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HomeMy WebLinkAboutPTM General Engineering Service, Inc. - 2012-08-20 City 9 Of Huntington o each INTER-DEPARTMENT COMMMUNICATION HUNTINGTON BEACH TO: THOSE LISTED HEREON FROM: David Verone DATE: March 5, 2013 SUBJECT: Retention Release Payment Company Name: PTM General Engineering Address: 5942 Acorn Street City, State and Zip Code: Riverside, CA 92504 Phone Number: (951) 710-1000 Business License Number:A271213 Local Address: NSA Notice of Completion Date:2/20/13 Contract Purpose: Safe Routes to Schools-Gold enview The conformed copy of the Notice of Completion for the above contract has been filed. The thirty-five (35) day waiting period has elapsed or will elapse before payment is made. Processing of the retention payment is recommended so long as no stop notices or outstanding invoices are on file with the City. I certify that no stop notices are on file on the subject at this time. J)�4b5a [date T4'v/"`�r Herbel, City Engineer I certify that there are no outstanding invoices on file. 31 13 Date Joyce Z cks, D epu City Treasurer I certify that no stop notices are on file on the subject contract, and that a guaranty bond has been filed with this office. r at Joan Flynn, " Clerk 1402 Retention_Release_Payment.doc 3/5/2013 2:50:00 PM Certification of Compliance with Tide VU of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntingtou Beach Department of Public Works 2000 Main Street/P.O.Box 190 Huntington Beach,CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: CC-1402 eject: Safe Routes to School Golden View Project The undersigned contractor on the Dove-roferenced project {Trojecf) hereby certifies that it has complied with Title VU of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its estabiis=eats on the basis of race, creed, color, sex,national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executedfl iS 25th (lay o f February 201�at Riverside California. PTM General Engineering Services Inc. (7 'pe Contracto Maw) By: Name. [Type Name] Title: [Type Title] R �" /� d ► . 1 �assrta • CONTRACTOR'S SWORN STATEMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROM: PTM General Engineering Services Inc. PROJECT: Safe Routes to School Golden View Project (Cardm for tame) 5942 Acorn Street (Street Address) Riverside,CA 92504 (City,State and Zip) TO: CITY OF HUPMNGTQN MACH DECLARATION Attached hereto is a true and correct copy of the current Certificate of Insurance and Additional Insurer!Endorsement CG 2010 1185,which Ceftcate complies with the insurance requirements of the Contract by and between the City of Huntington Beach("City")and the above-named Contractor(Tontrrador°)for the above-described project{"Project")• I declare under penalty of perjury under the laws ofthe State of California that the above statement Is true and correct. Signed on 20LM at Riverside,California (Date) (city,State) (Signature of Individual Who Is Malting Declaration) WARRANTY Contractor hereby warrants and agrees to maintain Products and Completed Operations Insurance In compliance with the insurance requirements of the Contract for the Project. Said insurance shall be maintained through and until the expiation of all Warranties provided by Contractor, Said Insurance shall contain Additional Insured Endorsement CG 20101185,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 February 25 ,20j_;lat Riverside,California (Bate) (City,State) CONTRACTOR: Names RPTM General Engineering Services Inc. By Name; Elizabeth H.Mendoza de McRae Title: Press en 277467,1.2 Elizabeth H.Mendoza de McRae President/CFQ ,state and certify that. (Name of Declarant) PTM General Engineering Services Inc. is the general contractor to the City of Huntington Beach ("City") on Contract NO- CC-1402 (the "Contract") for the construction of the public work of improvement entitled Safe Routes to School/Golden View Elementary School (the`Trolect"). 2. ,All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents(as such term is defined in the Contract). 3. Except for the claims listed.below and the disputed claims listed in paragraph five(5),all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied(list unpaid debts and claims;ifnane,write"NONE"): None 4. A.ttaohed hereto are the lien waivers required by the Contract Dvcumerits, which Lien waivers have been mouted by all persons who performed work qn or supplied lttbor, services,materials,and/or equipment for use at the Project. 5, Set forth below is a list of disputed claims or claims that are the subject of a Notice to Wiftold fled prusuannt to the Civil Code of the State of California (list all disputed claims;if none,write`NONB"): None I declare under penalty of perjury under the laws of the State of California that the foregoing is tme and correct. Executed at Riverside,California on this 25th day I February 20 13. , (Signa a of Declart�nt) APPROVED AS To FORM By: r Name: [Type Name] . ,'itle: (Type Title] 24914.1 ISSUED 1N THREE (3) ORIGINAL COUNTERPARTS OWNER ❑ CONSENT OF SURETY ARCHITKT ❑ TO FINAL PAYMENT CONTRACTOR ❑ Conforms with the American Institute of SURITY ❑ Architects, .AIA Document G707 QTIIL•R ❑ TO OWNER: ARCHITECT'S PROJECT NO.: (Nome and udilrersl CITY OF HUNTINGTON BEACH 2000 MAIN STREET CONTRACT FOR:CC-1402; SAFE ROUTES TO SCHOOL . P.O. BOX 190 GOLDEN VIEW PROJECT HUNTINGTON BEACH, CA 92648 PROJECT: CONTRACT DATED:AUGUST 7TH, 2012 (Nauuv and fiddress) SAFE ROUTES TO SCHOOL GOLDEN VIEW ELEMENTARY SCHOOL CC-1402 CITY OF HUNTINGTON BEACH In uccurdunce with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert mane and address uJ'Surety) INTERNATIONAL FIDELITY INSURANCE COMPANY 233 WILSHIRE BLVD., SUITE 820 SANTA MONICA, CA 90401 SURETY, on blind or ((nscrt naure aid address u�'CfurUrurrorJ PTM GENERAL ENGINEERING SERVICES, INC. 5942 ACORN ST. RIVERSIDE, CA 92504 CONTRACTOR, hereby uppruves ol'tlle linul ptiynlent to the Contractor,and agrees that final payment to the Contractor shall not retieve•the Surety ul'uny nl'its ubligotiuns to (hcserf aurult(flirt fu/dress(duo„cr) CITY OF HUNTINGTON BEACH 2000 MAIN ST. P.O. BOX 190 HUNTINGTON BEACH, CA 92648 OWNER, as set Forth in said Surety's bond. IN WITNESS WFIEREOP,the Surety has hereunto set its hand on this date: FEBRUARY 27TH, 2013 (Insert Ili wrirbig the uiuwdlf Jollumd by fire ummteric•flute and yam•,J 1NTERNATI NAL FIDELITY INSURANCE COMPANY (Surety) (S(gnnlur at prized representative) Attest: (Seal): PHILIP E. VEGA, ATTORNEY-in-FACT (Printed nunte and tple) S-21341GEEF 10101 FftP Ceramcation of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of'Public Works 2000 Main StreetlP.O. Box 190 Huntington Beach, CA 92648 I've: Certification of Compliance with Prevailing Wage Laws Contract: Safe Routes to School CC No. 1402 ProjOct: Safe Routes to School-Golden View Project, Huntington Beach The undersigned contwactor on the above-referenced protect ("Project") hereby certiit:;s that ail laborers, rnech=cs, app:crtices, trai.uues, w-atchnten and guards _.niployed `ay liini or by any subcontractor performing work under the contract for tfte Projec: have been paid pursuant to the ralinununi wage and. bona fide fringe benefit requirements srecified for each particular classification of wort;, as sat forth in :he v:age-rate detenninations of the State of California, Department of lndustr_al Re:atiors, and:'or the Unitad States Department of Labor. I declare under petialt;v of p}e 'ury under tt;e iaV,s A'tlic State u_ C:aliforriia that the (cre.going is tru:� and correct. f-xecutedthis 277 davof^ _February . 20 L-3at �i•yex ..de__.____, c alifuinia. PTM General Engineering Services, Inc. .,re Cor:tractw',�:'clr,it By: Indira Mendoza P ol1_..11aiiager Maine: I l..p, Naln-j CI't'1'A1'iYiRr:L�' I RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signingidating (Date) A, CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: , City Treasurer FROM: DATE: �> SUBJECT: Bond Acceptance I have received the bonds for (Company Nam Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved Agenda Item No. (Coup I Approval Date) �l City Clerk Vault No. � �J #27 g1followup/bondletter.doc ISSUED IN THREE(3) ORIGINAL COUNTERPARTS BOND NUMBER 0601205 MAINTENANCE BOND KNOW ALL MEN BY THESE PRESENTS: That: PTM GENERAL ENGINEERING SERVICES INC. [contractor's name) 5942 ACORN ST. RIVERSIDE, CA 92504 [contractor's street address,city and state and zip code) as Principal (hereinafter called Contractor), and: INTERNATIONAL FIDELITY INSURANCE COMPANY [surety's name] 233 WILSHIRE BLVD. #820 SANTA MONICA, CA 90401 [surety's street address,city and state and zip code] a corporation organized and existing under the jaws of the State of NEW JERSEY with its principal office in the City of NEWARK as Surety (hereinafter called Surety), are held firmly bound unto CITY OF HUNTINGTON BEACH as Obligee(hereinafter called Owner), in the amount of FOURTEEN THOUSAND ONE HUNDRED FOURTEEN 10/100Dollars ($ 14,014.10 1, for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents, WHEREAS, Contractor has by written agreement dated AUGUST 7TH, 2013 entered into a contract with Owner for the CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT in accordance with drawings and specifications prepared by CITY OF HUNTINTON BEACH which contract is by reference made a part hereof(hereinafter referred to as the Contract);and WHEREAS, the Contract provides that the principal will guarantee, for a period of one year, the work performed as part of the Contract from and against all defects in materials and workmanship; and WHEREAS, the Contract also provides that the Contractor shall secure Contractor's obligations during the one- year period with a bond executed by a surety duly admitted in the state of California; and WHEREAS, the Contract has been completed, and the. Owner Contractor and Surety agree that the commencement date for this Guarantee and Bond shall be APRIL 15TH 2013 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner, repair and/or replace any and all defects arising in the Work, whether resulting from defective materials or detective workmanship, then this obligation shatl be null and void; otherwise it will remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within thirty (30) following Owner's written notice of default, either: (a) remedy the default, or (b) shall promptly complete the Contract in accordance with its terms and conditions. Surety shall save the Owner harmless from any claims, judgments, liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions in a timely manner. Whenever the Principal shall be, and declared by the Owner to be in default under the Contract, which shall include without limitation, any breach or default of the Contract, then, after written notice from the Owner to the Surety, as provided for below, the Surety shall either. (a) remedy the default or breach by the Principal; or (b) shall promptly and faithfully take charge of the Work and complete the Work in accordance with the requirements of the Contract with a contractor other than the Principal, at its own expense, and make available 1 10-2567150543 t. r- as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder; provided, however, that the procedure by which the Surety undertakes to discharge its obligations under this Bond shall be subject to the advance written approval of the Owner. Within thirty (3 0) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal, it shall be the duty of the Surety to give to the Owner a notice, in writing, of the Surety's election to (a) remedy the default(s) of the Principal promptly, or (b) arrange for performance of the Contract promptly by a contractor other than the Principal, time being of essence to this Bond. In said Notice of Election, the Surety shall state the date of commencement,of its cure or remedy of the Principal's default(s) or its performance of the Contract, The Surety's obligations for cure or remedy, include but are not limited to: correction of defective work and completion of the Contract, additional legal, design professional and delay costs arising from Surety's actions or failure to act; and liquidated damages (or if no liquidated damages are specified in the Contract, actual damages caused by delayed performance or non- performance by .the Principal). The Surety shall give prompt written notice to the Owner upon completion of the cure or remedy of the Principal's default(s) of its performance of the Contract. If the Surety does issue its Notice of Election and does not proceed to cure or remedy the Principal's default(s) of its performance of the Work within thirty(30)days after receipt of a written notice from Owner, Surety shall be deemed to be in default on this bond, and the Owner shall be entitled to enforce any remedy available to Owner. No right of action shall accrue.on this bond to or for the use of any person or corporation other than the Owner named herein or the successors of Owner. Signed and sealed this 25TH day of FEBRUARY 2013 Principal Raised Corporate Seal PTM GEN L ENGINEERING SERVICES, INC. [MUST BE AFFIXED] (Contractor Name) By: (Seal) Principal Ralsed Corporate Seal [MUST BE AFFIXED] Ica (Title) INTERNATIONAL FIDELITY INSURANCE COMPANY (Surety dame) By: Seal) -in- A T NOTES: PH7GA, A I 1. Acknowledgments must be completed and returned as part of the bond. ARVIED AS TO FORM 2. Raised Corporate Seals are mandatory. 3. Please attach Power of Attorney. Ji1 ?�CGRATH, City AtImPey 2 10-2567/50583 Tel (973) 624 POWER OF ATTORNEY INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEV\IARI< CENTER, 20TH FLOOR NEWARK, NE\N JERSEY 07102-5'07 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY , a corporation organized and existing unde the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized aiCi existing under the Ic;ws of the jl;;te Of Pennnysvlvanfa,having their principal office in the City of Newark.Navv Jersey,do hereby conslitula and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, MYRNA SMITH, PHILIP E. VEGA Covina, CA. their true and lawful atlorney(s)-in-fact to execute,seal and deliver for and on its behalf as surety,any and all bonds and undertakings,contracts or indenmity and other writings obligatory in the nature thereof, which are or may be allowed,required or permrtled by law,statute,rule,regulation, contract or otherwise, and the execution of such instrument(s) in Pursuance of these presents,shall be as binding upon the said INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY„COMPANY, as fully and amply, to all intents and purposes,as if the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed,and may be revoked, pursuant to and by authority of the By-Laws of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY and is granted under and by authority of the following resolution adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY al a meeting du ,held on the 201h day of July,2010 and by the Board of Directors of ALLEGHENY CASUALTY COMPANY at a meeting duly held on the 15th day of August,4000; "RESOLVED, that (1)the President, Vice President, or Secretary of the Corporation shall have the power to appoint,and to revoke the appointments of, Altorneys-in-Fac( or agents with power and authority as defined or limited in their respective powers of attorney,and to execute on behalf of the Corporation ;and affix the Corporation's seal thereto,bonds,undertakings, recognizances, contracts of indemnity and other wrillen obligations in the nralure thereof or related thereto; and(2)any such Officers of the Corporation may appoint and revoke the appointments of joint-control custodians,agents for acceptance of process,and Attorneys-fn-fact with authority to execute waivers and consents on behalf of the Corporation;and (3) the signature of any such Officer of the Corporation and the Corporafion's seal may be affixed by facsimile to any power of attorney or certification given for the execufion of any bond,underlaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so usod whether• herelofore or hereafter, being hereb adopted by the Corporation as the original signature of such officer and the original seal of the Corporation,to be valid .end binding upon the Corporation wi h the same force and effect as lhnugh manually affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed an 'ill(,sli:these presents on this 12I1 day of March,2012. {uti T'Yv�+,�' �NS�t Y` STATE OF NEW JERSEY a. I/ 'f�1 , Counly of Essex 1's04 r-T. t * ROBERT W. MINSTER �F LV ,1� Executive Vice Presidenl/Chief Olx;raling OlffcIlk" r:r tr'o, Yf�.,, (International Fidelity tnsurancr; C on-Ipsuiy) and President(Allegheny Casualty Company) On this 12Ih day of March 20'12, before me came the individual who executed the preceding instrument,to nre personally known,and, being by me drily sworn, laid he is the therein described and authorized officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY (::UMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies;Ilia the said Corporate Seals and his signalurr wcrr.. duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have herunlo'set my hand affixed my OffirJ al Seal, `4„u «�•.,,,,J ., at the City of Newark, New.Jersey the day and yr•_,ar hrsl above well Ielt. tip` \1Y V/.>Q' ., A NOTARY PUBLIC OF NEW JERSEY F C y�4 My Commission Expiry,,Mar.27,201'I ��" w''� ` CERTIFICATION I,the undersigned officer of IIdTL=RNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do hweby certify II ial I havr; compare d file lorr•gofng cripy of the Power of Attorney and affidavil,rand the ropy or the Sections of the By-Laws or,rain!Cornpanfes ar,sr_i forth in :r:rfcl Power of Attorney, with the original..<, on ffle in the home office of said rompanies, and that the same are correct transcripts Ihereraf,anrd of the:whotra of the said originals,and that the said Power of Atlornr y has not br.en revoked and i,now in full force and effect. Itd-rcsi,iMONY WHEREOF, I have hereunto set my hand this 25TH day of FEBRUARY, 2013 MARIA BRANCO,Assistant Seise lary CALAFORNIA ALL-PURPOSE ACKNOWLEDGMENT --y...-. -,..-,ter--M.:-�-�..�.c�c•��-x vc� ��r�,.m.�^ �..,�.c"~•�r�-,�•'�cacc��=.�s".cx~.r-s=z�-�,..,;�!��ze State of California County of ORANGE On �,�'�I� before me, Philip Vega, Notary-public Dsle Here insert Name find Tlilo oi I o Qtflcar personally appeared ELIZABETH H. MENDOZA de MCRAE • smo: o gnor(bJ who proved to me on the basis of satisfactory evidence to be.the person(% whose names) is/gre subscribed to the within Instrument and acknowied to me that he(�AiA� executed the same in hid/99h16ir authorized PHILIP VELA capacrty(� ), and that by hiss/qet//t4r signatA(s) on the COMM.#1977088 instrument the person(g), or the entity upon behaif of WCOMM-EXOMMAY311. TARY PUBLIC-CALIFORNIA s which the person(g) acted, executed the Instrument. LOS ANGELES COUNTY 20 i6 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correet.. WITNESS my hand and official s Signature Plaoe Notary Seal Abo-e 6lgnatbre of ubllc ---�-�—.. OPTIONAL Though the information below is not required by law,it may prove veivable to persons relying on the to ument 1 and could prevent fraudulent removal and reaftaohment of thls torn to anothor document, Description of Attached Dcoument Title or Type of Document: Document Data; Number of Pages Signer(s) Other Than Named Above; Capacity(ies) Claimed by Signer(s) Signer'a Name: Signer's Name: ❑ individual ❑ Individual ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Partner--U Limited ❑ General 0 Partner- 0 Limited ❑General 0 Attorney in Fact Top of mumu nary ❑Attorney in Fact Top of 01umo here F7 Trustee 07rustee ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other, __ Signer is Representing: Signer Is Representing: P32007 Nellonel Notary AusWaUotr 9360 Do Salo Am,P,O,Box 21122-0halawor111,CA 91313.2402•www,Nallonamiaryotg IIem 859a7 Roo*r...CF009-Pree 1-800.878.8227 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT cmL CODE g 1189 State of California i County of Los Angeles On FEB 2 5 2013 before me, Monica Blaisdell, Notary Public Date Here Insert Name and Title of the Officer ' F 1 personally appeared Philip E. Vega Name(s)of Signer(s) M r who proved to me on the basis of satisfactory evidence to be the personX whose name is/a#;a- ( subscribed to the within instrument and acknowledged to me that he/sIge/t#ey executed the same in 1� his/bar/tbair authorized capacity(a®s), and that by hisA;ar/#K.4f signature(* on the instrument the MONICA BLAISDELL person; or the entity upon behalf of which the Commission# 1970845 Notary Public-California z person f�j acted, executed the instrument. Z Orange County My Comm.Explres Mar 26,2016 1 certify under PENALTY OF PERJURY under the I F laws of the State of California that the foregoing paragraph is true and correct. F WITNESS my hand and official seal. rM Signature: b&krkwj 4 Place Notary Seal Above Signature of Notary Public RECE[,VED, CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office _(Name) after signing/dating (Date) ®-A, CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION FK TO: Sh-d-fiZIFFe-OUn—rich, City Treasurer FROM: 0/" DATE: -:� 112 SUBJECT: Bond Acceptance I have received the bonds for (Company Nam,0 Faithful Performance Bond No. Labor and Material Bond No. Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved /(�I)J IleV'', Agenda Item No. (Council Approvhl Date) City Clerk Vault No. #27 g:/followup/bondletter.doc This Document was electronically recorded by PLEASE COMPLETE THIS INFORMATION City of Huntington Beach RECORDING REQUESTED BY: Recorded in Official Records, Orange County Renee Ramirez,Assistant Clerk Recorder II I I II II II II I I I I 11111111111111111111111111111 IIIIIINO F E E 2013000103171 08:54am 02/20/13 WHEN RECORDED MAIL TO: 37 402 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 CITY OF HUNTINGTON BEACH Attn: David Verone P.O. Box 190—2000 Main Street Huntington Beach, CA 92648 THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN by the City of Huntington Beach, owner in fee, 2000 Main Street, Huntington Beach, CA 92648, that the contract heretofore awarded to PTMI General Services, Inc. who was the company thereon for doing the following work to-wit: SAFE ROUTES TO SCHOOL, GOLDENVIEW, CONSTRUCTION CONTRACT-1402 That said work was completed February 19, 2013 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 February 19, 2013, per City Council Resolution No. 2003-70 adopted October 6,2003. That upon said contract International Fidelity Insurance Company was surety for the bond given by the said company as required by law. This document is solely for the official business of the City of Huntington Beach, as contemplated under Government Code Section 6103 and should be recorded free of charge. Dated at Huntington Beach, California,this February 19,2013. �it or bf-P&ric Works or City Engineer City of Huntington Beach, California STATE OF CALIFORNIA) County of Orange ) ss: City of Huntington Beach ) I, the undersigned, say: I am an Agent of the City of Huntington Beach, owner in fee, in the foregoing NOTICE OF COMPLETION. I have read said NOTICE OF COMPLETION and know the contents thereof; the same is true of my knowledge. I declare under penalty of perjury that the foregoing is true and correct, and that said NOTICE OF COMPLETION was duly and regularly ordered to be recorded in the Office of the County Recorder of Orange County. Dated at Huntington Beach, California,this February 19, 2013. Director of Public Works or City Engineer This document is solely the official business of `ity of Huntington Beach, California the City of Huntington Beach, as contemplated under Government code section. 6103 and should be recorded free of charge. THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION (Additional recording fee applies) Council/Agency Meeting Held: Deferred/Continued to: App ve ❑ Conditionally Approved ❑ Denied Cit lerk'S Erignatup, Council Meeting Date: November 19, 2012 TDepartment ID Number: PW 12-066 CITY OF HUNTINGTON REACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Approve Temporary Construction Easement from the Ocean View School District for the Safe Routes to School Project at Golden View School Statement of Issue: On August 20, 2012, the City Council Awarded a construction contract for Safe Routes to School improvements in the vicinity of Golden View School (CC-1402). One curb ramp location is located on Ocean View School District Property and will require a Temporary Construction Easement form the Ocean View School District. Financial Impact: As this construction contract was previously awarded by Council, no funding is required for this action. Recommended Action: Motion to: Approve and authorize the Director of Public Works to execute and accept the Temporary Construction Easement from the Ocean View School District (Grantor) to the City of Huntington Beach (Grantee) for the construction of Safe Routes to School improvements at the southwest corner of Golden View Lane and Norino Drive. Alternative Action(s): Reject the temporary construction easement and provide staff with alternative direction. xB -103- Item 6. - 1 REQUEST FOR COUNCIL ACTION MEETING DATE: 11/19/2012 DEPARTMENT ID NUMBER: PW 12-066 Analysis: In July 2010, City -staff, working in conjunction with the Ocean View School District, applied for a grant for traffic safety improvements in the vicinity of Golden View School under the Safe Routes to School program. The grant was approved and the State allocated funds in January 2011 A construction contract for these improvements was awarded by the City Council on August 20, 2012 A curb ramp is proposed at the southwest corner of Golden View Lane and Norino Drive, at the front of the school. A search of property records indicates that the westerly half of Golden View Lane and the southerly half of Norino Drive were apparently never dedicated to the City when the school was constructed in the 1960's and therefore is still the property of the School District. While staff has been discussing a long term solution with the Ocean View School District, there is an immediate need to construct this ramp and comply with the improvements specified in the Safe Routes to School grant. The Temporary Construction Easement will allow the City's contractor to construct this improvement on what is technically school district property. Public Works Commission Action: Not required. Environmental Status: This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c). Strategic Plan Goal: Improve the City's infrastructure Attachment(s): s 1. Project Location Map 2. 1 Temporary Construction Easement Item 6. - 2 xs -104- ATTACHMENT # 1 iiu .io.. Item 6. - 3 s Q`P� C° BOLSA AVE. a Mc FADDEN AVE. v � = cn EDINGER AVE. N.T.S. J Z 0 Oo z HEILm a Q 3 z AVE. m � 0 a ui Q Q Z w J 0 U3 WARNER a 0 AVE. cn SLATER AVE. 405 BOLSA CHICA WETLANDS TALBERT AVE. GOLDEN VIEW LEMENTARY SCH00 -09 ELL IS IAVE. 0 GARFIEL AVE. V) (YORKTOWN AVE. 3 ADAMS AVE. PACIFIC iNDIANAPOLIS AVE. "9/%c• z ATLANTA z j AVE. m m HAMIL ON AVE. 'y�Yy BANNING OCEAN AVE. SAFE ROUTES TO SCHOOL—GOLDEN VIEW SCHOOL o�� LOCATION MAP CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS TRAFFIC ENGINEERING ATTACHMENT 1 Item 6. - 4 HB -106- ATTAC H M E N T #2 This Document was electronically recorded by City of Huntington Beach Recorded in Official Records, Orange County Tom Daly, Clerk-Recorder RECORDING REQUESTED BY �IIIII III IIII III III IIIII 1111111111111111111111111111111111III AND WHEN RECORDED MAIL TO: NO FEE City of Huntington Beach 65 2012000714817 11:23am 11/20/12 0. 2000 Main Street 404 E01 6 Huntington Beach, CA 92648 0.00 0.00 0.00 0.00 15.00 0.00 0.00 0.00 Attention: City Clerk Exempt from Recording Fee Exempt from Documentary Transfer Tax Pursuant to Government Code Section 6103 Pursuant to R&T Code§ 11922 (Space above this tine for Recorder's use) TEMPORARY CONSTRUCTION EASEMENT Orange County Assessor's Parcel Number: 165 — 062-41 FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, Ocean View School District, a school district of the State of California (hereinafter Grantor") HEREBY GRANTS TO THE City of Huntington Beach,a Municipal Corporation (hereinafter"Grantee") A temporary construction and access easement for purposes incidental to construct the Safe Routes to School Improvements—Golden View School Construction Project (CC-1402), including the construction of a corner curb ramp with signing and striping modifications at the southwest corner of Golden View Lane and,Norino Drive in; on, over and across that certain real property in the City of Huntington Beach, County of Orange, State of California, as depicted on the legal description and sketch attached hereto as Exhibits"A"and UB,"which are incorporated by this reference;as:though fully set forth herein. Said temporary easement shall commence forty-eight(48) hours after Grantee provides written notification.to Grantor of its intent-to commence construction,and;except as otherwise provided below; shall terminate and be of no further force or effect immediately(1) upon acceptance of the improvements by the City of Huntington Beach or(2) upon the expiration of four months after the completion of the improvements,whichever is earlier in time. Grantee shall repair any damages caused by its use of the property at Grantee's sole cost and expense, and shall restore said property as neariy as practicable to the state in which it existed prior to Grantee's use. Grantee shall defend,.indemnify, and save the Ocean View School District harmless frorn any and all liabilities, claims, or damages for injuries,to, or death of, any and all persons; and.for any property damages or losses, that,are based upon or arise out of any construction work or activities performed in connection with or pursuant to this easement, which liabilities, claims, damages, or losses_are-caused:by or result from any acts, errors, or omissions on the part of Grantee or any of Grantee's agents, representatives; employees; personnel,contractors, or subcontractors. Grantee shall not assign, transfer, lease, pledge,surrender, or otherwise dispose of this temporary easement without the prior written consent of Grantor. IN WITNESS WHEREOF, Grantor has caused this Temporary Construction Easement to be executed by and through its authorized officer(s) on Notreg ik 20 ta i !tI' ia.G ED AS TO FORM RATH :.,�O x CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of 0►�Ct-y�G��- On 11 13 ,�-0 1 �L before me, b-j vA'h f A- �-er2 1�)U-1-ztir y Pt&b Ir`, / 1 Date Here Insert Name and Title of the Officer personally appeared Mcuj<_ A. SC P\i4 L- Name(s)of Signer(s) e who proved to me on the basis of satisfactory evidence to be the person(V whose name(g) is/are- subscribed to the within instrument and acknowledged to me that he/she/tfiey executed the same in CYNTHIA A :.: ! his/her/their authorized capacity(4es), and that by Commission# 18:1'297 his/herftheir signature(-sy on the instrument the •r Notary Public-Calr+ornia z = Orange County D person(s}, or the entity upon behalf of which the My Comm. Expires Jun 9. 2013 person(s) acted, executed the instrument. CYNTHIA A.LEE I certify under PENALTY OF PERJURY under the Commission# 1853297 Z laws of the State of California that the foregoing Notary Public-California D Orange County paragraph is true and correct. -My Comm.Mires Jun 9,2013 WITNESS my hand and official seal. -( Signature: Place Notary Seal and/or Stamp Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Individual M. ❑ Individual ❑ Partner—❑Limited ❑General Top of thumb here ❑ Partner—❑ Limited ❑General Top of thumb here ❑ Attorney in Fact ❑Attorney in Fact ❑ Trustee ❑Trustee ❑ Guardian or Conservator ❑Guardian or Conservator ❑ Other: ❑Other: Signer Is Representing: Signer Is Representing: ©2008 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 Exhibit A THOSE LANDS LOCATED IN THE CITY OF HUNTINGTON BEACH, COUNTY OF ORANGE, STATE OF CALIFORNIA, IN THE RANCHO LA BCLSA CHICA, BEING A PORTION OF THE NORTHEAST QUARTER, OF SECTION 27, TOWNSHIP 5 SOUTH, RANGE 11 WEST, SAN BERNARDINO MERIDIAN AS SHOWN ON THE MAP FILED IN BOOK 51, PAGE 13 OF' MISCELLANEOUS MAPS, IN REQ0RDS OF SAID COUNTY, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE CENTERLINE INTERSECTION_ OF GOLDEN VIEW LANE AND N'ORINO DRIVE, AS SHOWN ON 'TRACT MAP 7330, FILED IN BOOK 276, PAGES 25 THROUGH 27 INCLUSIVE OF MISCELLANEOUS MAPS, IN SAID COUNTY, THENCE ALONG THE CENTERLINE OF SAID NORINO DRIVE, SOUTH B9'23'O3" WEST, 49;77 FEET, THENCE AT RIGHT ANGLES SOUTH 00`36'57" EAST; 50.00 FEET; THENCE NORTH 89'07'27" EAST, 50.00 FEET TO THE CENTERLINE QF GOLDEN VIEW DRIVE AS SHOWN ON SAID TRACT MAP 7330; THENCE AT RIGHT ANGLES, ALONG THE CENTERLINE OF SAID GOLDEN VIEW LANE NORTH 00`52'33" WEST, 49.`77 FEET TO THE POINT OF BEGINNING OF THIS DESCRIPTION, CONTAINING 2489 SQUARE FEET (0.06 ACRES) MORE OR LESS SUBJECT TO ALL COVENANTS, RIGHTS, FLIGHT--OF-WAYS AND EASEMENTS OF RECORD. EXH1811 "13" ATTACHED AND BY THIS REFERENCE MADE A PART HEREOF, l.ANO JOSFPH G. DERLETH a Exa.1z--3t—i3 PLS 7540 EXPIRES 12/31/13 GOLDEN VIEW SCHOOL 17251 GOLDEN VIEW LANE: A.P.N. 165-- 062--41 TEMPORARY CONSTRUCTION EASEMENT CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORDS Exhibit B NORINO DRIVE POINT OF S 89'23`03" W BEGINNING 49.77' LLI EXIS71NG CURBS 2O z AND GUTTER Lo r p EXISTING BACK ' ' OF SIDEWALK N 8-07'27" 5 -00 10' 2a' TEMPORARY CONSTRUCTION EASEMENT AREA = GRAPHIC SCALE i inch -:?Oft 20 0 10 zo GOLDEN VIEW SCHOOL 17251 GOLDEN VIEW LANE: A.P.N. 155--082--41 TEMPORARY CONSTRUCTION EASEMENT CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBUC WORKS i CERTIFICATE OF ACCEPTANCE This is to certify that the interest in real properly conveyed by the Temporary Construction Easement to the City of Huntington Beach CCity") is hereby accepted in accordance with the terms by the undersigned officer on behalf of the City, and City consents to recording thereof by its duly authorized officer. CITY OF HUNTINGTON BEACH, A MUNICIPAL,. CORPORATION BY: RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to J., City Clerk's Office (Name) after signing/dating (Date) L 0 I CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Shari Freidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for (company Name) Faithful Performance Bond No. Labor and Material Bond No. 0 -A a,[- Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved 1/`,-). Agenda Item No. (CoUP6i1Appr6V,a1Date) City Clerk Vault No. #27 g1followup/bondletter.doc FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND PTM GENERAL ENGINEERING SERVICE, INC FOR SAFE ROUTES TO SCHOOL GOLDEN VIEW ELEMENTARY SCHOOL CC-1402 TABLE OF CONTENTS PageNo. 1. STATE OF WORK; ACCEPTANCE OF RISK 1 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS 2 3. COMPENSATION 4 4. COMMENCEMENT OF PROJECT 4 5. TIME OF THE ESSENCE 4 6. CHANGES 5 7. NOTICE TO PROCEED 5 8. BONDS 6 9. WARRANTIES 6 10. INDEPENDENT CONTRACTOR 6 11. LIQUIDATED DAMAGES/DELAYS 7 12. DIFFERING SITE CONDITIONS 8 13. VARIATIONS IN ESTIMATED QUANTITIES 9 14. PROGRESS PAYMENTS 10 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES 11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS 11 17. WAIVER OF CLAIMS 11 I& INDEMNIFICATION, DEFENSE, HOLD HARMLESS 11 19. WORKERS' COMPENSATION INSURANCE AND EMPLOYER'S LIABILITY INSURANCE 12 20. INSURANCE 12 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS 13 22. NOTICE OF THIRD PARTY CLAIM 14 23. DEFAULT& TERMINATION 14 24. TERMINATION FOR CONVENIENCE 15 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS 15 26. NON-ASSIGNABILITY 16 27. CITY EMPLOYEES AND OFFICIALS 16 28. STOP NOTICES; RECOVERY OF ADMINISTRATIVE COSTS 16 29. NOTICES 16 30. SECTION HEADINGS 17 31. IMMIGRATION 17 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED 17 i FEDERALLY FUNDED CONSTRUCTION CONTRACT TABLE OF CONTENTS, continued Page No. 33. ATTORNEY'S FEES 18 34. INTERPRETATION OF THIS AGREEMENT 18 35. GOVERNING LAW 18 36. DUPLICATE ORIGINAL 19 37. CONSENT 19 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT 19 39. CALIFORNIA PREVAILING WAGE LAW 19 40. CALIFORNIA EIGHT-HOUR LAW 20 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE 21 42. EMPLOYMENT OF APPRENTICES 21 43. PAYROLL RECORDS 21 44. FEDERAL PARTICIPATION 21 45. ADDITIONAL FEDERAL REQUIREMENTS 22 46. DAVIS-BACON ACT 22 47. DISCRIMINATION, MINORITIES, ALIENS 23 48. EQUAL EMPLOYMENT OPPORTUNITY 23 49. COPELAND "ANTI-KICKBACK" ACT 24 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT 24 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT 25 52. ENERGY CONSERVATION 26 53. HOUSING AND URBAN DEVELOPMENT 26 54. SIGNATORIES 26 55. ENTIRETY 26 ii FEDERALLY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND PTM GENERAL ENGINEERING SERVICE, INC FOR SAFE ROUTES TO SCHOOL GOLDEN VIEW ELEMENTARY SCHOOL CC-1402 THIS AGREEMENT ("Agreement") made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY," and PTM General Engineering Services, Inc, a [type of entity and state] California Corporation, hereinafter referred to as "CONTRACTOR." WHEREAS, CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT," more fully described as SAFE ROUTES TO SCHOOL GOLDEN VIEW ELEMENTARY SCHOOL CC-1402 in the City of Huntington Beach; and CONTRACTOR has been selected to perform said services, NOW, THEREFORE, in consideration of the promises and agreements hereinafter made and exchanged, the parties covenant and agree as follows: 1. STATEMENT OF WORK; ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pursuant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner. CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, including, but not g/agree/surfnet/federal const Page 1 of 27 12/11 limited to, all expenses incurred by or in consequence of the suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CITY, and for well and faithfully completing the work within the stipulated time and in the manner shown and described in this Agreement, and in accordance with the requirements of CITY for the compensation set forth in the accepted bid proposal. 2. ACCEPTANCE OF CONDITIONS OF WORK; PLANS AND SPECIFICATIONS CONTRACTOR acknowledges that it is fully familiar with all the terms, conditions and obligations of this Agreement and the Contract Documents (as defined below in this Section), the location of the job site, and the conditions under which the work is to be performed, and that it enters into this Agreement based upon its thorough investigation of all such matters and is relying in no way upon any opinions or representations of CITY. It is agreed that the Contract Documents are incorporated into this Agreement by this reference, with the same force and effect as if the same were set forth at length herein, and that CONTRACTOR and its subcontractors, if any, shall be bound by the Contract Documents insofar as they relate in part or in any way, directly or indirectly, to the work covered by this Agreement. "Contract Documents" as defined herein mean and include: A. This Agreement; B. Bonds covering the work herein agreed upon; C. The CITY's standard Plans and Specifications and special contractual provisions, including those on file in the office of the Director of Public Works of CITY and adopted by the City Council, and any revisions, amendments or addenda thereto; g/agree/surfnet/federal const Page 2 of 27 12/11 D. The current edition of Standard Specifications for Public Works Construction, published by Builders' News, Inc., 10801 National Boulevard, Los Angeles, CA 90064, and all amendments thereto, written and promulgated by the Southern California chapter of the American Public Works Association and the Southern California District Associated General Contractors of the California Joint Cooperative Committee; E. Bid documents including the Notice Inviting Bids, the Special Instructions to Bidders, the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference), and the Federal Requirements from FHWA 1273 and additional requirements (which is attached hereto as Exhibit "B"); F. The particular Plans, Specifications, Special Provisions and Addenda applicable to the PROJECT. Anything mentioned in the Specifications and not indicated in the Plans or indicated in the Plans and not mentioned in the Specifications, shall be of like effect as if indicated and mentioned in both. In case of a discrepancy between any Plans, Specifications, Special provisions, or Addenda, the matter shall be immediately submitted by CONTRACTOR to the Department of Public Works of CITY (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense. g/agree/surfnet/federal const Page 3 of 27 12/11 Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith. 3. COMPENSATION CITY agrees to pay and CONTRACTOR agrees to accept as full compensation for the faithful performance of this Agreement, subject to any additions or deductions made under the provisions of this Agreement or the Contract Documents, a sum not to exceed One Hundred Forty One Thousand One Hundred Forty One Dollars ($141,141.00), as set forth in the Contract Documents, to be paid as provided in this Agreement. 4. COMMENCEMENT OF PROJECT CONTRACTOR agrees to commence the PROJECT within ten (10) working days after the Notice To Proceed is issued and diligently prosecute the PROJECT to completion within Fifty (50) consecutive Working Days from the day the Notice to Proceed is issued by DPW, excluding delays provided for in this Agreement. 5. TIME OF THE ESSENCE The parties hereto recognize and agree that time is of the essence in the performance of this Agreement and each and every provision of the Contract Documents. CONTRACTOR shall prepare and obtain approval as required by the Contract Documents for all shop drawings, details and samples, and do all other things necessary and incidental to the prosecution of its work in conformance with the progress schedule set forth in the Contract Documents. CONTRACTOR shall coordinate its work with the work of all other contractors, subcontractors, and CITY forces working on the PROJECT in a manner that will facilitate the efficient completion of the PROJECT and in accordance with the terms and provisions g/agree/surfnet/federal const Page 4 of 27 12/11 of this Agreement. CITY shall have complete control of the premises on which the work is to be performed and shall have the right to decide the time and order in which the various portions of the work shall be performed and the priority of the work of other contractors, subcontractors and CITY forces and, in general, all matters concerning the timely and orderly conduct of the work of CONTRACTOR on the premises. 6. CHANGES CONTRACTOR shall adhere strictly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in writing by DPW. CONTRACTOR agrees to make any and all changes, furnish materials and perform all work necessary within the scope of the PROJECT as DPW may require in writing. Under no condition shall CONTRACTOR make any changes without the prior written order or acceptance of DPW, and CITY shall not pay any extra charges made by CONTRACTOR that have not been agreed upon in writing by DPW. When directed to change the work, CONTRACTOR shall submit immediately to DPW a written cost proposal reflecting the effect of the change. Should DPW not agree to such cost proposal, the work shall be performed according to the changes ordered in writing by DPW and the proper cost thereof shall be negotiated by the parties upon cost and pricing data submitted by CONTRACTOR; thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the Agreement price will be adjusted upward or downward accordingly. 7. NOTICE TO PROCEED No work, services, material, or equipment shall be performed or furnished under this Agreement unless and until a Notice to Proceed has been given to CONTRACTOR by CITY. CITY does not warrant that the work will be available on the date the Notice to Proceed is issued. In the event of a delay in commencement of the work due to unavailability of the job site, for any g/agree/surfnet/federal const Page 5 of 27 12/11 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability. 8. BONDS Only bonds issued by California admitted sureties will be accepted. CONTRACTOR shall, prior to its performance of this Agreement, furnish the following two (2) bonds approved by the City Attorney: One in the amount of one hundred percent (100%) of the Agreement price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the Agreement price to guarantee payment of all claims for labor and materials furnished. In addition, CONTRACTOR shall submit to CITY a bond in the amount of one hundred percent (100%) of the final Agreement price, including all change orders, to warrant such performance for a period of one (1) year after CITY's acceptance thereof within ten (10) days of filing of the Notice of Completion. 9. WARRANTIES CONTRACTOR unconditionally guarantees all work done under this Agreement including, but not limited to, any workmanship, installation, fabrication, material or structural facilities constructed. CONTRACTOR, within ten (10) days after notice by CITY of any defect in the work, shall have the option to make appropriate repairs or replace the defective item or items. Upon expiration of such ten- (10) day period, CITY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense. 10. INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY. CONTRACTOR shall g/agree/surfnet/federal const Page 6 of 27 12/11 secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONTRACTOR and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services performed hereunder. 11. LIQUIDATED DAMAGES/DELAYS It is agreed by the parties hereto that in case the total work called for hereunder is not in all parts and requirements finished or completed within the number of calendar days as set forth herein, damage will be sustained by CITY; and that it is, and would be, impractical and extremely difficult to ascertain and determine the actual damage which CITY would sustain in the event of and by reason of such delay. It is, therefore, agreed that CONTRACTOR will pay to CITY, as liquidated damages and not as a penalty, the sum of Five Hundred Dollars ($500.00) per day for each and every working day's delay in completing the work in excess of the number of working/calendar days set forth herein,which represents a reasonable endeavor by the parties hereto to estimate a fair compensation for the foreseeable damages CITY would sustain in the event of and by reason of such delay; and CONTRACTOR agrees to pay these damages herein provided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CONTRACTOR hereunder. For projects on the National Highway System (NHS), the local formula for liquidated damages will be provided. CONTRACTOR will be granted an extension of time and will not be assessed damages for any portion of the delay in the completion of the work due to unforeseeable causes beyond the control and without the fault or negligence of CONTRACTOR, including, but not limited to, acts of God or of the public enemy, fire, floods, epidemics, quarantine restrictions, strikes, unsuitable weather, or delays of subcontractors due to such causes. g/agree/surfnetlfederal const Page 7 of 27 12/11 CONTRACTOR shall, within fifteen (15) days from the beginning of any such delay (unless DPW shall grant a further period of time), notify DPW in writing of the cause of the delay and CITY shall extend the time for completing the work if, in its judgment, the findings of fact thereon justify the delay; and the decision of DPW shall be conclusive on the parties hereto. Should CONTRACTOR be delayed in the prosecution or completion of the work by the act, neglect or default of CITY, or should CONTRACTOR be delayed by waiting for materials required by this Agreement to be furnished by CITY, or by damage caused by fire or other casualty at the job site for which CONTRACTOR is not responsible, or by the combined action of the workers, in no way caused by or resulting from default or collusion on the part of CONTRACTOR, or in the event of a lockout by CITY, then the time herein fixed for the completion of the work shall be extended by the number of days CONTRACTOR has thus been delayed, but no allowance or extension shall be made unless a claim therefor is presented in writing to CITY within fifteen (15) days of the commencement of such delay. No claims for additional compensation or damages for delays, irrespective of the cause thereof, and including without limitation the furnishing of materials by CITY or delays by other contractors or subcontractors, will be allowed and an extension of time for completion shall be the sole remedy of CONTRACTOR. 