /& . ( C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE DEPT TENANT IMPROVEMENTS) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: Date: D Z D<<O Print Name: Title: ��� JCS%• C-24 EXHIBIT F 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 with Bidder 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 him/her 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. Note: 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. Signature: Date: 20 (� Print Name:�/j, Title: C-25 EXHIBIT G 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. Signature: Date: zo 1 b Print Name: ZR�11h— Z1;G� Title: //ele �/1L-e'-_7,4 �`i�%-. C-26 EXHIBIT H DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 I. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a. contract ®a. bid/offer/application ® a. initial b. grant b. initial award b. material change c. cooperative agreement c. post -award d. loan For Material Change Only: e.loan guarantee year quarter_ f loan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier ifknown Congressional District, ifknown Congressional District, ifknown 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, ifapplicable 8. Federal Action Number, ifknown: 9. Award Amount, ifknown: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address ifdifterent from No. 10a) (last name, first name, MI) (attach Continuation Sheet(s) ifnecessary) In 12. 14. Amount of Payment (check all that apply) 13. Type of Payment (checkall that apply) S 0 Actual D planned a. retainer b one-time fee Form of Payment (check all that apply): c commission a. cash d contingent fee b. in -kind, specify: nature e deferred value f. other, specity Brief Description of Services Performed or to be performed and Date(s) of Service, including ofTicer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) ifnecessary) 15. Continuation Sheet(s) attached: Yes11 No 16. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. Print Name: 1352. This information will be reported to Congress semiannually and will be available for public inspection Any Title person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than Telephone No.: Date $100,000 for each such failure. Federal Use Only: Form l.I.I.Rev 09-17-97 Authorized for Local Reproduction Standard Form - LLL C-27 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, October 24, 2016. Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3, 2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. "32 /)A./ i t43!t-�,4 ) e4&&1njzeAi 1), Company Name ,B ` tl,e�ih Date ' All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUs(a-)republicservices.com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact — Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell: 714-328-8341 Lauren.kandela-redhawkus.com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated NICE controls Model # HMC-1000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor: ThyssenKrupp contact— Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Daniel.VanMil(a-)thyssenkrupp.com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppelevator.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2"d floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2.0. 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached): 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Number Three, October 27, 2016. Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FOUR For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Four, October 31, 2016. S C� Ole— C `7 '"O -Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FIVE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations November 2, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide %" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide'/" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in. 5) Where applicable, locksets will be Corbin Russwin. Keyway is 59C1— 6 PIN-10. This is to acknowledge receipt and review of Addendum Number Five, November 2, 2016. v lCom- pang Name By �e / Date / All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. BID OR PROPOSAL BOND KNOW ALL MEN BY THESE PRESENTS: That we,JR Universal Construction, Inc. (hereinafter called the Principal), and SureTec Insurance Company , a corporation organized and doing business under and by the virtue of the laws of the State TX , and duly licensed for the purpose of making, guaranteeing or becoming sole Surety upon bonds or undertakings required or authorized by the laws of the State of CA , as Surety, are held and firmly bound unto Huntington Beach Police Department (hereinafter called the obligee) in the just and full sum of Sixty-seven thousand five hundred Dollars ($ 67,500.00***) lawful money of the United States of America, for the payment of which, well and truly to be made, we hereby bind ourselves and heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the above bounded Principal as aforesaid, is to hand in and submit to the Obligeee a bid or proposal dated 11/08/2016 for bid Police Department Facilities Renovation and Improvements, in accordance with the plans and specifications filed in the office of the oblige ands under the notice inviting proposals therefore. NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said Obligee and said Principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect. IN WITNESS WHEREOF, said Principla and said Surety caused these presents to be duly signed and sealed this 31 st day of October 2016 . JR Universal Construction, Inc. Principal By: Na ee and title SureTec Insurance Company Surety e�,"By /f,+�(��1�' J,ammes R. Olsen (Attorney in Fact) f� ame and Title POA #: 510031 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint James R. Olsen its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force until 5/18/2017 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20'' of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 21 st day of March, A.D. 2013. �SAN,w� SURETEC INSURANCE COMPANY X q By: til �w n �_ John noz Jr. resident ; 1 = State of Texas ss: ��'•., d ,.r Y= County of Harris On this 21 st day of March, A.D. 2013 before me personally came John Knox Jr., tome known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. =JACQUELYNLDONADOblicxas5/1812017 Jacq' elyn Maldonado, Notary Public My commission expires May 18, 2017 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 7E�V _day of �-tq��� / y� -' A.D. . Bretft Beaty, Assistant Secretary Any instrumar.t issued in excess of the penalty stated above is totally void and without any validity. For verification cf the authority of tnis� power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST. 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 10/31/2016 before me, CRISTINA BARJOLLO, Notary Public (Here insert name and title of the officer) personally appeared JAMES R. OLSEN, Attorney -in -Fact , 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. CR!STINA BAR JOLLO � WITNESS my hand and official seal. m Commission # 20508ni a ;m " Notary Public - California v Los Angeles County My Comm. Expires Dec 5, 2017 Notary Public Signature J (Notary Publlc Seal) ADDITIONAL OPTIONAL INFORMATION DWCBRI P I D %JJ EPWHED DOCUMENT BOND NO, N/a (Title or description of attached document) (Title or description of attached document continued) Number of Pages —2—Document Date 10/31/16 CAPACITY CLAIMED BY THE SIGNER p Individual (s) El Corporate Officer (Title) El Partner(s) TLXXAttorney-in-Fact p Trustee(s) E] Other 2015 Version wNw.NotaryClasses.com 800-873-9865 INSTRUCTIONS FOR COMPLETING THIS FORM This farm complies with current California stanrtes regarding notmy wording and, if needed, should be completed and attached to the document. acknowledgments from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. • 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 commnma 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. }�e/slme/ }3ey- 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 forum. • 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 Mbi15MAId atlicer, indicate time title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple. City of Huntington Beach 2000 Main Street o Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov Office of the City Clerk Robin Estanislau, City Clerk January 23, 2017 Kazoni Construction, Inc. 18672 Florida St. #101-B Huntington Beach, CA 92648 RE: Police Department Lobby Security — MSC-510 & 515 Enclosed please find your original bid bond for MSC-510 & 515. Sincerely, Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities. Anjo, Japan o Waitakere, New Zealand i = '' City Clerk's Office — 2nd Floor 2.000 Main Street Huntington Beach, CA 92648 Bid Nos. MSC 510 Police Department Lobby Security, MSC 515 — Police Department � Limited AD I A Renovations BID: Police Department Renovations (Huntingt®n Beach) Bid Due 'Date: November 4, 2016@ 2pm FROM: Kazoni Inc. dba Kazoni Construction 18672 Florida Street, Ste. 101-B Huntington Beach, CA 92648 SECTION C PROPOSAL for the construction of MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS 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 therefore, 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 105 working days, starting fi-om 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 re -advertise 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 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, c ber 24, 2016. Company Name gy II -2-Iw Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3, 2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. 47_QNI INC tp/mfej Company Name B 1I-g-1 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUs(a�republicservices com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact— Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell: 714-328-8341 Lauren. kandel(a redhawkus com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated MCE controls Model # HMC-1000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor: Thyssen Krupp contact — Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Daniel.VanMil(a�,thyssenkrupp.com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppelevator.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2�d floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2.0. 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached): 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Number Th e, October 27, 2016. Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31. 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number F October 31, 2016. I/' -now I IUC���� Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations November 2, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide'/4" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide'/4" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in. 5) Where applicable, locksets will be Corbin Russwin. Keyway is 59C1— 6 PIN-10. This is to acknowledge receipt and review of Addendum Number Fiv ovember 2, 2016. 1107M l INC APP-jL' k_t+L-FIrwk— Company Name g iI —0 -hr Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default ul 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 mill and void. Accompanying this proposal of bid, find 10 G% 1b) p D 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 /1 Addenda No Date Received 2$ er's Signuture 1 October 24, 2016 2 October 27, 2016 3 October 27, 2016 ViV 4 October 31, 2016 5 November 2, 2016 MW PROJECT BID SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per plans and specifications $ 523,616.00 2. PD Lobby ADA Constrict improvements per Improvements (Separate plans and specifications. Funding Source) Refer to the following plan $ 249,760.00 sheets for ADA scope of work: A1.0, A1.1, A2.0, A2.1, A3.1, A4.01 E3.0, E4.0, E5.0 Total Bid Amount $ 773,376.00 Total Bid Amount in Words: Seven Hundred and Seventy -Three Thousand Three -Hundred and Seventy -Six Dollars C-2 The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. 1: New Carpet tile floor to match, per schedule. Refer to sheet A l . 1. Additive Alternate No. 2: New office ceiling grid and acoustical tile to match adjacent ceiling grid (existing light fixtures to remain). Refer to sheet A2.1. 12,358.00 Lump Sum (use figures only) $ 43,802.00 Lump Sum (use figures only) Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. 