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HomeMy WebLinkAboutPTM General Engineering Service, Inc. - 2015-08-17 FOB CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION DATE: 3/22/2017 TO: THOSE LISTED HEREON FROM: John Griffin, PW Contract Administrator SUBJECT: Retention Release Payment- PO#21469 OJ Supplier#33132 Co.#219 Traffic Signal Modification -Bolsa Chica Street and Bolsa Avenue, Project#1485 Contractor's Name: PTM General Engineering Services, Inc. Address: 5942 Acorn Street City, State and Zip Code: Riverside, California 92504 Phone Number: (951) 710-1000 City Business License Number: A271213 Notice of Completion (Date by City Clerk): 12/21/2016 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. Dite Travis K. Hopkins, Director of Public Works I certify that there are no outstanding invoices on file. bbIll M A,3-4� Date Jo Zacks, Deputy City Treasurer I certify that no stop notices are on file, and that a guaranty bond has been filed with the City Clerk's Office. Date Robin Estanislau, City Clerk Attachments 1. Notice of Completion llk� 2. Maintenance Bond 3. Certificate of Compliance with Prevailing Wage Laws 4. Contractor's Certificate 5. Certificate of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 6. Consent for Release letter from the Surety Company 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 92649 Re: Certification of Compliance with Prevailing Wage Laws Project#1485 Traffic Signal Modification Contract: Bolsa Chica Street and Bolsa Ave. (PTM Job No. P15-17) Project#1485 Traffic Signal Modification Project, Bolsa Chica Street and Bolsa Ave. (PTM Job No. P15-17) 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 tide 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 17th day of January 297_,R4verside , California. PTM General Engineering Services, Inc. Mendoza de McRae, President/CFO (Conlrartor Name) APPROVED.AS TO FORIVI By. a. Michael E. Gates Oi ty Attorney 1 CONTRACTOR'S CERTIFICATE 1, PTM General Engineering Services Inc. state and certify that: (.Name of Declarant) 1 PTM General Engineering Services, Inc. is the general contractor to the City of Huntington Beach ("City")on Contract No. #1485 (the"Contract") for the construction of the public work of improvement entitled: Traffic Signal Modification- Bolsa Chica Street and Bolsa Ave. (the"Project"). 1 All work to be performed pursuant to the Contract has been completed in accordance with the Contract Documents (as such term is defined in the Contract), 3. Except for the claims listed below and the disputed claims listed in paragraph five(5),all persons supplying labor, services,materials and equipment to the Project, including all claims against the contractor arising from the performance of the Contract,have been paid and satisfied (list unpaid debts and claims; if none, write "NONE"): None 4. Attached hereto are the lien waivers required by the Contract Documents,which lien waivers have been executed by al l persons who performed work on or supplied labor, services,materials, and/or equipment for use at the Project. 5. Set forth below is a list of disputed claims or claims that are the subject of a Notice to Withhold filed pursuant to the Civil Code of the State of California(list all disputed claims; if none,write"NONE"). None 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed at Riverside. CA on this day of .lanuary 20�Z• PT a ineering Services, Inc. Mendeza__de McRae (Signature ofDeclaranPresident/CFO APPROVED AS `fig-rORM ,. M ; n a Michae E. Gates City Attorney 1 Certification of Compliance with Title VII of the Civil Rights Act and Equal Employment Opportunity Act of 1972 To: City of Huntington Beach Department of Public Works 2000 Main Strcct/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 #1485 Traffic Signal Modification Contract: Bolsa Chica S r e anti Rn %a Ave_(PTM Job No. P15-17) Pro'cet: #1485 Traffic Signal Modification �. Bolsa Chica Street and Bolsa Ave (PTM Job No. P15-17) The undersigned contractor on the above-referenced project("Project") hereby certifies that it has complied with title VII of the Civil Rights Act, the Equal Opportunity Act of 1972 and Executive Order 11246, and has not discriminated against any employee or applicant for employment because of race, color, religion, sex,sexual orientation,gender identity, national origin, age or disability. The undersigned contractor also certifies that it has not maintained any segregated facilities at its establishments on the basis of race,color,religion,sex,sexual orientation,gender identity,national origin,age or disability(with the exception of access for the disabled). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed this 17th day of January 20 17 _ , at Riverside California. t4&!2 ,164 /-1 ( o ractor ame) APPROVED AS TO PRM f By_ Michael E, Gates City. Attorney 1 RECEIVED BY: CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Name) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION TO: City Treasurer FROM: City Cler DATE: 5L SUBJECT: Bond Acceptance I have received the bonds for 6 / )& (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. Approved c�/J (coundf Approval Date) CC No. 0 1-N Agenda Item No. — 4 MSC No. City Clerk Vault No. -U Other No. SIRE System ID No. ® Q g:/forms/bond transmittal to treasurer ISSUED IN THREE(3)ORIGINAL COUNTERPARTS BOND NUMBER 691092 MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: Tt1at 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 CDnt,actor),and: INTERNATIONAL FIDELITY INSURANCE (surety's name) COMPANY 2400 E.KATELLA AVE.#250,ANAHEIM,CA 92806 (surety's street address,city and state and zip code) a corporation organized and existing under the laws of the State of NEW JERSEY with Its principal office In the City of ANAHEIM,CA as Surety(hereinafter called Surety),are held firmly bound urdo CITY OF HUNTINGTON BEACH as Ob;igee (hereinafter called Owner), in the amount of ONE HUNDRED THIRTY FIVE* Dollars ($ 135,735.96 I, equivalent to the entire contract amount Including all change orders, for the payment whereof Contractor and Surety bind themselves, their heirs,executors, admirifstrators,successors,and assigns,jointly and severally,firmly by these presents, *THOUSAND SEVEN HUNDRED THIRTY FIVE 96/100 WHEREAS, Surety rs a duly admitted surety insurer under the laws of the State of Callfomia;and Surety is oeitified and listed in the U.S.Department of the Treasury Circular 570,and able to provide proof of bonding limitation shown in said circular is sufficient-to provide bonds in the amount required by said Contract;and Surety has provided financial strength ratings from reputable companies,such as from A.M. Best,Moody's, Standard &Poor's,to validate that Surety has positive ratings of being secure or stable; and Surety is registered and listed with the Califo;nla Department of Insurance;and Contractor has by written agreemerd dated AUG. 15 2015,entered into a contract with Owner for the BOLSA CHICA ST.AT BOLSA AVE.TRAFFIC SIGNAL MODIFICATION In accordance with drawings and specifications prepared by which contract is by reference made a pa;-t hereof(hereinafter referred to as the Contract);wid The Contract provides that the principal will guarantee, for a period of one year, the work performed as part of the Contract from and against all defects In materials and workmanship;and The Contract also provides that the Contractor shall secure Contractor's obligations during the one-year period with a bond executed by a surety duly admitted In the state of California; and The Contract has been completed,and the Owner,Contractor and Surety agree that the commencement date for this Guarantee and Bond shall be JANUARY 31 ST ,2017, NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION Is such that If Contractor shall, for a period of one year from and after the date of completion and acceptance of the Contract by Owner,repair and/or replace any and all defects arising in the Work, whether resulting from defective materials or defective workmanship, then this obligation shall be null and void;otherwise it will remain in full force and effect The Surety hereby waives notice of any alteration or extens;on of time made by the Owner, Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Surety shall, within thirty (30) days following Owner's written notice of default, either. (a) remedy the default, or (b) shall promptly compkete the Contract in accordance with Its terms and conditions. Surety shall save the Owner harmless from any claims,judgme-nits,liens or losses arising from the Surety's failure to either remedy the default or to complete the Contract in accordance with its terms and conditions In a timely manner. 15.4584/119138 1 Whenever the Principal sha'I be, and declared by the Owner to be in default under the Contract,which shall include without Ilmitation,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 fa..%hfully take charge of the Work and complete the Work In accordance with the requirements of the Contract with a contractor other than the Pri,)clpal,at Its own expense,and make available as work progresses sufficient funds to pay the cost of completion less the unpaid balance of the Contract including other costs and damages for which the surety may be liable hereunder,provided,however,that the procedure by which the Surety undertakes to discharge its obligatons under this Bond shell be subject to tie advance written approval of the Owner. Within thirty (30) days after Surety's receipt of a written notice from Owner of the failure of performance of the Contract by the Principal,it shall be the duty of the Surety to give to the Owner a notice, In writing,of the Surety's election to(a)remedy the default(s)of the Principal promptly,or(b)arrange for performance of the Contract promptly by a contractor other than the Principal,time being of essence to this Bond. In sald 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: correctlon of defective work and completion of the Contract, additional legal, design professional and delay Costa 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 a-id 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 writlen 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 thls 9th day of MARCH 20 17 Principal Raised Corporate Seal PTM GENERAL ENGINEERING SERVICES, INC. (MUST BE AFFIXED) (Contractor Name) f By: ~ (Seal) Principal Raised Corporate Seal (MUST BE AFFIXED) (Title) INTERNATIONAL FI LITY URANCE COMPANY (AAS By: (Seal) PHIT RNEY-in-FACT APPROM. NOTES; Michael E. Ga es, City Attorney a 1. Acknowledgments must be completed and returned as part of the bond. 2. Rased Corporate Seats are mandatory. 3. Please attach Power of Attorney. 154584/1 I8138 2 Tel Id�624 7200. .. ...-POWER OF ATTORN�l( �NTERNA ZONAL 5IDELITY INSURANCE COMPANY' ALLEGHENY CASUALTY COMPANY ONE NEWARK CENTER, 20TH FLOOR NEWARK, NEW JERSEY 07102-5207' KNOW ALL MEN'BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY,a corporation organized and 'existing under the laws,,.of the,State of New Jersey, and ALLEGHENY CASUALTY COMPANY a:corporation organized and existing under the laws of the State,of New Jersey,having their'principal office in the City of Newark,New Jersey,do hereby constitute and appoint KEVtN E,VEGA, BRITTON CHRISTIANSEN, PHILIP E. VEGA, MYRNA SMITH CoVin;,'CA. their true'and lawful attorneyts)-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:.writingsobiigatory m the nature thereof,.which are or may be allowed;;requited or permitted by law,,statute,rule,reggulation,contract.or otherwise, and the execution of such instrument(s) In ppursuance 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 authori y 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 duly 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'15th day of August,2000, "RESOLVED that(1)the President,Vice President, Chief Executive Officer 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 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 appointments 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 such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification ggives for the execution of any bond,undertaking,recognizance, contract of indemnity or other written obligation in the nature thereof or related'theretb,'such signature and seals' when 'so used whether heretofore or hereafter, being hereby ado pled by the Corporation as the original signature':of sucWofficer and the original seal of the Corporation,to.be valid and binding upon the Corporation with the same force and effect as though manually affixed.' IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed and attested these Presents on this 31stday of December,2016. STATE OF NEW JERSEY ���A5UA�Ty0 County of Essex o� UAL ` In '/� v. � _.. _. -w' Z 1936 z ROBERT W.MINSTER ' Chief Executive Officer(International Fidelity f�yuERSE� Insurance Company)and President(Allegheny Casualty Company) On this 31st day:of December'2016,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 CASUALTY COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies;that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto set m hand affixed my Official Seal at the City of Newark,New Jersey the day and year first above written. P�HY CR :.0 NOTARY PUBLIC 0 u' �v A NOTARY PUBLIC OF NEW JERSEY My Commission Expires April 16,2019 CERTIFICATION i;the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do.hereby certify that I have compared°the foregoing,copy of the Power of Attorney and:;affidavit,and the copy of the Sections of the By-Laws of said Companies asset forth in said Power of Attorney, with the originals on file in the h ome office of said companies, and:that the same are correct transcripts thereof,and of the whole of the said originals,and that the said Power of Attorney has not been revoked and is now in full force and effect. , IN TESTIMONY WHEREOF, I have hereunto set my hand this day of /14J4'YCf ` MAfRIA BRANCO,Assistant Secretary CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Riverside } On before me, Elizabeth H. M. McRae.Notary Public era mce name en i e o o cer personally appeared Brian MPntitt7a who proved to me on the basis of satisfactory evidence to be the person(s) whose nameks) is/ subscribed to the within instrument and acknowledged to me that he/ # executed the same in hiss authorized capacity(, and that by his/hPrr signatures) on the instrument the person(), or the entity upon behalf of which the personas) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing ra raph is true and correct. WITNESS m hand and official seal. r ELIZA.E- H. M.fvl O e :: r; { .* �MTvi.#2100,521 Ry PUSL`:C-CALIFORNIA �II r:?tiaas; RIVERSIDE COUNTY COUPtI.EXPIRES FEB.20,2019-L Notary Public Signature (Notary Public Seal) �{ ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded,should be completed and attached to the document.Acknowledgments front other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. (Title or description o1 attached document continued) • Date of notarization must be the date that the signer(s)personally appeared which must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date 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 or notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. El Individual(s) +telshelthey-is lere)or circling the correct forms.Failure to correctly indicate this information may lead to rejection of document recording. EX Corporate Officer • The notary seal impression must be clear and photographically reproducible. Vice President/Secretary Impression must not cover text or lines. If seal impression smudges,re-seal if a -7It a sufficient area permits;otherwise complete a different acknowledgment form. ❑ Partner(s) • 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). 2015 Version www.NotaryClasses.cmn 800-873-9865 • Securely attach this document to the signed document with a staple. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) L: County of ORANGE ) On MAR 0 9 2017 before me, Monica Blaisdell, Notary Public Date Here Insert Name and Title of the Officer personally appeared Philip E. Vega Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(* whose name%) is/awe subscribed to the within instrument and acknowledged to me that he/XkWl:Wexecuted the same in his/XxD( authorized capacity j, and that by hisXXXXXX csignature(§)on the instrument the person(), or the entity upon behalf of which the person(,�4 acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph MONICA 8LAISDELL___j is true and correct. a Commission#2144666 z WITNESS my hand and official seal. z Notary Public-California z Orange County My Comm.Expires Mar 26,2020 Signature ignature of Notary Public ISSUED IN TWO(2)ORIGINAL COUNTERPARTS ❑ OWNER CONSENT OF SURETY ARCHIT1 CT ❑ TO FINAL PAYMENT CONTRACTOR ❑ Conforms with the American Institute of SUItL"TY ❑ Architects, AIA Document G707 OTIII:R ❑ TO OWNER: ARCHITECT'S PROJECT NO.: (Namie atal uthiress) CITY OF HUNTINGTON BEACH 2000 MAIN STREET CONTRACT FOR: MODIFICATION HUNTINGTON BEACH,CA 92648 PROJECT: CONTRACT DATED: AUGUST 17TH,2015 (Name and address) CC-1485 TRAFFIC SIGNAL MODIFICATION AT BOLSA CHICA STREET AND BOLSA AVE. CITY OF HUNTINGTON BEACH,CA In accordunce with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert name and address uJ'Sta•ely) INTERNATIONAL FIDELITY INSURANCE COMPANY 2400 E.KATELLA#250 ANAHEIM,CA 92806 , SURETY, on bond of (lnserl name and address uJ'C'uniractuO PTM GENERAL ENGINEERING SERVICES,INC. 5942 ACORN ST. RIVERSIDE,CA 92504 ,CONTRACTOR, hereby approves ol'the linul payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of'any of it,,;obligations to (Illerl tnnth!nlld taldl'eA5'q/'Uurnc•/Y CITY OF HUNTINGTON BEACH 2000 MAIN ST. HUNTINGTON BEACH,CA 92648 OWNER, us set forth in said Surety's bond, IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: MARCH 28TH,2017 (Itsert in writing the munilt Jolluwed kv the maneric dale andyear.) INTERNATIONAL FIDELITY IN RANCE COMPANY (Surety) (Sigllatai•e Of(1111hariZed eser, live) Attest: (Seal): PHILIP E.VEGA,ATTORN in-FACT (Printed name and tide) S-2134/GEEF 10101 FRP 4 lb T 6247200 TORel(973) ROF. ANE Y INTERNATIONAL PIDELIT;Y INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEWARK CENTER, 20TH FLOOR NEWARK, NEW JERSEY 0710.2-5207 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY,a corporation organized and existing under the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized and existing under the laws of the State of New Jersey,having their principal office in the City of Newark,New Jersey,do hereby constitute and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, PHILIP E. VEGA, MYRNA SMITH :Covina; CA. their true lawful attorney(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 in the nature thereof, which are or may be allowed,required or permitted 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 at a meeting duly 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 15th day of August,2000 "RESOLVED,that (1)the President,Vice President, Chief Executive Officer 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 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 t control custodians, agents nature thereof or related thereto; and(2)any such Officers of the Corporation may appoint and revoke the appointments of join 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 such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond;undertaking,recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto,such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation,to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed and attested these presents on this 31st day of December,2016. Iw STATE OF NEW JERSEY � rPSt1gCTycO County of Essex �r UAL v 1904 + ROBERT W.MINSTER N �y Chief Executive Officer(International Fidelityr uFRs Insurance Company)and President(Allegheny Casualty Company) On this 31st day of December 2016,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 CASUALTY COMPANY; that the seals affixed to said instrument are the Corporate Seal&;of said Companies;that the said Corporate Seals and his signature,were duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto set m hand affixed my Official Seal, at the City of Newark,New Jersey the day and year first above written. HYCR �.��ssioM•G� PUBUF • .:: .: N� . ry A NOTARY PUBLIC OF NEW JERSEY �9 j......'�¢`°� My Commission Expires April 16,2019 )F NEW C ERTIFICATfON I,the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do hereby certify that l have compared the foregoing copy of the Power of Attorney and affidavit,and the copy of the Sections of the By-Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof,and of the whole of the said originals,and that the said Power'of Attorney has not been.revoked;and is now in full force and effect. - IN TESTIMONY WHEREOF, I have hereunto set my hand this 02 day of , 7 MARIA BRANCO,Assistant Secretary CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of ORANGE ) On MAR 2 8 2017 before me, Monica Blaisdell,Notary Public Date Here Insert Name and Title of the Officer personally appeared Philip E. Vega Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(* whose name%) is/ice subscribed to the within instrument and acknowledged to me that he/Xb(*XX Xexecuted the same in his/kXD( authorized capacity(,and that by hlsXjMX QMsignature(.9)on the instrument the person(), or the entity upon behalf of which the person( acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph MONICA BLAISDELL is true and correct. a Commission #2144666 WITNESS my hand and official seal. Z Notary Public-California i Orange County /t�1,,/ M Ex Comm.Expires Mar 26.2020+ Signature V''t`1 Signature of Notary Public RECEIVED,,BY- CITY CLERK RECEIPT COPY Return DUPLICATE to City Clerk's Office (Na-me) after signing/dating (Date) CITY OF HUNTINGTON BEACH INTERDEPARTMENTAL COMMUNICATION LD TO: City Treasurer FROM: City Clerk DATE: o SUBJECT: Bond Acceptance I have received the bonds for )&11�L (Company Name) CAPITAL PROJECTS (includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No. Approved -7 (Council Approval,Date) CC No. Agenda Item No. 4 MSC No. City Clerk Vault No. o ilo-, 115 Other No. SIRE System ID No. ef e rdl� g:/forms/bond transmittal to treasurer Document-2531033-Page-1 Page 1 of 1 Recorded in Official Records,Orange County # Hugh Nguyen,Clerk-Recorder 7 II II II1 1 1111 1111111 II NO FEE f PLEASE COMPLETE THIS INFORMATION $ R 0 0 0 8 9 4 3 4 3 3 $ RECORDING REQUESTED BY: 2016000647780 10:12 am 12121116 217 405 N12 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7 WHEN RECORDED MAIL TO: j CITY OF HUNTINGTON BEACH PUBLIC WORKS DEPARTMENT Attn:John Griffin P.O.Box 190—2000 Main Street Huntington Beach,CA 92648 i { f I j THIS SPACE FOR RECORDER'S USE ONLY TITLE OF DOCUMENT } f NOTICE OF COMPLETION j ! 