12. DIFFERING SITE CONDITIONS A. Notice: CONTRACTOR shall promptly, and before such conditions are disturbed, notify DPW in writing of: (1) Subsurface or latent physical conditions at the job site differing materially from those indicated in this Agreement or the Contract Documents; or g/agree/surfnet/federal const Page 8 of 27 12/11 (2) Unknown physical conditions at the job site, of an unusual nature, differing materially from those ordinarily encountered and generally recognized as inherent to work of the character to be performed under this Agreement. DPW shall promptly investigate the conditions and if it finds that such conditions do materially so differ and cause an increase or decrease in the time required for performance of any part of the work under this Agreement, whether or not changed as a result of such conditions, an equitable adjustment shall be made and the agreement modified in writing accordingly. B. Time Extension: No claim of CONTRACTOR under this Section shall be allowed unless CONTRACTOR has given the notice required hereunder provided, however, the time prescribed therefor may be extended by CITY. 13. VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment. Payment to CONTRACTOR will be made only for the actual quantities of Agreement items used in construction of the PROJECT, in accordance with the plans and specifications. Upon completion of the PROJECT, if the actual quantities used are either more than or less than the quantities listed in the bid schedule, the bid price shall prevail subject to the provisions of this Section. DPW may, at its sole discretion, when warranted by the facts and circumstances, order an equitable adjustment, upwards or downwards, in payment to CONTRACTOR where the actual quantities used in construction of the PROJECT are in variation to the quantities listed in the bid schedule. No claim by CONTRACTOR for an equitable adjustment in price or time for completion shall be allowed if asserted after final payment under this Agreement. If the quantity variation is such as to cause an g/agree/surfnet/federal const Page 9 of 27 12/11 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. CITY's final payment to CONTRACTOR, if unencumbered, or any part thereof unencumbered, shall be made thirty-five (35) days after the acceptance of the work and the filing of a Notice of Completion by CITY. Provided, however, that in the event of a dispute between CITY and CONTRACTOR, CITY may withhold from the final payment an amount not to exceed 150 percent of the value of any disputed amount of work. Payments shall be made on demands drawn in the manner required by law, each payment to be accompanied by a certificate signed by DPW, affirming that the work for which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement. Partial payments on the contract price shall not be considered as a acceptance of any part of the work. 15. WITHHELD CONTRACT FUNDS, SUBSTITUTION OF SECURITIES At the request and at the sole cost and expense of CONTRACTOR, who shall retain beneficial ownership and receive interest, if any thereon, CITY shall permit the substitution and deposit therewith of securities equivalent to the amount of any monies withheld by CITY to ensure performance under the terms of this Agreement. g/agree/surfnetlfederal const Page 10 of 27 12/11 16. AFFIDAVITS OF SATISFACTION OF CLAIMS After the completion of the work contemplated by this Agreement, CONTRACTOR shall file with DPW its affidavit stating that all workers and persons employed, all firms supplying materials and all subcontractors working upon the PROJECT have been paid in full and that there are no claims outstanding against the PROJECT for either labor or material, except certain items, if any, to be set forth in CONTRACTOR's affidavit covering disputed claims, or items in connection with Notices to Withhold, which have been filed under the provisions of the statutes of the State of California. 17. WAIVER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or arising out of this Agreement. 18. INDEMNIFICATION, DEFENSE, HOLD HARMLESS CONTRACTOR hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents, and volunteers from and against any and all, claims, damages, losses, expenses, judgments, demands defense costs, and consequential damage or liability of any kind or nature, however caused, including those resulting from death or injury to CONTRACTOR's employees and damage to CONTRACTOR's property, arising directly or indirectly out of the obligations or operations herein undertaken by CONTRACTOR, caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractors, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including but not limited to concurrent active or passive negligence, except where caused by the active negligence, sole negligence, or willful misconduct of the CITY, its officers, elected or appointed officials, employees, agents, and g/agree/surfnet/federal const Page I I of 27 12/11 volunteers. CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall approve selection of CONTRACTOR's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as a limitation upon the amount of indemnification to be provided by CONTRACTOR. 19. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE Pursuant to California Labor Code Section 1861, CONTRACTOR acknowledges awareness of Section 3700 et seq. of this Code, which requires every employer to be insured against liability for workers' compensation; CONTRACTOR covenants that it will comply with such provisions prior to commencing performance of the work hereunder. CONTRACTOR shall maintain workers' compensation and employer's liability insurance in an amount of not less than the State statutory limits. CONTRACTOR shall require all subcontractors to provide such workers' compensation and employer's liability insurance for all of the subcontractors' employees. CONTRACTOR shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation and employer's liability insurance and CONTRACTOR shall similarly require all subcontractors to waive subrogation. 20. INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT. This policy shall indemnify CONTRACTOR, its officers, employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount: combined single g/agree/surfnet/federal const Page 12 of 27 12/11 limit bodily injury and property damage, including products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which includes a designated general aggregate limit, the aggregate limit must be no less than One Million Dollars ($1,000,000) for this PROJECT. This policy shall name CITY, its officers, elected or appointed officials, employees, agents, and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONTRACTOR's insurance shall be primary. Under no circumstances shall said above-mentioned insurance contain a self-insured retention without the prior written consent of CITY; however an insurance "deductible" of $5,000.00 or less is permitted. 21. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement; the certificates shall: 1. provide the name and policy number of each carrier and policy; 2. state that the policy is currently in force; and 3. promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of CITY. 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 g/agree/surfnet/federal const Page 13 of 27 12/11 policies of insurance. CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, naming CITY, its officers, elected and appointed officials, employees, agents and volunteers as Additional Insureds, to the City Attorney for approval prior to any payment hereunder. 22. NOTICE OF THIRD-PARTY CLAIM Pursuant to Public Contracts Code §9202, CITY shall provide notice to CONTRACTOR of receipt of any claim filed with CITY or a court of competent jurisdiction which arises out of performance of this agreement within ten(10) days of receipt of such claim or claims. 23. DEFAULT AND TERMINATION If CONTRACTOR fails or refuses to prosecute the work hereunder with diligence, or fails to complete the work within the time specified, or is adjudged bankrupt or makes an assignment for the benefit of creditors or becomes insolvent, or violates any provision of this Agreement or the Contract Documents, CITY may give CONTRACTOR notice in writing of its intention to terminate this Agreement. Unless the violation is cured within ten (10) days after such Notice of Intention has been served on CONTRACTOR, CITY may, without prejudice to any other remedy it may have, terminate this Agreement upon the expiration of that time. Upon such default 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 g/agree/surfnet/federal const Page 14 of 27 12/11 to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 23. 24. TERMINATION FOR CONVENIENCE CITY may terminate this Agreement for convenience at any time with or without cause, and whether or not PROJECT is fully complete upon seven (7) calendar days written notice to CONTRACTOR. In the event of termination, under this Section CITY shall pay CONTRACTOR for value of work in place on the PROJECT through the termination period less all such payments already made. In case of such termination for convenience, the CONTRACTOR shall be entitled to receive payment for work executed, and costs incurred by reason of such termination. In no event shall CONTRACTOR be entitled to recover overhead, profit or CONTRACTOR's fee on work not performed. Such payment by CITY shall be CONTRACTOR's sole and exclusive remedy for termination by CITY for its convenience and CITY shall have no further obligation to CONTRACTOR. 25. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONTRACTOR agrees that upon completion of the work to be performed hereunder, or upon expiration or earlier termination of this Agreement, all original plans, specifications, drawings, reports, calculations, maps and other documents pertaining to this Agreement shall be delivered to CITY and become its sole property at no further cost. 26. NONASSIGNABILITY CONTRACTOR shall not sell, assign, transfer, convey or encumber this Agreement, or any part hereof, or any right or duty created herein, without the prior written consent of CITY and the surety. g/agree/sur$iet/federal const Page 15 of 27 12/11 27. CITY EMPLOYEES AND OFFICIALS CONTRACTOR shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the California Government Code. 28. STOP NOTICES, RECOVERY OF ADMINISTRATIVE COSTS CITY shall be entitled to all reasonable administrative costs and necessary disbursements arising out of the processing of Stop Notices, Notices to Withhold, or any similar legal document. This obligation shall be provided for in the labor and materials payment bond required of CONTRACTOR. CITY may charge an administrative fee of One Hundred Dollars ($100) for every Stop Notice filed in excess of two (2), regardless of whether or not CITY is named in an action to enforce such stop notices. CITY may set off any unreimbursed cost or expense so incurred against any sum or sums owed by CITY to CONTRACTOR under this Agreement. 29. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent(as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below; provided that CITY and CONTRACTOR, by notice given hereunder, may designate different addresses to which subsequent notices, certificates or other communications will be sent: TO CITY: TO CONTRACTOR: City of Huntington Beach PTM General Engineeriing Services, Inc. ATTN: David Verone ATTN: Brian Mendoza 2000 Main Street 5942 Acorn Street Huntington Beach, CA 92648 Riverside, CA 92504 g/agree/surfnet/federal const Page 16 of 27 12/11 30. SECTION HEADINGS The titles, captions, section, paragraph, and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of maters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 31. IMMIGRATION CONTRACTOR shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the Immigration Reform and Control Act of 1978 (8 USC Section 1324a) regarding employment verification. 32. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONTRACTOR and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONTRACTOR. 33. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear g/agree/surfnet/federal const Page 17 of 27 12/11 its own attorney's fees and the prevailing party shall not be entitled to recover its attorney's fees from the nonprevailing party. P 34. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 35. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 36. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the g/agree/surfnet/federal const Page 18 of 27 12/11 date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 37. CONSENT Where CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event. 38. CALIFORNIA FAIR EMPLOYMENT AND HOUSING ACT CONTRACTOR agrees to comply with all requirements and utilize fair employment practices in accordance with California Government Code Sections 12900 et seq. 39. CALIFORNIA PREVAILING WAGE LAW. A. The CITY has ascertained from the Director of Industrial Relations of the State of California the general prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime work in the locality in which the work is to be performed for each craft or type of work needed to execute this Agreement, and the same has been set forth by resolution on file in the office of the City Clerk of CITY. CONTRACTOR and any subcontractor under it shall pay not less than said prevailing wage rates to all workers employed on this public works Agreement, as required by California Labor Code Sections 1771 and 1774. In accordance with the provisions of Section 3700 of the California Labor Code, CONTRACTOR agrees to secure payment of compensation to every employee. B. Pursuant to this Agreement and in accordance with Section 1774 and 1775 of the California Labor Code, CONTRACTOR shall, as penalty to CITY, forfeit g/agree/surfnet/federal const Page 19 of 27 12/11 twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work. 40. CALIFORNIA EIGHT-HOUR LAW A. California Labor Code, Sections 1810 et seq, shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours shall constitute one day's work and CONTRACTOR.and each subcontractor employed by its hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per week from any one person employed by it hereunder, except as stipulated in California Labor Code Section 1815. CONTRACTOR and each subcontractor employed by it hereunder shall, in accordance with California Labor Code Section 1812, keep an accurate record, open to inspection at all reasonable hours, showing the name and actual hours worked each calendar day and each calendar week by each worker employed in connection with the PROJECT. B. Pursuant to this Agreement and in accordance with California Labor Code Section 1813, CONTRACTOR shall, as a penalty to CITY, forfeit twenty- five dollars ($25) for each worker employed hereunder by CONTRACTOR or any subcontractor for each calendar day during which such worker is 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. g/agree/surfnet/federal const Page 20 of 27 12/11 41. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE Section 1773.8 of the California Labor Code, regarding the payment of travel and subsistence allowance is applicable to this PROJECT. 42. EMPLOYMENT OF APPRENTICES Section 1777.5 of the California Labor Code, regarding the employment of apprentices is applicable to this PROJECT. 43. PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record showing the name, address, social security number, work classification, straight time and overtime hours worked each day and week, and the actual per diem wages paid to each journeyman, apprentice or worker employed by it in connection with the PROJECT and agrees to require each of its subcontractors to do the same. CONTRACTOR further agrees that its payroll records and those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the employee or his representative, and the Division of Labor Standards Enforcement and the Division of Apprenticeship Standards, and to comply with all of the provisions of California Labor Code Section 1776, in general. 44. FEDERAL PARTICIPATION The PROJECT pursuant to which the work covered by this Agreement is being executed is being assisted by the United States of America. Several Agreement provisions embodied herein are included in this Agreement in accordance with the provisions applicable to such federal assistance. As federal funds are financing all or part of this work, all of the statutes, rules and regulations promulgated by the Federal Government and applicable to the work will apply, and CONTRACTOR agrees to comply therewith. Attached is FHWA Form 1273, known as Exhibit "B", which describes required contract provisions for federal-aid construction contracts. g/agree/surfnet/federal const Page 21 of 27 12/11 Additionally, the CONTRACTOR shall insert in each subcontract all of the stipulations contained in the Required Contract Provisions of Form 1273, and further require their inclusion in any lower tier subcontract or purchase order that may in turn be made. The Required Contract Provisions shall not be incorporated by reference in any case. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with these Required Contract Provisions. Certain sections of Form 1273 may not be applicable depending upon the project and will be crossed out. 45. ADDITIONAL FEDERAL REQUIREMENTS CONTRACTOR agrees to abide by the additional requirements necessary for federal aid (see pgs. 12-14 of Exhibit "B"). The CONTRACTOR agrees to buy only steel and iron made in the United States for all federal-aid construction projects (`Buy America"). The CONTRACTOR also agrees to be subject to the legislative and regulatory Disadvantaged Business Enterprise (DBE) requirements (42 USC Section 2000d, et seq.). If the CONTRACTOR does not specify the goals for this program, then the CONTRACTOR's obligation under these regulations will be determined by the CITY. The CONTRACTOR shall also sign a non-collusion certification. Select projects may also require "Federal Trainee" or "On-the-Job Training" provisions to comply with federal regulations. 46. DAVIS-BACON ACT CONTRACTOR agrees to pay and require all subcontractors to pay all employees on said PROJECT a salary or wage at least equal to the prevailing rate of per diem wage as determined by the Department of Labor (29 CFR part 5) in accordance with the Davis-Bacon Act (40 USC Section 276a to 276a-7) for each craft or type of worker needed to perform this Agreement. g/agree/surfnet/federal const Page 22 of 27 12/11 CONTRACTOR agrees to comply with all applicable federal labor standards provisions; said provisions are incorporated herein by this reference. 47. DISCRIMINATION, MINORITIES, ALIENS The CONTRACTOR or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The CONTRACTOR shall carry out applicable requirements of 49 CFR, Part 26 in the award and administration of DOT-assisted contracts. Failure by the CONTRACTOR to carry out these requirements is a material breach of this contract, which may result in the termination of this contract or such other remedy, as recipient deems appropriate. 48. EQUAL EMPLOYMENT OPPORTUNITY The CONTRACTOR will comply with all provisions of Executive Order 11246, entitled "Equal Employment Opportunity," and amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR part 60). The CONTRACTOR will also comply with all provisions detailed in FHWA Form 1273 Exhibit"B"). CONTRACTOR is required to have an affirmative action plan which declares that it does not discriminate on the basis of race, color, religion, creed, national origin, sex or age to ensure equality of opportunity in all aspects of employment. Section 503 of the Rehabilitation Act of 1973 (29 USC Section 701, et seq.) prohibits job discrimination because of handicap and requires affirmative action to employ and advance in employment qualified handicapped workers. Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974 (38 USC Section 219 et seq.) prohibits job discrimination and requires affirmative action to comply and advance in employment (1) qualified Vietnam veterans during the first four (4) years after their g/agree/surfnet/federal const Page 23 of 27 12/11 discharge and (2) qualified disabled veterans throughout their working life if they have a thirty percent (30%) or more disability. To ensure compliance with these requirements, the CONTRACTOR shall provide the CITY its written affirmative action plan prior to commencement of work. The CONTRACTOR is required to provide the CITY with a listing of its subcontractors together with a completed affirmative action program from each subcontractor when applicable. 49. COPELAND "ANTI-KICKBACK" ACT CONTRACTOR and its subcontractors shall comply with the provisions of the Copeland "Anti-Kickback" Act (18 USC Section 874), as supplemented in Department of Labor regulations (29 CFR part 3), which Act provides that each shall be prohibited from including, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he is otherwise entitled. 50. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The CONTRACTOR shall comply with the provisions of Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) as supplemented by Department of Labor regulations (29 CFR, part 5). Under Section 103 of the Act each CONTRACTOR shall be required to compute the wages of every mechanic and laborer on the basis of a standard workday of eight(8) hours and standard workweek of forty (40)hours. Work in excess of the standard workday or workweek is permissible provided that the worker is compensated at a rate of not less than 1-1/2 hours worked in excess of eight 8 hours in an calendar day or times the basic rate of a for all o g ( ) Y Y pay forty (40) hours in the workweek. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health and safety as determined g/agree/surfnet/federal const Page 24 of 27 12/11 under construction, safety and health standards promulgated by the Secretary of Labor. These requirements do not apply to the purchase of supplies or materials or articles ordinarily available on the open market or contracts for transportation. 51. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT. A. CONTRACTOR stipulates that all facilities to be utilized in the performance of this Agreement were not listed, on the date of Agreement award, on the United States Environmental Protection Agency (EPA) List of Violating Facilities, pursuant to 40 CFR 15.20. B. The CONTRACTOR agrees to comply with all of the requirements of Section 306 of the Clean Air Act and section 508 of the Federal Water Pollution Control Act and all regulations and guidelines listed thereunder. C. The CONTRACTOR shall promptly notify the CITY of the receipt of any communication from the Director, Office of Federal Activities, EPA, indicating that a facility to be utilized pursuant to this Agreement is under consideration to be listed on the EPA List of Violating Facilities. D. The CONTRACTOR agrees to include or cause to be included the requirements of paragraph (a) thorough (d) of this section in every nonexempt subcontract, and further agrees to take such action as the Government may direct as a means of enforcing such requirements. g/agree/surfnet/federal const Page 25 of 27 12/11 52. ENERGY CONSERVATION Agreements with federal participation shall recognize mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act(42 USC Section 6201, et seq.). 53. HOUSING AND URBAN DEVELOPMENT CONTRACTOR agrees to comply with any and all rules, regulations, guidelines, procedures and standards of the United States Department of Housing and Urban Development and complete any and all reports and forms that may be required in accordance therewith. 54. SIGNATORIES Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall,indemnify CITY fully for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. 55. ENTIRETY The foregoing, and Exhibits "A" and "B" attached hereto, set forth the entire Agreement between the parties. No waiver or modification of this Agreement shall be valid unless in writing duly executed by both parties. The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiations, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf,which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, g/agree/surfnet/federal const Page 26 of 27 12/11 inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers onAU6Ms7- / , 24�• CONTRACTOR CITY OF HUNTINGTON BEACH, a 7-- (�� ,� 2� 4 municipal corporation of the State of California M or By: C Clerk print name ITS: (circle one)Chairma resident7lVice President INITIATED AND APPROVED: AND Director of Publ Works By: p e ARD11AAND APPROVED: Chief Finacial ManagerITS: (circle one Secet f Secretary-Treasurer PPROVED AS TO FORM: � Il, CityVrriey g/agree/surfnet/federal const Page 27 of 27 12/11 8 SECTION C PROPOSAL, for the Safe Routes to School In the vicinity of Golden View Elementary School CC No. 1402 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT_ It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid,unit prices shall govern over extended amounts,and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void. Accompanying this proposal of bid, find bidder's bond in the amount of$10%bidder's bond which said amount is not less than 10%of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check",or"Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Ailada IYo DdteReceived Brdder'sS mature „t . 1 7/12/2012 a'+ (per Cindy,on], 1 addendum on 7/18/12 at 11:03a1n) C-2 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 �'... 1 1 L.S. Mobilization. $ Wo " $ Z{ooa — Per L.S. 2 1 L.S. Furnish Construction Surveying and Monument Preservation. $ 96 3- 90 $ C16 3 ---26 Per L.S. Furnish Project Traffic Control. Per L.S. _ 4 1 L.S. Furnish and Install Traffic Striping and Signing. $qq 6 e Per L.S. 5 1 L.S. Modify Traffic Signal at Goldenwest Street and Slater Avenue(Excludes AC Surface $ („!s Grinding). Per L.S. 6 1 EA. Construct Curb Ramp per Caltrans Standard Plan No.A88A,Case A, and Per Typical Section at New $ Ramps Adjacent to AC Paving Detail. Per EA. 7 2 EA. Construct Curb Ramp per Caltrans Standard Plan No.A88A, Case B, _ and Per Typical Section at New $ 3 5a g $ 7o 56 Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 � t rein Estunated� � B Item ' c 1 ffd Amflu €IN � 0 NIlt £' '� k S K ds. E il 1 } 5 ...#.. fix' :.». <''S' L.�'S"r.'. y A t ...3i.. . 8 14 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case C, and Per Typical Section at New $3 36 0 � $ 47010 Ramps Adjacent to AC Paving Detail. Per EA. 9 1470 S.F. Surface Grind Existing A.C. to a Depth of 0.17 FT and Construct New 0.17 FT Surface Coat Over $ - 1''� $ jaG� ' a Existing Asphalt Concrete. 11 Per S.F. Total Amount Bid in Figures: $ 14 ) 1 q � Total Amount Bid in Words: $ Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. �Bz�' Nartze ar�a�Add"ress of Subcontractor State- ass Dollar %of,�' rte (s� Zicense Amount �onfrac 30 ES S Genenat iEAo)rnZer �� (oc.00 I(o A 9TI? zz 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 furuished by subcontractor for this project. C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 7/18/201,2at Riverside ,California Date City State Brian Mendoza , being first duly sworn, deposes and says that he or she is Vice President/Secretary of PTM General Engineering Service lnc.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 t 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. PTM General Engineering Service Inc. Name of Bidder Brian Mendoza,Vice President/Secretary Signature of Bidder 5942 Acoin Street,Riverside,CA 92504 Address of Bidder C-4 UTILITY AGREEMENT HONORABLE MAYOR AND CITY COUNCIL CITY OF HUNTINGTON BEACH, CALIFORNIA Gentlemen: The undersigned hereby promises and agrees that in the performance of the work specified in the contract, known as the Safe Routes to School in the Vicinity of Golden View Elementary School, CC 1402, (1)(we)(it) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transmission facilities. The term "Qualified Person" is defined in Title 8, California Administrative Code, Section 2700, as follows: "Qualified Person: A person who, by reason of experience or instruction, is familiar with the operation to be performed and the hazards involved." The undersigned also promised and agrees that all such work shall be performed in accordance with all applicable electrical utility company's requirements, Public Utility Commission orders, and State of California Cal-OSHA requirements. The undersigned further promises and agrees that the provisions herein shall be and are binding r 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. PTM General Engineering Service Inc. Contractor -_0Brian Mendoza By Vice President/Secretary Title Date: 7/18/2012 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete,under penalty of perjury,the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes �,No If the answer is yes,explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. PTM General Engineering Sen ice Inc. Contractor Brian Mendoza By Vice President/Secretary Title t Date: 7/18/2012 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: PTM General Engineering Service Inc. Bidder Name 5942 Acorn Street Business Address Riverside CA 92504 City, State Zip 951 710-1000 Telephone Number 891265 State Contractor's License No. and Class 2/2007 Original Date Issued 2/2013 Expiration Date Brian Mendoza July 18 2 The work site was inspected by of our office on 201—. The following are persons,firms, and corporations having a principal interest in this proposal: Elizabeth McRae,President/CFO,595 A.Los Coyotes Dr.Anaheim Hills,CA 92807,Tel:951-722-5678 Brian Mendoza,Vice President/Secretary. 11080 Kay Jay Street,Riverside,CA 92504 Tel: 951-722-5755 C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. PTM General Engineering Service Inc. Co y Name Signature of Bidder Brian Mendoza,Vice President/Secretary Printed or Typed Signature Subscribed and sworn to before me this ll 8thday of July ,2012. ELIZABETH H.M. MCRAE Co 1910816 In u! ®� NOTARYPUBLIC•CALIFORNIA N Ri ERsi E COUNTY NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. City of National City, 1234 National City Blvd.,National City,CA 91950 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr. Man-=aniello,Tel:619-336-4380 $594,536.17 Safe Route to School 1/2010 Contract Amount Type of Work Date Completed 2 City of Anaheim,200 S. Anaheim Blvd.,Anaheim,CA 92807 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr. Heimberger,Tel;714-765-5176 $318,318 Pioneer Park Security Ltg. ADA Access&Play Ground Imp. 6112010 Contract Amount Type of Work Date Completed 3. Department of Transportation, 17274 30th Street, Sacramento,CA 95816 Name and Address of Public Agency Name and Telephone No. of Project Manager: Mr.Joe Obadike,Tel: 951-830-6821 $492,155 Install Electrical System Emergency Force Account 08-OM5504 6/2009 Contract Amount Type of Work Date Completed C-9 All Purpose Acknowledgement Stateof California County of �Riverside On II(( ((V , before me, Elizabeth H. M. McRae (date) (notary) personally appeared, Brian Mendoza (signers) ❑ personally known to me —OR— [3 proved to me on the basis of satisfactory evidence to be the person(s)whose name(o is subscribed to the within instrument and acknowledged to me that he/shEVt"executed the same in his/h5rjl r authorized capacity ' and that by his/hurAt*c signature( on the H.M. MCRAE instrument a person(s)or the entity upon behalf of oMM.# 191�818 Nwhich-the;p on(s)acted, executed the instrument 4EL71ZABETH RY PUBLIC-CALIFORNIARIVERSIDE COUNTYMY vOMM.EXP.OCT.29,2ota^' WITNESS hand and official seal r` \ (seal) ✓` (notary signature) OPTIONAL INFORMATION The information below is not required by law.However,it could prevent fraudulent attachment of this acknowledgement to an unauthorized document. CAPACITY CLAIMED BY SIGNER(PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT ❑ Individual ❑ Corporation Officer Title or Type of Document title(s) ❑ Partner(s) Number of Pages ❑ Attorney-In-Fact ❑ Trustee(s) Date of Document ❑ Guardian/Conservator ❑ Other: Other Right Thumbprint of Signer SIGNER IS REPRESENTING: (if required) Name of Person(s)OR Entity(ies) r Irian Mendoza PA Box 7745 Nvsrsldo,CA OU.7745 > noaiit brian&ar-enp,com I Coll 9811,722,57s5 Chief Estimator and Supervisor of Outelde Operations Supervisor of outside opmrnWons with over I years of axpeaienee,Blectrician with over 20 years of experience,An effective cowmunicator and team leader;ex*fficed in coordinating and executing largo and Ault-mod Projects. •CAxEx.� rtc.>' •freeway Mectrlc( M General EngineedngServices,be, Riverside,CA 0612006 to Date Chief Estimator/Supervisor of Outside Operations In charge of mmaging the estimating department and finalizing bid packages; coordinating the begh ming phase of an awarded project between the coupany and agency. Project submittals, contract review. Coordinated and managed crews Califbnnia region; handled various sized projects ranging in size from$1,000 tb$4.5 million dealing with dry utilities,wet utilities,traffic signals, and road improvements, Maintained coordination Freeway BIcctriclPTIVI Qeneral Engineering and subcontractor, and project owners. In. charge of handling pOene's administrative work;montWY gross estimates, project progress schedule, materials requisitions, contract change order negotiations and equigznentpinhase and rentals, .High Light Electric InOdVete&Sons Construction Inc.Riverside,CA, 10/96 to OW006 ChiefBethutor Ln charge of managing the estimating department and finalizing bid packages, Coordinating the beginning phase of an awarded project between the company and agency or prime contractor; project submittals, contract review. Successfully bid on projects totaling $12 mUllon with an " average spread 6%, A'eA gupervisor Coordinated-and managM-10 crews eonsi&g of 6 mobers por team in tho southern California region; handled various sized prgloots ranging in giro tom$Ipo to $4.5 million dealing with dry atiiitles, wet utllitiee, tnatilo siguais, and mad imgrovemonts, Malntained coordination betweon High Light BleMc lno and mboontraotor, gcmeral contmotor and project owners, In charge of handling projooN' adminispotivo work; mot(Wy gross estimates, pmjeot progress schedule,msterhtls regaialdans,contract change order negotiations and egWpment purchase and rerttats, Continued,.. BRUN MWOZA • Page 2 CA R EXPUMCk COMINUED MBE Electric Inc,In Riverside;CA 10/I998M10jq996 Vice President and Head of Outside Operations Managed outside operations for all pwJoots ranging In size hom'$1 to$2.5 million. Headed an around the clock eleetdo crew end.coordinated with CC Mayes to repair the I.10 Santa Mon.loa 'Freeway After it collapsed during the 1994 Northridge Barthquake to complete the fast paced project in 65 days. Maintain coordination botween MBB Electric and subcontractors, general contractor and project owners; implamonted and enforced safety guidelines. Handled administrative work monthly progress estimates, material requisitions, contract change order negotiations. Vasco Corporation in San Fernando,CA 1011987-0611998 Foreman(Part Time) Managed day to day operations of work crews and various projects ranging in size from$1,000 to$5,000 in Eastern Los Angeles Count},trafftc signals,stfeet lighting,signal interconnect. Raymor Metric 1n Rosemead,CA 0G/1996-10/1987 Crew Leader(.part TIZme) In charge ofwork crew on projects ranging from$25,000 to$250,000 through out Los Angeles County. WORK RULS ® Capable of operatingheavy equipment stint as slip loaders,cranes,and backhoes; • Hands-on eaperionoe with bead tools and power tools; o Capable of overseeing ihst paced W high profile projeots; e An efdbOtive oomumdoew sad leader; HD UCAnON s bntemational Brotherhood of Bleoftioal Workers Completed training oo=e(1980.1989)in'stroet lighting and tcaflio signal installations,code enfbroa of and blue ptlnt reeding. 0 804tla 0410 Higb School R eoolved High ftaol diploma In 1988 BRIAN MENDOZA + Page 3 CANER BXPRfMCR CONTI N11$p PRoMSIONAl11V1 BE1[SHMS + Intmadonal Brotherhood ofBleotrical Workers(IBM + MOM Hootdoal Contractors Association MCA,) ACCREDITATION ® ID13W-Joumeyman Wireman;CSI,B-Electrical Contractors;Certified Trench Safety Coordinator. LANGUAGES 13tzgli9h(Native) . Spanish(Fluent) AWARD RECFMD • Recipient of the US.Small Business"Young Entrepreneur of the Year"Award in. 1996,nationally, ® Recipient of the Certificate of Recognition by the City of Los Angeles for"Small Business"in 1997, + Reoipient of the Certificate of Rwcootion by the City ofRiversido for"Small Business"in 1997. + Recipient of the Certif sate of Recognition by the State Assembly,Assemblyman A*. Rod Pacheco,for the"top 506 Inland Empire Small Business"In 1997. + Ranked among the"Top 50 Inland Empire Hispanic Owned Companies"since 1997, ' + Certification ofAppreoiation for ourpartioipatiou and maximization in the"Century Freeway Affirmative,Action"by CFAAC. PROI+')SSSIONAL AND PERSONAL REF'ERBNCEt4 -- QdtrAw project 007•1214U4(Bleotdoal oantraot amount$4.5 tnillion) Inject oompleted In 2005 Description otprojeM Installation of traffic signals,ramps metering,sign illumination, MAWay liggh ft Off Optic oonnnualoodon,and eleotrioal irrigation along the I-10 Freeway In Los Angeles County, Doug Awason-Projoct Manager,ibrprlmo ocatraotor,HalfourBeatty Cell(949)232.3276 and Office(909)397-8040 Patty Qalvaa•Resident Buglaaar,Office(909)594r4270 e Veranloa ROU-E1e0ttrio41 k Wpeotor.Coll(714)606.6311 r f a BMAN AUNDOZA • Pstgo 4 CAMIt EXPERMNCE Ct1NnNV1D City of Redlands Contract#208300.72304/41008(Electrical contract amount is$218,800) Project completed in 2003 Description ofprojeats Installation of traffic signals,modification of ramp metering,lighting and sign illumination • Bill Hawley-Senior Civil Engineer-Office(909)798-7586 ext 2 • han Olvera-Protect Manager for general contractor,H&H Construotion-Con (951)453-7712 and Office(909)473.7331. CaltrawprojectN8-4567V4)Electrical contract amount is$938,238) Project completed in 2005 Description of project:Installation of lighting system along the I-5 Freeway in San Berllax'd1no,County; Gary Vogel-Project Manager form prime contractor,Granite Construction Cell; (661)549-3953 and Office(661)726-4447 Sanbag Projects,Segment 1,2,31 early segment 9,segment 9,and alder Ave.(Total electrical 6ulmd amount was$3.2 million)Project completed in 2004. Description afprojects:Installation of traffic signals,ramp metering,sign illurgination,' hlghway lighting,fiber optic communication,and electrical irrigation along the I-10 Freeway is San 13mm-dino County. • Harold Lantis-Sanbag Contract Manager-Cell(760)802-7730 and Office (909)875.8029 at 213. • Tim Hmable-Caltrans Inspector-Cell(951)712-0021 • Al Ortega-Project Manager for prime contractor,Yeager ShMft-Cell(714)240- 5333. Clty of Indio project#ST0137(BlecWcal contract amount was$1,4 million) : Praject ocmgl4ted to 2005 ' Description of projects -Installation of street. lighting system, traffic signals, electdoal Hgation,sad dry utillt(es. • Una Baxter-Area_Mawger 1br prime contractor, Yeager Shan h Construction. COD(909)721.9749 and pffioo(760)343.5472 ® Tammy Young-Project Manager for prime contractor- Ce11 (951)232-6618 and 01floe(760)343-3472 ® Mel`V Sepehd-C9ty Bngineer Cog(760)250 2201 Additional Profeeriouai R,oferenem: • 2ale ifrris-Caltxatts Inspector-Cell(951)289.0047 • 1ZayRobles-Caltrans araa suporviaor-Cali(909)799.0646 (For federally funded projects,use this following page) 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 requiremnents 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: PTM General Engineering Service Inc. Contact Person: Brian Mendoza Contact Phone: 951-710-1000 Signed: Date: 7/18/2012 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 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 19%8;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: PTM General Engineering Service Inc Contact Person: Brian Mendoza Vice PresiiPnti �ia� Contact Phone: Brian MAOoza. Signed: Date: 7/18/2012 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992(HUD), Previous non-compliance with Section 3 could result in disqualification. C-1I Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WIIICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder PTM General Engineering Service Inc. ,proposed subcontractor 4 Z hereby certifies that he has x , has notes participated in a previous contractor su contract subject to the equal opportunity clauses,as required -.by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note. The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts,which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5, (Generally only contracts or subcontracts of$10,000 or under arc exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. i z 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. 1�1 _ 1 f Page 12-79 LPP 01-04 C-12 March 15,2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376,Stars. 1985),the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has_,has not ,been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereon as referred to in Section 10285.1. Note: The bidder must place a check mark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signatm of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal•prosecutiom Public Contract Code Section 10162 Questionnaire in conformance with Public Contract Code Section 10162,the Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No X If the answer is yes,explain the circumstances in the following space. . 1 1 C-13 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature e of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. i C-14 Local Assistance Procedures Manua[ EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY/COUNTY of Huntington Beach./orange DEPARTMENT OF PUBLIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company, association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding,that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof,or divulged information or data relative thereto,or paid, and will not pay,any fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note. The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion davit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 i LPP 01-04 C-15 March is,2001 Local Assistance Procedures Manual EXHIBIT ME PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,and manager: • Is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any federal agency; • Has not been suspended,debarred,voluntarily excluded or determined ineligible by any federal agency within the past 3 years; e Does not have a proposed debarment pending;and - f Has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page I2-83 LPP 01-04 C-16 March 15,200I Local Assistance Procedures Manual ExHnalT 12'E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDER.AI Al® CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any federal contract,grant,loan,or cooperative agreement (2) if any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this federal contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered'into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$140,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 UP 01-04 C-17 March Is,2001 N/A=Not Applicable Local Assistance Procedures Manual EXROff 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTTVI E S 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: F-1 N/A I�l N/A ® N/A a. contact 2.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 to Ioan insurance date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No.4 is Subawardee, N/A Enter Name and Address of Prime: Prime Subawardec N/A Tier ,if known Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Descriptiow N/A N/A CFDA Number,if applicable S. Federal Action Number,if known: 9. Award Amount,if known: N/A N/A 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.10a) (last name,first name,W j N/A (attach Continuation Sheet(s)if necessary) 11. Amount of Payment(check all that apply) N/A 13. Type of Payment(check all that apply) N/A S actual placated P. retainer b. oae-time fee 12, Form of Payment(check all that apply): N/A c. commission a. cash d. contingent fee b. In-kind; specify: aature a deferred value U f other,specify i i 14. Brief Description of Services Performed or to be performed and Date(s)of Servlce,including officer(s),employee(s),or member(s)contacted,for Payment Indicated in Item 11: N/A (attach Continuation Shoot(s)if necessary) 15. Continuation Sheets)attached: Yes ® No Y6. Information requested through this form is authorized by Tide 1 31 U.S.C.Section 1352. 'this disclosure of lobbying reliance Signature: i was placed by the tier above when his transaction was made oreatcredinto. nisdisclusumis=quircdpursuantta31 Print Name Brian Mendoza U.S.C.1352. This informationwill be reported to Congress semiannually aid will be available for public inspection. Any Title: Vice President/Secretary f person who fails to file the required disclosure shall be subject ii to a civil penalty of nat less than$10,000 and not more than $100,000 for each such failure. Telephone No.: 951-710-1000 1D` ": 7/18/12 Authorized for Local Reproduction Federal Use Only: Standard Forth-LLL f 5taadaid Form tLL itev.09-I2 97 Page 12-87 LPP 01-04 C..1$ March 15,2001 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient,at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city, State and zip code of the prime federal recipient. Include Congressional District,if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action(item./). 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 QFB)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-90-00I." 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 far the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,State and zip code of the Iobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action (b)Enter the full names of the individuals)performing services and include full address if different.from 10(a). Enter Last Name,First Name and Middle Inioal(ND). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(hem 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 im-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other,specify nature. i Page 12-38 LPP 01-04 Mareb 15,2001 C-19 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G. I4. Provide a specific and detailed description of the services that the Iobbyist 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 sheets)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503. SF-U.Glnmhtwdons Rev,06.04-90n6ND0 0 i t i Page 12-89 LPP 01-04 C-20 March 15,2001 Local Assistance Procedures Manual Exhibit 15-G1 Local Agency Bidder UDBE Commitment(Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment(Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SSE OF THIS FORM AGENCY: City of Huntington Reach _ LOCATION: Golden View Elementary School PROJECT DESCRHMON: Safe pRoutes to School TOTAL CONTRACT AMOUNT: [D DA E: 7/19/2012 BIDDER-SNAME: PTM General Engineerin,T Service ltic- CONTRACT UDBE GOAL: 9.04% CONTRACT M OF WORK AND DESCRIPTION DNo00lRATION (Must be certitied on the date bids f UDBE NAME OF UDBES L LAR AMOUNT ITEM NO. R SERVICES TO BE BE UBCONTRACTED OR MATERIALS DATE arc opened-include UDBE O BE PROVIDED address and phone numbs tn.of material supply 9994 Grand F.Jectric Supply IncS ista, 4 T 760-744-5281 For Local Agency to Complete: Total Claimed i�75 1 IS Agency Contract Number: Participation Federal Aid Project Number. 9.04 % Federal Share: ontraet Award Date. cal Agenoy certifies that all information is compiete and wmate. rran Mendoza,V.P./Secretary P :nc�" L'L�Cv�a In . ignature of Bidder rintName signature Date 7/18/12 951-710-1000 Local Agency Representative Date (Area Code)Tei.Na Area Cade Tel hone Number Elizabeth McRae For Caltrans Review: Perron to Contact (Please Type or Print) Print Name Signat+ue Date Caltrans District Local Assistance Engineer L WAgwcyBidder-UDBBC4=mihnwt(Rev3/09) Distribution: (I)Copy—Fax or scazr a copyio the C:du s DistrietLocal Assistaucc Engineer(DLAE)wither t5 days of award.Faliure to send a copy to the DLAE within 15 days of award may result in do-obligation offrmds for this project. (2)Copy —Include in award package to Caltrans District Local Assistance (3)Original—Loral agency fades Page 15-31 LPP 09-mac Cr2I March 27,2009 Exhibit 15-G1 Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER UDBE COMMITMENT(CONSTRUCTION CONTRACTS)(Revised 03109) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s)falls into one of the following groups in order to count towards the UDBE contract goal: 1)Black American;2)Asian-Pacific American; 3)Native American; 4)Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian-Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name,and Contract Goal. _ The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification .number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to ,perform the work(who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors'certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including,if the prime is a UDBE,work performed by its own forces. R PORTANT: identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s)of work Listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. Provide copies of the UDBEs'quotes,and if applicable,a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. - There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (if 100%of item is not to be performed or furnished by the UDBE,describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts);to determine how to count the participation of UDBE firms. Exhibit 15-0(1)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 Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the ;information has been verified,the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27,2M C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good Faith Effort EXHIBIT I5-H UDBE INF01(2MATION—G001) FAITH EFFOI<tTS Federal-aid Project No. Bid Opening Date 7//19/2012 Huntington Beach Orange The (,Ci /County Qfl established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the"Local Agency Bidder—UDBE Commitment"form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g.,a UDBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment", form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement Goals Met B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations,telephone records,fax confirmations,etc.): Names of Date of Follow Up UDBEs initial Methods and Solicited Solicitation Dates Goals Met C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces)into economically feasible units to facilitate UDBE Page 15-33 UP 09-zx March 4,209 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBE Information-Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract Goals Met D. The names,addresses and phone numbers of rejected UDBE firms,the reasons for the bidder's rejection of the UDBEs,the firms selected for that work(please attach copies of quotes from the firms involved),and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: C,(,)31S Met _ Names,addresses and phone numbers of firms selected for the work above: Grand Electric Supply Inc 2430 S. Satna Fe Ave.#510 Vista,CA 92084 Tel: 760-744-5981 E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: Cin`31S(`het F. Efforts made to assist interested UDBEs in obtaining necessary equipment,supplies,materials,or. related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: Goals Met I G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms(please attach copies of requests to agencies and any responses received,i.e.,lists,Internet page download,etc.): Page 15-34 March 4,2009 >LPP 09-xx C 24 Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good Faith Effort Name of Method/Date Results Agency/Organization of Contact Goals Met H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): Goals Met NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a 1LPP 09-xx March 4,2009 C-25 Local Assistance Procedures Manual Exhibit I5-G2 Local Agency Bidder DBE Information(Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information(Construction Contracts) (Inclusive of all DBEs including the UDBEs Iisted at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON TDE REVERSE SIDE OF THIS FORM GENCY: City of Huntington Beach LOCATION: Golden View Elementary School PROJECT DESCRIPTION: Safe Routes to School TOTAL CONTRACT AMOUNT:$ 1D DATE. 7/19/2012 IDDER'SNAME: PTM General Fnaineerino Service Inc, CONTRACT' OF WORK AND DESCRIPTION tON BE Cert No. AME OF DBEs LIAR AMOUNT ITEM NO, 311 SERVICES TO BE AND EXPIRATION Must be certified on the date bids DBF EJBCONTRACTED OR MATERIALS DATE im opened-include DBE address 0 BE PROVIDED Lnd ofione number 15 Ptn.of material supply tsta,CA 92084 Tel- 760-744-5981 For Local Agency to Complete: Total Claimed $f, 7 s • r� Local Agency Contract Number. Participation Federal Aid Project Number, 9.04 % Federal Share: Contract Award Date: Local Agency certifies thattheDBEcertification(s)hasbeeaverifiedandall rtan Mendoza, V.P./Secretary information is complete and accurate. PTM ,General L1g, Svcs_ InQ ignature of Bidder 7/18/12 951-710-1000 Print Name Signature Date Date (Area Code)Tel,No. Local Agency Repteseatative Area Code Tcleaone Number. Fh7aheth McRae For Caitrans Review' Person to Contact (Please Type or Print) Print Name Signature Date CaIt ans District Local Assistance Engineer Local Agwey Bidder DBE luformauon{Rev W09) . Distribution: (I)Copy—Fax or scan a oapy to the Calhans District Local Assistance Engineer(DL.AE) within I5 days of contract execution. Faiture to send a copy to the DLAE wither I5 days of oontractexecutlon may result in de-obli 0100 of funds for this project (2)Copy—Include in award package to Caftans District Local Assistance (3)Original—Local agency flies Page 15-322 UP 09-XX C 26 March 27,2009 Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS)(Revised 03109) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name,and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date.The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work(must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number, Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project--including all UDBEs listed on the UDBE Commitment form(Exhibit 15G(1)),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 total DBE 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 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(2)must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact, Local agencies should complete the Contract Award Date,Federal Share,Contract and Project Number fields,and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. i 1 Page 15-32b March 27,2009 C x7 UP 09-xs nonce Procedures Manual EXW 12-G Bidder's List of Subcontractors(DBE and Pan-DBE) BIDDER"S LIST OF SUBCONTRACTORS (086 and NON-DOR). PART I The bidder shall list all subcontractors(both DBE and non-DBE)in accordance with Section2-1.054 of the Standard Specifications and per Title 49,Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere In the proposal. Photocopy this form for additional firms. Firm Nam Phone/ Annual Address/� Fax Gross Description of Portion of Work to be Performed cityi state,111P Receigts Name phone 0<$1 million -Ptn n f njnteri-.d-,�ijppl�i Grand Electric Supply Inc. 760-744-5981 $5 million Address [2<slomlllion 994 2430 S. Santa Fe Ave.,#5 10 Fax <$15mi1lion 06'stateziP ED>$15 million Vista,CA 92084 760-744-5982 Name�aPhone ME]<S1=mHlion ��/ 1;7 $5 million 14 e-rol f4 $5 million Address Mslomlllion -*/0 0 Fax million PLEM 0fly Stare qjri—2 7 >$15 million -PAry—n6e4:k —IU,9A-I?- ID&C .�g �a8.7 Name Phone ❑<$1 million 13--ss million Address [3<$10million Fax $15 million CIV State Rp Name phone $5 million Address <ito million Fax El<$15 million 7jp M>$15 million DIstribudom 1)OrI&AI-Lowl Agency File Page 12-111 November 14,2006 t isance Procedu Rld 1i;lddc .:�iLlst afSabcontrictors(DIBEand Non-1DBly) Local Ass .danual BIDDER'S LIST OF SUBCONTRACTORS (CBE and NON-DBE)- PART 19 ate bidden shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project, This is required for compliance with Title 49 Section 26 of the Code of Federal Reon1ations. Photoc,00Y this form for additional firms. Firm Na f Phoioel Attttval Addressi Fax Gross Description of Portion of Work to be Performed Name ce Ci State. fP Recei' is Phone �.,.0V161. �SI-J7'75-i�17 <$iraillion nr� cn n, C� r <$5 motion Addrau <$t0 million PROS C:I l Ke t Faz 4$15 million CIO,Y teZIP 6JSi-77S-W >$i5 mlliion • Name Phone •! <$t million $5 million . Address . y� <$t0 million J- tJ1G &-' / ; Fax <SlSmillion CtryStare7.lP %�j._ q ���> >$ISmitlion Name Phone <$I mutton 5�2-a l� �iscy rsr eyt �' S rti- - _J 0— <$5 million Address <$tomillion �0 1Y k,115? $15 million Cttystate zrp 3;.6 5;�'-2 >SIS mitiian Al ame® Phone $t million .(e P' Lc / �(„1 cq 1 <$S mUlion - f ,� ,� <$[0 million I Ct St to 2tP�k i� St F Fax _ �G _ <$€S million >$i5 million BC Traffic Specialist ;;dr frC n_ �f 3 f Y!f';n� _ e _cl 4ac D19rlbutlon:1)Odglnal-i oml Agency File 638 W Southern Ave,Orange,CA 92865 i< License No:877686 Exp:5-31-12,Class:B,C31,C32,D42 Tel(714)974-1190 Fax(714)974-1753 Page M112 J&S Striping November 14,2006 10715 Bloomfield Ave,Santa Fe Springs,CA 90670 47 License No.538211 Exp 8-31-12,Class A&C32 ����� LPP 06-06 Pleq,. 'e- Tel:562)777-2411 Fax:562)777-2499 Orange County Striping Service ���'Pr f r e�t © F 571+"t�'+� kj�g -b Q 6r 183 N.Pixley St,Orange,CA 92868 Superior Pavement Markings License No.346095,Class C31 &C32 14656 Industry Circle,La Mirada,CA 90638 I Tel:714)639-4550 Fax:714 639-6353 — - - - - License No.776306,Class C32 t fz p 49¢ Tel:714)562-9100 Fax:714)995-9400 �` 3!$i'1rc z Chrisp CompanyPee - License Box 1368,Fremont,CA 94538 License No.374600 Exp 5-3-11,Class A,C13&C32 Tel:909)746-0356 Fax:909)820-1311 1Se C,Dtt CrLfL k5�rttG �K tkG. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For Safe Routes to School, Golden View — CC 1402 July 12, 2012 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) The following shall be added to Section 6-7, Time of Completion of the Special Provisions. At the intersection of Golden View Lane and Norino Drive, curb ramp construction activities shall be completed within five(5) consecutive working days, from stark to completion. 2)The following shall be added to Section 7-10.3 of the Special Provisions. Pedestrian access shall be maintained throughout the construction area. Barricades and delineators shall be placed to provide a pedestrian path of travel throughout the work area. This is to acknowledge receipt and review of Addendum Number One, dated July 12, 2012. PTM General Engineering Service Inc. � Brian Menedoza,Vice President/Secretary Company Name By 7/18/20I2 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. BID BOND ;NOW ALL BY THESE PRESENTS,That we, PTM GENERAL ENGINEERING SERVICES,_INC._ of 5942 ACORN ST. RIVERSIDE, CA 92504 (hereinafter called the Principal), as Principal, and INTERNATIONAL FIDELITY INSURANCE COMPANY (hereinafter called the Surety),as Surety are held and firmly bound unto CITY OF HUNTINGTON BEACH (hereinafter called the Obligee) in the penal sum of TEN PERCENT OF AMOUNT BID Dollars(1 10% ) For the payment of whici3 the Principal and the Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents, THE CONDITION Of- TlilS 08LIGATION 1S SUCH Tliat WIIERRAS, the Principal has submitted or is about to submit a proposal to t))e Obligee on a contract For SAFE ROUTES TO SCHOOL NOW, THBRBFORE, if the said Contract be timely awarded to the Principal and the Principal shall, within such time as may be specified, enter into the Contract in writing, and give bond, if bond is required, with surety acceptable to the Obligee for the faithful perforinance of the said Contract,(lien this obligation shall be void; otherwise to remain in full force and effect. Signed and sealed this 12TH day of JULY 2012 PTM GENERAL ENGINEERING SERVICES, INC. (Seal) Principal Witness �6V Title INTER ONL FIDELITY INSURANCE COMPANY Witness By - Attorney-in-Fact Tel (073) 024-7200 POWER OF ATTORNEY INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEhNARK CENTER, 20TH FLOOR NEWARK, NEVV JERSEY 07102-K07 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY , a corporation oraani=ed and eXi;lin4 un,re the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized and existing under the. Ia4vs of(ha Sl<,te cf Pennnysylvania,having their principal office in the City of Newark, Ne,,Jersey,do hereby constitute and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, MYRNA SMITH, PHILIP E. VEGA i I Covina, CA. ^------.._---------.... _....-- ------ -— --------- ---------... - ----....--- _...--................ their true and lawful attorneys)-in-fact to execute,seal and deliver for and on its behalf as surety,any and all bonds and undertakings,contracts of indemnify and other writinggs obligatory in the nature thereof, which are or may be allowed,required or permitted by law,Statute,rule,re elation,contract or otheR•vise, and the execuliOn Of such instrument(s) in pursuance of these presents, shall be as binding upon the said INTERNATIONAL.FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY, as fully,and amply, to all intents and purposes,as if the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed,and may be revoked, pursuant to and by authority of the By-Laws of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY and is granted under and by authority of the following resolution aclopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 201h day of July,2010 and by the Board of Directors of ALLEGHENY CASUALTY COMPANY at a meeting duly held on the 15Ih day of AuguSt, 2000: "RESOLVED, that (1)the President, Vice President, or Secretary of the Corporation shalt have the power to appoint,and to revoke (lie appointments Of, Attorneys-in-Fact or agents with power and authority as defined or limited in their respective powers of attorney,and to execute on behalf of the Corporation and affix the Corporation's seal thereto,bonds,undertakings, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and(2)any such Officers of the Corporation may appoint and revoke the apppointments of joint-control custodians,agents for acceptance of process,and Attorneys-in-fact with authority to execute waivers and consents on behalf of the Corporation;and (3) the signature of any st.ich Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of allorney or certification given for the execulinn of any bond, underl'2king, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, Such Signature and seals when SO useil whr,'Iher herelofore or hereafter, being hereby adopted by the Corporation as the original signature of Stich officer and the original seal of the Corporation, to be valid ,Ind binding upon the Corporation with [he same farce and effect as IhouClh manuafly a.ffixecl." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have cioch executed nn taltesled these presents on[his 121h clay of March,2012. STATE OF NEW JERSEY County of EssexSEAL GW7 1711 tci 1936 1 * - 000 �•* � ROBCRT W.MINIS-I"EIS 10. r�SYLVF".� Executive Vice Presideril/Chief Operating Offices (International Fidelity InStlrarlce Carnp,any) and President(Allegheny Casually Company) On this 12th clay of March 20'12, before me came the individual who executed the preceding instrument,to me personally known,and, being by me duly sworn, said he is the therein described and authorized officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CAS IJA1_TY COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies; that the said COrperale Seals Fill(]his r,;ignalurc:;were: duly lfIir.e:d by order of the Beards of Directors of Said Companies. IN TESTIMONY WHEREOF, I have hereunto stet my hand affixed try Officinal Sr;al, ,yy4;�111Hfyl� l + at the City of Newark, New Jersey the clay and year lull zibove wrillen. V/ A 11IOTARY PUBLIC OF I'•IEW JERSEY �t �q� Qr-N LIN My Commission Expires ivlsar. 27, 20'I I CERTIFICATION I, the iindcmigned officer Of IN-rL=RNATtONAL FfDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do horr;aiy certify Mal I havi:; corrilrare d the loregoing ropy of Ile Power of Attorney and affidavit,and the ropy of the Section:of II'ie By-Laws of said CornpYanirs as sel l(iril-i in Cdir.l Power of Attorney, with the originals on file in the home office-, of said companies, and that the same are correct Iran3cripls lhnreof,Find of thii;whole of Ilse said original;,and that the said Power ofAtlornry has not kern revoked and is now in full force and effect. IN TESTIMONY WHEREOF. I have hereunto set my hand Ibis 12TH day of JULY, 2012 i MARIA BRANCO,Assislanl Ser,re Islr'y CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT cnnL CODE§ 1189 G State of California County of Los Angeles On JUL 12 2012 before me, Monica Blaisdell, Notary Public Date Here Insert Name and Title of the Officer personally appeared Philip E. Vega i Name(s)of Signer(s) 4 who proved to me on the basis of satisfactory evidence to be the persons whose name(K is/am subscribed to the within instrument and acknowledged to me that het executed the same in MONICA BLAISDELL his authorized capacity(W, and that by Commission # 1970845 a- Z Notary Public-California his signature(*, on the instrument the Z ` �� or the enti ty ty upon on behalf of which the Z `�` Orange County > P My Comm.Expires Mar 26,2016 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: Place Notary Seal Above CERTIFICATE OF CORPORATE RESOLUTION 1 Brian Mendoza , Secretary of PTM General Engineering Services Inc. (Corporation) do hereby certify that at a duly constitutetd meeting of the Stockholders and Directors of the Corporation held at the office of the Corporation on December 30 2 0 07(year), it was upon motion duly made and seconded; that it be VOTED: Elizabeth H. Mendoza de McRae, President/CFO . . . . . OR. . . . Brian Mendoza, Vice President/Secretary Authorized to sign & execute contracts and submit bids with either one of the corporate officer' s signatures . It was upon further motion made and seconded that it be further VOTED: That Elizabeth H. Mendoza de McRae, President/CFO ... ..OR....Brian Mendoza, Vice President/Secretary in the capacity as of the Corporation is empowered, authorized and directed to execute, deliver and accept any and all documents and undertake all acts reasonably required or incidental to accomplish the foregoing vote, all on such terms and conditions as he in his discretion deems to be in the best interests of the Corporation. = I further certify that the foregoing votes are in full force this date without rescission, modification or amendment. Signed this i k�� day of —JtJ.j Z (year). A TRUE RECORD ATTEST Brian Mendoza Secretary/Clerk Vice President/Secretary (Corporate Seal) 53 All Purpose Acknowledgement State of California County of Riverside On `7 It 9 (( y , before me, Elizabeth H. M. McRae —� (date) (notary) personally appeared, Brian Mendoza (signers) ❑ personally known to me -OR- [3 proved to me on the basis of satisfactory evidence to be the person(V whose name(#iskDamubscribed to the within instrument and acknowledged to me that he/ "executed the same in hisfh§T:Ar authorized - EI.IZASETH H.M. capacity( and that by his/We >t;signature( on the Comm.# 1910MCRAE 816 N instrument th person(50 or the entity upon behalf of N .mom NOTARY PUBLIC-CALIFORNIA which s n(zo acted,executed the instrument +a RIVERSIDE COUNTY MY COMM.EXP.oCT.29,2814 WITNESS m h nd official seal (seal) (notary signature) OPTIONAL INFORMATION The information below is not required by law.However,it could prevent fraudulent attachment of this acknowledgement to an unauthorized document. CAPACITY CLAIMED BY SIGNER(PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT ❑ Individual ❑ Corporation Officer Title or Type of Document title(s) ❑ Partner(s) Number of Pages ❑ Attorney-In-Fact ❑ Trustee(s) ❑ Date of Document Guardian/Conservator ❑ Other: Other Right Thumbprint of Signer SIGNER IS REPRESENTING: (if required) Name of Person(s)OR Entity(ies) l W 4 L l✓�_/4�._ I { I lr� L�i!'y lj t.- w•;-:a Y ,I`. + .. ...L _- -_—.._—__-_-__.�_�_,��.-.___ —x_. -i„p.,,.., tt"�51"v_.,,T ^y...-.r� 3.,. M N' - 6 hr: 'S "'..WF'C ��, - 1M41.1 f 1 I I:;,,,� }i{� �. .,r t',,•C� �s iJ Ir�{ ', .�tom..,a.._:i°=,._...:v_�v_s�*���::._ ,.•�, >-r+_v ._.._:wY`s"a,n±*."ss.„-.a_��,+r:W,rh::�y�.,,.tei ^"st,W.rrc'g�' 'e�"fin`p ;;,Yr� ~; N - �+ z 4e r � t _ . w, t' Ls pt � �x �x Bidder; PTM General Engineering Service Inc. P ; a„ # , 5942 Acorn Street x , . �` Riverside, CA92504 � � X{rs. s i r y e 1, ,�5° f^5 W,n '. Bid Recipient; City of Huntington Beach r 4 INN- Mg Attn: City Clerk sF r Second Floor,2000 Main StreetE * � Huntington Beach,CA 92648 ..� '- « Y ' Tel:714-536-5431 . z r Bid Date; 7/19/2012 yrix ` Bid Time: 2:00p111 �tt 3 :. Account Now' r sS ax k ry P1.1 ;k4 %41,;"a k«: Desc; Safe Routes to School in the vicinity of Golden View Elementary School " I Bid Enclosed-Do Not Open gg With Regular Mail. dwi- y 5 Nil ..,P,,., ,,,+, m_,L ..„ ,, u.r :. t. .,t( ., i'. ,w, ,''s`• •a-a.: „,. ... ,..x.- , -'rs. •rm ,, X:� n.r, ., '. .... Viz' { , a, t,�........ .�r r^ ,'Z? :.t•��,•,,�s s,� fit:'. �. :,�. ..�.,. "�4. :.&,,..: ...r,..,. ,,, -�:'.:,,:• ., :'a2'� �.5: ,,,,,t. .r.a�, c.•.°",��'.. n.„,.5>* '�° e^�' .„,,.�.,...r'„ ,,. ._,� .,.: .,;� ..'�>-."_ r, k, `�Mm .,., i'.,.•a.:,- ...�,:..n y� ..i. ..�.e' �.;,,....,,`"F' � .w rr�.,:.*` ,c„.,._-. ,r :�.�k �. ��� �s'�,,z.,. ..^r, '�i', _ •,a� ..},a` i2... ..� .; ;;.w-uc.,. ..::. �.. P�.0 ,.., :# -r- .:.., 23r :,..5' `!... ,,.• .. :. .,: ...t.. .." 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'� '�,M _ 5�-sx �,.,.,. �. ..< , - �'. .. ti' :., y.,,, ,�:• r.. -.:-,.�- �, .r,. .. ,,. ,.. ... ,,. „�A.. . -a .:,r~,-.'...- .,,r, I aow,, .c, ."« ��'i�> fir.. ,r., ,m�.. ,.�., ,,,�.. ,.A,.:,w" .- .,+:1; ,. ..>.1. rxxS'.� ��.,..,.�:r �.% u..t �t, q„ a:'�..4a-.,�nzt'�m,...,r�u:"wa•...«a„z»..r;'r.'dR.�-> «?._n. ..'�:....»,kxb.�.re.N•-:m•rcC�4u-�•i+r.A:�?.r'�"�•.,,..:r.'r.>:,ri�ea�,.•m-. r..a'�".'.i.,r.z .. .«.e"3,...._.�+ k+_3� ,...«^.r,',trr� ^�r'....,�4_.,zk�F',�W�et Yr..„.r.�..r ....,,+�....�'ia� ,s... ��,°„w.rs �� : -. .r_ ,.3^?'�i"�.n�:. n',`n:d._.E. ,=.'.w_s�,_...e.-.,_..n ....nY,.�-�•r"....3,_.mCP:..�.�r,i2.�,.�Mm� Certification of Compliance with 'Title VH of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 Contract: Project: The undersigned contractor on the above-referenced project ("Project") hereby certifies that it has complied with Title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, creed, color, sex, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities.at its establishments on the basis of race, creed, color, sex, national origin, age or disability (with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct" Executed this day of , 20,, at , California: (Type Contractor Name) By: Name: [Type Name] n� Title: [Type Title] E > IF R A t�RNEX T-) 1 245911 1 CO 1 RAC A OW S CEAA MCATE L ,state and certify that: (Name of Declarant) 1 is the general contractor to the City of Huntington Beach ("City") on Contract No. (the "Contract') for the construction of the public work of improvement entitled: (the"Project"). 2. All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract). 3. Except for the claims listed.below and the disputed claims listed-in paragraph five(5), all persons supplying labor, services, materials and equipment to the Project, including all claims against the Contractor arising from the performance of the Contract, have been paid and satisfied(list unpaid debts and claims; if none, write"NONE"),: 4. Attached hereto are the lien waivers required by the Contract Documents, which lien waivers have been executed by all persons who performed work on or supplied labor, services,materials, and/or equipment for use at the Project. S. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California (list all disputed claims; if none, write"NONE"): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at on this day of , 20_ (Signature of Declarant) APPROVED AS TO FORM By: a\V�n sj 1-7 3 yo ot� Name: [Type Name] Title: [Type Title] 1 245914 1 Certification of Compliance with Prevailing Wage Laws To: City of Huntington Beach Department of Public Works 2000 Main Street/P.O. Box 190 Huntington Beach, CA 92648 Re: Certification of Compliance with Prevailing Wage Laws Contract: Project: The undersigned contractor on the above-referenced project ("Project') hereby certifies that all laborers, mechanics, apprentices, trainees, watchmen and guards employed by him or by any subcontractor performing work under the contract for the Project have been paid pursuant to the minimum wage and bona fide fringe benefit 'requirements specified for each particular classification of work, as set forth in the wage-rate determinations of the State of California, Department of Industrial Relations, and/or the United States Department of Labor. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this day of , 20 , at , California. (Type Contractor Name) By: Name: [Type Name] Title: [Type Title] M TO ow .. 1V1c IZA t,P Y S, CITY ATTORNEY _TLC 03 ab •� 1 247542.1 RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) i 1 CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: Shari Freidenrich, City Treasurer FROM: DATE: SUBJECT: Bond Acceptance I have received the bonds for L0 �it1l/it16 (Company Name) Faithful Performance Bond No. 060 Z-4r Labor and Material Bond No. � 0 Monument Bond No. Maintenance Bond No. Guarantee and Warranty Bond No. Re: Tract No. CC No. MSC No. Approved r�il! i Agenda Item No. pp g(Cou ApproAl Date / City Clerk Vault No. #27 g:/followup/bondletter.doc ISSUED IN THREE (3) ORIGINAL COUNTERPARTS Bond No. 0601205 PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: WHEREAS, City of Huntington Beach(hereinafter referred to as"City")has,byy written aggreement dated AUGUST 7TH 2012 , entered into a contract with PTM GENERAL ENGINEERII�IG SERVICES, INC. 5942 ACORN ST. RIVERSIDE, CA 92504 (name and address of Contractor) (hereinafter referred to as"Principal"), for performance of the work described as follows: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT (Project Title) WHEREAS, said contract,and all documents referenced therein(hereinafter collectively "Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full. WHEREAS, said Principal is required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful performance of said Contract. NOW THEREFORE, we, the undersigned, as Principal, and INTERNATIONAL FIDELITY INSURANCE COMPANY 233 WILSHIRE BLVD., SUITE 820 SANTA MONICA, CA 90401 (name and address of Surety) (a duly admittedsurety insurer under the laws of the State of California tyand hereinafter referred to as ONE Fi13NDRED FOR`ftv are ONE THOUSAND ONE HUNDRED FORTY ON in E NO/100 penal sum of Dollars($ ),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")from any and all losses, liability and damages, claims,judgments, stop notices,fees and costs of every description, whether imposed by law or in equity,which may be incurred by the Obligees by reason of the failure or default on the part of the Principal in the performance of any or all of the terms or the obligations of the Contract, including all alterations, amendments and modifications thereto, and any warranties or guarantees required thereunder; then this obligation shall be void; otherwise, it shall be and shall remain in full force and effect. Surety stipulates and agrees,for value received,that no adjustment of the time or price in the Contract or any alteration, change, deletion, addition or other modification to the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict, impair or release the obligations of the Surety tinder this Bond. Surety waives notice of any adjustment of contract time or contract price,and 277591.1 PERFORMANCE BOND Page 1 of 2 1 Bond No. 0601205 any other alteration,change,deletion, addition or other modification to the Contract,or the work to be performed thereunder, and agrees to automatically adjust the penal sum of this Bond to reflect such adjustments,alterations,changes,deletions,additions or other modifications. Surety agrees to provide written confirmation of such adjustments-in the penal sum to City on not less than a quarterly basis. Surety also waives the provisions of Civil Code§§2845 and 2849. The obligations of this Bond shall survive the completion of the work described in the Contract as to all obligations and liabilities of the Principal which survive completion of the work. IN WITNESS WHEREOF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below,that the name of each corporate party being affixed hereto is such parry's proper legal name and that the individuals signing this instrument have been duly authorized pursuant to the authority of its governing body. Surety,by execution of this bond, waives any defense which Surety has or may have by reason of any failure of the Principal to execute or properly execute this bond. Dated: AUGUST 15TH, 2012 ATTEST PTM GENERAL ENGINEERING SERVICES, INC. (Corporate Seal) (Principal Name) By: Name: l , Title: ATTEST INTERNATIONAL FIDELITY INSURANCE (Corporate Sea[) (Su a ame) By: Name: PHILIP E. I -in ACT - (Signature of Aft-in-Fact for Surety) (Attach Attorney-in-Fact Certificate) (626)859-1000 (Area Code&Telephone Number of Surety) APPROVED AS TO FORM: CITY 0 UNTINGTON BEACH By ennifer Mc th $lI S�aG ity Attorney Note: This bond must be executed in duplicate and dated,all signatures must be notarized,and evidence of the authority of any person signing as attomeydn-fact must be attached. 277591.1 PERFORMANCE BOND Page 2 of 2 Tel (973) 62 f-7200 POWER OF ATTORNEY : INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEWARK CENTER, 20TH FLOOR NEV\rARK, NtVV JERSEY 07102-5207 KNOWN ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY , a corporation oroanizzd nd rsiitwlo unot the laves of the. Slate of Neal Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organi-_ed and exigtmcl under the 13\vs of the. Sill to, of Fennnysvlvania.havhiq their principal office in the City of Newark, Ne,,Jersey,do hereby constitute and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, MYRNA SMITH, PHILIP E. VEGA Covina, CA. (heir Prue and lawful altorney(s)-in-fact to execute,seal and deliver for and on its behalf as surety,any and all bonds and undertakings,contracts of indemnity and other writings obligatory ul the nature thereof, which are or may be allowed,required or permitted by law,statute,rule, regulation,contract or olhemise, and the execution of such inslrument(s) in pUrsuance of these presents, shall be as Llinding upon the said INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY, as fully and amply, to all intents and purposes,as if the same had heen dUly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed,and naa be revoked, pursuant to and by authority of the By-Laws of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY and is granted under and by authority of the following resolution adopted by the. Board of Direclors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting du�held on the 20111 day of July,2010 and by the Board of Directors of ALLEGHENY CASUALTY COMPANY at a meeting duly held on the 151h day of August, 4000: "RESOLVED, that (1)the President, Vice President, or Secretary of the Corporation shall have the power to appoint,and to revoke the appointments of. Attorneys-in-Fact or agents with power and authority as defined or limited in their respective powers of attorney,and [o execute on behalf of the Corporalion and affix the Corporation's seal thereto, bonds,undertakings, recognizances, contracts of indemnity and other written oblinalians in,he nature(hereof or related thereto; and(2)any such Officers of the Corporation may appoint and revoke the appointments of joint-conlrol custodians,agents for acceptance of process,and Attorneys-in-lac(will)authority to execute waivers and consents on behalf of [Ile Corporation;and (3) the signature ol•any such Officer of the Corporation anal the Corporation's seal may be affixed by facsimile to any power of attorneyy or certification given for the execution of any bond, underl;iking, recognizance, contract of indemnity or olhor written obligation in the na(ure Ihereof or eel od lherelo, such signature and seals when so used whether herelofore or hereafter, being hereby adapted by the Corfuoration as the original signature of sr.rch officer and the original seal of the Corporation,to be valid find binding upon the Corporation with the same force and effect as Ihnugh manuafiy affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed an I—,II('sIed these presents on[Iris '1211)clay of March,2012. A �—� C ` STATE OF NEW JERSEY �a1 County of Essex / off. SISAL _ 1936 rf ROBERT W.MINISTER ✓f `''E 1`� Executive Vice PresidentlChiel Oporalinrg Olfir..l::r (Intc-lmalional Fidelity Insurance Company) and President(Allegheny Ca wally Company) On this; 12th clay of March 2012, before me came the individual who executed the preceding irrsUumerrt, to are peisanally known,arrd, being l y ale duly sworn, saicl he is the therein described and -R.11horized officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CAS IJAI_TY COMPANY; that Iho seals affixed to said instrument are the Corporate Seals of SF11CI Companies;tha[ the said Corfhoiale Seel, area 1"ki::.ir:pholurc:were: duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hr;1reunlo sel my hand :iffixr..d my Official at the City of Newark, New Jersey the clay and year hr sl srbove wrillen. G 0� ` �• ' 49-. Q� _ o r ,�• _. C/BL� Zw, A ra(jTARY uBl_Ic OFI'4f=VV JERSEY My Commission Expire:Mar.27,20I4 ""'^ . CERTIFICATION I, IPna uruJc;raigned office-,r of IhdTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do hc;rr:by cr-.rlil`y Mal I harvl: rnriyr fr:d Ihr lore-going copy of Ilia Power of Attorney,and affidsdvil,and [he ropy of the Sections of the By-Laws of said Corrrpar des as set Inrth in Powc:r of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof,:end of lhr;wh o1r,- of the said originals,and Mal the said Power of Attorney has not been revoked and is now in full force and effeci. u•I-f—ES IM01,1Y vv1-IEREOF, I have hereunto zsra my hand this 15TH day of AUGUST, 2012 MARIA BRANCO,Assislant 3eer-Lary CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles On AUG 15 2012 before me, Monica Blaisdell, Notary Public Date Here Insert Name and Title of the Officer personally appeared Philip E. Vega Name(s)of signets) who proved to me on the basis of satisfactory evidence to be the person(z) whose name(s) iskmsubscribed to the within instrument and acknowledged to me that MONICA BLAISDELL he/3tmMKtcexecuted the same in hisAWAMxauthorized capacitykq& and that by his/JaxftvtDCsignature4on the Commission# 1970845 a - z instrument the person or the entity upon behalf of z ;p, Notary Public-California z z Orange County a which the person(gkacted,executed the instrument. My Comm.Expires Mar 26,2016 J I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official sea). Signature DAk/04X .,Place Notary Seal Above Signature of Notary Public All Purpose Acknowledgement Stateof California County Of Riverside On 1. , before me, Elizabeth H. M. McRae te) (notary) personally appeared, Brian Mendoza (signers) ❑ personally known to me —OR— [3 proved to me on the basis of satisfactory evidence to be the person(20 whose name(o is subscribed to the within instrument and acknowledged to me that het "executed the same in his/h5r*bte7r authorized capacity( and that by his/VrAt*_X signature()on the ELIZABETH H.M. MCRAE instrument th er on( j or the entity upon behalf of Cc�MM.# 1911)816 which the a son ' acted, ® NOTARY PUBLIC-CALIFORNIA P �(� ted, executed the instrument RIVERSIDE COUNTY MY Comm.EXP.oci.29,20t� WITN a S/ hand and official seal (sea)) f (notary signature) OPTIONAL INFORMATION The information below is not required by law.However,it could prevent fraudulent attachment of this acknowledgement to an unauthorized document. CAPACITY CLAIMED BY SIGNER(PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT ❑ Individual ❑ Corporation Officer Title or Type of Document title(s) ❑ Partner(s) Number of Pages ❑ Attorney-In-Fact ❑ Trustee(s) ❑ Date of Document Guardian/Conservator ❑ Other: Other Right Thumbprint of Signer SIGNER IS REPRESENTING: (if required) Name of Person(s) OR Entity(ies) ISSUED IN THREE (3) ORIGINAL COUNTERPARTS �� Bond No. 0601205 i gpR�®® r 1f"A Y MENT.13®ND „_....__..._.._..,v... (LAS®R AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS,the City of Huntington Beach (hereinafter referred to as"City")has awarded to PTM GENERAL ENIGNEERING SERVICES, INC. 5942 ACORN ST. RIVERSIDE, CA 92504 (name and address of Contractor) (hereinafter referred to as"Principal"), a contract("Contract")for the work described as follows: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT (project title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to secure the payment of claims of laborers, mechanics, materialmen, and other persons as provided by law. NOW THEREFORE, we, the undersigned Principal, and INTERNATIONAL FIDELITY INSURANCE COMPANY 233 WILSHIRE BLVD. #820 SANTA MONICA, CA 90401 (name and address of Surety) (a duly admitted surety insurer under the laws of the State of California and hereinafter referred to as"Surety"), as Surety,are held and firmly bound unto City in the penal sum of ONE HUNDRED FORTY ONE THOUSAND ONE HUNDRED FORTY ONE NO/100 dollars, ($141,141.00 ), this amount being not less than one hundred percent(100%) of the total price set forth in the Contract, in lawful money of the United States of America, for the payment of which sum, well and truly to be made, we bind ourselves, and each of our heirs, executors, administrators, successors, and assigns; jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal, his, her, or its heirs, executors, administrators, successors or assigns, or subcontractors shall fail to pay any of the persons named in Section 3181 of the California Civil Code ("Claimants") for all labor, materials or services used or reasonably required for use in performance of the work described in the Contract, or any amounts due under the Unemployment Insurance Code with respect to work or labor performed by any such Claimant, or prevailing wages due and penalties incurred pursuant to Sections 1774, 1775, 1813 or 1815 of the Labor Code, or any amounts required to be deducted, withheld and paid over to the Employment Development Department from the wages of employees of the Principal and Subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to the work or labor performed under the Contract, Surety will pay for the same, in an amount not exceeding the penal sum specified in this bond; otherwise, this obligation shall be null and void. This bond shall inure to the benefit of any of the persons named in Section 3181 of the California Civil Code so as to give a right of action to such persons or their assigns. In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court. 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 worst 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, 277589.1 PAYMENT BOND Page 1 of 2 Bond No. 0601205 extension of time, alteration, addition, or modification to the terms of the Contract, the contract documents or the work thereunder. Surety also waives the provisions of California Civil Code §§ 2845 and 2849. IN WITNESS WHEROF, each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below,that the name of each corporate party being affixed hereto is such 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:AUGUST 15TH, 2012 ATTEST PTM GENERAL ENGINEERING SERVICES, INC. {Corporate Seal} (Principal Name) By: _ Name: Its: A0A ATTEST INTERNATIONAL FIDELJY INSURANCE (Corporate Seal) COMPANY kety Name) Na:me:PRTLI -in- (Signaturemey-in-Fact for Surety) e26 )859 (Attach Attorney-in-Fact Certificate) (Area Code&Telephone Number of Surety) APPROVED AS TO FORM: CITY OF HUNTINGTON BEACH By .z ennifer Mc rath 1 ity At 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 aftomey-in-fact must be attached. 277589.1 PAYMENT BOND Page 2 of 2 Tel (973) 62a_7 200 POWER OF ATTORNEY INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEVVARK CENTER, 20TH FLOOR NEVI+ARK, NEVV JERSEY 07102-5207 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY , a coiporlGon oroanl_ed and ev tino unr, the la-vs of the State of Nev,, Jersey, and ALLEGHENY CASUALTY COMPANY =corporaiion organiz..i and esi;Gng unier Iha of lh,'. Siaie. of Penonysylvania,havmg their principal office in the City of Newark, Nev,, Jersey,do hereby consttute and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, fvll'RNA SMITH, PHILIP E. VEGA Covina, CA. (heir true.and lawful attorneys)-in-fact to execute,seat and deliver for and on its behalf as surety,any and all bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed,required or permitted by law,statute, rule,regulation,contract or othenvise, and the execution of such inslrumenl(s rn pursuance of these presents, shall be as binding upon the said INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY, as fully and amply, to all intents and purposes,as if the same had been duly exec.uled and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed,and may be revoked, pursuant to and by authority of the By-Laws of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY and is granted under and by authority of the following resolution adopted by the. Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duty held on the 20th day of July, 2010 and by the Board of Directors of ALLEGHENY CASUALTY-COMPANY at a meeting duly held on the 151h day of August,2000: "RESOLVED,that (1)the President, Vice President, or Secrelary of the Corporation shall have the power to appoint,and to revoke the,appointments of, Attorneys-in-Fact or agents with power and authority as defined or limited in their respective powers of attorney,and to execute on behalf of the Corporation and affix the Corporation's seal thereto,boncls,undertakings, recognizances, contracts of indemnify and other wrillen obligations in the n ilure thereof or related thereto; and(2)any such Officers of the Corporation may appoint and revoke the appointments of joint-conlrol custodians,agents for acceplancia of process,and Attorneyys-in-tact with authority to execute waivers and consents on behalf of the Corporation; and (J) the signature oI any such Officer of the; corporaiion and the Gorporalion's seal may be affixed by facsimile to an power of attorney or certification given for the execution of any bond,undertaking, recognizance, contract of indemnityor other written obligation in the nature thereof or related thereto, such signature and seals when so used whr,the:r herelofoie or herealler, being hereb adopted by the Corporalion as the original signature of such officer and the original seal of Iho Corporation, to he valid and binding upon the Corporation wits the sarria force and Off(-Cl as Ihnuph manually affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executec an rallesh:d These presents on this 1211)clay of March,2012. 1C Y r�h�;ur�z ra /� ,'� STATE OF NEW JERSEY f GC?, Count of Essex a aye y SEAL _5 1936 - `` t�' ROBERT W.MINISI-ER Executive Vice Prosidonl/Chief Ohoralin J Officer , +F rfg (International Fidelily Insurance (ornpaoy) a.nd President(Allegheny casually Gonnp<unY) On this 12th clay of March 20,12, before me came the individual who executer) the preceding insUunnerut,to one personally known,arid, hexing by one duly sworn, said lie is the therein described and authorized officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUAL]Y COMPANY; that flee seals affixed to said inslrumenl are the Corporate Seals of said Companies;that the said Corporate seals and his 5irl1laIL1rc were: dUly allixi-A by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto s,ct my hand riffixr-rl my Offici l at the City of Newark,New Jersey the clay and year lu'sl:above wrillen. ty�Y VA,-� 410- "!J B�\P.-',(u A(NOTARY PIJBI-IC OF 11EVV JERSEY �4�' My Cornmissiorr Expires Mar.27.201 1 of- �!L`N s "` 1` CERTIFICATION 1, Ifn ururler.Jgned officer of INTERNATIONAL FIDELI"Y INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do l rere:by c:r-:dil`y Ilnal I he:ever cnriil-r,rcd the lomgoing copy of the Powr--r of Attorney and affirl ivil,and the ropy of the Sections of the By-Laws of;,,id Cornpanirs as era lorth in Pow(--:r of Altorney, will)thr originals on file in the home office of ;air)cornpanics, and that the same are corrrcl Iranscripts thereof,and of tlw.