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 $ l 0,000, whichever is greater, and the portion of the woi* to be done by such subcontractor. Bid Dollar Item(y) State Lie. # Amount % of Name and Address o f Subcontractor and Class DIR # Contract N/A Penner Partitions, Inc. 924223 1000004040 $12,380.00 2% 3501 E. La Palma Ave. Anaheim, CA 92806 Partitions N/A DSI 936886 1000002162 $39,500.00 5% P.O. Box 79198 Corona, Ca 92877 Demo N/A Parpac Corporation 862681 1000009619 $42,500.00 5% 2201 N. Lakewood Blvd. Lakewood, CA 90815 Plumbing N/A Westco 670542 1000000840 $16,600.00 2% 9691 Sunland Blvd. Shadow Hills, CA 91040 HVAC N/A Genesis Floor Covering 883027 1000004026 $48,548.10 6% 11823 Slauson Ave., Ste. #21 Ceramic Tile Santa Fe Springs, CA 90670 & Flooring N/A ThyssenKrupp Elevator Americas 65137 1000002104 $25,905.00 3% P.O. Box 933004 Atlanta, GA 31193 Elevator N/A Stolo Cabinets 267920 1000004779 $109,828.00 14% 860 Challenger St. Brea, CA 92821 Millwork N/A KTM Enterprises Inc. 600 S. Jefferson, Ste. B Bullet Proof B-992582 1000020180 $53,775.00 7% Placentia, Ca 92870 System 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-4 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 11/08/16 at Huntington Beach CA Date City State April Kulpinski being first duly sworn, deposes and says that he or she is President of Kazoni Inc. dba Kazoni Construction 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. Kazoni Inc. dba Kazoni Construction Name of Bi e Signat of Bid er 18672 Florida St., Ste. 101-B, Huntington Beach, CA 92648 Address of Bidder C-5 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 PROJECT NAME, (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: November 8, 2016 Kazoni Inc. dba Kazoni Construction Contractor April Kulpinski By President Title C-6 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. N/A Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-7 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: November 8, 2016 Kazoni Inc. dba Kazoni Construction Contractor April Kulpinski By President Title C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Kazoni Inc. dba Kazoni Construction Bidder Name 18672 Florida St., Ste. 101-13, Huntington Beach, CA 92648 Business Address Huntington Beach, CA 92648 City, State Zip ( 714 ) 882-1088 Telephone Number 974982 / B State Contractor's License No. and Class July 31, 2012 Original Date Issued July 31, 2018 Expiration Date The work site was inspected by April Kulpinski of our office on October 18 , 201 6. The following are persons, firms, and corporations having a principal interest in this proposal: April Kulpinski, President Keith Kulpinski, Vice 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. Kazoni In a Kazoni Construction Com Signature of Bidder April Kulpinski Printed or Typed Signature Subscribed and sworn to before me this 8th day of November 2016 . NOTARY PUBLIC �e A�Cirt NOTARY SEAL C-9 �` �4 ,. �A • 1, ,\, j ..l.n A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF Subscribed and sworn to (or affirmed) before me on this day of IP /� y�}} Date Month Year by Apt; I Name of Signers proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. SUSAN CATHERINE HICKS COMMISSION # 2092261 3 Signature: Notary Public - Caidorna 3 ORANGE COUNTY Signature of Notary Pu liC My Conan Expires Dec 16 2018 Seal Place Notary Seal Above --------------------------------------------------- OPTIONAL --------------------------------------------------- Though this section is optional, completing this information can deter alteration of the document or fraudulent attachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of P Signer(s) Other Than Named Above: Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. List below the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 2 Eastbluff Site Improvement and Bldg Alt, 2985 E. Bear St., #E, Newport Beach, CA Name and Address of Public Agency Marly Croofoot - (949) 275-0110 Name and Telephone No. of Project Manager $271,000 Contract Amount DSA Project Type of Work November 2016 Date Completed Provide additional project description to show similar work: Demo, concrete, plumbing, HVAC, remodel, landscape partition, electrical, millwork Jack Bulik Teen Center Interior Remodel, 16581 Filbert St., Fontana, CA Name and Address of Public Agency Shawn Matjcek - (909) 350-7649 Name and Telephone No. of Project Manager $358,899 Interior Remodel November 2016 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Remodel of existing kitchen, adding additional interior office, restroom remodel, demo framing, plumbing, mechanical, acoustical ceiling, electrical, stucco, millwork, partitions John Wayne Airport Information Booth Name and Address of Public Agency Kory Hariri - (949) 351-8497 Name and Telephone No. of Project Manager $175,000 Information Booth Remodel December 2015 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Remodel and Reconfigure existing information booth. Demo, structural, solid surface corian, steel security glass, glazing, security doors, millwork and electrical C-10 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. Keith Kulpinski Name of proposed Project Manager Telephone No. of proposed Project Manager: (714) 330-1766 Eastbluff Site Improv and Building Alt $271,000 Tenant Improv and ADA Upgrades November 2016 Project Name & Contract Amount Type of Work Date Completed Jack Bulik Teen Center Interior Remodel $358,899 Tenant Improv and ADA Upgrades November 2016 Project Name & Contract Amount Type of Work Date Completed LeVision $301,883 Tenant Improvement September 2015 Project Name & Contract Amount Type of Work Date Completed �. Bob Brakeville Name of proposed Superintendent Telephone No. of proposed Superintendent: (714) 290-9239 Eastbluff Site Improv and Bulding Alt $271,000 Tenant Improv and ADA Upgrades November 2016 Project Name & Contract Amount Type of Work Date Completed Jack Bulik Teen Center Interior Remodel $358,899 Tenant Improv and ADA Upgrades November 2016 Project Name & Contract Amount Type of Work Date Completed LeVision $301,883 Tenant Improvement September 2015 Project Name & Contract Amount Type of Work 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/PublicWorks/SB854FactSheet 6.30.14.pdf DIR's Contractor Registration Link —Call (844) 522-6734 https://efiling.dir.ca.gov/PWCRJActioilServlet?action=displayPWCRegistratioiiForm DIR's Contractor Registration searchable database: https://efiling.dir.ca.gov/PWCRJSearch.action 1 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 as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid, or no later than contract award date. Date: November 8, 2016 DIR 4: 1000002212 Kazoni Inc. dba Kazoni Construction Contractor April Kulpinski By ai President Title G12 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 pei jury, 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: Kazoni Inc. dba Kazoni Construction Contact Person: April Kulpi Contact Phone: (714 Signed: Date: N er 8, 2016 *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). C-13 FXHIRIT A DISADVANTAGED BUSINESS ENTERPRISE (DBE) This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.321, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be frilly informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 FYIAIRIT R DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. N Bid Opening Date November 8, 2016 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 DBE Goal for this project is 0. 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 Solicitation and Dates DBE Goal for this�roject is 0_ C-15 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. Bidder Normally Items of Work Performs Item Breakdown Amount Percent of Y or N ( ) of Items N Contract DBE Goal for this project is 0. 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: DBE Goal for this protect is 0. Names, addresses and phone numbers of firms selected for the work above: DBE Goal for this project is 0. 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: DBE Goal for this project is 0. C-16 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: DBE goal for this project is 0. 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 DBE goal for this project is 0. H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): DBE goal for this project is 0. NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 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 �jrime contractor or its affiliate: t ea S e �e. c e-kA —UU d 2 Ol 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 IQC, &,-- "� ee!- a a c H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): (-2 ci &-c. S e-- NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname) of proprietor (3) Place of Business City and State (4) Zip Code (5) E-Mail IF A PARTNERSHIP, SIGN HERE: N/A (Street and Number) Telephone No. (1) Name under which business is conducted N/A (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business City and State (4) Zip Code (5) E-Mail (Street and Number) Telephone No. C-18 IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted Kazoni Inc. dba Kazoni Construction (2) (Si President (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of California (4) Place of Business 18672 Florida St., Ste. 101-B (Street and Number) City and State Huntington Beach, CA (5) Zip Code 92648 (6) E-Mail april@kazoni-inc.com Telephone No. (714) 882-1088 NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED Q�Aadn�-ot C-19 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 Ney,-vAb before me, Susan Catherine Hicks, Notary Public (insert name and title of the officer) personally appeared A pr; t 'K11I o;t-sk'I , 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. _ SUSAN CAI FiERINE HICKS COMMISSION # 2092261 3 WITNESS my hand and official seal. _ Notary PLVIC- Cal,forn,a ORANGE COUNTY — My Comm Expres Oec 16 2018 Signature / �l—� (Seal) C - 0 B List below names of president, vice president, secretary and assistant secretary, if corporation; if a partnership, list names of all general partners and managing partners: April Kulpinski, President Keith Kulpinski, Vice President April Kulpinski, Treasurer Keith Kulpinski, Secreta C-20 10NII- IDINEN LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL AGENCY LOCATION. PROJECT DESCRIPTION TOTAL CONTRACT AMOUNT $ BID DATE BIDDER'S NAME CONTRACT DBE GOAL: CONTRACT ITEM NO FI L-M OF WORK AND DESCRIPTION OR SERVICES TO BE SUBCONTRACTED OR MATERIALS TO BE PROVIDED (or contracted if the bidder is a DBE) DBE CERT NO AND EXPIRATION DATE NAME OF I ACI1 DBE (Must be certified on the date bids are opened - include D13F address and phone number) DOLLAR AMOUNT DBE For Local Agency to Complete: Local Agency Contract Number Federal -aid Prglect Number Federal Share Total Claimed DBE Participation $ Contract Award Date Local Agency certifies that all DBE certifications have been verified and mtimnation is complete and accurate Print Name Signature Date Local Agency Representative (Area Code) Telephone Number Signkt qpe/c,113i 111r, November 8, 2016 (714) 882-1088 Date (Area Code) "Fcl No April Kulpinski Person to Contact (Please "hype or Print) Local .4gencv Bidder DRL" Convmonent (Consuucunn Contracts) (Rev 6/26/09) C-21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" submitted with your bid. There is a column for the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit I5-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the narne of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder Kazoni Inc. dba Kazoni Construction [proposed subcontractor J hereby certifies that he/she/it has has notes-, participated in a previous contract or subcontract subject to the Equal Opportunity clauses, as required by Executive Orders 10925, 11114, or 11246, and that, where required, he/she/it 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. (eeoc.gov/employers/eeotsun,ey/index.cftn) 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 Admi 'st .ation or by the Director, Office of Federal Contract Compliance, U.S. Department of L or Signature: ix_r Date: November 8, 2016 Print Name: April Kulpinski Title: President C-23 EXHIBIT E NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7I06) MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE DEPT TENANT IMPROVEMENTS) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7106 the bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are caution that making a false Certification may subject the Bidder to criminal prose/ Signature: Date: November 8, 2016 April Kulpinski Print Name: Title: President C-24 EXHIBIT F 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 with Bidder 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 him/her 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. Note: 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 ereof shall also constitute signature of this Certification. Signature: Date: November 8, 2016 Print Name: April Kulpinski Title: C-2.5 FXurRIT C. 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. .-I Signature: Date: November 8, 2016 Print Name: April Kulpinski Title: President C-26 Evuro r-r u DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIE'S PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Repart T)pe: 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 ol' last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardec, Enter Name and Address of Prime: Pnme � Subawardec Tier it -known Congressional District, ifknown 6. Federal Department/Agency: 8. Federal Action Number, If known Congressional District, ifknown 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, If known 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No I Oa) (last name, first name, MI) (attach Continuation Sheet(s) fnecessary) I I. Amount of Payment (check all that apply) S Actual 1:1planned 12. Form of Payment (check all that apply): a cash b tit -kind, specify nature value 13. Type of Payment (check all that apply) a retainer b one -tine fee c commission d contingent fee e deferred f other, specity 14. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employce(s), or member(s) contacted, for Payment Indicated in Item 1 I: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes ❑ No l 16. lnftumation requested through this ibnn is authorized by Title 31 U.S C Section 1352 This disclosure of lobbying reliance Signature was placed by the tier above when his transaction was made or entered into This disclosure is required pursuant to 31 U S.0 Print Name II KUlpinskl 1352 This information will be reported to Congress semiannually and will be available for public inspection Any Title President person who fails to file the required disclosure shall be subject �� 14� $$�_ �$$ ��08��� to a civil penalty of not less than $10,000 and not more than Telephone No Date $100,000 for each such Ihllure Federal Use Only: flanUMU rUrm LLL KCV. Authorized for Local Reproduction Standard Form - LLL C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H 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 prograrn 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 itern l (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10) (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered Federal action. (b) Enter the full names of the individual(s) performing services and include full address if C-28 different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 1 1) Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13) Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 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. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 Bond No. NIA BID OR PROPOSAL BOND KNOW ALL MEN BY THESE PRESENTS, that we Kazoni, Inc. dba Kazoni Construction as Principal, (hereinafter called the Principal), and American Contractors Indemnity Company . a corporation duly organized under the laws of Calitornia and authorized to transact a general surety business in the State of California as Surety, (hereinafter called the Surety), are held firmly bound unto: City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 as OBLIGEE, (hereinafter called the Obligee), in the sum equal to % of the accompanying bid of the Principal, not, however, in excess of Ten percent of the Total mown o the Bid for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns., jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION IS SUCH, That, whereas, the Principal has submitted or is about to submit to the Obligee a Proposal or bid, dated on or about the date mentioned below, for: (1) the performance of the designated work, or (2) the furnishing of the specified goods, supplies orproducts, to -wit: MSC-510 Police Dept. Lobby Security and MSC-515 Police Dept. Limited ADA Renovations NOW, THEREFORE, if the Principal shall not legally withdraw said bid within or at the times permitted therefor, but shall duly make and enter into a written contract with the Obligee, in accordance with the terms of said proposal or bid, or any amendment thereof acceptable to the Principal, within the time permitted therefore after such contract forms are presented to the Principal for execution, should the Obligee award the Principal the said work or contract or any part thereof and if the Principal shall give bond or bonds for the faithful performance thereof, and/or for payment for labor and materials going thereinto, as in the specifications or contracts provided: or if the Principal shall in case of failure so to do, pay the Obligee the damages which the Obligee shall have actually suffered by reason of such failure, not exceeding the penal sum of this bond, then this obligation shall be null and void, otherwise to be and remain in full force and virtue. PROVIDED, HOWEVER, that no action shall lie, or claim be enforced hereunder, unless the award on the basis of said bid shall have been made within thirty (30) days after the formal opening of said bid, or within the time specified within the bid provisions, whichever time shall be greater, and unless the Obligee hereunder shall give notice to Surety of said award at the time of notification to the Principal; and unless legal action to enforce any claim hereunder shall have been commenced within six (6) months from the date of the formal opening of said bid. PROVIDED, always, that this Bond shall not be valid and binding upon Surety unless accompanied by a Certified Copy of a Power of Attorney authorizing the undersigned Attorney -in -Fact to execute such a bond. the Serial Number upon which Copy of Power of Attorney shall correspond with the Bond Number set out above. Signed, sealed and dated this 3rd day of November 1 2016 Kazoni, Inc. dbA Kazoni Construction Principal m By: , P ' ,pal American Contractors Indemnity Company Name of S2!7_7 ---___� By: n ' -F isa aiazar CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles ) On NOV 0 3 2016 before me, Angel Nunez, Notary Public Date Here Insert Name and Title of the Officer personally appeared Elisabete Salazar Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person($) whose name(§) isl&6 subscribed to the within instrument and acknowledged to me that Kle/she/tfidy executed the same in Ws/her/Wdir authorized capacityfps), and that by Ws/her/0#)r signature(p) on the instrument the person(q), 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 ANGEL NUNEZ �p Signature Commission :x 2140301 ' Signature of Notary Public i Wc Notary Public - California .r4-V Los Angeles County My Comm. Expires Mar 14, 2020 �-�-,• �-.,-.moo ::--�� =-� -_�- ���-v :,� 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 — Limited LO General Individual Ix7 Attorney in Fact Trustee ILI Guardian or Conservator Other: Signer Is Representing: Signer's Name: � Corporate Officer — Title(s): Partner — 1-1 Limited ❑ General D Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator !_.J Other: Signer Is Representing: :ievi'ri 'y'.'er:`..� ✓s it�x.'i.� `..v'+�' ✓.'yti✓t�✓ ��6��'t��n✓t �n✓'.�✓.�';t�:.'.✓mot ✓tvT.vn.:`..���:J+`%. ri.`%t�tC✓i+`✓, .•it�:t�•✓a'✓tv I'IJ'''I'lll, '�I illy II IjIIIIII,I:I,� III','I I IIIIlllllllll I I l''iI'' II,II''11��L' lllll'II'IIII'Illlll'I jl 'II'IIIG LluluVl, POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY IIIIII II 'Ilij; ;. IIIIII;!' II — — "IIIIII ill'I II'hI'IIIII,IIIL., III IIIIIII II'lul — KNOW AMMEMBY THESE1 T "T at rr€ ican Contract) isllind n o all'! a Calif0rnI offi) ol�Texas �ll I1 II 111 I'll II II IIIII i 'll IV '1"' III' BW CampaiLy an assumed name= ni ncan factors Inden ! I bi " till Ll ti lllll�tates Surety Com�an� rY nd 6IIIIIIIIIII mi --corporation and U.S. Specialty Insurance Company, a Texas corporation (col'lectrve�y, the "Companies"), do by these presents make, constitute and appoint: Patricia Zenizo, Elisabete Salazar or Pietro Micciche of Los Angeles California Illlilfl!I',,logill'II!IdIllll,, Il�liill. IVI�ip�LIIIII,y;;lillll!I.=— Ats-t tt t� L ttorney(s)-m-falct,l eachl'tnI thetr sep'ar to capacity if moibi' blamed wave, with ful --I--Mower and auth�nty y Vgpl 'I11'IIII'lllllll 'lldlllll !IIIIII�I11 IIIIJIIIIII:,ilIII'llu' reonrrtr its name, place d s�e �l to execute, la'cknowledge anai_ands recognizances under�alc�ngs__ PIIV:IIUI "ull'lllllll'iI'll°' IIII,I =or osier instruments or contracts ibf suretyship to include riders, amulmentis-, and consents of surety, providing the bond penalty does not exceed *****Three Million***** Dollars (S **3,000,000.00** )• This Power of Attorney shall expire without further action on December 20, 2017. This Power of Attorney is granted under and by authority ofthe-following resolutions adopted by the Deat-ds of Directors of the Co Dame — 'I IIIII I, Ilh l llllll� — IIuIIIII'�''llllllllllllflllldl'ly, ill d II��III II II Be rt Resolve�c that thhe�resident, any VOTiM a A3sustant President, any Slecre� pr any' ss stan ISeI retary shall be andmnhi �€es et �v fuZL (IIII IIIIII: IIIII IIIII 'I I' III IV III INI I!I' IIII' olll' _power anauthont�to appoint any one or tre�atfa6leostney(s)-in-Fact to repieseorr orjan n behalf of the Companyc€ta the folio ng ' ! 9111!1PIIIIIdIII'"' — __proision - — — = II'iil IV Jill I Attorney -in -Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, 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-m-Fact shall be binding upon the Company as if signed by the President and sealed and effected I 'I °lul'lIul,, 'illllill!III'� 1111111iQ1'I'llllllllllll. IIIIIII !,I� IIIII! iI 'lllllll �— � -- iBaTR�v tflaAMEignature of any a t'honze'{I officer an sea'( f ' (Company hereto a eerie€eafte€af d3o=gr ower of attorney_or=anYceftificate_relafing- llli��llli tllllllll' Ill l 1. IIIIIII') l'a! IlTlil aII P. 'llli; ' dudl,p ' theretu c�i1---Tany power of attorneylor' certificate bearin (facsimile signature or fae isiWe eal sM Mali d binding upon the Compariywit�uespect to— III�!'PIlllllllllld "-- =any�r un�rtakmg to which it is attached�j!!', = =- IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 1st day of December, 2014. - — - AMERICAN CON-1RAACTORSHINDEMNITY COMPANY P�CI II'!IT ,llBODI1G'' Oll�llillMPANYIr.lllalAlii11l'Jill C'MPANYUNITKTSTM WSMEU�NY U.S.SCorafea15 n.. �; a?r": ., III IIIII — �a�i— y: B s a '�� Daniel P. Aguilar, Vice President Illllllla, dill,,.,.. _ — — — — "II"II�:IJI!III;III"'^gppp4'" 16111CIIfl I'IIIPIIII9! °IUJIGIII Ib — tSaruc�l other officer complet�tngthig certIII11111U'l ')Jfcateve fies'pnly the identit-_ivtiiva= hid the o'fIIII IV „ ,'' III II II l '6911Q 111 l III 'lll °IIII — �ormet�iiciis certificate is attac}� d, and nqt thenulness, accuracy, orif twat dacar — IIIIII', 411111 106hyI' III III — - — State of California County of Los Angeles SS On this 1st day of December, 2014, before me, Maria G. Rodriguez -Won-. a notary public, personally appeared Dan P. Aguilar, Vice President of American _GontraCtorsaindemnity Company, Texas Bonding mpg =re states Surety Company:. and U S. Specia''1' ylinsurance Company wh"r�d-to rri o _ ttie asis of atisfacto - evidence to berme ersar vie i sa5scribed to the wi lun'�nVls;attuilllmllhpoelnf an$Iac""laiowyed ed to me thatTe_exaeirt t&am�in— _= "— -- =p — 'll P°Illli .1ji1 ls,III''! "ID 'll6'U"I'll ""Ibllllll' 4'llll'"III' 'tlIIpII III'' g -- -- — hi§=authonz3ea—Pacfty and that by his signature an thh_s�rrreh�person, or the en iry upon behalfllof�w'hich!the'person acted, executenst�nen gl l l lll,'ll !IIjI j''l allll h!01 '!I !I I IIII IIIIIIIIIIIII _ I certify under PENALTY OF PERJURY under the laws of the State of California that thellIJoregoing paragraph is true and correct. WITNESS my hand and official seal. MARIA G. RODRIGUEZ-WONG Co Mission #r 2049771 _Signature _ — — (S'eall)'i'4III1 i ..� - — otarft- Z' l i' '! IIIIIII �orAn eTes C9nnb — — z II I I I II 1 III, ,I III('ill la l = [A COMM i[as ec 20. 2017 -- I, Kio Lo, Assistant Secretary of American Contractors Indemnity Company, Texas Bonding Company, United States Surety. Company and U.S. Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full _force -and effect �_ - -_ = —= = = = I'IIIIIIIIIII jl r!I!llllllll'I'''I I I ` ':IIIGIII;I — — — I I y tl l IIIIII IIII. Eg y_ In W itifamhereof I have hereur e m harmer d d the seals of d ��o anl�es ai >� s ti' eles, Califot a thi da -IiII �'II 'III19Iulllllllll!IIIII'll' Illllldl Illlllh!IIII II'° _ — �-° �:IIIIIII6 - - Corporate Seals ""��CTOR' ng SUR ' °N� NG o`N lnsura�� Kio Lo, Assistant Secretary_ �_ AgC11Cy--NQ 3 57 "„o`il roa4�; � III?,l II*Ibllllll !lull IIII %greoFYE�P`O ninunao" peon„da�� 'I�I�lillli!Iillll' II'I IJIauLIIIIiI�II' 961fIIlil +Iluuiu�IIl,l 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 January 23, 2017 Marjami Builders, Inc. 26091 Ravenna Rd. Mission Viejo, CA 92692 RE: Police Department Lobby Security — MSC-510 & 515 Enclosed please find your original bid bond for MSC-510 & 515. Sincerely, 4�1� 9'44W414� Robin Estanislau, CMC City Clerk RE:pe Enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand SECTION C PROPOSAL for the construction of MSC-510 POLICE DEFT. LOBBY SECURITY and DISC-515 POLICE DEFT. LIMITED ADA RENOVATIONS in the CITY OF HUNTI NGTON ]BEACH TO THE HONORABLE 1/1AYOR AND NIETTNIBERS OF THE COUNCIL OF HUNTINGTON REACH: 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 therefore, 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 105 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 re -advertise 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 3 1�1/ /n 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. Bate Received Bidder's Si -nature 02 /.D. 2-7 l4' 03 / o. 2-7. /,f� 02 PROJECT BIB SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per plans and specifications $ 51? is 000. QQ 2. PD Lobby ADA Construct improvements per Improvements (Separate Funding Source) plans and specifications. Refer to the following plan $ QQ sheets for ADA scope of work: A1.0, ALL, A2.0, A2.1, A3.1, A4.0, E3.0, E4.0, E5.0 Total Bid Amount $ $2-5.1 0M QQ Total Bid Amount in Words: 1' C-2 zoom The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. 1: New Carpet the floor to match, per schedule. Refer to sheet A1.1. Additive Alternate No. 2: New office ceiling grid and acoustical the to match adjacent ceiling grid (existing light fixtures to remain). Refer to sheet A2.1. Q� A/ (use figures only) Lump Sum $ S, azw ? Lump Sum (use figures only) Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. C-3 NS 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 $10,000, whichever is greater, and the portion of the work to be done by such subcontractor. Bid Dollar Item(s) State Lie.# Amount % of - Name and Address of Subcontractor and Class >DIR # Contract pl%K 0���,J, lne . , , 9596�� /0 4_1,0,1,4siz Gla cZ% �6.) 1217 7 9 9S2 o / (o o.0.0 19/03 E/ .Se a,,-1dlo, Cif q6'? 5 2-3 700 /o,lcf `/TI Enfe,-r6e-s 1nc P-44,11aas 12.6o S . ��� to C� �(a�t P 2 3 0236 /oo�o0s7So 'l- CR,r�� C V�ar�Fp � e.la�� 1 i�2 Coal�rRc�'o,r lnc. 536 PQi,st�,� sE, ��b9oo �p0.o0�3364 �6 R80 Ara CA a 2_14l r1apr-e. 1 �o0r:ny�, �nC• 472/35 rao0,w10 7 L4'1.. klno C. giT-0 16 .Sor1� .�Id�-s Cfl. gC'8 A51ia.�,�d C' �(� 437?6l lVp960o-0�7 Qp8d•� Lprgria` CA 92-88) WO �„� LA�I_ ��cf� coRP• 1+S6"3v L� C� /Jr i p--e "$ � S �$2j q / oa Qoo3�3G --�'J'-_ , CA 925'30 5877o 61 R &"11 CO- ,1nC 3 314o O CJ tA, W r A 91 7 63 350\P 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-a N.1� LffS- T OF SUBCONTRI AC TORS 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 eNcess 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. j B,;d Item(5) 1"Vcaaaae apd Adr1r es5 of Subcont,- actor State lac.# caeca` Grass ID1:R,, 4 Dollar Amount % of Contract gvt�{pJJ� /<%/% i610 C �S�Zo� � � B 07 9%15dZ 7 /t�Od�G�J��Q 53 77S % U Lo �ti Chi 900/5 (cwo9C/J �?)"j`kD 'i00Z� g0340\ i�lL O -V-VU (AA 0 By submission of this proposal, the Bidder certifies: That he is able to and ,vill perform the balance of all work which is not covered in the above subcontractors listin'g. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds fiirnished by subcontractor for this project. C-4 NONCOLLUSION AFFIDAVIT 1T© 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 /1,041 at Date City State f19(6v —k N being first duly sworn, deposes and says that he orshe is CGSO CFO S of Nffv,i4N/ 8U/LD612the party making the foreg ing b d that the bi 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. 