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 PTM General Engineering Services,Inc.,who was the company thereon for doing the following work to-wit: 3 I Traffic Signal Modification-Bolsa Chica Street and Bolsa Avenue,Project#1486 1 I a That said work was completed 12/15I2016 by said company according to plans and specifications and to the satisfaction of the City t { Engineer of the City of Huntington Beach and that said work was accepted by the Director of Public Works on 12/15/2016,per City i Council Resolution No.2003-70 adopted October 6,2003. !, That upon said contract International Fidelity Insurance Company,was surety for the bond given b the said company as required b P YY 9 Y P Y Q Y i s 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. j j t 'rector of Public Works or ity Engineer Date City of Huntington Beach,California i STATE OF CALIFORNIA) + County of Orange )ss: City of Huntington Beach ) { 1 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 i regularly ordered to be recorded in the Office of the County Recorder of Orange County. 1 ) This document is solely the official business of the City of Huntington Beach,as contemplated t under Government code section.8103 and erector of Public Wo s City Engineer Date t should be recorded free of charge. City of Huntington Beac California f { THIS PAGE IS ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION { t (Additional recording fee applies) f I I i # r about:blank 12/22/2016 ` "+✓2+"'Fs`V n.y L7 K`I t.no-SY r ..- . i T " ( e r Y R 1 A RECEIVED BY,- CITY CLERK RECEIPT COPY Return C CATE to t ClerkDUPL's Office '(Name) after signing/dating (Date) l J i, CITY OF HUNTINGTON BEACH • INTERDEPARTMENTAL COMMUNICATION TO City Treasurer FROM City Clerk / DATE O ,h SUBJECT Bond Acceptance I have received the bonds for (Company Name) CAPITAL PROJECTS (Includes CC's and MSC's) Performance Bond No. Payment Bond (Labor and Materials) Bond No. z (� ,Warranty or Maintenance Bond No. TRACT AND DEVELOPMENT Faithful Performance Bond No. Labor and Material Bond No. Guarantee and Warranty Bond No. Monument Bond No. Franchise Bond No. Letter of Credit Bond No. Other Re: Tract No Approved 9 / �i (Counctl Approval Date) CC No �K Agenda Item No MSC No City Clerk Vault No Other No SIRE System ID No �� g/forms/bond transmittal to treasurer CITY FUNDED CONSTRUCTION CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND PTM GENERAL ENGINEERING SERVICES, INC FOR CC-1485 TRAFFIC SIGNAL MODIFICATION AT BOLSA CHICA STREET AND BOLSA AVENUE THIS AGREEMENT("Agreement") is 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, a California corporation, hereinafter referred to as "CONTRACTOR " WHEREAS. CITY has solicited bids for a public works project, hereinafter referred to as "PROJECT." more fully described as CC-1485 Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue 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 I STATEMENT OF WORK ACCEPTANCE OF RISK CONTRACTOR shall complete and construct the PROJECT pui suant to this Agreement and the Contract Documents (as hereinafter defined) and furnish, at its own cost and expense, all labor, plans, tools, equipment, supplies, transportation, utilities and all other items, services and facilities necessary to complete and construct the PROJECT in a good and workmanlike manner CONTRACTOR agrees to fully assume the risk of all loss or damage arising out of the nature of the PROJECT, during its progress or prior to acceptance by CITY, from the action of the elements, from any unforeseen difficulties which may arise or be encountered in the prosecution of work, and for all other risks of any description in connection with the work, 1 14-4390/121301 including, but not limited to, all expenses incurred by or in consequence of the Suspension or discontinuance of work, except such as are herein expressly stipulated to be borne by CI FY, 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), has inspected the location of the_lob 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 opimons 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 Department of Public Works of CITY, and any revisions, amendments or addenda thereto, 2 14-4390/121301 D The edition of Standard ,Spec fcations f'or Public lfloiks 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 Commitlee as specified in the particular Plans, Specifications, Special Provisions and Addendum applicable to the Project, E Bid documents including the Notice Inviting Bids,the Special Instructions to Bidders and the CONTRACTOR's proposal, (which is attached hereto as Exhibit "A" and incorporated herein by this reference). 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 bti CONTRACTOR to the Director of Public Works of CITY or his or her written designee (hereinafter referred to as "DPW"), and CONTRACTOR shall not attempt to resolve or adjust the discrepancy without the decision of DPW, save only at its own risk and expense Should there be any conflict between the terms of this Agreement and the bid or proposal of CONTRACTOR, then this Agreement shall control and nothing herein shall be considered as an acceptance of the terms of the bid or proposal which is in conflict herewith 14-4390/121301 I� 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 Thirty Thousand, One Hundred Five Dollars ($130.105 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 thirty(30) consecutive Worlang 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 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 wort: of other contractors, 4 14-4340/121301 subcontractors and CITY forces and. in general, all matters concermncy the timely and orderly conduct of the work of CONTRACTOR on the premises 6 CHANGES CONTRACTOR shall adhere stnctly to the plans and specifications set forth in the Contract Documents unless a change therefrom is authorized in wntmg 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 paities upon cost and pricing data submitted by CONTRACTOR, thereupon, CITY will promptly issue an adjusted change order to CONTRACTOR and the contract 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 reason, relief to CONTRACTOR shall be limited to a time extension equal to the delay due to such unavailability 5 14-4340/121301 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 AttorneN One in the amount of one hundred percent (100%) of the contract price to guarantee the CONTRACTOR's faithful performance of the work, and one in the amount of one hundred percent of the contract 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 contract 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, MY may then make appropriate repair or replacement at CONTRACTOR's risk and own cost and expense 10 INDEPENDENT CONTRACTOR It is understood and agreed that CONTRACTOR is, and shall be, acting at all times hereunder as an independent contractor and not an employee of CITY CONTRACTOR shall secure at its own cast and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other 6 14-4390/121301 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 (S_500.00 ) per day for each calendar days 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 piw ided, and further agrees that CITY may deduct the amount thereof from any monies due or that may become due to CON IRAC fOR hereunder CONTRACTOR will be granted an extension of time and will riot be assessed damages for any portion of the delay to 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, of delays of subcontractors due to such causes CONTRACTOR shall, within fifteen (15) days from the beginning of any such dela} (unless DPW shall grant a further period of line), 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 7 14-4390/121301 findings of fact thereon justify the delay, and the decision of DPW shall be conclusive on the parties hereto Should CON]RACTOR 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 tlus 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 CHANGES IN WORK A Definitions (1) "Change OrdeC' means a document signed by the CONTRACTOR and CITY which authorizes an addition, deletion of revision in the work. or an adjustment in the Compensation under Section 3, or the Completion i ime specified at Section 4 (2) "Demand" means a written demand for a Change Order by the CONTRACTOR or CITY for changes in the work as stipulated in the contract documents B No Change Order may be granted except where the CONTRACTOR has submitted a Demand to the DPW (or his or her written designee) All Demands shall be 8 14-4390/121301 submitted promptly, but in no event later than fifteen (15) days after the occurrence of the event giving rise to the Demand The Demand shall be in writing and include all documents necessary to substantiate the Demand The DPW shall act on the Demand within fifteen (15) days after receipt, including by requesting additional information from the CONTRACTOR to determine whether to approve the Change Order the Demand seeks The DPW shall act on the Demand within fifteen (15) days after receipt of the additional information or within a period of time no greater than the time the CONTRACTOR took to produce the additional information requested, whichever is greater C Notwithstanding the fifteen (15) days to submit a Demand under Subparagraph C. in the case of changed conditions or unknown site conditions, immediately upon encountering the conditions, CONTRACTOR shall notify the DPW in writing of the conditions immediately, so that the CITY may promptly investigate the conditions D If the CONTRACTOR disputes the DPW's written response on the Demand, or the CITY fails to respond within the time prescribed, the CONTRACTOR may so notify the DPW in writing, either within fifteen (15) days of receipt of the DPW's response or within fifteen (15) days of the DPW's failure to respond within the time prescribed, respectively, and request an informal conference to meet and confer for settlement of the Demand Upon the CONTRACTOR's request. the DPW shall schedule a meet and confer conference within thirty (30) days to seek to resolve E CITY and CONTRACTOR shall execute appropriate Change Orders covering changes to the time or price by executing the Change Order by mutual agreement If the CITY and CONTRACTOR are unable to reach a mutual agreement, then the DPW shall issue a written decision on the claim within a reasonable time 9 14-43901 1?1301 F Following the meet and confer conference, if the Demand remains in dispute, the CONTRACTOR may file a claim with the City as provided in Chapter 1 (commencing with Section 900) and Chapter 2 (comrnencmg with Section 910) of Part 3 of Division 3 b of Title 1 of the Government Code For purposes of those provisions, the rumung of the period of time within which a claim must be filed shall be tolled from the time the CONTRACTOR submits his or her Demand until the Demand is denied as a result of the meet and confer process, including any period of time utilized by the meet and confer process 13 VARIATIONS IN ESTIMATED QUANTITIES The quantities listed in the bid schedule will not govern final payment Payment to CON-TRACTOR will be made only for the actual quantities of contract 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 mole 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 Agieernent If the quantity variation is such as to cause an increase in the time necessary for completion, DPW shall ascertain the facts and circumstances and make such adjustment for extending the completion date as in its sole judgment the findings warrant 14 PROGRESS PAYMENTS Each month DPW will make an estimate in writing of the work performed by CONTRACTOR and the value thereof From each progress estimate, five percent (5%) will be 10 14-4390/121301 deducted and retained by C11 Y and the remainder of the progress estimate, less the amount of all previous payments since commencement of the work, will be paid to CONTRACTOR When CONTRACTOR has, in the Judgment of DPW, faithfully executed fifty percent (50%) or more of the value of the work as detenmined from the bid schedule, and if DPW finds that satisfactory progt ess has been and is being made CONTRAC FOR may be paid such sum as will bring the payments of each month up to one hundred percent (100%) of the value of the work completed since the commencement of the PROJECT, as determined in its sole discietron by DPW. less all previous payments and less all pievious ietamed amounts Cl I Y'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 films 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 foi which payment is demanded has been performed in accordance with the terms of the Agreement and that the amount stated in the certificate is due under the terms of the Agreement Partial payments on the contract price shall not be considered as an acceptance of any part of the work 15 WITHHELD CONTRACT FUNDS SUBSTITUTION OF SECURI I IES At the request and at the sole cost and expense of CONTRACT OR, 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 II 14-4390/121301 16 AFFIDAVITS OF SATISFACTION OF CLAI1v1S 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 WADER OF CLAIMS The acceptance by CONTRACTOR of the payment of the final certificate shall constitute a waiver of all claims against CITY under or ansing out of this Agreement 18 INDEMNIFICATION DEFENSE, HOLD HNRMLISS 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 volunteers CONTRACTOR will conduct all defense at its sole cost and expense and CITY shall 12 14-4390/121301 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 Califorrua 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 obtain and furnish to City 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 similatly require all subcontractors to waive subrogation 20 INSURANCE In addition to the workers' compensation and employer's liability insurance and CONTRACTOR's covenant to defend, hold harmless and indemnify CITY, CONTRACTOR shall obtain and furnish to CITY, a policy of general public liability insurance, including motor vehicle coverage covering the PROJECT This policy shall indemnify CONTRACTOR, its officers. employees and agents while acting within the scope of their duties, against any and all claims arising out or in connection with the PROJECT, and shall provide coverage in not less than the following amount. combined single limit bodily injury and property damage, including 13 14-4390/121301 products/completed operations liability and blanket contractual liability, of One Million Dollars ($1,000.000) per occurrence If coverage is prodded under a form ANhich 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 (the "Additionally Insured Parties") as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable to the PROJECT shall be deemed excess coverage and that CONT'RACTOR's insurance shall be primary and non-contnbutory with any other valid and collectible insurance or self-insurance available to the Additionally Insured Parties Any available insurance proceeds in excess of the minimum coverage amount specified herein shall be available to the Additionally Insured Parties All coverage available to CONTRACTOR shall also be available to the Additionally Insured Parties Under no circumstances shall said above-mentioned insurance contain a self-insured retention without the express written consent of CITY, however an insurance policy "deductible"of $5,000 00 is pennitted CONTRACTOR shall be responsible for causing all Subcontractors to maintain the same types and limits of insurance coverage as that required of CONTRACTOR by this Agreement 21 CERTIFICATES OF INSURANCE, ADDITIONAL INSURED ENDORSEMENTS Prior to commencing performance of the work hereunder, CONTRACTOR shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverages as required by this Agreement, the certificates shall 1 Provide the naive and policy number of each carrier and policy. 2 State that the policy is currently in force, and 14 14-4390/121 i01 3 Promise to provide that such policies will not be canceled or modified without thirty (30) days' prior written notice of C11'Y CON IRACTOR 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 CONTRACTOR's defense, hold harmless and indemnification obligations as set forth under this Agreement CITY or its representative shall at all times have the right to demand the original or a copy of all the policies of insurance CONTRACTOR shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required CONTRACTOR shall provide a separate copy of the additional insured endorsement to each of CONTRACTOR's insurance policies, nan-ting 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 CON 1RACTOR 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 cieditors 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 15 14-4 390/131301 after such Notice of Intention has been served on CONTRACTOR, CITY may,without prejudice to anv other remedy it may have, terminate this Agreement upon the expiration of that time Upon such default by CONTRACTOR. CITY may elect not to terminate this Agreement, in such event CITY may make good the deficiency in which the default consists and deduct the resulting costs from the progress payments then or to become due to CONTRACTOR If it is subsequently determined by a court of competent,jurisdiction that CITY's termination of this Agreement under this Section was wrongful, such termination shall be converted to a termination for convenience under Section 24 and any damages shall be assessed as set forth in Section 24 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 CONTRAC FOR 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 sale 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, 16 14-4390/121301 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 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 of 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 171thhold, or any similar legal document This obligation shall be piovided for in the labor and materials payment bond i cquired of CONTRACTOR CITY may charge an administrative fee of One Hundred Dollars ($IOU) 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, of other communications hereunder shall be given either by personal delivery to CONTRACTOR's agent (as designated in Section 1 heiemabove) 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 17 14-4390/121301 below, proN ided that CITY and CONTRACTOR may desic,nate different addresses to which subsequent notices, certificates or other communications will be sent by notifying the other party via personal delivery,reputable overnight earner or U S certified mail-return receipt requested TO CITY TO CONTRACTOR City of Huntington Beach PTM General Engineering Services, Inc ATTN John Griffin, Public Works 5942 Acorn Street 2000 Main Street Riverside, CA 92504 Huntington Beach, CA 92648 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 interpiet define limit or describe, or construe the intent of the parties or affect the construction or interpretation of any piovision 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 United States Code Section 1324a regarding employment venfication 32 LEGAL SERVICES SUBCONIRACTING PROHIBITED CON1 RAC I OR and CI 1 Y agree that CH Y is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of sei vices contemplated hereundei CONTRACTOR understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel foi 18 14-4390/121301 CITY, and CITY shall not be liable for payment of any legal serN ices 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 its own attorney's fees, such that the prevailing party shall not be entitled to recover its attorney's fees from the non-prevailing party 34 INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not mvalydate 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 convnission 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 19 14-4390/121301 36 DUPLICATE ORIGINAL The onginal of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original Each duplicate original shall be deemed an original instrument as against any party who has signed it 37 CONSENT Where CITY's consent/approval is required under this Agreement. its consent/approval for one transaction or event shall not be deemed to be consent/approval to any subsequent occurrence of the same or any other transaction or event 38 SURVIVAL Perms and conditions of this Agreement, wluch by their sense and context survive the expiration or termination of this Agreement shall so survive 39 MODIFICATION No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties 40 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 41 ENTIRETY The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiation. and that each has had the opportunity to consult with legal counsel prior to executing this Agreement The parties also 20 14-4390,1121301 acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement. promise. agreement, warranty, fact or circumstance not expressly set forth in this Agreement This Agreement. and the attached Exhibit "A", contain the entire agreement between the parties respecting the subject matter of this Agreement, and supersede all prior understandings and agreements whether oral or in writing between the parties respecting the subject matter hereof 42 CALIFORNIA PREVAILING WAGE LAW A The CITY has ascertained from the Director of Industrial Relations of the State of Califorrua 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 m accordance with Section 1774 and 1775 of the California Labor Code, CONTRAC I'OR shall, as penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day or portion thereof for each worker paid (either by CONTRACTOR or any of its subcontractors) less than the prevailing wage rate established for that particular craft or type of work 21 14-4390/1121301 43 PAYROLL RECORDS CONTRACTOR agrees to keep accurate payroll record shov�nng the name. address. social security number, work classification. straight time and overtime hours worked each day and week. and the actual per them wages paid to each joumeyman, 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-,vith all of the provisions of California Labor Code Section 1776. in general 22 14-4390/121301 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers on 4 477 20/ CONTRACTOR CI TY OF HUNTINGTON BEACH, a PTM Generr Engineerin4 Services_ Inc. municipal rporation o the` to of California By-- --- _ Elizabeth H Mendoza de McRae,President/CFO Mayor ri me} ITS Chairman President Vice-President r circle one) V/Op INITIATED AND AP V D AND By Director of Public orks Brun Mendoza,Vice President/Secretary (print name) REVIE APPROVED ITS Secretary Chief Financial Officer 14 Asst Secretary/Treasurer (circle one) ity Manager APPROV AS 0. Crtv Attornev 23 14-4390/121301 CONTRACTOR'S SWORN STATMENT AND WARRANTY REGARDING CONTINUING INSURANCE OBLIGATIONS FROM: PTM General Engineering Services Inc PROJECT; CC1485 (Contractor name) T/S Modification @ Bolsa Chica St 5942 Acorn St _ and Bolsa Ave (PTM Job No P15-17) V� (Street Address) Riverside,CA 92504 (City,State and Yip) TO CMY OF HUNTINS5TON BEACH DECLARATION Attached hereto Is a true and correct copy of the current Certificate of Insurance and Additional Insured Endorsement CG 2010 1185, which Certificate compl,es with the insurance requirements of the Contract by and between the City of Huntington Beach('City)and the above-named Contractor(Contractor')for the above-described project Cproject'� I declare under penalty of pepury under the laws of the State of Cahfomia that the above statement Is true and correct. Signed on-11 24 2015 at Riverside,Ca (Date) (City,State) lizabeth H Mendoza de McRae President/CFO (Signs e or Individual Wno is Mal,ing Declaration) F WARRANTY Contractor hereby warrants and agrees to maintain Products and Completed Operations Insurance in compliance with the Insurance requirements of the Contract for the Project Said Insurance shall be maintained through and until the expiration of all Warranties provided by Contractor, Said insurance shall contain Additional Insured Endorsement CG 2010 1185,naming City as an addihonal insured Contractor shall supply to City,on at least an annual basis,a Certificate of Insurance and the aforementioned Endorsement evidenung continued coverage which meets the Contract requirements Signed on 1124 J 2015 at __Riverside,CA (Date) (City,State) CONTRACTOR Name,=Gejeral Engineering Services,Inc sy Name i H NTCN-ndoza cle mcilae Title PrP'1dPaf.1 E0 _M111 lq SECTION C PROPOSAL for the TRAFFIC SIGNAL MODIFICATION At the intersection of BOLSA CHICA STREET AND BOLSA AVENUE CC No. 1485 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 30 working days, starting from the date of the Notice to Proceed. The undersigned acknowledges that the issuance of the Notice to Proceed will occur approximately two months after the award of the contract to allow procurement time for city furnished equipment. 