-wholr of tine said originals, and Thal the said Power of Attorney has not,br;en revoked and is now in full force and effect. IN TESTIMONY WHEREOF. I havr_• hereunto set my hand Ihis 15TH day of AUGUST, 2012 MARIA BRAtNCO,Assilant�r rrclerry CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Los Angeles On AUG 152012 before me, Monica Blaisdell, Notary Public Date Here Insert Name and Title of the icer personally appeared Philip E. Vega Names)of Signer(F) who proved to me on the basis of satisfactory evidence to be the person(i) whose name(S) is (subscribed to the within instrument and acknowledged to me that MONICA BLAISDELL hel3tnOW(executed the same in hisDWAIW 6Kauthorized Commission# 1970845 z capacity and that by his&xof rjxsignature0Won the Notary Public-California zD instrument the personft or the entity upon behalf of z `�Y% Orange County which the person(aj(acted, executed the instrument. My Comm.Expires Mar 26,2016 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official sea?. /� ` Signature F U Place Notary Seal Above Signature of Notary Public All Purpose Acknowledgement Stateof California County OfQ Riverside On _ Owl( I/ , before me, Elizabeth H. M. McRae (date) (notary) personally appeared, Brian Mendoza (signers) ❑ personally known to me —OR— [3 proved to me on the basis of satisfactory evidence to be the person(s)whose name(ois subscribed to the within instrument and acknowledged to me that he/sheYf"executed the same in hisfh0jrAb%KT authorized ELIZABETH H.M. MCRAE capacity0ask and that by his/hWMXX signature(-S) on the Comm.# 1910816 instrument thie person(.9)or the entity upon behalf of NOTARY PUBLIC-CALIFORNIA N which the p rson(4 acted, executed the instrument O � * RIVERSIDE COUNTY 1 :e. MY Comm.UP.OCT.29,2011� 3... ^� W11 NES. (seal) y hand and official seal C (notary signature) OPTIONAL INFORMATION The information below is not required by law.However,It could prevent fraudulent attachment of this acknowledgement to an unauthorized document. CAPACITY CLAIMED BY SIGNER(PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT ❑ Individual ❑ Corporation Officer Title or Type of Document title(s) ❑ Partner(s) Number of Pages ❑ Attorney-In-Fact ❑ Trustee(s) Date of Document ❑ Guardian/Conservator ❑ Other: Oth er Right Thumbprint of Signer SIGNER IS REPRESENTING: (if required) Name of Person(s)OR Entity(ies) Su '' INSURANCE AND INDEMNIFICATION WAIVER HunSn Beach MODIFICATION REQUEST 1. Requested by: Eric Charlonne 2. Date: 8/24/12 3. Name of contractor/permittee: PTM General Engineering Service, Inc. 4. Description of work to be performed: I Installation of curb ramps and a traffic signal modification 5. Value and length of contract: $141,141.00 - 50 working days 6. Waiver/modification request: Allow for a $10,000 general liability deductable 7. Reason for request and why it should be granted: To allow for work to proceed and the contractor has retention funds that can be used for the deducible if needed. 8. Identify the risks to the City in approving this waiver/modification: None Department Head Signature Da e: APPROVALS Approvals must be obtained in the order listed on this form. Two approvals are required for a request to be granted. Approval from the City Ad inistrator's Office is only required if Risk Management and the City At ey's agree 1. �Risy Management (� t Approved ❑ Denied ,1Z, ftQature Date 2. City Attorney's Office ')--YU proved ❑ D nie ignature Date 3. City Manager's Office 9 Approved ❑ Denied ' 12— rlSignature Date If approved, the completed waiver/modification request is to be submitted to the City Attorney's Office along with the contract for approval. Once the contract has been approved, this form is to be filed with the Risk Management Division of Human Resources Insurance Waiver Form 8/24/2012 8:15:00 AM ATE A CERTIFICATE OF LIABILITY INSURANCE D08/14/2012 ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTAPRODUCER LICENSE NO. 0637431 NAME: PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES PHCO"o Ext: (714)779-6999 ac No): (714)779-6903 (AI1290 N. HANCOCK ST., SUITE 210 E-MAIL ADDRESS: P.MCRAE@SBCGLOBAL.NET ANAHEIM HILLS, CA92807 INSUREII AFFORDING COVERAGE NAIC# INSURERA:JAMES RIVER INSURANCE COMPANY 12203 INSURED INSURERB: CENTURY NATIONAL INSURANCE CO 26905 INSURERC: SCOTTSDALE INSURANCE COMPANY 41297 PTM GENERAL ENGINEERING SERVICES INC. INSURERD: FIRST NATIONAL INSURANCE COMPANY 24724 5942 ACORN STREET INSURER EBARRET BUSINESS SERVICES(BBSI) 2246 (SIP) RIVERSIDE CA 92504 INSURER F COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MMIDD/YYYY A GENERAL LIABILITY 00053260-0 05/11/201205/11/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY X X DEDUCTIBLE: $10,000/ DAMAGPREEMISToR NT.E'Dence $ 100,000 CLAIMS-MADE � OCCUR OCCURRENCE IVIED EXP(Any one person) $ X XCU/OCP PERSONAL&ADV INJURY $ 1,000,000 X EBL: $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY BAP0175004 02/09/2012 02/09/2013 E°COMBID LIMIT 1,000,000 X ANY AUTO X X BODILY INJURY(Per person) $ ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS x NON-OWNED PROPccERTY DAMAGE $ AUTOS Per aident X HIRED PHY. $ C UMBRELLA LIAB XLS0082177 05/11/2012 05/11/2013XoccuR EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE UNDERLYING POLICIES: AGGREGATE $ 10,000,000 X DED I I RETENTION$ NIL GL&AL PROD>COMP/OPS $ 10,000,000 E WORKERS COMPENSATION 2246 11/18/201111/19/2012 X I WCSTATU- OTH- AND EMPLOYERS'LIABILITY LIMITSORY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N X E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? a N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 PROPERTY& INLAND 01-CI-242900-4 07/10/20107/10/201 $1:000 E UTIBusBLEPEROC Property $1,000 DEDUTIBLE PER OCCURRENCE D MARINE 2 3 Equipment Breakdown Coverage Included Contractors Equipment(90%Coinsurance)$123,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS,OFFICIALS,AGENTS,REPRESENTATIVES,EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT. INSURANCE AFFORDED BY THE COMMERCIAL GENERAL LIABILITY POLICY FOR THE BENEFIT OF THE ADDITIONAL INSURED IS PRIMARY INSURANCE AS RESPECTS ANY CLAIM,LOSS OR LIABILITY CAUSED IN WHOLE OR IN PART BY THE NAMED INSURED(S)OPERATIONS,AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED EXCESS AND NON-CONTRIBUTORY. *SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF,A 30 DAYS WRITTEN NOTICE WILL BE ISSUED. RE:CC-1402;SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT;PTM JOB NO P12-12 CERTIFICATE HOLDER CANCELLATION CITY OF HUNTINGTON BEACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2000 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HUNTINGTON BEACH, CA 92648 AUTHORIZED REPRESENTATIVE �y ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD INSURED: PTM GENERAL ENGINEERING SERVICES INC. INSURANCE COMPANY:JAMES RIVER INSURANCE COMPANY POLICY NO:00053260-0 POLICY PERIOD:5/11/12-5/11/13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY LIMITATION - AMENDED AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS COMBINED LIABILITY POLICY SECTION III—LIMITS OF INSURANCE-The General Aggregate Limit applies separately to each"Project"of the Named Insured. Notwithstanding the application of the General Aggregate Limit to each"Project" of the Named Insured, under no circumstances will we pay more than $10,000,000 for all claims under this policy that are subject to the General Aggregate limit. For the purpose of this endorsement, the following definition is added: "Project" means all work done by you or on your behalf, away from premises owned or rented to you,to complete an individual bid or negotiated contract to provide services for a specified period of time. Multiple jobs, work orders, purchase orders, or work done at multiple"locations" under one contract are not separate"projects"within the meaning of this coverage. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT; PTM JOB NO P12-12 AP5012US 12-03 Page 1 of 1 INSURED:PTM GENERAL ENGINEERING SERVICES INC. INSURANCE COMPANY:JAMES RIVER INSURANCE COMPANY POLICY PERIOD:5/11/12-5/11/13 POLICY NUMBER:00053260-0 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Or anization s : Locations Of Covered Operations CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW P OJECT; PTM JOB NO P12-12 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodilyinjury" or damage" or "personal and advertising injury" "property damage"occurring after: in J y caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equip- ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project(other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations has been completed; or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a prin- cipal as a part of the same project. CG 20 10 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 ❑ INSURED:PTM GENERAL ENGINEERING SERVICES INC. INSURANCE COMPANY:JAMES RIVER INSURANCE COMPANY POLICY PERIOD:5/11/12-5/11/13 POLICY NUMBER: 00053260-0 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Opera- Or Organ izatio n s : tions CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITI NAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT; PTM JOB NO P12-12 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11—Who Is An Insured is amended to include as an additional insured the person(s) or organiza- tion(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 desig- nated and described in the schedule of this endorse- ment performed for that additional insured and included in the"products-completed operations hazard". CG 20 37 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 0 INSURED:PTM GENERAL ENGINEERING SERVICES INC. INSURANCE COMPANY:JAMES RIVER INSURANCE COMPANY POLICY NO:00053260-0 POLICY PERIOD:5/11/12-5/11/13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by"your work'which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT; PTM JOB NO P12-12 AP5004US 11-06 Page 1 of 1 INSURED: PTM GENERAL ENGINEERING SERVICES INC. INSURANCE COMPANY:JAMES RIVER INSURANCE COMPANY POLICY NO:00053260-0 POLICY PERIOD:5/11/12-5/11/13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Or anization s : CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT; PTM JOB NO P12-12 If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AP5031 US O4-10 Page 1 of 1 a CENTURY NAA1 NAIL INSURANCE COMPANY POLICY NO. : BAP0175004 BUSINESS AUTO POLICY - ENDORSEMENT PAGE 1 I CONTRACTORS BROKER NO.s 122800 POLICY PRRIODs Policy covers FROR 12s54 PM ON 02/09/2012 TO 02/09/2013 ENDORSEMROT NO.s 51 I i MWORSMUM BFFSCTIVB DATE s 02/09/2012 FROM 12s54 PM I INSURED: BROKER: j FREEWAY ELECTRIC INC CHAIX & ASSOC INS BROKERS INC PTM GENERAL ENGINEERING SVCS POCBOX 7745 41 CORPORATE PARK STE 310 RIVERSIDE CA 92503 IRVINE CA 92606-5181 i I ADD-L INSURED/WAIVER OF SUBROGATION i i IT IS AGREED THAT INSURANCE AFFORDED BY THE ABOVE POLICY SHALL APPLY TO THE PARTY(S) NAMED BELOW, AS THEIR INTEREST MAY APPEAR BUT SHALL NOT OPERATE TO INCREASE THE LIMITS OF COMPANY'S LIABILITY. WAIVER OF SUBROGATION "THE RIGHT TO SURROGATE AGAINST THE ADDITIONAL INSURED NAMED BELOW IS WAIVED FOR LOSSES PAID WHICH ARISE OUT OF THE OPERATIONS OF THE NAMED INSURED--, FOR WHICH THE NAMED ADDITIONAL INSURED HAS NO INDEPENDENT NEGLIGENCE. I AUTHOR ZED REP ENTATIVE i f( I i ADDITIONAL INSURED i TECH INSURANCE IS PRIMARY AND NON-CONTRIBUTORY WITH RESPECT TO ANY INSURANCE CARRIED BY THE ADDITIONAL INSURED. CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT; PTM JOB NO P12-12 i CN613A WAIVER OF SUBRO (5/99) Date Printed : 02/16/2012 MARICELA SANCHEZ i 1 CENTURY NA OVAL INSURANCE COMPANY POLICY NO. : BAP0175004 BUSINESS AUTO POLICY - ENDORSEMENT PAGE: 1 I CONTRACTORS BROKER NO.; 1228DO POLICY PERIOD; Policy covers FROM 12:54 PM ON 02/09/2012 TO 02/09/2013 ENDORSEMENT NO.; 52 MMOROMONT EFFECTIVE DATE , 02/09/9012 FROM 12154 PM INSURED: BROKER: FREEWAY ELECTRIC INC CHAIX & ASSOC INS BROKERS INC PTM GENERAL ENGINEERING SVCS INC 7745 41 CORPORATE PARK STE 310 RIVERSIDE CA 92503 IRVINE CA 92606-5181 i ADDITIONAL INSURED ENDORSEMENT CH613 5/99 i IT IS AGREED THAT INSURANCE AFFORDED BY THE ABOVE POLICY SEALL APPLY TO THE PARTY(S) NAMED BELOW, AS THEIR INTEREST MAY APPEAR BUT SEALL NOT OPERATE TO INCREASE THE LIMITS OF THE: COMPANY'S LIABILITY. ANY ADDITIONAL INSURED LANGUAGE ON A CERTIFICATE OF INSURANCE IS VOID. I The additional insured named below is only an insured for liability which is the result of an act or omission of the "NAMED INSURED" of the policy and shall have no coverage under this endorsement or the policy for its own acts or omissions, those of its agents or employees, or those of any other person or entity for which it is vicariously liable, save for acts of omissions of the "NAND INSURED" of the policy. Further, any insurance provided by this endorsement shall be excess insurance to all other insurance available to any person or entity who becomes an insured by reason of this endorsement whether the other insurance be primary or excess and whether or not the other insurance be collectible. Ia the r... event the other insurer has a duty to defend any person or entity added to our policy by reason of this endorsement, we will have no duty to defend that person or entity however, we may elect to do no, and, if we do, we will be entitled to the rights of any person or entity we do defend against the other insurer. i y Authori d Repr tative E f 1 ADDITIONAL INSURED CITY OF HUNTINGTON BEACH,ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED. RE: CC-1402; SAFE ROUTES TO SCHOOL GOLDEN VIEW PROJECT; PTM JOB NO P12-12 Date Printed : 02/16/2012 MARICELA SANCHEZ August 15, 2012 f3f3sl A Human Resowce Mam pment Company PTM GENERAL ENGINEERING SERVICS 5942 ACORN ST RIVERSIDE, CA 92504-1040 Re: Barrett Business Services, Inc. ("BBSI") Letter of Self-Insurance for Workers' Compensation Coverage As the named addressee of this Letter, your company's required workers'compensation coverage is provided through BBSI's state approved Self-Insured Workers'Compensation Plan by way of your co-employment contract with BBSI. BBSI's California customers can also verify BBSI's state certification at http://www.dir.ca.gov./SIP/sip.html; next, click on"Self Insured Employers";then"Rosters"; then scroll down to Barrett(the list is alphabetical by company name). Additional information is as follows: Self Insurance Certification Number: California: 2246 Oregon: 1068 Washington: 706, 116 Delaware: 152 Maryland: 11365 Colorado: 463 Other Comments (place an "X" if applicable): Waiver of Subrogation: BBSI and PTM GENERAL ENGINEERING SERVICS agree to waive their right of subrogation for the benefit of: City of Huntington Beach at CC-1402; Safe Rte to School Golden View Project PTM Job#P12-12 Named"Letter Holder": City of Huntington Beach 2000 Main St Huntington Beach, CA 92648 Other: Coverage Effective Dates: 11/19/11 through 11/18/12; Barrett Business Services will notify City of Huntington Beach 30 days in advance of a cancellation of coverage for PTM. Additionally, BBSI's self-insured program is further supported by an excess workers'compensation insurance policy with National Union Fire Insurance Company of Pittsburgh, PA. Copy of certificate is available upon request. For additional information, please contact your local BBSI office at: (909)890-3633 . Very truly yours, Michael L. Ellch BBSI Office: SAN BERNARDINO President and Chief Executive Officer doc:LOSI-2 8100 HE Parkway Drive,Suite 200 Vancouver,Washington 98662 800.494.5669 360.828.0700 Fax 360.828.0701 www.barrettbusiness.com PARTNERS IN PROFITABILITY l City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachea.gov FF8�17 1969 Office of the City Clerk 8 Joan L. Flynn, City Clerk September 6, 2012 PTM General Engineering Services, Inc. Attn: Brian Mendoza 5942 Acorn St. Riverside, CA 92504 Re: Safe Routes to School/Golden View Elementary School — CC-1402 The City Council awarded the bid to your company for the above referenced project. Enclosed is a copy of the executed contract with the City of Huntington Beach. A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds. In addition, the following item must also be on file, with this office before the City can release any retention funds: A warranty bond guaranteeing the final amount of work and materials for one year. If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted. Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517. Sincerely, ?Jn L. Flynn, C M C City Clerk JF:pe Enclosures: Copy of Contract including Proposal Copies of insurance/bonds Contractor's Certificate Certificate of Compliances Bid-,Bond (original) 4Y16h n,0ii bnt *cJa@andA Waitakere, New Zealand Council/Agency Meeting Held: Deferred/Continued to: g.App p,ved ❑ Conditionally Approved ❑ Denied " Y City rl 's -gnat r Council Meeting Date: August 20, 2012 Department I Number: PW 12-047 CITY OF HUNTINGTON BEACH REQUEST FOR CITY COUNCIL ACTION SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Travis K. Hopkins, PE, Director of Public Works SUBJECT: Approve plans and specifications, award and authorize execution of a Construction Contract in the amount of$141,141 to PTM General Engineering Service, Inc. for Safe Routes to School Project in the vicinity of Golden View School; and, authorize change orders not to exceed fifteen (15) percent, CC-1402 Statement of Issue: On July 19, 2012, bids were opened for the Safe Routes to School improvements in the vicinity of Golden View School (CC-1402). City Council action is requested to award the contract to PTM General Engineering Services, Inc., the lowest responsive and responsible bidder. Financial Impact: Funds in the amount of $200,000 are available in Safe Routes to School, Traffic Improvements, Account No. 87890006.82700 and funds in the amount of $24,905 are available in Gas Tax Account No. 20790006.8200. Recommended Action: Motion to: A) Declare the apparent low bid from Rakan, Inc., as non-responsive; and, B) Accept the lowest responsive and responsible bid submitted by PTM General Engineering Services, Inc., in the amount of $141,141.00; and, C) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney; and, D) Authorize the Director of Public Works to execute change orders not to exceed a total of 15 percent of the contract construction costs. Alternative Action(s): Reject all bids and provide staff with alternative direction. Item 4. - 1 HB -49- REQUEST FOR COUNCIL ACTION MEETING DATE: 8/20/2012 DEPARTMENT ID NUMBER: PW 12-047 Analysis: In July 2010, City staff, in conjunction with the Ocean View School District, applied for a grant for traffic safety improvements in the vicinity of Golden View School under the Safe Routes to School program. The grant was approved and the State authorized funds in January 2011. The goals of the Safe Routes to School program include facilitating the planning, development and implementation of projects that improve safety in the vicinity of schools. These projects will enable and encourage children to walk and bicycle to school and make walking and bicycling a safer and more appealing lifestyle choice. The project includes the installation of east-west left turn arrows at the intersection of Slater Avenue and Goldenwest Street, which is a major crossing point for students from both Golden View School and Mesa View Middle School. The installation of the left turn arrows will eliminate the conflict between the left turning vehicles and the pedestrians. Also included are curb ramp installations on the local streets near Golden View School along with signing and striping improvements. A complete set of plans and specifications are available for review at the Public Works counter during normal business hours. Bids were opened publically on July 19, 2012, and are listed in ascending order: Bidder Submitted Bid 1 Rakan, Inc. $130,590.00 2 PTM General Engineering Service, Inc. $141,141.00 3 California Professional Engineering, Inc. $145,483.20 4 Nobest, Incorporated $153,000.00 5 1 J.F.L. Electric, Inc. $186,007.00 The bid from Rakan, Inc. was non-responsive due to apparently inaccurate responses to critical elements contained in the bid package. These inaccuracies were deemed significant enough to warrant disqualification of the bid and the bidder was promptly notified of the decision. The engineer's estimate for the bid items was $160,000. The total estimated cost for this project is $224,000 which includes the City's direct purchase of all major equipment. This practice ensures consistency of equipment among the traffic signals and street lighting maintained by the City. Direct purchase also provides the added benefit of reduced costs to the City due to elimination of contractor mark-ups, typically in excess of 20 percent on this type of equipment. Staff is requesting that the Director of Public Works be given authorization to approve change orders on this project up to 15 percent of the construction cost rather than the standard 10 percent. The request equates to a 10 percent contingency based on the total of the construction contract and the materials purchased by the City. This authorization will provide xB -49- Item 4. - 2 REQUEST FOR COUNCIL ACTION MEETING DATE: 8/20/2012 DEPARTMENT ID NUMBER: PW 12-047 the added flexibility needed to complete a typical construction project yet still be consistent with the intent of the 10 percent limit. Public Works Commission Action: The Public Works Commission recommended this project on February 15, 2012, by a vote of 5-0-2. (McGovern and Spencer absent) Environmental Status: The project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c). Strategic Plan Goal: Improve the City's infrastructure Attachment(s): 1. Project Location Ma 2. Proposed Improvements Item 4. - 3 HB -50- ATTAC H M E N T # 1 tad .. 1. Item a. - a BOLSA AVE. Q Mc FADDEN AVE. U � � z in EDINGER AVE. PROJECT AREA z o o z HEILm a a a 3 AVE. m o 3 z TRAFFIC SIGNAL Q ¢ z w p MODIFICATION N WARNER iR p (L ca SLATER EAVE. 405 BOLSA C►ICA VISTA WETLANDS TALBERT AVE. GOLDEN VIEW LEMENTARY SCH00 9 ELLIS AVE. GARFIEL AVE. N (�YORKTOWN AVE. 3 c0gsT ADAMS AVE. PACIFIC �'Qq �%K cF INDIANAPOLIS AVE. z J ATLANTA � z = AVE. = z M m HAMIL ON m AVE. BANNING OCEAN AVE. PROJECT LOCATION MAP N.T.S. SAFE ROUTES TO SCHOOL—GOLDEN VIEW SCHOOL PROJECT AREA CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS TRAFFIC ENGINEERING ATTACHMENT 1 Item 4. - 5 HB -52- ATTACHMENT #2 WARNER AVE. RETAIL CENTER NTS WRENFIEW DR. ROOK DR. 3 cm 3 � mm" CR. Nom DR. FT TucANA aR. 3 � RKILWDAC4R. CAPSTONE DR. oOLDEl1 VIEW � ' S%=L FEW*= 9 RENNM CR. 3 C � U W KIRKLUND CR. BAKEp DR. O[j L u FO SNEENLYN DR. WXMTTAN OR. U rw earn DR. ---T---IFTI SPKSTARD CR, SLATER AVE. ®p NIS S 0= EXISTING RAMP ®= PROPOSED RAMP IMPROVEMENT �= PROPOSED TRAFFIC SIGNAL MODIFICATION SAFE ROUTES TO SCHOOL—GOLDEN VIEW SCHOOL PROPOSED IMPROVEMENTS CITY OF HUNTINGTON BEACH DEPARTMENT OF PUBLIC WORKS ATTACHMENT 2 Item 4. - 7 HB -54- PROOF OF PUBLICATION The AGENCY will deduct Project Descripfion: STATE OF CALIFORNIA) 5% retention from all The project consists pri- progress payments. The marily of modifying an SECTION Contractor may substi- existing traffic signal, SS. NOTICE INVITING SEALED tute an escrow holder the installation of curb surety of equal value to ramps and signing and COUNTY O F ORANGE ) BIDS the retention in. actor- striping improvements. I forfhe dance with the provi- • The contract shall al- Safe Routes to School sions .of the California low the Contractor 50 CC No.1402 Government Code, Sec- working days to com- in the ' tion 4590. The Contrac- plete the contract. am a citizen Of the,United States and a -CITY OF HUNTINGTON for shall be. beneficial • The engineer's es- BEACH owner of the surety and timate of probable con- s I PUBLIC NOTICE IS shall receive any inter- struction cost for the resident Of the County Of Los Angeles; HEREBY GIVEN that the est thereon. 1, work included in the am over the age of eighteen years and CITY OF HUNTINGTON The AGENCY hereby af- basis of award is BEACH, as AGENCY, in- .firmatively ensures that $120,000.00 not a art to Or Interested In the notice vites sealed bids'for the minority business enter- •The Project Disadvan- p y above stated projects prises will be afforded tage Business Enterprise published. I am a principal clerk of the and will receive such full opportunity to sub- (DBE) goal is 9.04% p p p bids in the office of the mit bids in response to (UDBE [Race Con- HUNTINGTON BEACH city Clerk, Second this notice and will not scious]:.6.64% and DBE Floor,2000 Main Street, be discriminated against [Race Neutral]2.40%). LNDEPENDENT .which was adjudged a Huntington Beach, Cali- on the basis of race, The AGENCY reserves g fornia 92648, up to the color, national origin, the right to reject 'any newspaper of general circulation On hour of 2:00 PM on July ancestry, sex, or reli- or all bids,to waive any g 19, 2012. Bids will be gion in any consider- irregularity and to take September 29 1961 case A6214 and publicly open r the away leading to the all bids under maximum Council Chambers. un- award of contract. ment for a maximum June 11 1963 case A24831 for the less otherwise posted. No bid shall be consid period of60days. > , r+> Copies of the Plans, ered unless it is pre- BY ORDER of the CITY City Of Huntington Beach County Of Specifications, and con--,pared on the 'approved COUNCIL of the CITY OF y g r y tract documents are Proposal forms in con- HUNTINGTON BEACH, Oran a and the State Of CaIlfOrnla. available from the Office formance with the CALIFORNIA,the 6th day g of the Director of Public Instructions to Bidders of September 2011, by . Works, 2000 Main as determined by the Resolution No.2011-68. Attached to this Affidavit is a true and Street, Huntington AGENCY. The bid must Attest: complete CO as was printed and Beach, CA 92648, upon. be accompanied, by a Joan L.Flynn p copy p payment of a $30.00 certified check, cash- CITY CLERK OF THE CITY published On the following date(s): nonrefundable fee if ier•'s check, or bidder's OF HUNTINGTON BEACH piked up, or payment bond made payable to Published H.B. Indepen- of a $50.00 nonrefun- the AGENCY for an dent 6/28,7/5,7112112 dable fee if sent by UPS amount. no less than Thursday, June 28, 2012 ground delivery (bidder 10% of the amount bid. shall pay additional The successful bidder Thursday July 5 2012 costs for special deliv- shall be licensed in ac- f , ery). cordance with provi- Thursday July 12 2012 This is n Davis-Bacon and r the Business , y project and the Federal and Professions Code Regulations will be en- and shall possess a forced.Any contract en- State Contractor's. Li- tered into pursuant to tense at the time of the this notice will incorpo- bid opening. The suc- rate the provisions of cessful Contractor and certify (or declare) under penalty the Federal Labor Stan- his subcontractors will Bards, which are on file be required to possess at, the office of the business licenses from of perjury that the foregoing is true Director of Public the AGENCY. Works, 2000 Main and correct. Street, Huntington Beach,CA 92648. Executed on August 9, 2012 at Los Angeles, California Signature CC-1402 Safe Routes to School- Golden View 7-19-12 Bidder' Addendum AmoUhT B d Bid Rank #1 Cf�G/�vl�rv/i9 ,�,g7eiEsSt��4e- 43 �CEL. T-�eaiFv�,t� ao - r�r3�sT PT J X/ ov SECTION A NOTICE INVITING SEALED BIDS for the Safe Routes to School CC No.1402 in the ®®� ®� CITY. OF HUNTINGTON BEACH ' ® �I PUBLIC NOTICE. ISl ® I��� 1 HEREBY GIVEN that they CITY OF'HUNTINGTON i BEACH,as AGENCY, in vites sealed bids f or'the above stated projects! and will receive such bids in''the office of thei City Clerk, Second! STATE OF CALIFORNIA) Floor,Huntington Main , CaliStreet , Huntington Beach, Cali-� fornia 92648, up to thee, hour of 2:00 PM on'July, ss0 19, 2012. Bids will be! ®���� ®� ®����� publicly open in the, Council Chambersun less otherwise posted..' Copies of the Plans, Specifications, and con-, am a citizen of the United States and a tract documents are; available from the Office of the Director of Publici resident of the County of Los Angeles; I Works, 2000 .Main{ am over the age of eighteen years, and Street, Huntington Beach, CA 92648, upon; payment of a I $30.00' not a party to or interested in the notice' ickedungaor fee it p published. I am a principal clerk of the picked up, or payment of a $50.00 nonrefun-' HUNTINGTON BEACH gable fee l t by UPS ground delivery (bidder shall pay additional INDEPENDENT, which was adjudged a costs for special deliv- ery). newspaper of general circulation on Thisis a Davis-Bacon project and,the Federal September 29, 1961, case A6214, and Regulations`Will be en- forced.Any contract en- June 11, 1963, case A24831 , for the t this into pursuant to notice wilb incorpo- City of Huntington Beach, County of thee Federal Labor Stan- Orange, and the State of California. Bards, w ffs are file at the o office off the Attached to this Affidavit is a true and Director of Public Works, 2000 ,Main complete copy as was printed and Beach,tCA92648.'ngton published on the following date(s): The AGENCY will deduct! a 5% retention from all; progress payments,.The Thursday, June 23, 2011 Contractor may I holder tute an escrow holders Thursday, June 30, 2011 surety, equal value,to' the retention in'accor-' �/ dance with the provi Thursday, July 7, 2011 GovernmenteCodeifoCal �i tion 4590. The Contrac-! for shall be beneficial; owner of the surety and' shall receive any inter- I certify (or declare) under penalty Theest AGEENCNC The AY hereby'af- firmatively ensures that of perjury that the foregoing is true minority business enter- pprises will be afforded nit and correct. u opportunity to ' mit bids in responsea to to ',this notice and will not be'discriminated against on the basis of race,, color, national origin, ancestry, sex, or reli Executed on July 14, 2011 atio i l any considee !ation leading to the at Los Angeles, California `awardofcolirbet. No-bid shall.be;consid- ered unless it is pre- pared on the approved I Proposal forms in con- formance with the instructions to Bidders +as determined by the I AGENCY. The bid must 'be accompanied by a certified check, cash- i ier's check, or bidder's Signature bond made payable to g :the -AGENCY for, an, amount no less than 110% of the amount bid. The successful bidder shall be,licensed in ac= cordance with provi- lions of the. Business land Professions Codel !and shall possess al State Contractor's Li- cerise at the time of the! I bid opening. The suc- cessful, Contractor and his subcontractors will be required, to possess business licenses from the AGENCY. Project Description: The project consists pri- marily of modifying an existing traffic signal, the installation of curb ramps and signing and striping improvements. • The contract shall al- low the Contractor 50 working days to com- plete the contract. • The engjneer's es- timate of probable con- struction cost for the work included in the basis . of award is $120,000.00 •The Project Disadvan- tage Business Enterprise' (DBE) goal is 9.04% (LOBE [Race Con- scious]:6.64% and DBE [Race Neutral]2.40%). The AGENCY reserves the right to reject any or all bids,to waive,any irregularity and to take all bids,under advise- ment -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 2011, by Resolution No.2011-68. Attest: Joan L.Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH Published H.B. Indepen- dent 6/28,7/5,7/12/12 a _D0 =a I #d 61 HA I CJZ CITY OF HUNTINGTON BEACH 2000 Main Street P . O . Box 190 Huntington Beach , CA 92648 LETTER OF TRANSMITTAL Fax (714) 374-1573 Attention: Joan L. Flynn Date: June 21,2012 To: City Clerk's Once Project/C.C.No.: C.C.No. 1402 2000 Main Street Regarding:Safe Routes to School. Golden View School Huntington Beach, CA 92648 ❑ We are sending you: ❑ By Mail ❑ By Fax Mail(Number of pages including this sheet:) ® We are hand delivering: ❑ Attached ❑ Under a separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other: Notice Inviting Sealed Bids Copies. Pa es a Aesctipton , 1 1 1 Notice Inviting Sealed Bids for CC-1402, Safe Routes to School, in the vicinity of Golden View Elementary School. 2 L.3 These are transmitted as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other: Remarks: Per Resolution 2011-68 (adopted on September 6, 2011), the City Council authorized the advertisement of the above Safe Routes to School, Project CC-1402. Please find attached the Notice Inviting Sealed Bids for advertisement on 6/28/12, 7/5/12 & 7/12/12. The bid opening is scheduled for 7/19/12. Please contact me at 374-1628 with any questions you may have. cc: fileCC-1402 By: Z 4Z��� William F.Janusz, Wcipal Civil En ' er SECTION A NOTICE INVITING SEALED BIDS for the Safe Routes to School CC No. 1402 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 PM on July 19, 2012. Bids will be publicly open in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $30.00 nonrefundable fee if picked up, or payment of a $50.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 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 California Government Code, Section 4590. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in SECTION A NOTICE INVITING SEALED BIDS for the Safe Routes to School CC No. 1402 in the CITY OF HUNTINGTON BEACH PUBLIC NOTICE IS HEREBY GIVEN that the CITY OF HUNTINGTON BEACH, as AGENCY, invites sealed bids for the above stated projects and will receive such bids in the office of the City Clerk, Second Floor, 2000 Main Street, Huntington Beach, California 92648, up to the hour of 2:00 PM on July 19, 2012. Bids will be publicly open in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $30.00 nonrefundable fee if picked up, or payment of a $50.00 nonrefundable fee if sent by UPS ground delivery (bidder shall pay additional costs for special delivery). This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incorporate the provisions of the Federal Labor Standards, which are on file at the office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648. The AGENCY will deduct a 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 California Government Code, Section 4590. The Contractor shall be beneficial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY. The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid. The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: The project consists primarily of modifying an existing traffic signal, the installation of curb ramps and signing and striping improvements. • The contract shall allow the Contractor 50 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $120,000.00 • The Project Disadvantage Business Enterprise (DBE) goal is 9.04% (UDBE [Race Conscious]: 6.64% and DBE [Race Neutral] 2.40%). 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 2011, by Resolution No. 2011-68. Attest: Joan L. Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License at the time of the bid opening. The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY. Project Description: The project consists primarily of modifying an existing traffic signal, the installation of curb ramps and signing and striping improvements. • The contract shall allow the Contractor 50 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $120,000.00 • The Project Disadvantage Business Enterprise (DBE) goal is 9.04% (UDBE [Race Conscious]: 6.64% and DBE [Race Neutral] 2.40%). 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 2011, by Resolution No. 2011-68. Attest: Joan L. Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH k.A Ar Prinled by:0602 Patricia Gamin Jun 21,20121 3.03 pm tlGl6 salesserson: QOAttg"' Phone: Ad 35067950 floa�•,AAgfzt�. a .✓. ^a .-,-' are - a-^ -::.y_. ,,>,.:a.... — �: Accbht ttiforttlatiarl Aidfii9ornli --. _ .N F. , RhOIe, ', {714)536-5227 sst rc e: 06-28-12 i? 1 x 158.410, 'u y A City Of Huntington Beach(Parent) 07-12-12 Biile`ul a 15.50 TCN Inch r PO Box 784 � �. w, ,:..•_.�,� .: y. Af , `Ise oris 3 Keyvoni Ratec 8r of Huntington Beach liner r Huntington Beac,CA 92648 I Leg g Ayp Uc 0602 Patricia Gatnino r f r }'.- -=:,ems - t C000070479 13000-Legal Notices tC�silce. $348.75 75 ),Pt�bs� TCN ttBl�rElie1:: City Of Huntington Beach-Clerk's O , $348 FtaCed,by Rebecca Ross �+t r § thm� ,, $348.75 PeJ (714)374-1557 a t A -T iCue nid,sii eta erati�:tig�s.! M1,. A Ad Copy_ SECTION A NOTICE INVITING SEALED BIDS for the Safe Routes to School CC Ne.1402 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, Cali- fornia 92648, up to the hour of 2:00 PM on July 19, 2012. Bids will be publicly open in the Council Chambers unless otherwise posted. Copies of the Plans, Specifications, and contract documents are available from the Office of the Director of Public Works, 2000 Main Street, Huntington Beach, CA 92648, upon payment of a $30.00 nonrefundable fee if picked up, or payment of a $50:00 nonrefund- able fee if sent by UPS ground delivery (bidder shall pay additional costs for special deliv- ery). This is a Davis-Bacon project and the Federal Regulations will be enforced. Any contract entered into pursuant to this notice will incor- porate the provisions of the Federal Labor Standards,which are on file at the office of the Director of Public Works, 2000 Main Street, Hun- tington Beach,CA 92648. The AGENCY will deduct a 5% retention from all progress payments. The Contractor may substi- ,.---_..,_ .....-.-.. --- ad proof pg.1 --- 111,irg S1111 GrLXS`S11FFEP,` 40T Printed by:0602 Patricia Garnino Jun 2l,2012,3:03 prn uiSaleglierson- Ad#35067950 F9, Phone: tute an escrow holder surety of equal value to the retention in accor- dance with the provi- sions of the California Government Code, Sec- tion 4590. The Con- tractor shall be benefi- cial owner of the surety and shall receive any interest thereon. The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in re- sponse to this notice and Will not be dis- criminated against on the basis of race, color, national origin,ancestry, sex, or religion in any consideration leading to the award of contract. No bid shall be consid- ered unless it is pre- pared 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 suc- cessful bidder shall be licensed in accordance with provisions visl ons of the Business and Profes- sions Code and shall possess a State Con- t License Con- tractor's L bens at the time of the id opening. The successful ucc essf u I Con- tractor and his sub- contractors will be required to possess business licenses from the AGENCY, Project Description:The project c onsists pri- marily of modifying an existing traffic signal, the installation of curb ramps and signing and striping improvements. - The contract shall allow the Contractor 50 working days to com- plete the contract. - The engineer's esti- mate of probable con- struction cost for the work included in the basis of award is $120,000.00 - The Project Disad- vantage Business En- terprise (DBE) goal is 9.04% (UDBE [Race Conscious): 6.64% and DBE [Race Neutral) 2.40%). The AGENCY reserves the right to reject any or all bids,to waive any irregularity and to take all bids under advise- ment for a maximum period of 60 days, BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA,the 6th day --- ad proof pg.2 --- k. v z. x� 1 �a Printed by:0602 Pe ftWa Camino Jun 21,2012.3;03 Pm � Phone: kd35067950 Resolution No.2011-68. Attest: Joan L.Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH Published H.B.Indepen- dent 6/28,7/5,7/12/12 --- ad proof pg.3 --- QQJ 402 Safe Routes fo School- Golden View 7-19-12 Bidder Addendum Amount Bid Bid Rank #1 California Professional Engineering Yes $145,483.20 3 JFL Electric, Inc. Yes $186,007.00 5 Nobest Inc. Yes $153,000.00 4 PTM General Engineering Services Inc. Yes $141,141.00 2 Rakan Inc. Yes $130,589.00 1 UNSUCCESSFUL BIDS CC- 1402 Safe Routes to School — Golden View f City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 - (714) 536-5227 ♦ www.huntingtonbeachca.gov a ��Bii eoe a� office of the City Clerk 0 ` Joan L. Flynn, City Clerk October 15, 2012 California Professional Engineering, Inc. 929 Otterbein Ave., Unit E La Puente, CA 91748 RE: Safe Routes to School — Golden View— CC-1402 Enclosed please find your original bid bond for CC-1402. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe enclosure Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand 201 lf,' 19 F i ? D� From: California Professional Engineering,, Inc 929 Otterbein Ave, Unit E La Puente, CA 91748 r. x t r City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 sir tk,.. a�y Sealed Bid For: July 19, 2012 @ 2PM Project Name: ry' Safe Routes to School- Golden View Elementary School 41 t , P Grp B � SECTION C PROPOSAL. for the Safe Routes to School In the vicinity of Golden View Elementary School CC No. 1402 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 1 y 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 ' r.S We mount of$ �J�+ which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check",or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. _ Date Received i nature `1 1 12 C-2 ti 1 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Item :Estimated --=Item} Unit Ince-N-J Extended Amount ' v 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Furnish Construction Surveying and Monument Preservation. $— $ 17 Per L.S. 3 1 L.S. Furnish Project Traffic Control. �� 2 Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $ tS, e6S 2—(o Z) Per L.S. 5 1 L.S. Modify Traffic Signal at Goldenwest Street and Slater Avenue (Excludes AC Surface $551 $ Grinding). Per L.S. 6 1 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case A, and Per Typical Section at New $ a, 1 3 $ Ramps Adjacent to AC Paving Detail. Per EA. 7 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B, and Per Typical Section at New $ $ (a Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 y i Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Item Estimated Item Unit Price ' Extended Amount No . Quantity 8 14 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case C, and Per Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 9 1470 S.F. Surface Grind Existing A.C. to a Depth of 0.17 FT and Construct New 0.17 FT Surface Coat Over © $ A Existing Asphalt Concrete. Per S.F. Total Amount Bid in Figures: Total Amount Bid idd in Words: M ce oweq 6bt— Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 ti LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Bid Name and Address of Subcontractor State Class Dollar % of Item(s) License Amount Contract Number . g00 A l Coronck, CA drancJe CovnN `F ( �b 3 N - pixl-e v) S:t% 3/4 (oOCI -3 2 `S� g53. O rar C a`oS� By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 1 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the tKate t of California that the foregoing is true and correct and that this declaration is executed on�] at L(� �/�QV�� , City State being first duly sworn, deposes and stays that he or she is of�fltfuy'h j cl `fr�\'Onci1 � Iknfi ev' " '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. C�i�l n101 � SSI ' Gl �h`��rl�i Name of Bidder (h C Signature of Bidder 922 0±:�abOn NWA) :iE Address of Bidder Lq PUMq) CR 9 1`�� C-4 t 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 Safe Routes to School in the Vicinity of Golden View Elementary School, CC 1402, (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. Contracto 1y)C By i'r�s�de� Title Date: Z C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes W<O If the answer is yes, explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 t t 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. k hlG V­�-c� & 'C)V)CA 1ne���kc Contractor Y�c - �V> -- By Title Date: 2- C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: iono C . Bidder Name T— qZq U nl + E Business Address City, State Zip Telephone Number A , C( 0 State Contractor's License No. and Class b Original lbate Issued sly I �� Expiration Date The work site was inspected by �'Mf our office on U , 201?. The following are persons, firms, and corporations having a principal interest in this proposal: C-s The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. ��Itrn� c� �r �Ss 1 `iCili �C�rh�� IBC._ Company Name i 1 Signature of Bidder Printed or Typed Signa e Subscribed and sworn to before me this day of , 201_ . NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. ecA5-p Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-9 t FFF--CALIFORNI[A ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Los Angeles On before me, Olivia Chea, Notary Public\)4� , (Here insert name and title of the officer) personally appeared Van Nguyen who proved to me on the basis of satisfactory evidence to be the person(s)whose name is subscribed to the within instrument and acknowledged to me that hek4e-y executed the same in is authorized capacityfte&�, and that by(@s signature(s) on the instrument the persono), or the entity upon behalf of which the personks)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. 0LIVIA CH�EA WITNESS m and o cial seal. N Comm.# 1931793 '^ NOTARY PUBLIC-CALIFORNIA aJ LOS ANGELES COUNTY MY Comm.UP.APR�8,20155 (Notary Seal) w•..+o..a•+.w Signature of Notary Pub' ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must a properly completed and attached to that document. The only exceptio 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 (Title or description of attached document) verbiage does not require the notary to do something that is illegal for a notary in California ri.e. certifying the authorized capacity of the signer). Please check the document carefully for proper notarial wording and attach this form ifrequired (Title or description of attached document continued) • State and County information must be the State and County where the document Number of Pages Document Date signer(s)personally appeared before the notary public for acknowledgment. • Date ofnotarization must be the date that the signer(s)personally appeared which must also be the same date the acknowledgment is completed (Additional information) • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your tide(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. CAPACITY CLAIMED BY THE SIGNER #e/she/#ieyr is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual(s) information may lead to rejection of document recording. ❑ Corporate Officer • 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 (Title) sufficient area permits,otherwise complete a different acknowledgment form. s • Signature of the notary public must match the signature on file with the office of El Partner ( ) the county clerk ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. El Other Indicate title or type of attached document,number of pages and date. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the tide(i.e.CEO,CFO,Secretary). • Securely attach this document to the signed document 2008 Version CAPA v12.10.07 800-873-9865 www.NomryClasses.corn 929 Otterbein Ave., Unit E La Puente, CA 91748 Ph: (626) 810-1338 Fax: (626) 810-1322 www.cpengineeringinc.com liforn a PrOWSS- ao --En ineer n , Inc. %.o Job References PROEM: Installation of Street Lighting on Mountain Street from Craig Avenue to Martelo Avenue and Other Locations Amount:$329,840 Owner: City of Pasadena Project Manager: Christine Hernandez Contact Phone#: (626) 744-4304 Status: Completed _ Signal Upgrade Project at the Intersection of Newhope Street/Warner Avenue and Heil Avenue/Euclid Street Amount:$331,825 Owner: City of Fountain Valley Project Manager:Alex Salazar Contact Phone#: (714)593-4516 Status: Completed Traffic Signal System Upgrade Phase I-IV Amount: $226,965 Owner: City of Santa Ana Project Manager: Ed Torres Contact Phone#: (714) 647-5018 Status: Completed Traffic Signal System Upgrade Phase V-VIII Amount: $292,175.99 Owner: City of Santa Ana Project Manager: William Albright Contact Phone#: (714) 647-5029 Status: Completed Traffic Si>;i al'Installa6-n at Main Street and Citron Street July 19, 2012 Page 2 Amount: $273,994 Owner: City of Corona Project Manager: Clint Herrera Contact Phone#: (951) 739-4888 Status: Completed *Additional references available upon request (For federally funded projects; use this following page) 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): i i� Will ensure that 10%of all new hires as a result of this project shall meet all requiremnents 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: �� m�g sly hGl� q l►�ed21f Itng 1 i�G . Contact Person: �an N Contact Phone: Signed: Date: Z *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 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: J � Contact Phone: CP Signed: Date: 2- *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE AN END ORSEMENT AND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder CIi XN a ?