1V#J,,I Nl AULOMS, We Name of Bidder - Signature of Bidder z6-aQu kc"/e, ,, f '4 M Vg a Address of Bidder C-5 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 PROJECT NAME, (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: Aperson who, by reason of experience or instruction, isfiamiliar with the o,peration to beperformed and the hazards involved " The undersi-ned 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 Z= 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. /\JO V,- 9 H, - Date: t��R(,714 A// -&PLOW, IAIC , Contractor By CEO Title C-6 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? El Yes �"o If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-7 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 I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured acainst 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. I �q" V. 10 Date: 1"1111U14 All �UIZbEkl� Contractor By Title C-8 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: 1VXA?j,4A11 6aILD6ez lAlc Bidder Nam 2-6,P 11 ��&n r)&— �� BL mess Address �5151Q,() \/iC,40 CA 6f M9 2- city, U // State zip (�49) 3oE�0-3�3 Tel hone Number 02-C-3 State Contractor's License No. and Class 0=1 Date Issued . 2-oll Expiration Date - 9/' office on 201�. The work site was inspected b A6av-[�A &%btrr The following are persons, firms, and corporations having a principal interest in this proposal: AltXOM --- - ------ AA �Aj 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. MAKj~ -8UILDEU 1AAC. C any Name SXnafure of Bidd U . X. 0 6-C Printed or Typed Si 'M � Subscribed and sworn to before me thisOA day of /%/� VL ef, 204-1 NOTARY PUBLIC C-(T(6\C. h /P? 6i-j"T NOTARYSEAL C-9 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 Ivalidity of that document. State of California County of 0 Cc� 0 Subscribed and sworn to (or affirmed) before me on this day of MVem kj � ii- _, 20 16 , by 1111�MIVOj�t�\ Iq ,09A' -A proved to me on the basis of satisfactory evidence to be the person(o who appeared before me. S. YAVAR -NOURII Commission 2072037 < z Notary Public - California z z Orange County My Comm. Expires Jul 18, 2 � J8 1-54 (Seal) Sig nature-(�-) Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. List below the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: 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 Z= Contract Amount Type of Work Date Completed Provide additional project description to show similar work: C-10 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. I Name of proposed Project NVnager Telephone No. of proposed Project Manager. 4/1 JL- i Project Name Amount Type of Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work 2. V, C/o r-- JV 11 01�— Name of proposed Superintendent Telephone No. of proposed Superintendent: A/ PI Project N S/4 111n -7 6/o - 4,�� 7. 941 / & Contract Amount Type of Work Project Name & Contract Amount Type of Work Project Name & Contract Amount Type of Work C-11 Date Completed Date Completed Date Completed Date Completed Date Completed Date Completed CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 177 1.1 (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 Pr Jects to register on an 01 annual basis (each July I through June 30 state fiscal year) with the California Department of Industrial Z7 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. D[R FACT SHEET on SB 854 http://w,,v�,v.dir.ca.-,ov/DLSE/PubllcWorks/SB854FactShect 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 Reoistration searchable database: https://efilinc,.dir.ca.gov/PWCR/Search.action I am aware and wil I 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 submittinc, the bid, or no later than contract award date. PMI�QMI�11 6,111Z_0E&,1A1C - Contractor 13 CEo/ �17b _`�-rJ�ej Date: A/0V, Title DIR 9: C-12 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 shalt apply to the prime contractor's sub -contracts related to this project. Contractor: Contact Person: Contact Phone: q4q. 30_S-. 03V Signed: Date: *Niote: 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 (RUD). C- 13 EXHIBIT A DISADVANTAGED BUSINESS ENTERPRIS This Project is subject to Part 200.321, Title 2, Code of Federal Recr lations entitled "Contracting with u I I I Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.3 )21, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.32 1, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain C� DBE participation in this pr 'ect, although there is no specific goal for DBE participation. 01 In -- C-14 EXHIBIT B DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. Bid Opening Date The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% I Z=1 for this Project. The information provided herein shows that a good faith effort was made. Z=1 Lowest, second lowest and third lowest bidders shall submit the following information to document Z=1 adequate good faith efforts. Bidders should submit the following information even if the "Local Aaency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will c I protect the bidder's eligibility for award of the contract if the administering acr ney determines that --e the bidder failed to meet the goal for various reasons, e.g­ a DBE firm was not certified at bid openin,-, or the bidder made a mathernatical error. Submittal of only the "Local Acrency Bidder DBE Conunitment" 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 I Project and the dates and methods used for following up initial solicitations to C 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 Solicitation and Dates C-15 C. The items of work which the bidder made available to DBE firms including-, where appropriate, any breakinza 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. Bidder Normally Amount Percent of Items of Work Performs Item Breakdown N Contract (Y or N) of Items D. The narnes, 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 obtaininza bonding, lines of credit or insurance, and any technical assistance or information related to the plans, s 'f peci ications and requirements for the work which was provided to DBEs: C-16 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 C, agencies and any responses received, i.e., lists, Internet page download, etc.): Z) Zn 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. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: (1) Name under which business is conducted (2) Signature (given and surname) of proprietor C� (3) Place of Business (Street and Number) City and State (4) Zip Code Telephone No. (5) E-Mail IF A PARTINERSHIP. SIGNI HERE: (1) Name Linder which business is conducted (2) Signature (given and surname and character of partner) (Note: Signature must be made by a general partner) (3) Place of Business City and State (4) Zip Code (5) E-Mail (Street and Number) Telephone No. C-18 IF A CORPORATION, SIGN HERE: (1) Name under which business is conducted 1AIC (2) (Signature) (Title) Impress Corporate Seal here (3 )) Incorporated Linder the laws of the State of CA (4) Place of Business -2-Gal 1 ��j (Street and Number) City and State 1'5 5-'10 r) \/t. CA (5) Zip Code 71- Telephone No. qA9 - -W; _0S9 3 (6) E-Mail VV\Ck 9 MfiLA C_V M \j NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED A) 0 V C9 L" Z,5;, ( -6 C-19 Senate Bill 105 0, amends Sections 1189 and 1195 of the Civil Code and Section 8202 of the Government Code, relating to notaries public. 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 2 County Of A!�)- C Ci 11 On NO V 614-y;?e 16 y AjaTeV )-c(b C, appeare, before me - . . I personally I'V f ) [-" 1 � " I q '!" -------who proved to me on the basis of s�tisfactory evidence to be the person(4whose nam' e(9"Iaigsubscribed to the within instrument and acknowledged to me that he/sh644@y-executed the same.in his/herAhinrit authorized capacity(ik), and that by hisftk&4dieir signature(61�on the instrument the persori(Q, or the entity upon behalf ofwhich the person(iKacted, 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-offi nia seal. S. YAVARI-NOURI A Commission # 2 12037 Signatui Notary Public - California 27 Orange County List below names of president, vice president, secretary and assistant secretary, if corporation: if a partnership, list names of all general partners and managing partners: P&e�jxj 70 L C-20 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder 1'141�J,411,11 -6U1Z-,0,5-1eS IAIC I [proposed subcontractor J hereby c 'f erti ies that he/she/dt has has not vl' . 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/sk4it has filed with the Joint Reporting Committee, the Director of the Office of Federal Contract Compliance, a Federal Government contracting or administerina agency, or the fon-ner President's Committee on Equal Employment Opportunity, ail 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 implementingregulations. (eeoc.gov/employers/eeolsurvey/index.cfm) 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. Sianature: 1\ Date. Print Name: A�Lxw,\�A- Mn Title- C-23 EXH 1B IT E NONCOLLUSION AFFIDAVIT (Title 2' ) United States Code Section 112 and Public Contract Code Section 7106) MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE DEPT TENANT IMPROVEMENTS) To the City of Hunt'no I _--ton Beach In conformance with Title 23 United States Code Section 112 and California Public Contract Code 7 t 06 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, souaht 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, oruanization. bid deposi member or agent thereof to effectuate a collusive or sham itory, or to any bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may Subject the Bidder to criminal prosecution. Signature: Date: mov. Print Name: A. Ma,�—A6AM- - Title: CF�Q (CV-0 sect'e-6, 'A \j C-24 EXHIBIT F 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 with Bidder 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; I Z-1 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 him/her 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 determimnQ bidder responsibility. For any exception noted above, indicate below to whom it applies. initiating agency, and dates of action. Note: Providina false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the Z-1 signature portion thereof shall also constitute signature of this Certification. Sianature: Z� ?N�� — Date: Print Name: Title: &E,0 CFo/ C-25 EXHIBIT G NONLOBBYJING CERTIFICATION FOR FEDERAL -AND 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 Con-ress, or an employee of a Member of Congress in connection with the awardin 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, -rant, 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 Z-- aoency, a Member of Congress, an officer or employee of Con ' gress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative acyreement, 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 makinQ 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 subreciplents shall certify and disclose accordingly. Sianature: Nov, 1016 Date: Print Name: At" ov� A - M Title: C-26 EXHIBIT H DISCLOSURE OF LOBBYING ACTIVITIES CONIPLETE THIS FORN/I TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: a contract b grant e cooperative agreement d loan e. loan guarantee f loan insurance 2. Status of Federal Action: r= a. bid/offer/application b initial award c. post -award 4. Name and Address of Reporting Entity Cl Prime Subavvardee Tier if'known Congressional District, ifknown 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. a. Name and Address ofLobby Entity (If individual, last name, first name, MI) 3. ReportType: a initial b. material change For tMaterial Change Only: year — quarter — date oflast renort 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, ifknown 7. Federal Program Name/Description: CFDA Number, ifapplicable — 9. Award Amount, ifknown: b. Individuals Performing Services (including address ifdifferent from No. 10a) (last name, first name, NII) (attach Continuation Sheet(s) if necessary) 11. Amount of Payment (check all that apply) 13. S 1:1 Actual F-1planned 12. Form of Payment (checkall thatapply): a. cash b. in -kind; specify nature Value Type of Payment (check all that apply) a retainer b. one-time fee c. commission d. continLent fee e deferred f. other, speci 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 Shect(s) ifnecessary) 15. Continuation Sheet(s) attached: Yes El No F1 16. Information requested through this form is authorized by Title 31 U S C. Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into This disclosure is required pursuant to 3 1 U.S C. Print Name. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any Title person who fails to file the required disclosure shall be subject to a civil penalty ofnot less than $10,000 and not more than Telephone No $100,000 for each such failure Federal Use Only: Standard Form LLL Rev. 09-12-97 Authorized for Local Reproduction Standard Form - LLL C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, DISCLOSURE OF LOBBYfNG 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 infori-nation 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 I 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. Identifv the status of the covered Federal action. Identiiv 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 da�e 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 Conaressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5) If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6) Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7) Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8) Enter the most appropriate Federal identifying number available for the Federal action identification in item I (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9) For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10) (a) Enter the full name, address, city, state and zip code of the lobbying entity I enga 'ged 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 I C-28 different from 10 (a). Enter Last Name, First Name and Middle Initial (_Ml). t 1) Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity 1 . (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actuat) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13) Check. the appropriate box(es). Check all boxes that apply. If other, specify nature. 