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 tune the contract is not awarded, the AGENCY will reject all bids and will readvertise the project. In the case of discrepancies in the amounts bid,unit prices shall govern over extended amounts, and words shall govern over figures C-1 If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may,at the AGENCY'S option,be considered null and void Accompanying this proposal of bid, find Bid Bond in the amount of 10% which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable Bidder shall signify receipt of all Addenda here,of any Addenda No.t `Date Received ` 'Bidder's Signature 6(9 a�Allh446 aw AiJ hfluv� C-a Project Bid Schedule Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue CC-1485 Item Estimated � Item Unit Price Extended Amount No. Quantity Mobilization. Per L.S. — ----- --- 2 Furnish Project Traffic Control. , Per L.S. -- — _ 3 1 L.S. Furnish and Install Tral-fic Stripi110 and Signing. Per L.S. 4 1 L.S. Reconstruct Raised Medians (Pull Back from Existing Location) _1 Pcr L.S. 5 1 L.S. Modify Traffic Signal at Bolsa Chica Street and Bolsa ,venues r Per 1"S. Total Amount Bid in Figures: Total Arnount Bid in Words: j Jo 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 (with his own labor) at the City Yard, 17371 Uothard Street. Contact Gcon,e Ruff two working days in advance for pick up at (714) 536-5530. C-2.l LIST" OF SUBCONTRACTORS In accordance with Government Code Section 4104, the Bidder sliall 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 O ass Dollar % of Item(s) License Amount Contract Nurnher Prime 1cr(orm,anccConaacfory ?,M Rial,elinc D 105,Corona.," A 9288' C I iccr,,, No )797101 XI) I.", I cl 951)lo., 135() i i I By submission of this proposal, the Bidder ce.rtifics: 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 i 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 15 15at Riverside CA Date City State Elizabeth H Mendoza de McRae , being first duly sworn, deposes and says that he or she is President/CFO of PTM General Engineering Services Inc 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 lus 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. Name-of Bidder Elizabeth H Mendoza de McRae President/ Signature of Bidder 5942 Acorn St Riverside,CA 92504 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 TRAFFIC SIGNAL MODIFICATION AT THE INTERSECTION OF BOLSA CHICA STREET AND BOLSA AVENUE, (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 familrar 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 8ConPTM General Engineering Services Inc Contractor hzabeth H.Mendoza de McRae By President/CFO Title Date 7 15 15 C-5 i DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete,under penalty of perjury,the following questionnaire QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation A ❑ Yes 0 No If the answer is yes, explain the circumstances in the space provided i i i 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 Services Inc Contractor Elizabeth H Mendoza de McRae By President/CFO Title Date: 715 15 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct PTM General Engineering Services Inc Bidder Name 5942 Acorn St Business Address Riverside,CA 92504 City, State Zip ( 951 )710 1000 Telephone Number 891265 A CIO State Contractor's License No. and Class 2 28 2007 Original Date Issued 2 28 2017 Expiration Date The work site was inspected by Brian Mendoza of our office on 7.15 , 2015 The following are persons,firms, and corporations having a principal interest in this proposal PTM General Engineering Services Inc Elizabeth H Mendoza de McRae President/CFO Brian Mendoza Secretary/V 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 improvcments in accordance with the plans and specifications set forth PTM General Engineering Services Inc Company Name ature of Bidder Brian Mendoza Secretary/V P Printed or Typed Signature Subscribed and sworn to before me this 15 day of MY ,2015 NOTARY PUBLIC NOTARY SEAL C-9 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 Fnotary public or other officer completing this certificate verifies only the identity of the Individual who signed the cument to which this certificate is attached,and not the truthfulness,accuracy, or validity of that document State of California ) County of Riverside 1 01 s� ' 1— before me, Elizabeth H M McRae, Notary Public Date Here Insert Name and Title of the Officer ^� pe, nally appeared Brian Mendoza Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(4 whose namCK) is/VI subscribed to the within instrument and acknowledged to me that he/s e/tl ,y executed the same in his/h)Kr/th�r authorized capacity(j�), and that by his/h>f/thWr signature( n m the instrument the person(, or the entity upon behalf of which the personacted, executed the ins ent I certify under PEN OF PERJURY under the laws of the State of Cal is that the foregoing paragraph is true and WITNES my h n \oTt-1cf—arNa.I ELlZABET I H M MCRAE t Signature V COMM #2100521 i •• NOTARY PUBLIC-CALIFORNIA@ Signature of Notary Public RIVERSIDE COUNTY 0 ; COMM EXPIRES FEB 20,2019-' _ Place Notary Seal Above i f Though this section is optional, completing OPTIONAL can deter alteration of the document or j fraudulent reattachment of this form to an unintended document Description of Attached Document ; Title or Ty pe of Document Document Date I Number of Pages Signer(s) Other Than Named Above _ Capacity(ies)Claimed by Signer(s) Signer's Name Brian Mendoza Signer's Name W Corporate Officer — Title(s)Vice President/Secretary ❑Corporate Officer — Title(s) _ 0 Partner — ❑Limited ❑ General ❑Partner — ❑Limited U General ❑individual D Attorney in Fact ❑Individual ❑Attorney in Fact CI Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other ❑ Other Signer Is Representing PTM General Engineering SvsLInc Signer Is Representing 02014 National Notary Associatlon •www NationalNotary org - 1-800-US NOTARY(1-800-876-6827) Item #5907 = - T e � ff L , d Bidder's Project History For the purposes of tlus project, the bidder shall provide project history of similar work This history shall specifically reference the construction of traffic signal modifications consisting of, at minimum the installation of four new traffic signal poles at a single intersection,two of which must include traffic signal mast arms of at least 25 feet in length Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed and completed similar work within the past five years 1 City of Newport Beach 100 Civic Center Dr,Newport Beach,CA 92660 Name and Address of Public Agency Name and Telephone No of Project Manager Brad Sommers 949 644 3326 $597,619 65 Traffic Signal Upgrades 22013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work 2 City of Garden Grove 11222 Acacia Pkwy,,Garden Grove,CA 92840 Name and Address of Public Agency Name and Telephone No of Project Manager Dai C Vu 714 7415186 $575,798 99 Traffic Signal 122013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work: 3 City of Rosemead 8838 E.Valley Blvd, Rosemead,CA 91770 Name and Address of Public Agency Name and Telephone No. of Project Manager Rafael Fajardo 626 569 2100 $482,024 30 Intersection Improvements 122013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work C-10 Km, vp OIACP d ftAa. i Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent. For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years These projects do not have to be under the employment of the bidder of this project Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein 1 Brian Mendoza Name of proposed Project Manager Telephone No. of proposed Project Manager 951 722 5755 Traffic Signal Rehabilitation$547,050 Traffic Signal 112012 Project Name& Contract Amount Type of Work Date Completed Upgrade Traffic Signals$354,453 Traffic Signal 112012 Project Naive& Contract Amount Type of Work Date Completed Hellman/San Gabriel Intersection Improvements$482,024 00 Traffic Signal 12013 Project Name& Contract Amount Type of Work Date Completed 2. Brian Mendoza ; Name of proposed Superintendent Telephone No of proposed Superintendent 951 722 5755 Traffic Signal Rehabilitation$547,050 Traffic Signal 11.2012 Project Name& Contract Amount Type of Work Date Completed Upgrade Traffiic Signals$354,453 Traffic Signal 112012 Project Name& Contract Amount Type of Work Date Completed Hellman/San Gabriel Intersection Improvements$482,024 Traffic Signal 12013 Project Name&Contract Amount Type of Work Date Completed C-11 i CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771 1(a)), passed by the Califorma State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the Califorma Department of Industrial Relations (DIR) Currently the annual non-refundable registration fee for Contractors is $300 Each contractor to whom a public works contract has been awarded shall sign the following certificate DIR FACT SHEET on SB 854 http://www dir ca gov/DLSE/PublicWorks/SB854FactSheet 6 30 14 pdf DIR's Contractor Registration Link—Call(844) 522-6734 https//efiling dir ca gov/PWCR/ActionServlet?action--displayPWCRegistrationForm DIR's Contractor Registration searchable database https//efiling dir ca gov/PWCR/Search action I am aware and will comply with the provisions of Labor Code Section 1771 l(a)which states "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725 5. It is not a violation of this section for an unregistered contractor to subnut a bid that is authorized by Section 7029 1 of the Business and Professions Code or by Section 10164 or 20103 5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725 5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid, or no later than contract award date PTM General Engineering Services Inc &Con,t1ractor beth H Mendoza de McRae President/CFO Title Date. 7 15.15 C-12 Brian Mendoza P O. Box 7745 Riverside, CA 92513-7745 Email: brian@ptni-eng.com • Cell 951.722.5755 Chief Estimator and Supervisor of Outside Operations Supervisor of outside operations with over 18 years of experience Electrician with over 20 years of experience An effective communicator and team leader, experienced in coordinating and executing large and fast-paced project, CAREER EXPERIENCE Freeway Electric/PTNI General Engineering Ser-vices, Inc. Riverside, CA 06/2006 to Date Chief Estimator/Supervisor of Outside Operations In charge of managing the estimating department and finalizing bid packages, coordinating the beginning phase of an awarded project between the company and agency Project submittals, contract review Coordinated and managed crews California region; handled various sized projects ranging in size from $1,000 to $4 5 million dealing with dry utilities, wet utilities, traffic signals, and road improvements Maintained coordination Freeway Electric/PTM General Engineering and subcontractor, and project owners In charge of handling project's administrative work, monthly gross estimates, project progress schedule, materials requisitions, contract change oidei negotiations and equipment purchase and rentals High Light Electric Inc/Pete& Sons Construction Inc. Riverside, CA 10/96 to 06/2006 Chief Estimatoi 1 In charge of managing the estimating department and finalizing bid packages Coordinating the beginning phase of an awai ded pi oject between the company and agency or prime contractor, I project submittals, contract review Successfully bid on projects totaling $12 million with an ; average spread 6% Area Supervisor Coordinated and managed 10 crews consisting of 6 members per team in the southern California region, handled various sized projects ranging in size from $1,000 to $4.5 million dealing with dry utilities, wet utilities, traffic signals, and road improvements. Maintained coordination between High Light Electric Inc and subcontractor, general contractor and project owners In ; charge of handling project's administrative work, monthly gross estimates, project progress schedule, materials requisitions, contract change order negotiations and equipment purchase and rentals i i i - 1 i Continued l l BRIAN MENDOZA . Page 2 CAREFR EXPERIENCr CONTINUED MBE Electric [►ic m Rivei side, CA 10/1998-10/1996 Vice President and Head of Outside Operations Managed outside operations for all projects ranging in size horn $1 to $2 5 nnillion Headed an around the clock electr ic, cre�A and coordinated with CC Me3 es to repair the I-10 Santa Monica Freeway after it collapsed during the 1994 Northridge Earthquake to complete the fast paced project in 66 days Maintain coordination between MBE Electric and subcontractors, general contractor and project o",ne1s, Implemented and enforced safety guidelines Handled admrnrstiative ti5ork monthly progress estimates material requisitions contract change order negotiations Vasco Corporation in San Fernando, CA 10/1987-06/1998 Foreman(fart 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 County, traffic signals, street lighting, signal rmerconnect Raymor Electric in Rosemead, CA 06/1986-10/1987 Crew Leader(Part Time) In charge of work cie« on projects ranging from S25 000 to$250,000 through out Los,Angeles County WORK SKILLS j 1 • Capable of operating heavy equipment such as skip loaders, cranes, and backhoes, • Hands-on experience with hand tools and power tools, • Capable of overseeing fast-paced and high profile projects,- - • An effective communicator and leader, ? 9 1 - 7 EDUCATION , • International Brotherhood of Electrical Workers Completed training course(1988-1989) in street lighting and traffic signal installations, code enforcement and blue print reading r i 1 South Gate High School Received High School diploma in 1988 ' i a 7 i i BRIAN MENDOZA • Page 3 CAREER EXPERIENCE CONTINUED PROFESSIONAL MEMBERSHIPS • International Brotherhood of Electrical Workers (IBEW) • National Electrical Contractors Association (NECA) ACCREDITATION • IBEW-Journeyman Wireman, CSLB-Electrical Contractors, Certified Trench Safety Coordinator LANGUAGES • English (Native) • Spanish (Fluent) AWARD RECEIVED • Recipient of the U S 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 • Recipient of the Certificate of Recognition by the City of Riverside for "Small Business" in 1997 • Recipient of the Certificate of Recognition by the State Assembly, Assemblyman Mr Rod Pacheco, for the "top 500 Inland Empire Small Business" in 1997 • Ranked among the "Top 500 Inland Empire Hispanic Owned Companies" since 1997 • Certification of Appreciation foi our participation and maximization in the"Century Freeway Affinnative Action" by CFAAC PROFESSIONAL AND PERSONAL REFERENCES 1 Caltrans project#07-1224U4 (Electrical contract amount $4 5 million) } Project completed in 2005 Description of project Installation of traffic signals, ramps metering, sign illumination, Highway lighting, fiber optic communication, and electrical irrigation along the I-10 Freeway in Los Angeles County s • Doug Dwason-Project Manager fou prime contractor, Balfour Beatty Cell (949)232-3276 and Office (909)397-8040 • Patty Galvan- Resident Engineer Office (909)594-4270 • Veronica Ross-Electrical Inspector Cell (714)606-6311 i T- BWAN MENDOZA • Page 4 CAREER EXTERIMCF CONVINTED City of Redlands Contract #208300-72304/41008 (Elect>>cal contract amount is $218 800) Project completed in 2003 Description ofpioject Installation oftlaffic signals modification of lamp metering, Lighting and sign illumination • Bill Hensley-Sensor Civil Engineer- Office (909)798-7586 ext 2 • Juan Olvera-Project Manager for general contractor, H&H Construction- Cell (951)453-7712 and Office(909)473-7331 Caltrans project#08-4567N%4) Electrical contract amount is $938 238) Project completed in 2005 Description of project Installation of lighting s�stem along The I-5 Fiee�va� in San Bernardino County • Gary Vogel-Project Manager form prime contractor, Granite Construction Cell - (661)549-3953 and Office (661)726-4447 Sanbag Projects, Segment 1, 2, 3, early segment 9, segment 9, and alder Ave. (Total electrical contract amount was S3 2 million) Project completed in 2004 Description of projects Installation of traffic signals, ramp metering, sign illumination, i highway lighting, fiber optic communication, and electrical irrigation along the I-10 Freeway in San Bemardino County, - i l • Harold Lantis-Sanbag Contract Manager- Cell (760)802-7730 and Office # (909)875-8029 ext 213 • Tim Hanable-Caltrans Inspector- Cell (951)712-0021 i • Al Ortega- Project Manager for prime contractor, Yeager Shanska- Cell (714)240- 5333 i City of Indio Project#ST0137(Electrical contract amount was$1 4 million) Project completed in 2005 j Description of project Installation of street lighting system, traffic signals, electrical - irrigation, and dry utilities • Gary Baxter-Area Manager for prime contractor, Yeager Shanska Construction- ' Cell (909)721-9749 and Office(760)343-5472 j • Tommy Young-Project Manager for prime contractor- Cell (951)232-6618 and r Office (760)343-5472 • Mehran Sepehri-City Engineer- Cell (760)250-2201 i i Additional Professional References: • Zale Harris-Caltrans Inspector- Cell (951)289-0047 _ L • Ray Robles-Caltrans area supervisor- Cell (909)799-0646 - 1 a registration raymeni auccess rage i of i f . k Division of Labor Standards Enforcement Thank you for your payment Payment Confirmation Number XXLGKHSBBDPC1 Registration Number 1000001433 Contractor Name PTM GENERAL ENGINEERING SERVICES INC —NOTICE If paying by ACH/EFT,please allow up to 7 days for processing Return to Public Woks Homepage Cop rrght 2014 ,taitofCahfo}nia { d ° r it S i i } i https:Hefiling.dir.ca.gov/PWCR/ActionServlet?action=paymentComplete 9/22/2014 j } CERTIFICATE OF CORPORATE RESOLUTION j, Brian Mendoza , Secretary of PTM General Engineering Services Inc (Corporation) do hereby certify that at a duly constituted meeting of the Stockholders and Directors of the Corporation held at the office of the Corporation on December 30 , 2007(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 I further certify that the foregoing votes are in full force this date without rescission, ; modification or amendment Signed this 1516"`day of (year) 3 A TRUE RECORD _ 1 ATTEST 1 Brian Mendoza , Secretary/Clerk Vice President/Secretary i (Corporate Seal) 53 i i i B"ID BOND BOND NO BBSU KNOW ALL MEN BY THESE PRESENTS, That we, PTM GENERAL ENGINEERING SERVICES, INC as Principal, and INTERNATIONAL FIDELITY INSURANCE COMPANY a corporation authorized to transact a general surety business In the State of NEW JERSEY as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH (hereinafter called the Obligee) in the Full and just sum of TEN PERCENT OF AMOUNT BID 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 BOLSA CHICA ST AT BOLSA AVE TRAFFIC SIGNAL MODIFICATION 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 2ND day of JULY 2015 YEAR ENERAL ENGINEERING SERVICES, INC INTERNATIONAL FIDE Y INSURANCE COMPANY nan en oza Surety VICE PRESIDENT/SECRETARY By JK) Principal PHILIP E VEGA Attorney-in-Fact Tel (973) 624-7200 POWER OF ATTORNEY INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEWARK CENTER, 20TH FLOOR NEWARK, NEW JERSEY 07102-5207 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY,a corporation organized and existing under the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized and existing under the laws of the State of Pennsylvania,having their principal office in the City of Newark,New Jersey,do hereby constitute and appoint KEVIN E. VEGA, SRITT ON CHRISTIANSEN, PHILIP E. VEGA, MYRNA SMi T H i Covina, CA. their true and lawful attorney(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 in the nature thereof, which are or may be allowed,required or permitted 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 princ;pal 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 duly 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 15th day of August,2000: "RESOLVED,that (1)the President, Vice President, Chief Executive Officer 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 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 appointments 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 such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond,undertaking,recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto,such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation,to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed and attested these presents on this 22nd day of July,2014.�41 STATE OF NEW JERSEY i GC.St1 gyp_ G''ap County o, Essex _ , SEAL r 1936 y 11904 a ROBERT W.MINSTER 4 Chief Executive Officer(International Fidelity insurance Company)and President(Allegheny Casualty Company) On this 22nd day of July 2014, 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 CASUALTY COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies;that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, ,1"Op„Ape„17,,B6j, at the City of Newark, New Jersey the day and year first above written. ,.�OP�HY CMG% N O T?.R Y -� PV BLIC aq e A NOTARY PUBLIC OF NEW JERSEY FQF NEW � � My Commission Expires April 1fi,2019 CERTIFICATION I,the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit,and the copy of the Sections of the By-Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof,Gnd of the whole of the said originals,and that the said Power of Attorney has not been revoked and is now in full force and effect. (, iN TESTIMONY WHEREOF, I have hereunto set my hand this \, day of c V �' MARIA BRANCO,Assistant Secretary I - eI CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT cr,� ,•c�*ti,z`..cFt{,C:,c£.f=afir�2z,'L�.,s.:t�.i�t?.c_T:�-rc":C;r"�,i. CIVIL CO DE§ 1189 ,•ec�e���-�u-r�s�r��.e:�s� y�,,...ti_:�ar�a.�:c�.r,.,c�;�vc.�izr^ rr^,��,�:�.�. A notary public: o"other o`fic-r co rip eting tnls ce tifi nle vc unl the e,�ti.y o`t7 In,{:via,ra who signeU ;ire doc:� en,tq w`nch th s oertifi,ate �rruached ana rut ,ho trut filn(_�ss n �r or valiei.v of 1ha1 document. State Oi C311'OrrL'3 --------------- ------ — ----- Co,jnty of Rivofside On L� iJre (`ia Elizabeth H.M. `&Pae, Notary Publ:c (— — who proved to me on the b .si of sat faufory v��jence to L ttre p rsUn(v who^e !