_MV2,S10V,"1 & Iw?eY t \Qj �h C. ,proposed subcontractor ,hereby certifies that he has has not___,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required -.by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts,which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a- report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. i i i i t !i I i i t i t t Page 12-79 LPP 01-04 C-12 March 15,2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376,Stats. 1995),the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has_,has not`�!been convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof,as referred to in Section 10285,1. Note: The bidder must place a check mark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal-prosecution, Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162,the Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No v if the answer is yes,explain the circumstances in the following space. f i I 1 i C-13 1 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board_ Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. C-14 I i 4 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Sectio 7106J To the CITY/COUNTY of L('I& .I CS DEPARTMENT OF P UMIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company, association,organization, or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding; that the bidder has not in any manner,directly or indirectly,sought by agreement,communication, or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead, profit,or cost element of the bid price,or of that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof,or divulged information or data relative thereto,or paid, and will not pay,any fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15,2W1 i w . Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,and manager: • Is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any federal agency; • Has not been suspended, debarred,voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending;and • Has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15,2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any .person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any federal contract, grant,loan,or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. Page 12-85 LPP 01-04 C-17 March I5,2U01 y f i Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE MS 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: F1a. contract A ❑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 r quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity S. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier ,if known ,, I Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name(Deseri tion: N CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: \Q & 0 /p, 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) -vl /� �'J /�_' (attach Continuation Sheet(s)if necessary) 11, Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) S actual planned a. retainer t�J b. one-time fee 12. Form of Payment(check all that apply): c. commission //A� ® a. cash N J d. contingent fee b. in-kind; specify: nature ! e deferred value f. other,specify 14. Brief Description of Services Performed or to be performed and Date(s)of Service,including officer(s),e�mprloyee(s),or member(s)contacted,for Payment Indicated in Item 11: (attach Continuation Sheets)if sary) 15. Continuation Sheet(s)attached: Yes No lI i i 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.1352. This information will be reported to Congress Print Name:_ semiannually and will be available for public inspection. Arry �" { person who fails to file the required disclosure shall be subject Title: to a civil penalty of not less than$10,000 and not more than �1 $I00,000 for each such failure. Telephone NofO')-W ''31U— k, S Date: 6 ZL Authorized for Local Reproduction Federal Use Only. Standard Form-LLL Standard Form UL Rev.09-12 97 Page 12-87 LPP 01-04 C-18 March 15,2001 t EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient,at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. S. 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. S. 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-90-00 1." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other,specify nature. Page 12-88 March 15,2001 C-19 LPP 01-04 i i Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheets) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. SF-LU,histrueuow Rev.06-04-90<HND[Fo i Page 12-89 LPP 01-04 C-20 March 15,2001 i t Local Assistance Procedures Manual Exhibit 15-Gl Local Agency Bidder UDBE Commitment(Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: LOCATION: PROJECT DESCRIPTION: s V-(' �j �J SC h TOTAL CONTRACT AMOUNT:$ J • U h ID DATE: t 2- IDDEWS NAME: 'Cnkipyloka F S�cwi m e'G r tv)Q CONTRACT UDBE GOAL: v' I Y CONTRACT ITEM OF WORK AND DESCRIPTION Cert.No.of UDBE NAME OF UDBEs DOLLAR AMOUNT ITEM NO. R SERVICES TO BE AND EXPIRATION (Must be certified on the date bids UDBE SUBCONTRACTED OR MATERL4I.S DATE are opened-include UDBE OBE PROVIDED address and phone number S CGI WOt' 312 "1 61 L -40 v IQV Lld Inc. R >-Ll OV70 O C For Local Agency to Complete: l j I Total Claimed Local Agency Contract Number. Participation Federal Aid Project Number. % Federal Share: Contract Award Date. Local Agency certifies that all information is complete and accurate. Sidergratu Print Name Signature Date 2' CO 2 LxKW Agency Representative Da (Area e)Tel.No. Area Code Telephone Number: �'�� For Caitrans Review: Person to Contactt a Type or Print) Print Name Signature Date Caltrans District Local Assistance Engineer Loca1AgwcyBidda-UDBEC*=a&n at(Rev 3109) Distribution: (1)Copy—Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE) within 15 days of award. Failure to send a copy to the DLAE within 15 days of award may result in do-obligation of funds for this project (2)Copy—Include in award padcage to Caltrans District Local Assistance (3)Original—Local agency files Page 15-31 LPP 09_xx C-21 March 27,2009 � s Exhibit 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER UDBE COMMITMENT(CONSTRUCTION CONTRACTS) (Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1)Black American; 2)Asian-Pacific American; 3)Native American; 4)Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian-Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name,and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work(who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors'certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including,if the prime is a UDBE,work performed by its own forces. IMPORTANT: identify all UDBE firms being participating in the project regardless of tier. Names.of the First Tier UDBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. Provide copies of the UDBEs'quotes,and if applicable,a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the UDBE,describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts);to determine how to count the participation of UDBE firms. Exhibit 15-G(1)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 Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. Page 15-32 March 27,2009 C-22 LPP 09-Jac r � Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good Faith Effort EXHIBIT 15-11 UDBE INFORMATION—C'OOD )FAITH EFFORTS Federal-aid Project No. Bid Opening Date O '�- The (City/County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third Iowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the"Local Agency Bidder—UDBE Commitment"form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g.,a UDBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder -- UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement mA B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations,etc.): Names of Date of Follow Up UDBEs initial Methods and Solicited Solicitation Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4,2009 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBi?Information-Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was;Wade available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N ) Contract D. The names,addresses and phone numbers of rejected UDBE firms,the reasons for the bidder's rejection of the UDBEs,the firms selected for that work(please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Names,addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: F. Efforts made to assist interested UDBEs in obtaining necessary equipment, supplies,materials,or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: i LA J I i G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms(please attach copies of requests to agencies and any responses received, i.e.,lists,Internet page download,etc.): Page 15-34 ` March 4,2009 LPP 09-xx C-24 I I Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good Faith Effort Name of Method/Date Results Agency/Organization of Contact H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): Lj NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-xx March 4,2009 C-25 Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information(Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs Iisted at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY: !J LOCATION: PROJECT DESCRIPTION: e Sch TIOTAL CONTRACT VOUNT. ID DATE: C IDDER'S NAME: Y n , V •N lvlc . CONTRACT ITEM OF WORK AND DESCRIPTION DBE Cert.No. NAME OF DBEs DOLLAR AMOUNT ITEM NO. OR SERVICES TO BE AND EXPIRATION (Must be certified on the date bids DBE —SUBCONTRACTED OR MATERIALS DATE arc opened-include DBE address O BE PROVIDED and vhone number ��2c eta z -1 CA `mot 2U 3 ti,.e�e .v 1"- . 1.cr P u-en C 1 -7 10i For Local Agency to Complete: Total Claimed Local Agency Contract Number. Participation Federal Aid Project Number. % ederal Share: Contract Award Date: Local Agency certifies that the DBE certification(s)has been verified and all information is complete and accurate. Signs r adder 13 142- int Name Signature Date D'� T (Am Cade)Tel.No. Local Agency Representative Area Code Telc hone Number. �LA n 4 VQ Vet 1'1 Or Caltrans Review: Person to Contact (Pte Typ r Print) Print Name Signature Date Caltrans District Local Assistance Engineer Local Agency Bidder DBE Wormadon(Rev 3109) Distribution: (I)Copy—Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE) within t5 days of contract execution. Failure to send a copy to the DLAE within 15 days of contract execution may result in de-obligation of funds for this project. (2)Copy—Include in award package to Caltrans District Local Assistance (3)original—Local agency files Page 15-32a LPP 09-xx C-26 March 27,2009 i Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BEDDER: The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date.The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work(must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project—including all UDBEs listed on the UDBE Commitment form(Exhibit 15G(1)),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 total DBE 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(2)must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date,Federal Share,Contract and Project Number fields,and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within IS days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. i i i { Page 15-32b March 27,2009 C-27 LPP 09-xx ! I Local ,stance Procedures Manual EXHIJ, - 12-G ' Bidder's List of Subcontractors(DBE and]Yon-DBE) _ BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON-DBE)- PART L Tice bidder shall list all subcontractors(both DBE and non-DBE)in accordance with Section 2-1.05.4 of the Standard Specifications and per Title 49,Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Nam i�/ Phone/ Annual Address/ Fax Gross ]Description of Portion of Work to be Performed cltyt statelP ilp Receipts Name r` ,ASS PQV�,P-nq� Phone [I<$1 million V N �}- qSA)� 3, o� <$5miliion Address 1000 <$10million Ito() Fax < 15 million _ City State VP >$15 million o rvl', CA 9 2 —7 S Name Phone ❑<$1 million `\ CA ,1 OrclhgQ Ct,)A-►Lj 5l-r1rm a) (11�'�3c(— Lg<$5 million Address �{SSO <$10 million Fax <$i5 million _ City StateVp C�� �f°��— >$15 million Name Phone ❑<$1 million <$5 million Address <$io million Fax Cj<$15 million city state zrp >$15 million Name Phone ©<$1 million <$5 million — Address 0<$10 million Fax 0<$15million ------ •---_._�_._.. _ City State Z!P >$15 million Dlstrlbadon:1)Original-Loos]Agency File L Page 12-111 PP 06-06 November 14,2006 + • 1 r 1Nam Phone/ bye: 3 i'� i a ,VL • , +ressA Fox ' ' �t 1 {, Gross1 • Portion 1 + 1 1 1 1 r Performedc z, ryt��t` t>:�♦,iU'¢{ if�� h9j;} t ii•~uta.,_'} . ml3 rid.�i it a�4 „L:{!..L1 a +� Receipts city PENN , TIM I all ■ _ 1 11 I EMT • 11 'tij+1y��II.�-�1�1f�l��•�1� �t+����{�,��Ii��i�':1 W��fl��'k;��� ■ , l �1 rt, Jt sir +tl v,l ; c, 14; r ■ 1 ♦ N ��i AaF,�y��IL�i4�r}ti4r lrNll r�(r/t ■��F7 FFp�i}�� -f �+vr`taC'ttt ipi,!(1rt'S,ri �a�4 y g ■ ��^�^'r�'°'�5h4u^'c�,� 6,fj;lp (M1 t,�,n9 ts� FO 175. ��a�{'a,.)�It�.ell�Pt,r�3+'� i',hl � r'T t'a�• f � ■ 1 T rq1 h ti ! nyS ■ . ''� {�<i�b�ia�r 1��t V{r 1�"' t II?�114 r,� } ■ 1 . ?fit�°lpif' °n �1h���,ey{,}h'r�q{ { , rrr .Y,� 'j ttwi ■ ♦ �T' SDI �YTi VlJ <<rtt4rrrrlrlt�c ■ �trv'�-�,So�t�tlli�'�^L ?l�i rMgdrfi�li'4���'•t,�nt� 1 1 I' City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For Safe Routes to School, Golden View — CC 1402 July 12, 2012 Notice To Al! Bidders Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) The following shall be added to Section 6-7, Time of Completion of the Special Provisions. At the intersection of Golden View Lane and Norino Drive, curb ramp construction activities shall be completed within five(5) consecutive working days, from start to completion. 2) The following shall be added to Section 7-10.3 of the Special Provisions. Pedestrian access shall be maintained throughout the construction area. Barricades and delineators shall be placed to provide a pedestrian path of travel throughout the work area. This is to acknowledge receipt and review of Addendum Number One, dated July/12, 2012. Company Name ' By -� /I b f 12 Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at (714) 536-5431. THE AMERICAN INSTITUTE OF ARCHITECTS A/A Document A310 Bid Bond BOND#7T912 KNOW ALL MEN BY THESE.PRESENTS, that we CALIFORNIA PROFESSIONAL ENGINEERING, INC. DBA CALIFORNIA PROFESSIONAL ELECTRICAL ENGINEERING 929 Otterbein Avenue,Suite E Rowland Heights,CA 91748 (Here insert full name,and address or legal title of Contractor) as Principal, hereinafter called the Principal,'and The Hanover Insurance Company 333 City Boulevard West,17th Fl. Orange,CA 92868 (Here insert full name,and address or legal title of Surety) a corporation duly organized under the laws of the State of NH 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-address or legal title of Owner) as Obligee; hereinafter called the Obligee, in the sum of Ten,Percent of Amount Bid-------------------=---------------------- Dollars ( $ 10.00% ), 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 SAFE ROUTES TO SCHOOL-GOLDEN VIEW ELEMENTARY SCHOOL (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 17th day of July, 2012 CALIFORNIA PROFESSIONAL ENGINEERING, INC. DBA CALIFORNIA PROFESSIONAU ELECTRICAL ENGINEERING (Principa ' (Seal) (Witness) (Title) TeHae In ce Company (Surety) al) (Witn ;(Title) Yung T. il901ic orney-in-Fact AIA DOCUMENT A310 BID BOND AIAP FEBRUA Y 1970 ED THE AMERICAN INSTITUTE OF ARCHITECTS,1735 N.Y. VE.,N.W. ASHINGTON,D.C. 20006 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Los Angeles On v before me, Olivia Chea, Notary Public (Here insert name and title of the officer) personally appeared Van Nguyen 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 le mieq�executed the same in is authorized capacityfies-};and that by Si 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. OLIVIA CHEA WITNES S my h fficial seal. Comm.# 1931793 tn N. NOTARY PUBLIC•CALIFOI �1 Los ANGELES COUNTY MY Comm.ExP,APR.8,2015 (Notary Seal) Signature of Notary Pub' ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Arty acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be properly completed mrd attached to that document The only exception is if a document is to be recorded outside of California In such instances,any alternative acknowledgment verbiage as may be printed on such a document so long as the (Title or description of attached document) verbiage does not require the notary to do something that is illegal for a notary in California(I.e. certifying the authorized capacity of the signer). Please check the document cmefully far proper notarial wording and attach this form if required (Title or description of attached document continued) Y .State and County information must be the State and County where the document Number of Pages Document Date signers)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.. (Additional information) 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. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(Le. l}e/shet§ey—is late)or circling the correct forms.Failure to cotrectiy indicate this ❑ Individual(s) information may lead to rejection of document recording. El Corporate Officer • 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 ('Title) sufficient area permits,otherwise complete a different aclarowledgment form. • Signanne of the notary public must match the signature on file with the office of ❑ Partner(s) the county cleric. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this El Trustee(S) acknowledgment is not misused or attached to a different document.Indicate title or type of attached document,number of pages and date. ❑ Other Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(Le.CEO,CFO,Secretary). • Securely attach this document to the signed document nnnv ii.—;,r,rap&vt7 in.o7 R00-873-9865 www.NotaryClasses.com ACKNOWLEDGMENT State of California County of Orange ) On July 17, 2012 before me, Jennifer C. Anaya,Notary Public (insert name and title of the officer) personally appeared Yuna T. Mullick who proved to me on the basis of satisfactory evidence to be the person()whose name(l) is/ subscribed to the within instrument and acknowledged to me that hem executed the sane in hissj6r authorized capacity( , and that by histmftaix signature(s)on the instrument the. person(), or the entity upon behalf of which the person(j6) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and of °a>yFs' JENNIFER C.ANAYA a a COMM. # 1974158 X T NOTARY PUBLIC-CALIFORNIA X ORANGE COUNTY Cn Signature (Seal) FOAM MY COMM.EXP.MAY2,2016 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint James W.Moilanen,Yung T..Mullick,and/or Jennifer C.Anaya of Mission Viejo,CA and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliverfor,and on its behalf,and as its act and deed any place within the United States, or, if the following line be filled in, only within the area therein designated any and all bonds,recognizances, undertakings,contracts of indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations in the United States,not to exceed Ten Million and No/100($10,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in.the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attorneys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances, contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company. Any such writings so executed by such Attorneys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons."(Adopted October 7,1981-The Hanover Insurance Company;Adopted April 14,1982 Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) IN WITNESS WHEREOF,THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals duly attested by two Vice Presidents, this 3rd day of January 2012. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CI71ZENS SURANCE OMPANY OF AMEBA Robert Thomas,Vice President i HE COMMONWEALTH OF MASSACHUSETTS ) 10� COUNTY OF WORCESTER )ss. renstram, ire President On this 3ed day of January 2012 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged that the seals.affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,respectively,and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. "A"ARAA.,3ARLtC, NOfaty Public �J C�nvnwea>tf afklaseatiwsHts F t?}I;emnatsion Ex,ir�a seq.Z'I,zeta - - Barbara A.Garlick, Notary Public My Commission Expires September 21,2018 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted October 7,1981-The Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) 17 July 12 GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this day of.• 20 THE HANOVER INSURANCE COMPANY MASSACHUSETTS SAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA 0Iphn Nlargosian,Vim President F City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov office of the City Clerk fgJl7 1904P � ` Joan L. Flynn, City Clerk October 15, 2012 JFL Electric, Inc. 8257 Compton Ave. Los Angeles, CA 90001-3915. RE: Safe Routes to School —Golden View— CC-1402 Enclosed please find your original bid bond for CC-1402. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Cities: Anjo,Japan ♦ Waitakere, New Zealand JAL.Electric, Inc. tnsn��Compton ,e�.u,- cm S��z Routes {�D School � �1 "�M ViGv'Ut�- cc 1hNu �Y)WZ)/) l�cti - � � Wii'h �yuRar rnr�-P SECTION C PROPOSAL for the Sale Routes to School In the vicinity of Golden View Elementary School CC No. 1402 in the CITY OF HUNI'INGTON BEACH[ TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL. OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with.AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the.unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids , and will readvertise the project. In the case of discrepancies in the amounts bid,unit,prices shall govern over extended amounts, and words shall govern over figures. C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may,at the AGENCY'S option,be considered null and void. Accompanying this proposal of bid, find bAdUSi n the amount of$ 401 Of f I*&4aQVO i said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). i Bidder shall signify receipt of all Addenda here, if any: .r. ROW E S P CeBYed C-2 City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For Safe Routes to School, Golden View — CC 1402 July 12, 2012 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1)The following shall be added to Section 6-7,Time of Completion of the Special Provisions. At the intersection of Golden View Lane and Norino Drive, curb ramp construction activities shall be completed within five(6) consecutive working days, from start to completion. 2)The following shall be added to Section 7-10.3 of the Special Provisions. Pedestrian access shall be maintained throughout the construction area. Barricades and delineators shall be placed to provide a pedestrian path of travel throughout the work area. This is to acknowledge receipt and review of Addendum Number One, dated July 12, 2012. I UT va 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 William F. Janusz at (714) 536-5431. Project Bid Schedule Safe Routes to School— Golden View Elementary School CC-1402 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Furnish Construction Surveying and �-�� $ 2 (02S ",� Monument Preservation. $ f !� r Per L.S. Furnish Project Traffic Control. Per L.S. 4 1 L.S. Furnish and Install Traffic Striping f°' w and Signing. $ *J $ TUD Per L.S. 5 1 L.S. Modify Traffic Signal at Goldenwest Street and Slater ,,�J Avenue(Excludes AC Surface $04, Grinding). ............ Per L.S. 6 1 EA. Construct Curb Ramp per Caltrans Standard Plan No.A88A,Case A, w $ u� ® q,and Per Typical Section at New $ r (`.�� Oq 5 Ramps Adjacent to AC Paving Detail. Per EA. 7 2 EA.- Construct Curb Ramp per Caltrans Standard Plan No. A88A,Case B, ` . and Per Typical Section at New $ $ D Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School— Golden View Elementary School CC-1402 8 14 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case C, u' and Per Typical Section at New $ i $ sq, �Oo Ramps Adjacent to AC Paving Detail. i Per EA. 9 1470 S.F. Surface Grind Existing A.C. to a Depth of 0.17 FT and Construct New 0.17 FT Surface Coat Over $ I �/• ® $ LJ 1 Existing Asphalt Concrete. Per S.F. Total Amount Bid in Figures: U� $ Total Amount Bid in Words: $ VU ? I� Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. i I C-2.2 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. i Item Contract" 2 ^ � (.01L 4 �J b ed-h v ff 0. O rmh rh,r +P c ma ' s 22�O L 31 y(vft C /3, IS I hqMh CA C VTR xilhC CA0'5 c, W aV r1a he . �� h, co- i d 1(PC) g4321o3 P�VR .,(Uver i By submission of this proposal,the Bidder certifies: 1. That he is able:to:and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of an subcouiacts entered into and bonds fuimished by subcontractor for this project. C-3 N®NC®LLUSI®N AFFIDAVIT i 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 'I f 9 114,at t •ZzS CA- Date uIry State fell (�(,n(j bm"Y'x , being duly sworn, deposes and says that he c is PY2kj of J t'L CLQAT I C. I 0)C. the parry 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. �'8 L thuyi 4c - Name of idder i row 1.gnature of Bidder Address of of Bidder C4 JURAT State of California County of Los Angeles)ss. Subscribed and sworn to (or affirmed) before me on this 19th day of July, 2012, by Feliciano Loera, proved to me on the basis of satisfactory evidence to be the personko who appeared before me. r E�gO'.ti TERESA LOERA U - COMM..#1969495 (� - NOTARY PUBLIC-CALIFORNIAL) r LOS ANt LES COUNTY 0 nor COmm.EXPIRES FEB.246 2� Signature o Notary Saal; OPTIONAL INFORMATION Date of Document Thumbprint of Signer Type or Title of Document Non-Collusion Affidavit Number of Pages in Document Document in a Foreign Language Type of Satisfactory Evidence: Personally Known with Paper Identification —�Paper Identification Credible Witness(es) ❑ Check here if Capacity of Signer: no thumbprint Trustee or fingerprint Power of Attorney is available. CEO/CFO/COO President/Vice D esident !SerretaFy /T-Feas ureF Other: Other Information: JFL Electric Inc. 2C08 Allstate Notary Preparation, li,c.-(800",689-84%-wom..,.a'ctatenotary.COM 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 Safe Routes to School in the Vicinity of Golden View Elementary School, CC 1402, (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. I �jf ' G"Y i C, �► c Contr G' y Title Dater 111 [ 2. C-5 DISQUALIFICATION QUESTIONNAIRE I. In accordance with Government Code Section 14310.5, the Bidder shall complete,under penalty of perjury,the following questionnaire. i 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 C(No If the answer is yes, explain the circumstances in the space provided. Nate- This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the.following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance. with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. ��FL flpc4y) C, lac Contractor,-' i Title Date: Z C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: � L E�WltY I c, V,C Bidder Name 12�;-j Cim P-bV) Avt4iw Business Address i l,osG -S CA- U170 City, State Zip j Telephone Number +G-TI 'd - .B, C f o q c? (o State Contractor's License No.and Class I L41 <gq Original Date Issued - ) Ir Expiration Date . The work site was inspected bye�d�r�S of our office on , h 201? The following are persons, firms,and corporations having a principal interest in this proposal: L aQ cf - c , IrrC - F-e1 i Q "C-) burl. - 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. JFL ctr i c Company N e Signs a of Bidder Printed or Typed Signature Subscribed and sworn to before me this OAIday of , ) ,2001J r TERESA LOERA S (7 •�o 949 NOTAROY PUBLIC-CALIF� ORNUIG� LOS ANGELES COUNTY 0 COMM.EXPIRES FEB.24,2016 J NOTARY PUBLIC NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 23 q20 W v64-&-36 Name and Address of Public Agency C6�J"A Gary 4• C�. Name and Telephone No. of Project Manager: (� GII(-Q/1� - 6bI �&— l� Contract Amount Type of Work Date Completed 2. Name Ad Address of Public Agency Name and Telephone No. of Project Manager: H,I G G� L _ clSa `�)3 -31 10 Wldlz a� ry J S )2 v��C+ 0-(x Contract Amount Type of Worrk� Date Completed 3. Name and Ad ess of Public Agency Name and Telephone J Manager.No. of Project Mana er: �/�r�,�,,n, ,, ✓ ' �s _ . UfJ�'� � I �"l�l.Q 41q, 2 g Contract Amount Type of VArk Date Completed C-9 JURAT State of California County of Los Angeles}ss. Subscribed and sworn to (or affirmed) before me on this 19th day of Jam, 2012, by Feliciano Loera, proved to me on the basis of satisfactory evidence to be the persons} who appeared before me. TERESALOERA U COMM.#1969495 o,� NOTARY PUBLIC•CALIFORNIAL� LOS ANGELES COUNTY 0 / COMM.EXPIRES FEB.24,2016'j Signatur of Notary tsenlj OPTIONAL INFORMATION Date of Document Thumbprint of Signer Type or Title of Document Number of Pages in Document Document in a Foreign Language Type of Satisfactory Evidence: Personally Known with Paper Identification X Paper Identification Credible Witness(es) ❑ Check here if Capacity of Signer: no thumbprint Trustee or fingerprint Power of Attorney is available. CEO/CFO/COO President/ViGe President /Se^reta Fy /Tread Fee Other: Other Information: JFL Electric Inc. %0i8 Allstate Notary Preparation, inc.- 8M 689-84 -%-vwl..a sty:enc ary.coi l ------------- (For federally funded projects,use this following page) BEDDER`S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24, Code of Federal Regulations,Part 135* i 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 requiremnents of Section 3 of CFR Part 135 of the HUD Act of 1968; or V 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: AL UA Ctr f c, I Pic . Contact Person: J;;tt 1 U OLAVI a LQ-&i Contact Phone: Signed: .,��� Date: 2 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992(HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 i BIDDER'S CERTIFICATION* j HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 1992, SECTION 3 TITLE 24,Code of Federal Regulations,Part 135* i 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 141JD .Act of 1968;or Will hire no new employees in conjunction with this project. Will award 14%of its sub-contracts to Section 3 businesses. i This certification shall apply to the prime contractor's sub-contracts related to this project. Contractor: J � G ► i C� I �C Contact Person: Ft � � cpn O l Contact Phone: " Signed: Date: 2 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act,as amended in 1992(HUD). Previous non-compliance with Section 3 could result in disauslification. C-11 Local Assistance Procedures Manual ]EXHIBrr 12-E PS&E Checklist Instructions Attachment C i (THE BIDDER'S EXECUT7ON ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WHICHAREA PART OF THISPROPOSAL) EQUAL.EMPLOYAIENT OPPORTUNITY CERTIFICATION The bidder J L GI.C' G'{-Ir 1 C 61 C. ,proposed subcontractor ,hereby certifies that he has ✓ , has not_,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts,which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits ar report covering the delinquent period or such other period specified by the Federal 1Tighway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. I i a t i Page 12-79 LP1P 01-04 C-12 March is,2001 i i PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376,Stats. 1485�the bidder hereby declares under penalty of under the laws of the State of California that the bidder has_,has not been convicted Pe ty P`�Jiny within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regeats of the University of California or the Trustees of the California State University. The berm"bidder"is understood to include any pad=,member,officer,director,responsible manag ng officer,or responsible managing employee thereof,as referred to in Section 10295.1. i Note: The bidder trust place a deck mark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Bid. Signing dils Bid on the signature portion thereofshall also constitute signature of this Staten Bidders are cautioned that making a Use certification may subject the certifier to c riminal•prosecuutir m I i Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162,the Bidder shall complete,under penalty of perjury,the,following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented kom 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,*Vlaln die circamsW=in the followirg space. C-13 I Public Contract Code 10232 Statement i In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor`s failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board. i Now The above Statement and Questionnaire are part of the Bid. Signing this Bid or the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that malting a false certification may subject the certifier to criminal prosecution. • i I i i ' f C-14 Local Assistance Procedures Manua[ EXHIBIT 12-E i PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the MY/COUNTY of Los ' ►'► &S DEPART1b=OF P MIC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company, association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage i 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 ndt,directly or indirectly,submitted his or her bid I price or any breakdown thereof,or the contents thereof,or divulged information or data relative thereto,or paid, and will not pay,any fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 1LPP 01-04 C-15 Mareb 15,2001 Local Assistance Procedures Manual EXHIBIT ME PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,and manager: Is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any federal agency; • Has not been suspended,debarred,voluntarily e=luded.or determined ineligible by any federal agency within the past 3 years; Does not have a proposed debarment pending;and • Has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. i Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom It applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page I2-83 LPP 01-04 C-16 Mauer 15,2001 I 1. Local Assistance Procedures Manual EXHMrr 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL-AIID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any .person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any federal contract,grant,loan,or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person far influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this federal contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities,"in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penally 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 subrecipieats shall certify and disclose accordingly. Page 12-85 March 15,2001 LPP 01-04 C-17 i Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G (DISCLOSURE OF LOBBYING ACTIVITIES WWLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C.1352 1. Type of Federal Action: 2. Status of Federal Action: . F-18. contract ®a. bid/offer/application r3RepDrtl�qw: a. initial b. grant b. initial award b. material change c. cooperative agreement a, post-award d. loan For Material Change Only: e. loan guarantee year_ arter t loan insurance date of I port 4. Name and Address of Reporting Entity. 5. If Reporting Entity la No.4 is ubawardee, Enter Name and Address of rime: ❑ Prime ® Subawardee I Tier ,if[mown I Congressional District,if known Congressional D trict,if known 6. Federal Department/Agency: 7. Federal Pr Name/Description: CFDA umber,if applicable 9, Federal Action Number,if known: 9. Awa Amount,if known: i i 10. a. Name and Address of Lobby Entity Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.10a) (last name,first name,MI) (attach Contin 'on Sheet(s)if necessary) 11, Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) S ❑ actual p ed a. retainer b. one-time See 12. Form of Payment(check all that app ): a commission ® a. cash d. contingent fee b. in-(rind; specify: as a deferred I v e U f. other,specify 14. Brief Description of Servic erformed or to be performed and Dates)of Service,including �c o cr(s),employees),or ember(s)contacted,for Payment Indicated In Item 11: (attach Continuation Sheets)ifnecessary) 15. Continuation She s)attached: Yes ❑ No ❑ 16. Information through this form is authorized by Title 31 US.C.Sectio 352. This disclowre of lobbying relianm Signature: was placed by tier above when his transaction was made or entered i . This disclosure is requuod pursuant to 31 Pdnt Name: U.S.C.13 . This information will be reported to Congress semiann ly and will be available for public iuspection. Any Title: perso fails to file the required duciosum shall be subject to a civil penalty of act less than$10,000 and not mare than, $100,000 for each such Pagrec Telephone No.: Date: Authorized fvs.Local Reproduction Federal Use Only: Standard Form-LLI; slated ftm LM Rm.09-1247 Page 12-87 LPP 01-04 C-18 March 15,2001 t i , E Local Assistance Procedures Manual I. Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient,at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I> Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the fall name,address,city,State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name,address,city, State and zip code of the prime federal recipient. Include Congressional District,if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number,the application/proposal control number assigned by the federal agency). Include prefixes,e.g.,"RFP-DE•90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity.identified in item 4 or 5. 10. (a)Enter the full name,address,city,State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual),or will be made (planned). Check all boxes that.apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12.Check the appropriate box(es). Check all boxes that apply. if payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other,specify nature. i Page 12-88 LPP OI-04 Marcie is,2001 C-19 i Local Assistance Procednres Manual EXH[E8rr 12-E PS&E Cheeldist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the dates)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s)or employees) contacted or the officer(s)employees)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. i 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 i estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503. sF-rarru��ao� rtc.a�-oa-�xn�b I i i j I i Page 12-89 LPE 01-04 G20. March Vs 2001 i Local Assistance Procedures Manual Exhibit 15-Gl Local Agency Bidder UDBE Commitment(Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment(Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVE�RS•E,SIDE OF THIS FORM AGENCY: CAh 0 11 if l IGLVpGA.ION: PROJECT DESCRIPTION: c�Uc7�Qf/ ouS 1y S ch O oI OTAL CONTRAg AM� BID DATE: 11-2- IDDER'S NAME: cc c4y I C. CONTRACT UDBE GOAL: tSJ D i CONTRA CT TEm OF WORK AND DESCRIPTION Cert.No.of UDBE NAME OF UDBEs DOLLAR AMOUNT ITEM NO. R SERVICES TO BE AND EXPIRATION (Must be certified on the date bids UDBE UBCONTRACTED OR MATERIALS DATE we opened-include UDBE 10 BE PROVIDED sand a number t � Sul ZZi 2 VJ y _t S I or Local Agency to Complete: Total Chimed $ Cad1 Agency Contract Number Participation Federal Aid Project Nurabor ^% Federal Sbare: Contra Award Date: I cal Agency certifies that all information is complete and accurate. ;of Bidder ntName signature Date Local Agency Representative Dat'T'—'�T (Area )Td.Na Arcz Code Td bare Number: 0Q Y ,— For Caltrans Review: Person to Contact (Please Type or Print) I Print Name Signature Date Calom District LocalAssis;WceEngineer Lawt Agency Bidder-UD EC=nitmaat(Rev 3" t) py— within E5 of award`Failure to Distribrihon: 1 Co Fax or Sean a copy to the Caltrans District Local Assistance EtWncer(M AE) days' seed a copy W the DLAE within 15 days of award may result in de-obligation offends fw11313 project. (2)Copy—Include in award package to Caltrans District Local Assistance (3 t)rigiaal—Localagen NO Page 15-31 March Z7,?A09 LPP 09-xx C-21 Exhibit I5-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER UDBE COMMITMENT(CONSTRUCTION CONTRACTS)(Revised 03/09) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s)falls into one of the following groups in order to count towards the UDBE contract goal: 1)Black American; 2)Asian-Pacific American; 3)Native American;4)Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third low bidder,it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. BlackAmerican 2. Asian-Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name,and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work(who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors'certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including,if the prime is a UDBE,work performed by its own forces, DMRTANT: Identify all UDBE firms being participating in the project regardless of tier: Names of the First Tier UDBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. Provide copies of the UDBEs'quotes,and if applicable,a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the UDBE,describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts);to determine how to count the participation of UDBE firms. i i Exhibit 15-0(1)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 Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the 15-day. time period may result in the de-obligation of fiends on this project. District DBE Coordinator should verify that'all information is complete and accurate. Once the information has been verified,the District Local Assistance:Engineer signs and dates the form. Page 0-32 March 27,2009 C-22 UP 09-Ar C�®0,0 �u--X Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good Faith Effort EXHIBIT ma UDBE INFORMATION—GOOD FAITH EFFORTS. i Federal-aid Project No. Bid Opening Date The (Cit /y Countx of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of % for this project. The information provided herein shows that a good faith effort was made, Lowest, second lowest and third Iowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the"Local Agency Bidder—UDBE Commitment"form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g.,a UDBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder. — UDBE Commitment" form, may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations,telephone records,fax confirmations,etc.): Names of Date of Follow Up UDBEs Initial Methods and Solicited Solicitation Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking,down of the contract work, items (including those items normally- performed by the bidder.with its own forces)into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4,2.009 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBE Information-Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract D. The names, addresses and phone numbers of rejected UDBE firms,the reasons for the bidder's rejection of the UDBEs,the firms selected for that work(please attach copies of quotes from the firms involved),and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidders rejection of the UDBEs: Names,addresses and phone numbers of firms selected for the work above: i I E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: F. Efforts made to assist interested UDBEs in obtaining necessary equipment,supplies,materials,or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: I i 1 G. The names-of agencies, organizations or groups. contacted to,provide assistance in contacting, recruiting and using UDBE ferns(please attach copies-of requests to agencies and any responses received,i.e.,lists,Internet page download,etc.): Page 15-34 March 4,2009 LPP 09-xx C 24 Local Assistance Procedures Manual Exhibit MR UDBE Information-Good Faith Effort Name of Method/Date Results. Agency/Organization of Contact i. I H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): i i NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. .. I i i Page I5-34a LPP 09-sx March 4,2009 C-25 i Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Informnation(Construction Contracts) Exhibit 15-Cr2 Local Agency Bidder DBE Information(Construction Contracts) (Inclusive of all DBEs including the UDBEs Iisted at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE `SIDE OF THIS FORM GENCY: ( tJ UVXATION: PROJECT DESCRIPTION: `o U T le ,ill—fz S 1� S On 0O TALCONTRACTAMO [D DATE: L-t 1 i 1—2 DER'S NAM: ✓ 1/�.1G vI I I l 1 I C CONTRACT I NI OF WORK AND DESCRIPTION DBE Cut No. 4AME OF DBEs DOLLAR AMOUNT ITEM NO. SERVICES TO BE kM EXPIRATION Must be certified on the date bids DEE UBCONTRACTED OR MATERIALS DATh we opened-include DBE address Q5 PROVIDED ind phone number t � VT Qzctf I123SI— Y(O W 111-40 CA dVth C�VI� EA V For Local Agency to Complete: $ Total Claimed Local Agency Contract Number. Participation Federa1A1dPrqjectNumbcr:. % eral Share: ntractAward Dam: Local Agency certifies that the DBE certification($)has been verified and all information is complete and accurate. Priftt Name Signature Date // Date ( Code)Tel.No. Local Agency Representative C 1 Atea Code Tel hone Number: �be jn� 1-0 f aS • OE'Caltrans RayYie�: person ao Contact (Please Type w Print) print Name Signature Date Caltraes District Local Assistence Engineer Imal Agency Bidder DBB Woeoerdoo(Raw 3109) .. Distribuliou: (I)Copy—Fax or scar a copy to dw Caltrans District Local AssutmceEni to (DLAE)within IS days of contract execution:Faitult to send a copy to the DLAE within 15 days of contract execution MAY result in de-obligation of fimds for this poled (2)Copy—Include in award package to Caltrans District Local Assistance (3)OdghW—I.oeal agency Me; Page 15-32a UP 09-XX C 26 March 27,2009 i Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS)(Revised 03/09) SUCCESSFUL El®DER: The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name,and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date.The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work(must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project—including all UDBEs listed on the UDBE Commitment form(Exhibit 15G(1)),regardless of tier. Names of the First Tier DBE Subcontractors and their respective items)of work listed should be consistent,where applicable, with the names and items of work in the "List of Subcontractors"submitted with your bid There is a column for the total DBE 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),"ofthe Special Provisions(construction contracts);to determine how to count the participation of DBE firms. Exhibit 15-G(2)must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date,Federal Share,Contract and Project Number fields,and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the i5-day time period may resuk in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. 1 . 