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 recardin,c, the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and CID Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California. that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8 103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 Completed Projects during last five years: Project Name: City of Rialto Improvements at Fitness Center - New Addition Contract Amount: $420,000 Contact: EddieChan City of Rialto - Public Works Department 335 W. Rialto Ave, Rialto, CA 92376 T. 909.820.2651 Architect: Miller Architecture Interior Planning 1177 Idaho St., Ste. 200, Redlands, CA 92374 Project Name: City of Arcadia Cay Mortenson Auditorium Remodel Contract Amount: $430,000 Contact: Dave McVey Public Work Services Department 11800 Goldring Road, Arcadia, CA 91066 T. 626.256.6664 Architect: TKE Planning 2305 Chicago Ave., Riverside, CA 92505 Project Name; Carmela Elementary School - South Whittier USD Site Work and Relocatable Library Media Building Contract Amount: 499,000 Contact: Ray Coco South Whittier Unified School District 11200 Telechron Ave., Whittier, CA 90605 T. 562.944.623lX2034 Architect: Frick, Frick, & Jette' Architects 19153 Town Center Drive, Apple Valley, CA 92308 Roger Abero T.760.240.6211 Project Name: La Serna High School - Whittier Building "M" Remodel Contract Amount: $438,000 Contact: Maia Rafael / Reyes Mendoza Project Manager URS Corporation 9401 South Painter Ave., Whittier, CA 90605 T. 562.698.8121X1535 Project Name: Kids Come First Community Health Center Ontario USD - Linda Vista School Contract Amount; $420,000 Contact: Beverly Speak Kids Come First 1556 South Sultana Ave., Ontario, CA 91761 T.909.455.4832 Architect: WLC Architects 8163 Rochester Ave., #100, Rancho Cucamonga, CA 91730 Lisa Cox T.909.987.0909 Project Name: Riverside County Innovation Center Press Enterprises Tenant Improvements Contract Amount: $532,000 Contact: Sergio Pena Economic Development Agency Supervising Facilities Project Manager 3403 Tenth Street, Suite 300, Riverside, CA 92501 T. 951.955.0911 Architect: DLR Group Marlis Harang, AIA - Lead AP BD+C Architecture, Engineering, Planning, Interior 4280 Latham Street, Suite H, Riverside, CA 92501 T.951.682.0470 Project Name: Bradley & Marshall ES Canopies San Bernardino City USD Contract Amount: $496,000 Contact: Steve Massetti Program Manager San Bernardino City Unified School District Facilities Planning and Development 956 West 9th Street, San Bernardino, CA 92411 T.909.388-6100 Architect: PCH Architects, I.I.p. Ralph Pacini - Principal Architect 30 South Center Street, Riverside, CA 92373 T.909.792.7397 Project Name: Riverside City College Early Childhood Education Center Contract Amount: $305,000 Contact: Scott Zwart - Director Facilities Maintenance and Operations 4800 Magnolia Ave., Riverside, CA 92506 T.951.222.8474X4048 Architect: Higginson + Cartozian Architects, Inc. 1455 Park Ave., Redlands, CA 92373 David Higginson T.909.793.3100 Project Name: HVAC Replacement, Site Electrical Upgrade, & CNG District Office Hacienda La Puente Unified School District Contract Amount: $600,000 Contact: Robert Wilcox Maintenance Supervisor - Facilities Department 15959 East Gale Ave., City of Industry, CA 91716 T.626.933.8705 Architect: DC Architects 820 N. Mountain Ave., Suite 200, Upland, CA 91786 Alan J. Camerano T.800.985.6939 Project Name: Hermosa Beach City School District Hermosa View ES Portable Classrooms & Restroom Contract Amount: $458,000 Contact: Angela M. Jones Business Manager 1645 Valley Drive, Hermosa Beach, CA 90254 T.310.937.5877 Architect: gkkworks 155 South Fair Oaks Ave, Pasadena, CA 91105 Dilip Tiwari T.818.482.9335 Project Name: UCI Engineering Tower 3rd & 6th Floor Renovation Contract Amount: $424,000 Contact: Dan P. Taylor Project Manager 130A Facilities Management Building Irvine, CA 92697 T. 949.923.5431 Architect: Bojorquez and Lefner T. 949.423.3271 Project Name: UCI Rowland Hall Loading Dock Build Out Contract Amount: $661,000 Contact: Craig A. Denney Project Manager 130A Facilities Management Building Irvine, CA 92697 T. 949.824.5853 Architect: Taraz Architecture T. 858.458.1137 Works in Progress: Project Name: Buena Park Community Center Liberty Hall Remodel Contract Amount: $615,000 Contact: Jeffrey Townsend Assistant City Engineer 6650 Beach Blvd., Buena park, CA 90622 T. 714.562.3670 Architect: Terrazas & Associates T. 626.241.5618 Completed: 30% as of Sept. 2016 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For MSC-51 0 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, October 24, 2016. Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For MSC-51 0 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number One, October 24, 2016. NI�K.114 All J/ UIL_,� &A-s, 11v6. Company Name Ala V. 2 )s 16 Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3,2016" TO "NOVEMBER 8, 2016." 2) THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. /,-I /I 1171�J,41VI &IIZA,��Iff /A/, - Company Name 3 '20 Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-51 0 Police Department LobbV and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions.- 1 ) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUs(a)republicservices.com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact — Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell.- 714-328-8341 Lauren. kandel(o),redhawkus.com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated MCE controls Model # HMC-11 000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor- ThyssenKrupp contact — Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Daniel.VanMil(CD_thyssenkrupp.com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppele tor.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2 nd floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2.0. 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached)-. 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Number Three, October 27, 2016. / 'V1 #"/0// gal,1-6eRT. IA& - Company Name 1�\Iov. 24 h.- Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31 � 2016 Notice to All Bidders. Please note the following clarification to the Project Plans, Specifications. and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Four, October 31, 2016. AL Company Name Date All bidders must acknowledge the receipt of this Addendum with your bid proposal Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER FIVE For MSC-51 0 Police Department Lobby and MSC-515 Police Departmen Limited ADA Renovations November 2, 2016 Notice to All Bidders. - Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1 ) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide %" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide %" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in. 5) Where applicable, locksets will be Corbin Russwin. Keyway is 59C1— 6 PIN-1 0. This is to acknowledge receipt and review of Addendum Number Five, November 2, 2016. Company Name Zo Date By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. AAi$ NASSURETYGROUP CONTRACTOR: BID BOND SURETY: (Name, legal status and address) North American Specialty Insurance Company MARJANI BUILDERS, INC. 475 N. Martingale Road, Suite 850 26091 RAVENNA ROAD Schaumburg, IL 60173 MISSION VIEJO, CA 92692-5211 This document has important OWNER: legal consequences. Consultation (Name, legal status and address) with an attorney is encouraged CITY OF HUNTINGTON BEACH with respect to its completion or 2000 MAIN STREET modification. HUNTINGTON BEACH, CA 92648 BONI[) AMOUNT: TEN PERCENT OF GREATER AMOUNT BID ------------ Any singular reference to Contractor, Surety, Owner or other party shall be considered PROJECT: plural where applicable. (Name, location or address, and Project number, ifany) MSC-51 0 POLICE DEPARTMENT LOBBY SECURITY AND MSC-515 LIMITED ADA RENOVATIONS The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 26TH day of OCTOBER, 2016 (Witness) (Witness) MARJANI BUILDERS, INC. (Phncipal) (Seal) (Title) North American Svecialtv Insurance Company (Sure A 0 ('Seal) (Title) MARK D. 1ATAROLA, ATTORNEY -IN -FACT This Document conforms to the AIA DocumeniA310rm-2010 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 SAN DIEGO On 10/26/2016 before me, SANDRA FIGUEROA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(&) of SignerH who proved to me on the basis of satisfactory evidence to be the person(s) whose name(&) is/a�e subscribed to the within instrument and acknowledged to me that he/she*oey executed the same in hisAie4#teir authorized capacity(ios), and that by his/49W#49i.F signature(s) on the instrument the person(s), or the entity upon behalf of which the person(&) acted, executed the instrument. SANDRA FIGU CIA COMM. # 2162642 Z SAN DIEGO COUNTY NOTARY PUBLIC-CALIFOMNIAZ QP MY COMMISSION FXPIRES AUGUST 14, 2020 L 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 :5ZcL.4,_k-,r, Signatureyof Mlotary Public 'OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: _ Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: MARK D. IATAROLA El Corporate Officer — Title(s): El Partner — 0 Limited El General El Individual X Attorney in Fact El Trustee El Guardian or Conservator El Other: Signer Is Representing: Signer's Name: El Corporate Officer — Titl ' e(s): El Partner — 0 Limited 0 General El Individual El Attorney in Fact El Trustee El Guardian or Conservator 0 Other: Signer Is Representing: NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHrNGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: JOHN G. MALONEY, HELEN MALONEY, MICHELLE M. BASUIL, and MARK D. IATAROLA JOrNTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or under -taking or contract or suretyship executed under this authority shall exceed the amount of.- FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9"b of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, under -takings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seat of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." ,\0"NP,UTy/, 12" �\�. ee .......... Cal -6jkP0r4-. 4, By L I M Steven P. Anderson, Senior Vice President ofWashington International Insurance Company S L 1973 & Senior Vice President ofNorth American Specialty Insurance Company c, Ilk By Michael A. Ito, Senior Vice President of Washington International lnsurance—i Company loin & Senior Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 17th day of September ---- 20 15 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 17th day of September 2015 before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A. Ito, Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. M.Keniiy,Notw-y Public 1, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 26th day of OCTOBER 20 16 Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company & North American Specialty Insurance Company 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 January 23, 2017 New Dynasty Construction Co. 3002 Dow Ave, Ste. 218 Tustin, CA 92780 RE: Police Department Lobby Security — MSC-51 0 & 515 Enclosed please find your original bid bond for MSC-510 & 515. Sincerely, Robin Estanislau, CIVIC City Clerk RE:pe Enclosure Sister Cities: Anio, Japan + Waitakere, New Zealand New Dynasty Construction Co. 3002 Dow Ave., Ste. 218 tin CA 92780 �cense # 971321 IR #1000004807 City of Huntington Beach Office of the City Clerk 2000 Main Street, Second Floor Huntington Beach, California 9264� Contract No.: MSC-510 & MSC-515 Due: TUeSday, November 08, 2016 Hour- 2:00pm ProjectDesc: MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS SECTION C PROPOSAL for the construction of MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS 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 r all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefore, 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 105 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 re -advertise the project. In the case of discrepancies -, o t,; flie ati .-,its 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 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 10% ", as the case may be) Any standard Surety Bid Bond form is acceptable. z1:;-1:�-`:,-r,J";111: i-ecelpt of all Addenda here, if any: Addenda No. Date Received _A Bidder's Signature 01 10/24/2016 C I.& 02 10/27/2016 10/27/2016 04 10/31/2016 05 11/05/2016 PROJECT BID SCHEDULE Item No. Item Bid Amount in Figures 1. PD Lobby Security Construct improvements per plans and specifications $ 51� Cf, / 6 2. PD Lobby ADA Construct improvements per Improvements (Separate Funding Source) plans and specifications. Refer to the following plan $ k0l, u3 sheets for ADA scope of work: A 1. 0, A 1. 1, A2. 0, A2. 1, A3.1, A4.0, E3.0, E4.0, E5.0 Total Bid Amount $ jq2"5yq-0z Total Bid Amount in Words: MeV1 VIU . NQ �uv)&PA fiAA &49- & C-2 17, The base bid will be used for comparison of bids including alternates and to determine the lowest bidder. Alternate bid items may be considered at the discretion of the AGENCY. BASIS OF AWARD The lowest bid shall be the lowest total of the base bid amount and those alternates that, when taken in order and added to, or subtracted from the base bid, are less than or equal to the project budget. If the City awards a contract, it will go to the responsible bidder who submitted the lowest bid as determined by this basis of award. The City is not precluded from adding to or deducting from the contract any of the additive or deductive alternates after they have determined the lowest responsible bidder. Additive Alternates Additive Alternate No. 1: New Carpet tile floor to match, per schedule. Refer to sheet Al. 1. Additive Alternate No. 2: New office ceiling grid and acoustical tile to match adjacent ceiling grid (existing I iolit fixtures to remain). Refer to sheet A2.1 $ 15, 3 (f T " Lump Sum (use figures only) $ 161, MD. n Lump Sum (use figures only) Bidder shall state the above amounts in figures only, and these are the total amounts bid for the alternates including all applicable taxes. Any alterations, erasures, or changes must be clearly indicated and initialed by the bidder. 