��.m� subscribed to ;i-)e within instrument and �hno�� -dq�c tO me that he/r)<e,'ti1C-y ex•,cuted tnc f isrh /ttr nuihonzed canar t ri�c1, ara t or t, e e tit y` 7� :�y t %hf/t prsiinatu-_-'sk c 'n2 in air_,hart the^e son( j, n y upon behalf of �a�'nc� t Ps �rst f cep y under PENA OF PE,EJURY under the Of the State of Cali �r, "a that the forr going paragraph is True and correc WITNESS har P roc ticia I. U ,�.E. .. ELl7ABETH CO H. M.05 MCRAE M11.#21621 ^a r U' NGTARY PUBLIC-CALIFORNIA � RIVERSIDE COUNTY 0 _ ✓re a`rvr <r nu:r;ir COMM.EXPIRES FEB.20,2019 Place Notary Seal Aho.4 rJPT10NAL _ Though this section is optran.al coropietinJ this �rstio n �i�-!� alto: a� 'w Phe do�7rj,^;en' frauduient rEattac Trent or phis �_�rrn to a„ �,,,n�erk7c,d document. Description of Attached 'Document Title or 7,vpe of Document: _ DOCLIili�ni .-utc: _ NLJ rnlJer of Paces: S! na,r'c) - 9 O.her i na:^ Named Abw2 Capacity(ies) Claimed by Signer(s) Signer's Name: Brian Mendoza Signer's Name: _ Corporate Officer — Tltie(s)'vice President/Sec eLary ❑CCrporate Officer — Title(,): , Cl Partner — ❑Limited ❑ General — O Partner — r Limited Generai❑Individual ' O Attorney in Fact Lj Individua! ❑Attorney in Fact O Trustee C7 Guardian or Gor-iservator -7 Trustee I I Other; ❑Guardian or Consa aior ❑ Other: Sr9ner is Representing;PTtv1 General Eng nearing Svs Inc. Si-ne s � -- -- a r Is Repre..E��tmg: v'A'7014 National NotaryAs Association • www.NationalNotary,org • 1-800-US NOTARY(1-800-876-6827) Item 95907 ACKNOWLEDGMENT State of California County of LIDS ANGELES ) On d 2 before me, Monica Blaisdell, Notary Public (insert name and title of the officer) personally appeared Philip E. Vega who proved to me on the basis of satisfactory evidence to be the personX whose name* is/afe subscribed to the within instrument and acknowledged to me that he/ /th'&y executed the same in his/I-e>/their authorized capacity(i*, and that by his/her/their signature(*,on the instrument the person;or the entity upon behalf of which the person*acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of Caiifomla that the foregoing paragraph is true and correct. MONICA BLAISDELL WITNESS my hand and official seal. _ ,ii4 Commission X 1970845 z _ -a Notary Public Calltorn,a z a "'Y ` Orange County ` M Comm.Ex ires Mar 26.2016 j.f n r Signature JM' (Seal) f T c CL 0 u O ®! Q ao c) 0 C J O � L m t N m 0 C U C I7 _ O V?to 4 �r U cry p o o c I/' a� V) u .� c m Li o ra N s L _> co 4 Ln o • QJ d c of o `n a-+ 0 ® VI Q d — a O a1 O U c O _ � O O � z co a °1 a7 cn m ISSUED IN THREE (3) ORIGINAL COUNTERPARTS BOND NUMBER 691092 .1CT�hr/VLL PEF.SC�hIS u`(THESE P`?FSENTS Wl-Il Cif;of I-iunlm.-tcn Beach (riereafier referred to as 'Ciiy") has, 'o}rn,IiUl I,a�recn2cnt dated AUGUST 17th 2015,eni=red into a contract with PTM GENERAL ENGINEERING SEWCES, INC. 5942 AC N RIVERSIDE,CA 92504 (riaine and address of Contractor) (heia natter referred to as"Principal"). for performance of the work described as follows- CC-1485, TRAFFIC SIGNAL MODIFICATION @BOLSA CHICA STREET AND BOLSA AVENUE (Project Title) WHEREAS, said contract, and all documents referenced t'ncrcin (hereinafter collectively 'Contract"), are incorporated herein by this reference made a part hereof as though set forth herein in full,and Said Principal !s required under the terms of the Contract to furnish a bond guaranteeing the prompt, full and faithful penomfance of said Contract, by a duly admitted surety insurer under Fine laws of the State of California(hereinafter referred to as"Surety"), and Surely is certified and listed in the U.S Department of the TfeaSUry Circular 570, and has provided proof of sufficient bonding lirriilarons as shown in said circular to provide bonds in the amount required by said Contract, and Surely has provided financial strength ratings from reputable companies, SLich as from A.M Best,k/oody's, or SCandard&Poor's,to validate that Surety has positive ratings of being secure or Stable, and Surety is registered and listed with d-)e California Department of Insuranc-e, NOW THEREFORE we the undersigned, as Principal,and INTERNATIONAL FIDELITY INSURANCE COMPANY 2400-E KATELIA-AVE- STANAHETM,C-A-9= -- — (name and address of Surety) as Surely,are held and firmly bound unto City in the penal sum of ONE HUNDRED THIRTY THOUSAND ONE HUNDRED FIVE NO/100 — Dollars ($130,105.00 this amount being not less than one hundred percent of the price set forth in the Contract,in lawful money of the United States,for the payment of which sum,weli 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 OBLIGA T ION IS SUCH THAT it the Principal shall promptly,fully and faithfully perform each and all of the covenants, obligations and things to be done and pet�ormed by the Principal in strict accordance with the terms of the Contract as said contract may be altered, amended or modified from time to time;and if the Principal shall indemnify and save harmless City and all of City's officers,agents and employees(hereinafter collectively referred to as"Obligees')fromany and all iosses, 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 lime or price in the Contract or any alteralion,change,deletion, addition or other modification to-the Contract, or the work to be performed thereunder, shall in any way affect, limit, restrict,impair or release the obligations of the Surety under this Bond. Surety waives notice of any adjustment of contract or contract price, and any other alteration,change, deletion, addition or other modification to the Contract, or the work to be performed thereunder,and agrees IS�r534/1171"J4 691092 to DUlo(-i`--ajCETY adjust the penal sum ofthis Bond 10 feilec',s cI: adjustrncnis, DItareilons, —Qtc-I ucleUons, add lions or other mcdificaCrons surety agrees to'If UvIde ry `lnrtatior ,;S-)Ch adlusirnerlis it the f,enal sum to City on not less lherl a basis SuIei_ti also vda1ves llr. pro��isio Is of Civil Code y 28'15 and 819 u'lhis Doric shut,survive the or thu:vvorlc to all pL�llyati�tt�,<-�rld liabilities of its Prin6pal which survive cornpb�turn of the vdorle. IN VVITNESS WHEREOF, each party rep esents acid vdarlanls lhai this instrument has been duly executed by Pnnapal and Surety, on the dale set forth below,dial the nanIme 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: NOVEMBER 20TH, 2015 ATTE-ST PTM GENERAL ENGINEERING SERVICES, INC. (Corporate Seal) Upai Name) —.__\__ Brian Mendoza N@me, V1 - PRESIDENT/SECRETARY Title:_ A .S T INTERNATIONAL FIDELIT 'SUR�CE COMPA_N_Y_ I (Corporaie Seal) (Surety Nam By. Name: -in- CT (Signature of Attorney or Surety) (Attach Attorney-in-Fact Certlflcate) �) 714-602-9170 EXT (Area Code Telephone Ntumber r Surety) APPROVED AS TO FORMi Py.—- Mlchael E.Gates,CiLy Attorney Note This hond,must be executed in duplicate arrd dated,all signalures must be notarized, and evidence of the authority of any person signing as attorney-in-fac!musr be attached. PERFORMANCE BOND Pagc 2 cf 2 i5 S8<I/I17174 1 el (973)624-7200 POWER OF ATTORNEY INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEWARK CENTER, 20TH FLOOR NEWARK, NEW JERSEY 07102-5207 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY,a corporation organized and existing under the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized and existing under the laws of the State of Pennsylvania,having their principal office in the City of Newark,New Jersey,do hereby constitute and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, PHILIP E. VEGA, MYRNA SMITH Covina, CA. their true and lawful attorney(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 in the nature thereof, which are or may be allowed,required or permitted 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 at a meeting duly 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 15th day of August,2000: "RESOLVED,that (1)the President, Vice President, Chief Executive Officer 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 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 appointments 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 such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond,undertaking,recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto,such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation,to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed and attested these presents on this 22nd day of July,2014. it CpSUAZry STATE OF NEW JERSEY �'A c'�w County of EssexLU p ' r� SEAL 1936 1904 �I ROBERT W.MINSTER p p Chief Executive Officer(International FidelityY9YLuA�l Insurance Company)and President(Allegheny Casualty Company) On this 22nd day of July 2014, 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 CASUALTY COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies;that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, ...... at the City of Newark,New Jersey the day and year first above written. ;•V�NOTARY _ 0/y Z RY7V� •`� P U G L I C U' '• I� A NOTARY PUBLIC OF NEW JERSEY y�� •°9'c.zo{9•' My Commission Expires April 16,2019 OF NEW �,`� CERTIFICATION I,the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit,and the copy of the Sections of the By-Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof,and of the whole of the said originals,and that the said Power of Attorney has not been revoked and is now in full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand this ad$i, day of NMAg,,%'Je,,1 ),4/S MARIA BRANCO,Assistant Secretary r All Purpose Acknowledgement Stateof California County of Riverside On �f °7`3 - W15- , 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(A whose name(#isioEmsubscribed to the within instrument and acknowledged to me that he/mh #ley executed the same in his/110AW&authorized capacity( )c and that by his/her/their sig nature( on the t,eF , ELIZABETH H M MCRAE� Instrument the p rson(s� or the entity upon behalf of COMM #2100521 which the perso acted, executed the Instrument 0 mA NOTARY PUBLIC CALIFORNIA� RIVERSIDE COUNTY O �.,oPt . COMPA EXPIRES FEB 20,201 91 WITNES n and 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 J Corporation Officer Vice President/Secretary 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) PTM General Engineering Services,Inc CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. State of California ) County of Los Angeles ) On NOV 2 0 2015 before me, Monica Blaisdell,Notary Public Date Here Insert Name and Title of the Officer personally appeared Philip E. Vega Names)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(K whose name0c) is/XXXX subscribed to the within instrument and acknowledged to me that he/0X executed the same in his/W#P&authorized capacityM and that by his/Vdo signatureoo on the instrument the person(), or the entity upon behalf of which the person( acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph MONICA BLAISDELL is true and correct Commission N 1970845 Vie' NotaryPuhllc California i my ' Drange County = WITNESS my hand and official seal. My Comm Ez ires Mar 26 2016 Signature ) QD_J Signature of Notary Public ISSUED IN THREE (3) ORIGINAL COUNTERPARTS BOND NUMBER 691092 _ n V ,�DB(jR -1WfE, hits' l=t�fi`�LS� 4 KNOW 4LL PERSONo BY THESE PRESENTS WHEREAS City or Huntington Beach(hereafter referred to as Gily')I ias awarded to PTM GENERAL ENGINEERING SERVICES,INC 5942 A T 4 -- � (name and addre<s of Contiacror) thereinafter i efei red to as"PnncipaP'),a contract((Contract")for the work described as follows CC-1485,TRAFFIC SIGNAL MODIFICATION @ BOLSA CHICA STREET AND BOLSA AVENUE (Project Title) WHEREAS, Principal is required under the terms of the Contract and the California Civil Code to furnish a bond to secure the payment of claims of laborers,mechanics,matenalmen,and other persons as provided by law, by a duly admitted surety insurer under the laws of the Sidle of Cdhfoinia (heieinafler referred to as 'Surety ),and Surety is certified and listed in the U S Department of the Treasury Circular 570,and has provided proof of sufficient bonding limitation, as shown In said circular to provide bonds in the dniuunl required by said Contract,and Surety has provided finai icial stierigth ratings from reputable companies,such as from A fin Best, Moody s of Standard&Poui's,to validate that Surety has positive ratings of being secure or sldble,and Surety is registered and listed with the California Department of Insurance NOW THEREFORE,we, the undersigned Principal,and INTERNATIONAL FIDELITY INSURANCE COMPANY 2400 E KATELLA AVE,SUITE 250 ANAHEIM,CA 92806 (name and address of Surety) as Surely,are held and firmly bound unto City in the penal sum of ONE HUNDRED THIRTY THOUSAND ONE HUNDRED FIVE NO/100 dollars($130,105 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 Slates of America,for the payment of which sum,well and truly to be made,we bind ourselves,and each of our heirs, Pxecutors, administrators,successors,and assigns,jointly and severally,finely by these presents THE CONDITION OF THIS OBLIGATION IS SUCH THAT, if the Principal,his, her,ui 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 worl(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 3 181 of the California Civil Code so as to give a right of action to such persons or their assigns In case any action is brought upon this bond, Surety further agrees to pay all court costs and a reasonable attorney's fee in an amount fixed by the court PAYMENT BO1gD Pace I of 2 15-45841117357 Surer/sUpulatos and agrees, for value received,that no che,ngc eKension of time altmation, addition or modification to the terms of the Contract,or any contract document or 2ny work -o be perfoin'ied lhei eunder,whether made after notice or not,shall in any wav affect, impair or release the obhg2hons of Surety under this bond Surety hereby waives notice of any Such change, extension of time alteration addition,of modification to the terms or the Contract., the contract documents or the work thereunder Surety also waives the provibions of California Civil Code§§ 2845 and 2849 IN WITNESS WHEREOF each party represents and warrants that this instrument has been duly executed by Principal and Surety, on the date set forth below,that the name of each c ulporate party being affixed hereto is such party's propel legal name and that the individuals signing this instrument have been duly authonzed pursuant to the authority of its governing body Surety,by execullon of this bond,waives any defense which Surety has or may have by reason of any failure of the Piincipal to execute or properly execute this bond Dated NOVEMBER 20TH, 2015 ATTEST PTM GENERAL ENGINEERING SERVICES,INC (Corporate Seal) e)NamBnan Mendoza FP:nnripal tcef�R� Nan Title ATTEST INTERNATIONAL FIDELIT INSURANCE COMPANY (Corporate Seal) (Surety a ) By ) Name PH LIP E VEGA O E -ilTn FACT (Signat.ire of Attor in F cl for Surety) (Attach Attorney-in-Fact Certificate) U 714-602 9170 EXT 30 (Area Code&Telephune Nuin et for Surety) APPROVED AS TO FORM By _ Michael E Gates,City Attorney t y�v,U�1/r5 !Vote This bond must be erecuted in duplicate and dated,all signatures must be notan2ed, and evidence of the authonty of any person signing as attorney-rn-fact must be attached PAYNiEXIT BOND Page 2 of 2 1545S4/117357 (973) 624-7200 POWER OF ATTORNEY INTERNATIONAL FIDELITY INSURANCE COMPANY ALLEGHENY CASUALTY COMPANY ONE NEWARK CENTER, 20TH FLOOR NEWARK, NEW JERSEY 07102-5207 KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY,a corporation organized and existing under the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized and existing under the laws of the State of Pennsylvania,having their principal office in the City of Newark,New Jersey,do hereby constitute and appoint KEVIN E. VEGA, BRITTON CHRISTIANSEN, PHILIP E. VEGA, MYRNA SMITH 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 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 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 at a meeting duly 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 15th day of August,2000: "RESOLVED,that (1)the President, Vice President, Chief Executive Officer 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 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 appointments 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 such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond,undertaking,recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto,such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation,to be valid and binding upon the Corporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY have each executed and attested these presents on this 22nd day of July,2014. STATE OF NEW JERSEY /� Cp5UAL1 r c County of EssexSEA L 904rn 1 936 � + �E ROBERT W.MINSTER t Chief Executive Officer(International Fidelity 'NSYLVP� Insurance Company)and President(Allegheny Casualty Company) On this 22nd day of July 2014, 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 CASUALTY COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies;that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. IN TESTIMONY WH , I haveat the City of Newark,N wOJersey thehereunto day and yearsetn f r t above writtehand affixed n Official Seal, -(j NOTARY �•• :f PUBLIC y- s yT.0-f-Ir 9_- g(v A NOTARY PUBLIC OF NEW JERSEY �c0..NEON ' My Commission Expires April 16,2019 ,',,,"1J.0 W 0V"% CERTIFICATION I,the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit,and the copy of the Sections of the By-Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof,and of the whole of the said originals,and that the said Power of Attorney has not been revoked and is now in full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand this Oz4I.-I day ofk)0110wb, , X15— MARIA BRANCO,Assistant Secretary All Purpose Acknowledgement Stateof California County of Riverside On - 12-6 /J_ , before me, Elizabeth H. M McRae (date) (notary) personally appeared, Brian Mendoza (signers) ❑ personally known to me — OR— [N proved to me on the basis of satisfactory evidence to be the person(.V whose name(#isimqsubscribed to the within Instrument and acknowledged to me that he/ l%Dy executed the same in hislhbN*f&authorized capacity( and that by his/her/their signature( on the r ELIZABETH H M MCRAEg instrument the p rson(50 or the entity upon behalf of COMM #2100521 which the perso S�acted, executed the instrument 7, .,® NOTARY PUBLIC-CALIFORNIA' �_ RIVERSIDE COUNTY n Fo? COMM EXPIRES FEB 20,2019" WITN SS m han and 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 Vice President/Secretary Type of Document title(s) ❑ Partner(s) Number of Pages ❑ Attomey-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) PTM General Engineering Services,Inc CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Los Angeles ) On NOV 2 0 2015 before me, Monica Blaisdell,Notary Public Date Here Insert Name and Title of the Officer personally appeared Philip E. Vega Name(s) of Signer(s) r who proved to me on the basis of satisfactory evidence to be the person(K whose name($) islXrXX subscribed to the within instrument and acknowledged to me that he/0X executed the same in his/ t authorized capacityoft and that by his/VJOWsignatureg on the instrument the person) or the entity upon behalf of which the person( acted, executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph MONICA BLAISDELL is true and correct. Commission N 1970845 Notary Public California WITNESS my hand and official seal. Z i Orange County My Comm Expires Mar 26 2016 Signature A / Signature of Notary Public it I DATE(MWDD/YYYY) AIR" CERTIFICATE OF LIABILITY INSURANCE 11/24/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements) PRODUCER LICENSE NO 0637431 NAME CONTACT PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES P"c°N a E t (714)779-6999 a/c Na (714)779-6903 1290 N HANCOCK ST, SUITE 210 ADDRESS P MCRAE@SBCGLOBAL NET ANAHEIM HILLS, CA 92807 INSURERS AFFORDING COVERAGE NAIC p INSURER JAMES RIVER INSURANCE COMPANY 12203 INSURED INSURER CENTURY NATIONAL INSURANCE CO 26905 INSURER SCOTTSDALE INSURANCE COMPANY 41297 PTM GENERAL ENGINEERING SERVICES INC INSURER GREAT AMERICAN INSURANCE CO 16691 5942 ACORN STREET INSURER LIBERTY SURPLUS INSURANCE COMPANY 10725 RIVERSIDE CA 92504 INSURER QBE SPECIALTY INSURANCE COMPANY 111515 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 POLICYNUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 00053260-3 05/11/201505/11/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR occurrence)X X DEDUCTIBLE $10,000/ PDAMAGE REMISES RENT TENTED $ 100,000 X XCU/OCP OCCURRENCE MED EXP(Any one person) $ X EBL $1,000,000 PERSONAL&ADV INJURY $ 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY�PE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ B AUTOMOBILE LIABILITY BAP0175004 02/09/2015 02/09/2016 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO X X BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident X HIRED AUTOS M AUTOS X HIRED PHY $ C UMBRELLA LIAB X OCCUR - - XLS0096965 05/11/2015 05/11/2016 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE UNDERLYING POLICIES AGGREGATE $ 10,000,000 X I DED RETENTION$ NIL GL&AL PROD>COMP/OPS $ 10,000,000 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E L DISEASE-EA EMPLOYE $ If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT 1 $ D PROPERTY&INLAND MARINE MAC0991838 07/10/2015 07/10/2016 11051 ° uidule B38650 Contents 260000 and Re ted Equipment $380 517 Scheduled Equipment $300 000 Leesed end Rented Equipment E POLLUTION LIABILITY UBELA524303115 05/06/201505/06/2016 $5000000EACH INCIDENT LIMIT $10 000 000 POLICY AGGREGATE F BUILDERS RISK BX10038200 08/01/201508/01/2016 $170000PERJOB $400000 PER OCCURRENCE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required THE CITY OF HUNGTINGTON BEACH,OFFICERS ELECTED OR APPOINTED OFFICIALS,EMPLOYEES,AGENTS 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 ABOVEDESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF,A 30 DAYS WRITTEN NOTICE WILL BE ISSUED RE Project Info CC-1485 Traffic Signal Modification @ Bolsa Chica St and Bolsa Avenue (PTM Job No P15-17) CERTIFICATE HOLDER CANCELLATION City of Huntington Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn Mr John Griffin, Public Contracts THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Administrator ACCORDANCE WITH THE POLICY PROVISIONS N 2000 Main St AUTHORIZED REPRESENTATIVE Huntington Beach, CA 92648 ©1988-2014 ACORD CORPORATION All rights reserved ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ,acoRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM11/24/2015 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 pollcy(les)must be endorsed If SUBROGRATION IS WAIVED, subject to the terms and Conditions of the policy,Certain policies may require an endorsement A statement on this Certificate does not confer rights to the certificate holder in lieu of such endorsement(s) PRODUCER OnPOlnt Underwriting Inc CONTACT NAME Steven McComb 8390 E Crescent Pkwy, Suite 200 PHONE(A/C,No Ext) (360)828-0644 FAX(A/C,NO) (360)828-0699 Greenwood Village, CO 80111 EMAIL ADDRESS INSURER(S)AFFORDING COVERAGE NAIC# INSURER A ACE American Insurance