3 Page 15-32b Mauch 27,2.009 C-27 LPP 09 XX lAxat _-etanice Proeedares Manual EXH1,..._- MG Bidder's List of Subcontractors(DBE and Non-DBE) BL®L3BR'S LIST OF SUBCONTRACTORS (BBB and NON-DBE)-)-PART 1 The bidder shall list all subcontractors(both DBE and non-DBE)in accordance with Section 2-1.054 of the Standard Specifications and per Title 49,Section 26.11 of the Code of Federal Regulations. nis listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Nam Phone/ Annual Address/ Fax Gross Deseription of Portion of Worts to be Performed am state. IP Receipts Name / P"M �i 0<$1 million Cl/i: $5 Million Add Z <$lo million::,`�. 'V�vF'• Fax�t� <S15 au�lion +� City State Zip >$is minion JUL�O CA (pZ Nam P11 L�,I� <$1 million I I . <$5 million p� Add f <$lo million N4-4-- Ll `!J�C Faz <$15 million 20 CRySIM i C � �35 $i5 million None\ AhC. ®,a ❑<$1 minion ' V 1 �� ��� � ' �, •� SS mltllon Add ` fJ <S10million \VpVI Fax pi0<$15minion ChyState P° >$isminion Phone �j <$1 minion $5 Mallon � Fax asi <$15 million 70>$15 million Alatrlbadon.1)Otiglna)-Local Agency File Page 12-111 LPP 0"6 November 14,2006 Zthff �G Local Assistance Procedut__..4anual Bidders List o 8abcontncctors(DBE and Non-DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON-DBE)- PART 6I The bidder shall list ail subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project. This is required for compliance with Title 49 Section 26 ofthe Code of Federal geolations, photocopy this form for additional firms. Firm Nantlet Phone/ Auntial Address. Fax Gross Description of Portion of Work to be Performed city,state Receipts Nance Phone ❑<Sl million <$5 million Address <$to million �r Fax <W million citystme mp >$IS million -- Name Phone <SI Addmw million <$5 millionmillion<SLO Million ► F'ox c$I5 million dry to 7.tP >$lS million Name Phone <sl million <SS million A�� <slomillion Fax <$15 million CtrySPalr ZiP >M million Name Phone ❑<$1 million <$5 million Adders L3<$10 million Fax <w million CIO,maee ZtP >$15 million DiaMBmtlow I)Odginal-•Local Agency File Page U-112 November 14,2006 LPP 06-06 BID BOND BOND NO. 111 KNOW ALL MEN BY THESE PRESENTS, That we, JFL Electric, Inc. as Principal, and The Gray Insurance Company a corporation authorized to transact a general surety business in the State of California as Surety, are held and firmly bound unto the City of Huntington Beach (hereinafter called the Obligee) in the full and just sum of TEN PERCENT OF THE AMOUNT OF THE Dollars, ($ ***10%*** _)for the payment whereof in lawful money of the United States,we bind ourselves,our heirs, administrators, executors,successors and assigns,jointly and severally,firmly by these presents. WHEREAS, the said PRINCIPAL has submitted the accompanying bid for Safe Routes to School-Golden View Elementary School CC No. 1402 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,or in the event of the failure of the Principal to enter 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. Signed and Sealed this 18th day of July 2012 YEAR JFL Electric. Inc. The Gray Ins rance Co any Sur By: Feliciano Loera,President Principal Ryan 4Mantle, Attorney-in-Fact r' P 'THE GRAY INSURANCE COMPANY THE GRAY CASUALTY&SURETY COMPANY 165941 GENERAL-POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS,THAT The Gray Insurance Company and The Gray Casualty&Surety Company,corporations duly organized and existing under the laws of Louisiana,and having their principal offices in Metairie,Louisiana,do hereby make,constitute,and appoint Les M.Mantle and Ryan S.a Mantle of Fullerton,California jointly or severally on behalf of each of the Companies named above its true and'. lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its deed,bonds,or other writings obligatory in the nature of a bond,as surety,contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or. undertaking or contract of suretyship executed under this authority shall exceed the amount of$10,000,000. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of ' Directors of both The Gray Insurance Company and The Gray Casualty&Surety Company at meetings duly called and held on the 26`h day of June, 2003. -� "RESOLVED,that the President,Executive Vice President,any Vice President,or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings,and all contracts of surety,and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney,and to attach the seal of the Company;and it is %i FURTHER RESOLVED;that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or ' r. ° e� to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond,undertaking or contract of surety to which it is attached. -4 IN WITNESS WHEREOF,The Gray Insurance Company and The Gray Casualty&Surety Company have caused their official seals to be hereinto affixed,and these presents to be signed by their authorized officers this 12`h day of September,2011. dgU RA y By: Attest:10 SEAL - Michael T.Gray Mark S.Manguno S E A L r President,The Gray Insurance Company Secretary, y1 ` ....... � and The Gray Insurance Company, * The Gray Casualty&Surety Company Vice President, The Gray Casualty&Surety Company Ki State of Louisiana ss: Parish of Jefferson On this 12'h day of September,2011,before me,a Notary Public,personally appeared Michael T.Gray,President of The Gray Insuiance Company" and Vice President of The Gray Casualty&Surety Company,and Mark S.Manguno,Secretary of The Gray Insurance Company and The Gray Casualty&Surety Company,personally known to me,being duly sworn,acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of, and acknowledged said instrument to be the voluntary act and deed,of their companies. s.1M1111441114" sa (,ory ?r'• O'ER}•t�s Lisa S.Millar,Notary Public,Parish of Orleans {, e= State of Louisiana ,�r., Puauc ?�, o� My Commission is for Life „1111i4n1,,,, I,Mark S.Manguno, Secretary of The Gray Insurance Company and The Gray Casualty&Surety Company,do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies,which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 18th day of July,,., 2012 gURA,y -06 PITY d 86 p� .�//�w/ //►► f SEAL SEAL Mark S.Manguno,Secretary The Gray Insurance Company y1. µ_.Jim y�� ., „.'�? The Gray Casualty&Surety Company m ;y ACKNOWLEDGMENT ■eeeeeeeeeeeeeeeeeeeseeeeeseeeseeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeseeeee State of California County of Los Angeles}ss. On July 19, 2012, before me, Teresa Loera Notary Public, personally appeared Feliciano Loera, who proved to me on the basis of satisfactory evidence to be the personks} whose name{o is/afe subscribed to the within instrument and acknowledged to me that he/sheAhey executed the same in his/her/4 h& authorized capacitykiL*, and that by his/her signatures(o on the instrument the person(s), or the entity upon behalf of which the person(o acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 4`° TERE LOERA U `E SA COMM.#1969495 NOTARY PUBLIC-CALIFORNIA@ �* LOS ANGELES COUNTY 0 COMM.EXPIRES FEB.24,2016-' Signature ;Seaii ■■eeeeeeeeeeeeeeseeeeeeeeoese�eeeeeeeeeeeeeeeeeeeeeeeseseeeeeseeeeeeeeee OPTIONAL INFORMATION Date of Document Thumbprint of Signer Type or Title of Document Bid Bond Number of Pages in Document Document in a Foreign Language No Type of Satisfactory Evidence: Personally Known with Paper Identification X Paper Identification Credible Witness(es) Check here if Capacity of Signer: no thumbprint Trustee or fingerprint Power of Attorney is available. CEO/CFO/COO X President/V;rePFes*deRt /SeGFetaFy /TFea6 Fec Other: Other Information: JFL Electric Inc. ."-2CC,8 Al lsta.E �IlJtary Prepar2tion, "Z.-�,.00)689-8456-w;rU:.aus"a enotar y.com City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 • www.huntingtonbeachca.gov Office of the City Clerk II 7909 e ` Joan L. Flynn, City Clerk October 15, 2012 Nobest, Inc. PO Box 874 Westminster, CA 92684-0874 RE: Safe Routes to School — Golden View—CC-1402 Enclosed please find your original bid bond for CC-1402. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Cities: Anjo,Japan ♦ Waitakere,New Zealand I � Ul 1 -77 ��,; &�-I ,,-_'A��­l":777-7-,7,� .1,I I-____ -,�,,, 1 Avow"'l ��t,"$=.-r- -1 '_ ,r� ­,� ..­­ - ., ��­� ,­,'­ ­, ,"i, . �,; ­ . _,,-�­.._nol, 11�­ �, ­ " � _ ­­�MP-1 ., - ..", ," I 1, , ��t'��,�'�, ,1,,,, ".�"­--j I. -:11 � '' "I'', ­ ­V, ­ ", " _R­ ­ 1,401�ONVAT"T, ",­ n� - ym.�. 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" ,; - 1 , SECTION C PROPOSAL for the Safe Routes to School In the vicinity of Golden View Elementary School CC No. 1402 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 v • 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 641 Ur' in the amount of$ 0�'d which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature 7 -1a -1 C-2 r Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 L Item. Unit;Puce, Extended Amount x Item, Estunated No Quantity , 1 1 L.S. Mobilization. $ -" $ 7 gad Per L.S. 2 1 L.S. Furnish Construction Surveying and Monument Preservation. $ Z/ $ z zlq 0. Per L.S. 3 1 L.S.] Furnish Project Traffic Control. �c� Per L.S. 4 1 L.S. Furnish and Install Traffic Striping 010 and Signing. $ $ �1 �= Per L.S. 5 1 L.S. Modify Traffic Signal at Goldenwest Street and Slater O Avenue(Excludes AC Surface $ ✓g $ S � __- Grinding). Per L.S. 6 1 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case A, and Per Typical Section at New $ 3, $ � Ramps Adjacent to AC Paving Detail. Per EA. 7 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A Case B and Per Typical Section at New $ $ Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Item Estirnafed Item Unit'Price ` Extended Amount No Quantity 8 14 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A Case C pa and Per Typical Section at New $ 3����, J $ © _ Ramps Adjacent to AC Paving Detail. Per EA. 9 1470 S.F. Surface Grind Existing A.C. to a Depth of 0.17 FT and Construct � / Qr New 0.17 FT Surface Coat Over $ $ �, 7(� Existing Asphalt Concrete. Per S.F. Total Amount Bid in Figures: rI 00 $ Total Amount Bid in Words: Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 LIST OF SUBCONTRACTORS L In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Bid Name and Address of Subcontractor State Class Dollar. % of Item(s) License , Amount. Contract Number 3sC 7_04;'� 0,1'alle1w By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 r , NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITTY 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 ' nft2,at G6vv&, <A Date City State being first duly sworn, deposes and says that he or she is Pfe'ji' P6'f of 11,012P5i' ;LrIC the parry 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. &-ObQs - Name of Bidder Signature of 11,idd Address //of Bidder C-4 r 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 Safe Routes to School in the Vicinity of Golden View Elementary School, CC 1402, (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. h)b(-2,5-� �nr. Contractor By ! // P� Title Date: C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ZNo If the answer is yes, explain the circumstances in the space provided. /Y Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. l�lr�b�st --nr- Contractor By EOr i.r� FI-P5%Ue'/7 t Title Date: C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: Bidder Name 2& 4? Business Address City, State Zip .71Y > Telephone Number State Contractor's License No. and Class 2 Original Date Issued 7--31 -0 Expiration Date The work site was inspected by MI kY !_`W S of our office on K�� j , 201�. The following are/persons, firms, and corporations having a principal interest in this proposal: L,OlY- P l Q<r� p/PSi Pl/� `-rPfSwt'P/" C-8 The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. A be s f- Company Name Signature of—Bidder J� / Printed or yped Signature Subscribed and sworn to before me this[4L day of 201 KAY E.ANDERSON comm. #1852452 O NOTARY PUBLIC-CALIFORNIA ^ ORANGE COUNTY NOTARY PUBLIC � ,.e,,;� My Comm.Expires June 13,2013 � J NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. S'ee q•fit'qC17e01 Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-9 NOBEST INCORPORATED REFERENCE CE LIST Page 1 No. 1 Project Name/Number: La Cuarta Street Reconstruction Project Description: Concrete Construction, Asphalt Overlay, Water Line Replacement Approximate Construction Dates: From: 6/2011 To: 9/2011 Agency Name: City of Whittier Contact Person: Kyle Cason Telephone: (562) 567-9511 Original Contract Amount: $ 1,022,001 Final Contract Amount: $ In Progress No. 2 Project Name/Number: Ocean Front Street and Alley Replacement Project Description: Remove &Replace Concrete Alleys, Streets, Curbs & Gutters, Sdwk Approximate Construction Dates: From: 3/2011 To: 8/2011 Agency Name: City of Newport Beach Contact Person: Mike Sinacori Telephone: (949) 644-3342 Original Contract Amount: $907,000 Final Contract Amount: $ In Progress NOBEST REFERENCE LISP' Page 2 No. 3 Project Name/Number: Maintenance Service Agreement Project Description: Remove& Replace Concrete at Various Locations Approximate Construction Dates: From: 10/2010 To: 10/2011 Agency Name: City of Westminster Contact Person: Todd Miller Telephone: (714) 681-3020 Original Contract Amount: $345,000 Final Contract Amount: In Progress No. 4 Project Name/Number: Annual Concrete Maintenance Project Description: Removal & Replace Concrete Sdwks., WC Ramps, Curb &Gutter Approximate Construction Dates: From: 8/2010 To: 8/2011 Agency Name: City of Huntington Beach Contact Person: Dereck Livermore Telephone: (714) 960-8861 Original Contract Amount: $250,000 Final Contract Amount: $ In Progress NOBEST REFERENCE LIST Page 3 No. 5 Project Name/Number: Citywide Sidewalk & Curb & Gutter Imp. 2009-10 Project Description: Remove&Replace Concrete Approximate Construction Dates: From: 2/2011 To: 5/2011 Agency Name: City of Corona Contact Person: Rosario Ruvalcaba Telephone: (951) 739-4813 Original Contract Amount: $ 578,711 Final Contract Amount: $ 450,677 No. 6 Project Name/Number: Residential Street on the Tree Petition List Project Description: Remove&Replace Concrete, Landscape, Trees Approximate Construction Dates: From: 11/2010 To: 3/2011 Agency Name: City of Huntington Beach Contact Person: Joseph Dale Telephone: (714) 536-5915 Original Contract Amount: $589,000 Final Contract Amount: $ 621,900 NOBEST REFERENCE LIST Page 4 No. 7 Project Name/Number: Pacific Blvd. Improvements Project Description: Concrete Construction, Grading, Electrical &Landscape Approximate Construction Dates: From: 9/2010 To: 4,12011 Agency Name: City of Huntington Park Contact Person: Wes Lind Telephone: (626) 447-4274 Original Contract Amount: $ 782,204 Final Contract Amount: $ 833,604 No. 8 Project Name/Number: Old Town Resurfacing Program Project Description: R &R Concrete Sidewalks, Curb & Gutter and Alleys Approximate Construction Dates: From: 4/2010 To: 11/2010 Agency Name: City of Seal Beach Contact Person: David Spitz Telephone: (562) 431-2527 Original Contract Amount: $ 1,500,000 Final Contract Amount: $ 1,730,000 (For federally funded projects, use this following page) BIDDER'S CERTIFICATION'S 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 requiremnents 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: A/C)Ae! hC. Contact Person: t—, Contact Phone: I`( 4 - s,S Signed: Date: "7�0 1 *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 f r BIDDER'S CERTIFICATION* HOUSING AND URBAN DEVELOPMENT ACT OF 1968 AS AMMENDED IN 19927 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 ,S 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: -7` Lf- S Signed: Date: 1-2— *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992(HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WHICHARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder d--AZ13F3&S 77 �VK5(- ,proposed subcontractor ,hereby certifies that he has has not___,participated in a previous contract or subcontract subject to the equal opportunity clauses,as required .by Executive Orders 10925, 11114,or 11246,and that,where required,he has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts,which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a, report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. i i 3 E I f1 i4 4 I I Page 12-79 LPP 01-04 C-12 March 15,2001 t PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with public Contract Code Section 10285.1(Chapter 376,Stats. 1985),the bidder h�erebyyddeclares under penalty of perjury under the Iaws of the State of California that the bidder has_,has not lea convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 1101,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof as referred to in Section 10285.1. Note: The bidder must place a check mark after"has"or"has not"in one of the blank spaces provided,ne above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal-prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162,the Bidder shall complete,under penalty ofperjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? / Yes No If the answer is yes,explain the circumstances in the following space. I I i C-13 1 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable funding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor`s failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board- Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that malting a false certification may subject the certifier to criminal prosecution. i C-14 ' 1 r Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code)Section 7106) To the CITY/G6 of �yI�r�ivt� ZL or,l4 DEPARTMENT OF P UBMC WORKS. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company, association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement, communication,or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit,or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and,further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof,or divulged information or data relative thereto,or paid, and will not pay,any fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15,2001 i i Local Assistance Procedures Manual EXHIBIT ME PSA Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49,CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below,he/she or any other person associated therewith in the capacity of owner,partner,director,officer,and manager: • Is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any federal agency; • Has not been suspended,debarred,voluntarily excluded or determined ineligible by any federal agency within the past 3 years; • Does not have a proposed debarment pending;and • Has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification,insert the exceptions in the following space. Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15,2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies,by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any .person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any federal contract,grant, loan,or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this federal contract,grant, loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. i I i Page 12-85 LPP 01-04 C-17 March 15,2001 I� i y � a Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTPIITEFS 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: Fla. contract ❑a. bid/offer/application Fla. initial b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year, quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity S. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime Q Subawardee Tier ,if known Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program NameiDescription: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,ifkno . ND 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.I0a) (last name,first name,MI) (attach Continuation Sheet(s)if necessary) II. Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) S actual planned a. retainer b, one-time fee 12. Form of Payment(check all that apply): c. commission ® a. cash d. contingent fee b. in-kind; specify: nature a deferred value LJ 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 16. Information requested through this form is authorized by Title 31 U.S.C.Section 1352. This disclosure of lobbying reliance Signature: was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 Print Name �/ /It U.S.C.1352. This information will be reported to Congress I 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 S 10,000 and not more than $100,000 for each such failure. Telephone No.: Date: Authorized for Local Reproduction j Federal Use Only: S Standard Form-LLL Standard Form Ild.Rev.09-I2 97 Page 12-87 LPP 01-04 C-18 March 15,2001 i I i 0 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient,at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C.Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last,previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"Subawardee"then enter the full name, address,city, State and zip code of the prime federal recipient. Include Congressional District,if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcement number,the contract grant.or loan award number,the application/proposal control number assigned by the federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other,specify nature. Page 12-88 Mamh 15,2001 C-19 LPP 01-04 i i Local Assist4ace Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046),Washington,D.C.20503. SF-LLL hLc ucaom Ray.06-04-90«ENDIN I i I Page 12-89 LPP 01-04 C-20 March 15,2Q01 Local Assistance Procedures Manual Exhibit 15-Gl Local Agency Bidder UDBE Commitment(Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM AGENCY:—City of Huntington Beach LOCATION:Golden View Elementary School PROJECT DESCRIPTION: Safe CRoutes to School TOTAL CONTRACT AMOUNT:S ✓3 Oda BID DATE: 7-19-12 IDDEWSNAME: Nobest Inc. CONTRACT UDBE GOAL: 6.64% CONTRACT ITEM OF WORK AND DESCRIPTION Cert.No.of UDBE NAME OF UDBEs DOLLAR AMOUNT ITEM NO R SERVICES TO BE AND EXPIRATION (Must be certified on the date bids UDBE SUBCONTRACTED OR MATERIALS DATE are opened-include UDBE BE PROVIDED dress and olione number Trucking 02037 Ra 's Trucki 2-1-15 P.O. Box 6553 fl �iIg G. Torrance CA 053A-9891 For Local Agency to Complete: Total Claimed Local Agency Contract Number. Participation Federal Aid Project Number: j o Federal Share: Contract Award Date: Local Agency certifies that all information is complete and accurate. Print Name Signature Date 7-19-12 )(714)�82-5583 Local Agency Representative Date (Area Code) eI.No. Area Code Tele hone Number. Kay E. And r s on For Caltrans Review: Person to Contact (Please Type or Print) Print Name Signature Date Caltrans District Local Assistance Engineer Local Agency Bidder-UDBE Commitment(Rev 3109) Distribution: (1)Copy—Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE) within IS days 6f award. Failure to send a copy to the DLAE within 15 days of award may result in de-obligation of frmds for this project (2)Copy—Include in award package to Caltrans District Local Assistance (3)Original—Local agency files Page I5-3I LPP 09-xx C-21 March 27,2009 r Exhibit 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER UDBE COMMITMENT(CONSTRUCTION CONTRACTS) (Revised 03109) ALL BIDDERS: PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s) falls into one of the following groups in order to count towards the UDBE contract goal: 1)Black American; 2)Asian-Pacific American; 3)Native American; 4)Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third Iow bidder,it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian-Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name,and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work(who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors' certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including,if the prime is a UDBE,work performed by its own forces. IMPORTANT: identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. Provide copies of the UDBEs'quotes,and if applicable,a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the UDBE,describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts);to determine how to count the participation of UDBE firms. Exhibit 15-0(1)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 Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate forth within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. Page I5-32 March 29,2009 C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good)faith Effort EXHIBIT 15-11 UDBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. Bid Opening Date 7-19-12 Huntington Beach The (City! established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of 6.64/0 for this project. The information provided herein shows that a good faith effort was made. Lowest, second Iowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the"Local Agency Bidder—UDBE Commitment"form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g.,a UDBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement Southern California Contractors Association SCCA) Magazine — Various Dates Please See Attached B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of Date of Follow Up UDBEs Initial Methods and Solicited Solicitation Dates Lindy's Cold Planing 7-12-12 Fax 7-19-12 Phone Precision Survey 7-12-12 Fax 7-19-12 Fax Lincoln Pacific 7-12-12 Fax 7-19-12 Phone California Proff. En 7-12-12 Fax 7-19-12 Phone. VT Electric 7-12-12 Fax 7-19-12 Phone Ray's Trucking 7-12-12 Phone 7-19-12 Phone Please See Attached C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-XX March 4,2009 C-23 i. Cheryl Noland............................................(310)830-6450 Rob Woods.................................................(818)834-0481 Construction Industry Research Board(CIRB) Bob Hill Hydraulic Crane Rentals,LLC Homer Mann Trucking John J.Clarke............................................(310)542-772 Karen Patin...............................................(323)875-1342 WBE/MBE Committee Clarke Contracting Corp. 82-1091 Alcom Fence Company James Halverson.......................................(951)6 Anna Camo................................................(949)540-0320 Craig Phillips..............................................(818)456-4560 Camo&Peters,LLP pavement Recycling Systems Sunstate Equipment Rita Ferguson.............................................(714)648-0397 Construction Industry Advancement Fund Sylvia Pizarroso...................................:......(949)616-9165 G&F Concrete Cutting,Inc. of Southern Card omia TCF Equipment Finance INDUSTRY COMMITTEES John J.Clarke............................................(310)542 7724 Dean Pultz.................................................(805)527-9330 American Road&Transportation Builders Association Clarke Contracting Corp. C.A.Rasmussen,Inc (ARIBA)Board of Directors Les Farrow.................................................(714)887-0788 Tom Walsh.................................................(714)578-9600 Les Farrow Excavating&Grading (909)356 8880 Sully-Miller Contracting,Ca. Doyle Powell............................................ Chuck Poss................................................(714)897-4326 Steven YoungPowell Constructors(term expires 2009) .,.„,,,,,,,,,,,,,,,dates,Inc.............(800)995 9170 909)350-3535 Earth Construction&Mining Paul Van Berg ........................................... Allen Lawrence&Associates,I Brutoco Engineering&Construction(term expires 2008) Fund for Construction Industry Advancement Scholarship Committee Construction Industry Air Quality Coalition Michael Crawford........................................(714)540-5351 Mike Meier,Chair.......................................(714)245 1500 14 540-5351 Sukut Construction Inc. Standard Concrete Products Inc. Mike Ortiz...nstr.ctio...Go...Inc. ................(7 ) Les Farrow.................................................(714)887-0788 John J.Clarke............................................(310)542 7724 Sukut Construction Ca.,Inc. Les Farrow Excavating&Grading Clarke Contracting Corp. Steve Aitfillisch....................................... )73 Charles W.Poss.........................................(323)726-3511 Lonnie Clausen..........................................(714)578-9508 ACI Past President Sutly-Miller Contracting Don Macintosh..........................................(562)692-1203 Scott Macintosh...........p...........................(562)692-1203 A.L Macintosh Public Works Standards Inc. A.L Macintosh Company Bob Shepherd............................................(562)463-4000 Board of Directors Sam Meyer................................................(619)938-8080 Quinn Shepherd Machinery Co. Greg Erickson,.........................................:.(323)875-1342 Marco Crane&Rigging Construction Industry Coalition on Water Quality Alcom Fence Company Pat poss....................................................(323)726-3511 Michael Crawford........................................(714)540-5351 Green Book Committee Transportation Committee Sukut Construction Inc. Paul Von Berg............................................(909)350 3535 Daniel Ugalde,Chair....................................(714)282-8012 Chuck Poss................................................(714)897-4326 Brutoco Engineering&Canstrvction...'..(909 356-8880 U9�de Trucking Co.,Inc. Earth Construction&Mining Paul Zolezzi.......................................... ) Chris Bragg................................................(562)984-2400 Paul Von Berg............................................(909)350 3535 Powell Constructors Heavy Transport Brutoco Eng.&Const.,Inc. Southern California Contractors Greg Dineen...............................................(760)249-4376 Construction Industry Crime Prevention Program Negotiating Committee(SCCNC) Greg Dineen&Associates Board of Directors Member John J.Clarke.....................I......................(310)542-7724 Bob McVay.................................................(714)554-5930 ..........(760)249-4376 Clarke Contracting Corp.Greg Dineen,President.................... g (714)887-0788 Marco Rentals Greg Dineen&Assoc. Les Farrow............................................... Les Farrow Excavating&Grading NOBEST I NCORPORATED GENERAL ENGINEERING CONTRACTOR SPECIALIZING IN PUBLIC WORKS PROJECTS The company seeks sub-bids from certified DBE/MBE/WBE contractors along with SECTION 3 BUSINESS CONCERNS. Contact estimating for details. P.O. Box 874 • Westminster, CA 92684 Phone: (714) 892-5583 • FAX: (714) 373-0039 License #359622 SCCA Directory 13 07/12/2012 f2:55 VAX 714 373 0039 NOBEST 2001 ACTIVITY REPORT � * ST. TIME CONNECTION TEL/ID SENDER NAME NO. MODE PGS. RESULT *07/11 15:19 19498529433 2139 TRANSMIT G3 6 OK 05'01 07/11 15:24 19498529620 2140 TRANSMIT G3 6 OK 04'58 07/11 15:56 7185 AUTO RX ECM 1 OK- 00'16 07/12 09:08 1 661 367 9099 7186 AUTO RX ECM 1 OK 00'23 07/12 10: 13 7187 AUTO RX G3 1 OK 02'05 07/12 10:52 CASE 2141 B'CAST ECM 3 OK 01'36 17146288905 07/12 10:54 CA TRAFFIC MAINT 2142 B'CAST ECM 3 OK 01'22 18189514093 07/12 10:57 CA TRAFFIC MAINT 2143 B'CAST ECM 3 OK 01'17 18189514093 07/12 10:58 2141 B'CAST 0 NG 00'00 0 #022 07/12 10:58 LINCOLN PACIFIC 2144 B'CAST ECM 3 OK 01'37 16269607739 07/12 11:00 PRSI 2145 B'CAST ECM 3 OK 03'23 19516821094 07/12 11:04 CHRISP CO 2142 B'CAST ECM 3 OK 01'34 19097460354 07/12 11:06 CHRISP CO 2143 B'CAST ECM 3 OK 01'38 19097460354 07/12 11:08 PRECISION 2141 B'CAST ECM 2 NG 01'51 19098626328 2 ##791 07/12 11:11 HIGHLIGHT 2144 B'CAST G3 3 OK 03'24 19513522921 07/12 11:14 LINDY'S 2145 B'CAST ECM 3 OK 01'22 15626972039 07/12 11:19 CNC 2141 B'CAST ECM 3 OK 02'52 19498630589 07/12 11: 22 CT&F 2144 B'CAST ECM 3 OK 04'06 15629274171 07/12 11:27 PRECISION 2145 B'CAST EC➢I 3 OK 05'15 19094468435 07/12 11:32 OC STRIPING 2142 B'CAST ECM 3 OK 02'42 17146396353 07/12 11:35 OC STRIPING 2143 B'CAST ECM 3 OK 03,09 17146396353 07/12 11:43 LA SIGNAL 2144 B'CAST 0 NG 00'36 16269685720 0 #018 07/12 11:44 RANCH ROCK 2142 B'CAST EC➢I 3 OK 01'32 19512802449 07/12 11:46 RANCH ROCK 2143 B'CAST ECM 3 OK 01'37 19512802449 07/12 11:49 PCI 2142 B'CAST ECM 3 OK 04'59 15622180634 07/12 11:54 PCI 2143 B'CAST ECM 3 OK 03'50 15622180634 07/12 11:58 ➢ZOORE ELECTRIC 2144 B'CAST 0 NG 00'00 19512783406 0 #018 07/12 11:59 STERNDAHL 2142 B'CAST ECM 3 OK 07'35 18188348618 07/12 12:07 STERNDAHL 2143 B'CAST ECM 3 OK 08' 52 18188348618 07/12 12:17 STEINY 2144 B'CAST ECM 3 OK 02'57 16263388343 07/12/2012 ,12:56 •FAX 714 373 0039 NOBEST ID002 r.7/,, i1.f 12:20 J&S 2142 B'CAST ECM 3 OK 02'04 19099479489 /12 12:23 J&S 2143 B'CAST EChI 3 OK O1'33 19099479489 12:24 HfOORE SIGNALS 2144 B'CAST ECM 3 OK 05'40 17146934838 07/12 12:30 SUPERIOR MINT 2142 B'CAST 0 NG 00'00 17145629400 0 #018 07/12 12:32 SUPERIOR PVMNT 2143 B'CAST 0 NG 00'00 17145629400 0 #018 07/12 12:33 DYNALECTRIC 2144 B'CAST ECM 3 OK 03'41 17144842389 07/12 12:37 WORKS 2142 B'CAST 0 NG 00'00 16268142805 0 #018 07/12 12:38 WORKS 16268142805 B'CAST 0 NG 00'36 16268142805 0 #018 07/12 12:40 CA PRO ENGINEER 2144 B'CAST ECK 3 OK 01'27 16268101322 07/12 12:41 VT ELECTRIC 2144 B'CAST ECM 3 OK 01'30 19099858186 NO BEST I Co P . O . BOX 874 WESTMINSTER , CA . 92684 TEL . # ( 714) 892 - 5583 FAX# ( 714) 373 - 0039 LIC . # 359622 A FACSIMILE TRANSMITTAL SHEET TO: FROM: Estimating MIKE LEWIS DATE: 7/12/2012 FAX NUMBER: TOTAL NO.OF PAGES INCLUDING COVER: 3 PHONE NUMBER: SENDER'S REFERENCE NUMBER: RE: YOUR REFERENCE NUMBER: Huntington Beach-Safe Routes to School ❑URGENT ❑FOR REVIEW ❑PLEASE COMMENT Q PLEASE REPLY ❑PLEASE RECYCLE Bids:July 19, 2012 @ 2:00 p.m. Nobest Incorporated seeks sub-bids from certified UDBE/DBE/MBE/WBE contractors along with Section 3 Business Concerns. Please attach certification number with quote. If you have any questions feel free to call Thanks NOBEST INC. MIKE LEWIS P.O.BOX 874 WESTMINSTER,CA.92684 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Item. Estimated Item Unit Price Extended Amount No Quantity.- 1 1 L.S. Mobilization. $ $ Per L.S. 2 1 L.S. Furnish Construction Surveying and Monument Preservation. $ $ Per L.S. 3 1 L.S. Furnish Project Traffic Control. Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. $ $ Per L.S. 5 1 L.S. Modify Traffic Signal at Goldenwest Street and Slater Avenue(Excludes AC Surface $ $ Grinding). Per L.S. 6 1 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case A, and Per Typical Section at New $ $ Ramps Adjacent to AC Paving Detail. Per EA. 7 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B, and Per Typical Section at New $ $ Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Extended:` Item Estimated Item Unit Price No Quantity; ............ 8 14 EA. Construct Curb Ramp per Caltrans Standard Plan No. A8 8A, Case C, and Per Typical Section at New $ Ramps Adjacent to AC Paving Detail. Per EA. 9 1470 S.F. Surface Grind Existing A.C. to a Depth of 0.17 FT and Construct New 0.17 FT Surface Coat Over $ F $ LExisting Asphalt Concrete. Per S.F. i --- ---J I Total Amount Bid in Figures: IL Total Amount Bid in Words: Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 Exhibit 15-H Local Assistance Procedures Manual UDBE Information-Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (Y/N) Contract Survey N 2 Electrical N 5 Trucking Y 6,7,8 Cold Planing N 9 D. The names,addresses and phone numbers of rejected UDBE firms,the reasons for the bidder's rejection of the UDBEs,the firms selected for that work(please attach copies of quotes from the firms involved),and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Not Known At This Time V T Electric — Not bidding on this project. Calif. Professional Eng. — Bidding as Prime, not giving sub bids. Names,addresses and phone numbers of firms selected for the work above: -.Ray's Trucking — Torrance May Be Additional — Not Known At This Time Please See Attached E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: No Assistance Needed F. Efforts made to assist interested UDBEs in obtaining necessary equipment,supplies,materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: No Assistance Needed ii i s G. The names of agencies, organizations or groups contacted to provide assistance in contacting, I recruiting and using UDBE firms(please attach copies of requests to agencies and any responses € received, i.e.,lists,Internet page download,etc.): Page 15-34 March 4,2009 LPP 09-xx C-24 Unified Certification Program Page 1 of 1 Back To Query Form Search Returned 1 Records Thu Jul 19 12:08:26 PDT 2012 Query Criteria Firm ID: 02037 Firm Type: DBE Firm ID 2037 Firm/DBA Name RAY'S TRUCKING Address Linel 17103 S HASS AVENUE Address Line2 City TORRANCE State CA Zip Codel 90504 Zip Code2 Mailing Address Linel P.O.BOX 6553 Mailing Address Line2 Mailing City TORRANCE Mailing State CA Mailing Zip Codel 90504 Mailing Zip Code2 Certification Type DBE Entail luckylady5555@sbcglobal.net Contact Name SHARON ALEXANDER Area Code (310) Phone Number 538-9891 Fax Area Code (310) Fax Phone Number 327-6922 Agency Name DEPARTMENT OF TRANSPORTATION Counties 19;30;36;56; Districts 07;08; 12; DBE NAICS 425120;484110; ACDBE NAICS Work Codes C9602 BOTTOM DUMP TRUCKING;C9771 TRUCK BROKER;C9774 TRUCKER; Licenses Trucks FOR HIRE-2; Gender F Ethnicity CAUCASIAN Firm Type DBE Back To Query Form http://www.dot.ca.gov/ucp/QuerySubmit.do 7/19/2012 Local Assistance Procedures Manual Exhibit I5-H UDBE Information•Good Faith Effort Name of Method/Date Results Agency/Organization of Contact SCCA (Internet) 7-12-12 (1) Union UDBE Contractor found. G & F Concrete Cutting H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): SCCA Membership Directory (Please See Attached) NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-xx March 4,2009 C-25 SCCA Members Page 1 of 11 M¢A 5 PRO 1 MENU SCCA Signatory Members A-K Home Contact an SCCA member today! Contact us What we do Events& Meetings Industry Resources Safety Resources a � aD SCCA Members Signatory members are those contractors and others allied to the field who are sic Signatory Members or more of the union trade agreements negotiated by SCCA. Affiliate Members For Signatory Members L-Z click here ADR Members Mobile Crane Operators 25th Street Recycling Inc. (818) 767-3088 • Fax (818) 767-3169 Inspection Group P.O. Box 579, Sun Valley, CA 91353; 2121 E. 25th St., Los Angeles, CA 90058 Contact: Mark Christie Honorary&Special Dump site for broken concrete and AC, Class II base and CMB base materials. Membership application Member Since 1974 Abbott Contracting &Engineering (951) 905-0823 • Fax (951) 898-0988 c:D SCCA Governance PO Box 5535, Norco, CA 92860 Contact: Kevin Abbott, kpabbott@abbottce.com SCCA Officers Member Since 2007 Board of Directors ABC Construction Committees (619) 239-3428 • Fax (619) 239-6614 3120 National Ave., San Diego, CA 92113 abc@abcconstruction.com • www.abcconstruction.com Contact: Kenneth Czubernat cO About SCCA Grading, asphalt paving and concrete for parking lots and roads. Turnkey service complete demolition, excavation, asphalt paving and concrete items. Street lighti Volunteer-led and governed by signals, storm drains, wet utilities and landscaping. We bid on prevailing and non its members, SCCA has served wage projects and are union signatory. CSI codes in our projects typically include the union heavy construction demolition, 02075 concrete removal, 02100 sitework, 02200 earthwork, 02510 a: industry since 1974. Membership concrete paving, 02520 Portland cement concrete paving, 02523 concrete curbs, is open to contractors signatory sewage and drainage, 02840 walk, road, and parking appurtenances. with the Operating Engineers, Member Since 2007 Laborers, Cement Masons, Ironworkers, Carpenters or ACI —Altfillisch Contractors Construction Teamsters. Affiliate (951) 736-2811 • Fax (951) 735-8934 member-ships are also available. 13300 Citrus St., Corona, CA 92880 www.acigrading.com Our Mission Contact: John Galloway http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 2 of 11 Member Since 1978 Addison Equipment Rental (909) 822-8282 • Fax (909) 822-6898 10206 Elm Ave., Fontana, CA 92335 www.addisonequipment.com Contact: Corey Addison, President Backhoes, dozers, motor graders, skip loaders, scrapers, water trucks, water tow lowbeds Member Since 1981 AESCO (714) 375-3830 • Fax: (714) 375-3831 17782 Georgetown Lane, Huntington Beach, CA 92647 www.aescotechnologies.com Contact: Adam Chamaa, adam.chamaa@aescotech.com Inspection/testing firm. Member Since 2008 Joseph J. Albanese Inc. (408) 727-5700 • Fax (408) 727-0366 986 Walsh Ave., Santa Clara, CA 95050, PO Box 667 (95052) www.jjalbanese.com Contact: Kevin J. Albanese, kalbanese@jjalbanese.com Member Since 2006 Alcorn Fence (323) 875-1342 • Fax (818) 768-9719 PO Box 1249, Sun Valley, CA 91353 Contact: Greg Erickson Locations: Riverside: (951) 685-1641, 6445 Old Pedley Rd. Orange: (714) 744-9447, 1212 W Struck Ave. San Diego: (619) 397-6500, 788 Energy Way, Chula Vista, CA 91911-6109. Ventura: (805) 642-3286, 3787 Transport Ave. Celebrating 68 years of service to Southern California construction, supplying fen k-rail and other protection and security services for highway and general construe Member Since 1984 Allied Testing Associates (661) 393-9711 2321 Perseus Court, Bakersfield, CA 93308 alliedtestingassociates@yahoo.com Contact: Greg Walker Member Since 2009 A. M. Concrete (818) 768-4767 • Fax (818) 768-7228 9050 Norris Ave., Sun Valley, CA 91352 PO Box 579 (91353-0579) Contact: Joseph Ferndino, Vice President Member Since 1983 L.D. Anderson Engineering &Grading (909) 879-7970 . Fax (909) 879-7975 2750 S. Lilac Ave., Bloomington, CA 92316 Contact: Lowell D. Anderson Jr. Member Since 1991 Anglemyer Crane Rental (626) 334-5109 • Fax (626) 969-9110 1190 W. Gladstone, Azusa, CA 91702 http://www.secaweb.org/Members.htm 7/19/2012 SCCA Members Page 3 of 11 www.angIemyercrane.com Contact: John Anglemyer,johnanglemyer@verizon.net Member Since 2000 A Power Sweeping (562) 568-5127 o Fax (562) 568-8824 3737 San Gabriel River Pkwy, Pico Rivera, CA 90660 Contact: David Patapoff Street sweepers, clean up for paving, grinding and dirt. Member Since 2004 Barler Equipment (714) 282-7540 o Fax (714) 637-4155 PO Box 6464, Orange, CA 92863-6464 Contact: Dennis Barler Member Since 1984 Barney's Hole Digging Service (562) 595-5224 o Fax (562) 595-1005 3252 Cherry Ave., Long Beach, CA 90807 barneyshol@aol.com Contacts: Ross Bumgarner, President Brett Bumgarner, Vice President Ryan Bumgarner, Vice President Scott Bumgarner, Sales/ Estimating Paula Felix, Secretary/Treasurer With different sized machines for various applications; truck-mounted machines f access drilling and track-mounted machines for low overhead and confined space holes from 12 inches to 8 feet in diameter to depths of 100 feet. Use augers (goc conditions), core barrels (for coring through concrete, rocks, etc.), and buckets (1 wet conditions). Member Since 1985 Basin Construction (949) 533-9958 9 Fax (949) 266-9868 14252 Culver Drive, Suite A#805, Irvine, CA 92604 www.basinconstruction.com Contact: David Kendrick, President, dkendrick@basinconstruction.com Excavating and grading contractor specializing in grading for schools, large Indus', buildings, parking structures, mass-graded sites, commercial buildings. Member Since 1976 R. C. Becker&Son (661) 259-4845 • Fax (661) 259-9869 28355 Kelly Johnson Pkwy., Santa Clarita, CA 91355 Contact: Mike Becker Member Since 1978 Bob's Crane Service (619) 443-5887 o Fax (619) 390-8279 12101 Highway 67, Lakeside, CA 92040 www.bobscrane.com Contact: Bob Turner, bturner@bobscrane.com Member Since 2007 Bob Hill Hydraulic Crane Rentals (310) 830-6450 • (800) 924-6445 9 Fax (310) 830-6490 P.O. Box 16069, Long Beach, CA 90810 www.BHCcrane.com Contact: Todd Durdella, Sales Manager, todd@bhccrane.com Our primary focus at BHC Crane Service is to provide a safe and accurate lift eve http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 4 of 11 we have succeeded at this for over 50 years now. With a fleet of mobile hydraulic 5 to 300 ton capacity and a group of dedicated operators and sales associates on hours a day, we have the ability to offer solutions for even the most demanding j look forward to demonstrating to you our ability to manage safety and expenses the accuracy and reliability BHC Crane Service has become known for. Member Since 1995 Boydco Equipment Rental (310) 850-0327 • Fax (951) 677-3207 40337 Via Reata, Murrieta, CA 92562 Contact: Boyd Sumner, President Member Since 2001 Bradley Recycling LLP (818) 767-6860 • Fax (818) 767-6848 8960 Bradley Ave, Sun Valley, CA 91352 Dump site for broken concrete and asphalt. Member Since 1974 Bragg Crane Service (562) 984-2400 • Fax (562) 984-2467 6251 Paramount Blvd., Long Beach, CA 90805 www.braggcrane.com Contacts: M. Scott Bragg, Vice President, braggS@braggcrane.com Michael Roy, Executive Vice President, royM@braggcrane.com Branches Fontana, CA: (909) 350-3738, 13188 Dahlia St., 92337 Mojave, CA: (661) 824-5128, 16922 Airport Blvd, Bldg 1, Rm. 11, 93501 Richmond, CA: (510) 232-7222, 457 Parr Blvd., 94801 Sacramento, CA: (916) 376-8754, 3440 West Capitol Ave, 95691, PO Box 980756 (95798) San Diego, CA: (619) 521-3900, 10329 Channel Rd., Lakeside 92040 Santa Maria, CA: (805) 922-7717, 1326 Jason Way, 93455 Thousand Palms, CA: (760) 343-3777, 27950 Sierra Del Sol, 92276 Sparks, NV: 2251 Larkin Circle, 89431 Phoenix, AZ: (602) 233-0205, 2816 N. 27th Ave., 85009 Odessa,TX: (432) 332-0484, 824 S. Grandview, 79761 Salt Lake City, UT: (801) 272-6348, 2198 West 2425 South, Woods Cross, UT 84 Operating a fleet of hydraulic cranes to 550-ton capacity, conventional truck cran capacity, rough-terrain cranes to 130-ton capacity and crawler cranes to 600-ton Affiliate, Bragg Crane and Rigging, provides complete mechanical and erection cc and lift-engineering services. Transportation division, Heavy Transport, provides 1 heavy hauling and over-the-road transportation. These three companies make Br "full service"provider. Locations throughout California, Utah, Texas, Nevada and provide the highest quality crane service to the Western United States. Member Since 1978 Brutoco Engineering &Construction (909) 350-3535 • Fax (909) 822-9661 PO Box 310189, Fontana, CA 92331-0189 brutoco@brutoco.net • www.brutoco.net Contacts: Mike Murphy, President Paul Von Berg, Executive Vice President Don Brake, Chief Financial Officer Mike Fenley, Senior VP/General Manager John Glanville, Vice President Ron Neal, Vice President Paul Sullivan, Vice President General engineering contractor engaged in heavy civil, highways, bridges, mecha http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 5 of 11 treatment plants and pump stations, and general building construction in souther Member Since 1974 Calex Engineering (661) 254-1866 • (310) 843-0710 • (818) 367-2177 • Fax (661) 259-9183 23651 Pine St., Newhall, CA 91321-3106 calex@calex.net• www.calex.net Contact: Ryan Seitz, General Manager Excavation, shoring, grading, drilling, mass excavation, hillside repair and equipn From daybreak to well after dark, from oceanfront to mountaintops, we provide v skilled management and field personnel, personal interest and commitment, knot experience in the demanding skills of trade diversified, which combine to translat consistent, high quality, on-site performance. We save customers money by mini with advanced scheduling, superior technology and innovative ideas. We can mar no matter what difficulties arise. Member Since 1975 California Boring Inc. (714) 632-1596 • Fax (714) 666-8975 3030 E. Coronado St., Anaheim, CA 92806 Contact: Sarah Gutierrez, sarah.cbi@sbcglobal.net Member Since 2010 California Crane and Rigging (800) 772-7263 • Fax: (562) 907-4495 8509 Chetle Ave, Sante Fe Springs, CA 90670 californiacrane@verizon.net www.californiacraneandrigging.com Contact: Andy Nader, Managing Member Located in Southern California for 31 years performing all types of general hoistir rigging. Fleet ranges from boom trucks to 200-ton hydro's with boom lengths of Operators are Local 12. Member Since 2008 Cattrac Construction (909) 355-1146 • Fax (909) 355-4410 15030 Slover Ave., Fontana, CA 92337 www.cattrac.com Contact: Stephanie Jacinto, President, steph@cattrac.com Grading, equipment rental and equipment transportation. A multifaceted compan encompassing all phases of grading, dirt work, and heavy equipment rental and t Equipped to handle emergency response. Serving the southern California constru since 1971. Also licensed in Nevada. Member Since 1982 Cedro Construction (805) 525-0599 • Fax (805) 525-0509 120 E. Santa Maria St., Santa Paula, CA 93060 andy@cedroconstruction.com Contact: Randy Almanza Member Since 2009 Champion Crane Rental, Inc. (818) 781-3497 • Fax (818) 896-6202 12521 Branford St., Pacoima, CA 91331 www.championcrane.us Champion Crane Rental, Inc., owned and operated by Mike Konle since 1983, hay established itself as an industry leader in crane rental. Champion has assembled fleet of state-of-the-art hydraulic cranes raging in size from 4 ton to 250 ton cap< boom lengths of up to 350 feet, and specialty cranes like the popular 33 ton Derr available for rental only thru Champion Crane. All equipment is fully maintained, http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 6 of 11 insured and certified. Service is available 24 hours a day, 7 days a week. Site evi job walks are available upon request. Member Since 1995 Clarke Contracting (310) 542-7724 • Fax (310) 542-2188 4646 Manhattan Beach Blvd., Lawndale, CA 90260 Contact: Brian Clarke Member Since 1976 Cleveland Wrecking (626) 967-9799 • Fax (626) 967-1479 628 E. Edna PI., Covina, CA 91723-1312 www.clevelandwrecking.com Contact: Jim Sheridan,jim_sheridan@urscorp.com Member Since 1997 Coburn Equipment (909) 591-6417 • Fax (909) 591-9383 13930 Oaks Ave., Chino, CA 91710 Contact: Ray Coburn Member Since 2001 Monte Collins Backhoe&Equipment (562) 430-3715 • Fax (562) 493-2610 3342 Cerritos Ave., PO Box 697, Los Alamitos, CA 90720 www.montecollins.com Contact: Lance Slimmer, LBSlimmer@montecollins.com Monte Collins, info@montecollins.com Member Since 1983 Concrete Coring (562) 634-4021 • Fax (562) 634-2305 14005 Orange Ave., Paramount, CA 90723 www.concoring.com Contact: Dennis Richens, President, dennisr@concoring.com Concrete coring, slab sawing (electric or gas), wall sawing, hand sawing, wire sa% demolition and rock drilling. Member Since 2004 Conco Pumping (866) 347-3407 • Fax (909) 350-0708 13052 Dahlia Street, Fontana, CA 92337 www.theconcocomanies.com Contact: Doug Marquis, General Manager, dmarquis@concopumping.com A full service signatory concrete pumping company serving the Southern Californ construction market. We service any size job. Member Since 2010 Cooper Engineering (951) 736-6135 • Fax (951) 736-0429 281 Corporate Terrace, Corona, CA 92879 cooperengineering@cox.net• www.cooperconcrete.net Contact: Hod Cooper Specializing in patented Slipstone architecturally treated barrier rail, standard bai concrete paving. Member Since 2000 Coral Construction (503) 682-2252 Y Fax (503) 682-0110 10780 SW Clutter Rd., Sherwood, OR 97140, PO Box 347, Wilsonville, OR 97070 http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 7 of 11 www.coralconstruction.com Contact: John Weisner,johnweisner@coralconstruction.com Member Since 2007 Crane Rental Service (714) 997-3100 o Fax (714) 771-5800 1901 W. Collins Ave., Orange, CA 92867 www.ecrane.net Contacts: Cathy Greinke, President, cathy@ecrane.net Greg Foster, Vice President Jess Sturgeon, General Manager Lori Hunter, Secretary/Treasurer Hydraulic cranes from 25 to 300 tons. Our motto is"Large enough to serve, smal care." Family owned and operated in the same location for more than 40 years, c unsurpassed service to all customers 24 hours a day, year round. Taking pride in customers. Member Since 1995 Tony R. Crisalli Inc. .