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 perfonn 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 Dollar Item(s) State Lic. # Amount % of Name and Address of Subcontractor and Class DIR # Contract. ASBESTOS QUALITY ENVIRONMENTAL INC Lic # DIR # 13123 LKELAND ROAD SUITE A 876494 1000001511 IDMO-OD �:l SANTA FE SPRINGS CA % QUALITY ENVIRONMENTAL INC Lic # DIR # DEMOLITION 13123 LK-ELAND ROAD SUITE A 876494 1000001511 M,7qo.oro /0 SANTA FE SPRINGS % CA Lic # DIR # ROUGH CARPENTRY KAAT Construction, Inc. 4195 Chino Hills Pkwy. #628 1013125 1000029705 Chino Hills, % CA FINISH PARS INDUSTRIES INC dba WOODCRAFT COMPANY Lic # DIR # CARPENTRN 6700 GATEWAY PARK DR STE 4 940315 1000008989 q SAN DIEGO, % CA DOORS & STAR HARDWARE INC Lic # DIR # HARDWAI 8727 LANYARD COURT 766703 1000005159 RANCHO CUCAMONGA % CA ALUM. Hioup- Cllctc._� Lic # DIR # GLASS & GLAZING 90(p N. YN- VP-rv'On m0002093 qq, m. aD CA BULLET PROOF K T M ENTERPRISES INC Lic # DIR # AASS G A N, & DOOR 600 S JEFFERSON ST STE B PLACENTIA, 992582 1000020180 % CA GYPSUM Lic # DIR # BOARD L GACY INTERIOR WALL SYSTEMS 1 489 MIRADA PLACE 1008728 1000033734 8�1 APPLE VALLEY, % CA By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-4 5C 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 Dollar Item (s) State Lic. # Amount % of Name and Address of Subcontractor and Class DIR # Contract CERAMIC CH[ARLES MC CANDLESS TILE CONTRACTOR INC Lie # DIR # TILE 636 POINSETTIA STREET 196900 1000003364 2("q eo q SANTA ANA, CA % NCOUSTICAI H61rA_1 Itoyj CV I k V1 Lie # DIR # CEILING 51:1 E. 514(4 1000019-492 1 q, SOD. ao SOLVi kMCjrCXiYL0, % CA CARPET & MOORE FLOORING INC Lie # DIR # VCT 472436 1000001027 5497 VINE STREET CHINO CA % PAINTING STREAMLINE PAINTING INC Lie # DIR # $ 9726 SUNNYBROOK DRIVE 799584 1000001540 �1 n - MORENO VALLEY, CA % TOILET GLOBAL SPECIALTIES DIRECT INC Lie # 418396 DIR # 1000005991 $ PARTITION 936 61 ST STREET 01 J 7 & ACCESS. OAKLAND CA % PLUMBING PIPING SERVICES INC Lie # DIR # $ 11721 WHITTIER BLVD #247 1007634 1000033529 WHITTIER, 112, M. OD (0 CA % I HVAC AIR DESIGN SOLUTIONS Lie # DIR # 403 SO MONTEBELLO BLVD 953818 1000004802 MONTEBELLO, % CA ELECTRICA1 Far cteayic' Lie # DIR # Po G'aX ft('Pla qQ'6311 lowop�(, q Oft. W Ayia"eim HIL, % 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-4 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 Dollar Item(s) State Lic. # Amount % of Name andAddress of Subcontractor and Class DIR # Contract FIRE RED HAWK FIRE & SECURITY CA LLC Lie # DIR # ALARM 1640 NORTH BATAVIA 713099 1000006967 ORANGE, CA % Lie # DIR # % CA Lie # DIR # % CA Lie # DIR # % CA Lie # DIR # CA % Lie # DIR # % CA Lie # DIR # % CA Lie # DIR # % CA. By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-4 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 Dollar Item(s) State Lic. # Amount % of Name andAddress of Subcontractor and Class DIR # Contract Lic # DIR # CA % Lic # DIR # % CA Lic # DIR # % CA Lic # DIR # % CA Lic # DIR # % CA Lic # DIR # % CA Lic # DIR # % CA Lic # DIR # % CA By submission of this proposal, the Bidder certifies: That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-4 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 11/08/16 , at Tustin CA Date City State Sherwin Chegini being first duly sworn, deposes and says that he orxsim is President of New Dynasty Construction Co. _ the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, r-1-11".1111ership, 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. New Dynasty Construction Co. Sherwin Chegini Name of Bidder Signaturof Eridder 3002 Dow Ave., Ste. 218 Tustin, CA 92780 Address of Bidder C-5 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 PROJECT NAME, (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, isfamiliar 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 i;ndc i� take steps as are necessary to assure compliance by any said subcontractor or V_10V i1h -he rcquirements contained herein. Date: 11/08/2016 New Dynasty Construction Co. Contractor Sherwin Chegini - By President Title C-6 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? LJ Yes U 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-7 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Date: 11/08/2016 New Dynasty Construction Co. Contractor Sherwin CheLyini - By President Title C-8 BIDDER'S INFORMATION � I � " 1 1 7' �, iiic i I diai, the J'61 lowing information is true and correct: New Dynasty Construction Co. Bidder Name 3002 Dow Ave., Ste. 218 Business Address Tustin CA 92780 city, State Zip 949 ) 502.6400 Telephone Number 971321 Class A & B State Contractor's License No. and Class 03/24/2012 Original Date Issued Expiration Date The work site was inspected by Mason Nikneiad of our office on October 18 � 2016 . The following are persons, firms, and corporations having a principal interest in this proposal: Sherwin Chegini - President Michelle Chegini - 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. Sherwin Chegini Printed or Typed Signature (%mRAN' LOU A. ARCE SLibscribed and sworn to before me this 8th day of November , 201 6 commJ 2082861 < NOTARY PUBLIC -CALIFORNIA ORANGE COUNTY Comm. Exp. SEP. 22, 2018 NOTARYPUBLIC RaniLouA.Arce NOTARY SEAL C-9 Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work. Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein. List below the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past five years: Ci t o t' R 1 Ci,�ic Clentei Cil. - Brea, CA Narne and Address ofPublic Agency \,lx sha Dell - '714 990.'762,S Name and Telephone No. of Project Manager $160,589.71 This project construct level III ballistic shields, woodwork and electrical July 2013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: Selective non-structural demolition, casework, doors, windows, paint and electrical 2. —Whittier Union High School District: 9401 S. Painter Ave., Whittier, CA 90605 Name and Address of Public Agency Reyes Mendoza - 562.698.8121 Name and Telephone No. of Project Manager S 1, 3 ') 7. 04 1. _-1 0 Remove and install HVAC Units and Roofing November 2015 Cotiti-Eict A111OL111t Type of Work Date Completed Provide additioiial project description to show similar work: Provide and install (4) new HVAC units with new platform, structural supports, with new ductwork. Remove bleachers, provide & intall motorized bleachers. 3. City of Riverside: 8095 Lincoln Ave., Riverside, CA 92504 Name and Address of Public Agency Jorge Villanueva - 951.826.2426 Name and Telephone No. of Project Manager $432,565.35 New tenant improvements Contract Amount Type of Work Provide additional project description to show similar work: New walls, ceiling, electric lights. livac, flooring and painting C-10 August 2015 Date Completed 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 perfon-ned 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. Al Chegini Nlame of proposed Pro.liect PvIanager 1-clophone No. Manager 949,701.2636 T �i Scinla Fliah School GVufl!a<-:1U1-P, Remove and install HVAC Bldg "G" HVAC Upgrade S 1307,041.20 Units and Roofing November 2015 Project Name & Contract Amount Type of Work Date Completed Interior tentant improvements of existing Orange Square Customer Service public lobby, customer service area, offices, printer Payment & 311 Call Center $913,725.00 copy room, data / IT. room, and hallway July 2015 Project Name & Contract Amount Type of Work Date Completed Brea Police Records Department S 160,589.71 Th ' s roect construct level III ballistic shi e1gs, woodwork and electrical July 2013 Project Name & Contract Amount Type of Work Date Completed 2. Fernando Duarte Hernandez Name of proposed Superintendent Telephone No. of proposed Superintendent: 323.385.1740 La Sema High School Gymnasium Remove and install HVAC Bld2 " Y" HVAC Upgrade SI.307,041.20 I Jnits and Roofing November MI S Prolocl Name S1,. Contract AnIOUnt Type of Work Date Completed L1110\ �illGu Rcmodel & addition to an existing bldg. October 2014 Project Name & Contract Amount Type of Work Date Completed Brea Police Records Department $160,589.71 This project construct level III ballistic shields, woodwork and electrical July 2013 Project Name & Contract Amount Type of Work Date Completed C-11 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 I 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/ActionServiet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database: https:Hefiling.dir.ca.gov/PWCR/Search.action �1111, �POV�A[,C;Mdl Nvill 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, or no later than contract award date. f ).,�l 1, C 1 1/0 8 , /2016 DIR #: 1000004807 New Dynasty Construction Co. Contractor Sherwin Chopini - By President Title C-12 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 13 5 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: New Dynasty Construction Co. Contact Person: Sherwin Chegini Contact Phone: Signed: Date: November 08, 2016 *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). C-13 EXHIBIT A D! H4.14 61 DF113.113 This Project is subject to Part 200.321, Title 2, Code of Federal Regulations entitled "Contracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus Area Firms." The Regulations in their entirety are incorporated herein by this reference. It is the policy of the City that disadvantaged business enterprises (DBEs), as defined in Part 200.321, Title 2 CFR, shall be encouraged to participate in the performance of Contracts financed in whole or in part with federal funds. The Contractor should ensure that DBEs, as defined in Part 200.321, Title 2 CFR, have the opportunity to participate in the performance of this Contract and shall take all necessary and reasonable steps, as set forth in Part 200.321, Title 2 CFR, for this assurance. The Contractor shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. Failure to carry out the requirements of this paragraph shall constitute a breach of Contract and may result in termination of this Contract or other remedy the City may deem appropriate. Bidders shall be fully informed respecting the requirements of the Regulations and are urged to obtain DBE participation in this project, although there is no specific goal for DBE participation. C-14 DBE INFORMATION — GOOD FAITH EFFORTS Federal -aid Project No. Not Required Bid Opening Date November 08, 2016 The City of Huntington Beach established a Disadvantaged Business Enterprise (DBE) goal of 0% 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 Not Reauired 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 deten-nine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confinnations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods Solicitation and Dates Not Required C-15 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. Bidder Normally Amount Percent of Iterns of Work Performs Item Breakdown (Y or N) of Items M Contract Not Required 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: Not Required -s i)f firnis selected for the work above: e i m b\O� kCL11111 Cd 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: Not Required C-16 to assist interested DBEs in obtaining necessary equipment, supplies, i 1.� I i�-Jdl 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 Not Required H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): Not Required NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. C-17 IF A SOLE OWNER OR SOLE CONTRACTOR SIGN HERE: Not Applicable hich business is conducte (1) Na nder which business is conducted j (2) Signature (given an ame) of proprietor (3) Place of Business (Street-d-nd-Number) City and State (4) Zip Code (5) E-Mail Telephone No. IF A PARTNERSHIP, SIGN HERE: Not Applicable Name under which business is conducted 2 Si ) Signat given and surname and character of partner) (Note: Signature must be made by a A�gei al partner) (3) Place of Business City and State Odo (5) E-Mail (Street and Number) Telephone No. C-18 IF A CORPORATION, SIGN HERE: ( i ), Nanw under which business is conducted New Dynasty Construction (2) (SignatuRT�/ President (Title) Impress Corporate Seal here (3) Incorporated under the laws of the State of California (4) Place of Business 3002 Dow Ave., Ste. 218 (Street and Number) City and State (5) Zip Code 92780 Tustin, CA (6) E-Mail achegini@new-dc.com Telephone No. 949.502.6400 NOTARIAL ACKNOWLEDGMENT OF EXECUTION BY ALL SIGNATORIES MUST BE ATTACHED C-19 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of orange On November 08, 2016 before me, Rani Lou A. Arce, Notary Public (Here insert name and title of the officer) personally appeared Sherwin Chegini who proved to me on the basis of satisfactory evidence to he the person(r.) whose name(:s) is/mx subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/luwkWx authorized capacity(jes), and that by his/hw/kkvir signature(o on the instrument the person(%t), 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. I RANI LOU A. ARCE � 0 CommA 2082861 NOTARY PUBLIC -CALIFORNIA W ITI/4 . E�S my hand and official seal. ORANGE COUNTY ( -VAB L* (Notary Seal) My Comm. UP. SEP. 22, 2M SignaW� of Notary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT Ci1y of Huntington Beach (Title or description of attached document) MSC-510 Mice Dept. Lobby Security & MSC-515 Police Department Limited ADA Renovations (Title or description of attached document continued) Number of Pages _ Document Date Bid Bond (Additional information) CAPACITY CLAIMED BY THE SIGNER 0 Individual (s) 0 Corporate Officer (Title) 0 Partner(s) 0 Attomey-in-Fact 0 Trustee(s) El Other 2008 Version CAPA v12.10.07 800-873-9865 www.NotarvClasses.com INSTRUCTIONS FOR COMPLETING THIS FORM Affv acknowledgment completed in California must contain verbiage exacil - i as appears above in the notan, section or a separate acknowledgment Juim must be Praperk completed and attached to that document The only exception is if a document is to be recorded outside of California. In such instances, aity alternative acknotHedgment verbiage as may be printed on such a documeni so long as the verbiage does not require the mourry to do something that is illegalfor a notary in Caltfornia (i.e. cerfifying the authomed capacii�y oir the signer). Please check the document carefidlyfor proper notarial wording and attach thisform if required • State and County information must be the State and Countv where the document signer(s) personally appeared before the notary public for ac��novdedginent. • 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 "lowed by a comma and then your title (notary puhlic). • 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. Wshe/dw�—, is /F&e ) or circling the correct forms. Fadure 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 simidges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment fionn. • Signature of the no", public must match the signature on file with the office of the county clerk. 