Company 22667 INSURED INSURER B Barrett Business Services,Inc L/C/F INSURER C P T M GENERAL ENGINEERING SERVICES,INC> INSURER D DBA P T M GENERAL ENGINEERING SERVICES, INSURER E INC IN- - - - SURER F 5942 ACORN STREET RIVERSIDE,CA 92504 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 ISSUES 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS /Y LTR INSR WVD (MM/DDYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea $ occurence) CLAIMS MADE F OCCUR MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY PROJ LOC PRODUCTS COMP/OP AGG $ ECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS RSCHEDULEDAUTOS BODILY INJURY(Per person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB OCCUR AGGREGATE $ DED RETENTION$ 1 $ A WORKERS COMPENSATION AND EMPLOYERS RWC 08/01/15 08/01/2016 �/ WCSTATU OTH LIABILITY Y/N C48538393 TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A Y EL EACH ACCIDENT $2 000 000 OFFICERIMEMBER EXCLUDED? Covered states EL DISEASE EA EMPLOYEE $2 000 000 (Mandatory in NH)If yes,describe under CA DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT $2 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101 Additional Remarks Schedule if more space is required) In the event of any payment under this policy for a Loss for which the named insured has waived the right of recovery in a written contract entered into prior to the Loss,insurer hereby agrees to also waive our right of recovery but only with respect to such Loss CERTIFICATE HOLDER CANCELLATION City Of Huntington Beach Attn Mr John Griffin, PUbIIC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATA THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Contracts Administrator POLICY PROVISIONS N 2000 Main Street AUTHORIZED REPRESENTATIVE Huntington Beach CA 92648 , Richard Poling c)1988-2010 ACORD CORPORATION All rights reserved ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID LOC # ACORL�® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMEDINSURED Barrett Business Services, Inc OnPolnt Underwriting Inc 8100 NE Parkway, Suite 200 POLICY NUMBER Vancouver WA 98662 RWC C48538393 CARRIER NAIC CODE ACE American Insurance Company 22667 EFFECTIVE DATE 08/01/15 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER 25 FORM TITLE Certificate of Liability(01/14) CERTIFICATE HOLDER City of Huntington Beach Attn Mr John Griffin,Public Contracts Administrator ADDRESS 2000 N Main Street Huntington Beach CA 92648 WOS in favor of The City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteer Pro3ect CC-1485 Traffic Signal Modification @ Bolsa Chica St and Bolsa Avenue (PTM Job no P15-17) ACORD 101 (2008/01) c)1988-2010 ACORD CORPORATION All rights reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER 00053260-3 COMMERCIAL GENERAL LIABILITY 05/11/2015 TO 05/11/2016 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 Organization(s) Locations Of Covered Operations THE CITY OF HUNGTINGTON BEACH OFFICERS,ELECTED OR RE Project Info CC-1485 Traffic Signal Modification @ APPOINTED OFFICIALS EMPLOYEES,AGENTS AND VOLUNTEERS Bolsa Chica St and Bolsa Avenue(PTM Job No P15-17) 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 "bodily injury" or damage" or "personal and advertising injury" caused, In whole or In part, by "property damage"occurring after 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 princi- pal as a part of the same project CG 20 10 07 04 ©ISO Properties, Inc,2004 Page 1 of 1 0 POLICY NUMBER 00053260-3 COMMERCIAL GENERAL LIABILITY 05/11/2015 TO 05/11/2016 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 Organization(s) tions THE CITY OF HUNGTINGTON BEACH,OFFICERS,ELECTED OR RE Protect Info CC-1485 Traffic Signal Modification @ Bolsa APPOINTED OFFICIALS,EMPLOYEES AGENTS AND Chica St and Bolsa Avenue(PTM Job No P15-17) VOLUNTEERS Information required to complete this Schedule, if not shown above,will be shown In the Declarations Section II—Who Is An Insured Is amended to include as an additional insured the person(s) or 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 13 POLICY NUMBER 00053260-3 05/11/2015 TO 05/11/2016 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 AP5004US 11-06 Page 1 of 1 POLICY NUMBER 00053260-3 05/11/2015 TO 05/11/2016 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 Organization(s) THE CITY OF HUNGTINGTON BEACH,OFFICERS,ELECTED OR APPOINTED OFFICIALS,EMPLOYEES, AGENTS AND VOLUNTEERS RE Project Info CC-1485 Traffic Signal Modification @ Bolsa Chica St and Bolsa Avenue(PTM Job No P15-17) 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 POLICY NUMBER 00053260-3 05/11/2015 TO 05/11/2016 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 AP5012US 12-03 Page 1 of 1 n�_Ic_onl� AI AA..� C.nm- - ••• ^^• ^ ^ r inn CENTURY-NAAONAL. INSURANCE COMPANY POLICY I30. : BAP0175004 BUSINESS AUTO POLICY - ENDORSEMENT pacE z CO CTO sam=NO 122800 NTRAAS pOL2Clr PESLLOD P01s_1' cov2Sa FXOIb 22:54 PM ONO2/09/2015 Go 02/09/2016 21=RBEmD;T NO : 27 IMM952WINT EMCTIVB DATE 02/09/2015 INSURED: BROKER: FREEWAY ELECTRIC: INC CHAIX & ASSOC INS BROKERS INC PTM GENERAL ENGINEERING SVCS INC 41 CORPORATE PARK STE 310 PO BOX 7745 r CA 92606-5181 RIVERSIDE CA 92503 IRVINE ADD'L INSURED/WAIVER OF SUBROGATION i IT IS AORRED THAT INSURANCE AFFORDED By THE ABOVE POLICY SHALT. APPLY TO THE PARTY(S) NAMED BELOW, AS THEIR LtQTEREST MAY AppgAR BD'T SHALL NOT OyHRATE TO INCREASE THE LIMITS OF COMPANY'S LIABILITY. wAIVE.R OF SUBROGATION "THE RIGHT TO SOBROGATE ACAINST THE ADDITIONALL INSURED NAMED BELOW IS WAIVE FOR LOSSES PAID WHICH ARISES OUT OF TB'E OPERAPIONS OF THE NAI&ED IN5UREDn, FOR WHICH THE NAMED ADDITIONAL INSM:= BAS NO INDLPSNDENT NBoutGENcs.. AUTHORIZIm REPRESENTATIVE ADDITIONAL INSURED THE INSURANCE IS PRIMARY AND NON-CONTRIBUTORY WITH RBSPECT TO ANY INSMZANCE CAk A11-D BY THE ADDITIONAL INSMM. THE CITY OF HUNGTINGTON BEACH OFFICERS ELECTED OR APPOINTED OFFICIALS EMPLOYEES AGENTS AND VOLUNTEERS RE Project Info CC-1485 Traffic Signal Modification @ Bolsa Chica St and Bolsa Avenue(PTM Job No P15-17) CN613A WAIVER OF SUBRO (5/99) pate Printed : 02/09/2015 MARICBLA 5ANCED CENT URY-INATIO14AL INSURANCE COMPANY POLICY NO. : BAP0175004 BIISINESS AUTO POLICY - ENDORSEMENT PAGE I COWRACl'ORS BRom NO I22800 POLICY RERSOD, Policy Covers FROM 12 $d I'M 06 02/09/2015 to 02/09/2016 RNOORSVIMNT NO. 28 mmoRSm4WT BFFECTM AAT2 02/09/2015 INSURED: BROKER: FREEWAY ELECTRIC INC CHAIX & ASSOC INS BROKERS INC PTM GENERAL ENGINEERING SVCS 8 0CBOX 7745 41 CORPORATE PARK STE 310 RIVERSIDE CA 92503 IRVINE CA 92606-5181 ADDITIONAL INSURED ENDORSEMENT C24613 5/59 IT IS AGR= THAT INSURANCE AFFORDED BY THE ABOVB POLICY SAAW APPLY TO TBES PARTY(S) NAMED MOW, AS THEIR ITTl'ERAST MAY APPEAR BUT SBALL NOT OPERATE TO INCREASE THE LIMITS OF TER COMPANY'S LIABILITY, ANY ADDITIONAL INSURED LANGUAGE ON A CRRTIF.TCATE OF INSURANCE IS VOID. The additional insured named below as oaly an insured for liability which is the result of an act or omission of the "NAMSEA INSURED" of the policy and shall have ao coverage under this endorsement or the Polley 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 aNAMED INSURED" of the policy. Further, any insurance provided by this endorsement shall be excess Insurance to all other Insurance available to say 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. In the event the other Insurer has a duty to defend any person or entity added to our policy by reason of this endorsement, we 4ill have no duty to defend that person or entity however, we May elect to do so, and, 7.f we do, we will be entitled to the rights of any person or entity we do defcnd against the other Insurer. yI �L�'B u iced Rc esentatsve ADDITIONAL INSURED THE CITY OF HUNGTINGTON BEACH,OFFICERS,ELECTED OR APPOINTED OFFICIALS,EMPLOYEES, AGENTS AND VOLUNTEERS RE Project Info CC-1485 Traffic Signal Modification @ Bolsa Chica St and Bolsa Avenue(PTM Job No P15-17) Date Printed : 02/09/2015 MAR.ICEI-k SANCRs6 05/11/2015 A� SCOTTSDALE INSURANCE COMPANY® COMMERCIAL EXCESS LIABILITY SCHEDULE OF CONTROLLING UNDERLYING INSURANCE Policy No XLS 0096965 Effective Date 05/11/2015 12 01 A M Standard Time Named Insured PTM GENERAL ENGINEERING INC Agent No 04787 INSURER, POLICY NUMBER TYPE OF COVERAGE APPLICABLE LIMITS AND POLICY PERIOD General Liability Applicable Limits $10,000,000 Each Occurrence Insurer's Name $10,000,000 Personal and SCOTTSDALE INSURANCE COMPANY Advertising Injury Policy Number $10,000,000 General Aggregate ON FILE WITH COMPANY (other than products/ completed operations) Policy Period 'PER PROD 05/11/2015 TO 05/11/2016 $10,000,000 Products/Completed Operations Aggregate General Aggregate Applies X Occurrence Claims Made Commercial Auto Liability Bodily Injury and Property Damage Limit Insurer's Name $1,000,000 Each Accident CENTURY NATIONAL BAP0175004 Policy Number ON FILE WITH COMPANY 05/11/2015 TO 05/11/2016 Policy Period Employer's Liability Bodily Injury Limit Insurer's Name $ Each Accident NOT APPLICABLE (by accident) Policy Number $ Policy Limit (by disease) $ Each Employee Policy Period (by disease) to XLS-SP-1 (11-08) Insured Copy ENDORSEMENT A� SCOTTSDALE INSURANCE COMPANY® NO Attached to and forming apart of Endorsement Effective Date 05/11/2015 Policy No XLS0096965 12 01 A M, Standard Time Named Insured PTM GENERAL ENGINEERING INC Agent No 04787 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY MINIMUM EARNED CANCELLATION PREMIUM The following provision is added to the Cancellation Condition If You request cancellation of this policy, We will retain not less than 25 o of the original premium AUTHORIZED REPRESENTATIVE DATE UTS-119g(1-00) Insured Copy Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number BARRETT BUSINESS SERVICES, INC L/C/F P T M GENERAL ENGINEERING SERVICES, INC>dba P T M Policy Number GENERAL ENGINEERING SERVICES, INC Symbol RWC Number C48538393 8100 NE PARKWAY DRIVE, STE 200 VANCOUVER WA 98662 Effective Date of Endorsement 08-01-2015 TO 08-01-2016 08-01-2015 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the Insurance provided by the policy because California is shown in Item 3 A of the Information Page We have the right to recover our payments from anyone liable for an injury covered by this policy We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule Schedule 1 ( ) Specific Waiver Name of person or organization ( X ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver 2 Operations ALL CALIFORNIA OPERATIONS 3 Premium The premium charge for this endorsement shall be 2 . 0 percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described 4 Minimum Premium $0 Authorized Agent WC 99 03 22 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ N,ww.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk February 10, 2016 PTM General Engineering 5942 Acorn St Riverside, CA 92504 Re Traffic Signal Modification at Bolsa Chica St & Bolsa Ave — CC-1485 The City Council awarded the bid to your company for the above referenced project Enclosed is a copy of the executed contract with the City of Huntington Beach A Certification of Compliance with Title VII of the Civil Rights Act, Certification of Compliance with Prevailing Wage Laws and Contractor's Certificate form must be returned to this office after the project is completed but prior to the release of retention funds In addition, the following item must also be on file, with this office before the City can release any retention funds A warranty bond guaranteeing the final amount of work and materials for one year If your performance bond does not include specific wording for a one-year warranty, then a rider or separate bond must be submitted Should you have any questions or concerns regarding the enclosures or items that must be on file in this office prior to release of retention funds, please call the Public Works Department at 536-5517 erely�� Joan L Flynn, CIVIC City Clerk JF pe Enclosures Copy of Contract including Proposal Copies of insurance/bonds Bid Bond (original) Szster Citzes. Anjo, Japan ♦ Waitakere, New Zealand Dept ID PW 15-046 Page 1 of 2 Meeting Date 8/17/2015 CITY OF HUNTINGTON REACH REQUEST FOR CITY COUNCIL ACTION MEETING DATE: 8/17/2015 SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A Wilson, City Manager PREPARED BY: Travis K Hopkins, PE, Director of Public Works SUBJECT: Accept the lowest responsive and responsible bid and authorize execution of a construction contract with PTM General Engineering Service, Inc in the amount of $130,105, for the traffic signal modification at the intersection of Bolsa Chica Street and Bolsa Avenue, CC-1485, appropriate $35,000 from the Proposition 42 undesignated fund balance, and, authorize fifteen (15) percent in change orders Statement of Issue On July 16, 2015, bids were opened for the traffic signal modification at the intersection of Bolsa Chica Street and Bolsa Avenue City Council action is requested to award the contract to PTM General Engineering Service, Inc , the lowest responsive and responsible bidder Financial Impact Funds in the amount of $200,000 are included in Fiscal Year 2014/2015 Capital Improvement Program (CIP), under Proposition 42, account No 21990422 82700 An additional appropriation from the Proposition 42 account in the amount of$35,000 will be required Recommended Action A) Accept the lowest responsive and responsible bid submitted by PTM General Engineering Service, Inc , in the amount of$130,105, and, B) Authorize the Mayor and City Clerk to execute a construction contract in a form approved by the City Attorney, and, C) Appropriate $35,000 from the Proposition 42 undesignated fund balance, 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 or$19,516 Alternative Action(s) Reject all bids and provide staff with alternative direction Analysis The existing traffic signal circuitry and poles at this intersection are deteriorated and experience a high frequency of maintenance issues In addition, the existing conduit and wiring will not accommodate emergency vehicle preemption This project will completely replace the poles, conduit and circuitry Emergency vehicle preemption will be provided and the traffic signal will be brought into conformance with current Manual on Uniform Traffic Control Devices (MUTCD) standards HB -63- Item 4. - I Dept ID PVV 15-046 Page 2 of 2 Meeting Date 8/17/2015 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 16, 2015, and are listed in ascending order Bidder Submitted Bid 1 PTM General Engineering Service, Inc $130,105 00 2 California Professional Engineering, Inc $141,637 00 3 DBX, Inc $164,818 00 4 Elecnor Belco Electric , Inc $176,500 00 5 Unique Performance Construction, Inc $179,800 00 The engineer's estimate for the bid items was $140,000 The total estimated cost for this project,is $230,000, 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 the added flexibility needed to complete a typical construction project yet still be consistent with the intent of the 10 percent limit The original budgeted amount for this project was $200,000 which included engineering, construction management and construction administration Approximately $5,000 has been expended on the engineering effort resulting in approximately $195,000 of budgeted funds available During the design phase of the project, it was determined that an additional $35,000'in funding would be required due to an escalation in construction prices over the past two years These funds are currently available in the Proposition 42 fund balance, the same funding source as was originally approved in the CIP Public Works Commission Action: The Public Works Commission recommended this project on September 17, 2014, by a vote of 6-0- 1 (McGovern absent) Environmental Status This project is categorically exempt pursuant to the California Environmental Quality Act, Section 15303 (c) Strategic Plan Goal Enhance and maintain infrastructure Attachments) 1 Project Location Map Item 4. - 2 HB -64- i .I 4� S PROJECT LOCATION 4P� 'o ~ AVE. CO _Q Mc FADDE AVE, U x EDINGER z - � AVE.. Y Z J Q (n V) > �� o cy m Q HEIL Q ¢ AVE. mIX z z c0a v~i � � o w o V) Q WARNER `'� o AVE. c� Ao SLATER Qr Cl m405 i0 TALBERT AVE PACIFIC ELLIS AVE. 00.9 GARFIEL -�' _ AVE s� V V) Q (yOlRKTOWN AVE ADAMS AVE. INDIANAPOLIS AVE vx) 9L o J o x OCEAN F ATLANTA < z = AVE. O U Lv < m m Z HAM LTON AVE. BANNING AVE. CITY OF HUNTINGTON BEACH * PUBLIC WORKS * TRAFFIC ENGINEERING • PROJECT LOCATION MAP ATTACHMENT BOLSA CHICA STREET AT BOLSA AVENUE HB -65- Item 4. - 3 Project Name: Bolsa Chica Street at Bolsa Avenue-CC1485 Date: 7 16 15 'Bidder Raank Addendu u . Bid Amount .,Corrected Bid Amount Unique Performance Const /77,' Traffic Development Services PTM General Contractors 130 /a S Pro-Tech MSL Electric Elecnor Belco Electric Inc lj ©o ADD California Professional Eng C- 3 /� I Atz 219 SECTION A NOTICE INVITING SEALED BIDS for the TRAFFIC SIGNAL MODIFICATION at the intersection of Bolsa Chica Street and Bolsa Avenue CC No. 1485 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 16, 2015. 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 $15.00 nonrefundable fee if picked up, or payment of a$25.00 nonrefundable fee if sent by UPS ground delivery(bidder shall pay additional costs for special delivery) Any contract entered into pursuant to this notice will incorporate the provisions of the State Labor Code Pursuant to the provisions of the Labor Code of the State of California, the mimmum prevailing rate of per diem wages for each craft, classification or type of workman needed to execute the contract shall be those determined by the Director of Industrial Relations of the State of Califorma, which are on file at the Office of the Director of Public Works, 2000 Main Street,Huntington Beach, CA 92648 The AGENCY will deduct 5% retention from all progress payments The Contractor may substitute an escrow holder surety of equal value to the retention in accordance with the provisions of the Public Contract Code, Section 10263 The Contractor shall be beneficial owner of the surety and shall receive any interest thereon The AGENCY hereby affirmatively ensures that minority business enterprises will be afforded full opportunity to submit bids in response to this notice and will not be discriminated against on , the basis of race, color, national origin, ancestry, sex, or religion in any consideration leading to the award of contract No bid shall be considered unless it is prepared on the approved Proposal forms in conformance with the Instructions to Bidders as determined by the AGENCY The bid must be accompanied by a certified check, cashier's check, or bidder's bond made payable to the AGENCY for an amount no less than 10% of the amount bid The successful bidder shall be licensed in accordance with provisions of the Business and Professions Code and shall possess a State Contractor's License Class A at the time of the bid opening The successful Contractor and his subcontractors will be required to possess business licenses from the AGENCY All extension of unit prices will be subject to verification by the AGENCY In case of a variation between the unit price and the extension, the unit price will govern Project Description The project consists primarily of modifying an existing traffic signal and making signing and striping improvements • The contract shall allow the Contractor 30 working days to complete the contract. • The engineer's estimate of probable construction cost for the work included in the basis of award is $175,000 The AGENCY reserves the right to reject any or all bids, to waive any irregularity and to take all bids under advisement for a maximum period of 60 days. BY ORDER of the CITY COUNCIL of the CITY OF HUNTINGTON BEACH, CALIFORNIA, the 2nd day of September 2014, by Resolution No 2014-69 Attest Joan L Flynn CITY CLERK OF THE CITY OF HUNTINGTON BEACH Esparza, Patty From: David Ward [DWard@ocregister corn] Sent: Thursday, June 18, 2015 5 40 PM To: Esparza, Patty Subject: RE Legal Ad -CC-1485 for HB Wave Good afternoon again Patty Have a great evening and weekend II Ad#10062248 Run Date 6/25, 7/2, 7/9 Cost$490 05 PROOF SIMON w for The i at VM WdISIMICUM of t�idlliwr Smart ear!Asa AMOMM in the f7lfrtr OW IfU]I7tlIISrI'Q!IIN1' I+ ualli,lte Il "09#III lill0lEBY d 11hat the 43111 X or III�i7M"I M M&C116 as AGENCY.inides sealed bxfr for Uwabc-e statdd pmipda and Will $won bids in the Otte 0 to city Ciark, Second F�oor. 2M main W Cmlrbmw w q�, tPms hour of t PM on a dw t% &V da WIM be put tkcfy'cam in the tarnbers+�nrerta pasted. Copies of On M specifications,and contrao documn are available frrom the mice of the tilt r ref P ie Woiks.,2C in nee Hunringlian 4 9e54% D Meat of a�i narvehr4able tee ff mad up.or pant cd a r u,Itarda *0 If Mn by LMS ground de1hr t(bidder shall pay addbonal for epeo1W cWhmr}. Any caratrast entered into pur3Lwa to thus e,will wi=vcveta#w of the stag l ai f�. Fwauent to ft provt5bas of tyre,data'Cep of ft$Lm of cam the rrirrurnum pm-why rate of par don Wiwi Ibrr each craft,daispric=nori pe of aro*rnan naded to e'recute tt car*=MMIIII be these deftennined bv the O ecMt of Infustaai Re- latlem of the State Of Caft"th,which me at the old of the ahwWr of Public ` tk%2M Win Streit,Huntington Beach,CA 92&4 Tre AGENCY vAll deduct 7%aftntion from ati prtugrm The mil Satm+dude an oacrraw holder su of ual uelLe to the rH in vWh"l'trtr p� ip of Ube re M26& 91ta CoMactor shall be benedeiai wmmr ad the surety and abW raceiv s any interest thereon. The AGENCY hereby attErnat eat 00�I r upKm�tl tea afore eau foil cpporrco8tlr to sl rlpl k34 iAm to Vft lAdoe and WIN rout be d againo on the basis of r2M,COW,raltgan6i ongin,ancestry,sit,at r>BrnOW in oft cones oration to Me award of contrea No trill adaall be red unlim 0 w pmoared on d*tipprtt dWtr fame;in c+on- naa With the to as Of the h p bid must ixg ent�nreiSt bV a c�titkas rhMK S chacl4 sir tsar"!bodttl - the Al�t+lk her an elrFl uaf no vase than tt7�of tree an rnt bed W ern � edlee be licerestd in accorbGe whit ArOvkbft otthe Buminess and Prohms nns Code and shwa tacsees a S Cantrarxoa Lfoenaa A Bt tt�t od th9 B The auccesa. I Contractor and his Subcontractors will be regwred be lioahm from AGENCY All extension of ances roll to sutleat to verftafion by the AGDCY, cry of a vaiallen bammm fhb unk pots$and the erWsdon,Ana cant price wX govern. r The project consists-bona of rrnw eng an dgeng Ora rg-s ret an0 s ty f s. f The contract efe ;hour the trGrrb=fty 30 wodft crap to tree •The s embrnmte oforabaM canthruc0on ocsat Corr ft work included in the baaw of 3w8rdia SM,00M The AGENCY resemes tlae o.rod eo any of ait bids WON*any irreautartty and to take all blda ursdsr advise r a rrm6man pwmd c So d daV40BY ORDER fiberMal,btr ITY COUNCIL as the Ramsolo� t�9fplVt� lA the No.2ON49L Mies! Joan TY�{SOF 111E CITY OF MUNTIAIG I'M BEACH ublislredc The i"IurttrnQ6on Beach Wave June M JuIV S.%.