(951) 727-0110 o Fax (951) 727-0130 3468 Campbell St., Riverside, CA 92509 Contact: Tony R. Crisalli, President Heavy equipment rental. Member Since 1989 Darco Demolition (562) 908-4000 o Fax (562) 903-8886 PO Box 2665, Santa Fe Springs, CA 90670 www.darco.com Contact: Gary Darnell, gadarco@darco.com Member Since 2005 D&D Equipment Rental (562) 903-9333 o Fax (562) 903-8881 PO Box 2369, 10936 Shoemaker, Santa Fe Springs, CA 90670. www.ddrental.com Contacts: Gary A. Darnell, President John Allaire, CFO Member Since 2000 Desert Commercial Sweeping, Inc. (775) 841-0985 o Fax (775) 841-7566 5620 Madras St., Carson City, NV 89704 dcsweeping@aol.com Contact: Bill Wallace Member Since 2007 DiDonna's Masonry(dba DMI) (562) 598-3292 o Fax (562) 598-3494 10661 Humbolt St., Los Alamitos, CA 90720 Contact: Cheryl Didonna, didonnamas@msn.com Member Since 2010 Dielco Crane Service (702) 364-5000 o Fax (702) 364-8117 5454 Arville St., Las Vegas, NV 89118 Contact: Richard Dieleman, President Crane rigging and specialized transportation services. Fleet is continually updatec latest in lifting technology and dependability. Staff includes supervisors, engineer best operators providing services including turnkey lump sum projects, hourly ref rentals. We provide any expertise and service a project requires from a simple cr http-//www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 8 of 11 an engineered lift plan. Member Since 2002 Diggerz (951) 640-1835 • Fax (909) 357-7261 14050 Cherry Ave., # R176, Fontana, CA 92337 Contact: Jeff Mitchell, President,jmitchell@diggerzinc.com Specializes in excavating, loading and breaking. Fleet includes excavators ranginc to 165,000 pounds. Member Since 2003 Earth Construction &Mining (714) 897-4326 • Fax (714) 897-2016 11542 Knott St. #10, Garden Grove, CA 92841 www.4ecm.com Contacts: Charles W. Poss III, President Chuck Bean, Operations Manager, cbean@4ECM.com Drilling, blasting, specialized explosive applications and technical services, as wel and mine development, production and reclamation. Drilling and blasting for mas structural excavations. Expansive chemical and sub-aqueous applications. Feasibi budget evaluations. Pre/post blast structural inspections. Vibration and sound me documentation. Blasting project public relations. USDOD, industrial research and manufacturing geotechnical investigations. Explosive demolition of steel and conc structures. U.S. Department of Labor MSHA Safety Certification, U.S. Department ATF&E, and regional licenses and permits. Member Since 2004 E.G.I. Contractors (805) 532-2077 • Fax (805) 532-1790 13840 Princeton Ave., Moorpark, CA 93021 Contact: Tom Mogan, tmogan@ sharmacontractors.com Member Since 2005 B. W. Farley Corp. (714) 995-2434 • Fax (714) 995-2494 8230 Electric Ave., Stanton, CA 90680 cat@farley1977.com Contact: Bert Farley, President Member Since 1989 Les Farrow Excavating and Grading (714) 887-0788 • Fax (714) 887-0791 17892 Jamestown Lane, Huntington Beach, CA 92647 Contacts: Curtis Farrow, President, cfatlfx@aol.com, Ken Farrow, Vice President, kfatlfx@aol.com Member Since 1998 Fife Concrete Construction (562) 429-5905 • Fax (562) 832-8232 4134 Country Club Drive, Lakewood, CA 90712 info@fifeconcrete.com Contact: Andy Fife Member Since 2009 Fonseca/McElroy Grinding (559) 636-2043 a Fax (559) 734-3809 139 N. Cain, Visalia, CA 93292 www.fmgrinding.com Contact: Jerry Mack,jerry@fmgrinding.com Member Since 2009 http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 9 of 11 G &F Concrete Cutting, Inc. (714) 648-0397 9 Fax (714) 550-0624 PO Box 10215, Santa Ana, CA 92711-0215 1006 E. Chestnut Ave., Santa Ana, CA 92701 www.gfconcretecutting.com Contact: Rita M. Vigil-Ferguson, President, r.ferguson@gfconcretecutting.com Full-service concrete cutting company specializes in deep cutting, as well as large (up to 42-inch holes). Primary work is within the Public Works sector. MBE/WBE/ UDBE Certified, Caltrans, City of LA, Clearinghouse, MTA and MWD. Member Since 1991 Gotcha Engineering Contractors (310) 521-9052 • Fax (310) 521-9052 663 West 35th St. #1, San Pedro, CA 90731 Full service engineering and construction. Griffin Dewatering Corporation (909) 986-4498 9 Fax (909) 988-8457 536 E. Maitland St., Ontario, CA 91761 California@griffindewatering.com e www.griffindewatering.com Contact: Jose Somera, Project Manager Eight branch offices provide personnel experienced in the equipment and installal groundwater extraction systems. Expertise in the design and installation of the s) consisting of deep wells, submersible pumps, vacuum wellpoints, eductors, surfac pumps. Member Since 1996 Harper's Backhoe Service, dba Harper Equipment Rental (714) 826-9740 a Fax (714) 826-5371 8141 Electric Ave, Stanton, CA 90680 info@harpereq.com • www.harpereq.com Contacts: Debra L. Harper; Dale Huss Jr. Full-service equipment rental company providing the latest in equipment operate Fleet includes backhoe-loaders, excavators, skiploaders and Bobcats. Member Since 1990 Hill Crane Service (562) 595=6031 • Fax (562) 595-1771 3333 Cherry Ave., Long Beach, CA 90807 Contact: Richard Hill, President Member Since 1995 Howard Contracting (562) 596-2969 • Fax (562) 596-2926 12354 Carson St., Hawaiian Gardens, CA 90716 Contact: Stanley L. Howard, VP Earthwork, demolition, site clearing and environmental work; public and private Member Since 1984 Hydraulic Cranes LLC (562) 944-6149 • Fax (562) 944-3879 10805 S. Painter Ave., Santa Fe Springs, CA 90670 Contact: Paul Henderson Member Since 1995 Jacobsson Engineering Construction (760) 345-8700 a Fax (760) 345-8799 77590 Enfield Lane, PO Box 14430, Palm Desert, CA 92255 www.jacobssoninc.com Contact: Dan Jacobsson, President http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 10 of 11 Member Since 1996 Jagur Tractor (626) 336-4554 • Fax (626) 961-2257 1670 Turnbull Cyn, PO Box 5007, Hacienda Heights, CA 91745 Contacts: Norm Gorgone, President Mark Gorgone, Vice President Phil Gorgone Vice President Operated and maintained equipment rentals with full backup from site mechanics trucks and fuel and lube equipment as follows. 657-651-637-623F-DION-D9R&N- D5M-5503-834B-824C&B-140G-14H-980C-631E-651B. 10,000-gallon water pulls 35-ton rock trucks. Member Since 1999 JBH Structural Concrete (951) 566-5220 . Fax (951) 566-5264 PO Box 869, Murrieta, CA 92564 Contact: Jeff Hale,jeff@jbhconcrete.com Member Since 2009 Jensen Drilling (541) 726-7435 o Fax (541) 726-6140 1775 Henderson Ave., Eugene, OR 97403 Contact: Jerry J. Jensen Member Since 1998 Jezowski &Markel Contractors (714) 978-2222 • Fax(714) 978-6931 748 N. Poplar St., Orange, CA 92868-1014 www.jmcontractors.com Contacts: Mike Barth, President Meredith Brownson, Marketing Member Since 1997 JLS Concrete Pumping (805) 643-0766 e Fax (805) 643-6167 PO Box 667, Oak View, CA 93022 2055 N. Ventura Ave., Ventura, CA 93001 www.jlspumping.com Contact: Jeffrey L. Switzer,jls@jlspumping.com Member Since 2005 The J.V. Land Clearing Co. (909) 592-2811 . Fax (909) 592-5179 207 E. Arrow Hwy, San Dimas, CA 91773 Contact: Cyril Manus Member Since 1981 JWT General Engineering (559) 325-3827 . Fax (559) 325-1584 PO Box 2549, Clovis, CA 93613 Contact: Bart Jones,jwtge@sbcglobal.net Member Since 2010 KEC Engineering (951) 734-3010 o Fax (951) 735-2041 200 North Sherman Avenue, Corona, CA 92882 kec@kecengineering.com • www.kecengineering.com Contacts: Les Card,Jim Elfring, Scott Pfeiffer Member Since 2007 http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 11 of 11 L.P. Kirby Excavation (909) 469-2200 • Fax (909) 469-2204 1398 E. Grand Ave., Pomona, CA 91766 sadler2654@msn.com Contact: Rob Kirby, robbykirby@att.net Gradall rentals, specialized excavation, long reach. Have XL Series Gradall, track rubber tired. Brush cutter/mower attachments available. Member Since 1993 KRC Safety (559) 732-0393 a Fax (559) 732-2684 6084 West Hurley, Visalia, CA 93291 Contact: Gary Castro Member Since 1996 Kroner Environmental Services (310) 474-1500 • Fax (310) 474-1577 10801 National Blvd., Suite 415, Los Angeles, CA 90064 www.kronerenvironmental.com Contact: Kurt Kroner, Vice President Member Since 2007 Copyright 2012 by Southern California Contractors Association. All rights re http://www.sccaweb.org/Members.htm 7/19/2012 SCCA Members Page 1 of 13 MENU SCCA Signatory Members L-Z Home Contact an SCCA member today! Contact us !That we do Events&Meetings Industry Resources Safety Resources A i cD SCCA Members Signatory members are those contractors and others allied to the field who are sic Signatory Members or more of the union trade agreements negotiated by SCCA. Affiliate Members For Signatory Members A-K click here ADR Members Mobile Crane Operators Laird Construction (909) 989-5595 a Fax (909) 944-9301 Inspection Group 9460 Lucas Ranch Rd., Rancho Cucamonga, CA 91730-5743 Honorary Special Contact: Ralph J. Laird, VP, RJL@lairdconstruction.com Membership application General engineering contractor specializing in road construction, demolition, grad paving, heavy equipment rental. Member Since 1984 SCCA Governance R. J. Lalonde, Inc., dba Lalonde Equipment Rentals (562) 595-6655 a Fax (562) 595-8833 SCCA Officers 2508 North Palm Drive #200, Signal Hill, CA 90755 Contact: Brian Lalonde, Vice President Board of Directors Operated equipment rental. Committees Member Since 1979 Leko Construction, Inc. (805) 583-3893 • Fax (805) 583-5081 c:D About SCCA 5215-B Kazuko Court, Moorpark, CA 93021 Contact: Martin Leko, marty@lekoconstruction.com Volunteer-led and governed by Member Since 1985 its members, SCCA has served the union heavy construction The L.K.R. Group, Inc. industry since 1974.on Membership (310) 320-4982 a Fax (310) 320-5428 is open to contractors signatory 370 Amapola Ave., Suite 111.Torrance, CA 90501 with the Operating Engineers, www.groupdelta.com Contact: Michael Reader, President, miker@groupdelta.com Laborers, Cement Masons, Member Since 2001 Ironworkers, Carpenters or Construction Teamsters. Affiliate member-ships are also available. Lorenz Construction (714) 832-1656 a Fax (714) 832-1444 Our Mission PO Box 868, Tustin, CA 92681-0868 http://www.secaweb.org/Members_1_z.htm 7/19/2012 SCCA Members Page 2 of 13 1042 St. Regis Place, Santa Ana, CA 92705 Contact: Tom Lorenz Member Since 1979 Lovex General Engineering Corp. (760) 249-5428 • Fax (760) 249-6616 PO Box 1968, Wrightwood, CA 92397 Contact: Lori R. Lovett, lovettexcavating@earthlink.net Member Since 1995 L T Engineering (949) 367-1941 • Fax (949) 367-9968 27601 Forbes Rd., Ste. 54, Laguna Niguel, CA 92677 jill@ltengineering.net Contact: David Elsberry, President Member Since 1996 Lukkes Striping (714) 352-7005 • Fax (714) 444-2362 1312 Warner Ave., Santa Ana, CA 92705 Contact: Chad Lukkes, clukkes@lukkesstriping.com Member Since 2010 A. L. MacIntosh Co. (562) 692-1203 • Fax (562) 695-8293 9501 Kruse Road, Pico Rivera, CA 90660 almacintosh@dslextreme.com Contacts: Don MacIntosh, President Gary Walker, Superintendent Scott MacIntosh, Estimator Since 1952, this third-generation family owned company specialized in site clearii excavation, backfilling and site grading. Work area includes Los Angeles, Orange, and San Bernardino counties; primary work is commercial, industrial, and institut projects. Fleet consists of more than 35 pieces of late-model earthmoving equipn numerous small support equipment with full backup from site mechanics and sere We take pride in our productivity and commitment to providing excellent work in schedule. Member Since 1974 Manhole Adjusting (323) 558-8000 • Fax (323) 558-8001 9500 Beverly Road, Pico Rivera, CA 90660 mainc@earthlink.net Contact: John Corcoran Member Since 2009 Marco Crane&Rigging (619) 938-8080 9 Fax(619) 938-8081 10168 Channel Road, Lakeside, CA 92040 www.marcocrane.com Contacts: Sam Meyer, smeyer@marcocrane.com Dan Mardian Jr., dmardian@marcocrane.com Branches:Santa Fe Springs: (562) 699-0664 • Fax (562) 699-0675, PO Box 306E Phoenix: 221 S. 35th Ave., 85009, PO Box 18008, 85005 Operated and maintained crane service; bare rental cranes; crane repair. Member Since 1996 Marina Landscape (714) 939-6600 • (714) 935-1199 1900 S. Lewis St., Anaheim, CA 92805 Contact: John Gutierrez,jgutierrez@marinaco.com http://www.secaweb.org/Members_1_z.htm 7/19/2012 SCCA Members Page 3 of 13 Locations: Anaheim, Sunland, Palm Desert Landscape construction, maintenance, erosion control and design divisions install projects ranging from $10,000 to $40 million. Provide bonding for all our projects landscape design build/design assist on any landscape project. Notable Projects: San Diego; Home Depot Center-Carson; Sprinter Light Rail-Oceanside; University Irvine, Humanities, Gateway (Design Build) Member Since 2009 Marne Construction (714) 935-0995 • Fax (714) 935-0585 748 N. Poplar St., Suite 200, Orange, CA 92868-1014 info@marneconstruction.com www.marneconstruction.com Contact: Charles Randolph, President Member Since 1993 Maxim Crane Works LP (562) 989-5709 • Fax (562) 595-7665 1101 E. Spring St., Long Beach, CA 90806 www.maximcrane.com Contact: Neil Goodale, ngoodale@maximcrane.com Branches: Fontana: (909) 428-2800 San Diego: (619) 563-7910 Sacramento: (916) 383-0470 Stockton: (209) 464-7635 Phoenix: (602) 242-4681 Leading coast-to-coast full-service crane rental company operating 45 branch offi regions. Specializes in sales and rentals of bare and operated rough-terrain crane trucks from 8 to 1,200 tons, and ancillary equipment. Each branch provides mani rigging, engineering and transportation - making Maxim's product and service ofl most comprehensive in the industry. One-stop shop for crane rental and sales - day/seven days a week. Member Since 1995 MB Professional Service (909) 988-2795 • Fax (909) 606-6555 1236 West Brooks St., Ontario, CA 91762 www.mbpsinc.com Contact: Dave Manefee, davem@mbpsinc.com Member Since 2009 Don McCoy Corp. (949) 492-0063 • Fax (949) 459-9188 PO Box 4020, Dana Point, CA 92629 29122 Rancho Viejo Rd., Ste 209., San Juan Capistrano, CA 92675 www.donmccoycorporation.com Contact: Don McCoy, President, donmccoycorp@yahoo.com Premier earthmoving contractor serving California for more than 40 years. McCo} President of the SCCA and Contractor of the Year. Specialize in heavy grading. Cr residential planned communities, golf courses and commercial developments fron undeveloped hillside properties. Work in Orange, Riverside and San Diego countie Coachella Valley Region. Late-model fine grading equipment utilizes GPS 3D stak, equipment from Topcon. This technology has allowed us to increase our productic on significant cost savings to our clients. Safety is a very important aspect of our work to prevent accidents before they happen. Member Since 1995 McGuire and Hester (510) 632-7676 a Fax (510) 562-5210 9009 Railroad Ave, Oakland CA 94603 www.mcguireandhester.com http://www.sccaweb.org/Members_l_z.htm 7/19/2012 SCCA Members Page 4 of 13 Contact: Michael Hester, President, mh@mcguireandhester.com General contractor with more than 80 years of experience in underground, gradir concrete, mechanical, materials and landscaping. Member Since 2008 McGuire and Hester/TerraCon Pipelines IV (510) 632-7676 • Fax (510) 562-5210 9009 Railroad Ave., Oakland, CA 94603 Contacts: Mike Hester, mh@mandhcorp.com Steve Lydon Member Since 2010 Tina McMinn Equipment Rental (951) 453-3913 o Fax (951) 780-8252 16235 Krameria Ave., Riverside, CA 92504 Contact: Tina McMinn Member Since 1998 John S. Meek Co. (310) 830-6323 • Fax (310) 835-2163 14732 So. Maple Ave, Gardena, CA 90248 www.johnsmeek.com Contact: John Meek, President,johnsmeek@johnsmeek.com Marine and general engineering construction with specialties in pile driving,fount construction, concrete, shoring and HazMat Certified. Member Since 1999 Merli Concrete Pumping (310) 323-0404 6 Fax (310) 327-7690 1230 W. 130th St., Gardena, CA 90274 merliinc@yahoo.com Contacts: Gunther Merli, Stefan Merli We are a concrete pumping service with branches in Los Angeles, San Diego and We have over 125 pieces of equipment including boom pumps up to 61 meters, 1- trailer pumps, pea-gravel trailer pumps, telebelts up to 130 feet, and placing boo meters. We are signatory to the Operating Engineers Local 12 union. We have ab employees. Member Since 2010 Midcity Works, Inc., dba Joseph Engineering (626) 974-6624 9 Fax (626) 331-3638 145 E. Rowland Ave., Suite C, Covina, CA 91723 Contact: Joseph R. Hernandez,josephengii@aol.com Member Since 2008 Milco Constructors (562) 595-1977 6 Fax (562) 424-2347 3930-B Cherry Ave., Long Beach CA 90807 info@milcoconstructors.com • www.milcoconstructors.com Contact: Dennis Schlarbaum Member Since 1998 Miller Blades (909) 985-7704 • Fax (909) 949-0636 PO Box 9000-150, Alta Loma, CA 91701 www.millerblades.com Contact: Gerald Miller, CEO Equipment rentals - primarily motor graders, operated and maintained. Our hanc operators are experts in laser, GPS and cross slope in rough or finish grade. We c you on a subcontract basis. Member Since 2003 http://www.sccaweb.org/Members—l—z.htm 7/19/2012 SCCA Members Page 5 of 13 Mission Paving and Sealing (626) 452-8200 a (626) 452-9200 12747 Schabarum Ave., Irwindale, CA 91706-6807 www.missionpaving.com Contact: Doug Sweeney, doug@missionpaving.com Member Since 2010 Ralph D. Mitzel Inc. (714) 554-4745 • Fax (714) 554-6831 1520 N. Fairview, Santa Ana, CA 92706 Contact: Ralph D. Mitzel, President, rdmitzelinc@sbcglobal.net Member Since 1988 Mr. Crane (714) 633-2100 • Fax (714) 633-6901 647 N. Hariton St., Orange, CA 92868 Sales@mrcrane.com • www.mrcrane.com Contacts: Lee Steinberg less MacMillan, COO Providing premier lift and rigging solutions to construction and industrial clients fc Fleet includes operated and maintained hydraulic truck and rough-terrain cranes, cranes, conventional truck cranes and crawler cranes with capacities of 40 to 50C Specialize in wind turbine, tower crane, precast bridge beam erection, refinery/ p vessel and equipment installation, plant maintenance, tilt-up panel, heavy equipr transportation and installation, multicrane lifts and a full range of general lifting. simulations, rigging design, site prep consultation, heavy-haul logistics, permittin management. Member Since 1995 Myles Equipment (949) 720-0299 • Fax (949) 722-6688 PO Box 2742, Newport Beach, CA 92659 catfinegrade@yahoo.com Contacts: Glenn Donahue, President Frank Donahue, Secretary Equipment rental, operated loaders and backhoe-loaders. Member Since 2000 NADA Pacific (559) 864-8850 . Fax (559) 864-7012 13206 S. West Ave., PO Box 8, Caruthers, CA 93609 Contacts: Cal Terrasas, President Frank Lorenzen, VP Operations Trenchless installation specializing in microtunneling and guided boring technolog Member Since 2005 Newman Backhoe Service (714) 739-2424 • Fax (714) 739-0812 7381 Walnut Ave., Buena Park, CA 90620 Contact: Russell L. Newman, President Member Since 1985 Nobest Inc. (714) 892-5583 • Fax (714) 373-0039 PO Box 874, Westminster, CA 92684 www.nobest.net Contact: Larry Nodland, President, tarry@nobest.net Public works contractor, specializing in concrete flatwork, concrete streets, alleys curbs and gutters. Member Since 1996 http://www.sccaweb.org/Members_l_z.htm 7/19/2012 SCCA Members Page 6 of 13 Northwest Excavating (800) 715-5755 • (818) 349-5861 • Fax (818) 701-9326 18201 Napa St., Northridge, CA 91325 www.nwexc.com Contact: Mike Piccard, General Manager, mpiccard@nwexc.com 50 years as a leader in operated equipment rental. Equipment also available for c or monthly bare rental. More than 70 late model machines, many of which are Til III compliant. We employ some of the most highly experienced operators in the ii insure our customers receive maximum productivity every time they use our sere Commitment to productivity and customer service that is unsurpassed in the indL Member Since 1974 Oberg Contracting (805) 522-1954 a Fax (661) 298-2963 PO Box 630519, Simi Valley, CA 93063 Contact: Karl Thomas Member Since 1988 Oldcastle Precast (951) 788-9720 a Fax (951) 784-4365 2434 Rubidoux Blvd, Riverside, CA 92509 www.oldcastleprecast.com Contact: David Reneson, david.reneson@oldcastleprecast.com Member Since 2010 OST Trucks and Cranes (805) 643-9963 • (800) 400-4852 • Fax (805) 643-7618 2951 W. Ventura Ave., Ventura, CA 93001, PO Box 237, 93002 ostcranes@aol.com • www.ostcranes.com Contact: L. Dennis Zermeno, President Cranes: 5-250 ton hydraulic, 45-140 ton conventional. Transportation svcs: highl heavy haul,jeep and dolly combos; storage facilities - office rentals; dockside fal of Hueneme, Bakersfield. Member Since 1995 Pacific Boring (559) 864-9444 9 Fax (559) 864-9256 PO Box 727, Caruthers, CA 93609 www.pacificboring.com Contact: David Cline, President Horizontal drilling and pipe jacking. Member Since 2005 Pacific Restoration Group (951) 940-6069 9 Fax (951) 940-6501 PO Box 429, Perris, CA 92572 Contacts: John Richards, President,jrichards@prgconst.com Danny Richards, Operations Public works landscaping and erosion control, including highway planting, irrigatic revegetation and maintenance. Erosion control activities consist of hydroseeding, hydromulching, stabilizing,Topein S, Earthguard, bonded fiber matrix, Caltrans e fence, gravel bags, erosion control blankets, Pyramat and more. Working in 11 S, California counties. Signatory to Operating Engineers and Southern California Lat 685511 A, B, C27 Member Since 2003 Palp, dba Excel Paving (562) 599-5841 • Fax (562) 599-3679 2230 Lemon Ave., PO Box 16405, Long Beach, CA 90806 Contacts: C. P. Brown, C. P. Brown Jr. http://www.secaweb.org/Members—l—z.htm 7/19/2012 SCCA Members Page 7 of 13 General engineering contractor specializing in asphalt paving, underground and s including road construction, widening and repairs; related sidewalk and curb and construction; paving school yards and parking lots; excavation and grading of pa sites. General contractor on approx. 80 percent of our projects with responsibility improvements, grading, removal, etc., subcontract work that is not specifically in All work in So. Calif., most of it in Los Angeles and Orange counties. Member Since 1996 Papich Construction (805) 473-3016 C Fax (805) 481-5966 PO Box 2210, Pismo Beach, CA 93448 www.papichconstruction.com Contact: Jason Papich, Jason@ papichconstruction.com Member Since 2007 Pavement Recycling Systems (800) 966-7774 e (951) 682-1091 e Fax: (951) 682-1094 10240 San Sevaine Way, Mira Loma, CA 91752-1100 www.pavementrecycling.com e (firstname lastname@pavementrecycling.com) Contacts: Rick Gove, President, rickgove@pavementrecycling.com Don Mathews and Marco Estrada, Sales and Engineering Don Sante and Jim O'Kane; Estimating Spencer Skipworth and Steve Concannon, Operations Branches: Bakersfield: Mike Smith; Fresno: John Giotta; Lancaster: Steve Ward; Kurt Eddy General Engineering Contractor focusing on subcontracting in the public works m. Milling, Full Depth Reclamation, Soil Stabilization, Cold In-Place Recycling, Paverr Preservation, Seal Coats. License 569352"A" Member Since 1989 Post Bros. Construction (714) 632-5290 e Fax (714) 632-7967 2967 E. Coronado St., Anaheim, CA 92806 Contact: Chris Post, President Member Since 1992 Post Company Grading (714) 832-4739 o Fax (714) 832-5010 1100 Irvine Blvd., Suite 27,Tustin, CA 92780 Contact: Dennis Post, dp@postgrading.com Julie Post-Smith,jp@postgrading.com Equipment rental. Union operated and maintained. Bare rental available Caterpill; scrapers, D9N &T dozers, 740 haul trucks, 330 excavators, 966C loaders. Member Since 2002 Powell Constructors (909) 356-8880 e Fax (909) 356-1299 8555 Banana, Fontana, CA 92335 tara@poweliconstructors.com Contacts: Doyle Powell, Paul Zolezzi, Mike Powell Heavy civil engineering contractor doing transportation infrastructure throughout Calif. Specializes in bridges, concrete structures, road construction. Member Since 2006 Powell Constructors Inc. (909) 356-8880 • Fax (909) 356-1299 8555 Banana Ave, Fontana, CA 92335 Contact: Mike Powell, mike@powellconstructors.com Member Since 2010 Edward M. Pozzo Co. http://www.secaweb.org/Members_1_z.htm 7/19/2012 SCCA Members Page 8 of 13 (323) 666-5316 9 Fax (323) 666-9355 3001 N. Coolidge Ave., Los Angeles, CA 90039 Contact: Richard L. Pozzo Member Since 1996 Professional Pipeline Contractors (661) 949-9799 • Fax 661-949-1998 42851 N. Sierra Hwy., Lancaster, CA 93534 www.profpipe.com Contact: Ray Butler, rbutler@profpipe.com Member Since 2006 QC Southwest, Inc. (760) 546-0350 • Fax (760) 546-0221 1441 Montiel Rd, #115, Escondido, CA 92026 quality@qcswest.com Contact: Carl E. Turley Member Since 2004 Quip-Con (951) 566-5220 . Fax (951) 566-5264 PC_Box 687, Murrieta, CA 92564 Contact: Jeff Hale,jeff@quip-con.com Member Since 2009 W. A. Rasic Construction (562) 928-6111 o Fax (562) 928-7339 4150 Long Beach Blvd., Long Beach, CA 90807 www.warasic.com Contact: Pete Rasic, President, prasic@warasic.com Member Since 2001 C. A. Rasmussen, Inc. (661) 367-9040 • Fax (661) 367-9099 28548 Livingston Ave., Valencia, CA 91355 www.carasmussen.com Contact: Charles Rasmussen, President General engineering contractor more than 45 years for private developers and pL Specializing in heavy grading, street improvements, bridges, structures, paving 8 contracting. Member Since 1974 R.E.B. Construction (702) 492-4723 9 Fax (702) 492-4723 9620 Padre Peak Court, Las Vegas, NV 89178 Contact: Robert E. Becker, rebeckco@cox.net Member Since 2005 Recycled Base Materials (818) 767-3088 9 Fax (818) 767-3169 9050 Norris Ave., Sun Valley, CA 91352, PO Box 579, 91353 Contact: Mark Christie Portable rock crushing/asphalt and concrete. Member Since 1978 RGW Construction (925) 606-2400 • Fax (925) 606-2499 550 Greenville Rd, Livermore, CA 94550 www.rgwconstruction.com Contact: Robert Purdy, bob@rgwconstruction.com Heavy civil construction building highway infrastructure projects, underground, cc http://www.sccaweb.org/Members—l—z.htm 7/19/2012 SCCA Members Page 9 of 13 bridges, waste water treatment plants, environmental remediation, hazardous wE Member Since 2008 Riverside Construction (951) 682-8308 e Fax (951) 682-8350 4225 Garner Rd., PO Box 1146, Riverside, CA 92502 Contacts: Richard Lounsbury, Matt Pim Member Since 1983 RMA Group (909) 989-1751 o Fax (909) 989-4287 12130 Santa Margarita Court, Rancho Cucamonga, CA 91730 www.rmacompanies.com Contact: Ed Lyon, elyon@rmacompanies.com Member Since 2002 Road Builders (951) 696-6962 . Fax (951) 696-6963 38040 Bore] Road, Murrieta, CA 92563 roadbuildersinc@verizon.net Contact: Joseph Augustine, President Member Since 2000 Rock Structures Construction Co. (951) 371-1112 . Fax (951) 278-2802 11126 Silverton Court, Corona, CA 92881 Contact: Tony T. Paredes Member Since 1994 Salsbury Engineering (714) 527-2121 a Fax (714) 527-1715 2465 W. La Palma Ave, Anaheim, CA 92801 www.salsburyeng.com Contact: Gregory L. Salsbury, President, greg@salsburyeng.com Excavation contractor. Member Since 1991 Samrod Corp. (661) 945-3602 • Fax (661) 949-8536 151 E. Avenue H-8, Lancaster, CA 93535 www,samrodcorp.com Contact: Michael S. Rodriguez, President, mrodriguez@samrodcorp.com Concrete site improvements, curbs, gutters, concrete paving, related work. Reinf concrete, culverts, retaining walls. Caltrans, public works, subdivisions, commerc industrial development. Member Since 2002 SCI Pavement Services (909) 546-1020 e (909) 546-1030 1450 N. Fitzgerald Ave., Rialto, CA 92376 www.scipavement.com Contact: Abi Adeot], aadeoti@scipavement.com Member Since 2010 Security Paving Company, Inc. (818) 767-8418 . FAX (818) 767-3169 P. O. Box 1489, Sun Valley, CA 91353 9050 Norris Ave., Sun Valley, CA 91352 Contact: Mike Rodriguez, mrodriguez@securitypaving.com General Contractor/Street Improvements Member Since 1974 http://w,,vw.sccaweb.org/Members—l—z.htm 7/19/2012 SCCA Members Page 10 of 13 Sequoia Consultants (714) 974-6316 • Fax (714) 974-6193 361 W. Grove Ave., Orange, CA 92865 www.sequoiaconsultants.com Contact: Pri DeSilva, PE, pri.desilva@sequoiaconsultants.com Member Since 2006 Seville Construction Services (626) 204-0800 • Fax (626) 204-0801 One Colorado/Old Pasadena, 35 Hugus Alley, Suite 210, Pasadena, CA 91103 www.sevillecs.com Contact: Jeff Flores Member Since 2004 Sharma General Eng. Contractors (805) 532-1141 a Fax (805) 532-1790 13840 Princeton Ave., Moorpark, CA 93021 Contact: Tom Mogan Member Since 1992 Smith Brothers Crane Rental, Inc. (310) 515-7368 a Fax: (310) 515-6769 16539 South Broadway, Gardena CA 90248 smbroscrane@sbcglobal.net• www.smithcert.com Member Since 2008 Smooth Move, Inc. (909) 884-6916 a Fax (909) 337-6300 PO Box 73, Lake Arrowhead, CA 92352 smoothestmover@aol.com Contact: Jim Underwood, President Operated equipment rental of Schwing boom concrete pumps. Member Since 2010 Soil Retention Systems (800) 346-7995 e (760) 966-6090 • Fax (760) 966-6099 250 State St., Carlsbad, CA 92008 www.soilretention.com Contact: Jan Erik Jansson, President; jjansson@soilretention.com Inventor, producer and installer of segmental retaining walls and erosion control Verdura wall systems provide solutions ranging from residential landscaping to cc structures of more than 60 feet that can be installed at high speed concurrent wii operation. Drivable Grass is a permeable, flexible and plantable concrete paving for fire lanes, access roads, driveways, parking lots, bio-swales/ditches, and varic construction BMP's. Enviroflex is a permeable and plantable protection for channE outlets, wetland traffic crossings. Member Since 1996 Southwest V-Ditch (951) 781-4303 • Fax (951) 781-2774 3625 Placentia Lane, Riverside, CA 92501 info@swvditch.com e www.swvditch.com Contact: Bob Shepherd, Owner Shotcrete: V-ditches, slope paving, channels, difficult access backhoe rental, retr structural shotcrete. Member Since 1995 Specialty Crane&Rigging (805) 967-4567 • Dispatch (877) 562-7263 Fax (805) 683-2844 1 S. Fairview Ave., Goleta, CA 93117 http://www.sccaweb.org/Members—l—z.htm 7/19/2012 SCCA Members Page 11 of 13 www.specialtycrane.net Contact: Seth Hammond Branches: Paso Robles, (805) 237-7600 Santa Maria, (805) 922-8544 Member Since 1995 Stice Co. (949) 654-4600 a Fax (949) 654-4940 10851 Jeffrey Road, Irvine, CA 92602 www.sticeco.com Contact: Robert N. Stice, President, rnstice@sticeco.com Established in 1987, Stice has a team of professionals with combined experience 75 years specializing in earthwork and site clearing for industrial, commercial, ref residential projects. Completed projects range from a few thousand square feet t, 200 acres, including flat land, hillside, slope repair, backfill and subterranean exc fleet of more than 30 pieces of equipment utilizes the latest GPS and laser machi technology and includes Tier 2 and 3 AQMD-approved Caterpillar equipment. Member Since 2006 Sukan, Inc. (626) 854-9467 a Fax (626) 854-9469 PO Box 8694, Rowland Heights, CA 91748 mail@sukaninc.com a www.sukaninc.com Contact: Suzanne Desatoff Member Since 2010 Sukut Construction (800) 339-6024 a Fax (714) 545-2438 4010 W. Chandler Ave.,Santa Ana, CA 92704 www.sukut.com Contacts: Mike Crawford, President and CEO, mcrawford@sukut.com Mike Ortiz, President, Sukut Equipment, mortiz@sukut.com Mike Zanaboni, Vice President, mzanaboni@sukut.com Jerry Pabbruwee,Vice President,jpabbruwee@sukut.com Dave Grattan, President, Landfill and Environmental, dgrattan@sukut.com Locations: San Diego: (760) 754-9100, Fax (760) 754-9130, 3156 Vista Way, Su Oceanside, CA 92056, Eric Mauldin, Division President, emauldin@sukut.com Los Angeles Division President, Steve Yurosek, syurosek@sukut.com Inland Empire: (951) 689-9000, Fax (951) 689-9009, 11840 Piece St., Suite 100 CA 92505, Joe Philbin, Division President,jphilbin@sukut.com Sukut moved more than a billion cubic yards of California earth to award winning Expertise includes mass excavation and grading for residential, commercial, indu! courses and resorts, landfills and environmental cleanup (#1 in US), flood and sti piping and structures (top 10 in US), public works, highway and roads, waste wai and emergency landslide repairs. Fleet includes 250 large dozers, scrapers, exca� trucks and loaders, many equipped with GPS and Clean Air engines up to tier 3. major industry awards including Best Place to Work, Contractor of the year, SC0 Award, ENR Top 25 Construction Companies in the World for Innovation and Accc OC Metro #6 Top Green Co. Member Since 1975 Sully-Miller Contracting (714) 578-9600 a Fax (714) 578-2850 135 S. State College Blvd., Suite 400, Brea, CA 92821 Contact: Dave Martinez, Pres. General engineering contractor, construction services, paving, underground, con( equipment rental. Division: Blue Diamond Materials, (714) 578-9600 a Fax (714) 449-2295 a (800) Lonnie Clausen, Iclausen@sully-miller.com Branches: Irwindale, Inglewood, South Gate, Sun Valley, Victorville. http://www.sccaweb.org/Members—l—z.htm 7/19/2012 SCCA Members Page 12 of 13 Hot mix asphalt producer, manufacturer of warm mix asphalt, emulsion and seal Member Since 1996 Sully's Precision Grading LLC (951) 737-4091 • Fax (951) 737-0435 1821 Cherokee, Norco, CA 92860 Contact: Randy Ray Sullivan, Sullivan.randy@sbcglobal.net Member Since 2010 T&T Truck&Crane Service (805) 648-3348 • Fax (805) 648-1185 1375 N. Olive St., Ventura, CA 93001 info@truckandcrane.com • www.truckandcrane.com Contact: Tim Holder, President Branch: Bakersfield: (661) 393-0795, Fax (661) 393-8648, 1600 James Rd., CA Hydraulic 15-300 tons, conventional 45-200 tons, crawler crane trucking services heavy specialized, 5-9 axle low-bed service, oversized permit loads, 14-19 ton be roll-off truck service, 24-hour service. Member Since 2010 M.R. Tudor Companies (909) 429-0113 • Fax (909) 874-9223 4940 Hilton Drive, Fontana, CA 92336 Mail to: 2512 E. 71st, St., Suite F,Tulsa O www.mrtudor.com Contact: Mike Tudor, President, mtudor@mrtudor.com Jason Larkin, VP,jlarkin@mrtudor.com Full-service equipment dealer. Features new Terex articulated and rigid-frame off 30-100 ton capacity. Klein Products master distributor featuring off-road water tr 6,000-20,000 gallon capacity. Portable water towers, hurricane pumps, material 60,000-120,000 pound capacity. Member Since 1984 Twining Inc. (562) 426-3355 • Fax (562) 426-6424 PO Box 47, Long Beach, CA 90806 www.twininglabs.com Contacts: Rob Ryan, Edward Twining Member Since 2004 Universal Asphalt (562) 941-0201 • Fax (562) 941-4080 10610 S. Painter Ave., PO Box 2548, Santa Fe Springs, CA 90670 Contact: Ellen Opalach, ellen@universalasphalt.com Member Since 1998 URS Corporation (909) 425-4200 • Fax (909) 862-8433 27400 E. 5th St., P.O. Box 600, Highland, CA 92346 www.urs.com Contact: Carl Sandstedt, Project Director Calif. Operations, carl.sandstedt@urs.cc Member Since 2011 URS Energy and Construction, Inc. 303-843-2415 Y Fax (303) 843-2684 7800 E. Union Ave., Suite 100, Denver, CO 80237 Contact: Warren R. Anderson, Dir of Labor Relations, warren.anderson@urs.com URS is a leading provider of engineering, construction and technical services for F agencies and private sector companies around the world. The company offers a fl program management; planning, design and engineering; systems engineering a assistance; construction and construction management; operations& maintenanc decommissioning and closure services for power, infrastructure, industrial and co http://www.sccaweb.org/Members_l_z.htm 7/19/2012 SCCA Members Page 13 of 13 federal projects and programs. Member Since 2011 URS/Signet Testing Labs (714) 399-1500 a Fax (714) 778-4282 1320 S. Simpson Circle, Anaheim, CA 92806 www.urscorp.com Contact: Jeff J. Roe,jeff_roe@urscorp.com Member Since 2004 U.S. Demolition (714) 695-9026 o Fax (714) 695-9024 4510 E. Eisenhower Circle, Anaheim, CA 92807 Contact: Scott A. Moore, Owner, scott@usdemolition.com Member Since 2000 Valley Base Materials (818) 767-3088 . Fax (818) 767-3169 P.O. Box 1489, Sun Valley, CA 91353 Contact: Mark Christie Class II, CMB Base Materials Member Since 1974 Viking Drillers (916) 372-4993 a Fax (916) 372-1337 801 Northport Drive, West Sacramento, CA 95691 www.vikingdrillersinc.com Contact: Kevin Montoya, kmontoya@vikingdrillersinc.com Member Since 2008 Webcor Construction, dba Webcor Builders (650) 349-2727 • Fax (650) 524-7399 951 Mariners Island Blvd., 7th Floor, San Mateo, CA 94404 www.webcor.com Contact: John Bowles, General Counsel, Senior Vice President Member Since 2004 Western Paving Contractors (626) 338-7889 a Fax (626) 338-3799 15533 E. Arrow Highway, Irwindale, CA 91706-2002 www.westernpaving.com Contacts: Enrique Castillo, President MBE/SBE Member Since 1992 Copyright 2012 by Southern California Contractors Association. All rights re - 4 http://www.sccaweb.org/Members—l—z.htm 7/19/2012 Local Assistance Procedures Manual Exhibit 15-G2 Local Agency Bidder DBE Information(Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information (Construction Contracts) (Inclusive of all DBEs including the UDBEs listed at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM GENCYP'ty of Huntington Beach LOCATION: Golden View Elementary School PROJECT DESCRIPTION: Safe Routes to School TAL CONTRACT AMOUNT:S [D DATE: 7-19-12 IDDER'SNAME: Nobest, Inc. CONTRACT ITEM OF WORK AND DESCRIPTION DBE Cert.No. NAME OF DBEs DOLLAR AMOUNT ITEM NO R SERVICES TO BE EXPIRATION (Must be certified on the date bids B£ SUBCONTRACTED OR MATERIALS DATE am opened-include DBE address O BE PROVIDED and phone number ,7,8 Trucking 02037 Ra 's Trucking 2-1-15 c(r. Torrance GA. 310 538-9891 For Local Agency to Complete: Total Claimed $_ Local Agency Contract Number. Participation Federal Aid Project Number: Federal Share: ntract Award Date: Local Agency certifies that the DBE certification(s)has been verified and all information is complete and accurate. td Print Name signature Die 7-19-12 714/89 —5583 LocalDate (Area Code)Tel.No. Agency Representative Area Code Tel hone Number. Kay E. Anderson Or Caltrans Review- Person to Contact (Please Type or Print) Print Name Signature Date Caltrans District Local Assistance Engineer Local Agency Bidder DBE Woraration(Rev Y09) . Distribution: (1)Copy—Fax or scan a copy to the Caltraus District Local Assistance Engineer(DLAE) within IS days of contract execution. Failure to send a copy to the DLAE within IS days of contract execution may result in de-obligation of funds for this project (z)Copy—Include in award package to Caltrans District Local Assistance (3)Original—Local agency files Page I5-32a LPP 09-xx C-26 March 27,2009 i Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date.The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work(must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project--including all UDBEs listed on the UDBE Commitment form(Exhibit 15G(1)),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 total DBE 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(2)must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date,Federal Share,Contract and Project Number fields,and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. i i i Page 15-32b March 27,2009 C-27 LPP 09-xx i Local stance Procedures Manua! EXHI,_- 12-G Bidder's List of Subcontractors(DBE and Nan-DBE) BIDDER'S LIST OF SUBCONTRACTORS (DBE and NON-DBE)- PART 1 The bidder shall fist all subcontractors(both DBE and non-DBE)in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Nam / Phone/ Annual Address/ Fax Gross Description of Portion of Work to be Performed Ctyl State IP Recei is Name Phone ❑<$1 million j <$5 million Address <$lOmillian _ �` Fax <$15 million Ctty State ZIP 0>$ismillion Name Phone ❑<$1 million <$5 million Address <$10 million A N Fax Oo City State VP 03sismillion Name Phone ❑<$1 million <$5 million I i Address <$IO million Far $$15 million city mate ZIP >$15 million Name Phone ❑<$1 million <$5 million Address <$10 million Fax <$15 million 'My mate IFF >$1$million Distribution:I)Original-Local Agency File Nobest Incorporated — Will Submit Upon Low Bid Page 12-111 LPP 06-06 November 14,2006 I • r � 1 r1 7 1 � : : , � r' : phon- el Anntial i, �,p �' r�1 1'�j nr',"•j� 1 I .. Gross 1 , ' Sn�_E�3��c_tfL t7i�E?� fl�'t L�4{ !S• 19'I .. � 1 • 1 1 1 1 1 1 1 1 • ' 1 1 •� r-� r t� �+,�,�hRt �} y�yu' ��. • . `U(7 ��•�y,t�w Mir •�j o)<e.f < tl tl Sri (^�I r r It +} '. 11w.4'�LISJ�4;r M 1L1�C•,��' ,"YM'l i+tl...C4S.��, ' (11 it y `I 11 4 {�1 8 };. 1:• t ' • r• q"1' �.r QS�' �F1�4�i� �,� Sr3t.i;S • r4 ff '1:�:J � 7 S � �A 1• m•, � I t� RI RNG II.,�f It1 I[U�I ■ • , '��y!1`gq�d�d ��e✓"1t�J���rI.�Ikt�I�Pj j l;.1p ■ 1 • rt 'k �,y�, S;•.tih j,4 ,M;$�p�>�1 rFtp,-r},1:,,•7p 'y ��,�r i�6i• ':.�x�l`�ry`\�6!;!t9�,•l�Jt`r'��'i�'ad - I 1 �^•S • s,�dc,.k'rr+ Fl is t�ts,y�T 1.,-tt L 1 el 111i Ir�,�1'� tIt4A7N tlr hYYt laP tFi''� ■ • "',,,,!r' �Yd,��dJ�,kyrlp4i'}i V�+''lh t�li 1�`�3, �'}a'Ji r fa141 ■ 1 • % � FIIt�-t;.:4,}•;.!e°LY!;U �(��:tj�j i��•{r„i��l?��.{r1tr�9rfn d!}iu�l}R�rA�`,y}"� aE ri 1 L 'Vi, Zt tr i I `o.. •�.u..::.-_:: _ _ i'uk,:lwl!,tL.as�!(L'::> tw'�N1a1• i .:.'"_•.•Ijyii. ■ • l rK. iC "�I ■ . . I�q��I�II,FS-a�ir I t�t tlIl Ilr' n+ }�ffl4*>' iu''},�� tltl� 1 rt t rit �°ga d" •n i 11+ `�I("�, ,�t e IA h+olWly� r • r r1 (. L■I>� 1 � �r�•-�rll .�Tt,:,, �a f t� ,•.DNA ■ • ��tts��V'.rllpply���x'l,�+U �iY ��.tr Irt Jr`tr�T'1+<<t:l ■ . 'W tTMa e l�t e�i��ti l��t r1 rpb fi�i E�I��''t� t• 17}i 1 h 1 t.. - - - ,...•....... �..uva a �}17�� jn'ly�N rl�}v,c I 111�t1�`11��F�>I 1 • , e City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For Safe Routes to School, Golden View — CC 1402 July 12, 2012 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1) The following shall be added to Section 6-7, Time of Completion of the Special Provisions. At the intersection of Golden View Lane and Norino Drive, curb ramp construction activities shall be completed within five (5) consecutive working days, from start to completion. 2) The following shall be added to Section 7-10.3 of the Special Provisions. Pedestrian access shall be maintained throughout the construction area. Barricades and delineators shall be placed to provide a pedestrian path of travel throughout the work area. This is to acknowledge receipt and review of Addendum Number One, dated July 12, 2012. C -Company Name By �a (2� Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, please call William F. Janusz at(714) 536-5431. THE AMERICAN INSTITUTE OF ARCHITECTS Bond Number:NOBIN-31 \ I � A!A Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS.that we Nobest Incorporated 7600 Acacia Ave. Garden Grove CA 92841 as Principal, hereinafter called the Principal,and Merchants Bonding Company(Mutual) 2100 Fleur Drive Des Moines , IA 50321 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 Street,Huntington Beach,CA 92648 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid Dollars($ 10%of Bid for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves,our heirs, executors,administrators,successors and assigns,jointly and severally,firmly by these presents. WHEREAS,the Principal has submitted a bid for: Safe Routes to School,CC No.1402 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 relay be specified in.the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material fumished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof,between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void,otherwise to remain in full force and effect. 