0 Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. 0 Indicate title or type ofattachcd document, number of pages and date- 0 Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary) • Securely attach this document to the signed document List below names of president, vice president, secretary and assistant secretary, if corporation; if a partnership, list names of all general partners and managing partners: Sherwin Chegini - President Michelle Chegeni - Secretary C-20 EXHIBIT C LOCAL AGENCY BIDDER DBE COMMITMENT (CONSTRUCTION CONTRACTS Not Required NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM LOCAL ENCY: LOCATION: PROJECT XDEIPTION TOTALCONTRACT AMOUNT: S T BID DATE BIDDER'S NAME: CONTRACT DBE GOAL: CONTRACT ITEM OF WORK AND DESCII�' FION DBECERTNO NAME OF EACH DBE DOLLAR AMOUNT ITEM NO. OR SERVICES TO BE A N D EXPIRATION (Must be certified on the date bids DBE SUBCONTRACTED OR MATERI,�AX DATE are opened - include DBE address TO BE PROVIDED (or contracted ifthe and phone number) bidder is a DBE) For Local Agency to Complete: Local Agency Contract Number Total Claimed XDB Participa"on Federal -aid Project Number % Federal Share Contract Award Date Local Agency certifies that all DBE certifications have been enfied and information is complete and accurate, Si gnatufe of Bidder November 8, 2016 949.502.6400 Date (Area Code) Tel. No. Print Name Signature Date Sherwin Chegini Person to Contact (Please Type or Print) Local Agency Representative (Area Code) Telephone Number. Local Agency Bidder DBE Commitment (Construction Contracts) (Rev 6/26/09) C-21 PLEASE NOTE: This information may be submitted with your bid. If it is not, and you are the apparent low bidder or the second or third low bidder, it must be submitted and received as specified in the Special Provisions. Failure to submit the required DBE commitment will be grounds for finding the bid nonresponsive The form requires specific information regarding the construction contract: Local Agency, Location, Project Description, Total Contract Amount, Bid Date, Bidder's Name, and Contract DBE Goal. The form has a column for the Contract Item Number and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. Prime contractors shall indicate all work to be performed by DBEs including, if the prime is a DBE, work performed by its own forces, if a DBE. The DBE shall provide a certification number to the Contractor and expiration date. Enter the DBE prime's and subcontractors' certification numbers.The form has a column for the Names of DBE contractors to perform the work (who must be certified on the date bids are opened and include the DBE address and phone number). IMPORTANT: Identify all DBE firms participating in the project regardless of tier. Names of the First -Tier DBE Subcontractors and their respective item(s) of work listed should be consistent, where applicable, with the names and items of work in the "List of Subcontractors" \t,;t!1 I,; d -1. %, MIF ,, - I - ic:;,c is a coiurnn fbr the DBE participation dollar amount. Enter the Total Claimed DBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100% of item is not to be performed or furnished by. the DBE, describe exact portion of time to be performed or furnished by the DBE.) See Section "Disadvantaged Business Enterprise (DBE)," of the Special Provisions (construction contracts), to determine how to count the participation of DBE firms. Exhibit 15-G must be signed and dated by the person bidding. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Local Agency Contract Award, Federal -aid Project Number, Federal Share, Contract Award Date fields and verify that all information is complete and accurate before signing and filing. C-22 EXHIBIT D EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder New Dynasty Construction Co. [proposed subcontractor 7M J hereby certifies that he/she/it 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/she/it 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. (eeoc.gov/employers/eeolsurvey/index.cfm) 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. Signature: Date: 11/08/2016 Print Name: Sherwin Chegini Title: C-23 F)CHIRIT F NONCOLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT. LIMITED ADA RENOVATIONS (AKA POLICE DEPT TENANT IMPROVEMENTS) To the City of Huntington Beach In conformance with Title 23 United States Code Section 112 and California 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 0`1e: aild.. furthen that the bidder has not, directly or indirectly, submitted his or her bid -Iments thereof, or divulged information or data relative -)r i,he co arid vvil" no! pay, any fee to any corporation, partnership, company association, or pai � I I organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Bidder's Proposal. By signing the Proposal, the Bidder has also signed this Noncollusion Affidavit. Bidders are cautioned that making a false Certification may subject the Bidder to criminal prosecution. Signature: P Date: 11/08/2016 Print Name: Sherwin Chegini Title: President C-24 EXHIBIT F 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 with Bidder in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debannent, voluntary exclusion, or deten-nination of ineligibility by any Federal agency; has not been suspended, debarred, voluntarily excluded or deten-nined 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 him/her 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. Note: 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. -Signature: Date: 11/og/2016 Print Name: SherN4in_CheainL._.._ Title: 124:eg 41ept C-25 PY"IRIT C. 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. -Iffiic�na-�t al,o aLrces by submitting his or her bid or proposal that he or she "),I this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly. Signature: Date: 11/08/2016 Print Name: Sherwin Chegin] Title: President C-26 U-111111F)TIP " DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. TypeofFederal ction: 2. Status of Federal Action: 3. Report Type: a contract F� a bid/offer/application F� 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: 0 Prime rl Subawardee Tier Congressional District, ifknown 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) III 12. 14. Congressional District, ifknown 7. Federal Program Name/Description: CFDA Number, ifapplicable 9. Award Amount, if known. b. Individuals Performing Services (including address if different from No. I Oa) (last name, first name, M 1) (attach Continuation Sheet(s) if necessary) Amount of Payment (check all that apply) 13. Type of Payment (check all that apply) Actual planned a. retainer b. one-time fee Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. jn-kmd� specify nature e deferred value f. other, specify Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary) 15. Continuation Sheet(s) attached: Yes No 16. Information requested through this form is authonzed by Title ', I I T S C Section 1352 This disclosure of lobbving reliance Signature %,,i� ;111nc�d 1r, !�i, :Ibm - �% licni his transaction was made or enier , ed into. This disclosure is required pursuant to 31 U.S.0 Print Name Sherwin Chegini 1352 This information will be reported to Congress serniannually and will be available for public inspection Any Title: President person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than Telephone No.: 949.502.6400 Date: 11.08.16 $ 100,000 for each such failure. Federal Use Only: Standard Form LLL Rev 09-12-97 Authorized for Local Reproduction Standard Form - LLL C-27 INSTRUCTIONS FOR COMPLETION OF EXHIBIT H, 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 4, �W employee of a Member of Congress in connection %vid, a covered Federal action. Attach a continuation sheet for additional information if the space on 'the forni is inadequate. Complete all items that apply for both the initial filing and materia� 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, I—! _I�L".nsnortat" on. United States Coast Guard. 7) LniCr the pi-o�:rani 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 C-28 difl'erew trom 1.0 (a). Enter Last Name, First Name and Middle Initial (MI). -)!i ation paid or reasonably expected to be paid by the a M oi S ol �:k -in rcporung en-Lity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12) Check the appropriate box(es). Check all boxes that apply. If payment is made through an in -kind contribution, specify the nature and value of the in -kind payment. 13) Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 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. By my signature on this proposal I certify, under penalty of perjury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103) of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). C-29 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-510 Police Department Lobby and MSC-515 Police Department, ' �r-&P-4 Ar LJ DA Renovations October 24, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated September 16, 2016 shall be the labor rates in effect for the subject project. is to acknowledge receipt and review of Addendum Number One, October 24, 2016. New Dynasty Construction Co. Company Name November 08, 2016 Date i - Sherwin Chegin By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER TWO for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 27, 2016 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Special Provisions: 1) ALL REFERENCES TO THE DATE BIDS ARE DUE ARE HEREBY CHANGED FROM "NOVEMBER 3,2016" TO "NOVEMBER 8,2016." 21, THE BIDS ARE DUE TO THE CITY CLERK UP TO THE HOUR OF 2:00 PM ON TUESDAY, NOVEMBER 8, 2016. This is to acknowledge receipt and review of Addendum Number Two, dated October 27, 2016. New Dynasty Construction Co. SherwinChegini- Company Name By November 08, 2016 Date Allbidders ust acknowledne the receint of this Addendum with vow hirl nrnnnqql Should You have any questions regarding this Addendum, please c City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER THREE For MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations 2016 INIcitice tc) Ali Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Contractor Work Hours are Monday through Friday, 6:00 A.M. — 4:00 P.M. Extended hours or weekend work requires approval by project/Police Department represtentative. 2) Utilities and building systems shutdowns/testing will be coordinated with project/Police Department representative. 3) Perimter of work area (limit of work) will be barraced from floor to ceiling with rigid type material i.e. plywood. 4) Construction access will be through main Police Department lobby enatrance (auto doors). Auto doors may be placed on by-pass or hold -open during work hours. Auto doors must be secured at end of each work day. 5) Contractor will provide exterior barricade enclosing front entrance to Police Department lobby with plywood or slatlink fencing, 8 feet tall extending no more than 20 feet from building and end at northeast corner of building. This space is intended for contractor staging/laydown and roll off/dumpster area. 6) Contractor is required to coordinate with Rainbow Environmental Services, phone 714-847-3581, email RBW ContactUserepublicservices.com 7) HVAC return duct vents will be sealed at all times. 8) Fire Panel: Make (Notifier), Model (AFP 1010). 9) Fire System Service Vendor: RedHawk contact — Lauren Kandel @ 1-714-685-8100. 1640 N Batavia St. Orange, CA 92867 Office: 714-685-8100 Cell: 714-328-8341 Lauren. kandele- red hawku s. com 10) Fire System Monitoring Service: Pyro-Comm, call Pyro-Comm to put system on test @ 1-888-815-6268 Account # 691754 for 2000 Main St Civic Center. 11) Police Depart Elevartor: U.S Elevator with updated MCE controls Model# HMC-1000 /updated 11/6/2002 ID #57289 Hydraulic. 12) Elevator Services Vendor: ThyssenKrupp contact — Daniel Van Mil @ 1-714-941-2318. Daniel Van Mil, Account Manager, Anaheim Branch T +1 714 941 2318, M +1 714 448 6422, F +1 866 768 8620, Daniel. VanMil(a)_thyssenkrupp.com Thyssenkrupp Elevator Corporation, 1601 S. Sunkist St, Ste E, Anaheim, CA 92806 www.thyssenkruppelevator.com 13) As -Built Plumbing: See attached. 14) As -Built Fire System: See attached. 15) Is there any other work to be done on the 2 nd floor other than the restrooms? 2nd floor work other than the restrooms is at the corridor for new drinking fountain, new Soffit, and new wall & floor finishes. 16) If GC is DBE, are we still required to do the outreach program? There is no stated goal for this project, 17) On page E-2.0 single line diagram shows a note next to new panel (1 PC2) that says to perform a neutral fault test. Will the test be performed only on panel 1 PC2? Note not found next to panel 1 PC2 on sheet E2. 