=5 MOMM 1 Cc REGISTO F. 714.347.2724 mill, - '� w A - �- From: Esparza, Patty [mailto.PEsparzaCaiisurfcity-hb org] Sent: Thursday, June 18, 2015 11:49 AM To: David Ward Subject: Legal Ad - CC-1485 for HB Wave Importance: High Hi David Attached is a legal ad that needs to be published 3 dates 6/25/2015, 7/2/2015 and 7/9/2015 in the Huntington Beach Wave Please confirm when time permits Thanksi Patty Esparza, CNC Senior Deputy City Clerk City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 (714) 536-5260 2 CITY OF HUNTINGTON BEACH 2 00 0 Main Street P . O . Box 190 Huntington Beach , CA 92 64 8 LETTER OF TRANSMITTAL Fax (714) 374-1573 Attention. Joan L Flynn Date, June 18,2015 To: City Clerk's Office ProlectlC C No CC No 1485 2000 Main Street Regarding Traffic Signal Modification at Bolsa Chica&Bolsa Huntington Beach, CA 92648 ❑ We are sending you ❑ By Mad ❑ By Fax Mail(Number of pages including this sheet) ® We are hand delivering. ❑ Attached ❑ Under a separate cover via the following items ❑ Shopdrawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change Order ® Other Notice Inviting Sealed Bids Item# I Copies I Pages Description 1 1 1 Notice Inviting Sealed Bids for CC-1485, Traffic Signal Modification at the intersection of Bolsa Chica Street and Bolsa Avenue 2 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 distnbution ® For your action ❑ Returned for corrections ❑ Return corrected prints ❑ For review/comment ❑ Other Remarks Per Resolution 2014-69 (adopted on September 2°d, 2014), the City Council authorized the advertisement of the above Traffic Signal Modification at Bolsa Chica Street at Bolsa Avenue, Project CC-1485 Please find attached the Notice Inviting Sealed Bids for advertisement on 6/25/15, 7/2/15 & 7/9/15. The bid opening is scheduled for 7/16/15 Please contact me at 374-1628 with any questions you may have cc: fffeCC-1485 By. William F.Janusz,&qcipal Civil Engllk6r ol En 04-<Ltd O cr% rTl -0 < =c M W m I-K cc > HOV39 NOIONIINIIH Jo Alto M8310 A 110 00 :? Wd 91 Ifir Ste? 03AI3338 UNSUCCESSFUL BIDS CC- 1485 Traffic Signal Modification at the intersection of Bolsa Chica Street and Bolsa Avenue City of Huntington Beach . ��. 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov "`f8 Vj jg09 *� Office of the City Clerk Joan L. Flynn, City Clerk February 11, 2016 California Professional Engineering, Inc 929 Otterbein Ave Unit E La Puente, CA 91748 RE Traffic Signal Modification/Bolsa Chica St & Bolsa Ave —CC-1485 Enclosed please find your original bid bond for CC-1485 Sincerely, Joan L Flynn, CIVIC City Clerk JF pe enclosure Sister Cities Anjo,Japan ♦ Waitakere,New Zealand cC O O J LL ..J p .:: O Li LA.1 LU a: V) C`' F-= tat v> o w w uLI w Lal c—cs OC w Z' iz z = F' z w H V) O Q z _ Q z V O -j W Q " o CO O O 0 in2 (A' a Z Y W L J W O O LU z 0 Q U— z C L1J V V) C7 �� Fes- V 2 N V) V Q V m m V mLU U 2 c Q V z F- H 0 LL < O z w O u vm LL c z L.L D O c w = w w -1-j L E O o D oo O .� ; V w � Q > o S Q a V QL •� 4- C o O °� rn a V m b � i. SECTION C PROPOSAL for the TRAFFIC SIGNAL MODIFICATION At the intersection of BOLSA CHICA STREET AND BOLSA AVENUE CC No. 1485 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 famish 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 Huntmgton Beach, and to enter into a contract at the following prices The undersigned agrees to complete the work within 30 working days, starting from the date of the Notice to Proceed The undersigned acknowledges that the issuance of the Notice to Proceed will occur approximately two months after the award of the contract to allow procurement time for city furmshed equipment 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 satisfactonly 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 cxtended amounts, and words shall govern over figures C-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 G NCY'S optio be considered null and void the', s��_' Accom anymg this proposal of bid, find "�" in the amount of I Q70 which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable Bidder shall signify receipt of all Addenda here, if any Addenda No. Date Received Bidder's Signature C-2 ' Project Bid Schedule Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue CC-1485 Item"' ``Estimateda .s T<_ Items x ?` Unit'Pr0, —ExteridedAmount� a Mobilization $ Per L S �l 2 1 L S Furnish Project Traffic Control $ , r,Y� $ �t�O Per 1, S �w 3 1 L S Furnish and Install Traffic Striping I0 Vv and Signing $ $ Per L S 4 1 L S. Reconstruct Raised Medians (Pull Back from Existing Location) $ $ a� Per L S 5 1 L S Modify Traffic Signal at Bolsa g Chica Street and Bolsa Avenue $ I I Z���� $ Per L S Total Amount Bid in Figures $ 11f( I (o;--7 Total Amount Bid in Words $One hIwA19 ore, sc 4 Yc hw�)dr�d�'h� seven dot, s . 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 (with his own labor) at the City Yard, 17371 Gothard Street Contact George Ruff two working days in advance for pick up at(714) 536-5530 C-2 1 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) LicenseAmount Contract . Number t�1,2G�C M W.aI-M sye&T -702-� &1() 4�410(,T3 3 /0 � s L4 I�� �, sIx`1'h S�: Boo 72001(0 A tPo 0 (DV-bhPL, Dk °126-1 el FC lTqff)c aVl�e t rvL�n .g2W(p By submission of tlus 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 furmshed copies of all subcontracts entered into and bonds furnished by subcontractor for this project C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the St a f C411ifornia that the foregoing is true and correct and that this declaration is executed on , at LO Dale City State Van Nquyen , being first duly sworn, deposes and sa s that he or she is President ofC'alQpfniGi ?10J(61 �'1 %heed 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 California Professional Engineering, Inc. Name of Bidder /I Signature of Bidd�r 'vVI IV Address of Bidder C-4 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me on this 16th day of July , 2015 , by Van Nquyen proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me Y DIEM CHU 42313 rn NOTARY^ 0 PUBLIC CALIFORNIA V' LOS ANGELES COUNTY MY Comm EXP SEEP 21,2017 wsrw (Seal) Signature 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 TRAFFIC SIGNAL MODIFICATION AT THE INTERSECTION OF BOLSA CHICA STREET AND BOLSA AVENUE, (I)(we)(rt) 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 California Professional Engineering, Inc. Contractor Van Nguyen y By President Title Date 01 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation'? ❑ Yes )(No If the answer is yes, explain the circumstances in the space provided Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire. 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 California Professional Engineering, Inc Contractor Van Nguyen " By - President Title Date - 1tPIg5- C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct California Professional Engineering, Inc. Bidder Name q2A &WW900 M UIVIit I Business Address U—A YmVil e U,� a�� City, State Zip ( Q tv) V 0- Telephone Number State Contractor's License No and Class Original Date Issued pLf tz 1-7 Expiration Date Van Nguyen 2 The work site was inspected by of our office on O Q✓ , 2015 The following are persons, firms, and corporations having a principal interest in this proposal Van Nguyen , %cep Cafiifornia"ro fees sionalEngineering, Inc C-a 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 California Professional Engineering, Inc. Company Name Signature of Bidder Van Nguyen Printed or Typed Signature Subscribed and sworn to before me this I LQ day of Ul ,201;D NOTARY PUBLIC NOTARY SEAL C-9 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document State of California County of Los Anqeles Subscribed and sworn to (or affirmed) before me on this 16th day of July , 2015 , by Van Nquyen proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me DIEM CHU COMM.# 2042313 rn NOTARY PUBLIC CALIFORNIA Ul 1 Los ANGELES COUNTY ,!6 MY COMM €xP 9EP,21,2017 (Seal) Signature CD Bidder's Project History Foi the purposes of this project, the bidder shall provide project history of similar work This history shall specifically reference the construction of traffic signal modifications consisting of, at minimum the installation of four new traffic signal poles at a single intersection, two of which must include traffic signal mast arms of at least 25 feet in length Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed and completed similar work within the past five years. 1 c �a �, CTn r�n�laX� fl'`�Q , r�ra e, C',�- Name and Address of Public Agency I Name and Telephone No of Project Manager �� �i yq Contract Amount Type of Work Date Completed Provide additional project description to show similar work 4 Yh� ,e ylaw►a s hS lY1 ►1/ 2 ( �mr< Il I I P-XooWily-e -AVP DDWn&y , L-, bZL 0 Name and Address of Public Agency T " p JManager Name and Telephone No of Project ' (5 2,Q�b —�fcr I C W&L Contract Amount Type of Work Date Completed Provide dditional proiect description to shoyv similar work I n aIC s M- at' lomas Y6► c lbifi rKhs, 3 G LIA PIAevH-e �%n st , JA PLAOY -e, CA 11-74y Name and Address of Public Agency Name and Telephone No of Project Manager Contract Amount Type of Work Date Completed Provide additional projeectt_d�scrption t how simila work YI ,In^�+ �A� a1'�iC Nvif&- fie jY 09 A 61 Y'AO teem Pt L-)v1 s1 e C-10 i Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years These piojects do not have to be under the employment of the bidder of this project Bidders ale encouraged submit supplemental relevant project history in addition to the piojects listed herein Lan �w"q�&n Name of proposed Project Manager ��771I Telephone No of proposed Project Manager(cp-) TrrAff(C s rk Mc�i� lc����l ak �3wrs� J col Project Name & Contract Amount Type of Work r bate Completed Project Name& Contract Amount Type of Work Date Completed -MCAWIC, OrXV�UAOY cr� V64 /(?D/;1.1� Project Name& Contract Amount Type of Woik Date ompletcd 2 - SaPV aS A'�OvZ -- yp�h Name of proposed Superintendent V Telephone No of proposed Superintendent Project Name& Contract Amount Type of Work Date Completed Project Nasne & Contract Amount Type of Work Date Completed Project Name & Contract Amount Type of Work Date Completed C-11 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771 1(a)), passed by the California State Senate on Tune 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR) Currently the annual non-refundable registration fee for Contractors is $300 Each contractor to whom a public works contract has been awarded shall sign the following certificate DIR FACT SHEET on SB 854 http//www dir ca gov/DLSE/PublieWorks/SB854FactSheet-6 30 14 pdf DIR's Contractor Registration Link—Call (844) 522-6734 https//efiling dir ca gov/PWCRIActionServlet?action--displayPWCRegistrationForm DIR's Contractor Registration searchable database https Hefilmg dir ca gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771 1(a) which states "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725 5 It is not a violation of this section for an unregistered contractor to submit a bid that is authon7ed by Section 7029 1 of the Business and Professions Code or by Section 10164 or 20103 5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725 5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor. as well as for ALL subcontractors at the tune of submitting the bid, or no later than contract award date California Professional Engine ring, Inc Contractor Van Nguyen By President �� I t A / Title Date �Y G..7 C-12 THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond BOND#20150710 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 5 HUTTON CENTRE,SUITE 1060 Santa Ana,CA 92707 (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----------------------------------------- ( 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 BOLSA CHICA ST.AT BOLSA AVE. TRAFFIC SIGNAL MODIFICATION (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 10th day of July, 2015 CALIFOR ROFES IONAL ENGINEERING INC. DBA CAL O hIIA PROF NAL ELECTRICAL ENGINEERING Principal) / (Seal (Witne I e) THE HANG INSUR ICE C Y ( ety) (Seal) (VNitnes (Title) ung T lick,Attorney-in-Fact AIA DOCUMENT A310 BIDBCINDIALAO FEBRUARY 1970 ED THE AMERICAN INSTITUTE OF ARCHITECTS,1 3 N Y AVE,N W WASHINGTON,D C 20006 CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness,accuracy, or validity of that j document STATE OF CALIFORNIA } COUNTY OF Los Angeles } On ` ` before me, Diem Chu , Notary Public, Date (here insert name and title of the officer) personally appeared \JCN who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me,that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct WITNESS my hand and official seal �..r... DIEM CHU Comm #2042313 rn N [ s NOTARY PUBLIC CALII'ORNIA N Los AN06L88 COUNTY MY COMM.EXP,BEr 21,2017 S1gna e' (Sea OPTIONAL Description of Attached Document Title or Type of Document Number of Pages Document Date Other 2015 Al2ooille Sc,n ice 707-992-S551 Nywy,Cali fomiaAposttIle us Calilornia Mobile Notan Nets+orl, wyw CAMNN com CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document STATE OF CALIFORNIA County of Orange On July 10, 2015 before me, Terah Johnston Notary Public, Date Insert Name of Notary exactly as it appears on the official seal personally appeared Yung T Mullick Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the TERAH JOHNSTON person(s), or the entity upon behalf of which the person(s) Commission #2004865 acted, executed the Instrument z Notary Public-Californiaz Z �' Orange County D I certify under PENALTY OF PERJURY under the laws of My Comm Expires Jan 21,2017 the State of California that the foregoing paragraph is true and correct Witness my hand and office I eal Signature Place Notary Seal Above Sig ure of Notary Public erah Joh OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of the form to another document i Description of Attached Document Title or Type of Document Bid Bond Document Date July 10,2015 Number of Pages 1 Signer(s)Other Than Named Above None Capacity(ies)Claimed by Signer(s) Signer's Name Yung T Mullick Signer's Name ❑ Individual ❑ Individual ❑ Corporate Officer—Titles) ❑ Corporate Officer —Title(s) ❑ Partner ❑Limited ❑Ceneral ❑ Partner ❑Limited❑General [Fj Attorney in Fact ••- El Attorney in Fact RIGHTTHUMBPRINT ❑ Trustee OF SIGNER ❑ Trustee OF SIGNER ❑ Guardian or Conservator Top of thumb here ❑ Guardian or Conservator Top of thumb here ❑ Other ❑ Other Signer is Representing Signer is Representing The Hanover Insurance Company i 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 deliver for,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 Attomeys-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 theirown proper persons"(Adopted October7,1981-The Hanover Insurance Company Adopted Apnl 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 ,,„„� �e THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY %4k CITIZENS URANCE OMPANY OF AMERICA Robert Thomas,Vice President, THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER )ss Joey renstror 10 President On this 3rd 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 BARBARA A GARLICK Notary Pubik Comramreaph�MasteehufNts �,,�' ''.� �� ��� Uyr Cartmmm Etpa�Sept 2t 2pit t 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 ofAmerica, 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,Thatany and all Powers of Attomey and Certified Copies of such Powers of Attomey 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 September7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 10 day of July 20 15 THE HANOVER INSURANCE COMPANY ' MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA n Margosian,Vice President _ City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov » 1909 Office of the City Clerk Joan L. Flynn, City Clerk February 11, 2016 DBX, Inc 42024 Avenida Alvarado, Suite A Temecula, CA 92590 RE Traffic Signal Modification/Bolsa Chica St & Bolsa Ave —CC-1485 Enclosed please find your original bid bond for CC-1485 Sincerely, Joan L Flynn, CIVIC City Clerk JF pe Enclosure Sister Cities Anjo,Japan ♦ Waitakere,New Zealand 2015 JUL16 PM 1= 15 C,'T Y CLERK CITY OF PUWTINGTON BEACH 00 = O � Q O � w LLQ m o U U O N = C� LLW O �� m ::) YU) O � wQZ 0 c) F_ F_ 0 D UUN2 W J O Q = � � Q F= Q Qom2 pd V -6J LL WJF- O _ LL. r O m C 0 p 8 .2m OZWLL O C) m a� O 0Z : l ti p yQ � Z = LL > Lo IT J L Q d H Q O) O Q — Z C N ZLL Z3: LL � N NtVV = Z = Q N E C) vim = LL. aC m 0 iL m0 00 � > Z LL. Q O a c lqLL - 0 � 0 J Xo � Em °° po m N N U_ E SECTION C PROPOSAL for the TRAFFIC SIGNAL MODIFICATION At the intersection of BOLSA CHICA STREET AND BOLSA AVENUE CC No. 1485 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 30 working days, starting from the date of the Notice to Proceed The undersigned acknowledges that the issuance of the Notice to Proceed will occur approximately two months after the award of the contract to allow procurement time for city furnished equipment 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 95 y Cps in the amount of ICA eC-bi dwhich said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable Bidder shall signify receipt of all Addenda here, if any Addenda No. Date Received Bidder's Signature C-2 s Project Bid Schedule Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue CC-1485 Item Estimated Item Unit Price, Extended Amount No Quantity ` 1 1 L S Mobilization Per L S 2 1 L S Furnish Project Traffic Control [per L S 3 1 L S Furnish and Install Traffic Striping and Signing. $ uO $ (e$ZD,W Per L S 4 1 L S Reconstruct Raised Medians (Pull Back from Existing Location) $ )L/OO©.�y3 Per L.S 5 1 L S Modify Traffic Signal at Bolsa Chica Street and Bolsa Avenue Per L S Total Amount Bid in Figures Total Amount Bid in Words E-A Ce've-Drn 6-c)U-Ou� q-md 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 (with his own labor) at the City Yard, 17371 Gothard Street Contact George Ruff two working days in advance for pick up at (714) 536-5530 C-2 1 r r ' 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 o.9F 7 0)I erg beck- nv- - qLj 5ciS5 0_9 �c m�F412�C_SPL) C-3Z. By submission of this proposal, the Bidder certifies. 1 That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing 2 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 1 , at '1':erriue atla__ , Cr} Date City State at rn �e►^r� , being first duly sworn, deposes and says that he or she is Pest CLe1n. of tp6X, T�� 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 Name of Bidder Sigifature of Bidder y20ay lWenida,.4lvaraJo,SW+c � Terntxkda, cpt-- ga Sq 6 Address of Bidder � r r C-4 i CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate Is attached,and not the truthfulness,accuracy,or validity of that document State of California ) County of Riverside ) On 7/15/15 before me, Phyllissa Martz, Notary Public Date Here Insert Name and Title of the Officer personally appeared Jim Perry Name(s)of Signer(s) � I who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph Is true and correct PHYLLISSA MARTZ WITNESS my hand and official seal. Commission# 1985150 i .=+: Notary Public-California z Riverside County My Comm Expires Aug 11,2016+ Signature Signature of Notary Public s Place Notary Seal Above OPTIONAL Though this section is optional, completing this informatlon can deter alteration of the document or fraudulent reattachment of this form to an unintended document. i 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 Jim Perry Signer's Name: ®Corporate Officer— Title(s). President ❑Corporate Officer — Title(s)- 0 Partner — ❑Limited ❑General ❑ Partner — ❑Limited ❑General ❑Individual ❑Attorney in Fact ❑Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other- ❑ Other. Signer Is Representing, Signer Is Representing• 02014 National Notary Association-www NationaiNotary org•1-800-US NOTARY(1-800-876-6827) Item#5907 UTILTI'Y 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 TRAFFIC SIGNAL MODIFICATION AT THE INTERSECTION OF BOLSA CHICA STREET AND BOLSA AVENUE, (I)(we)(1t) 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 DbA, Snc, Contractor l� By 9re15 i Title Date C-5 r � DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire. QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes L`7 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 bf-bX,TT'n C Contractor By Title Date C-7 r ' BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct- Bidder Name Business Address fi'ernec-4 c� Gasq o City, State Zip (C151 ap�u - Otaog Telephone Number 0-4oS14-7 P--4- State Contractor's License No and Class l9Cot, Original Date Issued -113111-, Expiration Date The work site was inspected bylQmeS of our office onj�isu 10 , 201s The following are persons, firms, and corporations having a principal interest in this proposal - :I i ry\Pen- jt, Prrs, �r� -1 Sec I TreCt S lames 0. &"i V► Le- fires i "O At 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 Comp y Name Signa e of Bidder —Ti ram P-erryA , Pres Printed or Type ignature Subscribed and sworn to before me this S day of T , 2015 NOTARY PUBLIC ��, /� NOTARY SEAL • PNYLLISSA MARTZ Commission# 1985150 z '• Notary Public-California i Riverside County D MY Comm Expires Aug11,2016 C-9 Bidder's Project History For the purposes of tlus project, the bidder shall provide project history of similar work This ; history shall specifically reference the construction of traffic signal modifications consisting of, at minimum the installation of four new traffic signal poles at a single intersection,two of which must include traffic signal mast arms of at least 25 feet in length Bidders ale encouraged to submit supplemental relevant project history in addition to the projects listed herein Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed and completed similar work within the past five years 1 Sxi 1 1 c-F Q CQ a Y)31 C). 'J©CD tom, Gust• 4AW,a i X ors n si C t9 Name Jnd Address of Public Agency Name and Telephone No of Project Manager -T-ea G Cep ear- -1 CoO- y 35- 3S3$ Contract Amount Type of Work Date Completed Provide additional project description to show similar work nu-O ±n 'L S i u Y�I ►'YZ c�-A. u S,�►' A� 4 � __� 2 'tea OC UQ 9"Si do A 00 ►'Yl Cain S't. fZ 3 Q-e Y"S i&D , C.P9 Name and Address of Public Agency Name and Telephone No of Project Manager. S �10-�.Kyj_-rA AZ>t--I 1 a-3a Oq °►_,��5 SOU � I cafi��zS tal\D I I Contract Amount Type of Work Date Completed Provide additional project description to show similar work _�LY1c� Si Cg:::��S Q-JI V(icy 6AS A-0 Ca E Carl s 3 C-A�xA oC' C.\rV e^e imOr\t "aj-vcr d Ctk>e Name and Address of Public Agency Name and Telephone No of Project Manager G7 Amos Oi Uq-?Aq-53q 5 r\,d �Ca� OrN Contract Amount Type of Work Date Completed Provide additional project description to show similar work �s�c?� u Sl r�,l Gam" O�,rraw �1w u �- C�:P.►-,��� c�A. C-10 Bidder's Critical Staff Listed below are the names of the bidders proposed Constiuction Project Manager, and Superintendent Foi each of these critical positions, please list at least three projects foi which the critical staff has performed similar work within the last five years These projects do not have to be under the employment of the bidder of this project Bidders are encouraged submit supplemental relevant project history in addition to the piojects listed herein 1 cam-CS C,P-CmA Name of proposed Proje anager Telephone No of proposed Project Manager C1 Y I-�PA to- q 0109 I c Yxr o ,6 C CTV \\ -ems y 3 a 4 lctli\-4 Project Name& Contract Amount Type of ork Date Completed c-St SC2,k a x-Ou rr\j�� S °-J 113, 1S Pioject Name & Contract Amount Type of Work Date Completed z $1 ,OU S ,a�'� rS)1 11 Project Naive & Contract Amount Type of Work Date Completed 2 1��a re_ �-Mn�K Name of proposed Superintendent Telephone No of proposed Superintendent qCA--la l-q QD--I o• -c_ S� u6J Gj SncvS-e. Uy � d'�o C � C(� (11j I jl Project Name & Contract Amount Type of Work Date Completed Si" 0--t 0A aA- CaA O O-`iS -4- U r\.C-61 n 3 1 a3,to 1 J- 51-)8))J- Project Name& Contract Amount Type of Work Date Completed SaS,3ga -•mo�('Fi� �,q r�oJ, c.