'Signed and sealed this 1 oth day of July,2012 Nobest Incorporated nncipa Seal) (Witness) Merchants Bon n C Mutual)) — (Su (Sea!) (Witness) Arturo Ayala (Title)A ey-in-F AIA DOCUMENT A310•BID BOND•AIA 0.FEBRUARY 1970 ED-THE AMERICAN INSTITUTE OF ARCHITECTS,1785 N_Y_AVE;,N.W.,WASHINGTON,D.C.201305 1 CAILIFO IA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of Orange On PI — 1_�-- before me, Kay E. Anderson/Notary Public , (Here insert name and title of the officer) personally appeared Larry Nodland who proved to me on the basis of satisfactory evidence to be the person( whose nameWis/ e'subscribed to the within instrument and acknowledged to that hel5heAay'executed the same in his/�mAlic- 'authorized capacity, and that by his/�I�ef g2-eif signature on the inst'I iment the persons);or the entity upon behalf of which the personSs-�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. ;`""'^ KAY E.ANDERSON WITNESS my hand and official seal. !_`` '= COMM. #1852452 U NOTARY PUBLIC-CALIFORNIA O �� "4 ORANGE COUNTY _ ''' My Comm.ExpiresJune 13.2013 (Notary Seal) ignature of Notary Public ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the,notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a document is 10 be recorded outside of California In such instances,any alternative ,(Title or description of attached document) acknowledgment verbiage as maybe printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California(i.e. certifying the authorized capacity of the signer). Please check the (Title or description of attached document continued) document carefullyfor proper notarial wording and attach this form if required Number of Pages Document Date • State and County information must be the State and County where the document g 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. (Additional information) • 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). u Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER a Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. s hetsheldwy,-is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual ( � information may lead to rejection of document recording. ® Corporate Officer o The notary seal impression must be clear and photographically reproducible. President Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Partner(s) u Signature of the notary public must match the signature on file'with the office of the county clerk. ❑ Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other Indicate title or type of attached document,number of pages and date. Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). Securely attach this document to the signed document 2008 Version CAPA v12.10.07 800-873-9865 wwwNotaryClasses.com CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT . > STATE OF CALIFORNIA County of Orange On 7/10/12 before me, Susan Pugh Notary Public Date Here Insert Name and Title of the Officer personally appeared Arturo Ayala Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(X) whose name( is/me subscribed to the within instrument and acknowledged to me that he/stxAbey executed the same in his/haddxft authorized capacity(), and that by his thZ*signature(x) on the instrument the SU3, °I PUc:' person(s), or the entity upon behalf of which the person(s) -j cor1i�� s:, 2z9 acted, executed the instrument. � Noiar Ft bli:-California � OF3 NUE COUNTY LL I certify under PENALTY OF PERJURY under the laws of : my cr:rr-�.E xiies Fear 29,2015 the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature Place Notary Seal Above Signa iire ol Notary Public Susan gh OPTIONAL Though the information below is not required by law, it may prove valuable to persons retying on the document and could prevent fraudulent removal and reattachment of this form to another document, Description of Attached Document Title or Type of Document: Bid Bond Document Date: 7/10/12 Number of Pages- One Signers) Other Than Named Above: None Capacity(ies) Claimed by Signer(s) Signer's Name: Arturo Ayala Signer's Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner—❑ Limited❑General ❑ Partner—❑Limited❑General 56 Attorney in Fact ❑ Attorney in Fact _ ❑ Trustee ❑ Trustee p ❑ Guardian or Conservator I Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other: ❑ Other: Signer Is Representing: I Signer Is Representing: ©2007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402•www.NationaiNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876-6827 MERCHANTM Bond No. NOBIN-31 BONDING COMPANY- POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,both being corporations duly organized under the laws of the State of Iowa(herein collectively called the"Companies"), and that the Companies do hereby make,constitute and appoint,individually, Andrew Waterbury; Arturo Ayala; Daniel Huckabay; Dwight Reilly of Orange and State of CA their true and lawful Attomey-in-Fact,with full power and authority hereby conferred in their name, place and stead, to sign,execute, acknowledge and deliver in their behalf as surety any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any such instrument shall not exceed the amount of: TEN MILLION($10,000,000.00)DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This Power-of-Attorney is made and executed pursuant to and by authority of the following By-Laws adopted by the Board of Directors of the Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 24,2011. "The President, Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fad,and to authorize them to execute on behalf of the Company,and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 27thday of February , 2012. +�„,uq°Rrr+fir •.•--'•e e °•�o�... CQ*A e• MERCHANTS BONDING COMPANY(MUTUAL) f.�'•:�+O O ' v em� 4Z) 4 r9y,�; MERCHANTS NATIONAL BONDING,INC. �; ._ •GO Co wti"r �Z: e =i!�• :• �j C1• ByN. 1t� e STATE OF IOWA •r•r�rr#1,rr1.{{#"'k0° •e` °'••ee President COUNTY OF POLK ss. On this 27th day of February 2012,before me appeared Larry Taylor,to me personally known,who being by me duly swom did say that he is President of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.;and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa,the day and year first above written. MARANDA GREENWALT a Commission Number 770312 own My Commission Expires October 28,2014 Notary Public,Polk County,Iowa STATE OF IOWA COUNTY OF POLK ss. I, William Warner,Jr.,Secretary of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof,I have hereunto set my hand and affixed the seal of the Companies on this 10th day of July 2012 i,,,,rrtsiNryi#,�r• o•e o 0 o a o e • �' e e . ft.. 0Ql; y V .►..c e yG� ; - 1933 :3� Secretary )t :yv' 0 .��'•.., POA 0014 (11/11) :.'��y•......•;,'-�it�.�'~ ee. ••��'grn�rtk{IN'rr'° °•o o°° City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov �FB'�77 }g09,1P�6 Office of the City Clerk B Joan L. Flynn, City Clerk October 15, 2012 Rakan, Inc. 2312 Park Ave., Suite 116 Tustin, CA 92782 RE: Safe Routes to School — Golden View— CC-1402 Enclosed please find your original bid bond for CC-1402. Sincerely, Joan L. Flynn, CMC City Clerk JF:pe Enclosure Sister Cities: Anjo,Japan ♦ Waitakere,New Zealand j, Rakan Inc 2312 Park Ave, Suite 116 s ,p Tustin,ca 92782 Phone: 949-698-9872 Fax: 949757-0114 i' .s' `Sim 't d City: Huntin ton Beach u � :f# Address: 2000 Main Street Huntington Beach ca 9264� Bid For: Safe Rout to School CC No 1402 Date & Time: 7/19/12 2:°° f'g 7 G .r3 G 1 ;$1 SECTION C PROPOSAL for the Safe Routes to School In the vicinity of Golden View Elementary School CC No. 1402 in the CITY OF HUNTINGTON BEACH TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF HUNTINGTON BEACH: In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of Huntington Beach. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of Huntington Beach, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 50 working days, starting from the date of the Notice to Proceed. BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal. BIDDER understands that a bid is required for the entire work, that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures. C-1 a / 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 ??49nJ in the amount of$ O � which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be). Bidder shall signify receipt of all Addenda here, if any: Addenda No. Date Received Bidder's Signature rZ 1 C-2 0 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Item Estimated y' Item Umt Price Extended Amount 4 No Quantify ti fk 1 1 L.S. Mobilization. Per L.S. 2 1 L.S. Furnish Construction Surveying and Monument Preservation. $ 2 ZU�,_ Per L.S. 3 1 L.S. Furnish Project Traffic Control. $ dam Per L.S. 4 1 L.S. Furnish and Install Traffic Striping and Signing. 0 0, Per L.S. 5 1 L.S. Modify Traffic Signal at Goldenwest Street and Slater Avenue(Excludes AC Surface Grinding). Per L.S. 6 1 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case A, and Per Typical Section at New Ramps Adjacent to AC Paving Detail. Per EA. 7 2 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case B, and Per Typical Section at New v o, Ramps Adjacent to AC Paving Detail. Per EA. C-2.1 Project Bid Schedule Safe Routes to School — Golden View Elementary School CC-1402 Item Estimated Item Unit'Price Extended Amount No Quantity 8 14 EA. Construct Curb Ramp per Caltrans Standard Plan No. A88A, Case C, and Per Typical Section at New $ ��/— $ 9, ZD o,- Ramps Adjacent to AC Paving Detail. Per EA. 9 1470 S.F. Surface Grind Existing A.C. to a Depth of 0.17 FT and Construct New 0.17 FT Surface Coat Over Existing Asphalt Concrete. Per S.F. Total Amount Bid in Figures: $Total Amount Amount Bid in Words: $ �I ('41n 7' 1 V ,9n Note: The City will provide the traffic signal equipment, as listed in the pole schedule, (also includes anchor bolts) to the contractor. The contractor is to pick up the materials at the City Yard, 17371 Gothard Street. Contact George Ruff two working days in advance for pick up at (714) 536-5530. C-2.2 LIST OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor. Bid . Name and Address of Subcontractor State Class Dollar % of Item(s)< License Amount Contract. Number �/110r' ��1�/¢✓ . q, q t4 ,70,E 27 el. Pipet ?01Td� %12rrA4% ton I o 7%3 Lf By submission of this proposal,the Bidder certifies: 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project. C-3 S f NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on �,'�, , at Iqdo , , 04 Date City State Ar`'1 ke"ae"., , being first duly sworn, deposes and says that he or she is ' ()d'd of R p\'-w r-) 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. eAk,4Al ant, Name of Bidder Q-t3 � Signature of Bidder Address of Bidder C-4 i r 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 Safe Routes to School in the Vicinity of Golden Vie-tv Elementary School, CC 1402, (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. Contractor By IiFt-e-s" . Title Date: ��'L C-5 IDISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury,the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ® Yes 2lo If the answer is yes, explain the circumstances in the space provided. WiPt Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. C-6 COMPENSATION INSURANCE CERTIFICATE Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self- insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract. Pe-4 V—dA 1te- Contractor By Title Date: Z C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct: /Z,q t-,qAl ^� Bidder Name ,771-z- 112,V Business Address City, State Zip (,I ke'I ) 6q � - q8 � Telephone Number State Contractor's License No. and Class �W/ .z Original Date Issued 00/ 14 Expiration Date The work site was inspected by of our office onI 11�- , 201_. The following are persons, firms,and corporations having a principal interest in this proposal: C-s The undersigned is prepared to satisfy the Council of the City of Huntington Beach of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth. Company Name Signature of Bidder Printed or Typed Signature Subscribed and sworn to before me this-V)-day of JU t 1 2012-. NOTARY PUBLIC \eqs Sf,G -`-aGh ec� e��w► NOTARY SEAL Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years: 1. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 2. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed 3. Name and Address of Public Agency Name and Telephone No. of Project Manager: Contract Amount Type of Work Date Completed C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 c State of California County of II OYavy, On �l'\ok2- before me, NtxNbeyls —_ Yr1l�CG Date Here Insert Name and Title of the Officer personally appeared �NTOc S. N ��,sey'1 Name(s)of Signer(s) F 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 F person(s) acted, executed the instrument. NERIBERTO ALMARAZ I certify under PENALTY OF PERJURY under the Commission*1972078 laws of the State of California that the foregoing _ "+o Notary Publfc-California z paragraph is true and correct. Orange County 3 My Comm.Expires Mar 15,201$ WITNESS my hand aAd official seal. Signature: " Place Notary Seal Above Signature oT11Mvrj15b1bIic OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document i g, Title or Type of Document: PJ\M-evS 1Y)4 iy jmc tU yl Document Date: —7 I 1 C I k Z Number of Pages: Signer(s) Other Than Named Above: N/A Capacity(ies) Claimed by Si ner(s) Signer's Name: FI6GS 1� �,;e v,^ Signer's Name: Corporate Officer — Title(s): '; S%OeYV'�- ❑Corporate Officer — Title(s):Y� ❑ Individual ❑ Individual ❑ Partner — ❑Limited ❑General Top of thumb here ❑ Partner — ❑ Limited ❑General Top of thumb here ❑ Attorney in Fact ❑Attorney in Fact ❑ Trustee %= ❑Trustee ❑ Guardian or Conservator ❑Guardian or Conservator F ❑ Other: ❑Other: Wk Signer Is Representing: 12 1, `%��%� Signer Is Representing: ©2010 National Notary Association•NationalNotary.org•1-800-US NOTARY(1-800-876-6827) Item#5907 (For federally funded projects, use this following page) 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 requiremnents 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: � � nL Contact Person: 1��1 Contact Phone: Signed: �� f _.. Date: *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992(HUD). Previous non-compliance with Section 3 could result in disqualification. C-10 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): Y 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: /Cx1 --l`C_ Contact Person: ,'��,� ��JlCi`�^ Contact Phone: q G on, ei CL), ' Signed: .� - —.. Date: �l Q /l-I- *Note: The above certification is required by the Department of Housing and Urban Development (24 CFR 135 and Subtitle A et al) and must be submitted by the bidders and proposed sub-contractors only in connection with contracts and subcontracts which are subject to Section 3 of the 1968 Housing and Urban Development Act, as amended in 1992 (HUD). Previous non-compliance with Section 3 could result in disqualification. C-11 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment C (THE BIDDER'S EXECUTION ON THE SIGNATURE PORTION OF THIS PROPOSAL SHALL ALSO CONSTITUTE ANENDORSEMENTAND EXECUTION OF THOSE CERTIFICATIONS WHICH ARE A PART OF THIS PROPOSAL) EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION The bidder- P-A k-A AJ proposed subcontractor ygqeA is' ,hereby certifies that he 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 has filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filling requirements. Note: The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor(41 CFR 60-1.7(b)(1)), and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts,which are subject to the equal opportunity clause. Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5. (Generally only contracts or subcontracts of$10,000 or under are exempt.) Currently,Standard Form 100(EEO-1)is the only report required by the Executive Orders or their implementing regulations. Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have not filed the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a• report covering the delinquent period or such other period specified by the Federal Highway Administration or by the Director,Office of Federal Contract Compliance,U.S.Department of Labor. i l i 1 i f I f i t f Page 12-79 f LPP 01-04 C-12 March 15,2001 PUBLIC CONTRACT CODE Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1(Chapter 376,Stats. 1985),the bidder hereby declares under penalty of perjury under the Iaws of the State of California that the bidder has- ,has not �ecen convicted within the preceding three years of any offenses referred to in that section,including any charge of fraud,bribery,collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in connection with the bidding upon,award of, or performance of,any public works contract,as defined in Public Contract Code Section 110I,with any public entity,as defined in Public Contract Code Section 1100,including the Regents of the University of California or the Trustees of the California State University. The term"bidder"is understood to include any partner,member,officer,director,responsible managing officer,or responsible managing employee thereof;as referred to in Section 10285.1. Note: The bidder must place a check mark after"has"or"has not"in one of the blank spaces provided.The above Statement is part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement.Bidders are cautioned that making a false certification may subject the certifier to criminal-prosecution. Public Contract Code Section 10162 Questionnaire In conformance with Public Contract Code Section 10162,the Bidder shall complete,under penalty of perjury,the following questionnaire: Has the bidder,any officer of the bidder,or any employee of the bidder who has a proprietary interest in the bidder,ever been disqualified,removed,or otherwise prevented from bidding on,or completing a federal,state,or local government project because of a violation of law or a safety regulation? Yes No If the answer is yes,explain the circumstances in the following space. i i C-13 � 1 Public Contract Code 10232 Statement In conformance with Public Contract Code Section 10232,the Contractor,hereby states under penalty of perjury,that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board_ Note: The above Statement and Questionnaire are part of the Bid. Signing this Bid on the signature portion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. i i C-14 i I Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment D Noncollusion Affidavit (Title 23 United States Code Section 112 and Public Contract Code Section 71006) To the CITY/COUNTY of 01-A At -- Z C I��0 DEPARTMENT OF PUBLIC woRks. In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidder declares that the bid is not made in the interest of,or on behalf of, any undisclosed person,partnership,company, association,organization, or corporation;that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly co[luded,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 wilt not pay,any fee to any corporation,partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Noncollusion Affidavit. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Page 12-81 LPP 01-04 C-15 March 15,2001 i i 1 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment E DEBARMENT AND SUSPENSION CERTIFICATION TITLE 49, CODE OF FEDERAL REGULATIONS,PART 29 The bidder,under penalty of perjury,certifies that,except as noted below, he/she or any other person associated therewith in the capacity of owner,partner,director,officer,and manager: • Is not currently under suspension,debarment,voluntary exclusion,or determination of ineligibility by any federal agency; Ala • Has not been suspended, debarred,voluntarily excluded or determined ineligible by any federal agency within the past 3 years; h/o • Does not have a proposed debarment pending;and Al O • Has not been indicted,convicted,or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. Alb If there are any exceptions to this certification, insert the exceptions in the following space. / Exceptions will not necessarily result in denial of award,but will be considered in determining bidder responsibility. For any exception noted above,indicate below to whom it applies,initiating agency,and dates of action. Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Page 12-83 LPP 01-04 C-16 March 15,2001 Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment F NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS The prospective participant certifies, by signing and submitting this bid or proposal,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any .person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any federal contract,the making of any federal grant,the making of any federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any federal contract,grant,loan,or cooperative agreement. (2) 1f any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any federal agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this federal contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying Activities," in accordance with its instructions. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,U.S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts,which exceed$100,000 and that all such subrecipients shall certify and disclose accordingly. i i Page 12-85 LPP 01-04 C-17 March 15,2001 i Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ® a contract Ea. 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 S. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier ,if(mown Congressional District,if known Congressional District,if known 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable 8. Federal Action Number,if known: 9. Award Amount,if known: 10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including (If individual,last name,first name,MI) address if different from No.IOa) (last name,first name,MI) (attach Continuation Sheets)if necessary) 11, Amount of Payment(check all that apply) 13. Type of Payment(check all that apply) $ actual planned a. retainer b. one-time fee 12. Form of Payment(check all that apply): c. commission ® a. cash d. contingent fee b. in-kind; specify: nature a deferred value D 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 16. Information requested through this form is authorized by Title I 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.1352. This information will be reported to Congress Print Name: semiannually and will be available for public inspection. Any Title: '�����` person who fails to file the required disclosure shall be subject to a civil penalty of not less than$10,000 and not more than �+ $100,000 for each such failure. Telephone No. Dater s Authorized for Local Reproduction Federal Use Only: Standard Form-LLL Standard Form UL Rev.09-12-97 Page 12-87 LPP 01-04 C-18 March 15,2001 ; . 3 EXHIBIT 12-E Local Assistance Procedures Manual Attachment G PS&E Checklist Instructions INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime federal recipient,at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name,address,city,State and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks"subawardee"then enter the full name, address,city, State and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the federal program name or description for the covered federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item I (e.g.,Request for Proposal(RFP)number,Invitation for Bid(IFB) number,grant announcement number,the contract grant.or loan award number,the application/proposal control number assigned by the federal agency). Include prefixes,e.g., "RFP-DE-90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influenced the covered federal action. (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last Name,First Name and Middle Initial(NU). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4) to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made (planned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other,specify nature. Page 12-88 March 15,2001 C-19 LPP 01-04 i Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions Attachment G 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s)or employee(s) contacted or the officer(s)employee(s)or Member(s)of Congress that were contacted. 15. Check whether or not a continuation sheet(s) is attached. 16. The certifying official shall sign and date the form, print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instruction, searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project(0348-0046), Washington,D.C.20503. SF-LLLdnmlructions Rev.06-04-40«ENDIP» i I Page 12-89 LPP 01-04 C-20 March 15,2001 Local Assistance Procedures Manual Exhibit 15-GI Local Agency Bidder UDBE Commitment(Construction Contracts) Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM GENCY: G D0 �,-A_pi�t� LOCATION: r PROJECT DESCRIPTION: L Rwt eJ -AO .SGko v I TOTAL CONTRACT AMOUNT:$ 13 O t 0 BID DATE: TCT/9!1-- fDDEWS NAME: EA l�/g�//j✓ l�L CONTRACT UDBE GOAL: •'I. O AC CONTRACT M OF WORK AND DESCRIPTION Cert.No.of UDBE NAME OF UDBEs DOLLAR AMOUNT ITEM NO. R SERVICES TO BE AND EXPIRATION (Must be certified on the date bids UDBE SUBCONTRACTED OR MATERIALS DATE are opened-include UDBE TO BE PROVIDED address and phone number S� Amw-e- vo _ n_,S3r- ssro s X ao 1 t oriow.c� 0.5� In S For Local Agency to Complete: Tots!Claimed 2-0 Local Agency Contract Number. Participation Federal Aid Project Number. % Federal Share: ontraet Award Date: Local Agency certifies that all information is complete and accurate. Signature of Bidder tint Name Signature Date 7 18t1'L AAct- 6gio-qpL cal Agency Representative Date (Area Code)Tel.No. Area Code Telephone Number. L-are,, ,1>-3 FBI Ct.�-.. For Caltrans Review: Person to Contact (Please Type or Print) Print Name Signature Date Caltrarts District Focal Assistance Engineer Local Agency Bidder-UDBE Commibneat(Rev 3109) Distribution: (1)Copy-Fax or scan a copy to the Caltrans District Local Assistance Engineer(DLAE) within l5 days bf award. Failure to send a copy to the DLAE within 15 days of award may result in de-obligation of funds for this project (2)Copy -Include in award package to Caltrans District Local Assistance (3)Original-Local agency files Page 15-31 LPP 09-xx C-21 March 27,2009 Exhibit 15-GI Local Assistance Procedures Manual Local Agency Bidder UDBE Commitment(Construction Contracts) INSTRUCTIONS-LOCAL,AGENCY BIDDER UDBE COMMITMENT(CONSTRUCTION CONTRACTS) (Revised 03109) ALL BIDDERS: ]PLEASE NOTE: It is the bidder's responsibility to verify that the UDBE(s)falls into one of the following groups in order to count towards the UDBE contract goal: 1)Black American; 2)Asian-Pacific American; 3)Native American; 4)Women. This information may be submitted with your bid proposal. If it is not, and you are the apparent low bidder or the second or third Iow bidder, it must submitted and received as specified in the Special Provisions. Failure to submit the required UDBE commitment will be grounds for finding the proposal nonresponsive UDBE is a firm meeting the definition of a DBE as specified in 49 CFR and is one of the following groups: 1. Black American 2. Asian-Pacific American 3. Native American 4. Women The form requires specific information regarding the construction contract: Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name, and Contract Goal. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by UDBEs. The UDBE should provide a certification number to the Contractor and expiration date. The form has a column for the Names of UDBE contractors to perform the work(who must be certified on the date bids are opened and include the UDBE address and phone number). Enter the UDBE prime's and subcontractors'certification numbers. Prime contractors shall indicate all work to be performed by UDBEs including,if the prime is a UDBE,work performed by its own forces, IMPORTANT: Identify all UDBE firms being participating in the project regardless of tier. Names of the First Tier UDBE Subcontractors and their respective item(s)of work listed should be consistent,where applicable, with the names and items of work in the"List of Subcontractors"submitted with your bid. Provide copies of the UDBEs'quotes,and if applicable,a copy of joint venture agreements pursuant to the Subcontractors Listing Law and the Special Provisions. There is a column for the total UDBE dollar amount. Enter the Total Claimed UDBE Participation dollars and percentage amount of items of work submitted with your bid pursuant to the Special Provisions. (If 100%of item is not to be performed or furnished by the UDBE,describe exact portion of time to be performed or furnished by the UDBE.) See Section "Disadvantaged Business Enterprise(DBE),"of the Special Provisions(construction contracts);to determine how to count the participation of UDBE firms. Exhibit 15-G(1)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 Contract Award Date and Federal Share fields and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of award. Failure to submit a completed and accurate form within the I5-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the Distract Local Assistance Engineer signs and dates the form. Page I5-32 March 27,2009 C-22 LPP 09-xx Local Assistance Procedures Manual Exhibit I5-H UDBE Information-Good Faith Effort EXHIBIT 15-H UDBE INFORMATION—GOOD FAITH EFFORTS Federal-aid Project No. CC-- I AO`t_ Bid Opening Date �/�y �•z. The (Ci /County of) established an Under-utilized Disadvantaged Business Enterprise (UDBE) goal of q..o,4 % for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the"Local Agency Bidder—UDBE Commitment"form indicates that the bidder has met the UDBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons,e.g., a UDBE firm was not certified at bid opening,or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder — UDBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of UDBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for UDBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified UDBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the UDBEs were interested (please attach copies of solicitations, telephone records, fax confirmations,etc.): Names of Date of Follow Up UDBEs initial Methods and Solicited Solicitation Dates C. The items of work which the bidder made available to UDBE firms, including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate UDBE Page 15-33 LPP 09-xx March 4,2009 C-23 Exhibit 15-H Local Assistance Procedures Manual UDBE information-Good Faith Effort participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate UDBE participation was made available to UDBE firms. Items of Work Bidder Normally Breakdown of Items Amount Percentage Performs Item ($) Of (YIN Contract A/ZA D. The names,addresses and phone numbers of rejected UDBE firms,the reasons for the bidder's rejection of the UDBEs,the firms selected for that work(please attach copies of quotes from the firms involved), and the price difference for each UDBE if the selected firm is not a UDBE: Names, addresses and phone numbers of rejected UDBEs and the reasons for the bidder's rejection of the UDBEs: Names,addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested UDBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to UDBEs: /yr Id F. Efforts made to assist interested UDBEs in obtaining necessary equipment,supplies,materials, or related assistance or services, excluding supplies and equipment the UDBE subcontractor purchases or leases from the prime contractor or its affiliate: j i� I G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using UDBE firms(please attach copies of requests to agencies and any responses received, i.e.,lists,Internet page download,etc.): Page 15-34 March 4,2009 LPP 09-xx C-24 Local Assistance Procedures Manual Exhibit 15-H UDBE Information-Good Faith Effort Name of Method/Date Results Agency/Organization of Contact W/IA H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): Al NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. Page 15-34a LPP 09-xx March 4,2009 C-25 Local Assistance Procedures Manual Exhibit I5-G2 Local Agency Bidder DBE Information(Construction Contracts) Exhibit 15-G2 Local Agency Bidder DBE Information(Construction Contracts) (Inclusive of all DBEs including the UDBEs Iisted at bid proposal) NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM GENCY: cl1 r� LOCATION: ROJECT DESCRIPTION: wJt�t/ TOTAL CONTRACT AMOUNT:$ Jf g7-q d! ID DATE: 71f q t-L IDDER'S NAME: CONTRACT ITEM OF WORK AND DESCRIPTION DBE Cert.No. NAME OF DBEs DOLLAR AMOUNT ITEM NO. R SERVICES TO BE AND EXPIRATION (Must be certified on the date bids BE SUBCONTRACTED OR MATERIALS DATE are opened-include DBE address O BE PROVIDED and phone number S 8 i IlL-o Nee✓ 1'�e- 2?A77 tQ bA.,lraw �e�b M rrr'4 o, 414 S7i'+- For Local Agency to Complete: Total Claimed Local Agency Contract Number. Participation Federal Aid Project Number: e c S'�3.a Rio Federal Share: Contract Award Date: Local Agency certifies that the DBE cerdfication(s)has been verified and all information is complete and accurate. Signatures of Bidder /� b riot Name Signature Date q ~q-6r LocalDate (Area Code)Tel.No, Agency Representative r Area Cod2l Tele hone Number. '�1 rAs f Jviv For Caltrans Review: Person to Contact (Please Type or Print) Print Name Sigrtahuc Date Caltrans District Local Assistance EngineerLocal Agency Bidder DBE Information(Rev Y09) , Distribution: (I)Copy—Fax or scan a copy to the Caltrans District Local Assistance Engineer(DEAF) within 15 days of contract execution, Failure to send a copy to the DLAE within 15 days of contract execution may result in de-0biigation of funds for this project. (2)Copy—Include in award package to Caltrans District Local Assistance (3)original—Local agency files Page I5-32a LPP 09-xx C-26 March 27,2©09 i r Exhibit 15-G2 Local Assistance Procedures Manual Local Agency Bidder DBE Information(Construction Contracts) INSTRUCTIONS-LOCAL AGENCY BIDDER DBE INFORMATION (CONSTRUCTION CONTRACTS) (Revised 03/09) SUCCESSFUL BIDDER: The form requires specific information regarding the construction contract:Agency,Location,Project Description,Federal Aid Project Number(assigned by Caltrans-Local Assistance),Total Contract Amount,Bid Date,Bidder's Name, and Contract Goat. The form has a column for the Contract Item Number(or Item No's)and Item of Work and Description or Services to be Subcontracted or Materials to be provided by DBEs. The DBE should provide a certification number to the Contractor and expiration date.The DBE contractors should notify the Contractor in writing with the date of the decertification if their status should change during the course of the contract. The form has a column for the Names of DBE certified contractors to perform the work(must be certified on the date bids are opened and include DBE address and phone number). Enter DBE prime and subcontractors certification number. Prime contractors shall indicate all work to be performed by DBEs including work performed by its own forces if a DBE. IMPORTANT: Identify all DBE firms participating in the project—including all UDBEs listed on the UDBE Commitment form (Exhibit 15G(1)),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 total DBE 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(2)must be signed and dated by the successful bidder. Also list a phone number in the space provided and print the name of the person to contact. Local agencies should complete the Contract Award Date,Federal Share,Contract and Project Number fields,and verify that all information is complete and accurate before signing and sending a copy of the form to the District Local Assistance Engineer within 15 days of contract execution. Failure to submit a completed and accurate form within the 15-day time period may result in the de-obligation of funds on this project. District DBE Coordinator should verify that all information is complete and accurate. Once the information has been verified,the District Local Assistance Engineer signs and dates the form. i i I Page15-32b March 27,2009 C 27 LPP 09-xa I Local stance Procedures Manual EXHl..._-. 12-G Bidder's List of Subcontractors(DBE and Non-DBE) r 1311 DER'B LIST OF SUBCONTRACTORS (I)BE and NON-DEE)- 1PA,RT The bidder shall list all subcontractors(both DBE and non-DBE)in accordance with Section 2-1.054 of the Standard Specifications and per Title 49, Section 26.11 of the Code of Federal Regulations. This listing is required in addition to listing DBE Subcontractors elsewhere in the proposal. Photocopy this form for additional firms. Firm Nam1�/ Phone/ Annual Address/ Fax Gross Description of Portion of Work to be Performed Ci State ]P Recei is NNW=Name Phone 1]<$1 million KA01'e {er r 11 r PWw/ll►t A,pj,ra `fol rff-/,6/i S million 1 Address <$l O million Fax D<$15 million + CityStatezIp >ms million Name Phone q ❑<$1 million R!Q ✓tI(ci' ?/°-SJdr'-i8�� <$5million + Address <sio million — l7 PO 7l aX 03`3`3 Fax <$15 million City Slate zrP op I >$I5 million /emu Name Phone ❑<$1 million 74►-5:?S4'rjo f <$5 minion Address O<Slomillion 3 fQ� �� Fax <$15 million City state 7j? >$15million Name Phone Q<$1 million S million Address <$10 million Fax <$15million Ctty State?1P jr(iZ, Zip- o�v3 >msmillion Distribution:1)Original-Local Agency File UP 46-46 Page 12-111 November 14,2006 , 1 91 FT,re 'i, l,lu f Btlx Add •Annual Description 1 Portion . ! , be Performed �� '1�u4it^�Pt+•pA ,4 Receipts '^I`�id) y6 ylt ��+�('�.�i♦�.,n� �tl _ i�'J[uL3:Ji� '4...)il7.utm�t'ia:al rH d L�,G aL•�'..•!♦ �� ♦ 1 r'.V. n {�f w 1 1 ,1 �0�# �ru rlC.'+.�.•:i�� .7�.'ffiw'lr4+u'lir' 'e".it�� 1,1�{r 1" y r lk hi♦t�`l`1�;�+ PIN +9yPgydddi✓Mt� i it 1 �y/ tit�Sn 01' Jlt iti�l is .1�t1^t t Rr l rti f + { i . '• �� s �11• r:.h:.a;;,fs4.,fi.r,'a j�� :l•"�! M t f;.�:C R• 7 .� � ty • • ... , .. / � �l• �n 7hr'r1'1 J�11�''I Srtl�f i vf,S�, c J f t , v r t 5tii*I raP Ip�, ♦ F'!�'i' t5V ��Sl A� r � 1 hf S. r 1ari+r tl i 61 •ll.,�i! iw'�lf,fl:.i t f 1�tcll Sr{I' I w 1 ,• t.n,>S9+RZ N�t�J'�)�r,�S�i���IS!.�;�i'�.I.e.�I�Si�I'r'ln�.'�y��� It 1il,b 1 ^S;)•���1'SI���PIr�)r�i ` fl I t11 �at•;S� .• ' j � � , le'.�8�-G''�;hlt i t l;i+��`f+„uuui�a t •f 1 • ♦M, � .• 111 i. i. City of Huntington Beach Public Works Department 2000 Main Street Tel. (714) 536-5431, Fax (714) 374-1573 ADDENDUM NUMBER ONE For Safe Routes to School, Gallen View — CC 1402 July 12, 2012 Notice To All Bidders: Please note the following clarification to the Project Plans, Specifications, and Technical Provisions: 1)The following shall be added to Section 6-7, Time of Completion of the Spacial Provisions. At the intersection of Golden View bane and Norino Drive, curb ramp construction activities shall be completed within five(5)consecutive working days, from start to completion. 2)The following shall be added to Section 7-10.3 of the Special Provisions. Pedestrian access shall be maintained throughout the construction area. Barricades and delineators shall be placed to provide a pedestrian lath of travel throughout the work area. This is to acknowledge receipt and review of Addendum Number One, dated July 12, 2012. Company Name —By 7 11 f Date All bidders must acknowledge the receipt of this Addendum with your bid proposal. Should you have any questions regarding this Addendum, Please call William F. Janusz at(714) 536-5431_ List oLlleference Owner Prime Name to contact Description Amount Caltrans Socal Engineers Tim Khairi Ramp termin $50,000 Haster/22 FRW 949-783-0796 C&G, sidewalk Wheel chair Caltran Socal Engineers Tim Khairi Ramp, C&G $60,000 Knott/ 91 FRW 949-783-0796 Sidewalk Wheel chair Fontana Socal Engineers Tim Khairi Block wall $15,000 949-783-0796 wheel chair Downy OL development Omar lavin Sidewalk $40,000 949-208-0138 wheel chair 2312 Park Ave Ste 116 Tustin,ca 92782 Phone(949)-698-9872,Fax(949)-757-0114 EmaiMakaninc@gmail.com BC>NDS Bid Bond Contractors Bonding (Public Work) and Insurance Company 1213 Valley Street P.O.Box 9271 Seattle,WA 98109-0271 For the MC branch INSURANCE nearest you,call Toll Free (888)283-2242 (888)293-2242 FAX Premium: Know all by these presents, that we, Rakan Inc as Principal, and Contractors Bonding and Insurance Company,as Surety,are held and firmly bound unto City of Huntington Beach Obligee,in the sum of Ten Percent of Bid Amount Dollars,($ 10% ) for the payment ofwhich we bind ourselves,and our successors and assigns,jointly and severally,firmly by these presents. Whereas,Principal has submitted or is about to submit a bid to the Obligee on a contract for Safe Routes to school in the vicinity of Golden West elementary school Project No 1402 ("Project"). . Now, Therefore, the condition of this bond is that if obligee accepts Principal's bid, and Principal enters into a contract with the Obligee in conformance with the terms of the bid and provides such bond or bonds as may be specified in the bidding or contract documents,then this obligation shall be void;otherwise the Principal and Suretywill pay to the Obligee the difference between the amout of the Principal's bid and the amount for which the Obligee shall in good faith contract with another person or entity to perform the work covered by the Principal's bid,but in no event shall the Surety's and Principal's liability exceed the penal sum of this bond. Signed and sealed this 10 day of July 12012 Rakan Inc (Seal) Principal By: �i`ra�S a1Jci•.� Firas A. Kassem President Sao itiraFt s Bonding and Insurance Company GpFPOq',��. SE' • o Attorn inFact y a Justin L . Kell y 00 e3- . 7979 • MTV V�.•�,' BndBID.01-US032905 Contractors Bonding and Insurance Company POWER OF ATTORNEY ®� 1213 Valley Street n,� P.O.Box A 98109-0271 an RU Company Seattle,WA Contractors Bonding and Insurance Company Know All Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed,but may be detached by the approving officer if desired. That Contractors Bonding and Insurance Company,a Washington corporation, does hereby make,constitute and appoint: Justin L.Kelley in the City of Newport Beach State of California its true and lawful Agent and Attorney in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, the following described bond. Any and all bonds,undertakings,and recognizances in an amount not to exceed Ten Million and 00/100 Dollars( $10,000,000.00 1 for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had been executed and acknowledged by the regularly elected officers of this Company. The Contractors Bonding and Insurance Company further certifies that the following is a true and exact copy of the Resolution adopted by the Board of Directors of Contractors Bonding and Insurance Company,and now in force to-wit: "All 'bonds, policies, undertakings, Powers of Attorney or other obligations of the Corporation shall be executed in the corporate name of the Corporation by the President,Secretary,any Assistant Secretary,Treasurer,or any Vice President,or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Corporation. The corporate seal is not necessary for the validity of any bonds, policies, undertakings,Powers of Attorney or other obligations of the Corporation. The signature of any such officer and the corporate seal may be printed by facsimile or other electronic image." IN WITNESS WHEREOF, the Contractors Bonding and Insurance Company has caused these presents to be executed by its Vice President with its corporate seal affixed this 2nd day of March 2012 G AND.NSG i `c 00,. q9 Contractors Bonding and Insurance Company a oPq.•ps? 11.1.1c+�s. tt. - 0' AT �0= Y' �EAL .a _ :Z. State of Washington } =0. • 1979 Roy C.Die Vice President 'I, SWING1 L,) County of King SS 0111111�' CERTIFICATE On this 2nd day of March 2012 I, the undersigned officer of Contractors Bonding and Insurance before me, a Notary Public, personally appeared Roy C. Die who Company,a stock corporation of the State of Washington,do hereby being by me duly sworn, acknowledged that he signed the above Power of certify that the attached Power of Attorney is in full force and effect Attorney as the aforesaid officer of the Contractors Bonding and a d is irrevocable; and furthermore, that the Resolution of the Insurance Company and acknowledged said instrument to be the volunta�WsOl� ° as set forth in the Power of Attorney, is now in force. In act and deed of said corporation. ag C on ayehereof, I have hereunto set my hand and the seal of the o4O�P.,.PPS od't�ai�$Bonding and Insurance Company this_ZtL, day %a� o / KrL�t&.rA]Bonding and Insurance Company Joseph B. uller Nota1'l Tic r_ �� o Notary Public oosoJb'a/•'•• "•• ; '�� State of Washington ����,oea utle�eti Vice President JOSEPH B.M MY COMMISSION EXPIRES March 29,2012 0469746032912 A0059511 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of 0 X 0(y On U q Z before me, _ re insert name and title c e officer) personally appeared i r) ; who proved to me on the basis of satisfactory evidence to be the perso whose name4zf is/,ik subscribed to the within instrument and acknowledged to me that he/X/•may executed the same in his authorized capacity), and that by his/}fi r signature(sTon the instrument the personika'j, or the entity upon behalf of which the persory(J acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. AN44 NAJANSY PINEDA OLIVA Commission # 1920724 WITNESS my hand and official s al. Z �+ Notary Public -California zz z ' Orange County My Comm. Expires Jan 7, 2015 (Notary Seal) Signature of Notary Pu is ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must contain verbiage exactly as DESCRIPTION OF THE ATTACHED DOCUMENT appears above in the notary section or a separate acknowledgment form must be properly completed and attached to that document. The only exception is if a OY\A document is to be recorded outside of California.In such instances,any alternative (Title or description of attached document) acknowledgment verbiage as may be printed on such a document so long as the verbiage does not require the notary to do something that is illegal for a notary in California (i.e. certifying the authorized capacity of the signer). Please check the (Title or description of attached document continued) document carefully for proper notarial wording and attach this form if required. Number of Pages Document Date • 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. (Additional information) • 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. CAPACITY CLAIMED BY THE SIGIeeeeo'ese • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. El Individual(s) ,.�'� S\NANQr t"**. he/she/theme is/are)or circling the correct forms.Failure to correctly indicate this �• �� ,.... •00, information may lead to rejection of document recording. ❑ Corporate Officer aavaQ�O:.P�E •. q9 • The notary seal impression must be clear and photographically reproducible. _o QQ y Impression must not cover tent or lines. If seal impression smudges,re-seal if a • 2 �/ sufficient area permits,otherwise complete a different acknowledgment form (Title) ®Z . a ®Z ; O � � • Signature of the notary public must match the signature on file with the office of ❑ Partner(s) � • U ^��• e the county clerk. ❑ Attorney-in-Fact iPb•.•• Additional information is not required but could help to ensure this ElTrustee(s) 0.- 0 �� acknowledgment is not misused or attached to a different document. ......•••�lP�e�� Indicate title or type of attached document,number of pages and date. ❑ Other •.,'y1 M0� 0yf L� Indicate the capacity claimed by the signer. If the claimed capacity is a 'ueeeeee corporate officer,indicate the title(i.e.CEO,CFO,Secretary). • Securely attach this document to the signed document 2008 Version CAPA vl2.10.07 800-873-9865 www.NotaryClasses.com