0, 18) Are there pages E-8 or E-9? No, pages E-8 & E-9 where removed from the set. 19) Page E-3.0 shows circuits 1, 3, 5 & 7connected into what looks to be systems furniture. Is this correct? Yes. If so, Will key note 3 apply to these receptacles? Yes. 20) Remove spec section 088000 Bullet Resistant Glass and add the following spec Sections (see attached): 084100 Entrances and Storefronts 087100 Door Hardware 088100 Glazing 131010 Bullet Resistant Partitions 21) Revised doors and door frames and door hardware per door schedule from sheet A3.0 of the Drawings. See attached. This is to acknowledge receipt and review of Addendum Number Three, October 27, 2016. New Dynasty Construction Co. Company Name November 08, 2016 Date Sherwin Chegini - By All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 For MSC-51 0 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations October 31, 2016 Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) FEDERAL LABOR RATES. The Federal Labor Rates contained in Appendix H of the specifications for MSC-510 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations shall be replaced with the following attached documents: The Federal Labor Rates dated October 28, 2016 shall be the labor rates in effect for the subject project. This is to acknowledge receipt and review of Addendum Number Four, October 31, 2016. New Dynasty Construction Co. SherwinChegini- 14c- Company Name By .01 November 08, 2016 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 - --- -- ------ A For MSC-51 0 Police Department Lobby and MSC-515 Police Department Limited ADA Renovations November 2, 2016 Notice to All Bidders: Please note the following clarification to the Project Plans, Specifications, Technical Provisions and Responses to Contractor Questions: 1) Limited Asbestos Containing Materials and Lead -Based Paint Bulk Survey Report. 2) Hazardous Materials Specifications for Remediation. 3) Provide %" EMT conduit with single gang box at all Voice/Data drops, except at lobby security counter. Confirm locations with City during rough -in. 4) Provide '/.I" flex conduit with double gang box at lobby security counter. Confirm locations with City during rough -in. � 11 Where applicable, locksets be Corbin Russwin. Keyway is 59C1— 6 PIN-1 0. This is to acknowledge receipt and review of Addendum Number Five, November 2, 2016. New Dynasty Construction Co. Sherwin Chegini - Company Name By November 08, 2016 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call Jerry Thompson at (714) 960-8845. 0 TM 50k-AIA Document A31 -2010 Bid Bond CONTRACTOR: (Alaine, legal status, and address) New Dynasty Construction Co 3002 Dow Ave., Suite 218 Tustin, CA 92780 SURETY: Developers Surety and Indemnity Company (Xarne, legalstatus andprincipal place ofbusiness) 500 S Kraemer Blvd, Suite 300 Brea, CA 92821 OWNER. City of Huntington Beach (Xwne, legal stattis and address) 2000 Main Street, Huntington Beach, CA 92648 BOND AMOUNT: 0 TEN PERCENT (10%) of the Total Amount Bid PROJECT. MSC-510 POLICE DEPT. LOBBY SECURITY and MSC-515 POLICE DEPT (Xwne, location or address, and Project number, if any) 2000 Main Street, Police Department, Huntington Beach, CA 92648 This document has important legal consequences. Consultation with an attorney is encouraged with respect to its complefion or modification, Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. LIMITED ADA RENOVATIONS Project Nuniber, if any: The Contractor and Surety are bound to the Owner in the amount set forth above . forthe 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 contractuith 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 ONNmer, 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 slW not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor. the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or odier legal requirement in the location of the Project, any provision in tl-ds Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so famished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Si aled this 26th day of October, 2016 gn71 I New Dynasty Construction Co By: (Principa (Seal) (Witnefs) F'oVA" Lou Nee- Pal MmiV110 ya Fr —By: (Titlq3-5Kytr)1V1 130: Developers Surety and Indemnity Company t�nesshristine Maestas, V.P. Surety OCT 26 2016 (e"' (Title) Edward N. Hackett , Atiorney in Fact AIA Document A31OTM —2010. Copyright 0 1963,1970 and 2010 by The Americ-an Institute of Architects. All rights reserved- CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On November 08, 2016 beforeme, Rani Lou A. Arce, Notary Public (Here insert name and title of the officer) personally appeared Sherwin Ch who proved to me on the basis of satisfactory evidence to be the person0s) whose name(s) is/me subscribed to the within instrument and acknowledged to me that he/she/tkey executed the same in his/bukhoix authorized capacity(ios), and that by his/harMwir signature(30 on the instrument the personW, 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. RAINJI LO A. ARCE CO"" IU < . 4 208'2861 W my hand and official seal. 'k OMNDTARY PUBLIC-CAUFORNIA ORANGE COUNTY (Notary Seal) >1 Cow Em SEP. 22,2018 Sig4ture ofNotary Public ADDITIONAL OPTIONAL INFORMATION DESCRIPTION OF THE ATTACHED DOCUMENT City of Huntington Beach (Title or description of attached document) M Pol=t. & MSC-515 Police D=ent d tions (Title or description of attached document continued) Number of Pages -1 M Document Date-1 0.26.16 Bid Bond (Additional information) CAPACITY CLAIMED BY THE SIGNER EJ Individual (s) EJ Corporate Officer (Title) EJ Partner(s) EJ Aitorney-in-Fact EJ Trustee(s) EJ Other 2008 Version CAPA 02.10-07 800-873-9865 www.NotaryClasses.com JNSTRUCTIONS FOR COWLETING 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 onh, 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 illegalfor a notary in California (i.e. certt&ing the authorized capacity of the signer). Please check the document carefidlyfor proper notarial woraing and allach thisform it'required. • State and County information must be the State and County where the document signer(s) personally appeared befiDre 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 acknoAlodgment 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. iaelshe/dw5— is /aFe ) or circling the correct forms. Fadure 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 bid could help to ensure this acknowledgment is not misused or attached to a different document Indicate title or type ofattacbed document, number ofpages and date. Indicate the capacity claimed by the signer If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary) • Securely attach this document to the signed document CAUFORNIA ALL-PURPOSE CERTWICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verified only the identity of the individual who signed State of Cal iforii la I the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. COL111ty Of _,_.._.___Orange Oil--.. 0 - CT 2 6 2016 -­ before le, C. Maestas, Notwy Public 111cro inicrt nanicand title ol'the ol'ficcr) personally appeared Edward N. Hackett "vilo Proved to me Oil (Ile basis or'satisfaclory evideilee to Lie the persoii�sj whose millic(s) is�crttv stibscribed to th( withiii histrumew alld acknowledged to me that he;1-i6&4h--y execUted the SMle III aLItI1OI-iZC( capacity�ies4, and that by Oil the iiistrIL1111CIlt the Pel'SOII(S4, Ot' the elltit)" LII)OIl behalfoll',whicl tile persoll(s) acted, exeCLIted die inStIMITIellt. I Cei-tify Wider PENALTY OF PERJURY Under die laws of the State of California that the foregollig Paragraph is and correct. WfTNESS my haild aild official seal C. IM A E S TA 1 ,j 4 Commission V 2117336 Notary Public - California z Orange County My Con, rn. Expires Jul 24, 2019 ADDrri[ONAL WrIONAL, INFORMA,riON DESCItl PTION or"n 1E ATTAU IED DOCUNIENT City of Huntington Beach Bid Bond I Tide to- descrilinori okmaclied doctoncirt I (I'alc or de,cijI)ii oil o I avached ductimet it continued) NumberofPcIoes DOCIAment Date OCT 26 ( AdditiO1131 in 1111111411 ioll I CAPACITY CLAINIED BY T1 1E SIGNER IndiVidL1,11 (S) Corporate officel- (I'iflcl pal-Iner(s) X Attorlacy-in-Fact 0 TrLISteC(S) 11 Other 200S Vcr.�ioii CAPA % 12. 10.07 WO-873-9,96.i w.Noiai INSTRUC.71ONS FOR C'01YIPLETING Tl 11S FORNI AnY a'.4il"Irledi.,invill ill C"lli'lol-elia illial onvahl rcrld,�ge vXat.141- as lippears ah,we ill tho nwar�r veclioll W- (ISCIV1,111" Inif5f 111-111)01'�V COM111C1,241 field 01111CIled 111 11AP (1,1011jET1. The oll/i. Lwceplim is i/ a 'filf-11111cill is 1, 1F., rccoracd oidilAl- q/ C,di nvi; j, fie sm-h iustaiiccs. emr eilic-i-itwive a(i l� i,,wrin rct el he pr; dcd ... I snch �l dw 'jv '"' vcrbh�,v 4)es iw re,711i'V 111c 11) ill 11101 i-s ilil-,`,leefill' It l"Ifill-I ill Calefin-ohi chei-A rkl, dilcialwill 11listiv-111 fl-rellilire'd stale and Collill , %. oll'olillatioll nillsi Ile the Suite aild County m here die docoulcol siglrer(sl Pelst)ll;lllv appeared huforc [fie liolary p1blic I'm :Icklio\% ledgrovilt Dile Lil'notiiiizalioil 111ti't tic the ck)tc flial ill,: signor(s) pcisorloll.\ alipciir�d %% hich most also be die sainc dale die ackrumle&irerit is c,,ii,,I)Icicd, Thc nolarY liublic rinisi print his or lier ilarric tis it npjicar� within his ill- her cuaiiiii%%ion follo\%ed I)%, a conlina �illd dicil Yoor tillc I liatar� pliblic). Prilit (Ile WIMC(O 01'LILICUMCol iLllel(0 \vIlo per,ollally )1PI)car al [Ile tillic of lntlicaic� the correct sinokir or likiral fornis bY crossing off incolTect torms (i.c. 4ve�shc4kt- r� is�tte ) oi ciichiiL the coireci llorni��. Failio-c io corrcciN hidic;iic ilik inforinalion 111.1%, lend (o jcjecuoij oNticorticii[ iccuidinL, The riolaq Neal inipresAkil nitisi be c1car and phoiogjapliically rt�rirodriciblc. hllj)rc.�sioll IlluSt 1101 COVer lext or lines. It'scid inilircssion srrwd�cs, re-scill it' a stilllick�irt aren I)crniit.i. 01 Ile] %% Ne LtA1lPlQICa dillcienlackow.% W--,mont lowi. Si-griawre or die noiary poblic nitist inatch the signature oil filc %% ilh the officc or the cotint), cleik. cA� Addition.11 irilornialitin k out lctloircd 11'a could hell) to clisore Illk eick00%%-Ictl�iiieni is tiol wistiscd oi illoviied to o dillIeterit dl)ctllllcllt, ol Indicale title orlyllz oCniloched doconicni, ourribcroflia.cs and daic. CA Irldivnie Ilic callncil�, claillied bY Ike %ii!rlcr. 11' [lie claillicd Cnllacil.v Is :1 colporatc ol'fiCCr. oldicate the title (i.e. CTO. CH ). Sectetar,,,I. - SMINIV alWC11 tIl1,S 1.10CURICIlt I--, the signed d0�:LllV1Cllt POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263-3300 KNOVVALL BY THESE PRESENTS that except as expressly limited, DEVELOPERS SURETYAND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA. do hereby make, constitute and appoint: —Christine M. Maestas, Edward N. Hackett, jointly or severally — as their true and lawful Attorney(s) -in- Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts 0 suretyship giving and granting unto said Attorney(s)-in-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewitJ I a s each of said corporations could do, but reserving to each of said corporations full power of substitution and revocalion, and all of the acts of said Attorn ey(s)-in -Fact, pursuant to these presents, are hereby ratifled and confirmed. I This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELDPERS AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January Ist, 2008. RESOLVED, that a combination of any two of the Chairman of the Board, the President, Executive Vice -President, Senior Vice -President or any Vice President ofthe corporations be, and that each of them hereby is, authorized to execute this Power of Attorney, qualifying the attorney(s) named in the Power of Attorney to execute, on behalfoft corporations, bonds, undertakings and contracts of suretyship, and that the Secretary or any Assistant Secretary ofether of the corporations be, and each of them hereby is, auth to attest the execution of any such Power ofAttorney; RESOLVED, FURTHER, that the signatures of such officers may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any Power of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in the future with respect to any bond, un or contract of suretyship to which it is attached. IN VVITNESS VVHEREOF, DEVELOPERS SURETYAND INDEMNITY COMPANY and INDEMNITY CDMPANY OF CALIFORNIA have severally caused these presents to be signed their respective officers and attested by their respective Secretary or Assistant Secretary this January 29, 2015. By: AND /410 00PANY0 Daniel Young, Senior Vice -President P 0 R4 P OC?4 t A, 0 OCT. C) OCT. 5 LU 0 ay: 1 9 3 6 1967 Mark Lansclon, Vice -President /Ow�, /pop, ............ 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 January 29, 2015 before me, Dale personally appeared LUCILLE RAYMOND : E44 Com-m-is-sio-n _# -20-81-945- Z Notary Public - California Z a Orange Count 31� My Comm. Expires Oct'113, 20181 Place Notary Seal Above Here insert Hama and Titie a f th a Officer Mark Lansclon CURFMIM 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 authorizE capacity(ies), and that by his/her/their signature(s) on the �nstrument the person(s), or the entity upon behalf 0 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 true and correct. VVITNESS my hand and official seal. /� - Signature CERTIFICATE Lucjli� R,�Y;- I , ond, Notary Public The undersigned, as Secretary of -Assistant Secretary of DEVELOPERS SURETYAND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA, does hereby certify that the foregoing Power ofAttorney remains in full force and has not been revoked and, furthermore, that the provisions of the resolutions of the respective Boards ofDirectors Of said corporations set forth in the Power ofAttorney are in force as of the date of this Certificate. This Certificate is executed in the City of Irvine, California, this day of OCT 26 2016 By� - I - Cassie J �Irrisforcl, Assistant Sectfitary ID-1380(Rev.01/1 5)