�- ��s�r c`� C9,.�-er d C�•e►vz (�ru 5 �a��1 r Project Name & Contract Amount Type of Work Date Completed C-11 r ` CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771 1(a)), passed by the Califonua State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate DIR FACT SHEET on SB 854 http//www dir ca gov/DLSE/PublieWorks/SB854FactSheet-6 30 14 pdf DIR's Contractor Registration Link—Call (844) 522-6734 https://efiling dir.ca gov/PWCR/ActionServlet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database https//efiling dir ca gov/PWCR/Search action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states. "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029 1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725 5 at the time the contract is awarded." I futtlierimore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid, or no later than contract award date. Contractor By Title Date: r- C-12 r/ -- - --- - -- --- --- - I x The Guarantee Company of North America USA 1800 Sutter Street, Suite 735, Concord, CA 94520 - BID BOND I I BOND NO. 8-B Premium: Nil KNOW ALL MEN BY THESE PRESENTS, That we, DBX, Incorporated 1 as Principal, and The Guarantee Company of North Amenca USA, a corporation duly organized under the laws of the State of Michigan, as Surety, are held and firmly bound unto City of Huntington Beach I i i I as Obligee, in the sum of Ten Percent of Amount bid ($ 10% ) Dollars for the payment of which Principal and Surety bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally WHEREAS, Principal has submitted a bid for Traffic Signal Modification, Bolsa Chica Street and Bolsa Avenue CC No. 1485 NOW, THEREFORE, if the Obligee accepts the bid of the Principal and the Principal enters into a Contract with the Obligee for the Project;or, if the Principal pays the Obligee the amount of this Bond or the difference between Principal's bid and the next lowest bid for the Project, whichever is less: this obligation is null and void, otherwise to remain in full force and effect. Signed and sealed this 6th day of July, 2015 DBX, Incorporated BY. (Witness) Principal ITS: es -9-\t The Guarantee Com ny of North America USA BY: 7u C -- (Witness) David L. Culbertson, Attorney-In-Fact i CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document State of California ) County of Riverside ) ; On 7/15/15 before me, Phyllissa Martz, Notary Public Date Here Insert Name and Trtle of the Officer personally appeared Jim Perry Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscnbed to the within instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized capacity(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. PHYLLISSA MARTZ WITNESS my hand and official seal. Commission# 1985150 z .'a Notary Public-California > Signature u3' � M Riverside County Signature of Notary Public y Comm Ex ues Aug 11,2016 Place Notary Seal Above i OPTIONAL Though this section Is optional, completing this information can deter alteration of the document or i fraudulent reattachment of this form to an unintended document Description of Attached Document Titie or Type of Document: Document Date, Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Jim Perry Signer's Name: ER Corporate Officer— Title(s): President ❑Corporate Officer — Title(s)- ❑Partner— ❑Limited ❑General ❑Partner -- ❑Limited ❑General ❑Individual ❑Attorney in Fact ❑Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other. Signer Is Representing, Signer is Representing- 02014 National Notary Association-www.NationaiNotary org- 1-800-US NOTARY(1-800-876-6827) Item#5907 1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 .�=-c,�=c•,�;�e�n,�:F,rt-,�c+,�,�=r,�=��,�=rc�'ec�=r,Fr,���,c.�ssc..�=rcr.�.rt:rcr�,ercr.�:r,�r.,�=t.�=���:c��rc'.c=:r�.�-c�c,�r.,�=:e.,cr� A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate Is attached,and not the truthfulness,accuracy,or validity of that document State of California ) County of ORANGE ) On 7/6/15 before me, LEXIE SHERWOOD - NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared DAVID L. CULBERTSON Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph LEXIE SHERWOOD is true and correct COMM #2031782 9 NOTARY PUBLIC•CALIFORNIA Q 0 WITNESS my hand and official seal ORANGE COUNTY i Comm Exp JULY 27,2017 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document 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) ❑ Partner — ❑ Limited ❑ General ❑ Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other ❑ Other Signer Is Representing Signer Is Representing ©2014 National Notary Association •www NationalNotary org • 1-800-US NOTARY(1-800-876-6827) Item#5907 1 f 4DTHE The Guarantee Company of North America USA GUARANTEEm Southfield,Michigan POWER OF ATTORNEY � KNOW ALL BY THESE PRESENTS That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint I David L Culbertson,Charles L Flake,Richard A Coon,Spencer Flake I Culbertson Insurance Services,Inc its true and lawful attomey(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 in the nature thereof,which are or may be allowed,required or permitted by law,statute,rule,regulation,contract or otherwise The execution of such instrument(s)in pursuance of these presents,shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the ' principal office i The Power of Attorney is executed and may be certified so,and may be revoked,pursuant to and by authority of Article IX,Section 9 03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31"day of December,2003 The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority 1 To appoint Attomey(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof,and 2 To revoke,at any time,any such Attomey-in-fact and revoke the authority given,except as provided below 3 In connection with obligations in favor of the Flonda Department of Transportation only,it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond 4 In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011,of which the following is a true excerpt RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certfcation thereof authorizing the execution and delivery of any bond,undertaking,contracts of indemnity and other writings obligatory in the nature thereof,and such signature and seal when so used shall have the same force and effect as though manually affixed +TEE IN WITNESS WHEREOF,THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by Its authorized officer,this 23rd day of February,2012 THE GUARANTEE COMPANY OF NORTH AMERICA USA AU STATE OF MICHIGAN Stephen C. Ruschak,President&COO Randall Musselman,Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument,to me personally known,and being by me duly swom,said that each is the herein described and authorized officer of The Guarantee Company of North America USA,that the seal affixed to said instrument is the Corporate Seal of said Company,that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthla A Taka! IN WITNESS WHEREOF,I have hereunto set my hand at The Guarantee Notary Public,State of Michigan Company of North America USA offices the day and year above written County of Oakland �L My Commission Expires February 27,2018 ft-lts Acting in Oakland County I,Randall Musselman,Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA,which is still In full force and effect TE4Z IN WITNESS WHEREOF,I have thereunto set my hand and attached the seal of said Company this 6 th day of July 2015 fAMt�` Randall Musselman,Secretary 1 City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov 77 1909� Office of the City Clerk ` Joan L. Flynn, City Clerk February 11, 2016 Elecnor Belco Electric, Inc 4331 Schaefer Ave Chino, CA 91710 RE Traffic Signal Modification/Bolsa Chica St & Bolsa Ave —CC-1485 Enclosed please find your original bid bond for CC-1485 Sincerely, qp*A)W. Joan L Flynn, CIVIC City Clerk JF pe Enclosure Szster Cities. Anjo,Japan ♦ Waitakere, New Zealand IAJ cc oz cs •'�'o�`Y't^''ten Lo LL. co ZL W N .° "Mi r d'' "1„4F m = qWFA e t�- '""<�,w`ic'W t�4,«T'=�•gN t"F�4� 7 y�s' ° ' � ■� � � � �4a ✓'3 'F` sIn � i O c r�YM"-^r3Pn pq���",s"R iz", - �i',�v*°�.r��5`s•.`+.�° �F`� � ■0 co 4pr< =J41h'�,,�;"�"`f, {-r r•i§'� - ■ram r/ W W s NMI ri ` C '-_•: ri"moo �=! � `�, v fi SECTION C PROPOSAL for the TRAFFIC SIGNAL MODIFICATION At the intersection of BOLSA CHICA STREET AND BOLSA AVENUE CC No. 1485 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 30 working days, starting from the date of the Notice to Proceed. The undersigned acknowledges that the issuance of the Notice to Proceed will occur approximately two months after the award of the contract to allow procurement time for city furnished equipment. 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% which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY (Please insert the words "Cash", "Certified Check", or "Bidder's Bond for_% ", as the case may be) Any standard Surety Bid Bond form is acceptable Bidder shall signify receipt of all Addenda here, if any Addenda No't Date Received ='` 'Bidder's Si nature , tJo�s� c-2 Project Bid Schedule Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue CC-1485 Itiem ^ u Xi Y +M iP ji N M z» s %Estimated ; - t4 EItextended Am ount; sa-t s � d 1 1 L.S. Mobilization $ O'f 000 $ `orOOO Per L S 2 1 L.S Furnish Project Traffic Control Per L S 3 1 L S Furnish and Install Traffic Stnpmg and Signmg $ tO©(� $ Q�b� Per L S. 4 1 L S. Reconstruct Raised Medians(Pull Back from Existing Location) $����� $ alp, Per L.S 5 1 L.S Modify Traffic Signal at Bolsa Chica Street and Bolsa Avenue 00, qco s W Per L S Total Amount Bid in Figures: 00 $ �—1,(o, s-�p Total Amount Bid in Words $ e tIurdW -%v - S`x -NgmvJ -vwe ftAr RWA 2ew c 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 (with his own labor) at the City Yard, 17371 Gothard Street Contact George Ruff two working days in advance for pick up at(714) 536-5530 C-2.1 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 Items) ry License Amount, Contract Number 4 A-It AM0064ngfha+ 1 400 E, �Vt b�a. o $ Soar-��t tpyov A" CA �2�"l� �l3 C- 2 22I 00� 1 Z•� 1 snrWtsm nedv lc,Ac. Spa tq (b e. eta A�e (o1�S� OMQ,e, C� g2q(DI 3 c-lo b,'�Z0 3.(D•l. �kkpenor fAvematt M,a"s CI-5 2 3 5312 CNVress S"r C-f F geS&, CA % 30 C-31 i By submission of this proposal,the Bidder certifies• 1. That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of per)ury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 7/13/1!jt Chino CA Date City State John Wong , being first duly sworn, deposes and says that he or she is Vice President of Elecnor Belco Electric, t9difarty 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. Elecnor Belco Electric Inc. Name of Bidder ign tore of Bidde 4 3 Schaefe Av Chino, CA 91710 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 TRAFFIC SIGNAL MODIFICATION AT THE INTERSECTION OF BOLSA CHICA STREET AND BOLSA AVENUE, (I)(we)(rt) will employ and utilize only qualified persons, as hereinafter defined, to work in proximity to any electrical secondary or transnnssion 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 Elecnor Belco Electric, Inc. Contractor John Wong Y Vice Presid Title Date: 7/13/15 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162,the Bidder shall complete,under penalty of perjury,the following questionnaire QUESTIONNAIRE Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified,removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation? ❑ Yes ®No If the answer is yes,explain the circumstances in the space provided. Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire 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. ; I } Elecnor Belco Electric, Inc. Contractor )qp,VA John Won B Vice President Title Date: 7/13/15 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct Elecnor Belco Electric, Inc. Bidder Name 4331 Schaefer Ave. Business Address Chino CA 91710 City, State Zip ( 909 ) 993-5470 Telephone Number 738518 A,B, C-10 State Contractor's License No. and Class 7/28/1997 Original Date Issued 7/31/2015 Expiration Date The work site was inspected by Bo Fuentes of our office on July 10 201 5 The following are persons, firms, and corporations having a principal interest in this proposal Alberto Garcia- Executive VP Glenn De Soto- Senior VP John Wong- VP 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 Elecnor Belco Electric, Inc. Company.Name Si a e of Bidder 0 Jo Wong Printed or Typed Signature Subscribed and sworn to before me this_day of ,201_. *SEE ATTACHED NOTARY PUBLIC NOTARY SEAL C-9 JURAT A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document State of California County of San Bernardino Subscribed and sworn to (or affirmed) before me on this 16th day of July , 2015 by John Wong , proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me OLIVIA CHEA c�! ^ ' Commission No 2107474 z!• � , ;� NOTARY PUBLIC-CALIFORNIA Si nature l +��. / SAN BERNARDINO COUNTY 9 (Seal) My Comm Expires APRIL 18 2019 , OPTIONAL INFORMATION INSTRUCTIONS The wording of all Jurats completed in California after January 1,2015 must be in the form as set forth within this Jurat There are no exceptions If a Jurat to be completed does not follow this form, the notary must correct the verbiage by using a/urat stamp containing the correct wording or attaching a separate jurat form such as this one with does contain the proper wording In addition, the notary must require an oath or DESCRIPTION OF THE ATTACHED DOCUMENT affirmation from the document signer regarding the truthfulness of the contents of the document The document must be signed AFTER the oath or affirmation If the document was previously signed,it must be re-signed in front of the notary public during the lurat (Title or description of attached document) process e State and county information must be the state and county where the City of Huntington Beach Bid 7/16/15 document signer(s)personally appeared before the notary public (Title or description of attached document continued) . Date of notarization must be the date the signer(s) personally appeared which must also be the same date the furat process is completed Number of Pages Document Date . Print the name(s)of the document signer(s)who personally appear at the time of notarization e Signature of the notary public must match the signature on file with the Additional information office of the county clerk e The notary seal impression must be clear and photographically reproducible Impression must not cover text or lines If seal impression smudges, re-seal if a sufficient area permits, otherwise complete a different furat form Additional information Is not required but could help to ensure this furat is not misused or attached to a different document ti Indicate title or type of attached document,number of pages and date 2015 Version www NotaryClasses com 800-873-9865 . Securely attach this document to the signed document with a staple Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work This history shall specifically reference the construction of traffic signal modifications consisting of, at minimum the installation of four new traffic signal poles at a single intersection,two of which must include traffic signal mast arms of at least 25 feet in length Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed and completed similar work within the past five years. 1 City of Victorville 14343 Civic Dr. , Victorville, CA 92393 Name and Address of Public Agency Name and Telephone No of Project Manager: Greg Heldreth 7 6 0-2 4 3-6 3 6 0 $1,278,432 . 00 Traffic Signals May 2014 Contract Amount Type of Work Date Completed Provide additional pioject description to show similar work Installation of new traffic signals and fiber optic system 2. San Bernardino Associated Governments (Sanbag) 1170 W. 3rd St. 2nd Fl . Name and Address of Public Agency San Bernardino, CA 92410', Name and Telephone No of Project Manager: Steve Moore $1, 445, 000 . 00 Traffic Signals January 2015 Contract Amount Type of Work Date Completed Provide additional project description to show similar work. Installation of new traffic signals, modify existing traffic signals, ! street lighting, and fiber optic system 3. City of Highland 27215 Base Line Highland, CA 92346 Name and Address of Public Agency Name and Telephone No. of Project Manager- Carlos Zamano 909-864-8132 $1, 712, 000 . 00 Traffic Signals December 2014 Contract Amount Type of Work Date Completed Provide additional project description to show similar work. Installation of new traffic signals, street lighting and interconnect systems . C-10 i Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years These piojects do not have to be under the employment of the bidder of this project Bidders are encouraged submit supplemental relevant project history in addition to the projects listed herein 1 Tom Gebelin Name of proposed Project Manager Telephone No. of proposed Project Manager._9 0 9-9 9 3-54 7 0 La Mesa Traffic Signals $1,278,432 . 00 Traffic Signals, Fiber Optic System May 2014 Project Name& Contract Amount Type of Work Date Completed I-15/La Mesa/Nisqualli Interchange $460, 602 . 00 Traffic Signals, Fiber Optic System March 2014 Project Name& Contract Amount Type of Work Date Completed I-15 Clinton Keith Interchange $236, 931. 00 Traffic Signals, Interconnect System March 2014 Project Name& Contract Amount Type of Work Date Completed 2 Brad Blokzyl ; Name of proposed Superintendent Telephone No of proposed Superintendent 9 0 9-9 9 3-5 4 7 0 La Mesa Traffic Signals $1, 278,432 . 00 Traffic Signals, Fiber Optic System May 2014 Project Name& Contract Amount Type of Work Date Completed Street Improvements at Kraemer Blvd _$750, 000 .00 Traffic Signals May 2014 Project Name &Contract Amount Type of Work Date Completed 2011-2012 As Needed Traffic Signal Construction $2, 100, 000 . 00 Traffic Signals June 2012 Project Name&Contract Amount Type of Work Date Completed C-11 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771 1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR). Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate DIR FACT SHEET on SB 854 http://www.dir.ca.gov/DLSE/PublicWorks/SB854FactSheet-6.30.14 pdf DIR's Contractor Registration Link—Call(844) 522-6734 https://efilmg.dir.ca gov/PWCR/ActionServlet?action--displayPWCRegistrationForm DIR's Contractor Registration searchable database: https//efiling.dir ca.gov/PWCR/Search.action I am aware and will comply with the provisions of Labor Code Section 1771.1(a)which states. "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725 5. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 at the time the contract is awarded." I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid, or no later than contract award date. Elecnor Belco Electric, Inc . Contractor Lot-,V/ John Wong B (J Vice President Title Date: 7/13/15 C-12 FIDELITY AND DEPOSIT COMPANY OF MARYLAND 600 Red Brook Blvd, Suite 600,Owings Mills,MD 21117 Statement of Financial Condition As Of December 31,2014 ASSETS Bonds . . $ 142,720,308 Stocks 21,816,223 Cash and Short Term Investments 2,077,768 Reinsurance Recoverable 10,375,303 Other Accounts Receivable 46,778,921 TOTAL ADMITTED ASSETS $ 223,768,523 LIABILITIES,SURPLUS AND OTHER FUNDS Reserve for Taxes and Expenses $ 1,321,332 Ceded Reinsurance Premiums Payable 49,965,411 Securities Lending Collateral Liability 4,009,064 TOTAL LIABILITIES $ 55,295,807 Capital Stock,Paid Up $ 5,000,000 Surplus 163,472,717 Surplus as regards Policyholders 168,472,716 TOTAL $ 223,768,523 Securities carried at$58,191,540 in the above statement are deposited with various states as required by law Securities carried on the basis prescribed by the National Association of Insurance Commissioners On the basis of market quotations for all bonds and stocks owned,the Company's total admitted assets at December 31,2014 would be$227,936,393 and surplus as regards policyholders$172,640,586 I,DENNIS F KERRIGAN, Corporate Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing statement is a correct exhibit of the assets and liabilities of the said Company on the 31st day of December,2014 orporate Secretary State of Illinois City of Schaumburg SS Subscribed and sworn to,before me,a Notary Public of the State of Illmois,in the City of Schaumburg this 15th day of March,2015 Nota>y Public DARRYL JO-'EH ` OFFICIAL SEAL Notary Public-State of Illinois My Commission Expires February 24,2010 i THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, THAT WE Elecnor Belco Electric, Inc 4331 Schaefer Avenue, Chino, CA 91710 as Principal, hereinafter called the Principal, and Fidelity and Deposit Company of Maryland 1400 American Lane, Tower I. 18th Floor, Schaumburg, IL 60196-1056 a corporation duly organized under the laws of the State of MD as Surety, hereinafter called the Surety, are held and firmly bound unto City of Chino 13220 Central Avenue, Chino, CA 91710 as Obligee, hereinafter called the Obligee, in the sum of Ten Percent of Amount Bid Dollars ($ 10% ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns,jointly and severally,firmly by these presents WHEREAS,the Principal has submitted a bid for Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue CC No 1485, City of Huntington Beach NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and materials 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 16th day of July 2015 � Elecnor Belco Electric, Inc '/ v . P 0 / ��s (seat) B ,a DUO s 1t'Q le 1/ ,/1 - miide) � 1' A. • �'o v Fidelity and osit Compan of Ma land (Seat) sh ey Al exi (Witness) '� e ftor-y4�-Fa6t-Aiza B`pez�� \Y,- (TI 6 e) AIA DOCUMENT A310•BID BOND•AIA•FEBRUARY 1970 ED.•THE AMERICAN INSTITUTE OF ARCHITECTS,1735 MY AVE.,N.W.,WASHINGTON,D.C.2 ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document State of California } County of San Bernardino } On July 16, 2015 before me, Olivia Chea, Notary Public , ere insert name and title of the cer personally appeared Glenn De Soto who proved to me on the basis of satisfactory evidence to be the person(s) whose name(-•) is re subscribed to the within instrument and acknowledged to me that the/they executed the same in is er their authorized capacity(ies), and that by is er/their signature(s) on the instrument the person(-), or the entity upon behalf of which the person(a) 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 WITNE rid official seal a: Commission Na 2107474 (j'.�^ w Z i,;i � NOTARY PUBLIC CALIFORNIA SAN BERNARDINO COUNTY My Comm Expires APRIL 18 2019 Notary Pu ignature (Notary Public Seal) P ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded should be completed and attached to the document Achnohvedgents from other states may be completed for documents being sent to that state so long as the Bidder's Bond wording does not require the California notary to violate California notary law (Tile or description of attached document) • State and County information must be the State and County where the document City of Huntington Beach Bid 7/16/15 signer(s)personally appeared before the notary public for acknowledgment • Date of notarization must be the date that the signer(s)personally appeared which (rile or description of attached document continued) must also be the same date the acknowledgment is completed • The notary public must pnnt his or her name as it appears within his or her Number of Pages Document Date 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(i e Wshe/*e5L-is/am)or circling the correct forms Failure to correctly indicate this 0 Individual(s) information may lead to rejection of document recording I] Corporate Officer • The notary seal impression must be clear and photograplucally reproducible Senior Vice 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) • Signature of the notary public must match the signature on file with the office of the county clerk • Attorney-in-Fact Additional mformation is not required but could help to ensure this p Trustee(s) acknowledgment is not misused or attached to a different document Other 4• Indicate title or type of attached document,number of pages and date Indicate the capacity claimed by the signer If the clan red capacity is a corporate officer,indicate the title(i e CEO,CFO,Secretary) 2015 Version www NotaryClasses corn 800-873-9865 Securely attach this document to the signed document with a staple ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of San Bernardino } On July 16, 2015 before me, Olivia Chea, Notary Public , ere insert name anflueo eftFi�iceTr personally appeared John Wong who proved to me on the basis of satisfactory evidence to be the person(s) whose name(-) is re subscribed to the within instrument and acknowledged to me that the/they executed the same in is er/their authorized capacity(tes), and that by is er/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct WITNES y an official seal. ,.,� ` Commisaw No 2107474 z NOTARY PUBLIC-CALIFORNIA • SAN BERNAROINO COUNTY MY Cavan EWU AM 18 2019 Netefrr—ublic Signature tary Public Seal) 0 0 ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and DESCRIPTION OF THE ATTACHED DOCUMENT rf needed should be completed and attached to the document Acknohvedgentsfrom other states may be completed for documents being sent to that state so long as the Bidders Bond wording does not require the California notary to violate California notary law (Title or description of attached document) • State and County information must be the State and County where the document City of Huntington Beach Bid 7/16/15 signer(s)personally appeared before the notary public for acknowledgment • Date of notanzation must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public) • Pnnt the name(s) of document signer(s) who personally appear at the time of notanzation CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i e Wshe/tliey is/am)or circling the correct forms Failure to correctly indicate this ❑ Individual(s) information may lead to rejection of document recording 0 Corporate Officer • The notary seal impression must be clear and photographically reproducible Vice 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) • 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 thus ❑ 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 btle(i a CEO,CFO,Secretary) 2015 Version ewvw NotaryClasses corn 800-873-9865 • Securely attach this document to the signed document with a staple CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT Civil Code § 1189 A notary public or other officer completing this certificate verifies only the Identity,of the individual who signed the document to which this certificate is attached, and not the truthfullness, accuracy or validity of that document State of Connecticut County of Hartford On July 16,2015 before me, Julie Perry , Notary Public Date Name and Tdle of Notary personally appeared Aiza Lopez Name and or Names of Signer(s) Who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authonzed capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entrty 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 JUUE PERRY NOTARYPUBLIC Witness my 4handaofficial seal. W COMMISSION EXPIRES JULY 31,2020 Signature / Notary Public S7—OPWONAL Place Notary Puhlic Seat Above Notary Public S Though the information below is not required by law,it may prove valuable to the 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 Name: ❑ Individual ❑ Individual ❑ Corporate Officer—Title(s). ❑ Corporate Officer—Title(s): ❑ Partner- ❑Limited ❑General ❑ Partner- ❑Limited❑General ❑ Guardian or Conservator rftob ❑ Guardian or Conservator Top of tuft ❑Attorney-in-Fact ❑ Attomey-in-Fact ❑ Trustee ❑ Trustee ❑ Other. ❑ Other. Signer is representing Signer is representing ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate,constitute,and appoint Jeannette PORRINI,Stacy RIVERA,Aiza LOPEZ,Elana V.SANCHEZ and Erin L.KIERNAN,all of Hartford,Connecticut, EACH its true and lawful agent and Attorney-in-Fact,to make,execute, seal and deliver,for,and on its behalf as surety, and as its act and deed any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents,shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York, the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland, in their own proper persons The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 8th day of December,A D 2014 ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND ,........ µw�y4 0 ocrof ''rs+`.�� O = `Coo S OP i 0` 86AL -- `�—•—'� toc .,.,� 7 itM tea' 3 u; ;o- 181aB �� By Secretary Vice President Eric D Barnes Thomas 0 McClellan State of Maryland County of Baltimore On this 8th day of December,A D 2014,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,THOMAS O MCCLELLAN, Vice President, and ERIC D BARNES, Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written Mana D Adamski,Notary Public My Commission Expires July 8,2015 POA-F 142-0587E City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov I `xf8 !1 1909 P� Office of the City Clerk Joan L. Flynn, City Clerk February 11, 2016 Unique Performance Construction, Inc 1321 N Jefferson St Anaheim, CA 92807 RE Traffic Signal Modification/Bolsa Chica St & Bolsa Ave —CC-1485 Enclosed please find your original bid bond for CC-1485 Sincerely, Joan L Flynn, CIVIC City Clerk JF pe Enclosure Sister Cities Anjo,Japan ♦ Wartakere, New Zealand { r I W Ln O °c L m Jam w E i u>.o Z W a W 91 O 11 0 0 0 CC d- �m w U}~ o aQ' , - — }ram �, A U � o U W H cn E-+ w o O 0 m 0Nm i O E ch H o � Voco O W ai z 5 H c N c .a U Q � mQ � e � SECTION C PROPOSAL for the TRAFFIC SIGNAL MODIFICATION At the intersection of BOLSA CHICA STREET AND BOLSA AVENUE CC No. 1485 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 i 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 30 working days, starting from the date of the Notice to Proceed The undersigned acknowledges that the issuance of the Notice to Proceed will occur approximately two months after the award of the contract to allow procurement time for city furnished equipment. 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 tune 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, urut prices shall govern over extended amounts, and words shall govern over figures C-1 I If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER,the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option,be considered null and void Accompanying this proposal of bid, find Bidder's Bond in the amount of which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY (Please insert the words "Cash", "Certified Check", or "Bidder's Bond forl0% ", as the case may be) Any standard Surety Bid Bond form is acceptable Bidder shall signify receipt of all Addenda here, if any Addenda No. Date Received 'Bidder's Signature C-2 Project Bid Schedule Traffic Signal Modification at Bolsa Chica Street and Bolsa Avenue CC-1485 Item Estimated °' Iteina� a'`Uuit; "icxtnded Airiount X0. o Quantity, 1 1 L S Mobilization $ t $ i 2, b c o Per LS 2 1 L S Furnish Project Traffic Control Per L S 3 1 L S Furnish and Install Traffic Stripmg and Signing $ t 2, o o Per L.S 4 1 L S Reconstruct Raised Medians(Pull K Back from Existing Location) 3U � Per L S 5 1 L S Modify Traffic Signal at Bolsa Chica Street and Bolsa Avenue $ 5 0 u' $ Per LS Total Amount Bid in Figures 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 (with his own labor) at the City Yard, 17371 Gothard Street Contact George Ruff two working days in advance for pick up at(714) 536-5530 C-2.1 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 Superior Pavement Markings 3 5312 Cypress St , Cypress, CA 90630 776306 /,. 5 Partial Taffic Loops Crackfillmg, Inc C-10 i Cj 0 30) 946 S Emerald St , Anaheim, CA 92804 652956 C-32 S- �� ✓� G C q rd� 8 2 o 15, o By submission of this proposal, the Bidder certifies. 1 That he is able to and will perform the balance of all work which is not covered in the above subcontractors listing. 2 That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project C-3 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on 7/16/15,at Anaheim , CA Date City State Moumtaz Kabany , being first duly sworn, deposes and says that he or she is President of Unique Performance Construction, Inc the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation, that the bid is genuine and not collusive or sham, that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract, that all statements contained in the bid are true, and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation,partnership, company association, organization,bid depository, or to any member or agent thereof to effectuate a collusive or sham bid UNIQUE PERFORMANCE CONSTRUCTION, INC Name of Bidder Signature of Bidder MOUMTAZ KABANY 1321 N JEFFERSON STREET,ANAHEIM, CA 92807 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 TRAFFIC SIGNAL MODIFICATION AT THE INTERSECTION OF BOLSA CHICA STREET AND BOLSA AVENUE, (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 UNIQUE PERFORMANCE CONSTRUCTION, INC Contractor By PRESIDENT Title Date 7/16/2015 C-5 DISQUALIFICATION QUESTIONNAIRE In accordance with Government Code Section 10162,the Bidder shall complete,under penalty of pel]ury,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 9No 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. UNIQUE PERFORMANCE CONSTRUCTION, INC Contractor By MOUMTAZ KABANY PRESIDENT Title Date 7/16/2015 C-7 BIDDER'S INFORMATION BIDDER certifies that the following information is true and correct UNIQUE PERFORMANCE CONSTRUCTION, INC Bidder Name 1321 N JEFFERSON STREET Business Address ANAHEIM CA 92807 City, State 'Zip ( 714 ) 528-2220 Telephone Number 801860 A , B State Contractor's License No and Class 12/06/2001 Original Date Issued 03/31/2017 Expiration Date The work site was inspected by JOSE VEGA of our office on JULY 7 , 2015 The following are persons, firms,and corporations having a principal interest in this proposal UNIQUE PERFORMANCE CONSTRUCTION, INC MOUMTAZ KABANY- PRESIDENT C-8 The undcrsigned 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 UNIQUQE PERFORMANCE CONSTRUCTION, INC Company Name Signature of Bidder MOUMTAZ KABANY Printed or Typed Signature Subscribed and sworn to before me this_day of ,201_ SEE ATTACHED CALIFORNIA JURAT NOTARY PUBLIC NOTARY SEAL C-9 CALIFORNIA JURAT (CALIFORNIA GOVERNMENT CODE §8202) A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which this certificate is attached, and not the truthfulness, accuracv, or validitv of that document STATE OF CALIFORNIA ) COUNTY OF Subscribed and sworn to (o a�ffirmed) before me on this day of 1 201 by 1 O - -z— n proved to [rie on the basis of (Name of Signer(s)) satisfactory evidence to be the person(s) who appeaJ before me. NICOLE MONIQUE PILLSBURY Commission#2091277 \ i .'� Notary Public-California i PZL - - - --- W W W W W—1 Z Orange County D MY Comm Expires Nov 24,2018 Signature of Notary Public otary Seal) ADDITIONAL O L INFORMATION Description of Attached Document Title or Type of Document* 1'�D�IP�� -1(���fVTI Document Date. Number of Pages Signer(s) Other Than Named Above Additional Information: revision date 01/01/2015 Bidder's Project History For the purposes of this project, the bidder shall provide project history of similar work This history shall specifically reference the construction of traffic signal modifications consisting of, at minimum the installation of four new traffic signal poles at a single intersection,two of which must include traffic signal mast arms of at least 25 feet in length Bidders are encouraged to submit supplemental relevant project history in addition to the projects listed herein Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed and completed similar work within the past five years 1 CITY OF RIVERSIDE, 3900 MAIN STREET, RIVERSIDE, CA 92522 Name and Address of Public Agency Name and Telephone No of Project Manager STEVE HOWARD (951) 826-5553 $394,598 78 SIGNAL MODIFICATIONS AT VARIOUS INTERSECTIONS 2/20/2015 Contract Amount Type of Work Date Completed Provide additional project description to show similar work STRIPING OF ROADWAY, PEDESTRIAN RAMP AND SIDEWALK IMPROVEMENTS 2 COUNTY OF SAN BERNARDINO, 825 E THIRD ST , SAN BERNARDINO, CA 92415 Name and Address of Public Agency Name and Telephone No of Project Manager: NIDHAN ALRYES (909) 387-1831 $466,826 23 MODIFYING TRAFFIC SIGNALS 12/19/2013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work GRADING AND PAVING ASPHALT CONCRETE, UPGRADING PEDESTRIAN RAMP, PAINTING TRAFFIC STRIPING AND PAVEMENT MARKINGS 3 COUNTY OF LOS ANGELES , 900 S FREMONT AVE , ALHAMBRA, CA 91803-1331 Name and Address of Public Agency Name and Telephone No of Project Manager OMID EMAM (626)458-3122 $416,213 00 SYNCHRONIZATION AND MODIFICATION OF TRAFFIC SIGNALS 03/22/2013 Contract Amount Type of Work Date Completed Provide additional project description to show similar work C-10 Bidder's Critical Staff Listed below are the names of the bidders proposed Construction Project Manager, and Superintendent For each of these critical positions, please list at least three projects for which the critical staff has performed similar work within the last five years. These projects do not have to be under the employment of the bidder of this project Bidders are encouraged submit supp]emental relevant project history in addition to the projects listed herein 1 MOUMTAZ KABANY Name of proposed Project Manager Telephone No of proposed Project Manager (949) 528-2273 2011-2012 Street Light Improvements $273,000 Street Lights 08/24/2012 Project Name& Contract Amount Type of Work Date Completed Traffic Signal Modification Malvern St &Ownes St $216,200 Traffic Signal Modification 06/15/2012 Project Name& Contract Amount Type of Work Date Completed Birch St &Voyager Ave , Brea $112,000 Traffic Signal Modification 08/30/2011 Project Name& Contract Amount Type of Work Date Completed 2 JOSE VEGA Nance of proposed Superintendent Telephone No of proposed Superintendent (949) 500-6458 Street Light Improvements $273,000 Street lights 8/24/2012 Project Name& Contract Amount Type of Work Date Completed Traffic Signal Modification Malvern &Ownes $216,200 Traffic signal 6/15/2012 Project Name& Contract Amount Type of Work Date Completed Birch St &Voyager Ave , Brea $112,000 Traffic signal modification 08/30/2011 Project Name& Contract Amount Type of Work Date Completed C-11 CONTRACTOR REGISTRATION WITH CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS (DIR) CERTIFICATE Pursuant to SB 854 (citing Labor Code Section 1771 1(a)), passed by the California State Senate on June 20, 2014, established a new public works Contractor Registration Program, which requires all contractors and subcontractors bidding and performing work on Public Works Projects to register on an annual basis (each July 1 through June 30 state fiscal year) with the California Department of Industrial Relations (DIR) Currently the annual non-refundable registration fee for Contractors is $300. Each contractor to whom a public works contract has been awarded shall sign the following certificate DIR FACT SHEET on SB 854 http//www dir ca.gov/DLSE/PublicWorks/SB854FactSheet-6 30 14 pdf DIR's Contractor Registration Link—Call(844) 522-6734 https//efilmg dir ca gov/PWCR/ActionServlet?action=displayPWCRegistrationForm DIR's Contractor Registration searchable database https//efiling dir ca gov/PWCR/Search action I am aware and will comply with the provisions of Labor Code Section 1771 1(a)which states "A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725 5 It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029 1 of the Business and Professions Code or by Section 10164 or 20103 5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725 5 at the time the contract is awarded " I furthermore will comply by providing proof of registration with DIR as the primary contractor, as well as for ALL subcontractors at the time of submitting the bid, or no later than contract award date. UNIQUE PERFORMANCE CONSTRUCTION, INC Contractor By OUMTAZ KABANY PRESIDENT Title Date 7/16/2015 C-12 NORTH AMERICAN SPECIALTY INSURANCE COMPANY BOND NO UNIPE-678 BID BOND KNOW ALL MEN BY THESE PRESENTS That we, UNIQUE PERFORMANCE CONSTRUCTION, INC., (hereinafter called the Principal), and NORTH AMERICAN SPECIALTY INSURANCE COMPANY, a corporation organized and doing business under and by virtue of the laws of the State of NEW HAMPSHIRE, and duly licensed for the purpose of making, guaranteeing or becoming sole surety upon bonds or undertakings required or authorized by the laws of the State of CALIFORNIA, as Surety, are held and firmly bound unto CITY OF HUNTINGTON BEACH, (hereinafter called the obligee) in the sum equal to 10% of the accompanying bid of the Principal, not, however, in excess of TEN PERCENT OF THE TOTAL AMOUNT OF THE BID Dollars (10% OF THE BID AMOUNT), for the payment of which, well and truly to be made, we hereby bind ourselves and our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEREAS, the above bounden Principal as aforesaid, is about to hand in and submit to the obligee a bid for TRAFFIC SIGNAL MODIFICATION AT THE INTERSECTION OF BOLSA CHICA STREET AND BOLSA AVENUE, PROJECT NO CC-1485, in accordance with the plans and specifications filed in the office of the obligee and under the notice inviting proposals therefore NOW, THEREFORE, if the bid or proposal of said principal shall be accepted, and the contract for such work be awarded to the principal thereupon by the said obligee, and said principal shall enter into a contract and bond for the completion of said work as required by law, then this obligation to be null and void, otherwise to be and remain in full force and effect IN WITNESS WHEREOF, said principal and said Surety have caused these presents to be duly signed and sealed this 14TH day of JULY, 2015. UNIQUE PERFORMANCE CONSTRUCTION, INC BY NORTH AMERICADO SPECIALTY INSURANCE COMPANY ffi ,1 BY MATTHEW A D BYNS, Attorney-m-Fact NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POIVER OF ATTORNEY hNt>\\ /%I L MI-N 131 1111 SI PIZI Y N 1 S I I IA I Not \I110IL,Iil Spt.ualt\ Imladn«Compam a Lulpulatlun duh ulsanvcd and cvtitln0 undkl laws of the State of New Hampshire and having Its p1 uulpal 011 ire Ili the City of Mani,hetitu New Hampshire and Washington International Insuiance Company a corporation organized and emsting under the laws of the State of New Hampshire and having its pilncipal office Ili the City of Schaumburg Illinois each does hereby make constitute and appoint RANDY SPOHN and MATTHEW R DOBYNS JOINTLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact to make execute seal and deliver for and on its behalf and as its act and deed bonds or other writings obligatory m the nature of a bond on behalf of each of said Companies.as surety on contracts of suretyship as are or may be required or permitted by law regulation contract or otherwise provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of FIFTY MILLION($50,000,000 00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty insurance Company and Washington international insurance Company at meetings duly called and held on the 9'h of May 2012 RESOLVED that any two of the Presidents any Managing Director,any Senior Vice President any Vice President any Assistant Vice President the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds undertakings and all contracts of surety.and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company, and it is FURTHER RESOLVED that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond undertaking or contract of surety to which it is attached �1rjuktrry lripfry/f/ �3 C SEAL TF�S=_ By 1��a��R.A.so g r SEAL_ n SIe\en P Anderson,Semor%ice President of Washington International Insurance Compan] 2= SEAL y :a ?a 1913 �tr On` &Semor Vicc President of North American Specialty Insurance Company O �H &ANPs "lotBy Dastd N1 La%man,Vice President of Washington Internauonil Insurance Compiny &Vice President of North Amencin Spea ilty Insurance Company IN WITNESS WHEREOF North American Specialty Insurance Company and Washington international Insurance Company have caused their official seals to be hereunto affixed.and these presents to be signed by their authorized officers this26th day of June 2p12 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss On this 26th day of lime 20 112 before me,a Notary Public personally appeared Steven P Anderson Senior Vice President of Washington International insurance Company and Senior Vice President of North American Specialty Insurance Company and David M Layman, Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies n I"OFFICIAL SEAL" /�X 11 U DONNA D.SKLENS Notary Public,State of Dhnois Donna D Sklens,Notary Public MY Commullum Expilles 10H1 M15 1 Jeffiev Goldberg the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company.do hereby certify that the above and foregoing is a true and correct copy of a Power of Attomey given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect 1N WiTNESS WHEREOF i have set my hand and affixed the seals of the Companies this 14th day of JulyQ 20 1515 Jeffrey Goldberg Vice President&Assistant Secretary of Washmyton International Insurance Compmty&North American Specialty Insurance Company CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to -,flAch this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of CALIFORNIA County of OkORA On 5 before me, ERIKA GUIDO, NOTARY PUBLIC, personally appeared MATTHEW R. DOBYNS ® who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/afe subscribed to the within Instrument and acknowledged to me that he/she/they executed the same In his/IeF/therf authorized capacity fies}, and that by his/heF/thew signatures) 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. ERIKAGUIDO WITNESS my hand and official seal. COMM #2022671 � g NOTARY PUBLIC CALIFORNIA v 3 ORANGE COUNTY ^' My Comm expires May 5,201]jt Si a of kat4ry r OPTI® A<T, 11 :� 9�` 110 Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ❑ INDIVIDUAL ❑ CORPORATE OFFICER ❑ PARTNER(S) ❑ LIMITED ® ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES)